QUESTION: Is the de Morton Mobility Index (DEMMI) valid for measuring the mobility of patients living in the community with Parkinson disease (PD)? DESIGN: A prospective cohort study comparing the DEMMI with existing mobility-related activity measures. PARTICIPANTS: 102 consecutive patients with PD (mean age 72.4 years, SD 8.3) who received multidisciplinary outpatient care in a community rehabilitation facility over 6 to 8 weeks. OUTCOME MEASURES AND ANALYSIS: The DEMMI and other measures of mobility-related activity at admission and discharge (10 metre walk test, Berg balance scale, timed up and go test, functional reach test and pull test) were used to assess convergent validity. Discriminant validity of the DEMMI was assessed by comparison to measures of other constructs, and. unidimensionality was examined using Rasch analysis. RESULTS: Evidence of convergent (rho ranged from 0.47 to 0.84), discriminant (rho ranged 0.12 to 0.22), and known groups validity were obtained for the DEMMI (Mean difference 20.3 units, 95% CI 14.5 to 26.0). Rasch analysis confirmed that the DEMMI was unidimensional. CONCLUSION: The DEMMI has a broader scale width than existing mobility-related activity measures, provides interval level measurement and is a unidimensional measure of mobility in patients with PD living in the community.
The benefits of Category Management for a supplier organisation are mamimised when there is a purchase marketing strategy in place for the category. Purchase marketing is essentially using the store as a marketing medium, via tools such as position on shelf, pricing, communications and in-store promotions. This paper highlightsvarious research approaches used for category management and, using case material drawn from different geographic markets-from Brazil to Canada and the UK-discusses the dynamics of purchase marketing in different contexts. It describes how manufacturers can successfully develop an alternative strategy for managing their brands in the face of retailer pressure to price discount.
A systematic review was conducted of the evidence for the effectiveness of the outcomes from treatment by multidisciplinary outpatient rehabilitation programs which were provided by more than one allied health or nursing discipline for people diagnosed with Parkinson's disease (PD). The search yielded only 4 studies ranging from poor to good quality, on the outcomes of multidisciplinary rehabilitation. There were no available random controlled trials on short term outcomes although some limited evidence from lower quality studies suggested significant short term gains are achieved in gait speed and step length. No consistent evidence is available for other outcome measures. From the available evidence for longer term outcomes over a period of 4-6 months post intervention the improvements in outcome measures for gait are not significant. The results of this systematic review suggest that there is limited evidence to suggest short term gains in outcomes for people with PD attending multidisciplinary programs but over a 4-6 month period these gains are no longer significant. Overall, there is very limited high level evidence available to show whether multidisciplinary out-patient programs produce effective, either short or long term, outcomes for PD and further research is needed.
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