.
Particle identification is an important feature of the ALICE detector at the LHC. In particular, for particle identification via the time-of-flight technique, the precise determination of the event ...collision time represents an important ingredient of the quality of the measurement. In this paper, the different methods used for such a measurement in ALICE by means of the T0 and the TOF detectors are reviewed. Efficiencies, resolution and the improvement of the particle identification separation power of the methods used are presented for the different LHC colliding systems (pp, p-Pb and Pb-Pb) during the first period of data taking of LHC (RUN 1).
In Deutschland erleiden jährlich 200.000 Menschen erstmalig einen Schlaganfall und 65.000 Menschen ein Rezidiv. Der Schlaganfall gehört zu den häufigsten Ursachen für eine erworbene lebenslange ...Behinderung. Er ist verbunden mit unterschiedlichen, in Art und Ausmaß vielfältigen funktionellen Störungsbildern und Beeinträchtigungen auf der Aktivitäts- und Partizipationsebene. Um im Alltag zurechtzukommen, müssen Betroffene erhebliche Anpassungsleistungen vollbringen und Bewältigungsstrategien ausbilden. Gelingt dies nicht, ist mit Folgeproblemen wie sozialer Rückzug, Depressivität und Pflegebedürftigkeit zu rechnen, womit erhebliche Behandlungs- und Versorgungskosten verbunden sind. Von hoher Bedeutung sind somit aus Sicht Betroffener die therapeutischen Hilfen, die sich nach Klinikentlassung auf Krankheitsbewältigung, soziale Teilhabe, die selbständige Bewältigung der Aktivitäten des täglichen Lebens und die Hilfsmittelversorgung richten. Genau dies soll ergotherapeutisches Alltagstraining nach Schlaganfall im häuslichen Bereich leisten.
Das aktuellste Cochrane Review aus dem Jahre 2006 bestätigt ein vorangehendes von 2004 und zeigt auf Basis neun randomisierter Vergleiche aus Großbritannien, Nordirland und China positive Effekte des ergotherapeutischen Alltagstrainings nach Schlaganfall auf basale Alltagsaktivitäten (8 Studien; 961 Teilnehmer; 0,18 SMD; 95%-KI 0,04 bis 0,32), auf instrumentelle Alltagsaktivitäten (6 Studien, 847 Teilnehmer; 0,21 SMD; 95%-KI 0,03 bis 0,39) und auf den Selbständigkeitsstatus (7 Studien, 1065 Teilnehmer; 0,67 Odds Ratio; 95%-KI 0,51 bis 0,87). Eine direkte Implementation der Interventionen in den deutschen Versorgungskontext ist allerdings auf Grund der Heterogenität und differierender Settings in den Primärstudien, fehlender Manualisierungen und unzureichender Erfassung klientenrelevanter Endpunkte kritisch zu beurteilen.
Empfohlen wird, ein modulares phasenspezifisches ergotherapeutisches Alltagstraining für den ambulanten Sektor klientenzentriert und standardisiert zu manualisieren und im Rahmen einer Machbarkeitsstudie zu untersuchen. Bei positiven Ergebnissen zu Praktikabilität und Akzeptanz bei Klienten und durchführenden Praktikerinnen und nach Ermittlung klientenzentrierter Veränderungsmaße kann eine Wirksamkeitsstudie angeschlossen werden.
Every year about 200,000 people in Germany suffer from a first stroke and 65,000 persons from a recurrent stroke. Stroke is one of the major causes of acquired life-long disability. It is associated with multiple limitations in functioning, activities of daily living and social participation. People with stroke must develop and apply considerable coping and adaptation strategies to manage the consequences of disabilities in daily life. Insufficient adaptations may result in social isolation, depressive disorders, need for medical and nursing care and subsequently lead to increasing costs for care. Thus occupational therapy-led treatment addressing social participation as well as skills training, adaptation strategies and assistive technology for activities of daily living is essential for stroke patients after hospital discharge.
Based on nine randomised comparisons, a Cochrane review from 2006 revealed that occupational therapy-led training after stroke had positive effects on personal activities of daily living (8 studies; 961 participants; 0.18 SMD; 95 % CI 0.04 to 0.32), on extended activities of daily living (6 studies; 847 participants; 0.21 SMD; 95 % CI 0.03 to 0.39), and on poor outcome (7 studies; 1,065 participants; odds ratio 0.67; 95 % CI 0.51 to 0.87). However, direct implementation into the German healthcare context is not recommendable due to (1) different settings and heterogeneity within the primary studies, (2) lack of manualisation of treatment programmes and (3) insufficient evaluation of client-oriented outcomes.
It is recommended to manualise client-centred standardised modules of a stage-specific occupational therapy-led training of activities of daily living and to pilot-test this intervention programme in a feasibility study. If this trial results in a set of reliable and valid client-oriented outcome measurements applicable within the German care context and in a feasible treatment programme well accepted by stroke patients and their treating occupational therapists, a large-scaled randomised clinical trial in terms of comparative effectiveness research may follow.
Every year about 200,000 people in Germany suffer from a first stroke and 65,000 persons from a recurrent stroke. Stroke is one of the major causes of acquired life-long disability. It is associated ...with multiple limitations in functioning, activities of daily living and social participation. People with stroke must develop and apply considerable coping and adaptation strategies to manage the consequences of disabilities in daily life. Insufficient adaptations may result in social isolation, depressive disorders, need for medical and nursing care and subsequently lead to increasing costs for care. Thus occupational therapy-led treatment addressing social participation as well as skills training, adaptation strategies and assistive technology for activities of daily living is essential for stroke patients after hospital discharge.
Based on nine randomised comparisons, a Cochrane review from 2006 revealed that occupational therapy-led training after stroke had positive effects on personal activities of daily living (8 studies; 961 participants; 0.18 SMD; 95 % CI 0.04 to 0.32), on extended activities of daily living (6 studies; 847 participants; 0.21 SMD; 95 % CI 0.03 to 0.39), and on poor outcome (7 studies; 1,065 participants; odds ratio 0.67; 95 % CI 0.51 to 0.87). However, direct implementation into the German healthcare context is not recommendable due to (1) different settings and heterogeneity within the primary studies, (2) lack of manualisation of treatment programmes and (3) insufficient evaluation of client-oriented outcomes.
It is recommended to manualise client-centred standardised modules of a stage-specific occupational therapy-led training of activities of daily living and to pilot-test this intervention programme in a feasibility study. If this trial results in a set of reliable and valid client-oriented outcome measurements applicable within the German care context and in a feasible treatment programme well accepted by stroke patients and their treating occupational therapists, a large-scaled randomised clinical trial in terms of comparative effectiveness research may follow.
Introduction
Vocational rehabilitation (VR) emphasizes a need for medical support, rehabilitation and biopsychosocial approach to enable individuals to successfully participate in the workforce. ...Optimal rehabilitation management relies on an in-depth knowledge of the typical spectrum of problems encountered of patients in VR. The International Classification of Functioning, Disability and Health (ICF) is based on a universal conceptual model and provides a holistic view of functioning of the lived experience of people such as those undergoing VR. The objectives of this study are to describe the functioning and health of persons undergoing VR and to identify the most common problems around work and in VR using the ICF as the reference framework.
Methods
An empirical cross-sectional multicenter study was conducted using convenience sampling from March 2009 to March 2010. Data were collected using a Case Record Form rated by health professionals which was based on an extended version of the ICF Checklist containing 292 ICF categories and sociodemographic information.
Results
152 patients with various health conditions participated. We identified categories from all four ICF components: 24 for
body functions
, six for
body structures
, 45 for
activities and participation,
and 25 for
environmental factors
.
Conclusions
Our study identified a multitude of ICF categories that describe functioning domains and which represent the complexity of VR. Such a comprehensive approach in assessing patients in VR may help to understand and customize the process of VR in the clinical setting and to enhance multidisciplinary communication.
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