Translation and validation of the Reaction to Impairment and Disability Inventory for Chinese population in Hong Kong.

PURPOSE: This study translated the reaction to impairment and disability inventory (RIDI) to Chinese and validated it for use in Hong Kong. METHODS: We conducted an instrument validation of the Chinese RIDI, with a sample of 244 persons with CID. The research questionnaire collected demographic information, illness-related variables, the Chinese version of RIDI (C-RIDI), and measures of resilience and well-being. We examined the factor structure, internal consistency, convergent validity, and criterion-related validity of the C-RIDI. RESULTS: The C-RIDI has good content validity and no major changes to the translated items were needed for the use in Hong Kong. For factor structure, we replicated the results of Livneh et al. The C-RIDI has two second-order factors of adaptive and nonadaptive scales, which interact with the two denial subscales. Internal consistency of the subscales is satisfactory except for the three-item denial subscales. Correlations of the C-RIDI subscales with illness-related variables, resilience, and mental well-being are consistent with our hypotheses and provide support for the convergent and criterion-related validity of the scale. CONCLUSIONS: The C-RIDI has satisfactory psychometric properties. The study results support its internal consistency, convergent validity, criterion-related validity, and factorial validity.IMPLICATIONS FOR REHABILITATIONEmotional adjustment to chronic illness and disability is a key determinant of illness self-management, mental well-being, and quality of life.The study translated the reaction to impairment and disability inventory into Chinese and conducted a psychometric evaluation of the translated instrument.The Chinese RIDI had a similar second-order factor structure as in the validation studies of the English version, and result of this confirmatory factor analysis support the theory underlying the design of the RIDI.The Chinese RIDI had satisfactory convergent and criterion-related validity and internal consistency, and is ready for application in rehabilitation practice and research in the Chinese context.

The unwritten history of medical treatment: Evidence for ritual-healers and their activities in the pre-literate past.

OBJECTIVE: To reveal the presence and activities of healers from funerary contexts. MATERIALS: Ethnohistoric and ethnographic textual descriptions and the bioarchaeological record. METHODS: A synthesis of human remains, grave contexts, and funerary objects. CONCLUSIONS: The capacity to act as a "healer" forms part of the social identity of a diverse range of uniquely specialized individuals cross-culturally who also perform a variety of other roles associated with transcendent ideologies, beliefs, and religion. They are ambivalent, capable of doing both good and ill. They defend the health and well-being of the individual and the community but, using the same knowledge, are also implicated in attacks on individuals and groups within and outside their communities. This ambivalence, combined with a lack of defined institutional organization and the great diversity of medico-religious healers in the recent ethnographic past and historically, makes the identification of such individuals in the archaeological record controversial, but they are present. SIGNIFICANCE: Not only are healers identifiable in the archaeological record, but their practices disproportionately influence it, acting as a powerful complement to historical sources for the development of medicine and medical knowledge. LIMITATIONS: Published literature is of variable detail, which means that healing practices and healers are under-appreciated and under-represented in reconstructions of past societies. SUGGESTIONS FOR FURTHER RESEARCH: Application of archaeothanatological approaches to recording and synthesis of the funerary context with the remains of the deceased can be used to identify objects and practices used in healing that have been more recently superseded by scientific approaches to health.

Age-Related Changes in Para and Wheelchair Racing Athlete's Performances.

During the last decades, all para-athletes with disabilities have significantly increased their performance level due to technological progress and human investment, through better training or recovery protocols, medical care and nutritional monitoring. Among these elements, the athlete's age is one of the determining factors in performance. The aim of this study was to investigate the effect of age on maximal performances for para-athletes and wheelchair racing athletes, scaled on able-bodied records. We collected 53,554 results including athlete's best performance of the year, event, age and disability classification from the International Paralympic Committee competitions between 2009 and 2017 for both female and male para-athletics and wheelchair racing disciplines for a total of 472 sport events in Track and Field (considering each impairment type for each event) and gathered the all-time able-bodied records from the International Association of Athletics Federations (IAAF) at the end of 2017. Maximal performance by age was fitted with the Moore function for each para-athletics and wheelchair racing event. This study finds a similar age-related pattern in maximal performance among para-athletes and wheelchair racing athletes. The age at peak performance varies according to sex, impairment type and event and increases gradually from sprint to endurance events. The best Top 100 performances include a large age range suggesting that performance has probably not been optimized yet for most elite para-athletes and wheelchair racers. The next Paralympic Games of Tokyo 2020 and Paris 2024 will certainly offer exceptional performance.

Measuring Functional and Patient-Reported Outcomes After Treatment of Mutilating Hand Injuries: A Global Health Approach.

Understanding the global burden of trauma, particularly upper extremity trauma, is necessary in addressing the need for surgical services. Critical to that mission is to understand, and accurately measure, disability and related disability-adjusted life-years from massive upper extremity trauma. The impact of these injuries is magnified when considering that they frequently occur to young people in prime working years. This article discusses these social and medical system issues and reviews components of a comprehensive approach to measuring outcomes after these injuries. Patient-reported outcomes are highlighted. Methods of optimizing outcomes measurements and studies, disability assessments, and associated research are also discussed.