RESUMO
BACKGROUND: Work capacity is a major outcome variable in cardiological rehabilitation. However, there is a lacks of capacious and economic assessment instruments for work capacity. By developing item response theory based item banks a first step to close this gap is done. The present study aims to validate the work capacity item banks for cardiovascular rehabilitation inpatients (WCIB-Cardio) in a sample of cardiovascular rehabilitation outpatients. Additionally, we examined differences between in- and outpatients with regard to their work capacity. METHODS: Data of 283 cardiovascular rehabilitation inpatients and 77 cardiovascular rehabilitation outpatients were collected in 15 rehabilitation centres. The WCIB-Cardio contains the 2 domains of "cognitive work capacity"(20 items) and "physical work capacity"(18 items). Validation of the item bank for cardiological outpatients was conducted with separate Rasch analysis for each domain. RESULTS: For the domain of cognitive work capacity 10 items showed satisfying quality criteria (Rasch reliability=0.71; overall model fit=0.07). For the domain of physical work capacity good values for Rasch-reliability (0.83) and overall -model fit (0.65) could be proven after exclusion of 3 items. Unidimensionality and a broad ability spectrum could be covered for both domains. With regard to content, outpatients evaluate themselves less burdened than inpatients for the domain of cognitive work capacity (â¾X outpatient =-2.06 vs. â¾X inpatient =-2.49; p<0.07) similarly for the domain of physical work capacity (â¾X outpatient =-3.68 vs. â¾X inpatient =-2.88; p<0.01). DISCUSSION: With the WCIB-Cardio II there is a precondition to develop self-report instruments of work capacity in cardiological in- and outpatients.
Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Reabilitação Cardíaca , Doenças Cardiovasculares/epidemiologia , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/reabilitação , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação da Capacidade de Trabalho , Doenças Cardiovasculares/diagnóstico , Transtornos Cognitivos/diagnóstico , Comorbidade , Avaliação da Deficiência , Feminino , Alemanha/epidemiologia , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais/estatística & dados numéricos , Prevalência , Psicometria/métodos , Fatores de Risco , Inquéritos e Questionários , Resultado do TratamentoRESUMO
The levels of human growth hormone (HGH), ACTH and cortisol in the plasma of 100 middle-aged men were measured by means of radioimmunoassay (12 patients in the phase of hospitalization after myocardial infarction, 47 patients in convalescence, 31 patients in post-convalescence, 10 healthy men). Twenty patients in the phase of convalescence and all patients in post-convalescence did exercises on bicycle ergometer with submaximal loading. Patients after myocardial infarction showed significantly lower basic levels of HGH than healthy persons, and the increase in the HGH level induced by exercise was significantly lower. The hormones ACTH and cortisol showed only slight differences. The secretion of the pituitary hormones, mainly HGH, seems to be altered in patients after myocardial infarction.
Assuntos
Hormônio Adrenocorticotrópico/sangue , Hormônio do Crescimento/sangue , Hidrocortisona/sangue , Infarto do Miocárdio/sangue , Adulto , Teste de Esforço , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In this paper pyramidal neurons of the CA 1-region of the hippocampus of the rat were investigated by means of GOLGI-methods. Animals were used in the stages of age E 20, P 5, P 10, P 15, P 20 added by 15 days old rats reared in darkness or under the influence of constant noise of 80 dB. In these cells the dendritic structure and the amount of visible spines were morphometrically estimated and evaluated by statistical procedures. The neurons of the normal ontogenetic range increase in dendritic length already from P 5 under particular emphasis on Stratum oriens and Stratum radiatum. The spines express a rapid development in the Strata oriens, radiatum, lacunosum beginning in Str. lacunosum at P 5 and in the others at P 10. This fact indicates certain systems of afferents to arrive at several times or to posess different importance to the layors. Because of the fact, that the Str. moleculare, which receives only extrahippocampal afferents, remains significantly behind the other layers regarding the development of spines, it is to be assumed, that the intrahippocampal afferents exhibit a higher importance to the development of CA 1-pyramids. The rearing in darkness causes a significantly decreased development of spines within all the layers, so that the amount of visible spines nearly remains at the values of P 10. Constant noise however causes only a significantly enforced development of spines in the Strata oriens, radiatum, molecular e.g. in layers receiving extrahippocampal afferents. An approach to stage P 20 takes place only at Str. moleculare possibly depending on its large extrahippocampal input. As an expression of specificity a pericaryon-dendrite-factor can be assumed responsible for the election of afferent fibres and the development of spines especially at the animals reared in darkness. The reactivity of the neurons is exhibited by the relative independence of the Strata lacunosum and oriens during the ontogenetic development and of the Stratum moleculare at rats reared under the influence of constant noise.