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Almansa J.,IMIM Hospital Del Mar | Ayuso-Mateos J.L.,Autonomous University of Madrid | Ayuso-Mateos J.L.,Institute Salud Carlos III | Garin O.,IMIM Hospital Del Mar | And 18 more authors.
Journal of Clinical Epidemiology | Year: 2011

Objective: There has been no attempt to obtain a continuous summary measure of disability from the checklist of the International Classification of Functioning, Disability and Health (ICF). Our objective was to assess whether valid scales of Capacity and Performance could be developed from the "Activities and Participation" domain of the ICF checklist. Study Design and Setting: A multicenter, observational study of 1,092 patients with 12 different chronic conditions from five European countries was conducted. Exploratory and confirmatory factor analyses were performed to assess the underlying factor structure. Reliability and validity of the Capacity and Performance scales were evaluated. Construct validity was assessed calculating effect size coefficients between extreme severity groups (discriminant ability). Results: The good fit of the confirmatory factor model supported the global scales of Capacity and Performance and their "Psychosocial" and "Physical" subscales. Reliability was excellent (coefficients = 0.79-0.92). Effect sizes of most conditions were large for the Capacity global scale (0.50-3.05), and slightly lower for the Performance global scale (0.45-2.57). Conclusions: Our findings support the measurement model, reliability, and validity of the Capacity and Performance scales. Summary measures of functioning based on the ICF can be obtained using these scales, which should facilitate their incorporation in clinical and epidemiological studies. © 2011 Elsevier Inc. All rights reserved.

Burtscher M.,University of Innsbruck | Ponchia A.,Unit of Cardiac Rehabilitation
Progress in Cardiovascular Diseases | Year: 2010

Annually, more than 100 million tourists are attracted by the mountainous areas around the world. On the one hand, leisure time activities at altitude may well contribute to the well-established beneficial effects of exercise; on the other hand, these activities are also associated with a relatively high risk of death. Sudden cardiac death (SCD) is the most frequent cause of nontraumatic death in males older than 34 years at altitude during leisure time activities such as downhill skiing and hiking. Whereas prior myocardial infarction is the most important risk factor for SCD, particularly relevant in downhill skiers, the unusual physical activity during the first days at altitude and the prolonged abstinence from food and fluid intake during exercise at altitude are the most important triggers. Unaccustomed physical activity seems more likely to trigger SCD than altitude per se. The detection of subjects at risk, evidence-based therapy, and advice on adequate behavior during the altitude sojourn will help to prevent SCD and to increase the health benefits generated by mountaineering activities. © 2010 Elsevier Inc.

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