This paper critically reviews the literature, describing a post-operative phenomenon which is traditionally seen by physiotherapists in the immediate inpatient setting, following neck dissection (ND) for head and neck cancer. The presence and incidence of this condition is explored and the potential impact on the surviving patient's quality of life is considered. The nature and development of shoulder disability following ND is investigated and proposed roles of key anatomical structures involved are considered with relation to pathodynamics. A model for understanding the assessment and holistic management of this condition is offered and the potential implications for physiotherapy practice in primary care are considered.
Survival after diagnosis of acquired immunodeficiency syndrome (AIDS) differs greatly depending upon the type of complications the patient experiences. A detailed understanding of this variation in survival is an essential component of health care planning so that demands for hospital beds and other health care resources can be more realistically anticipated. We developed two severity indices for predicting the prognosis of AIDS patients using additive and multiplicative multi-attribute utility models. A panel of physicians described the scoring of each index. On 97 randomly selected patient profiles, we compared both severity scores to the clinical assessments of the expert panel. The multiplicative index was more accurate than the additive index. We describe the multiplicative scoring system for AIDS severity.
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