3,623 research outputs found
Herpes simplex encephalitis as a complication of adjuvant chemotherapy treatment for breast cancer
No full textPain, disability, and physical therapy in older adults: issues of patients and pain, practitioners and practice
No full textPain in older adults is a complex multidimensional (biopsychosocial) problem that is always unpleasant and is frequently associated with physical disability, psychosocial distress, and reduced quality of life. Physical therapists knowledgeable about pain are in an excellent position to identify and manage problems related to pain and pain-related dysfunction for this older population. Unfortunately, although pain is prevalent, complex, and integral to health care, it has not been integral to health care education. Inadequate knowledge has led to inadequate assessment and management. Current evidence shows that optimum pain and disability management is predicated on a sound assessment. Optimal management of the person with pain involves education and activity guided by practitioners knowledgeable about the complexities of pain. Recommendations regarding pain and disability assessment and management by physical therapists are provided
Residential Location Choice - Models and Applications
No full textThe effective planning of residential location choices is one of the great challenges of contemporary societies and requires forecasting capabilities and the consideration of complex interdependencies which can only be handled by complex computer models. This book presents a range of approaches used to model residential locations within the context of developing land-use and transport models. These approaches illustrate the range of choices that modellers have to make in order to represent residential choice behaviour. The models presented in this book represent the state-of-the-art and are valuable both as key building blocks for general urban models, and as representative examples of complexity science.<br/
The differential influence of pain and fatigue on physical performance and health status in ambulatory patients with human immunodeficiency virus
No full textObjectives: The purposes of this study were to: 1) characterize physical performance in individuals with human immunodeficiency virus; and 2) examine group differences by pain and fatigue on a multivariate profile of disease, physical, and psychologic symptoms.Methods: One hundred outpatients, 78 men and 22 women (mean age 40.70 +/- 7.49 years) participated. Patients completed a battery of physical performance tests in which the time taken or the distance reached or walked was measured. Self-report questionnaires included measures of pain (0-10 numerical rating scale), fatigue (Brief Fatigue Inventory), and perceived health status (Medical Outcomes Survey-HIV scale).Results: Physical performance was compromised in a task specific manner. Patients took twice as long as healthy individuals on a belt-tie and 4 times as long on a sit-to-stand task and in 6 minutes walked 75% of the distance covered by healthy individuals. Fifty percent of patients (n = 50) had pain at the time of testing (mean 6.3 +/- 2.4), and 98% had fatigue (mean 5.4 +/- 2.3). Multivariate analysis of variance showed pain had a greater influence on performance than fatigue. Pain, distance walked in 6 minutes, and unloaded forward reach accounted for 26% of the variability in quality of life (r = 0.51, P <= 0.0001).Discussion: Pain has a substantial impact on physical performance and quality of life among ambulatory human immunodeficiency virus patients. Fatigue also impacts physical performance. Compromised ability to perform certain physical tasks affects quality of life. Further investigation of the roles of these relevant variables should be investigated in path analyses
Management of spinal cord and cauda equina compression secondary to epidural metastatic disease in adults with malignant germ cell tumours
No full textAim: to review the management and clinical outcome of 10 patients, presenting to a single centre with symptoms and signs of spinal cord or cauda equina compression secondary to epidural metastatic disease from a testicular germ cell cancer.Methods: clinical data regarding presenting history, physical examination, staging investigations, treatment and clinical outcome were retrospectively obtained from patient records.Results: eight patients exhibited neurological deficits at the time of initial presentation of germ cell cancer or as a first manifestation of relapse following dog leg irradiation. Four of these cases were managed with chemotherapy alone, with excellent neurological recovery, whilst four underwent decompressive laminectomy – in three cases prior to referral and in one case after commencing chemotherapy. Five of the eight patients relapsed. Four required further chemotherapy (high dose in two cases). The remaining patient underwent thoracic surgery, with resection of teratoma differentiated. Six of the eight patients are currently alive and disease free. Two patients had chemorefractory disease and died, though one was treated in the pre-cisplatin era. Two patients presented with cord compression as a feature of disease relapse following chemotherapy, and were managed with radiotherapy alone in an attempt to achieve local disease control and limit neurological dysfunction. However, both subsequently died with progressive disease.Conclusion:epidural spinal cord or cauda equina compression is a rare complication of metastatic germ cell cancer, which can be successfully managed in chemo-naive patients with good neurological outcome
Relationships between physical and cognitive performance in individuals with and without back pain
No full textImproving access to palliative care services for ethnic minority groups. A report of a study funded by Community Fund
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