Material requirements planning: a new tool for controlling hospital inventories.
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The social environmental barriers are considered to be important because the "social participation" of people with impairments would be facilitated by the prevention and reduction of environmental barriers. The Craig Hospital Inventory of Environmental Factors (CHIEF) is one of the few scales to assess the environmental barriers. In this study, we developed the Korean version of CHIEF and evaluated its construct validity and utility in a sample of Korean community-dwelling elderly with or without stroke. We evaluated the construct validity of the CHIEF by testing the original five-factor structure using a confirmatory factor analysis in 400 elderly in Seoul, Korea. The utility of the CHIEF was then assessed by examining the relationships between individual characteristics, Barthel Index and perceived environmental barriers, measured by the CHIEF, using a structural equation modeling approach. The confirmatory factor analysis result demonstrated the validity of a second-order factor model of the CHIEF comprising the five factors as first-order factors. The perceived environmental barrier was a second-order factor when provided acceptable fit indices after two modifications. The structural equation modeling indicates that perceived environmental barriers are significantly related to activities of daily life but not age, gender, and the episode of stroke. The CHIEF is useful in measuring environmental factors for Korean older adults with or without stroke.
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OBJECTIVES: To describe the prevalence of perceived environmental barriers in a population of amputees; to compare and contrast those barriers reported by amputees with reported barriers of a sample of disabled and nondisabled persons; and to identify the correlates of barriers among amputees. DESIGN: Cross-sectional survey. SETTING: A community sample who were interviewed by telephone. PARTICIPANTS: A stratified sample by etiology of 914 community-dwelling persons with limb loss. INTERVENTION: Telephone interview. MAIN OUTCOME MEASURES: Frequency (never, less than monthly, monthly, weekly, daily) and magnitude (little problem, big problem) of perceived environmental barriers in 5 domains as measured by the Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), characteristics of the amputation, prosthetic use, and sociodemographic characteristics of the amputee. RESULTS: The majority (87%) of persons surveyed reported barriers in 1 or more areas with 57% reporting barriers in 4 or more of the 5 domains (policies, physical/structural, work/school, attitudes/support, and services/assistance subscales). Mean frequency-magnitude scores were lower for amputees with cancer-related amputation across all subscales, while traumatic amputees reported the greatest perceived barriers, except in the area of services/assistance. Across all domains, poverty level and comorbidity were significant predictors of significant barriers (CHIEF-SF score >/=3; range, 0-8). When compared with a general population sample of disabled and nondisabled Americans, amputees were more likely to perceive barrier in all areas except work/school. CONCLUSIONS: Perceived environmental barriers among persons with limb loss are highly prevalent. Reduction of environmental barriers may lead to reduction of disability and improvement of overall quality of life for amputees.
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Most instruments used to assess poststroke depression have never been specifically validated in stroke patients. This study evaluated the depression screening abilities of three questionnaires and one observer-rated scale in 202 consecutive patients 1 month after they experienced their first-ever ischemic stroke. At their respective optimum cutoff values, the sensitivity of the self-rated scales varied between 80% and 90%, while the specificity was about 60%. For the observer-rated scale (Hamilton Depression Rating Scale), sensitivity was 78.1%, and specificity was 74.6%. The instruments clearly performed better in men than in women. Despite this difference, it was concluded that all scales were acceptable screening instruments for poststroke depression.
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Standard business inventory procedures can be cost effective when they are adapted to hospital laboratory inventory management in a 500-bed hospital. The investment in a central laboratory store-room and one additional employee yields financial benefits and indirect service benefits. The system requires consistent use of simple procedures throughout the laboratory, and can be coupled with improved strategies for purchasing supplies.
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