Immersive Environments in ADL

DTIC Science & Technology

2009-08-20

Tracking and Storing In Browser 3-D 13 Questions or Comments? Peter Smith Team Lead, Immersive Learning Technologies peter.smith.ctr@adlnet.gov +1.407.384.5572 ...Immersive Environments in ADL Mr. Peter Smith, Lead, ADL Immersive Learning Team 08/20/2009 Report Documentation Page Form ApprovedOMB No. 0704-0188...5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Advanced Decision Learning (ADL),1901 N

Cognitive Impairment as a Strong Predictor of Incident Disability in Specific Adl-Iadl Tasks among Community-Dwelling Elders: The Azuchi Study

ERIC Educational Resources Information Center

Dodge, Hiroko H.; Kadowaki, Takashi; Hayakawa, Takehito; Yamakawa, Masanobu; Sekikawa, Akira; Ueshima, Hirotugu

2005-01-01

Purpose: We examined differential effects of cognitive impairment on each of the activities of daily living (ADL) and instrumental activities of daily living (IADL) tasks. Design and Methods: In a 3-year follow-up of community-dwelling elderly persons in Azuchi, Japan, we assessed cognition by using the Hasegawa Dementia Scale. We examined (a) the…

Activities of daily living, instrumental activities for daily living and predictors of functional capacity of older men in Jamaica

PubMed Central

Bourne, Paul Andrew

2009-01-01

Background: An extensive search of the literature found no studies that have examined functional capacity [Activities of Daily Living (ADL) and Instrumental Activities for Daily Living (I) ADL)] of Jamaican older men as well as factors that determine their functional capacity. Aims: The current study examines 1) ADL, 2) (I) ADL), 3) self-reported health status, 4) functional capacity, and 5) factors that determine functional capacity of older men. Methods and Method: Stratified multistage probability sampling technique was used to draw a sample of 2,000 55+ year men. A132-item questionnaire was used to collect the data. Descriptive statistics provide background information on the sample, cross tabulations were used to examine non-metric variables and logistic regression provides a model of predictors of functional capacity. Result: Fifty-five percent of sample indicated good current health status. Four percent was mostly satisfied with life; 21.7% had moderate dependence; 77.1% had high dependence (i.e. independence); 1.2% had low dependence; 21.9% were ages 75 years and older; 35.6% were ages 65 to 74 years and 42.6% reported ages 55 to 64 years. Functional capacity can be determined by church attendance (β=0.245; 95% CI: 0.264, 1.291); social support (β=0.129; 95% CI: 0.129, 0.258), area of residence (β=-0.060; 95% CI: -0.427, -0.061) and lastly by age of respondents. Conclusion: Ageing in explains deterioration in their (I) ADL, suggesting the challenges of ageing men's independence. More rural men were rarely satisfied with life; but more of them had a greater functional capacity than urban men. Depression was found to negatively relate to functional capacity, and church attendees had a greater functional status than non-attendees. PMID:22666693

The Impact of Decline in Activities of Daily Living (ADL) of Patients With Critical Limb Ischemia (CLI) After Endovascular Treatment.

PubMed

Tokuda, Takahiro; Hirano, Keisuke; Yamawaki, Masahiro; Araki, Motoharu; Kobayashi, Norihiro; Sakamoto, Yasunari; Mori, Shisuke; Tsutsumi, Masakazu; Honda, Yosuke; Ito, Yoshiaki

2018-01-01

Certain patients with critical limb ischemia (CLI) experience significant decline in activities of daily living (ADL) during hospitalization. The prognosis of decline in ADL during hospitalization remains unknown. A retrospective analysis was performed on collected data of patients with CLI treated by endovascular treatment between April 2007 and December 2015. We evaluated CLI in patients ADL at the time of hospitalization and after discharge using the Barthel index. We classified all patients into patients with decline in ADL and stable in ADL and compared clinical outcomes (cumulative incidence of wound healing, amputation-free survival at 1 year) between the 2 groups. Two hundred and fifty-five consecutive patients with CLI (221 limbs), who underwent successful endovascular intervention, were enrolled in this study. Of all patients, 22 patients were classified into the decline group. The prevalence of wound, Ischemia, foot infection (WIfI) classification high grade was higher in the decline group (30.7% vs 63.6%; P < .01). The wound healing rates were worse in the decline group than in the stable group (40% vs 78% at 1 year; P < .01). The same trends were observed in the amputation-free survival (37% vs 78%; P < .01). After multivariate analysis, decline in ADL was an independent predictor of wound healing and amputation-free survival (odds ratio [OR]: 2.85, 95% confidence interval [CI]: 1.61-3.35, P < .01; OR: 2.46, 95% CI: 1.26-4.53, P = .01). Patients with CLI with decline in ADL during hospitalization were found to have a poor prognosis suggesting that a decline in ADL may affect the clinical outcomes.

[Factors associated with activities of daily living (ADL) in independently living elderly persons in a community: a baseline examination of a large scale cohort study, Fujiwara-kyo study].

PubMed

Komatsu, Masayo; Nezu, Satoko; Tomioka, Kimiko; Hazaki, Kan; Harano, Akihiro; Morikawa, Masayuki; Takagi, Masahiro; Yamada, Masahiro; Matsumoto, Yoshitaka; Iwamoto, Junko; Ishizuka, Rika; Saeki, Keigo; Okamoto, Nozomi; Kurumatani, Norio

2013-01-01

To investigate factors associated with activities of daily living in independently living elderly persons in a community. The potential subjects were 4,472 individuals aged 65 years and older who voluntarily participated in a large cohort study, the Fujiwara-kyo study. We used self-administered questionnaires consisting of an activities of daily living (ADL) questionnaire with the Physical Fitness Test established by the Ministry of Education, Culture, Sports, Science and Technology (12 ADL items) to determine the index of higher-level physical independence, demographics, Geriatric Depression Scale, and so on. Mini-mental state examination, measurement of physical fitness, and blood tests were also carried out. A lower ADL level was defined as having a total score of the 12 ADL items (range, 12-36 points) that was below the first quartile of a total score for all the subjects. Factors associated with a low ADL level were examined by multiple logistic regression. A total of 4,198 remained as subjects for analysis. The male, female and 5-year-old groups showed significant differences in the median score of 12 ADL items between any two groups. The highest odds ratio among factors associated with lower ADL level by multiple logistic regression with mutually adjusted independent variables was 4.49 (95%CI: 2.82-7.17) in the groups of "very sharp pain" or "strong pain" during the last month. Low physical ability, self-awareness of limb weakness, a BMI of over 25, low physical activity, cerebrovascular disorder, depression, low cognitive function, unable "to see normally", unable "to hear someone", "muscle, bone and joint pain" were independently associated with lower ADL level. Multiple factors are associated with lower ADL level assessed on the basis of the 12 ADL items.

Association among activities of daily living, instrumental activities of daily living and health-related quality of life in elderly Yi ethnic minority.

PubMed

Ran, Lingyun; Jiang, Xiaodong; Li, Baogang; Kong, Hongqian; Du, Mengqi; Wang, Xiaolan; Yu, Hua; Liu, Qin

2017-03-22

The health-related quality of life (HRQoL) of the elderly population of Yi ethnic minority, which is the seventh largest nationality in China, has been rarely reported. This study was designed to explore the HRQoL of the elderly Yi ethnicity and association between their HRQOL and functional abilities. A total of 291 Yi ethnic residents were randomly recruited from 12 rural counties in Yunnan province and divided into different age groups. Local residents in Yunnan province and the elderly from Hangzhou were enrolled as controls. The MOS 36-Item Short Form Health Survey (SF-36), activities of daily living (ADL), instrumental activities of daily living (IADL) scales were utilized to evaluate the HRQoL and functional ability. One-way ANOVA was used to statistically compare the ADL and IADL among different age groups. The influential variables on HRQOL were analyzed by multiple linear regression analysis. Pearson correlation analysis was used to analyze the association among HRQoL, ADL and IADL. The HRQoL of the elderly Yi minority was significantly lower than those of local residents in Yunnan province and the elderly counterparts in Hangzhou. The IADL ability of the elderly Yi minority was low, whereas they could perform most items of ADL. ADL, IADL, and education level were positively associated with HRQoL, whereas age, chronic diseases, and the frequency of medication use were negatively correlated with HRQoL. The HRQoL and functional capacity of the elderly Yi ethnic minority were lower compared with their counterparts in Yunnan province and Hangzhou. The low level of IADL indicated that the elderly Yi participants had a high risk of cognitive impairment. Much attention should be diverted to influential factors of the HRQoL.

Algorithm integration using ADL (Algorithm Development Library) for improving CrIMSS EDR science product quality

NASA Astrophysics Data System (ADS)

Das, B.; Wilson, M.; Divakarla, M. G.; Chen, W.; Barnet, C.; Wolf, W.

2013-05-01

Algorithm Development Library (ADL) is a framework that mimics the operational system IDPS (Interface Data Processing Segment) that is currently being used to process data from instruments aboard Suomi National Polar-orbiting Partnership (S-NPP) satellite. The satellite was launched successfully in October 2011. The Cross-track Infrared and Microwave Sounder Suite (CrIMSS) consists of the Advanced Technology Microwave Sounder (ATMS) and Cross-track Infrared Sounder (CrIS) instruments that are on-board of S-NPP. These instruments will also be on-board of JPSS (Joint Polar Satellite System) that will be launched in early 2017. The primary products of the CrIMSS Environmental Data Record (EDR) include global atmospheric vertical temperature, moisture, and pressure profiles (AVTP, AVMP and AVPP) and Ozone IP (Intermediate Product from CrIS radiances). Several algorithm updates have recently been proposed by CrIMSS scientists that include fixes to the handling of forward modeling errors, a more conservative identification of clear scenes, indexing corrections for daytime products, and relaxed constraints between surface temperature and air temperature for daytime land scenes. We have integrated these improvements into the ADL framework. This work compares the results from ADL emulation of future IDPS system incorporating all the suggested algorithm updates with the current official processing results by qualitative and quantitative evaluations. The results prove these algorithm updates improve science product quality.

Scaling functional status within the interRAI suite of assessment instruments

PubMed Central

2013-01-01

Background As one ages, physical, cognitive, and clinical problems accumulate and the pattern of loss follows a distinct progression. The first areas requiring outside support are the Instrumental Activities of Daily Living and over time there is a need for support in performing the Activities of Daily Living. Two new functional hierarchies are presented, an IADL hierarchical capacity scale and a combination scale integrating both IADL and ADL hierarchies. Methods A secondary analyses of data from a cross-national sample of community residing persons was conducted using 762,023 interRAI assessments. The development of the new IADL Hierarchy and a new IADL-ADL combined scale proceeded through a series of interrelated steps first examining individual IADL and ADL item scores among persons receiving home care and those living independently without services. A factor analysis demonstrated the overall continuity across the IADL-ADL continuum. Evidence of the validity of the scales was explored with associative analyses of factors such as a cross-country distributional analysis for persons in home care programs, a count of functional problems across the categories of the hierarchy, an assessment of the hours of informal and formal care received each week by persons in the different categories of the hierarchy, and finally, evaluation of the relationship between cognitive status and the hierarchical IADL-ADL assignments. Results Using items from interRAI’s suite of assessment instruments, two new functional scales were developed, the interRAI IADL Hierarchy Scale and the interRAI IADL-ADL Functional Hierarchy Scale. The IADL Hierarchy Scale consisted of 5 items, meal preparation, housework, shopping, finances and medications. The interRAI IADL-ADL Functional Hierarchy Scale was created through an amalgamation of the ADL Hierarchy (developed previously) and IADL Hierarchy Scales. These scales cover the spectrum of IADL and ADL challenges faced by persons in the community

Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-07-05

This study's aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly. Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47-2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44-5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01-3.55) compared to having both hobbies and PIL. Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.

Preliminary cognitive scale of basic and instrumental activities of daily living for dementia and mild cognitive impairment.

PubMed

Rodríguez-Bailón, María; Montoro-Membila, Nuria; Garcia-Morán, Tamara; Arnedo-Montoro, María Luisa; Funes Molina, María Jesús

2015-01-01

In the present study we explored cognitive and functional deficits in patients with multidomain mild cognitive impairment (MCI), patients with dementia, and healthy age-matched control participants using the Cognitive Scale for Basic and Instrumental Activities of Daily Living, a new preliminary informant-based assessment tool. This tool allowed us to evaluate four key cognitive abilities-task memory schema, error detection, problem solving, and task self-initiation-in a range of basic and instrumental activities of daily living (BADL and IADL, respectively). The first part of the present study was devoted to testing the psychometric adequateness of this new informant-based tool and its convergent validity with other global functioning and neuropsychological measures. The second part of the study was aimed at finding the patterns of everyday cognitive factors that best discriminate between the three groups. We found that patients with dementia exhibited impairment in all cognitive abilities in both basic and instrumental activities. By contrast, patients with MCI were found to have preserved task memory schema in both types of ADL; however, such patients exhibited deficits in error detection and task self-initiation but only in IADL. Finally, patients with MCI also showed a generalized problem solving deficit that affected even BADL. Studying various cognitive processes instantiated in specific ADL differing in complexity seems a promising strategy to further understand the specific relationships between cognition and function in these and other cognitively impaired populations.

Predictors of performance-based measures of instrumental activities of daily living in nondemented patients with Parkinson's disease.

PubMed

Pirogovsky, Eva; Martinez-Hannon, Mercedes; Schiehser, Dawn M; Lessig, Stephanie L; Song, David D; Litvan, Irene; Filoteo, J Vincent

2013-01-01

Few studies have examined instrumental activities of daily living (iADLs) in nondemented Parkinson's disease (PD), and the majority of these studies have used report-based measures, which can have limited validity. The present study had two main goals: (a) to examine the performance of nondemented PD patients on two performance-based measures of iADLs, which are considered more objective functional measures, and (b) to examine the cognitive, motor, and psychiatric correlates of iADL impairment in PD. Ninety-eight nondemented PD patients and 47 healthy older adults were administered performance-based measures that assess the ability to manage medications (Medication Management Ability Assessment) and finances (University of California, San Diego, UCSD, Performance-based Skills Assessment), the Mattis Dementia Rating Scale to assess global cognitive functioning, the Unified Parkinson's Disease Rating Scale Part III to assess motor symptom severity, and the Geriatric Depression Scale to assess depressive symptoms. Nondemented PD patients demonstrated significantly impaired scores relative to the healthy comparison group on the performance-based measure of financial management, but there were no significant group differences in medication management. Global cognitive functioning, motor severity, and depressive symptoms did not correlate with scores on either of the functional measures, except for a small correlation between depressive symptoms and financial management. The two performance-based measures of iADL functioning did not correlate with one another. These findings suggest that medication and financial management may not be predicted based on global cognitive functioning and that iADLs may not be represented by a single construct. Furthermore, these findings suggest the potential need for a multidimensional approach to assessing iADLs.

Aspects of housing and perceived health among ADL independent and ADL dependent groups of older people in three national samples.

PubMed

Tomsone, Signe; Horstmann, Vibeke; Oswald, Frank; Iwarsson, Susanne

2013-06-01

Good housing solutions are important for the ageing population in order to promote health and maintain functional ability. The objective of this study was to investigate whether and how objective and perceived aspects of housing were related to perceived health among ADL independent and ADL dependent groups of older, single-living people within three national samples. The current study was based on national samples (German, n = 450; Latvian, n = 303; Swedish, n = 397) from the European ENABLE-AGE Project, using data on ADL dependence, perceived health, objective and perceived aspects of housing. Descriptive statistics, correlations and multivariate ordinal regression models were used to analyze the data. The participants in the ADL dependent groups generally were older, had more functional limitations and perceived their health as poorer compared to ADL independent groups. With regard to perceived housing, usability as well as meaning of home indicators was often lower in the ADL dependent groups, housing satisfaction was at the same level while housing-related external control beliefs were higher. The differences among the national samples were highly significant for both ADL groups, for all variables except number of outdoor environmental barriers in the ADL independent groups. The relations between perceived health on one hand and objective and perceived aspects of housing on the other show great diversities among the ADL groups and the national samples. The results serve to alert health care practitioners that it is important to draw attention to how older people perceive their housing situation and to the fact that different levels of functional independence demand different interventions.

Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds

PubMed Central

de Paula, Jonas J.; Diniz, Breno S.; Bicalho, Maria A.; Albuquerque, Maicon Rodrigues; Nicolato, Rodrigo; de Moraes, Edgar N.; Romano-Silva, Marco A.; Malloy-Diniz, Leandro F.

2015-01-01

Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer’s disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity. PMID:26257644

Functional decline in the elderly with MCI: Cultural adaptation of the ADCS-ADL scale.

PubMed

Cintra, Fabiana Carla Matos da Cunha; Cintra, Marco Túlio Gualberto; Nicolato, Rodrigo; Bertola, Laiss; Ávila, Rafaela Teixeira; Malloy-Diniz, Leandro Fernandes; Moraes, Edgar Nunes; Bicalho, Maria Aparecida Camargos

2017-07-01

Translate, transcultural adaptation and application to Brazilian Portuguese of the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) scale as a cognitive screening instrument. We applied the back translation added with pretest and bilingual methods. The sample was composed by 95 elderly individuals and their caregivers. Thirty-two (32) participants were diagnosed as mild cognitive impairment (MCI) patients, 33 as Alzheimer's disease (AD) patients and 30 were considered as cognitively normal individuals. There were only little changes on the scale. The Cronbach alpha coefficient was 0.89. The scores were 72.9 for control group, followed by MCI (65.1) and by AD (55.9), with a p-value < 0.001. The ROC curve value was 0.89. We considered a cut point of 72 and we observed a sensibility of 86.2%, specificity of 70%, positive predictive value of 86.2%, negative predictive value of 70%, positive likelihood ratio of 2.9 and negative likelihood ratio of 0.2. ADCS-ADL scale presents satisfactory psychometric properties to discriminate between MCI, AD and normal cognition.

Simple Counts of ADL Dependencies Do Not Adequately Reflect Older Adults' Preferences toward States of Functional Impairment

PubMed Central

Sims, Tamara; Holmes, Tyson H.; Bravata, Dena M.; Garber, Alan M.; Nelson, Lorene M.; Goldstein, Mary K.

2008-01-01

Objective To use unweighted counts of dependencies in Activities of Daily Living (ADLs) to assess the impact of functional impairment requires an assumption of equal preferences for each ADL dependency. To test this assumption, we analyzed standard gamble utilities of single and combination ADL dependencies among older adults. Study Design and Setting: Four hundred older adults used multimedia software (FLAIR1) to report standard gamble utilities for their current health and hypothetical health states of dependency in each of 7 ADLs and 8 of 30 combinations of ADL dependencies. Results Utilities for health states of multiple ADL dependencies were often greater than for states of single ADL dependencies. Dependence in eating, the ADL dependency with the lowest utility rating of the single ADL dependencies, ranked lower than 7 combination states. Similarly, some combination states with fewer ADL dependencies had lower utilities than those with more ADL dependencies. These findings were consistent across groups by gender, age, and education. Conclusion Our results suggest that the count of ADL dependencies does not adequately represent the utility for a health state. Cost-effectiveness analyses and other evaluations of programs that prevent or treat functional dependency should apply utility-weights rather than relying on simple ADL counts. PMID:18722749

Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults

PubMed Central

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-01-01

Background This study’s aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly. Methods Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. Results During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47–2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44–5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01–3.55) compared to having both hobbies and PIL. Conclusions Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults. PMID:26947954

JPSS Cryosphere Algorithms: Integration and Testing in Algorithm Development Library (ADL)

NASA Astrophysics Data System (ADS)

Tsidulko, M.; Mahoney, R. L.; Meade, P.; Baldwin, D.; Tschudi, M. A.; Das, B.; Mikles, V. J.; Chen, W.; Tang, Y.; Sprietzer, K.; Zhao, Y.; Wolf, W.; Key, J.

2014-12-01

JPSS is a next generation satellite system that is planned to be launched in 2017. The satellites will carry a suite of sensors that are already on board the Suomi National Polar-orbiting Partnership (S-NPP) satellite. The NOAA/NESDIS/STAR Algorithm Integration Team (AIT) works within the Algorithm Development Library (ADL) framework which mimics the operational JPSS Interface Data Processing Segment (IDPS). The AIT contributes in development, integration and testing of scientific algorithms employed in the IDPS. This presentation discusses cryosphere related activities performed in ADL. The addition of a new ancillary data set - NOAA Global Multisensor Automated Snow/Ice data (GMASI) - with ADL code modifications is described. Preliminary GMASI impact on the gridded Snow/Ice product is estimated. Several modifications to the Ice Age algorithm that demonstrates mis-classification of ice type for certain areas/time periods are tested in the ADL. Sensitivity runs for day time, night time and terminator zone are performed and presented. Comparisons between the original and modified versions of the Ice Age algorithm are also presented.

ADL State of the Union. Where We Are and Where We Are Going

DTIC Science & Technology

2009-08-18

Activities  Job Performance Technology Center  Resources 2 ADL Vision Provide access to the highest quality education and training, tailored to...LETSI  Others New Direction – Harmonization  Independent development of point-solutions has caused fragmentation of e- learning technologies ...Ed Tech Working Group  DoD designated as leader in learning technology research  Interest in CORDRA/ADL-R as framework for entire government

Assessment Instrument for Problem-focused Coping. Reliability test of APC. Part 1.

PubMed

Tollén, A; Ahlström, G

1998-01-01

A new self-report instrument, the Assessment Instrument of Problem-focused Coping (APC) developed from qualitative interviews, is described. This instrument provides knowledge of the patients' own competence in coping with activities of daily living (ADL), the patients' own assessment of what they experience as problems, and the extent to which they are satisfied with their ADL. The purpose of the study was to test the reliability of the instrument with regard to intra-rater reliability and internal consistency. The study group comprised 40 patients with muscular weakness and other symptoms relating to the postpolio syndrome. The result showed an acceptable internal consistency (alpha 0.70), which confirms the construct validity of the instrument. The test-retest showed that the stability over a period of time varied from low to high for a total of 28 items. At the same time, it is evident that the instrument does not achieve the aim of being a good evaluation instrument, because the stability over a period of time was unsatisfactory. The test-retest should be repeated with a larger test group in future research projects.

QMG and MG-ADL correlations: Study of eculizumab treatment of myasthenia gravis.

PubMed

Howard, James F; Freimer, Miriam; O'Brien, Fanny; Wang, Jing Jing; Collins, Stephen R; Kissel, John T

2017-08-01

A phase 2 study of eculizumab for treating myasthenia gravis (MG) used the quantitative myasthenia gravis score (QMG) and myasthenia gravis activities of daily living profile (MG-ADL) to evaluate baseline disease severity and treatment response. Correlations were then analyzed between these assessments. Patients were given eculizumab or placebo during the first 16-week treatment period of the crossover study, with treatment assignments reversed for the second treatment period following a 5-week washout. QMG and MG-ADL scores at baseline and endpoint of each treatment period generated correlation coefficients for baseline status and treatment response during eculizumab therapy. Correlation strength between QMG and MG-ADL scores was higher for treatment response (R = 0.726; 95% confidence interval, 0.264-0.907; P = 0.0036) than for assessing baseline disease status (R = 0.552; 95% confidence interval, -0.022-0.839; P = 0.0495). MG-ADL may be more sensitive for assessing treatment response than point-in-time disease status. Muscle Nerve 56: 328-330, 2017. © 2016 Wiley Periodicals, Inc.

A Long-Term Perspective on Person-Environment Fit and Adl Dependence among Older Swedish Adults

ERIC Educational Resources Information Center

Iwarsson, Susanne

2005-01-01

Purpose: This study described person--environment (P-E) fit and activities of daily living (ADLs) among older adults, and it explored the relationship between P-E fit and ADL dependence, testing Lawton's docility hypothesis at two points in time. Design and Methods: From a random sample of individuals aged 75-84 living in a Swedish municipality,…

Firearms in Frail Hands: An ADL or A Public Health Crisis!

PubMed

Patel, Dupal; Syed, Quratulain; Messinger-Rapport, Barbara J; Rader, Erin

2015-06-01

The incidence of neurocognitive disorders, which may impair the ability of older adults to perform activities of daily living (ADLs), rises with age. Depressive symptoms are also common in older adults and may affect ADLs. Safe storage and utilization of firearms are complex ADLs, which require intact judgment, executive function, and visuospatial ability, and may be affected by cognitive impairment. Depression or cognitive impairment may cause paranoia, delusions, disinhibition, apathy, or aggression and thereby limit the ability to safely utilize firearms. These problems may be superimposed upon impaired mobility, arthritis, visual impairment, or poor balance. Inadequate attention to personal protection may also cause hearing impairment and accidents. In this article, we review the data on prevalence of firearms access among older adults; safety concerns due to age-related conditions; barriers to addressing this problem; indications prompting screening for firearms access; and resources available to patients, caregivers, and health care providers. © The Author(s) 2014.

Advancements in Distributed Learning (ADL) Environment in Support of Transformation

DTIC Science & Technology

2017-01-01

REPORT TR-HFM-212 Advancements in Distributed Learning (ADL) Environment in Support of Transformation (Progrès en apprentissage distribué (ADL) à...l’appui de la transformation ) This report documents the findings of Task Group 212. The primary objective of this Task Group was to explore an agile...STO TECHNICAL REPORT TR-HFM-212 Advancements in Distributed Learning (ADL) Environment in Support of Transformation (Progrès en apprentissage

Identifying factors of activities of daily living important for cost and caregiver outcomes in Alzheimer's disease.

PubMed

Reed, Catherine; Belger, Mark; Vellas, Bruno; Andrews, Jeffrey Scott; Argimon, Josep M; Bruno, Giuseppe; Dodel, Richard; Jones, Roy W; Wimo, Anders; Haro, Josep Maria

2016-02-01

We aimed to obtain a better understanding of how different aspects of patient functioning affect key cost and caregiver outcomes in Alzheimer's disease (AD). Baseline data from a prospective observational study of community-living AD patients (GERAS) were used. Functioning was assessed using the Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale. Generalized linear models were conducted to analyze the relationship between scores for total activities of daily living (ADL), basic ADL (BADL), instrumental ADL (IADL), ADL subdomains (confirmed through factor analysis) and individual ADL questions, and total societal costs, patient healthcare and social care costs, total and supervision caregiver time, and caregiver burden. Four distinct ADL subdomains were confirmed: basic activities, domestic/household activities, communication, and outside activities. Higher total societal costs were associated with impairments in all aspects of ADL, including all subdomains; patient costs were associated with total ADL and BADL, and basic activities subdomain scores. Both total and supervision caregiver hours were associated with total ADL and IADL scores, and domestic/household and outside activities subdomain scores (greater hours associated with greater functional impairments). There was no association between caregiver burden and BADL or basic activities subdomain scores. The relationship between total ADL, IADL, and the outside activities subdomain and outcomes differed between patients with mild and moderate-to-severe AD. Identification of ADL subdomains may lead to a better understanding of the association between patient function and costs and caregiver outcomes at different stages of AD, in particular the outside activities subdomain within mild AD.

Ventilatory demand and dynamic hyperinflation induced during ADL-based tests in Chronic Obstructive Pulmonary Disease patients

PubMed Central

dos Santos, Karoliny; Gulart, Aline A.; Munari, Anelise B.; Karloh, Manuela; Mayer, Anamaria F.

2016-01-01

ABSTRACT Background Airflow limitation frequently leads to the interruption of activities of daily living (ADL) in patients with Chronic Obstructive Pulmonary Disease (COPD). These patients commonly show absence of ventilatory reserve, reduced inspiratory reserve volume, and dynamic hyperinflation (DH). Objective To investigate ventilatory response and DH induced by three ADL-based protocols in COPD patients and compare them to healthy subjects. Method Cross-sectional study. COPD group: 23 patients (65±6 years, FEV1 37.2±15.4%pred); control group: 14 healthy subjects (64±4 years) matched for age, sex, and body mass index. Both groups performed all three tests: Glittre-ADL test; an activity test that involved moving objects on a shelf (TSHELF); and a modified shelf protocol isolating activity with upper limbs (TSHELF-M). Ventilatory response and inspiratory capacity were evaluated. Results Baseline ventilatory variables were similar between groups (p>0.05). The ventilatory demand increased and the inspiratory capacity decreased significantly at the end of the tests in the COPD group. Ventilatory demand and DH were higher (p<0.05) in the TSHELF than in the TSHELF–M in the COPD group (p<0.05). There were no differences in DH between the three tests in the control group (p>0.05) and ventilatory demand increased at the end of the tests (p<0.05) but to a lower extent than the COPD group. Conclusion The TSHELF induces similar ventilatory responses to the Glittre-ADL test in COPD patients with higher ventilatory demand and DH. In contrast, the ventilatory response was attenuated in the TSHELF-M, suggesting that squatting and bending down during the Glittre-ADL test could trigger significant ventilatory overload. PMID:27333482

The evaluation of daily living activities, pressure sores and risk factors.

PubMed

Aydın, Gökçen; Mucuk, Salime

2015-01-01

This study was conducted to assess daily living activities, pressure sores and risk factors. This was a descriptive study. The study was conducted at a rehabilitation center with 188 individuals participating in the study. Data were collected with a questionnaire form, Activities of Daily Living Scale (ADLS), Instrumental Activities of Daily Living Scale (IADLS) and Braden Risk Assessment Scale (BRAS). Among the participants, 48.9% were dependent according to activities of daily living and 71.8% were dependent on instrumental activities of daily living. It was noted that 4.8% had pressure sores and 38.8% were at high risk. A strong and positive correlation was found among ADLS, IADLS, and BRAS scores (p < .001). Participants who had a low body mass index, had lived at the rehabilitation center for a long time, and were fed on regime 1 or 2, had a higher risk of developing pressure sores (p < .001). Individuals who were dependent according to ADLS and IADLS were at increased risk for the development of pressure sores. Individuals who are treated at rehabilitation centers should be periodically assessed in terms of risk. Pressure sore development can be prevented with appropriate nursing interventions. To reduce the risk of developing pressure sores, nurses should describe the individual's degree of dependency according to ADLS and IADLS and initiate preventive nursing care. © 2014 Association of Rehabilitation Nurses.

Measurement Equivalence in ADL and IADL Difficulty Across International Surveys of Aging: Findings From the HRS, SHARE, and ELSA

PubMed Central

Kasper, Judith D.; Brandt, Jason; Pezzin, Liliana E.

2012-01-01

Objective. To examine the measurement equivalence of items on disability across three international surveys of aging. Method. Data for persons aged 65 and older were drawn from the Health and Retirement Survey (HRS, n = 10,905), English Longitudinal Study of Aging (ELSA, n = 5,437), and Survey of Health, Ageing and Retirement in Europe (SHARE, n = 13,408). Differential item functioning (DIF) was assessed using item response theory (IRT) methods for activities of daily living (ADL) and instrumental activities of daily living (IADL) items. Results. HRS and SHARE exhibited measurement equivalence, but 6 of 11 items in ELSA demonstrated meaningful DIF. At the scale level, this item-level DIF affected scores reflecting greater disability. IRT methods also spread out score distributions and shifted scores higher (toward greater disability). Results for mean disability differences by demographic characteristics, using original and DIF-adjusted scores, were the same overall but differed for some subgroup comparisons involving ELSA. Discussion. Testing and adjusting for DIF is one means of minimizing measurement error in cross-national survey comparisons. IRT methods were used to evaluate potential measurement bias in disability comparisons across three international surveys of aging. The analysis also suggested DIF was mitigated for scales including both ADL and IADL and that summary indexes (counts of limitations) likely underestimate mean disability in these international populations. PMID:22156662

Greater Independence in Activities of Daily Living is Associated with Higher Health-Related Quality of Life Scores in Nursing Home Residents with Dementia

PubMed Central

Chan, Charice S.; Slaughter, Susan E.; Jones, C. Allyson; Wagg, Adrian S.

2015-01-01

Health-related quality of life (HRQL) for nursing home residents is important, however, the concept of quality of life is broad, encompasses many domains and is difficult to assess in people with dementia. Basic activities of daily living (ADL) are measured routinely in nursing homes using the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS) and Functional Independence Measure (FIM) instrument. We examined the relationship between HRQL and ADL to assess the future possibility of ADL dependency level serving as a surrogate measure of HRQL in residents with dementia. To assess ADL, measures derived from the RAI-MDS and FIM data were gathered for 111 residents at the beginning of our study and at 6-month follow-up. Higher scores for independence in ADL were correlated with higher scores for a disease-specific HRQL measure, the Quality of Life—Alzheimer’s Disease Scale. Preliminary evidence suggests that FIM-assessed ADL is associated with HRQL for these residents. The associations of the dressing and toileting items with HRQL were particularly strong. This finding suggests the importance of ADL function in HRQL. The RAI-MDS ADL scales should be used with caution to evaluate HRQL. PMID:27417776

Dependence for basic and instrumental activities of daily living after hip fractures.

PubMed

González-Zabaleta, Jorge; Pita-Fernandez, Salvador; Seoane-Pillado, Teresa; López-Calviño, Beatriz; Gonzalez-Zabaleta, Jose Luis

2015-01-01

The objective of the study is to determine basic activities of daily living (Barthel Index) and instrumental activities of daily living (Lawton-Brody Index) before and after hip fracture. Follow-up study of patients (n=100) with hip fracture, operated at Complejo Hospitalario Universitario de A Coruña (Spain). Period January/2009-December/2011. Demographic characteristic of the patients, Charlson Index, Glomerular filtration rate, Barthel index, Lawton index, type of proximal femur fracture and surgical treatment delay were recorded. Multivariate regression was performed. Informed patient consent and ethical review approval were obtained. Before fracture were independent for activities of daily living (ADL) a 38.0%, at 90 days were 15.4%. The Barthel index score decreased from 75.2±28.2 to 56.5±31.8) (p<0.0001). If we consider the age, gender, comorbidity (Charlson index), renal function, fracture type and surgical delay objectify the only independent variable to predict dependency effect is age. If we also consider the Barthel score objectify the variable that significantly modifies that score at 90 days is the baseline value of the index. The prevalence of independence for instrumental activities of daily living (IADL) at the baseline moment is 11% and at 90 days is decreased to 2.2%. There is a decrease in the independence effect in all activities. The variable predictor of independence for all activities after taking into consideration age, sex, comorbidity, fracture type, surgical delay and renal function is the baseline score of the Barthel and Lawton index. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Effects of tai chi on cognition and instrumental activities of daily living in community dwelling older people with mild cognitive impairment.

PubMed

Siu, Mei-Yi; Lee, Diana T F

2018-02-02

Cognitive impairment places older adults at high risk of functional disability in their daily-life activities, and thus affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong. The study adopted a multi-site nonequivalent control-group pretest-posttest design. 160 community-dwelling older people, aged ≥60, with MCI, from four community elderly centers participated in the study. The intervention group (IG, n = 80) received training in the Yang-style simple form of Tai Chi, at a frequency of two lessons per week for 16 weeks. Each lesson lasted for one hour. The control group (CG, n = 80) had no treatment regime and joined different recreational activity groups in community centers as usual within the study period. Outcome measures included measures of global cognitive status and IADL. The Chinese version of the Mini-Mental State Examination (CMMSE) was used for global cognitive assessment. The Hong Kong Chinese version of Lawton's Instrumental Activities of Daily Living (IADL-CV) was used to assess the participants' IADL levels. General Estimating Equations (GEE) was used to examine each of the outcome variables for the two groups at the two study time points (the baseline and at the end of the study). Meanwhile, minimum detectable change (MDC) was calculated to estimate the magnitude of changes required to eradicate the possibility of measurement error of outcome measures. Seventy four participants in the IG and 71 participants in the CG completed the study. With adjustments for differences in age, education, marital status and living conditions, the findings revealed that the participants in the IG scored significantly better on the CMMSE test (P = 0.001), and the instrumental ADL questionnaire (P = 0.004). However, those scores changes did not exceed the

Development of a Proxy-Free Objective Assessment Tool of Instrumental Activities of Daily Living in Mild Cognitive Impairment Using Smart Home Technologies.

PubMed

Jekel, Katrin; Damian, Marinella; Storf, Holger; Hausner, Lucrezia; Frölich, Lutz

2016-01-01

The assessment of activities of daily living (ADL) is essential for dementia diagnostics. Even in mild cognitive impairment (MCI), subtle deficits in instrumental ADL (IADL) may occur and signal a higher risk of conversion to dementia. Thus, sensitive and reliable ADL assessment tools are important. Smart homes equipped with sensor technology and video cameras may provide a proxy-free assessment tool for the detection of IADL deficits. The aim of this paper is to investigate the potential of a smart home environment for the assessment of IADL in MCI. The smart home consisted of a two-room flat equipped with activity sensors and video cameras. Participants with either MCI or healthy controls (HC) had to solve a standardized set of six tasks, e.g., meal preparation, telephone use, and finding objects in the flat. MCI participants needed more time (1384 versus 938 seconds, p <  0.001) and scored less total points (48 versus 57 points, p <  0.001) while solving the tasks than HC. Analyzing the subtasks, intergroup differences were observed for making a phone call, operating the television, and retrieving objects. MCI participants showed more searching and task-irrelevant behavior than HC. Task performance was correlated with cognitive status and IADL questionnaires but not with participants' age. This pilot study showed that smart home technologies offer the chance for an objective and ecologically valid assessment of IADL. It can be analyzed not only whether a task is successfully completed but also how it is completed. Future studies should concentrate on the development of automated detection of IADL deficits.

The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands

PubMed Central

Gobbens, Robbert J. J.; van Assen, Marcel A. L. M.

2014-01-01

Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N = 264, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability. PMID:24782894

Development of a Proxy-Free Objective Assessment Tool of Instrumental Activities of Daily Living in Mild Cognitive Impairment Using Smart Home Technologies

PubMed Central

Jekel, Katrin; Damian, Marinella; Storf, Holger; Hausner, Lucrezia; Frölich, Lutz

2016-01-01

Background: The assessment of activities of daily living (ADL) is essential for dementia diagnostics. Even in mild cognitive impairment (MCI), subtle deficits in instrumental ADL (IADL) may occur and signal a higher risk of conversion to dementia. Thus, sensitive and reliable ADL assessment tools are important. Smart homes equipped with sensor technology and video cameras may provide a proxy-free assessment tool for the detection of IADL deficits. Objective:The aim of this paper is to investigate the potential of a smart home environment for the assessment of IADL in MCI. Method: The smart home consisted of a two-room flat equipped with activity sensors and video cameras. Participants with either MCI or healthy controls (HC) had to solve a standardized set of six tasks, e.g., meal preparation, telephone use, and finding objects in the flat. Results: MCI participants needed more time (1384 versus 938 seconds, p <  0.001) and scored less total points (48 versus 57 points, p <  0.001) while solving the tasks than HC. Analyzing the subtasks, intergroup differences were observed for making a phone call, operating the television, and retrieving objects. MCI participants showed more searching and task-irrelevant behavior than HC. Task performance was correlated with cognitive status and IADL questionnaires but not with participants’ age. Conclusion: This pilot study showed that smart home technologies offer the chance for an objective and ecologically valid assessment of IADL. It can be analyzed not only whether a task is successfully completed but also how it is completed. Future studies should concentrate on the development of automated detection of IADL deficits. PMID:27031479

Six-month observational follow-up on activities of daily living in people with dementia living in nursing homes after a 6-month group based on either exercise or social activities.

PubMed

Maltais, Mathieu; Rolland, Yves; Haÿ, Paul-Emile; Armaingaud, Didier; Vellas, Bruno; de Souto Barreto, Philipe

2018-06-07

Studies have demonstrated changes in activities of daily living after an exercise intervention in people with dementia (PWD) living in nursing homes (NH). However, some discrepancies are shown during follow-up. Our objective was to measure activities of daily living (ADL) performance during a 6-month observational follow-up after a 6-month exercise or social activity intervention in PWD living in NH. After cluster randomisation, 91 PWD living in NH performed a 6-month structured exercise intervention (n = 44) or a social activity intervention (n = 47). After the intervention, 85 PWD were assessed for post-intervention follow-up. Instrumental and basic activities of daily living (IADL, ADL) were measured at 6-month observational follow-up after the intervention using the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory for Severe Alzheimer's Disease (ADCS-ADL-sev) scale (scores ranging from 0 to 51, higher is better). Compared to participants in the social activity, those who participated to the exercise intervention had a significant decrease of their ADCS-ADL-sev score (between-group adjusted mean difference: 4.6 points, p = 0.001) with IADL having the most decrease (2.8 points, p = 0.004). Unexpectedly, exercisers declined sharply in the performance of ADLs and IADLs, whereas participants in the social intervention group maintained their levels. The potential mechanisms to explain these findings remain still to be elucidated.

Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults

PubMed Central

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-01-01

Background Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Methods Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens’ clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. Results After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens’ clubs among males. Conclusions Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males. PMID:27180933

Association Between Social Participation and Instrumental Activities of Daily Living Among Community-Dwelling Older Adults.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2016-10-05

Population-based data examining the relationship between social participation (SP) and instrumental activities of daily living (IADL) are scarce. This study examined the cross-sectional relationship between SP and IADL in community-dwelling elderly persons. Self-administered questionnaires were mailed to 23 710 residents aged ≥65 years in Nara, Japan (response rate: 74.2%). Data from 14 956 respondents (6935 males and 8021 females) without dependency in basic activities of daily living (ADL) were analyzed. The number, type, and frequency of participation in social groups (SGs) were used to measure SP. SGs included volunteer groups, sports groups, hobby groups, senior citizens' clubs, neighborhood community associations, and cultural groups. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression models stratified by gender were used. After adjustment for putative confounding factors, including demographics, health status, life-style habits, ADL, depression, cognitive function, social networks, social support, and social roles, participation in various SGs among both genders was inversely associated with poor IADL, showing a significant dose-response relationship between an increasing number of SGs and a lower proportion of those with poor IADL (P for trend <0.001). A significant inverse association between frequent participation and poor IADL was observed for all types of SGs among females, whereas the association was limited to sports groups and senior citizens' clubs among males. Our results show that participation in a variety of SGs is associated with independent IADL among the community-dwelling elderly, regardless of gender. However, the beneficial effects of frequent participation on IADL may be stronger for females than for males.

A Process for the Representation of openEHR ADL Archetypes in OWL Ontologies.

PubMed

Porn, Alex Mateus; Peres, Leticia Mara; Didonet Del Fabro, Marcos

2015-01-01

ADL is a formal language to express archetypes, independent of standards or domain. However, its specification is not precise enough in relation to the specialization and semantic of archetypes, presenting difficulties in implementation and a few available tools. Archetypes may be implemented using other languages such as XML or OWL, increasing integration with Semantic Web tools. Exchanging and transforming data can be better implemented with semantics oriented models, for example using OWL which is a language to define and instantiate Web ontologies defined by W3C. OWL permits defining significant, detailed, precise and consistent distinctions among classes, properties and relations by the user, ensuring the consistency of knowledge than using ADL techniques. This paper presents a process of an openEHR ADL archetypes representation in OWL ontologies. This process consists of ADL archetypes conversion in OWL ontologies and validation of OWL resultant ontologies using the mutation test.

The Complex Association between Religious Activities and Functional Limitations in Older Adults

ERIC Educational Resources Information Center

Hybels, Celia F.; Blazer, Dan G.; George, Linda K.; Koenig, Harold G.

2012-01-01

Purpose of the Study: To examine the longitudinal associations between 3 dimensions of religious involvement--religious attendance, use of religious media, and private religious activities--and 3 domains of functional status--limitations in basic activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility in…

Ambient and smartphone sensor assisted ADL recognition in multi-inhabitant smart environments.

PubMed

Roy, Nirmalya; Misra, Archan; Cook, Diane

2016-02-01

Activity recognition in smart environments is an evolving research problem due to the advancement and proliferation of sensing, monitoring and actuation technologies to make it possible for large scale and real deployment. While activities in smart home are interleaved, complex and volatile; the number of inhabitants in the environment is also dynamic. A key challenge in designing robust smart home activity recognition approaches is to exploit the users' spatiotemporal behavior and location, focus on the availability of multitude of devices capable of providing different dimensions of information and fulfill the underpinning needs for scaling the system beyond a single user or a home environment. In this paper, we propose a hybrid approach for recognizing complex activities of daily living (ADL), that lie in between the two extremes of intensive use of body-worn sensors and the use of ambient sensors. Our approach harnesses the power of simple ambient sensors (e.g., motion sensors) to provide additional 'hidden' context (e.g., room-level location) of an individual, and then combines this context with smartphone-based sensing of micro-level postural/locomotive states. The major novelty is our focus on multi-inhabitant environments, where we show how the use of spatiotemporal constraints along with multitude of data sources can be used to significantly improve the accuracy and computational overhead of traditional activity recognition based approaches such as coupled-hidden Markov models. Experimental results on two separate smart home datasets demonstrate that this approach improves the accuracy of complex ADL classification by over 30 %, compared to pure smartphone-based solutions.

Ambient and smartphone sensor assisted ADL recognition in multi-inhabitant smart environments

PubMed Central

Misra, Archan; Cook, Diane

2016-01-01

Activity recognition in smart environments is an evolving research problem due to the advancement and proliferation of sensing, monitoring and actuation technologies to make it possible for large scale and real deployment. While activities in smart home are interleaved, complex and volatile; the number of inhabitants in the environment is also dynamic. A key challenge in designing robust smart home activity recognition approaches is to exploit the users' spatiotemporal behavior and location, focus on the availability of multitude of devices capable of providing different dimensions of information and fulfill the underpinning needs for scaling the system beyond a single user or a home environment. In this paper, we propose a hybrid approach for recognizing complex activities of daily living (ADL), that lie in between the two extremes of intensive use of body-worn sensors and the use of ambient sensors. Our approach harnesses the power of simple ambient sensors (e.g., motion sensors) to provide additional ‘hidden’ context (e.g., room-level location) of an individual, and then combines this context with smartphone-based sensing of micro-level postural/locomotive states. The major novelty is our focus on multi-inhabitant environments, where we show how the use of spatiotemporal constraints along with multitude of data sources can be used to significantly improve the accuracy and computational overhead of traditional activity recognition based approaches such as coupled-hidden Markov models. Experimental results on two separate smart home datasets demonstrate that this approach improves the accuracy of complex ADL classification by over 30 %, compared to pure smartphone-based solutions. PMID:27042240

Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients.

PubMed

Kim, Eun-Kyung; Lee, Dong-Kyu; Kim, Young-Mi

2015-01-01

[Purpose] This study investigated the effect of aquatic proprioceptive neuromuscular facilitation (PNF) patterns in the lower extremity on balance and activities of daily living (ADL) in stroke patients. [Subjects] Twenty poststroke participants were randomly assigned to an experimental group (n = 10) or a control group (n = 10). The experimental group performed lower extremity patterns in an aquatic environment, and the control group performed lower extremity patterns on the ground. Both exercises were conducted for 30 minutes/day, 5 days/week for 6 weeks. Balance was measured with the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Functional Reach Test (FRT), and One Leg Stand Test (OLST). Activities of daily living were measured with the Functional Independence Measure (FIM). A paired t-test was used to measure pre- and post-experiment differences, and an independent t-test was used to measure between-group differences. [Results] The experimental and control groups showed significant differences for all pre- and post-experiment variables. In the between-group comparison, the experimental group was significantly difference from the control group. [Conclusion] These results indicate that performing aquatic proprioceptive neuromuscular facilitation patterns in the lower extremity enhances balance and ADL in stroke patients.

Pictorial Playground-Based Physical Activity Assessment Instrument: Uses and Applications of the ADL-PP

ERIC Educational Resources Information Center

Sinclair, Christina; Babkes Stellino, Megan

2017-01-01

Comprehensive school physical activity programs (CSPAPs) are designed to support children in getting 60 minutes of daily physical activity, as well as meet SHAPE America's goal of developing physically literate individuals who have the knowledge, skills and confidence to be physically active for a lifetime. The Activities for Daily…

Respiratory constraints during activities in daily life and the impact on health status in patients with early-stage COPD: a cross-sectional study.

PubMed

van Helvoort, Hanneke Ac; Willems, Laura M; Dekhuijzen, Pn Richard; van Hees, Hieronymus Wh; Heijdra, Yvonne F

2016-10-13

In patients with chronic obstructive pulmonary disease (COPD), exercise capacity is reduced, resulting over time in physical inactivity and worsened health status. It is unknown whether ventilatory constraints occur during activities of daily life (ADL) in early stages of COPD. The aim of this study was to assess respiratory mechanics during ADL and to study its consequences on dyspnoea, physical activity and health status in early-stage COPD compared with healthy controls. In this cross-sectional study, 39 early-stage COPD patients (mean FEV 1 88±s.d. 12% predicted) and 20 controls performed 3 ADL: climbing stairs, vacuum cleaning and displacing groceries in a cupboard. Respiratory mechanics were measured during ADL. Physical activity was measured with accelerometry. Health status was assessed by the Nijmegen Clinical Screening Instrument. Compared with controls, COPD patients had greater ventilatory inefficiency and higher ventilatory requirements during ADL (P<0.05). Dyspnoea scores were increased in COPD compared with controls (P<0.001). During ADL, >50% of the patients developed dynamic hyperinflation in contrast to 10-35% of the controls. Higher dyspnoea was scored by patients with dynamic hyperinflation. Physical activity was low but comparable between both groups. From the patients, 55-84% experienced mild-to-severe problems in health status compared with 5-25% of the controls. Significant ventilatory constraints already occur in early-stage COPD patients during common ADL and result in increased dyspnoea. Physical activity level is not yet reduced, but many patients already experience limitations in health status. These findings reinforce the importance of early diagnosis of COPD and assessment of more than just spirometry.

The ADL Registry and CORDRA. Volume 1: General Overview

DTIC Science & Technology

2008-08-01

and problems encountered by others in related fields, such as library science , computer and network systems design, and publishing. As ADL...in and exist in isolated islands, limiting their visibility, access, and reuse. 4 Compared to publishing and library science , the learning

The tool in the brain: apraxia in ADL. Behavioral and neurological correlates of apraxia in daily living.

PubMed

Bieńkiewicz, Marta M N; Brandi, Marie-Luise; Goldenberg, Georg; Hughes, Charmayne M L; Hermsdörfer, Joachim

2014-01-01

Humans differ from other animals in the way they can skilfully and precisely operate or invent tools to facilitate their everyday life. Tools have dominated our home, travel and work environment, becoming an integral step for our motor skills development. What happens when the part of the brain responsible for tool use is damaged in our adult life due to a cerebrovascular accident? How does daily life change when we lose the previously mastered ability to make use of the objects around us? How do patients suffering from compromised tool use cope with food preparation, personal hygiene, grooming, housework, or use of home appliances? In this literature review we present a state of the art for single and multiple tool use research, with a focus on the impact that apraxia (impaired ability to perform tool-based actions) and action disorganization syndrome (ADS; impaired ability to carry out multi-step actions) have on activities of daily living (ADL). Firstly, we summarize the behavioral studies investigating the impact of apraxia and other comorbidity syndromes, such as neglect or visual extinction, on ADL. We discuss the hallmarks of the compromised tool use in terms of the sequencing of action steps, conceptual errors committed, spatial motor control, and temporal organization of the movement. In addition, we present an up-to-date overview of the neuroimaging and lesion analyses studies that provide an insight into neural correlates of tool use in the human brain and functional changes in the neural organization following a stroke, in the context of ADL. Finally we discuss the current practice in neurorehabilitation of ADL in apraxia and ADS aiming at increasing patients' independence.

Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients

PubMed Central

Kim, Eun-Kyung; Lee, Dong-Kyu; Kim, Young-Mi

2015-01-01

[Purpose] This study investigated the effect of aquatic proprioceptive neuromuscular facilitation (PNF) patterns in the lower extremity on balance and activities of daily living (ADL) in stroke patients. [Subjects] Twenty poststroke participants were randomly assigned to an experimental group (n = 10) or a control group (n = 10). The experimental group performed lower extremity patterns in an aquatic environment, and the control group performed lower extremity patterns on the ground. Both exercises were conducted for 30 minutes/day, 5 days/week for 6 weeks. Balance was measured with the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Functional Reach Test (FRT), and One Leg Stand Test (OLST). Activities of daily living were measured with the Functional Independence Measure (FIM). A paired t-test was used to measure pre- and post-experiment differences, and an independent t-test was used to measure between-group differences. [Results] The experimental and control groups showed significant differences for all pre- and post-experiment variables. In the between-group comparison, the experimental group was significantly difference from the control group. [Conclusion] These results indicate that performing aquatic proprioceptive neuromuscular facilitation patterns in the lower extremity enhances balance and ADL in stroke patients. PMID:25642076

Variation in the Gender Gap in Inactive and Active Life Expectancy by the Definition of Inactivity Among Older Adults.

PubMed

Malhotra, Rahul; Chan, Angelique; Ajay, Shweta; Ma, Stefan; Saito, Yasuhiko

2016-10-01

To assess variation in gender gap (female-male) in inactive life expectancy (IALE) and active life expectancy (ALE) by definition of inactivity. Inactivity, among older Singaporeans, was defined as follows: Scenario 1-health-related difficulty in activities of daily living (ADLs); Scenario 2-health-related difficulty in ADLs/instrumental ADLs (IADLs); Scenario 3-health-related difficulty in ADLs/IADLs or non-health-related non-performance of IADLs. Multistate life tables computed IALE and ALE at age 60, testing three hypotheses: In all scenarios, life expectancy, absolute and relative IALE, and absolute ALE are higher for females (Hypothesis 1 [H1]); gender gap in absolute and relative IALE expands, and in absolute ALE, it contracts in Scenario 2 versus 1 (Hypothesis 2 [H2]); gender gap in absolute and relative IALE decreases, and in absolute ALE, it increases in Scenario 3 versus 2 (Hypothesis 3 [H3]). H1 was supported in Scenarios 1 and 3 but not Scenario 2. Both H2 and H3 were supported. Definition of inactivity influences gender gap in IALE and ALE. © The Author(s) 2016.

Prevalence and predictors of healthcare utilization among older people (60+): focusing on ADL dependency and risk of depression.

PubMed

Sandberg, Magnus; Kristensson, Jimmie; Midlöv, Patrik; Fagerström, Cecilia; Jakobsson, Ulf

2012-01-01

The aim of this study was to investigate healthcare utilization patterns over a six-year period among older people (60+), classified as dependent/independent in Activities of Daily Living (ADL) and/or at/not at risk of depression and to identify healthcare utilization predictors. A sample (n=1402) comprising ten age cohorts aged between 60 and 96 years was drawn from the Swedish National study on Aging and Care (SNAC). Baseline data were collected between 2001 and 2003. Number and length of hospital stays were collected for six years after baseline year. Group differences and mean changes over time were investigated. Healthcare utilization predictors were explored using multiple linear regression analysis. The results revealed that 21-24% had at least one hospital stay in the six years after baseline, 29-37% among ADL dependent subjects and 24-33% among those at risk of depression. There was a significant increase of hospital stays in all groups over time. ADL-dependent subjects and those at risk of depression had significant more hospital stays, except for those at/not at risk of depression in years 2, 4 and 5. The healthcare utilization predictors 5-6 years after baseline were mainly age, previous healthcare utilization and various symptoms and, in 1-2 and 3-4 years after baseline, age, various diagnostic groups and various physical variables. Thus healthcare utilization patterns seem to be similar for the different groups, but it is difficult to find universal predictors. This suggests that different variables should be considered, including both ADL and psychosocial variables, when trying to identify future healthcare users. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Restrictions and satisfaction with participation in patients who are ADL-independent after an aneurysmal subarachnoid hemorrhage.

PubMed

Huenges Wajer, Irene M C; Visser-Meily, Johanna M A; Greebe, Paut; Post, Marcel W M; Rinkel, Gabriel J E; van Zandvoort, Martine J E

2017-03-01

Most survivors of an aneurysmal subarachnoid hemorrhage (aSAH) are ADL-independent, but they often experience restrictions in (social) activities and, therefore, cannot regain their pre-morbid level of participation. In this study, participation restrictions and participation satisfaction experienced after aSAH were assessed. Moreover, possible predictors of participation after aSAH were examined to identify goals for rehabilitation. Participation restrictions experienced by a series of 67 patients visiting our SAH outpatient clinic were assessed as part of standard clinical care using the Participation Restrictions and Satisfaction sections of the Utrecht Scale for Evaluation of Rehabilitation Participation (USER-Participation) 6 months after aSAH. Cognitive impairments, cognitive and emotional complaints, and symptoms of depression and anxiety, assessed 10 weeks after aSAH, were examined as possible predictors of participation by means of linear regression analysis. Although patients were ADL-independent, 64% reported one or more participation restrictions and 60% were dissatisfied in one or more participation domains. Most commonly experienced restrictions concerned housekeeping, chores in and around the house, and physical exercise. Dissatisfaction was most often reported about outdoor activities, mobility, and work/housekeeping. The main predictors of participation restrictions as well as satisfaction with participation were cognitive complaints (subjective) (β = -.30, p = .03 and β = -.40, p = .002, respectively) and anxiety (β = .32, p = .02 and β = -.34, p = .007, respectively). Almost two-thirds of the ADL-independent patients experienced problems of participation 6 months after aSAH. Cognitive complaints (subjective) and anxiety symptoms showed the strongest association with participation restrictions and satisfaction. Cognitive rehabilitation and anxiety-reducing interventions may help to optimize rehabilitation and increase

Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study.

PubMed

Björk, Sabine; Juthberg, Christina; Lindkvist, Marie; Wimo, Anders; Sandman, Per-Olof; Winblad, Bengt; Edvardsson, David

2016-08-22

Earlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay. Cross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test. The results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units. The prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and

Associations between results of post-stroke NDT-Bobath rehabilitation in gait parameters, ADL and hand functions.

PubMed

Mikołajewska, Emilia

2013-01-01

In patients after a stroke there are variable disorders. These patients often need rehabilitation in more than one area beceause of multiple limitations of the ability to perform everyday activities. The aim of the study was to assess correlations - statistical relationships between observed gait parameters, ADL and hand functions - results of rehabilitation of patients after ischaemic stroke according to the NDTBobath method for adults. The investigated group consisted of 60 patients after ischaemic stroke, who participated in the rehabilitation programme. 10 sessions of the NDT-Bobath therapy were provided in 2 weeks (10 days of the therapy). The calculation of correlations was made based on changes of parameters: Bobath Scale (to assess hand functions), Barthel Index (to assess ADL), gait velocity, cadence and stride lenght. Measurements were performed in every patient twice: on admission (before the therapy) and after last session of the therapy to assess rehabilitation effects. The main statistically relevant corellations observed in the study were as follows: in the whole group of patients: poor and moderate (negative) correlation between changes of gait parameters and Bobath Scale and Barthel Index, moderate and severe (negative) correlation between changes of gait parameters and Bobath Scale and Barthel Index in the group of women, correlation between changes in Bobath Scale and Barthel Index in the group of patients with left side of paresis, (negative) correlation between changes of gait parameters and Bobath Scale in group of patients younger than 68 years, moderate, high and very high correlations between changes in gait parameters in groups of women, men, younger than 68 years and older than 68 years. There have been observed statistically significant and favourable changes in the health status of patients, described by gait parameters, changes in hand functions and ADL. Based on the presented correlations there is an assumption that it is hard to

Alternate Communications Spectrum Study (ACSS) for Aviation Data Links (ADL)

NASA Technical Reports Server (NTRS)

Matolak, David W.

2003-01-01

The aim of the work was to identify the key factors involved in the use of alternate spectrum in various bands for a future integrated CNS data link. The study focused on systems and spectral bands that can deliver VDL-or-higher data rates in a two-way communication setting (including air-ground, ground-air, and air-air modes of operation), with multiple platforms (aircraft) operating in the same local environment. We begin with a review of the initial task list, and the final task list. The final task list contained a focus upon spectral availability and related systems that could be affected by the deployment of a new aviation data link (ADL) system. Most of this addresses the lower few layers of the communications protocol stack. A brief review of current related efforts in the aeronautical community is then provided, in which we describe several systems and programs of interest. Participation in some of these efforts is recommended. We also delineate several of the advantages and disadvantages of these system/efforts, in view of anticipated requirements of a new ADL. Desired attributes of a new ADL system are then discussed, and a connection with existing systems is made. The need to consider a wider set of alternative systems and technologies is described, and the beneficial aspects of a particular transmission technique- spread spectrum-are discussed. We then discuss in more detail several potential spectral regions, in terms of propagation conditions, available technology, spectrum availability, and waveform selection. Some comments on the need for standardization are also provided. We note that none of the existing systems described will likely meet the full range of desired features of a new ADL, but that several systems and spectral regions offer promise in terms of one or more characteristics. A system design and analysis approach is then provided. In this, we again focus on the lower few layers of the protocol stack, and aim to capture the main features

Effectiveness of Work, Activities of Daily Living, Education, and Sleep Interventions for People With Autism Spectrum Disorder: A Systematic Review.

PubMed

Weaver, Lindy L

2015-01-01

To examine interventions addressing work, activities of daily living (ADLs), instrumental activities of daily living (IADLs), education, and sleep for people with autism spectrum disorder. A total of 23 studies were identified, and 9 work-, 11 ADL/IADL-, and 3 education-related interventions were examined. No sleep studies were identified. Use of mobile and tablet technologies for vocational skills was supported. Support for ADL/IADL intervention is variable, with indications that Cognitive Orientation to Occupational Performance, sensory integration, and contextual interventions may increase occupational performance. Preliminary evidence suggests that daily yoga and brief exercise may improve classroom performance and behavior; group physical activities may assist with school readiness variables. Evidence for using technologies for IADLs was limited, as was evidence determining effective interventions for feeding and eating issues. Studies investigating interventions related to sleep are lacking. More studies are needed in all areas, presenting opportunities for the expansion of science-driven occupational therapy practice and research for people with ASD. Copyright © 2015 by the American Occupational Therapy Association, Inc.

The validity and reliability of the ADL-Glittre test for children.

PubMed

Martins, Renata; Assumpção, Maíra S de; Bobbio, Tatiana G; Mayer, Anamaria F; Schivinski, Camila

2018-04-16

The ADL-Glittre was created to assess more comprehensively the essential activities of daily living in adults with chronic obstructive pulmonary disease. The aim of this study was to validate the ADL-Glittre test adapted for children (TGlittre-P) and verify its reliability. This is a cross-sectional study with 87 healthy children aged 6 to 14 years (mean 10.36 ± 2.32 years). Biometric and spirometry data were collected from all participants. On the same day, part of the sample (36 children included in the validation process) performed two 6MWT and two TGlittre-P (30-minute interval between them). The other part of the sample just performed two TGlittre-P for the reliability process. Pearson and Spearman correlation tests were used to verify the correlation between the time spent on the TGlittre-P and the distance walked in the 6MWT. The intraclass correlation coefficient (ICC) was also used to assess the reproducibility of the TGlittre-P. The TGlittre-P showed a moderate negative correlation with the 6MWT (r = -0.490; p = 0.002; 95%CI -0.712 to -0.233). However, the behavior of the physiological variables that were monitored during the tests was similar and showed to be reproducible (ICC = 0.843; p = 0.000; 95%CI 0.695 to 0.911). The TGlittre-P proved to be a valid and reliable assessment of the functional capacity of healthy children aged 6 to 14 years.

The Impact of Leisure and Social Activities on Activities of Daily Living of Middle-Aged Adults: Evidence from a National Longitudinal Survey in Japan

PubMed Central

Monma, Takafumi; Takeda, Fumi; Noguchi, Haruko; Takahashi, Hideto; Tamiya, Nanako

2016-01-01

This study investigated the effects of leisure and social activities on the ability of middle-aged adults to maintain activities of daily living (ADL), and whether performing these activities alone or with others contributed to the ability to perform ADL. The study used nationally representative longitudinal data of 22,770 adults in Japan, aged 50–59 years, who did not have limitations in performing ADL at the beginning of the 5-year survey period. The study considered six activity categories: two leisure activities (“hobbies or cultural activities” and “exercise or sports”) and four social activities (“community events,” “support for children,” “support for elderly individuals,” and “other social activities”). Multiple logistic regression analysis was used to examine the relation between participation in these categories at baseline and difficulties in ADL at the 5-year follow-up. The association between the extent of social interaction during these activities (“by oneself,” “with others,” or “both”) and difficulties in ADL was also investigated. The analysis yielded significant negative correlations between “exercise or sports” and difficulties in ADL for both men and women, and between “hobbies or cultural activities” and difficulties in ADL for women. However, these significant relationships occurred only when activities were conducted “with others.” The present findings might help prevent deterioration in middle-aged adults’ performance of ADL in Japan. PMID:27788163

Predictors of a Change and Correlation in Activities of Daily Living after Hip Fracture in Elderly Patients in a Community Hospital in Poland: A Six-Month Prospective Cohort Study

PubMed Central

Ganczak, Maria; Chrobrowski, Krzysztof

2018-01-01

Objectives: The consequences of hip fractures (HFs) in elderly persons include a deterioration in functional capacity to perform activities that enable independent living. Since prior research into this issue in Central Europe is rather scant, this study sought to assess the change in activities and instrumental activities of daily living (ADL/IADL) after HF surgery among Polish patients, to study predictors of regaining pre-fracture functional status three and six months later, and to evaluate the correlation between ADL and IADL limitations over time. Methods: A prospective study was conducted between 2011 and 2013 in a tertiary hospital in Western Poland. ADL/IADL were evaluated using the Katz index and Lawton scale, respectively. Results: About half (50.8%) of 120 patients (mean age 80.1 ± SD 7.59) had cognitive impairment (CI). Patients with CI were older (p = 0.002) and had lower scores for pre-fracture ADL/IADL (p = 0.001 and p < 0.001, respectively). Six months after HF, 33.3% of patients failed to return to their pre-fracture ADL and 62.5% failed to return to pre-fracture IADL; 20% of those who could walk before HF were unable to walk after six months. The pre-fracture Spearman correlation coefficient between ADL and IADL summary scores was 0.46; it increased to 0.70 at three months after HF surgery and 0.77 at six months (p < 0.0001). Regaining ADL after six months was more likely in patients with pre-fracture intact intellectual function and independence in pre-fracture ADL; regaining IADL, in younger patients and those with higher pre-fracture IADL scores. Conclusions: Impairment in functional performance is common after HF surgery. ADL and IADL were strongly correlated in these patients, with this increasing over time. Functional outcomes after HF were more dependent on patient characteristics than treatment-related factors. Therefore, more emphasis should be directed towards the pre-fracture period and, in particular, maintaining cognitive function

Risk Factors for Nursing Home Placement in Alzheimer's Disease: A Longitudinal Study of Cognition, ADL, Service Utilization, and Cholinesterase Inhibitor Treatment

ERIC Educational Resources Information Center

Wattmo, Carina; Wallin, Asa K.; Londos, Elisabet; Minthon, Lennart

2011-01-01

Purpose of the Study: To identify risk factors for early nursing home placement (NHP) in Alzheimer's disease (AD), focusing on the impact of longitudinal change in cognition, activities of daily living (ADL), service utilization, and cholinesterase inhibitor treatment (ChEI). Design and Methods: In an open, 3-year, prospective, multicenter study…

[Development of an activity of daily living scale for patients with COPD: the Activity of Daily Living Dyspnea scale].

PubMed

Yoza, Yoshiyasu; Ariyoshi, Koya; Honda, Sumihisa; Taniguchi, Hiroyuki; Senjyu, Hideaki

2009-10-01

Patients with COPD often experience restriction in their activities of daily living (ADL) due to dyspnea. This type of restriction is unique to patients with COPD and cannot be adequately evaluated by the generic ADL scales. This study developed an ADL scale (the Activity of Daily Living Dyspnea scale [ADL-D scale]) for patients with COPD and investigated its validity and internal consistency. Patients with stable COPD were recruited and completed a pilot 26-item questionnaire. Patients also performed the Incremental Shuttle Walk Test (ISWT), and completed the St George's Respiratory Questionnaire (SGRQ), and Medical Research Council (MRC) dyspnea grade. There were 83 male participants who completed the pilot questionnaire. Following the pilot, 8 items that were not undertaken by the majority of subjects, and 3 items judged to be of low clinical importance by physical therapists were removed from the pilot questionnaire. The final ADL-D scale contained 15 items. Scores obtained with the ADL-D scale were significantly correlated with the MRC dyspnea grades, distance walked on the ISWT and SGRQ scores. The ADL-D scores were significantly different across the five grades of the MRC dyspnea grade. The ADL-D scale showed high consistency (Chronbach's alpha coefficient of 0.96). The ADL-D scale is a useful scale for assessing impairments in ADL in Japanese male patients with COPD.

The relationship between walking, manual dexterity, cognition and activity/participation in persons with multiple sclerosis.

PubMed

Kierkegaard, Marie; Einarsson, Ulrika; Gottberg, Kristina; von Koch, Lena; Holmqvist, Lotta Widén

2012-05-01

Multiple sclerosis has a vast impact on health, but the relationship between walking, manual dexterity, cognition and activity/participation is unclear. The specific aims were to explore the discriminative ability of measures of walking, manual dexterity and cognition, and to identify cut-off values in these measures, for prediction of independence in personal and instrumental activities of daily living (ADL) and activity/participation in social and lifestyle activities. Data from 164 persons with multiple sclerosis were collected during home visits with the following measures: the 2 × 5 m walk test, the Nine-hole Peg Test, the Symbol Digit Modalities Test, the Katz Personal and Instrumental ADL Indexes, and the Frenchay Activities Index (measuring frequency in social and lifestyle activities). The 2 × 5 m walk test and the Nine-hole Peg Test had high and better discriminative and predictive ability than the Symbol Digit Modalities Test. Cut-off values were identified. The accuracy of predictions was increased above all by combining the 2 × 5 m walk test and the Nine-hole Peg Test. The proposed cut-off values in the 2 × 5 m walk test and the Nine-hole Peg Test may be used as indicators of functioning and to identify persons risking activity limitations and participation restrictions. However, further studies are needed to confirm the usefulness in clinical practice.

Disability Measurement for Korean Community-Dwelling Adults With Stroke: Item-Level Psychometric Analysis of the Korean Longitudinal Study of Ageing

PubMed Central

2018-01-01

Objective To investigate the psychometric properties of the activities of daily living (ADL) instrument used in the analysis of Korean Longitudinal Study of Ageing (KLoSA) dataset. Methods A retrospective study was carried out involving 2006 KLoSA records of community-dwelling adults diagnosed with stroke. The ADL instrument used for the analysis of KLoSA included 17 items, which were analyzed using Rasch modeling to develop a robust outcome measure. The unidimensionality of the ADL instrument was examined based on confirmatory factor analysis with a one-factor model. Item-level psychometric analysis of the ADL instrument included fit statistics, internal consistency, precision, and the item difficulty hierarchy. Results The study sample included a total of 201 community-dwelling adults (1.5% of the Korean population with an age over 45 years; mean age=70.0 years, SD=9.7) having a history of stroke. The ADL instrument demonstrated unidimensional construct. Two misfit items, money management (mean square [MnSq]=1.56, standardized Z-statistics [ZSTD]=2.3) and phone use (MnSq=1.78, ZSTD=2.3) were removed from the analysis. The remaining 15 items demonstrated good item fit, high internal consistency (person reliability=0.91), and good precision (person strata=3.48). The instrument precisely estimated person measures within a wide range of theta (−4.75 logits < θ < 3.97 logits) and a reliability of 0.9, with a conceptual hierarchy of item difficulty. Conclusion The findings indicate that the 15 ADL items met Rasch expectations of unidimensionality and demonstrated good psychometric properties. It is proposed that the validated ADL instrument can be used as a primary outcome measure for assessing longitudinal disability trajectories in the Korean adult population and can be employed for comparative analysis of international disability across national aging studies. PMID:29765888

Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation

PubMed Central

Chien, Tsair-Wei; Wu, Hing-Man; Wang, Weng-Chung; Castillo, Roberto Vasquez; Chou, Willy

2009-01-01

Background The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT). Methods Based on an item bank of the Barthel Index (BI) and the Frenchay Activities Index (FAI) for assessing comprehensive activities of daily living (ADL) function in stroke patients, we developed a visual basic application (VBA)-Excel CAT module, and (1) investigated whether the averaged test length via CAT is shorter than that of the traditional all-item-answered non-adaptive testing (NAT) approach through simulation, (2) illustrated the CAT multimedia on a tablet PC showing data collection and response errors of ADL clinical functional measures in stroke patients, and (3) demonstrated the quality control of endorsing scale with fit statistics to detect responding errors, which will be further immediately reconfirmed by technicians once patient ends the CAT assessment. Results The results show that endorsed items could be shorter on CAT (M = 13.42) than on NAT (M = 23) at 41.64% efficiency in test length. However, averaged ability estimations reveal insignificant differences between CAT and NAT. Conclusion This study found that mobile nursing services, placed at the bedsides of patients could, through the programmed VBA-Excel CAT module, reduce the burden to patients and save time, more so than the traditional NAT paper-and-pencil testing appraisals. PMID:19416521

Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation.

PubMed

Chien, Tsair-Wei; Wu, Hing-Man; Wang, Weng-Chung; Castillo, Roberto Vasquez; Chou, Willy

2009-05-05

The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT). Based on an item bank of the Barthel Index (BI) and the Frenchay Activities Index (FAI) for assessing comprehensive activities of daily living (ADL) function in stroke patients, we developed a visual basic application (VBA)-Excel CAT module, and (1) investigated whether the averaged test length via CAT is shorter than that of the traditional all-item-answered non-adaptive testing (NAT) approach through simulation, (2) illustrated the CAT multimedia on a tablet PC showing data collection and response errors of ADL clinical functional measures in stroke patients, and (3) demonstrated the quality control of endorsing scale with fit statistics to detect responding errors, which will be further immediately reconfirmed by technicians once patient ends the CAT assessment. The results show that endorsed items could be shorter on CAT (M = 13.42) than on NAT (M = 23) at 41.64% efficiency in test length. However, averaged ability estimations reveal insignificant differences between CAT and NAT. This study found that mobile nursing services, placed at the bedsides of patients could, through the programmed VBA-Excel CAT module, reduce the burden to patients and save time, more so than the traditional NAT paper-and-pencil testing appraisals.

Linking Existing Instruments to Develop an Activity of Daily Living Item Bank.

PubMed

Li, Chih-Ying; Romero, Sergio; Bonilha, Heather S; Simpson, Kit N; Simpson, Annie N; Hong, Ickpyo; Velozo, Craig A

2018-03-01

This study examined dimensionality and item-level psychometric properties of an item bank measuring activities of daily living (ADL) across inpatient rehabilitation facilities and community living centers. Common person equating method was used in the retrospective veterans data set. This study examined dimensionality, model fit, local independence, and monotonicity using factor analyses and fit statistics, principal component analysis (PCA), and differential item functioning (DIF) using Rasch analysis. Following the elimination of invalid data, 371 veterans who completed both the Functional Independence Measure (FIM) and minimum data set (MDS) within 6 days were retained. The FIM-MDS item bank demonstrated good internal consistency (Cronbach's α = .98) and met three rating scale diagnostic criteria and three of the four model fit statistics (comparative fit index/Tucker-Lewis index = 0.98, root mean square error of approximation = 0.14, and standardized root mean residual = 0.07). PCA of Rasch residuals showed the item bank explained 94.2% variance. The item bank covered the range of θ from -1.50 to 1.26 (item), -3.57 to 4.21 (person) with person strata of 6.3. The findings indicated the ADL physical function item bank constructed from FIM and MDS measured a single latent trait with overall acceptable item-level psychometric properties, suggesting that it is an appropriate source for developing efficient test forms such as short forms and computerized adaptive tests.

Activities of daily living independence in Iranian blind war survivors: a cross sectional study, 2008.

PubMed

Amini, Reza; Sahaf, Robab; Kaldi, Alireza; Haghani, Hamid; Davatgaran, Keyvan; Masoumi, Mehdi; Hayatbakhsh, Reza; Rassafiani, Mehdi

2013-07-01

Assessment of activities of daily living (ADL) can be helpful for designing individualized rehabilitation programs for disabled individuals. Measuring and comparing the basic ADL (BADL) and instrumental ADL (IADL) independence between middle aged and senior Iranian blind war survivors (IBWS) was the aim of this study. This cross-sectional study assessed BADL and IADL of 312 blind war survivors, using the Barthel Index and the Lawton-Bordy scale. Data collection was carried out in a recreational event for the blind war survivors in Mashhad, Iran, 2008. The majority of the participants were male (99%), and more than 80% had multiple injuries. None of them were independent in all BADL and IADL. Older groups were more dependent in IADL such as telephone use, drug management, financial management, and BADL such as walking on uneven surfaces, bed/chair transfer and using stairs. The functional status and activities' level differences between those aged younger than 50 years and those aged older than 50 years were significant (P<0.05). In the present study, all the IBWS were dependent in at least one ADL. Multiple physical injuries could be one of the main reasons for the dependency in this group. IBWS aged older than 50 years were considerably more dependent in their BADL and IADL than the younger group. It appears that starting the fifth decade of age in IBWS might cause some considerable decrease in their function. Training and individualized rehabilitation programs are warranted. © 2012 Japan Geriatrics Society.

Structure design for a Two-DoF myoelectric prosthetic hand to realize basic hand functions in ADLs.

PubMed

Hoshigawa, Suguru; Jiang, Yinlai; Kato, Ryu; Morishita, Soichiro; Nakamura, Tatsuhiro; Yabuki, Yoshiko; Yokoi, Hiroshi

2015-01-01

Prosthetic hands are desired by those who have lost a hand or both hands not only for decoration but also for the functions to help them with their activities of daily living (ADL). Prosthetic robotic hands that are developed to fully realize the function of a human hand are usually too expensive to be economically available, difficult to operate and maintain, or over heavy for longtime wearing. The aim of this study is therefore to develop a simplified prosthetic hand (sim-PH), which is to be controlled by myoelectric signals from the user, to realize the most important grasp motions in ADL by trading off the cost and performance. This paper reports the structure design of a two-DoF sim-PH with two motors to drive the CM joint of the thumb and the interlocked MP joints of the other four fingers. In order to optimize the structure, the model of the sim-PH was proposed based on which 7 sim-PHs with different structural parameters were manufactured and tested in a pick-and-place experiment. Correspondence analysis of the experimental results clarified the relationship between the hand functions and the shapes of fingers.

Functional competency and cognitive ability in mild Alzheimer's disease: relationship between ADL assessed by a relative/ carer-rated scale and neuropsychological performance.

PubMed

Matsuda, Osamu; Saito, Masahiko

2005-06-01

Alzheimer's disease (AD) is characterized by multiple cognitive deficits and affects functional competency to perform daily activities (ADL). As this may contribute to the patient's overall disability, it is important to identify factors that compromise competency. The relationship between different cognitive domains and functional activities in AD was studied. The functional competency of 73 Japanese AD patients, most with mild dementia, was assessed using a 27-item relative/carer-rating scale covering 7 ADL: managing finances, using transportation, taking precautions, self-care, housekeeping, communication and taking medicine. Cognitive assessment used 16 neuropsychological tests from the Japanese version of the WAIS-R and COGNISTAT, covering 9 cognitive domains: orientation, attention, episodic memory, semantic memory, language, visuoperceptual and construction abilities, computational ability, abstract thinking, and psychomotor speed. Multiple regression analysis by the stepwise method indicated that functional competency could, for the most part, be predicted from test scores for orientation, abstract thinking and psychomotor speed. The results of this study suggest that impairment of these three cognitive domains plays an important role in the functional deterioration of AD.

Assessment of Activity of Daily Living among Older Adult Patients in Home Health Care and Skilled Nursing Facilities: An Integrative Review

PubMed Central

Osakwe, Zainab Toteh; Larson, Elaine; Agrawal, Mansi; Shang, Jinjing

2017-01-01

Older adult’s ability to self-manage illness is dependent on their ability to perform activities of daily living (ADL). Forty-five percent of those older than 65 years will have ongoing clinical needs after hospital discharge and require post-acute care (PAC) services in settings such as home health care (HHC) and skilled nursing facilities (SNF). The Improving Medicare Post-Acute Care Transformation Act (IMPACT) of 2014 requires PAC providers to begin collecting and reporting ADL data to build a coordinated approach to payment and standardize patient assessments and quality measurement. The aim of this integrative review was to compare the methods of assessing ADLs in HHC to SNF. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to ensure results were reported systematically. A scientific literature search without date restriction within the PubMed and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases was conducted. Two independent investigators assessed study quality using the quality appraisal instrument developed by Kmet and colleagues. Study quality ranged from 94.5% to 100%. Of the 18749 articles identified by the search, eight met inclusion criteria and four tools were identified that are used to assess ADLs in SNF and HHC. Although SNF and HHC collect similar ADL information, the range of content covered, item definitions, scoring, and psychometrics are not comparable across settings. PMID:28471793

The effect of premenstrual symptoms on activities of daily life.

PubMed

Dennerstein, Lorraine; Lehert, Philippe; Bäckström, Torbjörn Carl; Heinemann, Klaas

2010-08-01

To assess impact of premenstrual symptoms on activities of women's daily lives (ADL). Cross-sectional population-based survey. Market research company. A total of 4,085 women aged 14-50 years recruited by random telephone digit dialing in France, Germany, Hungary, Italy, Spain, the United Kingdom, Brazil, and Mexico. None. A telephone interview checklist of 23 premenstrual symptoms, sociodemographic and lifestyle variables, and ADL effects (global question and seven areas). Stepwise regression measured the effect of premenstrual symptoms and sociodemographic factors on ADL. Symptoms and symptom domains (physical and mental) had similar negative effects on ADL. Activities of daily life were predominantly affected by symptom severity. Income level, age, and country also significantly affected ADL. In all, 2,638 women (64.6%) were minimally affected in ADL, 981 (24%) were moderately affected, and 454 (11.1%) were severely affected. Both physical and mental premenstrual symptoms have significant impact on quality of life, assessed as ADL. Up to 35% of women of reproductive age in Europe and Latin America were moderately or severely affected in ADL by cyclical premenstrual symptoms. Copyright (c) 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The Glittre-ADL Test Cut-Off Point to Discriminate Abnormal Functional Capacity in Patients with COPD.

PubMed

Gulart, Aline Almeida; Munari, Anelise Bauer; Klein, Suelen Roberta; Santos da Silveira, Lucas; Mayer, Anamaria Fleig

2018-02-01

The study objective was to determine a cut-off point for the Glittre activities of daily living (ADL)test (TGlittre) to discriminate patients with normal and abnormal functional capacity. Fifty-nine patients with moderate to very severe COPD (45 males; 65 ± 8.84 years; BMI: 26 ± 4.78 kg/m 2 ; FEV 1 : 35.3 ± 13.4% pred) were evaluated for spirometry, TGlittre, 6-minute walk test (6 MWT), physical ADL, modified Medical Research Council scale (mMRC), BODE index, Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). The receiver operating characteristic (ROC) curve was used to determine the cut-off point for TGlittre in order to discriminate patients with 6 MWT < 82% pred. The ROC curve indicated a cut-off point of 3.5 minutes for the TGlittre (sensitivity = 92%, specificity = 83%, and area under the ROC curve = 0.95 [95% CI: 0.89-0.99]). Patients with abnormal functional capacity had higher mMRC (median difference 1 point), CAT (mean difference: 4.5 points), SGRQ (mean difference: 12.1 points), and BODE (1.37 points) scores, longer time of physical activity <1.5 metabolic equivalent of task (mean difference: 47.9 minutes) and in sitting position (mean difference: 59.4 minutes) and smaller number of steps (mean difference: 1,549 minutes); p < 0.05 for all. In conclusion, the cut-off point of 3.5 minutes in the TGlittre is sensitive and specific to distinguish COPD patients with abnormal and normal functional capacity.

Audio Development Laboratory (ADL) User Test Planning Guide

NASA Technical Reports Server (NTRS)

Romero, Andy

2012-01-01

Test process, milestones and inputs are unknowns to first-time users of the ADL. The User Test Planning Guide aids in establishing expectations for both NASA and non-NASA facility customers. The potential audience for this guide includes both internal and commercial spaceflight hardware/software developers. It is intended to assist their test engineering personnel in test planning and execution. Material covered includes a roadmap of the test process, roles and responsibilities of facility and user, major milestones, facility capabilities, and inputs required by the facility. Samples of deliverables, test article interfaces, and inputs necessary to define test scope, cost, and schedule are included as an appendix to the guide.

Ability of three motor measures to predict functional outcomes reported by stroke patients after rehabilitation.

PubMed

Li, Kuan-Yi; Lin, Keh-Chung; Wang, Tien-Ni; Wu, Ching-Yi; Huang, Yan-Hua; Ouyang, Pei

2012-01-01

This investigation examined the demographic characteristics along with 3 measures of motor function in determining outcomes in activities of daily living (ADL) after distributed constraint-induced therapy (dCIT). The study recruited 69 stroke patients who received 3 weeks of dCIT for 2 hours daily, 5 days a week. The self-reported outcome measures for daily function were the Motor Activity Log (MAL) including the amount of use (AOU) and quality of movement (QOM), Nottingham Extended Activities of Daily Living Questionnaire (NEADL), and the Stroke Impact Scale (SIS). Age, sex, onset, side of stroke, Fugl-Meyer assessment (FMA), Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT) were the potential predictors. The ARAT grasp-grip-pinch score was the most dominant predictor for MAL-AOU and NEADL (P< 0.05), and the ARAT total score for the subscore of the ADL/instrumental ADL section of the SIS (P< 0.05). The FMA wrist-hand score was a significant predictor for MAL-QOM (P< 0.05). Age was the only demographic factor that significantly predicted NEADL performance (P< 0.05). Among the 3 commonly used measures of motor function after stroke, ARAT was the strongest determinant in predicting MAL-AOU, MAL-QOM, and SIS-ADL/instrumental ADL after dCIT.

Both deterioration and improvement in activities of daily living are related to falls: a 6-year follow-up of the general elderly population study Good Aging in Skåne.

PubMed

Stenhagen, Magnus; Ekström, Henrik; Nordell, Eva; Elmståhl, Sölve

2014-01-01

To determine the relationship between long-term change in activities of daily living (ADL) and falls in the elderly and to identify characteristics of groups at risk for falls. This was a 6-year, prospective cohort study using data from the Good Aging in Skåne study in southern Sweden, involving 1,540 elderly subjects, including the oldest-old (age, 60-93 years). The subjects were recruited from the general population. ADL was measured at a baseline and follow-up assessment, using Sonn and Åsberg's revised scale and the ADL staircase. Falls were recorded in a period of 6 months before the follow-up assessment. The association between falls and change in ADL was calculated using adjusted, multiple logistic regression analysis and presented in odds ratios (ORs). Thirteen percent of the study population reported one or several falls in the measured period. Over the course of 6 years, one in four participants changed their ADL status, and parts of this category had an increased risk for falls compared with those who stayed independent in ADL or who had no change in the ADL staircase. Groups with different characteristics had a prominent risk for falls: those with a reduction of two to eight steps in the ADL staircase (OR, 4.05; 95% confidence interval [CI], 1.62-10.11) and those becoming independent from dependency in instrumental ADL (OR, 4.13; 95% CI, 1.89-9.00). The former group had advanced age with a greater burden of cognitive impairment, gait disability, arrhythmia, and fall risk medications. The latter group had a higher prevalence of ischemic heart disease and low walking speed. Both deterioration and improvement in ADL over the course of 6 years increased the risk for falls in a general elderly population. Interventional efforts may require different strategies, as groups with different characteristics were at risk. Those at risk with improved ADL function may have a history of sufficient burden of comorbidity combined with obtained mobility for exposure to

The Effects of the Green House Nursing Home Model on ADL Function Trajectory: A Retrospective Longitudinal Study

PubMed Central

YOON, Ju Young; BROWN, Roger L.; BOWERS, Barbara J.; SHARKEY, Siobhan S.; HORN, Susan D.

2015-01-01

Background Growing attention in the past few decades has focused on improving care quality and quality of life for nursing home residents. Many traditional nursing homes have attempted to transform themselves to become more homelike emphasizing individualized care. This trend is referred to as nursing home culture change in the U.S. A promising culture change nursing home model, the Green House (GH) nursing home model, has shown positive psychological outcomes. However, little is known about whether the GH nursing home model has positive effects on physical function compared to traditional nursing homes. Objectives To examine the longitudinal effects of the GH nursing home model by comparing change patterns of ADL function over time between GH home residents and traditional nursing home residents. Design A retrospective longitudinal study. Settings Four GH organizations (nine GH units and four traditional units). Participants A total of 242 residents (93 GH residents and 149 traditional home residents) who had stayed in the nursing home at least six months from admission. Methods The outcome was ADL function, and the main independent variable was the facility type in which the resident stayed: a GH or traditional unit. Age, gender, comorbidity score, cognitive function, and depressive symptoms at baseline were controlled. All of these measures were from a minimum dataset. Growth curve modeling and growth mixture modeling were employed in this study for longitudinal analyses. Results The mean ADL function showed deterioration over time, and the rates of deterioration between GH and traditional home residents were not different over time. Four different ADL function trajectories were identified for 18 months, but there was no statistical difference in the likelihood of being in one of the four trajectory classes between the two groups. Conclusions Although GH nursing homes are considered to represent an innovative model changing the nursing home environment into more

Racial and sex differences in associations between activities of daily living and cognition in community-dwelling older adults.

PubMed

Garrett, Stephanie L; Sawyer, Patricia; Kennedy, Richard E; McGuire, Dawn; Simon, Roger P; Strothers, Harry S; Allman, Richard M

2013-12-01

To examine the association between function measured according to activities of daily living (ADLs), instrumental activ1ities of daily living (IADLs), and cognition assessed according to Mini-Mental State Examination (MMSE) scores of older African-American and non-Hispanic white community-dwelling men and women. Cross-sectional study assessing associations between self-reported ADL and IADL difficulty and MMSE scores for race- and sex-specific groups. Homes of community-dwelling older adults. A random sample of 974 African-American and non-Hispanic white Medicare beneficiaries aged 65 and older living in west-central Alabama and participating in the University of Alabama at Birmingham Study of Aging, excluding those with reported diagnoses of dementia or with missing data. Function, based on self-reported difficulty in performing ADLs and IADLs, and cognition, using the MMSE. Multivariable linear regression models were used to test the association between function and cognition in race- and sex-specific groups after adjusting for covariates. Mini-Mental State Examination scores were modestly correlated with ADL and IADL difficulty in all four race- and sex-specific groups, with Pearson correlation coefficients ranging from −0.189 for non-Hispanic white women to −0.429 for African-American men. Correlations between MMSE and ADL or IADL difficulty in any of the race- and sex-specific groups were no longer significant after controlling for sociodemographic factors and comorbidities. Mini-Mental State Examination was not significantly associated with functional difficulty in older African-American and non-Hispanic white men and women after adjusting for sociodemographic factors and comorbidities, suggesting a mediating role in the relationship between cognition and function. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Toward real time detection of the basic living activity in home using a wearable sensor and smart home sensors.

PubMed

Bang, Sunlee; Kim, Minho; Song, Sa-Kwang; Park, Soo-Jun

2008-01-01

As the elderly people living alone are enormously increasing recently, we need the system inferring activities of daily living (ADL) for maintaining healthy life and recognizing emergency. The system should be constructed with sensors, which are used to associate with people's living while remaining as non intrusive views as possible. To do this, the proposed system use a triaxial accelerometer sensor and environment sensors indicating contact with subject in home. Particularly, in order to robustly infer ADLs, we present component ADL, which is decided with conjunction of human motion together, not just only contacted object identification. It is an important component in inferring ADL. In special, component ADL decision firstly refines misclassified initial activities, which improves the accuracy of recognizing ADL. Preliminary experiments results for proposed system provides overall recognition rate of over 97% over 8 component ADLs, which can be effectively applicable to recognize the final ADLs.

Quantifying kinematics of purposeful movements to real, imagined, or absent functional objects: implications for modelling trajectories for robot-assisted ADL tasks.

PubMed

Wisneski, Kimberly J; Johnson, Michelle J

2007-03-23

Robotic therapy is at the forefront of stroke rehabilitation. The Activities of Daily Living Exercise Robot (ADLER) was developed to improve carryover of gains after training by combining the benefits of Activities of Daily Living (ADL) training (motivation and functional task practice with real objects), with the benefits of robot mediated therapy (repeatability and reliability). In combining these two therapy techniques, we seek to develop a new model for trajectory generation that will support functional movements to real objects during robot training. We studied natural movements to real objects and report on how initial reaching movements are affected by real objects and how these movements deviate from the straight line paths predicted by the minimum jerk model, typically used to generate trajectories in robot training environments. We highlight key issues that to be considered in modelling natural trajectories. Movement data was collected as eight normal subjects completed ADLs such as drinking and eating. Three conditions were considered: object absent, imagined, and present. This data was compared to predicted trajectories generated from implementing the minimum jerk model. The deviations in both the plane of the table (XY) and the sagittal plane of torso (XZ) were examined for both reaches to a cup and to a spoon. Velocity profiles and curvature were also quantified for all trajectories. We hypothesized that movements performed with functional task constraints and objects would deviate from the minimum jerk trajectory model more than those performed under imaginary or object absent conditions. Trajectory deviations from the predicted minimum jerk model for these reaches were shown to depend on three variables: object presence, object orientation, and plane of movement. When subjects completed the cup reach their movements were more curved than for the spoon reach. The object present condition for the cup reach showed more curvature than in the object

A randomized cross-over controlled study on cognitive rehabilitation of instrumental activities of daily living in Alzheimer disease.

PubMed

Thivierge, Stéphanie; Jean, Léonie; Simard, Martine

2014-11-01

The goal of the study was to investigate the effectiveness of a memory rehabilitation program to re-learn instrumental activities of daily living (IADLs) in patients with Alzheimer disease (AD). This was a 6-month block-randomized cross-over controlled study. All evaluation and training sessions were performed at each patient's home. Twenty participants with mild to moderate AD. The trained IADL was chosen by the patient and his/her caregiver in order to target the patient's needs and interests. Participants were trained twice a week for 4 weeks with the errorless learning (ELL) and spaced retrieval (SR) cognitive techniques. After training, there were several follow-ups over a period of at least 3 months. Performance on the trained IADL was assessed by a Direct Measure of Training (DMT), an observational instrument adapted from a well-validated scale. General cognitive function, everyday memory functioning, quality of life, neuropsychiatric symptoms and ADL/IADL of patients, as well as the caregiver's burden were assessed as secondary outcomes. A statistical significant difference was found between the trained and untrained groups on the DMT immediately following the intervention. Improvements were maintained for a 3-month period. The training did not have effects on any other measures. The present study showed that it is possible for AD patients to relearn significant IADLs with the ELL and SR techniques and to maintain these gains during at least 3 months. The findings of this study emphasize the importance to design robust but individualized intervention tailored on patients' particular needs. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Both deterioration and improvement in activities of daily living are related to falls: a 6-year follow-up of the general elderly population study Good Aging in Skåne

PubMed Central

Stenhagen, Magnus; Ekström, Henrik; Nordell, Eva; Elmståhl, Sölve

2014-01-01

Objectives To determine the relationship between long-term change in activities of daily living (ADL) and falls in the elderly and to identify characteristics of groups at risk for falls. Methods This was a 6-year, prospective cohort study using data from the Good Aging in Skåne study in southern Sweden, involving 1,540 elderly subjects, including the oldest-old (age, 60–93 years). The subjects were recruited from the general population. ADL was measured at a baseline and follow-up assessment, using Sonn and Åsberg’s revised scale and the ADL staircase. Falls were recorded in a period of 6 months before the follow-up assessment. The association between falls and change in ADL was calculated using adjusted, multiple logistic regression analysis and presented in odds ratios (ORs). Results Thirteen percent of the study population reported one or several falls in the measured period. Over the course of 6 years, one in four participants changed their ADL status, and parts of this category had an increased risk for falls compared with those who stayed independent in ADL or who had no change in the ADL staircase. Groups with different characteristics had a prominent risk for falls: those with a reduction of two to eight steps in the ADL staircase (OR, 4.05; 95% confidence interval [CI], 1.62–10.11) and those becoming independent from dependency in instrumental ADL (OR, 4.13; 95% CI, 1.89–9.00). The former group had advanced age with a greater burden of cognitive impairment, gait disability, arrhythmia, and fall risk medications. The latter group had a higher prevalence of ischemic heart disease and low walking speed. Conclusion Both deterioration and improvement in ADL over the course of 6 years increased the risk for falls in a general elderly population. Interventional efforts may require different strategies, as groups with different characteristics were at risk. Those at risk with improved ADL function may have a history of sufficient burden of comorbidity

Instrument pre-development activities for FLEX

NASA Astrophysics Data System (ADS)

Pettinato, L.; Fossati, E.; Coppo, P. M.; Taiti, A.; Labate, D.; Capanni, A.; Taccola, M.; Bézy, J. L.; Francois, M.; Meynart, R.; Erdmann, L.; Triebel, P.

2017-09-01

The FLuorescence Imaging Spectrometer (FLORIS) is the payload of the FLuorescence Explorer Mission (FLEX) of the European Space Agency. The mission objective is to perform quantitative measurements of the solar induced vegetation fluorescence to monitor photosynthetic activity. FLORIS works in a push-broom configuration and it is designed to acquire data in the 500-780 nm spectral range, with a sampling of 0.1 nm in the oxygen bands (759-769 nm and 686- 697 nm) and 0.5-2.0 nm in the red edge, chlorophyll absorption and Photochemical Reflectance Index bands. FLEX will fly in formation with Sentinel-3 to benefit of the measurements made by the Sentinel-3 instruments OLCI and SLSTR, particularly for cloud screening, proper characterization of the atmospheric state and determination of the surface temperature. The instrument concept is based on a common telescope and two modified Offner spectrometers with reflective concave gratings both for the High Resolution (HR) and Low Resolution (LR) spectrometers. In the frame of the instrument pre-development Leonardo Company (I) has built and tested an elegant breadboard of the instrument consisting of the telescope and the HR spectrometer. The development of the LR spectrometer is in charge of OHB System AG (D) and is currently in the manufacturing phase. The main objectives of the activity are: anticipate the development of the instrument and provide early risk retirement of critical components, evaluate the system performances such as imaging quality parameters, straylight, ghost, polarization sensitivity and environmental influences, verify the adequacy of critical tests such as spectral characterization and straylight, define and optimize instrument alignment procedures. Following a brief overview of the FLEX mission, the paper will cover the design and the development of the optics breadboard with emphasis on the results obtained during the tests and the lessons learned for the flight unit.

Optimal Levels of All Major Cardiovascular Risk Factors in Younger Age and Functional Disability in Older Age: The Chicago Heart Association Detection Project in Industry 32-Year Follow-Up Health Survey.

PubMed

Vu, Thanh-Huyen T; Lloyd-Jones, Donald M; Liu, Kiang; Stamler, Jeremiah; Garside, Daniel B; Daviglus, Martha L

2016-07-01

The associations of optimal levels of all major cardiovascular disease risk factors, that is, low risk, in younger age with subsequent cardiovascular disease morbidity and mortality have been well documented. However, little is known about associations of low-risk profiles in younger age with functional disability in older age. The sample included 6014 participants from the Chicago Heart Association Detection Project in Industry Study. Low-risk status, defined as untreated systolic/diastolic blood pressure ≤120/≤80 mm Hg, untreated serum total cholesterol <5.18 mmol/l, not smoking, body mass index < 25 kg/m(2), and no diabetes mellitus, was assessed at baseline (1967 to 1973). Functional disability, categorized as (1) any disability in activities of daily living (ADLs), (2) any disability in instrumental ADLs but not in ADL, or (3) no disability, was assessed from the 2003 health survey. There were 39% women, 4% Black, with a mean age of 43 years and 6% low-risk status at baseline. After 32 years, 7% reported having limitations in performing any ADL and 11% in any instrumental ADL only. The prevalence of any ADL limitation was lowest in low-risk people and increased in a graded fashion with less-favorable risk factor groups (P trend <0.001). Compared with those with 2+ high-risk factors, the multivariable-adjusted odds of having any disability in ADLs versus no disability in people with low risk, any moderate risk, and 1 high-risk factor at baseline were lower by 58%, 48%, and 37%, respectively. Results were similar for instrumental ADLs, in both men and women. Having an optimal cardiovascular disease risk factor profile at younger age is associated with the lowest rate of functional disability in older age. © 2016 American Heart Association, Inc.

Cognitive impairment categorized in community-dwelling older adults with and without dementia using in-home sensors that recognise activities of daily living

NASA Astrophysics Data System (ADS)

Urwyler, Prabitha; Stucki, Reto; Rampa, Luca; Müri, René; Mosimann, Urs P.; Nef, Tobias

2017-02-01

Cognitive impairment due to dementia decreases functionality in Activities of Daily Living (ADL). Its assessment is useful to identify care needs, risks and monitor disease progression. This study investigates differences in ADL pattern-performance between dementia patients and healthy controls using unobtrusive sensors. Around 9,600 person-hours of activity data were collected from the home of ten dementia patients and ten healthy controls using a wireless-unobtrusive sensors and analysed to detect ADL. Recognised ADL were visualized using activity maps, the heterogeneity and accuracy to discriminate patients from healthy were analysed. Activity maps of dementia patients reveal unorganised behaviour patterns and heterogeneity differed significantly between the healthy and diseased. The discriminating accuracy increases with observation duration (0.95 for 20 days). Unobtrusive sensors quantify ADL-relevant behaviour, useful to uncover the effect of cognitive impairment, to quantify ADL-relevant changes in the course of dementia and to measure outcomes of anti-dementia treatments.

Are there cross-cultural differences of ADL ability in children measured with the Assessment of Motor and Process Skills (AMPS)?

PubMed

Peny-Dahlstrand, Marie; Gosman-Hedström, Gunilla; Krumlinde-Sundholm, Lena

2012-01-01

In many studies of self-care assessments for children, cultural differences in age-norm values have been shown. No study has evaluated whether there are cross-cultural differences in ADL motor and/or process skills in children when measured with the Assessment of Motor and Process Skills (AMPS). To investigate if there were systematic differences in ADL ability measured with the AMPS between children from the Nordic countries and North America and to evaluate the applicability of the existing international age-normative values for children from these two regions. Values from a total of 4 613 children, 3-15 years old, without known disabilities, from these geographical regions were compared with ANOVA. The difference in logits between each region and the mean values for each age group were calculated. No differences of relevance in age-related ADL ability measures between children from the two geographical regions were found, and the age-norm values are applicable to both regions. The AMPS may be considered free from cultural bias and useful in both clinical practice and research concerned with children in both the Nordic countries and North America.

Physical activity measurement instruments for children with cerebral palsy: a systematic review.

PubMed

Capio, Catherine M; Sit, Cindy H P; Abernethy, Bruce; Rotor, Esmerita R

2010-10-01

this paper is a systematic review of physical activity measurement instruments for field-based studies involving children with cerebral palsy (CP). database searches using PubMed Central, MEDLINE, CINAHL Plus, PsycINFO, EMBASE, Cochrane Library, and PEDro located 12 research papers, identifying seven instruments that met the inclusion criteria of (1) having been developed for children aged 0 to 18 years, (2) having been used to evaluate a physical activity dimension, and (3) having been used in a field-based study involving children with CP. The instruments reviewed were the Activities Scale for Kids - Performance version (ASKp), the Canada Fitness Survey, the Children's Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE/PAC), the Compendium of Physical Activities, the Physical Activity Questionnaire - Adolescents (PAQ-A), StepWatch, and the Uptimer. Second-round searches yielded 11 more papers, providing reliability and validity evidence for the instruments. the instruments measure physical activity frequency, mode, domain, and duration. Although most instruments demonstrated adequate reliability and validity, only the ASKp and CAPE/PAC have established reliability and validity for children with physical disabilities; the Uptimer has established concurrent validity. No instrument measuring intensity in free-living has been validated or found reliable for children with CP. the findings suggest that further studies are needed to examine the methodological properties of physical activity measurement in children with CP. Combining subjective and objective instruments is recommended to achieve better understanding of physical activity participation.

Energy Expended by Adults with and without Intellectual Disabilities during Activities of Daily Living

ERIC Educational Resources Information Center

Lante, Kerrie; Reece, John; Walkley, Jeff

2010-01-01

The aims of this study were to (1) determine the energy expenditure of adults with and without intellectual disabilities during common activities of daily living (ADL), (2) use these values to evaluate the accuracy of equivalent activity values reported in the Compendium of Physical Activities (CPA), and (3) identify ADL that may confer a health…

[The effects of hand acupuncture therapy on pain, ROM, ADL and depression among elders with low back pain and knee joint pain].

PubMed

Yang, Jin-Hyang

2009-02-01

The purpose of this study was to identify the effects of hand acupuncture therapy on pain, ROM, ADL, and depression among older people with low back pain and knee joint pain. The research was a quasi-experimental design using a non-equivalent control group pre-post test. The participants were 40 patients, 18 in the experimental group and 22 in the control group. A pretest and 2 posttest were conducted to measure the main variables. For the experimental group, hand acupuncture therapy, consisting of hand acupuncture and press-pellets based on corresponding points, was given. There were statistically significant differences in pain, ROM in knee joint, and ADL in the experimental group but not in depression compared to the control group over two different times. The hand acupuncture therapy was effective for low back pain, knee joint pain, ROM in knee joint and ADL among the elders in this study. Therefore, the hand acupuncture therapy can be utilized in the field of geriatric nursing as a nursing intervention for older people with low back pain and knee joint pain.

Barriers associated with reduced physical activity in COPD patients.

PubMed

Amorim, Priscila Batista; Stelmach, Rafael; Carvalho, Celso Ricardo Fernandes; Fernandes, Frederico Leon Arrabal; Carvalho-Pinto, Regina Maria; Cukier, Alberto

2014-10-01

To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score. In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

Barriers associated with reduced physical activity in COPD patients*

PubMed Central

Amorim, Priscila Batista; Stelmach, Rafael; Carvalho, Celso Ricardo Fernandes; Fernandes, Frederico Leon Arrabal; Carvalho-Pinto, Regina Maria; Cukier, Alberto

2014-01-01

OBJECTIVE: To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score. METHODS: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. RESULTS: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001), as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001). The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. CONCLUSIONS: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures. PMID:25410838

Informant Perceptions of the Cause of Activities of Daily Living Difficulties in Parkinson's Disease.

PubMed

Benge, Jared F; Balsis, Steve

2016-01-01

Individuals with Parkinson's disease (PD) can have difficulties with activities of daily living (ADL) that stem from cognitive, motor, or affective manifestations of the disease. Accurately attributing ADL difficulty specifically to cognitive decline is critical when conducting a neuropsychological evaluation of a person with PD. Informant description of ADL performance is frequently used for this purpose, but there has been little work assessing informants' ability to attribute ADL dysfunction to a specific symptom source in PD. Fifty community dwelling individuals with PD completed cognitive, motor, and affective measures. A knowledgeable informant completed an ADL scale that asked about degree and perceived source of difficulty (cognitive, motor, affective) for each task. Informants indicated that motor dysfunction was the most common source of ADL difficulty, but the informants viewed difficulty with certain tasks, such as financial management, as particularly related to cognitive dysfunction. Informant reports of the source of ADL dysfunction (cognitive, motor, affective) were consistent with clinical measures of those specific dysfunctions. ADL dysfunction attributed to cognition specifically (χ(2) = 9.80, p = .01) was higher in those with measurable cognitive impairment. Informant reports of the sources of ADL dysfunction correlate with clinical measures of these symptoms, suggesting that informants may provide useful clinical information about the cause of ADL dysfunction in persons with PD.

Comparisons of social interaction and activities of daily living between long-term care facility and community-dwelling stroke patients.

PubMed

Yoon, Jeong-Ae; Park, Se-Gwan; Roh, Hyo-Lyun

2015-10-01

[Purpose] This study was conducted to compare the correlation between social interaction and activities of daily living (ADL) between community-dwelling and long-term care facility stroke patients. [Subjects and Methods] The Subjects were 65 chronic stroke patients (32 facility-residing, 33 community-dwelling). The Evaluation Social Interaction (ESI) tool was used to evaluate social interaction and the Assessment of Motor and Process Skills (AMPS) measure was used to evaluate ADL. [Results] Both social interaction and ADL were higher in community-dwelling than facility-residing stroke patients. There was a correlation between ESI and ADL for both motor and process skills among facility-residing patients, while only ADL process skills and ESI correlated among community-dwelling patients. In a partial correlation analysis using ADL motor and process skills as control variables, only process skills correlated with ESI. [Conclusion] For rehabilitation of stroke patients, an extended treatment process that combines ADL and social activities is likely to be required. Furthermore, treatment programs and institutional systems that can improve social interaction and promote health maintenance for community-dwelling and facility-residing chronic stroke patients are needed throughout the rehabilitation process.

Low activated incore instrument

DOEpatents

Ekeroth, Douglas E.

1994-01-01

Instrumentation for nuclear reactor head-mounted incore instrumentation systems fabricated of low nuclear cross section materials (i.e., zirconium or titanium). The instrumentation emits less radiation than that fabricated of conventional materials.

Active Flow Control: Instrumentation Automation and Experimental Technique

NASA Technical Reports Server (NTRS)

Gimbert, N. Wes

1995-01-01

In investigating the potential of a new actuator for use in an active flow control system, several objectives had to be accomplished, the largest of which was the experimental setup. The work was conducted at the NASA Langley 20x28 Shear Flow Control Tunnel. The actuator named Thunder, is a high deflection piezo device recently developed at Langley Research Center. This research involved setting up the instrumentation, the lighting, the smoke, and the recording devices. The instrumentation was automated by means of a Power Macintosh running LabVIEW, a graphical instrumentation package developed by National Instruments. Routines were written to allow the tunnel conditions to be determined at a given instant at the push of a button. This included determination of tunnel pressures, speed, density, temperature, and viscosity. Other aspects of the experimental equipment included the set up of a CCD video camera with a video frame grabber, monitor, and VCR to capture the motion. A strobe light was used to highlight the smoke that was used to visualize the flow. Additional effort was put into creating a scale drawing of another tunnel on site and a limited literature search in the area of active flow control.

Effect of exercise on apparent total tract digestibility of nutrients and faecal recovery of ADL and TiO2 in ponies.

PubMed

Schaafstra, F J W C; van Doorn, D A; Schonewille, J T; Roelfsema, E; Westermann, C M; Dansen, O; Jacobs, M; Lee, J-Y; Spronck, E A; Blok, M C; Hendriks, W H

2018-03-07

Exercise and physical training are known to affect gastrointestinal function and digestibility in horses and can lead to inaccurate estimates of nutrient and energy digestibility when markers are used. The effect of exercise on apparent nutrient digestibility and faecal recoveries of ADL and TiO2 was studied in six Welsh pony geldings subjected to either a low- (LI) or high-intensity (HI) exercise regime according to a cross-over design. Ponies performing LI exercise were walked once per day for 45 min in a horse walker (5 km/h) for 47 consecutive days. Ponies submitted to HI exercise were gradually trained for the same 47 days according a standardized protocol. Throughout the experiment, the ponies received a fixed level of feed and the daily rations consisted of 4.7 kg DM of grass hay and 0.95 kg DM of concentrate. The diet was supplemented with minerals, vitamins and TiO2 (3.0 g Ti/day). Total tract digestibility of DM, organic matter (OM), CP, crude fat, NDF, ADF, starch, sugar and energy was determined with the total faeces collection (TFC) method. In addition, DM and OM digestibility was estimated using internal ADL and the externally supplemented Ti as markers. Urine was collected on the final 2 days of each experimental period. Exercise did not affect apparent digestibility of CP, crude fat, starch and sugar. Digestibility of DM (DMD), OM (OMD), ADF and NDF tended to be lower and DE was decreased when ponies received the HI exercise regime. For all treatments combined, mean faecal recoveries of ADL and Ti were 87.8±1.7% and 99.3±1.7%, respectively. Ti was not detected in the urine, indicating that intestinal integrity was maintained with exercise. Dry matter digestibility estimated with the TFC, ADL and Ti for ponies subjected to LI exercise were 66.3%, 60.3% and 64.8%, respectively, while DMD for HI ponies were 64.2%, 60.3% and 65.2%, respectively. In conclusion, physical exercise has an influence on the GE digestibility of the feed in ponies provided

[Association between Minamata disease status and activities of daily living among inhabitants in previously methylmercury-polluted areas].

PubMed

Ushijima, Kayo; Sung, Woncheol; Kawakita, Minoru; Mukai, Yoshito; Tamura, Kenji; Tanaka, Shiro; Tanaka, Mika; Maruyama, Sadami

2008-07-01

Minamata disease (MD), first discovered in 1956, is a neurological disorder caused by mercury poisoning due to daily intake of fish and shellfish that have been contaminated by methylmercury discharged from chemical factories. However, reports of ill health increased sharply following the 2004 Supreme Court ruling instructing the Japanese government to pay damages to MD patients. We examined the distribution of disability in activities of daily living (ADL), and the association between MD status in terms of compensation system and ADL disability among the general population of previously methylmercury-polluted areas. Data were collected by two-stage stratified sampling of residents 40-79 years old in 172 postal-code areas on the Shiranui Sea coast, the endemic area of MD. Questionnaires were distributed to eligible subjects (n = 2100) and collected at a later visit or by mail. Information on demographic factors, basic ADL (BADL), and instrumental ADL (IADL) was obtained using questionnaires. We performed logistic regression analysis to assess the relationship between MD status in terms of compensation system and ADL disability. We classified the 1422 residents who completed the questionnaire in accordance with their MD status in terms of compensation system: Early (those who received MD compensation before the Supreme Court decision), Recent (those who applied for compensation after the Supreme Court decision), Not Yet (those who have not yet applied for compensation, but have health-related anxieties about MD effects), and Normal (those who have not applied for compensation, and do not have health-related anxieties about MD effects). Adjusting for confounding factors, MD status was significantly associated with the disability grades of BADL and IADL with an increasing trend in the order of Normal, Not Yet, Recent, and Early. The odds ratios (95% CI) based on Normal were 2.08 (1.08-4.01), 3.87 (2.14-7.01), and 4.50 (2.66-7.61) for BADL and 2.41 (1.62-3.61), 3.20 (2

Low activated incore instrument

DOEpatents

Ekeroth, D.E.

1994-04-19

Instrumentation is described for nuclear reactor head-mounted incore instrumentation systems fabricated of low nuclear cross section materials (i.e., zirconium or titanium). The instrumentation emits less radiation than that fabricated of conventional materials. 9 figures.

Psychometric Evaluation of the Lower Extremity Computerized Adaptive Test, the Modified Harris Hip Score, and the Hip Outcome Score.

PubMed

Hung, Man; Hon, Shirley D; Cheng, Christine; Franklin, Jeremy D; Aoki, Stephen K; Anderson, Mike B; Kapron, Ashley L; Peters, Christopher L; Pelt, Christopher E

2014-12-01

The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood. To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision. Cohort study (diagnosis); Level of evidence, 2. Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index. All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good. The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior in all psychometric aspects examined in this study. Future

Psychometric Evaluation of the Lower Extremity Computerized Adaptive Test, the Modified Harris Hip Score, and the Hip Outcome Score

PubMed Central

Hung, Man; Hon, Shirley D.; Cheng, Christine; Franklin, Jeremy D.; Aoki, Stephen K.; Anderson, Mike B.; Kapron, Ashley L.; Peters, Christopher L.; Pelt, Christopher E.

2014-01-01

Background: The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood. Purpose: To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index. Results: All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good. Conclusion: The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior

Evaluation of An Activities of Daily Living Scale for Adolescents and Adults with Developmental Disabilities

PubMed Central

Maenner, Matthew J; Smith, Leann E; Hong, Jinkuk; Makuch, Renee; Greenberg, Jan S; Mailick, Marsha R

2012-01-01

Background Activity limitations are an important and useful dimension of disability, but there are few validated measures of activity limitations for adolescents and adults with developmental disabilities. Objective/Hypothesis To describe the development of the Waisman Activities of Daily Living (W-ADL) Scale for adolescents and adults with developmental disabilities, and systematically evaluate its measurement properties according to an established set of criteria. Methods The W-ADL was administered among four longitudinally-studied groups of adolescents and adults with developmental disabilities: 406 with autism; 147 with fragile-X syndrome; 169 with Down syndrome, and 292 with intellectual disability of other or unknown origin. The W-ADL contains 17 activities and each is rated on a 3-point scale (0=“does not do at all”, 1=“does with help”, 2=“independent”), and a standard set of criteria were used to evaluate its measurement properties. Results Across the disability groups, Cronbach’s alphas ranged from 0.88 to 0.94, and a single-factor structure was most parsimonious. The W-ADL was reliable over time, with weighted kappas between 0.92 and 0.93. Criterion and construct validity were supported through substantial associations with the Vineland Screener, need for respite services, caregiving burden, and competitive employment. No floor or ceiling effects were present. There were significant group differences in W-ADL scores by maternally-reported level of intellectual disability (mild, moderate, severe, profound). Conclusions The W-ADL exceeded the recommended threshold for each quality criterion the authors evaluated. This freely-available tool is an efficient measure of activities of daily living for surveys and epidemiological research concerning adolescents and adults with developmental disabilities. PMID:23260606

EGSE customization for the Euclid NISP Instrument AIV/AIT activities

NASA Astrophysics Data System (ADS)

Franceschi, E.; Trifoglio, M.; Gianotti, F.; Conforti, V.; Andersen, J. J.; Stephen, J. B.; Valenziano, L.; Auricchio, N.; Bulgarelli, A.; De Rosa, A.; Fioretti, V.; Maiorano, E.; Morgante, G.; Nicastro, L.; Sortino, F.; Zoli, A.; Balestra, A.; Bonino, D.; Bonoli, C.; Bortoletto, F.; Capobianco, V.; Corcione, L.; Dal Corso, F.; Debei, S.; Di Ferdinando, D.; Dusini, S.; Farinelli, R.; Fornari, F.; Giacomini, F.; Guizzo, G. P.; Laudisio, F.; Ligori, S.; Mauri, N.; Medinaceli, E.; Patrizii, L.; Sirignano, C.; Sirri, G.; Stanco, L.; Tenti, M.; Valieri, C.; Ventura, S.

2016-07-01

The Near Infrared Spectro-Photometer (NISP) on board the Euclid ESA mission will be developed and tested at various levels of integration by using various test equipment. The Electrical Ground Support Equipment (EGSE) shall be required to support the assembly, integration, verification and testing (AIV/AIT) and calibration activities at instrument level before delivery to ESA, and at satellite level, when the NISP instrument is mounted on the spacecraft. In the case of the Euclid mission this EGSE will be provided by ESA to NISP team, in the HW/SW framework called "CCS Lite", with a possible first usage already during the Warm Electronics (WE) AIV/AIT activities. In this paper we discuss how we will customize that "CCS Lite" as required to support both the WE and Instrument test activities. This customization will primarily involve building the NISP Mission Information Base (the CCS MIB tables) by gathering the relevant data from the instrument sub-units and validating these inputs through specific tools. Secondarily, it will imply developing a suitable set of test sequences, by using uTOPE (an extension to the TCL scripting language, included in the CCS framework), in order to implement the foreseen test procedures. In addition and in parallel, custom interfaces shall be set up between the CCS and the NI-IWS (the NISP Instrument Workstation, which will be in use at any level starting from the WE activities), and also between the CCS and the TCC (the Telescope Control and command Computer, to be only and specifically used during the instrument level tests).

Multitask protocols to evaluate activities of daily living performance in people with COPD: a systematic review.

PubMed

Paes, Thaís; Machado, Felipe Vilaça Cavallari; Cavalheri, Vinícius; Pitta, Fabio; Hernandes, Nidia Aparecida

2017-07-01

People with chronic obstructive pulmonary disease (COPD) present symptoms such as dyspnea and fatigue, which hinder their performance in activities of daily living (ADL). A few multitask protocols have been developed to assess ADL performance in this population, although measurement properties of such protocols were not yet systematically reviewed. Areas covered: Studies were included if an assessment of the ability to perform ADL was conducted in people with COPD using a (objective) performance-based protocol. The search was conducted in the following databases: Pubmed, EMBASE, Cochrane Library, PEDro, CINAHL and LILACS. Furthermore, hand searches were conducted. Expert commentary: Up to this moment, only three protocols had measurement properties described: the Glittre ADL Test, the Monitored Functional Task Evaluation and the Londrina ADL Protocol were shown to be valid and reliable whereas only the Glittre ADL Test was shown to be responsive to change after pulmonary rehabilitation. These protocols can be used in laboratory settings and clinical practice to evaluate ADL performance in people with COPD, although there is need for more in-depth information on their validity, reliability and especially responsiveness due to the growing interest in the accurate assessment of ADL performance in this population.

People with stroke living in the community: Attention deficits, balance, ADL ability and falls.

PubMed

Hyndman, D; Ashburn, A

2003-08-05

To describe levels of attention deficits among people with stroke living in the community and explore relationships between attention, balance, function and falls. Forty-eight mobile community-dwelling people with stroke (30 men, 18 women, mean age 68.4 +/- 11.2) were recruited to this cross-sectional investigation through General Practitioners. Twenty-six participants had a right, 21 a left hemisphere infarction and one had a brain stem lesion; mean time since stroke was 46 months (range five to 204). Participants' were interviewed about fall-events; attention, balance and function were assessed using standardised tests. Visual inattention was identified in five participants (10%), deficits of sustained attention in 15 (31%), auditory selective attention in nine (19%), visual selective attention in 17 (35%) and divided attention deficits in 21 participants (43%). Sustained and divided attention scores correlated with balance, ADL ability and fall-status (p < 0.01). The balance and function of subjects with normal attention were better than those with abnormal scores (p < 0.01). Analysis of variance revealed differences between repeat-fallers and non-fallers with no near-falls for divided attention, balance and ADL ability (p < 0.01). Attention deficits were common among this sample; sustained and divided attention deficits correlated with functional impairments and falls, highlighting that attention deficits might contribute to accident prone behaviour and falling.

AeroADL: applying the integration of the Suomi-NPP science algorithms with the Algorithm Development Library to the calibration and validation task

NASA Astrophysics Data System (ADS)

Houchin, J. S.

2014-09-01

A common problem for the off-line validation of the calibration algorithms and algorithm coefficients is being able to run science data through the exact same software used for on-line calibration of that data. The Joint Polar Satellite System (JPSS) program solved part of this problem by making the Algorithm Development Library (ADL) available, which allows the operational algorithm code to be compiled and run on a desktop Linux workstation using flat file input and output. However, this solved only part of the problem, as the toolkit and methods to initiate the processing of data through the algorithms were geared specifically toward the algorithm developer, not the calibration analyst. In algorithm development mode, a limited number of sets of test data are staged for the algorithm once, and then run through the algorithm over and over as the software is developed and debugged. In calibration analyst mode, we are continually running new data sets through the algorithm, which requires significant effort to stage each of those data sets for the algorithm without additional tools. AeroADL solves this second problem by providing a set of scripts that wrap the ADL tools, providing both efficient means to stage and process an input data set, to override static calibration coefficient look-up-tables (LUT) with experimental versions of those tables, and to manage a library containing multiple versions of each of the static LUT files in such a way that the correct set of LUTs required for each algorithm are automatically provided to the algorithm without analyst effort. Using AeroADL, The Aerospace Corporation's analyst team has demonstrated the ability to quickly and efficiently perform analysis tasks for both the VIIRS and OMPS sensors with minimal training on the software tools.

EASY-An Instrument for Surveillance of Physical Activity in Youth.

PubMed

Pate, Russell R; McIver, Kerry; Dowda, Marsha; Schenkelberg, Michaela A; Beets, Michael; DiStefano, Christine

2018-01-23

Physical activity (PA) promotion among youth is a public health priority and there is a need for robust surveillance systems to help support such initiatives. Existing youth PA self-report instruments that are used for surveillance lack information regarding the types and contexts of activity. Further, these instruments have limited validity with accelerometry. The purpose of the present study was to develop a self-report instrument, with sound psychometric properties, for monitoring compliance with PA guidelines in youth. In focus groups, 162 middle school students identified 30 forms of PA that are highly prevalent in that age group. We incorporated these activities into three preliminary forms of a self-report instrument. An independent sample of middle school students (n = 537) was randomly assigned to complete one of the three preliminary versions of the instrument. Rasch analysis was applied to the responses to the three formats, and a yes/no plus frequency format emerged as the preferred method. A third sample of 342 middle school students then completed the yes/no plus frequency instrument twice following a seven-day period during which they wore an accelerometer. Using both Rasch analysis and traditional correlational methods, validity and reliability of a 14-item instrument were established. Data were collected during 2012 - 2015. Spearman correlation coefficient for the association between the cumulative score for the 14 items and minutes per day of accelerometry-derived moderate-to-vigorous physical activity (MVPA) was 0.33 (95% CI 0.22, 0.43; p<.001). Sensitivity and specificity of the 14-item instrument was 0.90 and 0.44, respectively. The study produced a PA self-report instrument for youth that was found to be reliable (r=0.91), valid versus accelerometry (r=0.33), and acceptably specific and sensitive in detecting compliance with PA guidelines.This is an open-access article distributed under the terms of the Creative Commons Attribution

Differences in Activities of Daily Living Performance Between Long-Term Pediatric Sarcoma Survivors and a Matched Comparison Group on Standardized Testing

PubMed Central

Parks, Rebecca; Rasch, Elizabeth K.; Mansky, Patrick J.; Oakley, Frances

2009-01-01

BACKGROUND: In a cross-sectional study examining late effects of pediatric sarcoma therapy, long-term survivors were evaluated on their activities of daily living (ADL) performance. PROCEDURE: Thirty-two persons with Ewing sarcoma family of tumors, rhabdomyosarcoma, and non-rhabdomysarcoma-soft tissue sarcoma enrolled an average of 17 years after treatment. Participants were evaluated using the Assessment of Motor and Process Skills (AMPS) [1], a standardized observational evaluation of ADL task performance. Means and 95% confidence intervals for ADL motor and ADL process ability measures were calculated for four groups: 1) sarcoma survivors, 2) “well” adults matched for age and gender, 3) “well” adults matched for gender that were 10 years older; and 4) “well” adults matched for gender that were 20 years older. RESULTS: ADL motor ability was significantly lower for sarcoma survivors than for the age and gender matched comparison group (p<0.05). There was no significant difference between ADL motor ability of sarcoma survivors and the comparison group 10 years older, but sarcoma survivors had significantly better ADL motor ability (p<0.05) than the oldest comparison group (20 years older). Sarcoma survivors had significantly worse ADL process ability than the age matched group (p<0.05). There was no difference in ADL process ability between the sarcoma survivors and comparison groups that were 10 and 20 years older. CONCLUSIONS: This first report of a clinical evaluation of ADL limitation in pediatric sarcoma survivors treated with intensive multimodal cancer therapy suggests that influences on performance of daily life activities are more common than previously reported. PMID:19533662

The Planned Soil Moisture Active Passive (SMAP) Mission L-Band Radar/Radiometer Instrument

NASA Technical Reports Server (NTRS)

Spencer, Michael; Wheeler, Kevin; Chan, Samuel; Piepmeier, Jeffrey; Hudson, Derek; Medeiros, James

2011-01-01

The Soil Moisture Active/Passive (SMAP) mission is a NASA mission identified by the NRC 'decadal survey' to measure both soil moisture and freeze/thaw state from space. The mission will use both active radar and passive radiometer instruments at L-Band. In order to achieve a wide swath at sufficiently high resolution for both active and passive channels, an instrument architecture that uses a large rotating reflector is employed. The instrument system has completed the preliminary design review (PDR) stage, and detailed instrument design has begun. In addition to providing an overview of the instrument design, two recent design modifications are discussed: 1) The addition of active thermal control to the instrument spun side to provide a more stable, settable thermal environment for the radiometer electronics, and 2) A 'sequential transmit' strategy for the two radar polarization channels which allows a single high-power amplifier to be used.

Health Status and ADL Functioning of Older Persons with Intellectual Disability: Community Residence versus Residential Care Centers

ERIC Educational Resources Information Center

Lifshitz, Hefziba; Merrick, Joav; Morad, Mohammed

2008-01-01

The objective of the study was to study differences in aging phenomena among adults with intellectual disability (ID), who live in community residence versus their peers in residential care centers and to determine the contribution of health status, age, gender, etiology and level of ID to the decline in ADL function with age. Our study was based…

Activity of daily living for Morquio A syndrome.

PubMed

Yasuda, Eriko; Suzuki, Yasuyuki; Shimada, Tsutomu; Sawamoto, Kazuki; Mackenzie, William G; Theroux, Mary C; Pizarro, Christian; Xie, Li; Miller, Freeman; Rahman, Tariq; Kecskemethy, Heidi H; Nagao, Kyoko; Morlet, Thierry; Shaffer, Thomas H; Chinen, Yasutsugu; Yabe, Hiromasa; Tanaka, Akemi; Shintaku, Haruo; Orii, Kenji E; Orii, Koji O; Mason, Robert W; Montaño, Adriana M; Fukao, Toshiyuki; Orii, Tadao; Tomatsu, Shunji

2016-06-01

The aim of this study was to evaluate the activity of daily living (ADL) and surgical interventions in patients with mucopolysaccharidosis IVA (MPS IVA). The factor(s) that affect ADL are age, clinical phenotypes, surgical interventions, therapeutic effect, and body mass index. The ADL questionnaire comprises three domains: "Movement," "Movement with cognition," and "Cognition." Each domain has four subcategories rated on a 5-point scale based on the level of assistance. The questionnaire was collected from 145 healthy controls and 82 patients with MPS IVA. The patient cohort consisted of 63 severe and 17 attenuated phenotypes (2 were undefined); 4 patients treated with hematopoietic stem cell transplantation (HSCT), 33 patients treated with enzyme replacement therapy (ERT) for more than a year, and 45 untreated patients. MPS IVA patients show a decline in ADL scores after 10years of age. Patients with a severe phenotype have a lower ADL score than healthy control subjects, and lower scores than patients with an attenuated phenotype in domains of "Movement" and "Movement with cognition." Patients, who underwent HSCT and were followed up for over 10years, had higher ADL scores and fewer surgical interventions than untreated patients. ADL scores for ERT patients (2.5years follow-up on average) were similar with the-age-matched controls below 10years of age, but declined in older patients. Surgical frequency was higher for severe phenotypic patients than attenuated ones. Surgical frequency for patients treated with ERT was not decreased compared to untreated patients. In conclusion, we have shown the utility of the proposed ADL questionnaire and frequency of surgical interventions in patients with MPS IVA to evaluate the clinical severity and therapeutic efficacy compared with age-matched controls. Copyright © 2016. Published by Elsevier Inc.

Socially supportive activity inventory: reliability and validity of a social activity instrument for long-term care institutions.

PubMed

Hsu, Ya-Chuan

2011-09-01

: Diverse social and recreational activities in elder care institutions have been provided to enrich a person's mental well-being amidst what is a relatively monotonous life. However, few instruments that measure the social activities of long-term care residents are available. : This study was designed to develop a culturally sensitive instrument (Socially Supportive Activity Inventory, SSAI) to assess quantity and quality of social activities for long-term care institutions and validate the instrument's psychometric properties. : The SSAI was developed on the basis of the social support theory, a synthesis of literature, and Taiwanese cultural mores. The instrument was rigorously subjected to a two-stage process to evaluate its reliability and validity. In Stage 1, six experts from diverse backgrounds were recruited to evaluate instrument items and estimate the content validity of the instrument using a content validity questionnaire. Items were modified and refined on the basis of the responses of the expert panel and a set of criteria. After obtaining approval from a university institutional review board, in the second stage of evaluating test-retest reliability, a convenience sample of 10 Taiwanese institutionalized elders in a pilot study, recruited from a nursing home, completed the revised instrument at two separate times over 2 weeks. : Results showed a content validity of .96. Test-retest reliability from a sample of 10 participants yielded stability coefficients of .76-1.00. The stability coefficient was 1.00 for the component of frequency, .76-1.00 for the component of meaningfulness, and .78-1.00 for the component of enjoyment. : The SSAI is a highly relevant and reliable culturally based instrument that can measure social activity in long-term care facilities. Because of the pilot nature of this study, future directions include further exploration of the SSAI instrument's psychometric properties. This should be done by enlarging the sample size to

Retrieval cue and delay interval influence the relationship between prospective memory and activities of daily living in older adults.

PubMed

Tierney, Savanna M; Bucks, Romola S; Weinborn, Michael; Hodgson, Erica; Woods, Steven Paul

2016-01-01

Older adults commonly experience mild declines in everyday functioning and the strategic aspects of prospective memory (PM). This study used multiprocess theory to examine whether the strategic demands of retrieval cue type (event vs. time based) and delay interval length (2 vs. 15 min) influence the relationship between PM and activities of daily living (ADLs) in older adults. Participants included 97 community-dwelling older adults recruited from the Western Australia Participant Pool. Participants were administered the Memory for Intentions Screening Test (MIST) and Prospective and Retrospective Memory Questionnaire (PRMQ) as part of a larger neurocognitive assessment. A knowledgeable informant completed the Activities of Daily Living Questionnaire (ADLQ), from which a cutpoint of ≥ 1 was used to classify participants into "ADL normal" (n = 37) or "mild ADL problems" (n = 60) groups. Repeated measures multivariate analysis of variance (MANOVA) controlling for age was conducted with ADL group as the between-subjects factor and either MIST or PRMQ cue and delay scores as the within-subjects factors. We observed a significant ADL group by PM interaction on the MIST, with pair-wise analyses showing that the mild ADL problems group performed worse than ADL normal participants on the 15-min time-based scale (p < .001, Cohen's d = 0.71). No other MIST or PRMQ cue-delay variable differed between the two ADL groups (ps > .10). Findings indicate that decrements in strategically demanding cue monitoring and detection over longer PM delays may partly explain older adults' mild problems in everyday functioning. Findings may inform neuropsychological interventions aimed at maintaining ADL independence and enhancing quality of life in older adults.

Masticatory muscle activity assessment and reliability of a portable electromyographic instrument.

PubMed

Bowley, J F; Marx, D B

2001-03-01

Masticatory muscle hyperactivity is thought to produce muscle pain and tension headaches and can cause excessive wear or breakage of restorative dental materials used in the treatment of prosthodontic patients. The quantification and identification of this type of activity is an important consideration in the preoperative diagnosis and treatment planning phase of prosthodontic care. This study investigated the quantification process in complete denture/overdenture patients with natural mandibular tooth abutments and explored the reliability of instrumentation used to assess this parafunctional activity. The nocturnal EMG activity in asymptomatic complete denture/overdenture subjects was assessed with and without prostheses worn during sleep. Because of the large variance within and between subjects, the investigators evaluated the reliability of the 3 instruments used to test nocturnal EMG activity in the sample. Electromyographic activity data of denture/overdenture subjects revealed no differences between prostheses worn versus not worn during sleep but demonstrated a very large variance factor. Further investigation of the instrumentation demonstrated a consistent in vitro as well as in vivo reliability in controlled laboratory studies. The portable EMG instrumentation used in this study revealed a large, uncontrollable variance factor within and between subjects that greatly complicated the diagnosis of parafunctional activity in prosthodontic patients.

Functional range of motion of the hand joints in activities of the International Classification of Functioning, Disability and Health.

PubMed

Gracia-Ibáñez, Verónica; Vergara, Margarita; Sancho-Bru, Joaquín L; Mora, Marta C; Piqueras, Catalina

Cross-sectional research design. Active range of motion (AROM) is used as indicator of hand function. However, functional range of motion (FROM) data are limited, and fail to represent activities of daily living (ADL). To estimate dominant hand FROM in flexion, abduction and palmar arching in people under 50 years of age performing ADL. AROMs and hand postures in 24 representative ADL of the International Classification of Functioning, Disability and Health (ICF) were recorded in 12 men and 12 women. FROM data were reported by activity and ICF area, and compared with AROMs. The relationship between ROM measures to gender and hand size was analyzed by correlation. FROM was 5° to 28° less than available AROM depending on the joint and movement performed. Joints do not necessarily move through full AROM while performing ADL which has benefits in retaining function despite loss of motion. This may also suggest that ADL alone are insufficient to retain or restore full AROM. Therapists should consider FROM requirements and normal AROM when defining hand therapy goals, interventions and evaluating the success of treatment. N/A. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

A web-based non-intrusive ambient system to measure and classify activities of daily living.

PubMed

Stucki, Reto A; Urwyler, Prabitha; Rampa, Luca; Müri, René; Mosimann, Urs P; Nef, Tobias

2014-07-21

The number of older adults in the global population is increasing. This demographic shift leads to an increasing prevalence of age-associated disorders, such as Alzheimer's disease and other types of dementia. With the progression of the disease, the risk for institutional care increases, which contrasts with the desire of most patients to stay in their home environment. Despite doctors' and caregivers' awareness of the patient's cognitive status, they are often uncertain about its consequences on activities of daily living (ADL). To provide effective care, they need to know how patients cope with ADL, in particular, the estimation of risks associated with the cognitive decline. The occurrence, performance, and duration of different ADL are important indicators of functional ability. The patient's ability to cope with these activities is traditionally assessed with questionnaires, which has disadvantages (eg, lack of reliability and sensitivity). Several groups have proposed sensor-based systems to recognize and quantify these activities in the patient's home. Combined with Web technology, these systems can inform caregivers about their patients in real-time (e.g., via smartphone). We hypothesize that a non-intrusive system, which does not use body-mounted sensors, video-based imaging, and microphone recordings would be better suited for use in dementia patients. Since it does not require patient's attention and compliance, such a system might be well accepted by patients. We present a passive, Web-based, non-intrusive, assistive technology system that recognizes and classifies ADL. The components of this novel assistive technology system were wireless sensors distributed in every room of the participant's home and a central computer unit (CCU). The environmental data were acquired for 20 days (per participant) and then stored and processed on the CCU. In consultation with medical experts, eight ADL were classified. In this study, 10 healthy participants (6 women

Comparing Differences in ADL Outcomes for the STOMP Intervention for Dementia in the Natural Home Environment Versus a Clinic Environment.

PubMed

Ciro, C A; Poole, J L; Skipper, B; Hershey, L A

2014-01-01

Few studies have examined structured rehabilitation techniques for improving activities of daily living in people with mild-moderate dementia. We sought to examine the advantages to delivering the Skill-building through Task-Oriented Motor Practice (STOMP) intervention in the home environment (versus the clinic), hypothesizing that ADL improvement would be significantly better, time to meeting goals would be faster and fewer displays of behavior would be noted. Compared results of two quasi-experimental studies of STOMP, one completed in the home, one completed previously in a clinic. Participants were English-speaking; community dwelling adults aged 50-90 diagnosed with mild-moderate dementia who could participate in an intensive rehabilitation program (5 days/week, 3 hours/day, for 2 weeks). Outcome measurements include examiner-observation of performance and proxy-report of performance and satisfaction with performance in patient-selected goals. No differences existed in the sociodemographic characteristics between the home and clinic groups where the groups were primarily white, married, had > high school education and had mild-moderate dementia. Results from the home group indicate that participants made significant improvement in ADL which was generally retained at the 90 day follow-up. These results were not significantly different than the clinic group. No significant advantages were noted for the home group in terms of time to meeting goals or exhibition of fewer behaviors. The STOMP intervention appeared to work equally as well in the home and in the clinic. Future studies should continue to examine the benefits of massed practice using high-dose regimens.

Impact of Rehabilitation on Outcomes in Patients With Ischemic Stroke: A Nationwide Retrospective Cohort Study in Japan.

PubMed

Yagi, Maiko; Yasunaga, Hideo; Matsui, Hiroki; Morita, Kojiro; Fushimi, Kiyohide; Fujimoto, Masashi; Koyama, Teruyuki; Fujitani, Junko

2017-03-01

We aimed to examine the concurrent effects of timing and intensity of rehabilitation on improving activities of daily living (ADL) among patients with ischemic stroke. Using the Japanese Diagnosis Procedure Combination inpatient database, we retrospectively analyzed consecutive patients with ischemic stroke at admission who received rehabilitation (n=100 719) from April 2012 to March 2014. Early rehabilitation was defined as that starting within 3 days after admission. The average rehabilitation intensity per day was calculated as the total units of rehabilitation during hospitalization divided by the length of hospital stay. A multivariable logistic regression analysis with multiple imputation and an instrumental variable analysis were performed to examine the association of early and intensive rehabilitation with the proportion of improved ADL score. The proportion of improved ADL score was higher in the early and intensive rehabilitation group. The multivariable logistic regression analysis showed that significant improvements in ADL were observed for early rehabilitation (odds ratio: 1.08; 95% confidence interval: 1.04-1.13; P <0.01) and intensive rehabilitation of >5.0 U/d (odds ratio: 1.87; 95% confidence interval: 1.69-2.07; P <0.01). The instrumental variable analysis showed that an increased proportion of improved ADL was associated with early rehabilitation (risk difference: 2.8%; 95% confidence interval: 2.0-3.4%; P <0.001) and intensive rehabilitation (risk difference: 5.6%; 95% confidence interval: 4.6-6.6%; P <0.001). The present results suggested that early and intensive rehabilitation improved ADL during hospitalization in patients with ischemic stroke. © 2017 American Heart Association, Inc.

[A study of factors related to activities of daily living (ADL) of the elderly receiving in-home service longitudinal study using functional independence measures].

PubMed

Suzuki, Ikuko; Yanagi, Hisako; Tomura, Shigeo

2007-02-01

We conducted a longitudinal study using Functional Independence Measures to clarify factor related to independence of activities of daily living of elderly receiving in-home service under the long-term care insurance system Fifty-four elderly users of the in-home service of Ibaraki Prefecture assented to participate in this study and were analyzed. A researcher conducted survey at the baseline and after follow-up by visiting the elderly at each home. The evaluation standards used here were the Japanese version of Functional Independence Measure (FIM), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS-15). The FIM score (mean+/-SD) was decreased 83.6+/-36.4 to 81.7+/-37.4 during the 112+/-22.2 day follow up period. Thirty-nine elderly demonstrated improvement or no change in FIM and 15 had declining scores. To clarify independent factors related to FIM change, we conducted a step-wise multifactor logistic regression analysis, and the results suggested importance for "in-home service availability" and "home care period less than one year". Our study suggested that it is important for maintenance or improvement of ADL in home care elderly to provide sufficient home .care services from the beginning under the long-term care insurance system.

Effects of interactive metronome training on upper extremity function, ADL and QOL in stroke patients.

PubMed

Yu, Ga-Hui; Lee, Jae-Shin; Kim, Su-Kyoung; Cha, Tae-Hyun

2017-01-01

Rhythm and timing training is stimulation that substitutes for a damaged function controls muscular movement or temporal element, which has positive impacts on the neurological aspect and movement of the brain. This study is to assess the changes caused by rhythm and timing training using an interactive metronome (IM) on upper extremity function, ADL and QOL in stroke patients. In order to assess the effects of IM training, a group experiment was conducted on 30 stroke patients. Twelve sessions of IM training were provided for the experimental group three times a week for four weeks, while the control group was trained with a Bilateral arm Self-Exercise (BSE) for the same period. Both groups were evaluated by pre- and post-tests through MFT, MAL, K-MBI and SS-QOL. There were more statistically significant differences (<0.05) in the total score of MFT and the finger control item in the IM Group than in the BSE Group. With respect to ADL, there were more statistically significant differences (<0.05) in the total score of K-MBI and the dressing item in the IM Group than in the BSE Group. The study proposes that IM training can be applied as an occupational therapy program in patients with various diseases who need to adjust the time for performing movements as well as stroke patients.

[An approach to ADL expansion for home pediatric patient with artificial respirator].

PubMed

Ogasawara, Yasuko

2010-12-01

A home pediatric patient with artificial respirator has little chance to go out. The primary reasons are as follows: (1) Lack of experience in controlling the situation by the family when artificial respirator related troubles occur. (2) Whenever the patient wants to go out, no caregiver is available for assistance. (3) Going-out is just a psychological burden for the patient and family. (4) Availability of receiving institutions for a patient who needs an emergency care. Hence, a caregiver should improve not only the patient's ADL but also establishes a system that provides a satisfactory care for the patient and family. In doing so, the caregiver's role is important more than ever.

[Integrated health information system based on Resident Assessment Instruments].

PubMed

Frijters, D; Achterberg, W; Hirdes, J P; Fries, B E; Morris, J N; Steel, K

2001-02-01

The paper explores the meaning of Resident Assessment Instruments. It gives a summary of existing RAI instruments and derived applications. It argues how all of these form the basis for an integrated health information system for "chain care" (home care, home for the elderly care, nursing home care, mental health care and acute care). The primary application of RAI systems is the assessment of client care needs, followed by an analysis of the required and administered care with the objective to make an optimal individual care plan. On the basis of RAI, however, applications have been derived for reimbursement systems, quality improvement programs, accreditation, benchmarking, best practice comparison and care eligibility systems. These applications have become possible by the development on the basis of the Minimum Data Set of RAI of outcome measures (item scores, scales and indices), case-mix classifications and quality indicators. To illustrate the possibilities of outcome measures of RAI we present a table and a figure with data of six Dutch nursing homes which shows how social engagement is related to ADL and cognition. We argue that RAI/MDS assessment instruments comprise an integrated health information system because they have consistent terminology, common core items, and a common conceptual basis in a clinical approach that emphasizes the identification of functional problems.

How Do People With COPD Value Different Activities? An Adapted Meta-Ethnography of Qualitative Research.

PubMed

Lindenmeyer, Antje; Greenfield, Sheila M; Greenfield, Charlotte; Jolly, Kate

2017-01-01

Chronic Obstructive Pulmonary Disease (COPD) is a long-term condition where activities of daily living (ADLs) may be very restricted; people with COPD need to prioritize what is important to them. We conducted a meta-ethnography to understand which ADLs are valued and why, systematically searching for articles including experiences of ADLs and organizing themes from the articles into five linked concepts: (a) caring for the body, (b) caring for the personal environment, (c) moving between spaces, (d) interacting with others, and (e) selfhood across time. In addition, we identified three key aspects of personal integrity: effectiveness, connectedness, and control. We found that ADLs were valued if they increased integrity; however, this process was also informed by gendered roles and social values. People whose sense of control depended on effectiveness often found accepting help very difficult to bear; therefore, redefining control as situational and relational may help enjoyment of activities that are possible. © The Author(s) 2016.

Activity restriction induced by fear of falling and objective and subjective measures of physical function: a prospective cohort study.

PubMed

Deshpande, Nandini; Metter, E Jeffrey; Lauretani, Fulvio; Bandinelli, Stefania; Guralnik, Jack; Ferrucci, Luigi

2008-04-01

To examine whether activity restriction specifically induced by fear of falling (FF) contributes to greater risk of disability and decline in physical function. Prospective cohort study. Population-based older cohort. Six hundred seventy-three community-living elderly (> or = 65) participants in the Invecchiare in Chianti Study who reported FF. FF, fear-induced activity restriction, cognition, depressive symptoms, comorbidities, smoking history, and demographic factors were assessed at baseline. Disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) and performance on the Short Performance Physical Battery (SPPB) were evaluated at baseline and at the 3-year follow-up. One-quarter (25.5%) of participants did not report any activity restriction, 59.6% reported moderate activity restriction (restriction or avoidance of < 3 activities), and 14.9% reported severe activity restriction (restriction or avoidance of > or = 3 activities). The severe restriction group reported significantly higher IADL disability and worse SPPB scores than the no restriction and moderate restriction groups. Severe activity restriction was a significant independent predictor of worsening ADL disability and accelerated decline in lower extremity performance on SPPB over the 3-year follow-up. Severe and moderate activity restriction were independent predictors of worsening IADL disability. Results were consistent even after adjusting for multiple potential confounders. In an elderly population, activity restriction associated with FF is an independent predictor of decline in physical function. Future intervention studies in geriatric preventive care should directly address risk factors associated with FF and activity restriction to substantiate long-term effects on physical abilities and autonomy of older persons.

Family caregivers' experience of activities of daily living handling in older adult with stroke: a qualitative research in the Iranian context.

PubMed

Hesamzadeh, Ali; Dalvandi, Asghar; Bagher Maddah, Sadat; Fallahi Khoshknab, Masoud; Ahmadi, Fazlollah; Mosavi Arfa, Nazila

2017-09-01

Patients with stroke require additional support from family to live independently in the area of activities of daily living. Family members are usually the main caregivers of stroke patients. Comprehensive explanation of ADL handling from family caregivers' view is lacking. This study explores and describes family caregivers' experiences about the strategies to handle activities of daily living (ADL) dependency of elderly patient with stroke in the Iranian context. A qualitative content analysis approach was conducted to analyse data. Nineteen family caregivers participated in the study from multiple physiotherapy clinics of physiotherapy in Sari (Iran) between September 2013 and May 2014. Data were generated through in-depth interviews, and content analysis method was used to analyse the data and determine themes. The findings show that family caregivers manage the ADL dependency of their elderly stroke patients through seven strategies including encouraging physical movements, providing personal hygiene, nutritional consideration, facilitating religious activities, filling leisure time, and facilitating transfer and assisting in financial issues. Family has an important role in handling of elderly stroke patients' ADL dependency. Health practitioners can take benefit from the findings to help the stroke families play more active role in the handling ADL dependency of their patients after stroke. © 2016 Nordic College of Caring Science.

The relationship between sarcopenia,undernutrition, physical mobility and basic activities of daily living in a group of elderly women of Mexico City.

PubMed

Velázquez Alva, María del Consuelo; Irigoyen Camacho, Maria Esther; Delgadillo Velázquez, Jaime; Lazarevich, Irina

2013-01-01

Sarcopenia is a geriatric syndrome, which affects the functional status and mobility of individuals. To identify the prevalence of sarcopenia and undernutrition, and to assess the association between sarcopenia and mobility, and sarcopenia and basic activities of daily living (ADL) in a group of elderly women. A cross-sectional study was performed in patients attending a geriatric service at a government hospital in Mexico City. Sarcopenia was identified applying Baumgartner's equation by obtaining skeletal muscle mass index (SMI) and undernutrition was diagnosed using mini-nutritional assessment instrument (MNA). The SENECA questionnaire and Katz index were used to evaluate mobility and ADL, respectively. lineal regression models were constructed fitting SMI as a dependent variable and SENECA, and ADL scores as independent variables, adjusted for age. 90 women with a mean age of 78.2 (± 6.8) were studied. Undernutrition was identified in 15.5% of the patients. The prevalence of sarcopenia was 41.1%. Patients with sarcopenia presented a high prevalence of undernutrition (p < 0.001). Sarcopenia was associated with difficulty in climbing stairs (OR = 2.63, p = 0.03), adjusted for age. The mobility score was associated with sarcopenia, in the group without sarcopenia the mean score was 16.3, and with sarcopenia it was 18.3, (p = 0.04). Regarding ADL, 64.9% of the patients with intermediate independence and dependence had sarcopenia, while 35.1% with total independence presented sarcopenia (p < 0.001). The elder women with sarcopenia had a higher prevalence of undernutrition. Sarcopenia was associated with difficulties in mobility, particularly difficulties in climbing stairs. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

Normal functional range of motion of the cervical spine during 15 activities of daily living.

PubMed

Bible, Jesse E; Biswas, Debdut; Miller, Christopher P; Whang, Peter G; Grauer, Jonathan N

2010-02-01

Prospective clinical study. The purpose of this investigation was to quantify normal cervical range of motion (ROM) and compare these results to those used to perform 15 simulated activities of daily living (ADLs) in asymptomatic subjects. Previous studies looking at cervical ROM during ADLs have been limited and used measuring devices that do not record continuous motion. The purpose of this investigation was to quantify normal cervical ROM and compare these results with those used to perform 15 simulated ADLs in asymptomatic subjects. A noninvasive electrogoniometer and torsiometer were used to measure the ROM of the cervical spine. The accuracy and reliability of the devices were confirmed by comparing the ROM values acquired from dynamic flexion/extension and lateral bending radiographs to those provided by the device, which was activated while the radiographs were obtained. Intraobserver reliability was established by calculating the intraclass correlation coefficient for repeated measurements on the same subjects by 1 investigator on consecutive days. These tools were employed in a clinical laboratory setting to evaluate the full active ROM of the cervical spines (ie, flexion/extension, lateral bending, and axial rotation) of 60 asymptomatic subjects (30 females and 30 males; age, 20 to 75 y) as well as to assess the functional ROM required to complete 15 simulated ADLs. When compared with radiographic measurements, the electrogoniometer was found to be accurate within 2.3+/-2.2 degrees (mean+/-SD) and the intraobserver reliabilities for measuring the full active and functional ROM were both excellent (intraclass correlation coefficient of 0.96 and 0.92, respectively). The absolute ROM and percentage of full active cervical spinal ROM used during the 15 ADLs was 13 to 32 degrees and 15% to 32% (median, 20 degrees/19%) for flexion/extension, 9 to 21 degrees and 11% to 27% (14 degrees/18%) for lateral bending, and 13 to 57 degrees and 12% to 92% (18 degrees/19

Old adults perform activities of daily living near their maximal capabilities.

PubMed

Hortobágyi, Tibor; Mizelle, Chris; Beam, Stacey; DeVita, Paul

2003-05-01

Old adults' ability to execute activities of daily living (ADLs) declines with age. One possible reason for this decline is that the execution of customary motor tasks requires a substantially greater effort in old compared with young adults relative to their available maximal capacity. We tested the hypothesis that the relative effort (i.e., the percentage of joint moment relative to maximal joint moment) to execute ADLs is higher in old adults compared with young adults. Healthy young adults (n = 13; mean age, 22 years) and old adults (n = 14; mean age, 74 years) ascended and descended stairs and rose from a chair and performed maximal-effort isometric supine leg press. Using inverse dynamics analysis, we determined knee joint moments in ADLs and computed relative effort. Compared with young adults, old adults had 60% lower maximal leg press moments, 53% slower knee angular velocity at peak torque, and 27% lower knee joint moments in the ADLs (all p <.05). Relative effort in ascent was 54% (SD +/- 16%) and 78% (+/-20%) in young and old adults, respectively; in descent, it was 42% (+/-20%) and 88% (+/-43%); and in chair rise, it was 42% (+/-19%) and 80% (+/-34%) (all p <.05). The relative electromyographic activity of the vastus lateralis and the coactivity of the biceps femoris associated with this relative effort were, respectively, 2- and 1.6-fold greater in old compared with young adults in the 3 ADLs (p <.05). For healthy old adults, the difficulty that arises while performing ADLs may be due more to working at a higher level of effort relative to their maximum capability than to the absolute functional demands imposed by the task.

Active Thermal Architecture for Cryogenic Optical Instrumentation (ATACOI)

NASA Technical Reports Server (NTRS)

Swenson, Charles; Hunter, Roger C.; Baker, Christopher E.

2018-01-01

The Active Thermal Architecture for Cryogenic Optical Instrumentation (ATACOI) project will demonstrate an advanced thermal control system for CubeSats and enable the use of cryogenic electro-optical instrumentation on small satellite platforms. Specifically, the project focuses on the development of a deployable solar tracking radiator, a rotationally flexible rotary union fluid joint, and a thermal/vibrational isolation system for miniature cryogenic detectors. This technology will represent a significant improvement over the current state of the art for CubeSat thermal control, which generally relies on simple passive and conductive methods.

Assessing Upper Extremity Motor Function in Practice of Virtual Activities of Daily Living

PubMed Central

Adams, Richard J.; Lichter, Matthew D.; Krepkovich, Eileen T.; Ellington, Allison; White, Marga; Diamond, Paul T.

2015-01-01

A study was conducted to investigate the criterion validity of measures of upper extremity (UE) motor function derived during practice of virtual activities of daily living (ADLs). Fourteen hemiparetic stroke patients employed a Virtual Occupational Therapy Assistant (VOTA), consisting of a high-fidelity virtual world and a Kinect™ sensor, in four sessions of approximately one hour in duration. An Unscented Kalman Filter-based human motion tracking algorithm estimated UE joint kinematics in real-time during performance of virtual ADL activities, enabling both animation of the user’s avatar and automated generation of metrics related to speed and smoothness of motion. These metrics, aggregated over discrete sub-task elements during performance of virtual ADLs, were compared to scores from an established assessment of UE motor performance, the Wolf Motor Function Test (WMFT). Spearman’s rank correlation analysis indicates a moderate correlation between VOTA-derived metrics and the time-based WMFT assessments, supporting the criterion validity of VOTA measures as a means of tracking patient progress during an UE rehabilitation program that includes practice of virtual ADLs. PMID:25265612

Assessing upper extremity motor function in practice of virtual activities of daily living.

PubMed

Adams, Richard J; Lichter, Matthew D; Krepkovich, Eileen T; Ellington, Allison; White, Marga; Diamond, Paul T

2015-03-01

A study was conducted to investigate the criterion validity of measures of upper extremity (UE) motor function derived during practice of virtual activities of daily living (ADLs). Fourteen hemiparetic stroke patients employed a Virtual Occupational Therapy Assistant (VOTA), consisting of a high-fidelity virtual world and a Kinect™ sensor, in four sessions of approximately one hour in duration. An unscented Kalman Filter-based human motion tracking algorithm estimated UE joint kinematics in real-time during performance of virtual ADL activities, enabling both animation of the user's avatar and automated generation of metrics related to speed and smoothness of motion. These metrics, aggregated over discrete sub-task elements during performance of virtual ADLs, were compared to scores from an established assessment of UE motor performance, the Wolf Motor Function Test (WMFT). Spearman's rank correlation analysis indicates a moderate correlation between VOTA-derived metrics and the time-based WMFT assessments, supporting the criterion validity of VOTA measures as a means of tracking patient progress during an UE rehabilitation program that includes practice of virtual ADLs.

Impairments in Activities of Daily Living in Older Japanese Men in Hawaii and Japan

PubMed Central

Abbott, Robert D.; Kadota, Aya; Miura, Katsuyuki; Hayakawa, Takehito; Kadowaki, Takashi; Okamura, Tomonori; Okayama, Akira; Masaki, Kamal H.; Ueshima, Hirotsugu

2011-01-01

Introduction. Hypertension and cigarette smoking are dominant risk factors for cardiovascular disease in Japan while in westernized countries, broader effects encompass obesity, diabetes, and hypercholesterolemia. This paper examines whether different associations also appear important in the manifestation of activities of daily living (ADL) in older Japanese men in Hawaii and Japan. Methods. Measures of ADL (feeding, toileting, dressing, bathing, and walking around the house) were assessed from 1995 to 1999 in 1,893 men in Hawaii and 543 men in Japan. Concomitant risk factors were measured from 1990 to 1993. Results. In Hawaii, diabetes increased the odds of ≥1 ADL impairment nearly 1.5-fold (P = .020). A similar association was absent in Japan. In contrast, the odds of an ADL impairment in Japan was increased more than 5-fold in the presence of stroke (P < .001). The association in Hawaii was significantly weaker (P = .007). In both cohorts, past alcohol use was associated with a greater likelihood of ADL impairment. Conclusion. In this comparison of genetically similar samples, findings suggest that different strengths in risk factor associations with cardiovascular disease in Japan and westernized countries may also include different strengths in associations with impaired ADL. PMID:21766031

Gender differences in physical disability among older adults in underprivileged communities in Lebanon.

PubMed

Zeki Al Hazzouri, Adina; Mehio Sibai, Abla; Chaaya, Monique; Mahfoud, Ziyad; Yount, Kathryn M

2011-03-01

To examine the role of health conditions, socioeconomic, and socioenvironmental factors in explaining gender differences in physical disability among older adults. We compared 412 women and 328 men residing in underprivileged communities in Lebanon on their activities of daily living (ADL), instrumental activities of daily living (IADL), and physical tasks (PT). Binary logistic regression analyses adjusting for possible explanatory covariates were conducted sequentially. Women showed higher prevalence rates of ADL, IADL, and PT compared to men. Gender disparities in ADL disability were explained by chronic-disease risk factors and health conditions (OR = 1.46; 95% CI = 0.94-2.25). The odds of disability in IADL and PT remained significantly higher for women compared to men after accounting for all available covariates. These results suggest underlying differences in functional status between women and men, yet, may have been influenced by the sensitivity of the measures to the social context and gendered environment surrounding daily activities.

Association of CKD with Disability in the United States

PubMed Central

Plantinga, Laura C.; Johansen, Kirsten; Crews, Deidra C.; Shahinian, Vahakn B.; Robinson, Bruce M.; Saran, Rajiv; Burrows, Nilka Rios; Williams, Desmond E.; Powe, Neil R.

2010-01-01

Background Little is known about disability in early-stage chronic kidney disease (CKD). Study Design Cross-sectional national survey (National Health and Nutrition Examination Survey 1999–2006). Setting and Participants Community-based survey of 16,011 non-institutionalized U.S. civilian adults (≥20 years). Predictor CKD, categorized as: no CKD, stages 1 and 2 [albuminuria and estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2], and stages 3 and 4 (eGFR 15–59). Outcome Self-reported disability, defined by limitations in working, walking, and cognition; and difficulties in activities of daily living (ADL), instrumental ADL, leisure and social activities, lower extremity mobility, and general physical activity. Measurements Albuminuria and eGFR assessed from urine and blood samples; disability, demographics, access to care, and comorbid conditions assessed by standardized questionnaire. Results Age-adjusted prevalence of reported limitations was generally significantly greater with CKD: e.g., difficulty with ADLs was reported by 17.6%, 24.7%, and 23.9% of older (≥65 years) and 6.8%, 11.9%, and 11.0% of younger (20–64 years) adults with no CKD, stages 1 and 2, and stages 3 and 4, respectively. CKD was also associated with greater reported limitations and difficulty in other activities after age adjustment, including instrumental ADL, leisure and social activities, lower extremity mobility, and general physical activity. Other demographics, socioeconomic status, and access to care generally only slightly attenuated the observed associations, particularly among older individuals; adjustment for cardiovascular disease, arthritis, and cancer attenuated most associations such that statistical significance was no longer achieved. Limitations Inability to establish causality and possible unmeasured confounding. Conclusion CKD is associated with higher prevalence of disability in the United States. Age and other comorbid conditions account for most

Cognitively-Related Basic Activities of Daily Living Impairment Greatly Increases the Risk of Death in Alzheimers Disease.

PubMed

Liang, Fu-Wen; Chan, Wenyaw; Chen, Ping-Jen; Zimmerman, Carissa; Waring, Stephen; Doody, Rachelle

2016-01-01

Some Alzheimer's disease (AD) patients die without ever developing cognitively impaired basic activities of daily living (basic ADL), which may reflect slower disease progression or better compensatory mechanisms. Although impaired basic ADL is related to disease severity, it may exert an independent risk for death. This study examined the association between impaired basic ADL and survival of AD patients, and proposed a multistate approach for modeling the time to death for patients who demonstrate different patterns of progression of AD that do or do not include basic ADL impairment. 1029 patients with probable AD at the Baylor College of Medicine Alzheimer's Disease and Memory Disorders Center met the criteria for this study. Two complementary definitions were used to define development of basic ADL impairment using the Physical Self-Maintenance Scale score. A weighted Cox regression model, including a time-dependent covariate (development of basic ADL impairment), and a multistate survival model were applied to examine the effect of basic ADL impairment on survival. As expected decreased ability to perform basic ADL at baseline, age at initial visit, years of education, and sex were all associated with significantly higher mortality risk. In those unimpaired at baseline, the development of basic ADL impairment was also associated with a much greater risk of death (hazard ratios 1.77-4.06) over and above the risk conferred by loss of MMSE points. A multi-state Cox model, controlling for those other variables quantified the substantive increase in hazard ratios for death conferred by the development of basic ADL impairment by two definitions and can be applied to calculate the short term risk of mortality in individual patients. The current study demonstrates that the presence of basic ADL impairment or the development of such impairments are important predictors of death in AD patients, regardless of severity.

Causes of decreased activity of daily life in elderly patients who need daily living care.

PubMed

Yoshino, Hiroshi; Sakurai, Takashi; Hasegawa, Kazuo; Yokono, Koichi

2011-07-01

The causes of decreased activity of daily life (ADL) in elderly patients include cerebrovascular diseases, bone fracture by falls, and dementia. The present study was conducted among elderly patients with decreased ADL who were hospitalized in nursing wards in order to investigate the causes of becoming early bedridden and to determine precautionary measures against decreased ADL. The study subjects were 224 elderly patients with decreased ADL (mean age: 83.3 ± 8.0 years) and 49 outpatients without decreased ADL (mean age: 76.8 ± 5.3 years). Current age, age at the start of ADL decrease, medical history and history of smoking were investigated. In the groups with decreased ADL, current age and the age of becoming bedridden in non-diabetic versus diabetic groups were 84.7 ± 7.9 versus 80.3 ± 7.5 and 82.7 ± 8.3 versus 77.6 ± 8.0 years, respectively, both showing significantly lower values in the diabetic group (P < 0.05). Multiple regression analysis revealed that sex difference and diabetes were the factors determining the age of becoming early bedridden. Diabetic patients with smoking habit were significantly younger than diabetic and non-diabetic patients without smoking habit. Sex difference, smoking habit and presence of diabetes mellitus are independent risk factors of becoming early bedridden. Therefore, the major targets of medical care among elderly should be diabetic men with a smoking habit to lower the risks of decreased ADL. © 2011 Japan Geriatrics Society.

Effects of impairment in activities of daily living on predicting mortality following hip fracture surgery in studies using administrative healthcare databases

PubMed Central

2014-01-01

Background Impairment in activities of daily living (ADL) is an important predictor of outcomes although many administrative databases lack information on ADL function. We evaluated the impact of ADL function on predicting postoperative mortality among older adults with hip fractures in Ontario, Canada. Methods Sociodemographic and medical correlates of ADL impairment were first identified in a population of older adults with hip fractures who had ADL information available prior to hip fracture. A logistic regression model was developed to predict 360-day postoperative mortality and the predictive ability of this model were compared when ADL impairment was included or omitted from the model. Results The study sample (N = 1,329) had a mean age of 85.2 years, were 72.8% female and the majority resided in long-term care (78.5%). Overall, 36.4% of individuals died within 360 days of surgery. After controlling for age, sex, medical comorbidity and medical conditions correlated with ADL impairment, addition of ADL measures improved the logistic regression model for predicting 360 day mortality (AIC = 1706.9 vs. 1695.0; c -statistic = 0.65 vs 0.67; difference in - 2 log likelihood ratios: χ2 = 16.9, p = 0.002). Conclusions Direct measures of ADL impairment provides additional prognostic information on mortality for older adults with hip fractures even after controlling for medical comorbidity. Observational studies using administrative databases without measures of ADLs may be potentially prone to confounding and bias and case-mix adjustment for hip fracture outcomes should include ADL measures where these are available. PMID:24472282

Longitudinal Changes in Disabled Husbands' and Wives' Receipt of Care

ERIC Educational Resources Information Center

Noel-Miller, Claire

2010-01-01

Purpose of the Study: This study contrasts 2-year adjustments in disabled husbands' and wives' amount of received care following both worsening and recovery in personal (activities of daily living [ADLs]) and routine care (instrumental activities of daily living [IADLs]) disability. Design and Methods: Using longitudinal data on 789 husbands and…

Physics Thematic Paths: Laboratorial Activities and Historical Scientific Instruments

ERIC Educational Resources Information Center

Pantano, O.; Talas, S.

2010-01-01

The Physics Department of Padua University keeps an important collection of historical physics instruments which alludes to the fruitful scientific activity of Padua through the centuries. This heritage led to the suggestion of setting up laboratory activities connected to the Museum collection for secondary school students. This article shows how…

Social withdrawal of persons with vascular dementia associated with disturbance of basic daily activities, apathy, and impaired social judgment.

PubMed

Honda, Yukiko; Meguro, Kenichi; Meguro, Mitsue; Akanuma, Kyoko

2013-01-01

Patients with vascular dementia (VaD) are often isolated, withdrawn from society because of negative symptoms and functional disabilities. The aim of this study was to detect factors associated with social withdrawal in patients with VaD. The participants were 36 institutionalized patients with VaD. Social withdrawal was assessed with the social withdrawal of the Multidimensional Observation Scale for Elderly Subjects (MOSES). Possible explanatory variables were the MOSES items depression and self-care, Cognitive Abilities Screening Instrument (CASI), apathy evaluation scale (AES), and Behavioral Pathology in Alzheimer's Disease Frequency-Weighted Severity Scale (BEHAVE-AD-FW). Multiple regression analyses were conducted for two groups: Analysis 1 was performed in all patients (N = 36) and Analysis 2 was performed in the patients with the ability to move by themselves (i.e., independent walking or independent movement with a cane or a wheelchair; n = 28). In Analysis 1, MOSES item social withdrawal was correlated with AES and MOSES item self-care. In Analysis 2, MOSES item social withdrawal was correlated with AES and CASI domain abstraction and judgment. Decreased social activities of VaD were not related to general cognitive function or depression. Disturbed activities of daily living (ADLs) for self-care may involve decreased frontal lobe function, indicating that comprehensive rehabilitation for both ADL and dementia are needed to improve the social activities of patients with VaD.

Shiatsu as an adjuvant therapy for depression in patients with Alzheimer's disease: A pilot study.

PubMed

Lanza, Giuseppe; Centonze, Stella Silvia; Destro, Gera; Vella, Veronica; Bellomo, Maria; Pennisi, Manuela; Bella, Rita; Ciavardelli, Domenico

2018-06-01

Among the complementary and alternative medicine, Shiatsu might represent a feasible option for depression in Alzheimer's disease (AD). We evaluated Shiatsu on mood, cognition, and functional independence in patients undergoing physical activity. Single-blind randomized controlled study. Dedicated Community Center for patients with AD. AD patients with depression were randomly assigned to the "active group" (Shiatsu + physical activity) or the "control group" (physical activity alone). Shiatsu was performed by the same therapist once a week for ten months. Global cognitive functioning (Mini Mental State Examination - MMSE), depressive symptoms (Geriatric Depression Scale - GDS), and functional status (Activity of Daily Living - ADL, Instrumental ADL - IADL) were assessed before and after the intervention. We found a within-group improvement of MMSE, ADL, and GDS in the active group. However, the analysis of differences before and after the interventions showed a statistically significant decrease of GDS score only in the active group. The combination of Shiatsu and physical activity improved depression in AD patients compared to physical activity alone. The pathomechanism might involve neuroendocrine-mediated effects of Shiatsu on neural circuits implicated in mood and affect regulation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Religiousness and Longitudinal Trajectories in Elders' Functional Status

PubMed Central

Park, Nan Sook; Klemmack, David L.; Roff, Lucinda L.; Parker, Michael W.; Koenig, Harold G.; Sawyer, Patricia; Allman, Richard M.

2010-01-01

The purpose of this study was to examine the effects of religiousness on the trajectories of difficulties with activities of daily living (ADLs) and instrumental ADLs (IADLs) in community-dwelling older adults over a three-year period. Seven waves of data from the University of Alabama at Birmingham Study of Aging were analyzed using a hierarchical linear modeling method. The study was based on the 784 participants who completed interviews every six months between December 1999 and February 2004. Frequent religious service attendance was associated with fewer ADL difficulties and IADL difficulties at baseline. Furthermore, religious service attendance predicted slower increases for frequent churchgoers and steeper increases for less frequent churchgoers in IADL difficulties, controlling for variables related to demographics and resources. Religious service attendance was independently associated with ADL and IADL difficulties cross-sectionally. However, significant protective effects of religious service attendance were identified longitudinally only for the IADL trajectory. PMID:20485460

Depression and Unmet Needs for Assistance With Daily Activities Among Community-Dwelling Older Adults.

PubMed

Xiang, Xiaoling; An, Ruopeng; Heinemann, Allen

2018-05-08

This study aims to investigate the impact of depressive symptoms on adverse consequences of unmet needs for assistance with daily activities among community-dwelling older adults. Data came from round 1 to 5 of the National Health and Aging Trends Study. Study sample consisted of 3,400 Medicare beneficiaries needing assistance with activities of daily living (ADL), instrumental activities of daily living (IADL), or mobility for any two consecutive years between 2011 and 2015. Study outcome was the number of self-reported adverse consequences of unmet needs for assistance with daily activities (e.g., went without eating, wet or soiled clothes). Mixed-effects negative binomial regression was used to estimate the association of lagged depressive symptoms and covariates in period t-1 and the number of adverse consequences of unmet needs in period t. The prevalence rates of adverse consequences of unmet needs were twice as high among older adults with elevated depressive symptoms as those without depression. After adjusting for covariates, prior wave depressive symptoms were associated with 1.24 times the rate of adverse consequences of unmet needs for assistance with ADL (Incidence Rate Ratio [IRR] = 1.24, 95% confidence interval [CI] = 1.09-1.41, p < .01) and IADL (IRR = 1.24, 95% CI = 1.06-1.44, p < .01), and 1.14 times the rate of adverse consequences of unmet needs for assistance with mobility (IRR = 1.14, 95% CI = 1.03-1.27, p < .05). Caring for older adults with mental health and long-term care needs calls for an integrated social and health services system.

Activity Restriction Induced by Fear of Falling and Objective and Subjective Measures of Physical Function: A Prospective Cohort Study

PubMed Central

Deshpande, Nandini; Metter, E. Jeffrey; Lauretani, Fulvio; Bandinelli, Stefania; Guralnik, Jack; Ferrucci, Luigi

2009-01-01

Objectives To examine whether activity restriction specifically induced by fear of falling (FF) contributes to greater risk of disability and decline in physical function. Design Prospective cohort study. Setting Population-based older cohort. Participants Six hundred seventy-three community-living elderly (≥65) participants in the Invecchiare in Chianti Study who reported FF. Measurements FF, fear-induced activity restriction, cognition, depressive symptoms, comorbidities, smoking history, and demographic factors were assessed at baseline. Disability in activities of daily living (ADLs) and instrumental activities of daily living (IADLs) and performance on the Short Performance Physical Battery (SPPB) were evaluated at baseline and at the 3-year follow-up. Results One-quarter (25.5%) of participants did not report any activity restriction, 59.6% reported moderate activity restriction (restriction or avoidance of <3 activities), and 14.9% reported severe activity restriction (restriction or avoidance of ≥3 activities). The severe restriction group reported significantly higher IADL disability and worse SPPB scores than the no restriction and moderate restriction groups. Severe activity restriction was a significant independent predictor of worsening ADL disability and accelerated decline in lower extremity performance on SPPB over the 3-year follow-up. Severe and moderate activity restriction were independent predictors of worsening IADL disability. Results were consistent even after adjusting for multiple potential confounders. Conclusion In an elderly population, activity restriction associated with FF is an independent predictor of decline in physical function. Future intervention studies in geriatric preventive care should directly address risk factors associated with FF and activity restriction to substantiate long-term effects on physical abilities and autonomy of older persons. PMID:18312314

The post-stroke depression and its impact on functioning in young and adult stroke patients of a rehabilitation unit.

PubMed

Amaricai, Elena; Poenaru, Dan V

2016-01-01

Stroke is a leading cause of disability and a major public health problem. To determine frequency and degree of post-stroke depression (PSD) and its impact on functioning in young and adult stroke patients in a rehabilitation unit. The study included 72 stroke patients (aged 29-59 years) who were attending rehabilitation. The patients were assessed for depressive symptoms by Beck Depression Inventory (BDI), and their functioning by using the Stroke Impact Scale (SIS) and the Barthel Index of Activities of Daily Living (ADL). Forty-eight patients had different degrees of depression: borderline clinical depression (13.8%), moderate depression (34.7%), severe depression (15.2%) or extreme depression (2.9%). There were no significant differences of BDI scores in 30-39, 40-49 and 50-59 years groups. Statistically significant correlations were between BDI score and SIS score, between BDI score and ADL index, and between SIS score and ADL index in men, women and total study patients. More than half of the PSD patients had a moderate degree of depression. Significant correlations were noticed between depressive symptoms and functional status evaluated both by an instrument of assessing stroke impact upon general health and an instrument for assessing the everyday activities.

The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease

PubMed Central

Gimeno-Santos, Elena; Raste, Yogini; Demeyer, Heleen; Louvaris, Zafeiris; de Jong, Corina; Rabinovich, Roberto A.; Hopkinson, Nicholas S.; Polkey, Michael I.; Vogiatzis, Ioannis; Tabberer, Maggie; Dobbels, Fabienne; Ivanoff, Nathalie; de Boer, Willem I.; van der Molen, Thys; Kulich, Karoly; Serra, Ignasi; Basagaña, Xavier; Troosters, Thierry; Puhan, Milo A.; Karlsson, Niklas

2015-01-01

No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD. Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts. 236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled “amount” and “difficulty”. After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test–retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r<0.3) with unrelated constructs, providing evidence for construct validity. Daily and clinical visit “PROactive physical activity in COPD” instruments are hybrid tools combining a short patient-reported outcome questionnaire and two activity monitor variables which provide simple, valid and reliable measures of physical activity in COPD patients. PMID:26022965

The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease.

PubMed

Gimeno-Santos, Elena; Raste, Yogini; Demeyer, Heleen; Louvaris, Zafeiris; de Jong, Corina; Rabinovich, Roberto A; Hopkinson, Nicholas S; Polkey, Michael I; Vogiatzis, Ioannis; Tabberer, Maggie; Dobbels, Fabienne; Ivanoff, Nathalie; de Boer, Willem I; van der Molen, Thys; Kulich, Karoly; Serra, Ignasi; Basagaña, Xavier; Troosters, Thierry; Puhan, Milo A; Karlsson, Niklas; Garcia-Aymerich, Judith

2015-10-01

No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD.Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts.236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled "amount" and "difficulty". After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test-retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r<0.3) with unrelated constructs, providing evidence for construct validity.Daily and clinical visit "PROactive physical activity in COPD" instruments are hybrid tools combining a short patient-reported outcome questionnaire and two activity monitor variables which provide simple, valid and reliable measures of physical activity in COPD patients. Copyright ©ERS 2015.

The Healthy Afterschool Activity and Nutrition Documentation Instrument

PubMed Central

Ajja, Rahma; Beets, Michael W.; Huberty, Jennifer; Kaczynski, Andrew T.; Ward, Dianne S.

2012-01-01

Background Policies call on afterschool programs to improve the physical activity and nutrition habits of youth attending. No tool exists to assess the extent to which the afterschool program environment meets physical activity and nutrition policies. Purpose To describe the development of the Healthy Afterschool Activity and Nutrition Documentation (HAAND) instrument, which consists of two subscales: Healthy Afterschool Program Index for Physical Activity (HAPI-PA) and the HAPI-Nutrition (HAPI-N). Methods Thirty-nine afterschool programs took part in the HAAND evaluation during fall/spring 2010–2011. Inter-rater reliability data were collected at 20 afterschool programs during a single site visit via direct observation, personal interview and written document review. Validity of the HAPI-PA was established by comparing HAPI-PA scores to pedometer steps collected in a subsample of 934 children attending 25 of the afterschool programs. Validity of the HAPI-N scores was compared against the mean number of times/week that fruits/vegetables (FV) and whole grains were served in the program. Results Data were analyzed in June/July 2011. Inter-rater percent agreement was 85%–100% across all items. Increased pedometer steps were associated with the presence of a written policy related to physical activity, amount/quality of staff training, use of a physical activity curriculum, and offering activities that appeal to both genders. Higher servings of FV and whole grains per week were associated with the presence of a written policy regarding the nutritional quality of snacks. Conclusions The HAAND instrument is a reliable and valid measurement tool that can be used to assess the physical activity and nutritional environment of afterschool programs. PMID:22898119

Influence of cerebral white matter lesions on the activities of daily living of older patients with mild stroke.

PubMed

Yamashita, Yutaka; Wada, Ikuo; Horiba, Mitsuya; Sahashi, Kento

2016-08-01

Neurological symptom severity is a prognostic factor for post-stroke activities of daily living (ADL). Recently, it has been reported that white matter lesions indicate poor functional prognosis in patients with stroke. The present study investigated the influence of white matter lesions on the ADL of older patients with stroke who have mild neurological symptoms. We investigated ADL at discharge in 44 patients with stroke (men, n = 27; women, n = 17; mean age 78 years [range 71-85 years]) aged ≥65 years with National Institutes of Health Stroke Scale scores of ≤5 (cerebral infarction, n = 37; cerebral hemorrhage, n = 7). We used single correlation analysis and multiple regression analysis to investigate factors that correlated with ADL at discharge. ADL at discharge was also evaluated on the basis of white matter lesion severity (Fazekas classification, grades 0-3). Single correlation analysis showed that age (r = -0.36, P = 0.016), male sex (r = 0.362, P = 0.016), neurological symptom severity (r = -0.361, P = 0.016), ADL on starting rehabilitation (r = 0.685, P < 0.001) and white matter lesion severity (r = -0.361, P = 0.016) significantly correlated with ADL at discharge. Multiple regression analysis showed that ADL on starting rehabilitation (β = 0.519, t = 4.723, P < 0.001) and white matter lesion severity (β = -0.309, t = -3.057, P < 0.01) were statistically significant prognostic factors for ADL at discharge. ADL at discharge score was significantly lower in the group with high white matter lesion severity (Fazekas, grade 2) than in the other two groups (Fazekas, grade 0, P < 0.01; Fazekas, grade 1, P < 0.05). Severe white matter lesions are a prognostic factor for poor ADL at discharge in older patients with stroke who have mild neurological symptoms. Geriatr Gerontol Int 2016; 16: 942-947. © 2015 Japan Geriatrics Society.

A SIMPLE FRAILTY QUESTIONNAIRE (FRAIL) PREDICTS OUTCOMES IN MIDDLE AGED AFRICAN AMERICANS

PubMed Central

MORLEY, J.E.; MALMSTROM, T.K.; MILLER, D.K.

2015-01-01

Objective To validate the FRAIL scale. Design Longitudinal study. Setting Community. Participants Representative sample of African Americans age 49 to 65 years at onset of study. Measurements The 5-item FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight), at baseline and activities of daily living (ADLs), instrumental activities of daily living (IADLs), mortality, short physical performance battery (SPPB), gait speed, one-leg stand, grip strength and injurious falls at baseline and 9 years. Blood tests for CRP, SIL6R, STNFR1, STNFR2 and 25 (OH) vitamin D at baseline. Results Cross-sectionally the FRAIL scale correlated significantly with IADL difficulties, SPPB, grip strength and one-leg stand among participants with no baseline ADL difficulties (N=703) and those outcomes plus gait speed in those with no baseline ADL dependencies (N=883). TNFR1 was increased in pre-frail and frail subjects and CRP in some subgroups. Longitudinally (N=423 with no baseline ADL difficulties or N=528 with no baseline ADL dependencies), and adjusted for the baseline value for each outcome, being pre-frail at baseline significantly predicted future ADL difficulties, worse one-leg stand scores, and mortality in both groups, plus IADL difficulties in the dependence-excluded group. Being frail at baseline significantly predicted future ADL difficulties, IADL difficulties, and mortality in both groups, plus worse SPPB in the dependence-excluded group. Conclusion This study has validated the FRAIL scale in a late middle-aged African American population. This simple 5-question scale is an excellent screening test for clinicians to identify frail persons at risk of developing disability as well as decline in health functioning and mortality. PMID:22836700

Genome-Wide Analysis of Seed Acid Detergent Lignin (ADL) and Hull Content in Rapeseed (Brassica napus L.)

PubMed Central

Wei, Lijuan; Qu, Cunmin; Xu, Xinfu; Lu, Kun; Qian, Wei; Li, Jiana; Li, Maoteng; Liu, Liezhao

2015-01-01

A stable yellow-seeded variety is the breeding goal for obtaining the ideal rapeseed (Brassica napus L.) plant, and the amount of acid detergent lignin (ADL) in the seeds and the hull content (HC) are often used as yellow-seeded rapeseed screening indices. In this study, a genome-wide association analysis of 520 accessions was performed using the Q + K model with a total of 31,839 single-nucleotide polymorphism (SNP) sites. As a result, three significant associations on the B. napus chromosomes A05, A09, and C05 were detected for seed ADL content. The peak SNPs were within 9.27, 14.22, and 20.86 kb of the key genes BnaA.PAL4, BnaA.CAD2/BnaA.CAD3, and BnaC.CCR1, respectively. Further analyses were performed on the major locus of A05, which was also detected in the seed HC examination. A comparison of our genome-wide association study (GWAS) results and previous linkage mappings revealed a common chromosomal region on A09, which indicates that GWAS can be used as a powerful complementary strategy for dissecting complex traits in B. napus. Genomic selection (GS) utilizing the significant SNP markers based on the GWAS results exhibited increased predictive ability, indicating that the predictive ability of a given model can be substantially improved by using GWAS and GS. PMID:26673885

Home Health Care Nursing Visit Intensity and Heart Failure Patient Outcomes

PubMed Central

Riggs, Jennifer S.; Madigan, Elizabeth A.; Fortinsky, Richard H.

2012-01-01

This study is a secondary analysis of data for 107 home health care heart failure patients. The authors investigate the impact of patient characteristics and nursing visit intensity on change in activities of daily living (ADL) status and instrumental activities of daily living (IADL) status and improvement/stabilization of dyspnea. Prior hospital stay (β = .38, p = .001) and nursing visit intensity (β = −.39, p = .001) predict improvement in ADL status. The model for change in IADL status is not significant. Patients with more than two comorbidities (OR = 6.5, p = .04) and patients who received higher nursing visit intensity (OR = 7.0, p = .04) are more likely to have improved/stabilized dyspnea at home care discharge. PMID:22279411

Age Group Differences in Depressive Symptoms among Older Adults with Functional Impairments

ERIC Educational Resources Information Center

Choi, Namkee G.; Kim, Johnny S.

2007-01-01

This study used data from the 2000 interview wave of the Health and Retirement Study to examine age group differences in the likelihood of self-reported depressive symptomatology among a nationally representative sample of 3,035 adults age 55 years or older who had at least one activities of daily living (ADL) or instrumental activities of daily…

Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study

PubMed Central

2012-01-01

Background Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL). The odds ratio and 95% Confidence Interval (CI) were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results In 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6) and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6). At baseline, 718 (82.5%) participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65). Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total daily physical activity

The healthy afterschool activity and nutrition documentation instrument.

PubMed

Ajja, Rahma; Beets, Michael W; Huberty, Jennifer; Kaczynski, Andrew T; Ward, Dianne S

2012-09-01

Policies call on afterschool programs to improve the physical activity and nutrition habits of youth attending. No tool exists to assess the extent to which the afterschool program environment meets physical activity and nutrition policies. To describe the development of the Healthy Afterschool Activity and Nutrition Documentation (HAAND) instrument, which consists of two subscales: Healthy Afterschool Program Index for Physical Activity (HAPI-PA) and the HAPI-Nutrition (HAPI-N). Thirty-nine afterschool programs took part in the HAAND evaluation during fall/spring 2010-2011. Inter-rater reliability data were collected at 20 afterschool programs during a single site visit via direct observation, personal interview, and written document review. Validity of the HAPI-PA was established by comparing HAPI-PA scores to pedometer steps collected in a subsample of 934 children attending 25 of the afterschool programs. Validity of the HAPI-N scores was compared against the mean number of times/week that fruits and vegetables (FV) and whole grains were served in the program. Data were analyzed in June/July 2011. Inter-rater percent agreement was 85%-100% across all items. Increased pedometer steps were associated with the presence of a written policy related to physical activity, amount/quality of staff training, use of a physical activity curriculum, and offering activities that appeal to both genders. Higher servings of FV and whole grains per week were associated with the presence of a written policy regarding the nutritional quality of snacks. The HAAND instrument is a reliable and valid measurement tool that can be used to assess the physical activity and nutritional environment of afterschool programs. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury.

PubMed

Martínez-Moreno, J M; Sánchez-González, P; Luna, M; Roig, T; Tormos, J M; Gómez, E J

2016-01-01

Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine. To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments. The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation. An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures. The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current

Study to determine the criterion validity of the SenseWear Armband as a measure of physical activity in people with rheumatoid arthritis.

PubMed

Tierney, Marie; Fraser, Alexander; Purtill, Helen; Kennedy, Norelee

2013-06-01

Measuring physical activity in people with rheumatoid arthritis (RA) is of great importance in light of the increased mortality in this population due to cardiovascular disease. Validation of activity monitors in specific populations is recommended to ensure the accuracy of physical activity measurement. Thus, the purpose of this study was to determine the validity of the SenseWear Pro3 Armband (SWA) as a measure of physical activity during activities of daily living (ADL) in people with RA. Fourteen subjects (8 men and 6 women) with a diagnosis of RA were recruited from rheumatology clinics at the Mid-Western Regional Hospitals, Limerick, Ireland. Participants undertook a series of ADL of varying intensities. The SWA was compared to the criterion measures of the Oxycon Mobile indirect calorimetry system (energy expenditure in kJ) and of manual video observation (step count). Bland and Altman, intraclass correlation coefficient (ICC), and correlation analyses were done using SPSS, version 19.0. The SWA showed substantial agreement (ICC 0.717, P < 0.001) and a strong relationship (Pearson's correlation coefficient = 0.852) compared with the criterion measure when estimating energy expenditure during ADL. However, it was found that the SWA overestimated energy expenditure, particularly at higher intensity levels. The ability of the SWA to estimate step counts during ADL was poor (ICC 0.304, P = 0.038). The SWA can be considered a valid tool to estimate energy expenditure during ADL in the RA population; however, attention should be paid to its tendency to overestimate energy expenditure. Copyright © 2013 by the American College of Rheumatology.

Improving the Validity of Activity of Daily Living Dependency Risk Assessment

PubMed Central

Clark, Daniel O.; Stump, Timothy E.; Tu, Wanzhu; Miller, Douglas K.

2015-01-01

Objectives Efforts to prevent activity of daily living (ADL) dependency may be improved through models that assess older adults’ dependency risk. We evaluated whether cognition and gait speed measures improve the predictive validity of interview-based models. Method Participants were 8,095 self-respondents in the 2006 Health and Retirement Survey who were aged 65 years or over and independent in five ADLs. Incident ADL dependency was determined from the 2008 interview. Models were developed using random 2/3rd cohorts and validated in the remaining 1/3rd. Results Compared to a c-statistic of 0.79 in the best interview model, the model including cognitive measures had c-statistics of 0.82 and 0.80 while the best fitting gait speed model had c-statistics of 0.83 and 0.79 in the development and validation cohorts, respectively. Conclusion Two relatively brief models, one that requires an in-person assessment and one that does not, had excellent validity for predicting incident ADL dependency but did not significantly improve the predictive validity of the best fitting interview-based models. PMID:24652867

Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review.

PubMed

Whitehead, Phillip J; Worthington, Esme J; Parry, Ruth H; Walker, Marion F; Drummond, Avril E R

2015-11-01

To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content; effectiveness in improving ability to perform ADL; and whether delivery by qualified occupational therapists influences effectiveness. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. We included: randomised controlled trials, non-randomised controlled trials and controlled before and after studies. Two reviewers independently screened studies for inclusion, assessed risk of bias and extracted data. A narrative synthesis of the findings was conducted. Thirteen studies were included, totalling 4975 participants. Ten (77%) were judged to have risk of bias. Interventions were categorised as those termed 're-ablement' or 'restorative homecare' (n=5/13); and those involving separate components which were not described using this terminology (n=8/13). Content of the intervention and level of health professional input varied within and between studies. Effectiveness on ADL: eight studies included an ADL outcome, five favoured the intervention group, only two with statistical significance, both these were controlled before and after studies judged at high risk of bias. ADL outcome was reported using seven different measures. Occupational therapy: there was insufficient evidence to determine whether involvement of qualified occupational therapists influenced effectiveness. There is limited evidence that interventions targeted at personal ADL can reduce homecare service users' dependency with activities, the content of evaluated interventions varies greatly. © The Author(s) 2015.

Promoting Active Learning by Practicing the "Self-Assembly" of Model Analytical Instruments

ERIC Educational Resources Information Center

Algar, W. Russ; Krull, Ulrich J.

2010-01-01

In our upper-year instrumental analytical chemistry course, we have developed "cut-and-paste" exercises where students "build" models of analytical instruments from individual schematic images of components. These exercises encourage active learning by students. Instead of trying to memorize diagrams, students are required to think deeply about…

Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation?

PubMed

Henseler, Jan Ferdinand; Nagels, Jochem; Nelissen, Rob G H H; de Groot, Jurriaan H

2014-04-01

The purpose of this study is to evaluate the muscle activity with surface electromyography (EMG) and the clinical outcome of the latissimus dorsi transfer. It remains unclear whether the clinical results of the latissimus dorsi transfer for massive posterosuperior rotator cuff tears are achieved either by active muscle contractions or by a passive tenodesis effect of the transfer. Eight patients were evaluated preoperatively and at 1 year (SD, 0.1) after the latissimus dorsi transfer. Clinical evaluation of outcomes included active range of motion, Constant score, and visual analog scale (VAS) for pain and activities of daily living (ADL). Muscle activity was recorded with EMG during directional isometric abduction and adduction tasks. The external rotation in adduction improved from 23° to 51° (P = .03). The external rotation in abduction improved from 10° to 70° (P = .02). The mean Constant score improved from 39 to 62 postoperatively (P = .01). The VAS for pain at rest improved from 3.3 preoperatively to 0.1 (P = .02). The VAS for ADL improved from 4.9 to 2.3 (P = .05). The transferred latissimus dorsi remained active in all cases, as reflected by increased latissimus dorsi EMG activity during abduction tasks. In addition, the latissimus dorsi EMG activity shifted from preoperative antagonistic co-activation in adduction to synergistic activation in abduction. The latissimus dorsi has synergistic muscle activity after transfer. Apart from a tenodesis effect, directional muscle activity seems relevant for improved clinical outcome and pain relief. A specific gain was observed for external rotation in elevated arm positions, a motion essential for ADL tasks. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Activities of Daily Living and Determinant Factors among Older Adult Subjects with Lower Body Fracture after Discharge from Hospital: A Prospective Study

PubMed Central

Ibrahim, Nurul Izzah; Ahmad, Mohd Sharkawi; Zulfarina, Mohamed S; Zaris, Sharifah Nurul Aqilah Sayed Mohd; Mohamed, Isa Naina; Mohamed, Norazlina; Mokhtar, Sabarul Afian; Shuid, Ahmad Nazrun

2018-01-01

Fracture is a type of musculoskeletal injury that contributes to an inability to perform daily activities. The objective of this study was to evaluate activities of daily living (ADL) of older adult patients with lower body fracture and to determine factors influencing ADL. Patient’s ADL was assessed at pre-fracture, ward admission and post-discharge phases using the Katz ADL questionnaire. There were 129 subjects at pre-fracture and ward phases and 89 subjects at discharge phase. There were four independent variables; age, gender, type of fracture and ability to walk before fracture. Logistic regression models showed that ‘age’ and ‘ability to walk before fracture’ were the determinant factors of dependent for ‘bathing’, ‘dressing’ and ‘toileting’. The ‘ability to walk before fracture’ was the determinant factor of dependent for ‘transferring’. ‘Age’ and ‘gender’ were the determinant factors of dependent for ‘continence’, while ‘age’ was the determinant factor of dependent for ‘feeding’. The ADL score changes were significant across the phases with a reduction in ADL score in the ward admission phase and partial increment during the post-discharge phase. There were improvements in the health outcomes of subjects aged more than 50 years old after 3 months of being discharged from the hospital. In conclusion, age, being female, having a hip fracture and using a walking aid before fracture were the determinants identified in this study. PMID:29772744

Effectiveness of Occupation-Based Interventions to Improve Areas of Occupation and Social Participation After Stroke: An Evidence-Based Review

PubMed Central

Chuh, Adrianna; Floyd, Tracy; McInnis, Karen; Williams, Elizabeth

2015-01-01

This evidence-based review examined the evidence supporting the use of occupation-based interventions to improve areas of occupation and social participation poststroke. A total of 39 studies met the inclusion criteria and were critically evaluated. Most of the literature targeted activity of daily living (ADL)–based interventions and collectively provided strong evidence for the use of occupation-based interventions to improve ADL performance. The evidence related to instrumental ADLs was much more disparate, with limited evidence to support the use of virtual reality interventions and emerging evidence to support driver education programs to improve occupational performance poststroke. Only 6 studies addressed leisure, social participation, or rest and sleep, with sufficient evidence to support only leisure-based interventions. The implications of this review for research, education, and practice in occupational therapy are also discussed. PMID:25553745

Decreased activity of daily living produced by the combination of Alzheimer's disease and lower limb fracture in elderly requiring nursing care.

PubMed

Inagawa, Toshimitsu; Hamagishi, Toshio; Takaso, Yuji; Hitomi, Yoshiaki; Kambayashi, Yasuhiro; Hibino, Yuri; Shibata, Aki; Ngoc, Nguyen T M; Okochi, Jiro; Hatta, Kotaro; Takamuku, Kiyoshi; Konoshita, Tadashi; Nakamura, Hiroyuki

2013-01-01

Alzheimer's disease (AD) impairs cognitive functions, subsequently decreasing activity of daily living (ADL), and is frequently accompanied by lower limb fracture including hip fracture in the elderly. However, there have been few studies on what kinds of physical functions are affected or what degrees of dysfunction are produced by this combination. This study aims to clarify the relationship between decreased ADL and the combination of AD and lower limb fracture. We examined present illness and ADL in 4340 elderly aged 82.8 ± 9.36 years [average ± standard deviation (SD)] requiring nursing care and compared ADL between elderly with and without AD or lower limb fracture treated with surgery or conservatively using analysis of covariance (ANCOVA), with age and sex as covariants. We recognized that activities of cognitive function (p < 0.001), eating (dysphagia) (p < 0.001), eating (feeding) (p < 0.001), and toilet use (p < 0.001) in the elderly with AD were significantly lower than in those without the disease, even after adjusting for sex and age. Activities of bed mobility (p < 0.05), transfer and locomotion (p < 0.001), and bathing (p < 0.05) in the elderly with a fracture treated with surgery were significantly lower, which differed from the results of AD. Significant interactions of AD and fracture treated with surgery on the ADL scores for bed mobility (p < 0.001), dysphagia (p < 0.01), feeding (p < 0.001), and toilet use (p < 0.05) show that the combination had a much more profound influence on the ADL scores than AD or fracture alone. We obtained almost the same results for fractures treated conservatively as for fractures treated with surgery. These results demonstrated that the combined effects of AD and lower limb fracture were significantly greater than expected additive effects of AD and fracture, suggesting that the combination of AD and lower limb fracture has synergistic effects on almost all types of ADL except cognitive functions.

Second Chandra Instrument Activated August 28

NASA Astrophysics Data System (ADS)

1999-08-01

Cambridge, MA--NASA's Chandra X-ray Observatory opened a new era in astronomy Saturday, August 28, by making the most precise measurements ever recorded of the energy output from the 10 million degree corona of a star. Last weekend's observations came after the successful activation of an instrument developed by MIT that will allow a one-thousand-fold improvement in the capability to measure X-ray spectra from space. The new measurements, made with the High Energy Transmission Grating Spectrometer, join spectacular images taken last week by Chandra of the aftermath of a gigantic stellar explosion. The spectrometer is one of four key instruments aboard Chandra, and the second to be activated. The others will be turned on over the next two weeks. The spectrometer activated yesterday spreads the X-rays from Chandra's mirrors into a spectrum, much as a prism spreads light into its colors. The spectrum then can be read by Chandra's imaging detectors like a kind of cosmic bar code from which scientists can deduce the chemical composition and temperature of the corona. A corona is a region of hot gas and magnetic loops that extend hundreds of thousands of miles above the star's visible surface and is best studied with X-rays. "The success of the new spectrometer is definitely a major milestone for modern astronomy," said MIT Professor Claude R. Canizares, principal investigator for the instrument and associate director of the Chandra X-ray Observatory Center (CXC). "Within the first hour we had obtained the best X-ray spectrum ever recorded for a celestial source. We can already see unexpected features that will teach us new things about stars and about matter at high temperatures." The spectrometer measured X-rays from the star Capella, which is 40 light years away in the constellation Auriga. Capella is actually two stars orbiting one another and possibly interacting in ways that pump extra heat into the corona, which appears more active than that of the Sun. How a star

The hierarchy of the activities of daily living in the Katz index in residents of skilled nursing facilities.

PubMed

Gerrard, Paul

2013-01-01

Nursing facility patients are a population that has not been well studied with regard to functional status and independence previously. As such, the manner in which activities of daily living (ADL) relate to one another is not well understood in this population. An understanding of ADL difficulty ordering has helped to devise systems of functional independence grading in other populations, which have value in understanding patients' global levels of independence and providing expectations regarding changes in function. This study seeks to examine the hierarchy of ADL in the nursing facility population. Data were analyzed from the 2004 National Nursing Home Survey, a cross-sectional data set of 13 507 skilled nursing facility subjects with functional independence items. The ADL difficulty hierarchy was determined using Rasch analysis. Item fit values for the Rasch model using Mean-Square infit statistics were also determined. The robustness of the hierarchy was tested for each ADL. Two grading systems were devised from the results of the item difficulty ordering. One was based on the most difficult item that he or she could perform, and the other assigned a grade based on the least difficult item that a subject could not perform. A total of 13 113 patients were included in this analysis, the majority of whom were female and white. They had an average age of 81 years. An ordered hierarchy of ADL was found with eating being the easiest and bathing the most difficult. All items in the Katz index fit the Rasch model adequately well. The majority of patients able to perform any particular ADL were also able to perform all easier ADL. Cohen's κ for the 2 grading systems was 0.73. This study is the first to show the expected hierarchy of difficulty of the 6 activities of daily proposed in the Katz index in the nursing facility population. The hierarchy found in this population matches the original hierarchy found in older adults in the community and acute care settings

Visual Impairment, Undercorrected Refractive Errors, and Activity Limitations in Older Adults: Findings From the Three-City Alienor Study.

PubMed

Naël, Virginie; Pérès, Karine; Carrière, Isabelle; Daien, Vincent; Scherlen, Anne-Catherine; Arleo, Angelo; Korobelnik, Jean-Francois; Delcourt, Cécile; Helmer, Catherine

2017-04-01

As vision is required in almost all activities of daily living, visual impairment (VI) may be one of the major treatable factors for preventing activity limitations. We aimed to evaluate the attributable risk of VI associated with activity limitations and the extent to which limitations are avoidable with optimal optical correction of undercorrected refractive errors. We analyzed 709 older adults from the Three-City-Alienor population-based study. VI was defined by presenting distance visual acuity in the better-seeing eye. Multivariate modified Poisson regressions were used to estimate the associations between vision, activity limitations, and social participation restrictions. Population attributable risk (PAR) and generalized impact fraction (GIF) were estimated. Bootstrapping was used to estimate 95% confidence intervals (CI). After adjustment for potential confounders, VI was associated with each domain of activity limitations, except basic activities of daily living (ADL) limitations. These associations were found for even minimal levels of VI. PAR was estimated at 10.1% (95% CI: 5.2-10.6) for mobility limitations, at 26.0% (95% CI: 13.5-41.2) for instrumental ADL (IADL) limitations, and at 24.9% (95% CI: 10.5-47.1) for social participation restrictions. GIF for improvement of undercorrected refractive errors was 6.1% (95% CI: 3.8-8.5) for mobility limitations, 15.8% (95% CI: 11.5-20.1) for IADL limitations and 21.4% (95% CI: 13.8-28.5) for social participation restrictions. About one-sixth of IADL limitations and one-fifth of social participation restrictions could be prevented by an optimal optical correction. These results underline the importance of eye examinations in older adults to prevent disability.

Approach for the Development of a Framework for the Identification of Activities of Daily Living Using Sensors in Mobile Devices.

PubMed

Pires, Ivan Miguel; Garcia, Nuno M; Pombo, Nuno; Flórez-Revuelta, Francisco; Spinsante, Susanna

2018-02-21

Sensors available on mobile devices allow the automatic identification of Activities of Daily Living (ADL). This paper describes an approach for the creation of a framework for the identification of ADL, taking into account several concepts, including data acquisition, data processing, data fusion, and pattern recognition. These concepts can be mapped onto different modules of the framework. The proposed framework should perform the identification of ADL without Internet connection, performing these tasks locally on the mobile device, taking in account the hardware and software limitations of these devices. The main purpose of this paper is to present a new approach for the creation of a framework for the recognition of ADL, analyzing the allowed sensors available in the mobile devices, and the existing methods available in the literature.

Approach for the Development of a Framework for the Identification of Activities of Daily Living Using Sensors in Mobile Devices

PubMed Central

Pombo, Nuno

2018-01-01

Sensors available on mobile devices allow the automatic identification of Activities of Daily Living (ADL). This paper describes an approach for the creation of a framework for the identification of ADL, taking into account several concepts, including data acquisition, data processing, data fusion, and pattern recognition. These concepts can be mapped onto different modules of the framework. The proposed framework should perform the identification of ADL without Internet connection, performing these tasks locally on the mobile device, taking in account the hardware and software limitations of these devices. The main purpose of this paper is to present a new approach for the creation of a framework for the recognition of ADL, analyzing the allowed sensors available in the mobile devices, and the existing methods available in the literature. PMID:29466316

Physical Activity Measurement Instruments for Children with Cerebral Palsy: A Systematic Review

ERIC Educational Resources Information Center

Capio, Catherine M.; Sit, Cindy H. P.; Abernethy, Bruce; Rotor, Esmerita R.

2010-01-01

Aim: This paper is a systematic review of physical activity measurement instruments for field-based studies involving children with cerebral palsy (CP). Method: Database searches using PubMed Central, MEDLINE, CINAHL Plus, PsycINFO, EMBASE, Cochrane Library, and PEDro located 12 research papers, identifying seven instruments that met the inclusion…

Using Claims Data to Predict Dependency in Activities of Daily Living as a Proxy for Frailty

PubMed Central

Faurot, Keturah R.; Funk, Michele Jonsson; Pate, Virginia; Brookhart, M. Alan; Patrick, Amanda; Hanson, Laura C.; Castillo, Wendy Camelo; Stürmer, Til

2014-01-01

Purpose Estimating drug effectiveness and safety among older adults in population-based studies using administrative healthcare claims can be hampered by unmeasured confounding due to frailty. A claims-based algorithm that identifies patients likely to be dependent, a proxy for frailty, may improve confounding control. Our objective was to develop an algorithm to predict dependency in activities of daily living (ADL) in a sample of Medicare beneficiaries. Methods Community-dwelling respondents to the 2006 Medicare Current Beneficiary Survey, >65 years old, with Medicare Part A, B, home health, and hospice claims were included. ADL dependency was defined as needing help with bathing, eating, walking, dressing, toileting, or transferring. Potential predictors were demographics, ICD-9 diagnosis/procedure and durable medical equipment codes for frailty-associated conditions. Multivariable logistic regression was to predict ADL dependency. Cox models estimated hazard ratios for death as a function of observed and predicted ADL dependency. Results Of 6391 respondents, 57% were female, 88% white, and 38% were ≥80. The prevalence of ADL dependency was 9.5%. Strong predictors of ADL dependency were charges for a home hospital bed (OR=5.44, 95% CI=3.28–9.03) and wheelchair (OR=3.91, 95% CI=2.78–5.51). The c-statistic of the final model was 0.845. Model-predicted ADL dependency of 20% or greater was associated with a hazard ratio for death of 3.19 (95% CI: 2.78, 3.68). Conclusions An algorithm for predicting ADL dependency using healthcare claims was developed to measure some aspects of frailty. Accounting for variation in frailty among older adults could lead to more valid conclusions about treatment use, safety, and effectiveness. PMID:25335470

Improving activities of daily living for nursing home elder persons in Taiwan.

PubMed

Chang, Su-Hsien; Wung, Shu-Fen; Crogan, Neva L

2008-01-01

Excess disability among nursing home elder persons can be prevented or remediated. Because of self-selected disuse and caregiver support of dependency, nursing home residents are likely to develop excess disability. No study was found to test a theory-based program aimed at improving elder persons' self-care abilities for Taiwanese nursing home elder persons who are at risk for developing excess disability. The purpose of this study was to test the effectiveness of a theory-based intervention program on self-care, specifically on activities of daily living (ADLs) performance among nursing home elder persons in Taiwan. A secondary aim was to determine the correlation between ADLs performance and three bliss concepts: life satisfaction, self-esteem, and motivation in health behavior. This study used a quasi-experimental, two-group, pretest-posttest design. Forty-two qualified participants were recruited from two nursing homes located in southern Taiwan and assigned to either the experimental group (n = 21) or the comparison group (n = 21). Participants in the experimental group received the Self-Care Self-Efficacy Enhancement Program (SCSEEP), and those in the comparison group received biweekly social visits for 6 weeks. Levels of ADLs performance were measured by Tappen's Refined ADL Assessment Scale. Life satisfaction was measured by Adams' Life Satisfaction Index A. Self-esteem was measured by Rosenberg's Self-Esteem Scale. Motivation in health behavior was measured by Cox's Health Self-Determinism Index. Elder persons receiving the SCSEEP had significant improvement in feeding, dressing, grooming, and washing activities. Self-esteem (p = .011) and life satisfaction (p = .033) but not motivation in health behavior (p = .282) were positively correlated with levels of ADLs performance. The SCSEEP provides a theory-based intervention model for Taiwanese nursing home elder persons aimed at improving ADLs performance. Further research with a larger sample size is

A field instrument for quantitative determination of beryllium by activation analysis

USGS Publications Warehouse

Vaughn, William W.; Wilson, E.E.; Ohm, J.M.

1960-01-01

A low-cost instrument has been developed for quantitative determinations of beryllium in the field by activation analysis. The instrument makes use of the gamma-neutron reaction between gammas emitted by an artificially radioactive source (Sb124) and beryllium as it occurs in nature. The instrument and power source are mounted in a panel-type vehicle. Samples are prepared by hand-crushing the rock to approximately ?-inch mesh size and smaller. Sample volumes are kept constant by means of a standard measuring cup. Instrument calibration, made by using standards of known BeO content, indicates the analyses are reproducible and accurate to within ? 0.25 percent BeO in the range from 1 to 20 percent BeO with a sample counting time of 5 minutes. Sensitivity of the instrument maybe increased somewhat by increasing the source size, the sample size, or by enlarging the cross-sectional area of the neutron-sensitive phosphor normal to the neutron flux.

Functioning and disability in adults with myotonic dystrophy type 1.

PubMed

Kierkegaard, Marie; Harms-Ringdahl, Karin; Holmqvist, Lotta Widén; Tollbäck, Anna

2011-01-01

 To provide a comprehensive description of functioning and disability with regard to stages of disease progression in adults with myotonic dystrophy type 1 (DM1). Further to explore associations of measures of manual dexterity and of walking capacity with measures of activities of daily living (ADL) and participation in social and lifestyle activities. Seventy persons with DM1 underwent examinations, tests and answered questionnaires. Stages of disease progression were based on the muscular impairment rating scale.  Overweight, cardiac dysfunctions, respiratory restrictions, fatigue and/or low physical activity levels were found in approximately 40% of those with DM1. Over 75% had muscle impairments, and activity limitations in manual dexterity and walking. Dependence in personal and instrumental ADL was found in 16% and 39%, respectively, and participation restrictions in social and lifestyle activities in 52%. The presence of concurrent body-function impairments, activity limitations and participation restrictions was high. Significant differences were found in muscle impairment, manual dexterity, mobility, ADL and social and lifestyle activities with regard to disease progression. Cut-off values in measures of manual dexterity and walking capacity associated to functioning are proposed.  This information can be used for developing clinical practise and for health promotion for persons with DM1.

Association of sarcopenia with swallowing problems, related to nutrition and activities of daily living of elderly individuals

PubMed Central

Shiozu, Hiroyasu; Higashijima, Misako; Koga, Tomoshige

2015-01-01

[Purpose] The purpose of the current study was to clarify problems associated with swallowing, related to nutrition and activities of daily living (ADL), in elderly individuals with sarcopenia. [Subjects and Methods] Seventy-seven subjects were assigned to a sarcopenia or a non-sarcopenia group according to a definition used by the European Working Group on Sarcopenia in Older People. Analyses were conducted including and excluding subjects with a central nervous system disorders in order to focus on the influence of sarcopenia. The swallowing ability, ADL, and nutrition levels were compared between the 2 groups. [Results] Swallowing function as well as ADL and nutrition levels were significantly lower in the sarcopenia group than in the non-sarcopenia group. [Conclusion] It is important to include dimensions of swallowing, nutrition, and ADL in the assessment and treatment of swallowing problems in elderly individuals with sarcopenia. PMID:25729176

Dual Sensory Loss and Its Impact on Everyday Competence

ERIC Educational Resources Information Center

Brennan, Mark; Horowitz, Amy; Su, Ya-ping

2005-01-01

Purpose: This study examined the relation of dual and single sensory impairments, within the context of cognitive function, by using the framework of everyday competence in terms of the probability of difficulty with specific personal and instrumental activities of daily living (ADLs and IADLs, respectively). Design and Methods: The Longitudinal…

Instrumental Neutron Activation Analysis and Multivariate Statistics for Pottery Provenance

NASA Astrophysics Data System (ADS)

Glascock, M. D.; Neff, H.; Vaughn, K. J.

2004-06-01

The application of instrumental neutron activation analysis and multivariate statistics to archaeological studies of ceramics and clays is described. A small pottery data set from the Nasca culture in southern Peru is presented for illustration.

Relationship between impairments, disability and handicap in reflex sympathetic dystrophy patients: a long-term follow-up study.

PubMed

Geertzen, J H; Dijkstra, P U; van Sonderen, E L; Groothoff, J W; ten Duis, H J; Eisma, W H

1998-10-01

To determine the relationship between impairments, disability and handicap in reflex sympathetic dystrophy (RSD) patients. A long-term follow-up study of upper extremity RSD patients. A university hospital. Sixty-five patients, 3-9 years (mean interval 5.5 years) after RSD of the upper extremity (mean age 50.2 years). Impairments: range of motion, moving two point discrimination, muscle strength of the hand and pain were measured. Disability was assessed with the Groningen Activity Restriction Scale (GARS) and handicap was assessed with three subscales (social functioning, role limitations due to physical problems and role limitations due to emotional problems) of the RAND-36. After RSD of the upper extremity, 62% of the patients are limited in activities of daily living (ADL) and/or instrumental ADL (IADL). Pain and restrictions in forward flexion of the shoulder, thumb opposition and grip strength are the most important impairments limiting ADL and IADL. Patients with limitations in ADL and IADL are significantly more handicapped than patients without limitations. Pain is the most important factor contributing to handicap. The relationship between impairments and disability and between disability and handicap in RSD patients is weak to moderate. Pain is the most important factor leading to disability and handicap.

Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review

PubMed Central

Whitehead, Phillip J; Worthington, Esme J; Parry, Ruth H; Walker, Marion F; Drummond, Avril ER

2015-01-01

Objectives: To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content; effectiveness in improving ability to perform ADL; and whether delivery by qualified occupational therapists influences effectiveness. Data sources: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. Review methods: We included: randomised controlled trials, non-randomised controlled trials and controlled before and after studies. Two reviewers independently screened studies for inclusion, assessed risk of bias and extracted data. A narrative synthesis of the findings was conducted. Results: Thirteen studies were included, totalling 4975 participants. Ten (77%) were judged to have risk of bias. Interventions were categorised as those termed ‘re-ablement’ or ‘restorative homecare’ (n=5/13); and those involving separate components which were not described using this terminology (n=8/13). Content of the intervention and level of health professional input varied within and between studies. Effectiveness on ADL: eight studies included an ADL outcome, five favoured the intervention group, only two with statistical significance, both these were controlled before and after studies judged at high risk of bias. ADL outcome was reported using seven different measures. Occupational therapy: there was insufficient evidence to determine whether involvement of qualified occupational therapists influenced effectiveness. Conclusion: There is limited evidence that interventions targeted at personal ADL can reduce homecare service users’ dependency with activities, the content of evaluated interventions varies greatly. PMID:25587088

Active region upflows. I. Multi-instrument observations

NASA Astrophysics Data System (ADS)

Vanninathan, K.; Madjarska, M. S.; Galsgaard, K.; Huang, Z.; Doyle, J. G.

2015-12-01

Context. We study upflows at the edges of active regions, called AR outflows, using multi-instrument observations. Aims: This study intends to provide the first direct observational evidence of whether chromospheric jets play an important role in furnishing mass that could sustain coronal upflows. The evolution of the photospheric magnetic field, associated with the footpoints of the upflow region and the plasma properties of active region upflows is investigated with the aim of providing information for benchmarking data-driven modelling of this solar feature. Methods: We spatially and temporally combine multi-instrument observations obtained with the Extreme-ultraviolet Imaging Spectrometer on board the Hinode, the Atmospheric Imaging Assembly and the Helioseismic Magnetic Imager instruments on board the Solar Dynamics Observatory and the Interferometric BI-dimensional Spectro-polarimeter installed at the National Solar Observatory, Sac Peak, to study the plasma parameters of the upflows and the impact of the chromosphere on active region upflows. Results: Our analysis shows that the studied active region upflow presents similarly to those studied previously, i.e. it displays blueshifted emission of 5-20 kms-1 in Fe xii and Fe xiii and its average electron density is 1.8 × 109 cm-3 at 1 MK. The time variation of the density is obtained showing no significant change (in a 3σ error). The plasma density along a single loop is calculated revealing a drop of 50% over a distance of ~20 000 km along the loop. We find a second velocity component in the blue wing of the Fe xii and Fe xiii lines at 105 kms-1 reported only once before. For the first time we study the time evolution of this component at high cadence and find that it is persistent during the whole observing period of 3.5 h with variations of only ±15 kms-1. We also, for the first time, study the evolution of the photospheric magnetic field at high cadence and find that magnetic flux diffusion is

Geriatric Assessment and Functional Decline in Older Patients with Lung Cancer.

PubMed

Decoster, L; Kenis, C; Schallier, D; Vansteenkiste, J; Nackaerts, K; Vanacker, L; Vandewalle, N; Flamaing, J; Lobelle, J P; Milisen, K; De Grève, J; Wildiers, H

2017-10-01

Older patients with lung cancer are a heterogeneous population making treatment decisions complex. This study aims to evaluate the value of geriatric assessment (GA) as well as the evolution of functional status (FS) in older patients with lung cancer, and to identify predictors associated with functional decline and overall survival (OS). At baseline, GA was performed in patients ≥70 years with newly diagnosed lung cancer. FS measured by activities of daily living (ADL) and instrumental activities of daily living (IADL) was reassessed at follow-up to define functional decline and OS was collected. Predictors for functional decline and OS were determined. Two hundred and forty-five patients were included in this study. At baseline, GA deficiencies were present in all domains and ADL and IADL were impaired in 51 and 63% of patients, respectively. At follow-up, functional decline in ADL was observed in 23% and in IADL in 45% of patients. In multivariable analysis, radiotherapy was predictive for ADL decline. No other predictors for ADL or IADL decline were identified. Stage and baseline performance status were predictive for OS. Older patients with lung cancer present with multiple deficiencies covering all geriatric domains. During treatment, functional decline is observed in almost half of the patients. None of the specific domains of the GA were predictive for functional decline or survival, probably because of the high impact of the aggressiveness of this tumor type leading to a poor prognosis.

Follow-Up Activities for the HISD Kindergarten Screening Instrument.

ERIC Educational Resources Information Center

Perry, Pat; Cater, Margot

The Kindergarten Screening Instrument consists of five sub-scales and attempts to screen for possible difficulty in the areas of distant vision, hearing, eye-hand coordination, language learning, and gross motor performance. In response to many requests for follow-up activities after screening, this manual was prepared by Volunteers in Public…

Planetary Geochemistry Using Active Neutron and Gamma Ray Instrumentation

NASA Technical Reports Server (NTRS)

Parsons, A.; Bodnarik, J.; Evans, L.; Floyd, S.; Lim, L.; McClanahan, T.; Namkung, M.; Schweitzer, J.; Starr, R.; Trombka, J.

2010-01-01

The Pulsed Neutron Generator-Gamma Ray And Neutron Detector (PNG-GRAND) experiment is an innovative application of the active neutron-gamma ray technology so successfully used in oil field well logging and mineral exploration on Earth, The objective of our active neutron-gamma ray technology program at NASA Goddard Space Flight Center (NASA/GSFC) is to bring the PNG-GRAND instrument to the point where it can be flown on a variety of surface lander or rover missions to the Moon, Mars, Venus, asterOIds, comets and the satellites of the outer planets, Gamma-Ray Spectrometers have been incorporated into numerous orbital planetary science missions and, especially in the case of Mars Odyssey, have contributed detailed maps of the elemental composition over the entire surface of Mars, Neutron detectors have also been placed onboard orbital missions such as the Lunar Reconnaissance Orbiter and Lunar Prospector to measure the hydrogen content of the surface of the moon, The DAN in situ experiment on the Mars Science Laboratory not only includes neutron detectors, but also has its own neutron generator, However, no one has ever combined the three into one instrument PNG-GRAND combines a pulsed neutron generator (PNG) with gamma ray and neutron detectors to produce a landed instrument that can determine subsurface elemental composition without drilling. We are testing PNG-GRAND at a unique outdoor neutron instrumentation test facility recently constructed at NASA/GSFC that consists of a 2 m x 2 m x 1 m granite structure in an empty field, We will present data from the operation of PNG-GRAND in various experimental configurations on a known sample in a geometry that is identical to that which can be achieved on a planetary surface. We will also compare the material composition results inferred from our experiments to both an independent laboratory elemental composition analysis and MCNPX computer modeling results,

BIRA-IASB Mars activities and instrument capabilities

NASA Astrophysics Data System (ADS)

Drummond, R.; Vandaele, A.-C.; Gillotay, D.; Willame, Y.; Depiesse, C.; Patel, M.; Daerden, F.; Neefs, E.; Ristic, B.; Montmessin, F.

2009-04-01

The Belgian Institute of Space Aeronomy (BIRA-IASB) is involved in many areas of Mars exploration, and has been for a long time. Current activities include analysis of SPICAM data, 3D atmospheric modelling as well as instrument development and characterization. This paper will focus on two different instruments to study the Martian atmosphere. UVIS(Patel, 2006) is part of the Exomars payload, that will gather information on the UV levels on the ground, study climatology and sterilisation and also be able to detect organic material in sublimating permafrost. BIRA-IASB is carrying out the characterization and calibration of UVIS. SOIR is an infra-red spectrometer that uses solar occultation measurements to examine major and minor constituents of planetary atmospheres. SOIR is currently orbiting Venus on the VEX spacecraft and has already made several interesting discoveries including the first observations of a new band of a CO2 isotopologue. The data from SOIR-VEX has allowed us to study the instrumental characteristics and perform a sensitivity study(Mahieux, 2008). These properties have been used to simulate realistic SOIR measurements of Mars atmospheric spectra. This work is supported by extensive 3D chemistry modeling work, as described in a paper by Frank Daerden (PS2.9Atmospheres of terrestrial planets). M. R. Patel, et al.,(2006) The UV-VIS spectrometer for the ExoMars mission, in 36th COSPAR Scientific Assembly, Beijing, China. A. Mahieux, et al.,(2008), Appl. Opt. 47 (13), 2252-65.

Mild versus moderate stages of Alzheimer's disease: three-year outcomes in a routine clinical setting of cholinesterase inhibitor therapy.

PubMed

Wattmo, Carina; Minthon, Lennart; Wallin, Åsa K

2016-02-17

There is an increasing interest in cognitive and functional outcomes in the respective stages of Alzheimer's disease (AD) and in novel therapies particularly for the milder phases of AD. Our aim was to describe and compare various aspects of disease progression in patients with mild versus moderate AD in routine clinical practice of cholinesterase inhibitor (ChEI) therapy. This 3-year, prospective, observational, multicentre study included 1021 participants. Of these, 734 had mild AD (Mini-Mental State Examination (MMSE) score, 20-26) and 287 had moderate AD (MMSE score, 10-19) at the start of ChEI treatment. At baseline and every 6 months, patients were assessed using cognitive, global, instrumental and basic activities of daily living (ADL) scales. Potential predictors of deterioration in moderate AD were analysed using mixed-effects models. The change from baseline between participants with mild and moderate stages of AD after 3 years of ChEI therapy differed significantly on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and basic ADL, but not using the MMSE and instrumental ADL scales. Protective independent factors for better cognitive long-term outcome in the group with moderate AD were older age, higher instrumental ADL ability, no antipsychotics, usage of non-steroidal anti-inflammatory drugs/acetylsalicylic acid, living with family member, lower education and a higher mean dose of ChEI. Apolipoprotein E genotype did not influence the rates of disease progression or the longitudinal outcomes. Prediction models were provided for moderate AD. More sensitive cognitive measures, such as the ADAS-cog scale, are required to detect a possibly faster deterioration among the participants with moderate AD. This study highlighted the clinical importance of instrumental ADL evaluations in patients at a mild stage of AD, and the importance of optimizing the ChEI dose even for individuals with moderate AD. Solitary living was a risk factor for

The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability.

PubMed

Dijkhuizen, Annemarie; Hilgenkamp, Thessa I M; Krijnen, Wim P; van der Schans, Cees P; Waninge, Aly

2016-01-01

The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and physical capacities. However, until recently, the impact of the significantly prevalent visual impairments on the performance of activities of daily living has not yet been revealed within this group. The purpose of this prospective cross-sectional study was to investigate the impact of visual impairment on the performance of activities of daily living for persons with a severe/profound intellectual disability. The Barthel Index (BI) and Comfortable Walking Speed (CWS) were used to measure the ability of performing activities of daily living (ADL) in 240 persons with severe/profound ID and having Gross Motor Functioning Classification System (GMFCS) levels I, II or III; this included 120 persons with visual impairment. The impact of visual impairment on ADL was analyzed with linear regression. The results of the study demonstrated that visual impairment slightly affects the ability of performing activities of daily living (BI) for persons experiencing a severe/profound intellectual disability. GMFCS Levels II or III, profound ID level, and visual impairment each have the effect of lowering BI scores. GMFCS Levels II or III, and profound ID level each have the effect of increasing CWS scores, which indicates a lower walking speed. A main effect of visual impairment is present on CWS, but our results do show a substantive interaction effect between GMFCS level III and visual impairment on Comfortable Walking Speed in persons with a severe/profound intellectual disability. Visual impairment has a slight effect on ability to perform ADL in persons experiencing severe/profound ID. Copyright © 2015 Elsevier Ltd. All rights reserved.

Arm Activity During Daily Life in Individuals With Chronic Obstructive Pulmonary Disease.

PubMed

Janaudis-Ferreira, Tania; Mathur, Sunita; Romano, Julia Marie; Goldstein, Roger Samuel; Brooks, Dina

2016-01-01

To determine whether individuals with chronic obstructive pulmonary disease (COPD) have decreased arm activity during daily life compared with healthy controls and explore the relationships between arm activity during daily life and arm functional measures in individuals with COPD. This was a prospective cross-sectional study that included 30 people with COPD and 14 healthy controls. Subjects attended a single assessment session in which measurements of arm exercise capacity, arm functional performance, self-perception of performance during activities of daily living (ADL), shoulder and elbow flexion force and biceps and triceps thickness were performed. On completion of this session, participants were issued a wrist actigraph and asked to wear the device on the dominant arm for 24 hours for 7 consecutive days. Compared with healthy controls, patients with COPD presented decreased total activity level in daily life (P = .001). When corrected for walking, the level of arm activity did not differ between individuals with COPD and healthy controls (P = .62). No correlations were found between arm activity and arm exercise capacity, arm functional performance, upper limb muscle strength, and self-perception of performance during ADL (r =-0.20 to 0.14; all P ≥ .10). Arm activity intensity in individuals with COPD did not differ from that of healthy controls when measured by a wrist actigraph. Moreover, arm activity was not associated with other clinical outcomes of arm function. Disability during ADL is multifactorial, and only limited inferences of function can be made from accelerometer data.

Disability associated with obesity, dynapenia and dynapenic-obesity in Chinese older adults.

PubMed

Yang, Ming; Ding, Xiang; Luo, Li; Hao, Qiukui; Dong, Birong

2014-02-01

Whether the combination of obesity and low muscle strength (dynapenic-obesity) would cause greater impairment of the activities of daily living (ADL)/instrumental activities of daily living (IADL) than obesity alone and low muscle strength alone (dynapenia) remains unclear. The aim of this study was to reveal the possible independent and additive effects of dynapenia and obesity on ADL/IADL disability in an older Chinese population. A cross-sectional study, including 616 community-dwelling older adults, was conducted in China from 2010 to 2012. Based on the World Health Organization Asian Criteria of Obesity and handgrip strength tertiles, 4 independent groups were identified as follows: nondynapenia/nonobesity, dynapenia alone, obesity alone, and dynapenic-obesity. The Katz Index of Independence in ADL was used to assess ADL disability, whereas 6 IADL items of the Older Americans Resources and Services (OARS) multidimensional functional assessment questionnaire were used to assess IADL disability. The prevalence of ADL and IADL disability was 21.1% and 28.9% in the dynapenic-obesity group, 15.5% and 22.6% in the dynapenia alone group, 13.1% and 19.6% in the obesity alone group, and 11.9% and 12.9% in the nondynapenia/nonobesity group, respectively. After adjusting for the covariates, in comparison with the dynapenic-obesity group, the adjusted odds ratios (95% confidence interval) for ADL disability were 0.36 (0.13-0.73) in the nondynapenia/nonobesity group, 0.51 (0.20-0.78) in the dynapenia-alone group, and 0.40 (0.11-0.61) in the obesity-alone group. The corresponding data for IADL disability were 0.55 (0.20-0.93), 0.82 (0.39-0.98), and 0.61 (0.30-0.91), respectively. Dynapenia, obesity, and dynapenic-obesity were associated with an increased risk of ADL/IADL disability. Dynapenic-obesity was associated with a greater risk of ADL/IADL disability in comparison with dynapenia or obesity alone. Copyright © 2014 American Medical Directors Association, Inc

Intercomparison of active and passive instruments for radon and radon progeny in North America

DOE Office of Scientific and Technical Information (OSTI.GOV)

George, A.C.; Tu, Keng-Wu; Knutson, E.O.

1995-02-01

An intercomparison exercise for radon and radon progeny instruments and methods was held at the Environmental Measurements Laboratory (EML) from April 22--May 2, 1994. The exercise was conducted in the new EML radon test and calibration facility in which conditions of exposure are very well controlled. The detection systems of the intercompared instruments consisted of. (1) pulse ionization chambers, (2) electret ionization chambers, (3) scintillation detectors, (4) alpha particle spectrometers with silicon diodes, surface barrier or diffused junction detectors, (5) registration of nuclear tracks in solid-state materials, and (6) activated carbon collectors counted by gamma-ray spectrometry or by alpha- andmore » beta-liquid scintillation counting. 23 private firms, government laboratories and universities participated with a 165 passive integrating devices consisting of: Activated carbon collectors, nuclear alpha track detectors and electret ionization chambers, and 11 active and passive continuous radon monitors. Five portable integrating and continuous instruments were intercompared for radon progeny. Forty grab samples for radon progeny were taken by five groups that participated in person to test and evaluate their primary instruments and methods that measure individual radon progeny and the potential alpha energy concentration (PAEC) in indoor air. Results indicate that more than 80% of the measurements for radon performed with a variety of instruments, are within {plus_minus}10% of actual value. The majority of the instruments that measure individual radon progeny and the PAEC gave results that are in good agreement with the EML reference value. Radon progeny measurements made with continuous and integrating instruments are satisfactory with room for improvement.« less

Wavefront sensors for the active control of earth observation optical instruments

NASA Astrophysics Data System (ADS)

Velluet, Marie-Thérèse; Michau, Vincent; Rousset, Gérard

2018-04-01

This paper, "Wavefront sensors for the active control of earth observation optical instruments," was presented as part of International Conference on Space Optics—ICSO 1997, held in Toulouse, France.

Aphasia and activities of daily living in stroke patients.

PubMed

Gialanella, Bernardo; Prometti, Paola; Vanoglio, Fabio; Comini, Laura; Santoro, Raffaele

2016-12-01

Few studies have investigated the relationships between aphasia and activities of daily living (ADLs) in stroke patients. This study was aimed firstly to determine which task within the ADLs has poorer functional recovery in stroke patients with aphasia after rehabilitation, second to identify which specific task is related to aphasia. This is a prospective and observational study. Inpatients of our Rehabilitation Unit. The study was carried out in 219 patients with primary diagnosis of stroke with (104) and without aphasia (115). All patients underwent usual rehabilitation. Aachen Aphasia Test and Functional Independence Measure scale were used to assess severity of aphasia and ADLs, respectively. Gain in ADLs was the main outcome measure. At the end of rehabilitation patients with aphasia had lower gain in bathing, dressing upper body, dressing lower body, toileting, stair climbing, and higher gain in social interaction, problem solving, and memory with respect to patients without aphasia. However, when data were adjusted for side of hemiplegia, Fugl-Meyer score and trunk control test, patients with aphasia showed lower gain in dressing upper body (P=0.027), dressing lower body (P=0.009), lower toileting (P=0.027), and higher gain in social interaction (P<0.001). In the multivariate regression analysis, aphasia was an important determinant of gain in bathing (β=0.26), dressing upper body (β=0.24), dressing lower body (β=0.22), lower toileting (β=0.22), and social interaction (β=-0.29). The current study points out that, after usual rehabilitation, the patients with aphasia show a poor gain in personal care activities and higher gain in social interaction. Knowledge of these findings: 1) can guide the rehabilitation team in selecting specific and appropriate therapies aimed to give patient with aphasia the highest possible functional independence in ADLs; 2) is useful to family members and social rehabilitation services for domiciliary management of patients

Age and gender differences in the association between social participation and instrumental activities of daily living among community-dwelling elderly.

PubMed

Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

2017-04-28

Although many studies have suggested social participation (SP) has beneficial effects on elderly people's health, most of them failed to deal with paid work. Additionally, few studies have focused on the age effect between SP and older people's health. To investigate whether the association between SP, including paid work, and instrumental activities of daily living (IADL), exhibits not only in gender, but also in age among community-dwelling older adults. In 2014, we distributed self-administered questionnaires to all community-dwelling elderly aged ≥65 in two medium-sized cities in Nara Prefecture, Japan (n = 32,825). 22,845 residents submitted the questionnaire (response rate, 69.6%). Analyzed subjects were limited to 17,680 persons who had neither dependency in basic ADL nor missing data for required items. SP was assessed based on participation frequency in seven types of social activities: volunteer groups, sports groups, hobby groups, cultural groups, senior citizens' clubs, neighborhood community associations, and paid work. Using Poisson regression models, prevalence ratio for poor IADL was calculated. To examine age and gender differences in the association between SP and IADL, we performed stratified analyses by age and gender group; male young-old (aged 65-74), male old-old (aged ≥75), female young-old, and female old-old. Prevalence of those with poor IADL was 17.1% in males and 4.5% in females, showing a significant gender difference. After adjustment for relevant covariates, volunteer groups were inversely associated with poor IADL only in males and the relationship was stronger in the old-old group than in the young-old group. Conversely, only females had a significant inverse association between paid work and poor IADL, and the association was not reliant on their ages but only those who participated infrequently had a favorable effect. Influence of age in the beneficial association between SP and IADL was generally larger in the old

Physics thematic paths: laboratorial activities and historical scientific instruments

NASA Astrophysics Data System (ADS)

Pantano, O.; Talas, S.

2010-03-01

The Physics Department of Padua University keeps an important collection of historical physics instruments which alludes to the fruitful scientific activity of Padua through the centuries. This heritage led to the suggestion of setting up laboratory activities connected to the Museum collection for secondary school students. This article shows how different thematic paths have been developed, reflecting on the importance of historical perspectives in science teaching. We also show how a scientific historical museum can play a central role in improving the learning of physics concepts.

Cigarette Smoking and Activities of Daily Living in Ocular Myasthenia Gravis.

PubMed

Gratton, Sean M; Herro, Angela M; Feuer, William J; Lam, Byron L

2016-03-01

Myasthenia gravis is an autoimmune disease of the neuromuscular junction, commonly affecting the ocular muscles. Cigarette smoking has been shown to influence many autoimmune diseases, including multiple sclerosis and rheumatoid arthritis, but its effect on myasthenia gravis has not been well studied. We sought to determine whether cigarette smoking influenced disease-related symptoms in ocular myasthenia gravis (OMG). We performed a prospective, clinic-based cross-sectional study in a single academic neuro-ophthalmology practice. All patients diagnosed with OMG between November 2006 and April 2014 were included. A prospective telephone survey was administered to determine smoking status and myasthenia gravis-related symptom severity. The main outcome measure was the myasthenia gravis-specific activities of daily living (MG-ADL) score, a well-validated marker of symptoms and quality of life in myasthenia gravis. Forty-four patients were included in the analysis. Comparison of MG-ADL ocular subscores between current smokers (3.4 ± 2.6), former smokers (1.8 ± 2.1), and never smokers (1.1 ± 1.5) revealed a statistically significant relationship (P = 0.031) where current smokers had the highest MG-ADL ocular subscores and never smokers the lowest. Comparison of MG-ADL total scores revealed the same relationship (current 5.6 ± 4.5, former 2.9 ± 3.1, never 1.4 ± 2.5, P = 0.003). There were borderline significant correlations of pack years with MG-ADL ocular subscore (r = 0.27, P = 0.074) and MG-ADL total score (r = 0.30, P = 0.051). Our findings indicate an association between cigarette smoking and symptom severity in OMG. This association suggests that smoking cessation in OMG patients may lead to improved symptom-related quality of life.

Clinical Prediction Rule for Declines in Activities of Daily Living at 6 Months After Surgery for Hip Fracture Repair.

PubMed

Tanaka, Ryo; Umehara, Takuya; Fujimura, Takafumi; Ozawa, Junya

2016-12-01

To develop and assess a clinical prediction rule (CPR) to predict declines in activities of daily living (ADL) at 6 months after surgery for hip fracture repair. Prospective, cohort study. From hospital to home. Patients (N=104) with hip fractures after surgery. Not applicable. ADL were assessed using the Barthel Index at 6 months after surgery. At 6 months after surgery, 86 patients (82.6%) were known to be alive, 1 patient (1.0%) had died, and 17 (16.3%) were lost to follow-up. Thirty-two patients (37.2%) did not recover their ADL at 6 months after surgery to levels before fracture. The classification and regression trees methodology was used to develop 2 models to predict a decline in ADL: (1) model 1 included age, type of fracture, and care level before fracture (sensitivity=75.0%, specificity=81.5%, positive predictive value=70.6%, positive likelihood ratio=4.050); and (2) model 2 included the degree of independence 2 weeks postsurgery for ADL chair transfer, ADL ambulation, and age (sensitivity=65.6%, specificity=87.0%, positive predictive value=75.0%, positive likelihood ratio=5.063). The areas under the receiver operating characteristic curves of both CPR models were .825 (95% confidential interval, .728-.923) and .790 (95% confidence interval, .683-.897), respectively. CPRs with moderate accuracy were developed to predict declines in ADL at 6 months after surgery for hip fracture repair. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Systematic Review of the Effects of Exercise on Activities of Daily Living in People With Alzheimer’s Disease

PubMed Central

Chou, Aileen; Bursley, Brett; Smulofsky, Jaclyn; Jezequel, Joel

2014-01-01

OBJECTIVE. Alzheimer’s disease (AD) results in a loss of independence in activities of daily living (ADLs), which in turn affects the quality of life of affected people and places a burden on caretakers. Limited research has examined the influence of physical training (aerobic, balance, and strength training) on ADL performance of people with AD. METHOD. Six randomized controlled trials (total of 446 participants) fit the inclusion criteria. For each study, we calculated effect sizes for primary and secondary outcomes. RESULTS. Average effect size (95% confidence interval) for exercise on the primary outcome (ADL performance) was 0.80 (p < .001). Exercise had a moderate impact on the secondary outcome of physical function (effect size = 0.53, p = .004). CONCLUSION. Occupational therapy intervention that includes aerobic and strengthening exercises may help improve independence in ADLs and improve physical performance in people with AD. Additional research is needed to identify specific components of intervention and optimal dosage to develop clinical guidelines. PMID:24367955

Economic Instruments for Population Diet and Physical Activity Behaviour Change: A Systematic Scoping Review

PubMed Central

Shemilt, Ian; Hollands, Gareth J.; Marteau, Theresa M.; Nakamura, Ryota; Jebb, Susan A.; Kelly, Michael P.; Suhrcke, Marc; Ogilvie, David

2013-01-01

Background Unhealthy diet and low levels of physical activity are common behavioural factors in the aetiology of many non-communicable diseases. Recent years have witnessed an upsurge of policy and research interest in the use of taxes and other economic instruments to improve population health. Objective To assemble, configure and analyse empirical research studies available to inform the public health case for using economic instruments to promote dietary and physical activity behaviour change. Methods We conducted a systematic scoping review of evidence for the effects of specific interventions to change, or general exposure to variations in, prices or income on dietary and physical activity behaviours and corollary outcomes. Systematic electronic searches and parallel snowball searches retrieved >1 million study records. Text mining technologies were used to prioritise title-abstract records for screening. Eligible studies were selected, classified and analysed in terms of key characteristics and principal findings, using a narrative, configuring synthesis focused on implications for policy and further research. Results We identified 880 eligible studies, including 192 intervention studies and 768 studies that incorporated evidence for prices or income as correlates or determinants of target outcomes. Current evidence for the effects of economic instruments and exposures on diet and physical activity is limited in quality and equivocal in terms of its policy implications. Direct evidence for the effects of economic instruments is heavily skewed towards impacts on diet, with a relative lack of evidence for impacts on physical activity. Conclusions The evidence-based case for using economic instruments to promote dietary and physical activity behaviour change may be less compelling than some proponents have claimed. Future research should include measurement of people’s actual behavioural responses using study designs capable of generating reliable causal

Economic instruments for population diet and physical activity behaviour change: a systematic scoping review.

PubMed

Shemilt, Ian; Hollands, Gareth J; Marteau, Theresa M; Nakamura, Ryota; Jebb, Susan A; Kelly, Michael P; Suhrcke, Marc; Ogilvie, David

2013-01-01

Unhealthy diet and low levels of physical activity are common behavioural factors in the aetiology of many non-communicable diseases. Recent years have witnessed an upsurge of policy and research interest in the use of taxes and other economic instruments to improve population health. To assemble, configure and analyse empirical research studies available to inform the public health case for using economic instruments to promote dietary and physical activity behaviour change. We conducted a systematic scoping review of evidence for the effects of specific interventions to change, or general exposure to variations in, prices or income on dietary and physical activity behaviours and corollary outcomes. Systematic electronic searches and parallel snowball searches retrieved >1 million study records. Text mining technologies were used to prioritise title-abstract records for screening. Eligible studies were selected, classified and analysed in terms of key characteristics and principal findings, using a narrative, configuring synthesis focused on implications for policy and further research. We identified 880 eligible studies, including 192 intervention studies and 768 studies that incorporated evidence for prices or income as correlates or determinants of target outcomes. Current evidence for the effects of economic instruments and exposures on diet and physical activity is limited in quality and equivocal in terms of its policy implications. Direct evidence for the effects of economic instruments is heavily skewed towards impacts on diet, with a relative lack of evidence for impacts on physical activity. The evidence-based case for using economic instruments to promote dietary and physical activity behaviour change may be less compelling than some proponents have claimed. Future research should include measurement of people's actual behavioural responses using study designs capable of generating reliable causal inferences regarding intervention effects. Policy

Objective Analysis of Performance of Activities of Daily Living in People With Central Field Loss.

PubMed

Pardhan, Shahina; Latham, Keziah; Tabrett, Daryl; Timmis, Matthew A

2015-11-01

People with central visual field loss (CFL) adopt various strategies to complete activities of daily living (ADL). Using objective movement analysis, we compared how three ADLs were completed by people with CFL compared with age-matched, visually healthy individuals. Fourteen participants with CFL (age 81 ± 10 years) and 10 age-matched, visually healthy (age 75 ± 5 years) participated. Three ADLs were assessed: pick up food from a plate, pour liquid from a bottle, and insert a key in a lock. Participants with CFL completed each ADL habitually (as they would in their home). Data were compared with visually healthy participants who were asked to complete the tasks as they would normally, but under specified experimental conditions. Movement kinematics were compared using three-dimension motion analysis (Vicon). Visual functions (distance and near acuities, contrast sensitivity, visual fields) were recorded. All CFL participants were able to complete each ADL. However, participants with CFL demonstrated significantly (P < 0.05) longer overall movement times, shorter minimum viewing distance, and, for two of the three ADL tasks, needed more online corrections in the latter part of the movement. Results indicate that, despite the adoption of various habitual strategies, participants with CFL still do not perform common daily living tasks as efficiently as healthy subjects. Although indices suggesting feed-forward planning are similar, they made more movement corrections and increased time for the latter portion of the action, indicating a more cautious/uncertain approach. Various kinematic indices correlated significantly to visual function parameters including visual acuity and midperipheral visual field loss.

Extracting aerobic system dynamics during unsupervised activities of daily living using wearable sensor machine learning models.

PubMed

Beltrame, Thomas; Amelard, Robert; Wong, Alexander; Hughson, Richard L

2018-02-01

Physical activity levels are related through algorithms to the energetic demand, with no information regarding the integrity of the multiple physiological systems involved in the energetic supply. Longitudinal analysis of the oxygen uptake (V̇o 2 ) by wearable sensors in realistic settings might permit development of a practical tool for the study of the longitudinal aerobic system dynamics (i.e., V̇o 2 kinetics). This study evaluated aerobic system dynamics based on predicted V̇o 2 data obtained from wearable sensors during unsupervised activities of daily living (μADL). Thirteen healthy men performed a laboratory-controlled moderate exercise protocol and were monitored for ≈6 h/day for 4 days (μADL data). Variables derived from hip accelerometer (ACC HIP ), heart rate monitor, and respiratory bands during μADL were extracted and processed by a validated random forest regression model to predict V̇o 2 . The aerobic system analysis was based on the frequency-domain analysis of ACC HIP and predicted V̇o 2 data obtained during μADL. Optimal samples for frequency domain analysis (constrained to ≤0.01 Hz) were selected when ACC HIP was higher than 0.05 g at a given frequency (i.e., participants were active). The temporal characteristics of predicted V̇o 2 data during μADL correlated with the temporal characteristics of measured V̇o 2 data during laboratory-controlled protocol ([Formula: see text] = 0.82, P < 0.001, n = 13). In conclusion, aerobic system dynamics can be investigated during unsupervised activities of daily living by wearable sensors. Although speculative, these algorithms have the potential to be incorporated into wearable systems for early detection of changes in health status in realistic environments by detecting changes in aerobic response dynamics. NEW & NOTEWORTHY The early detection of subclinical aerobic system impairments might be indicative of impaired physiological reserves that impact the capacity for physical activity

Reduced Gray Matter Volume Is Associated With Poorer Instrumental Activities of Daily Living Performance in Heart Failure.

PubMed

Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth; Narkhede, Atul; Griffith, Erica Y; Cohen, Ronald; Sweet, Lawrence H; Josephson, Richard; Hughes, Joel; Gunstad, John

2016-01-01

Heart failure patients require assistance with instrumental activities of daily living in part because of the high rates of cognitive impairment in this population. Structural brain insult (eg, reduced gray matter volume) is theorized to underlie cognitive dysfunction in heart failure, although no study has examined the association among gray matter, cognition, and instrumental activities of daily living in heart failure. The aim of this study was to investigate the associations among gray matter volume, cognitive function, and functional ability in heart failure. A total of 81 heart failure patients completed a cognitive test battery and the Lawton-Brody self-report questionnaire to assess instrumental activities of daily living. Participants underwent magnetic resonance imaging to quantify total gray matter and subcortical gray matter volume. Impairments in instrumental activities of daily living were common in this sample of HF patients. Regression analyses controlling for demographic and medical confounders showed that smaller total gray matter volume predicted decreased scores on the instrumental activities of daily living composite, with specific associations noted for medication management and independence in driving. Interaction analyses showed that reduced total gray matter volume interacted with worse attention/executive function and memory to negatively impact instrumental activities of daily living. Smaller gray matter volume is associated with greater impairment in instrumental activities of daily living in persons with heart failure, possibly via cognitive dysfunction. Prospective studies are needed to clarify the utility of clinical correlates of gray matter volume (eg, cognitive dysfunction) in identifying heart failure patients at risk for functional decline and determine whether interventions that target improved brain and cognitive function can preserve functional independence in this high-risk population.

Londrina Activities of Daily Living Protocol: Reproducibility, Validity, and Reference Values in Physically Independent Adults Age 50 Years and Older.

PubMed

Paes, Thaís; Belo, Letícia Fernandes; da Silva, Diego Rodrigues; Morita, Andrea Akemi; Donária, Leila; Furlanetto, Karina Couto; Sant'Anna, Thaís; Pitta, Fabio; Hernandes, Nidia Aparecida

2017-03-01

It is important to assess activities of daily living (ADL) in older adults due to impairment of independence and quality of life. However, there is no objective and standardized protocol available to assess this outcome. Thus, the aim of this study was to verify the reproducibility and validity of a new protocol for ADL assessment applied in physically independent adults age ≥50 y, the Londrina ADL protocol, and to establish an equation to predict reference values of the Londrina ADL protocol. Ninety-three physically independent adults age ≥50 y had their performance in ADL evaluated by registering the time spent to conclude the protocol. The protocol was performed twice. The 6-min walk test, which assesses functional exercise capacity, was used as a validation criterion. A multiple linear regression model was applied, including anthropometric and demographic variables that correlated with the protocol, to establish an equation to predict the protocol's reference values. In general, the protocol was reproducible (intraclass correlation coefficient 0.91). The average difference between the first and second protocol was 5.3%. The new protocol was valid to assess ADL performance in the studied subjects, presenting a moderate correlation with the 6-min walk test (r = -0.53). The time spent to perform the protocol correlated significantly with age (r = 0.45) but neither with weight (r = -0.17) nor with height (r = -0.17). A model of stepwise multiple regression including sex and age showed that age was the only determinant factor to the Londrina ADL protocol, explaining 21% ( P < .001) of its variability. The derived reference equation was: Londrina ADL protocol pred (s) = 135.618 + (3.102 × age [y]). The Londrina ADL protocol was reproducible and valid in physically independent adults age ≥50 y. A reference equation for the protocol was established including only age as an independent variable (r 2 = 0.21), allowing a better interpretation of the protocol

Does private religious activity prolong survival? A six-year follow-up study of 3,851 older adults.

PubMed

Helm, H M; Hays, J C; Flint, E P; Koenig, H G; Blazer, D G

2000-07-01

Previous studies have linked higher religious attendance and longer survival. In this study, we examine the relationship between survival and private religious activity. A probability sample of elderly community-dwelling adults in North Carolina was assembled in 1986 and followed for 6 years. Level of participation in private religious activities such as prayer, meditation, or Bible study was assessed by self-report at baseline, along with a wide variety of sociodemographic and health variables. The main outcome was time (days) to death or censoring. During a median 6.3-year follow-up period, 1,137 subjects (29.5%) died. Those reporting rarely to never participating in private religious activity had an increased relative hazard of dying over more frequent participants, but this hazard did not remain significant for the sample as a whole after adjustment for demographic and health variables. When the sample was divided into activity of daily living (ADL) impaired and unimpaired, the effect did not remain significant for the ADL impaired group after controlling for demographic variables (hazard ratio [RH] 1.11, 95% confidence interval [CI] 0.91-1.35). However, the increased hazard remained significant for the ADL unimpaired group even after controlling for demographic and health variables (RH 1.63, 95% CI 1.20-2.21), and this effect persisted despite controlling for numerous explanatory variables including health practices, social support, and other religious practices (RH 1.47, 95% CI 1.07-2.03). Older adults who participate in private religious activity before the onset of ADL impairment appear to have a survival advantage over those who do not.

The Development of a Physical Education Teachers' Physical Activity Self-Efficacy Instrument.

ERIC Educational Resources Information Center

Martin, Jeffrey J.; Kulinna, Pamela Hodges

2003-01-01

Developed a valid, reliable physical education teachers' physical activity self-efficacy scale for teaching classes in which students were engaged in high levels of physical activity. Results offer preliminary support for the psychometric properties of this instrument, which can help understand physical education teachers' efficacy in overcoming…

Natural History of Dependency in the Elderly: A 24-Year Population-Based Study Using a Longitudinal Item Response Theory Model.

PubMed

Edjolo, Arlette; Proust-Lima, Cécile; Delva, Fleur; Dartigues, Jean-François; Pérès, Karine

2016-02-15

We aimed to describe the hierarchical structure of Instrumental Activities of Daily Living (IADL) and basic Activities of Daily Living (ADL) and trajectories of dependency before death in an elderly population using item response theory methodology. Data were obtained from a population-based French cohort study, the Personnes Agées QUID (PAQUID) Study, of persons aged ≥65 years at baseline in 1988 who were recruited from 75 randomly selected areas in Gironde and Dordogne. We evaluated IADL and ADL data collected at home every 2-3 years over a 24-year period (1988-2012) for 3,238 deceased participants (43.9% men). We used a longitudinal item response theory model to investigate the item sequence of 11 IADL and ADL combined into a single scale and functional trajectories adjusted for education, sex, and age at death. The findings confirmed the earliest losses in IADL (shopping, transporting, finances) at the partial limitation level, and then an overlapping of concomitant IADL and ADL, with bathing and dressing being the earliest ADL losses, and finally total losses for toileting, continence, eating, and transferring. Functional trajectories were sex-specific, with a benefit of high education that persisted until death in men but was only transient in women. An in-depth understanding of this sequence provides an early warning of functional decline for better adaptation of medical and social care in the elderly. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluation of low-cost, objective instruments for assessing physical activity in 10-11-year-old children.

PubMed

Hart, Teresa L; Brusseau, Timothy; Kulinna, Pamela Hodges; McClain, James J; Tudor-Locke, Catrine

2011-12-01

This study compared step counts detected by four, low-cost, objective, physical-activity-assessment instruments and evaluated their ability to detect moderate-to-vigorous physical activity (MVPA) compared to the ActiGraph accelerometer (AG). Thirty-six 10-11-year-old children wore the NL-1000, Yamax Digiwalker SW 200, Omron HJ-151, and Walk4Life MVP concurrently with the AG during school hours on a single day. AG MVPA was derived from activity count data using previously validated cut points. Two of the evaluated instruments provided similar group mean MVPA and step counts compared to AG (dependent on cut point). Low-cost instruments may be useful for measurement of both MVPA and steps in children's physical activity interventions and program evaluation.

Disability Among Veterans: Analysis of the National Survey of Veterans (1997-2001).

PubMed

Gerber, Lynn H; Weinstein, Ali A; Frankenfeld, Cara L; Huynh, Minh

2016-03-01

This manuscript assesses whether the Veterans Administration Rating System (VADR) correlates with self-reported activities of daily living (ADL) used in the National Survey of Veterans and likelihood of employment. Veterans' disability benefits are determined based on a single-index standardized rating scheme, measured at time of discharge. The primary aim of this study was to assess how this single-index rating of disability for veterans compares to multidimensional measures of disability (ADL and instrumental activities of daily living [IADL]). The relationship between disability ratings and labor market outcomes such as job search behavior and the likelihood of being employed was assessed. Successful labor market reintegration requires both physical/mental well-being, we examined the extent that VADR can capture the relationship between job market behavior and measures of mental/physical health. Kernel regression estimates were obtained of the likelihood of working/looking for work. Mean numbers of IADL and ADL difficulties and medical conditions were positively associated with VADR (p-trend < 0.001). An inverse relationship was observed with VADR and predicted probability of working (p-trend < 0.001). The combination of >4 ADL/IADL deficits and mental health diagnosis increased the likelihood of not working. The probability of not working correlated with VADR when VADR was greater than 40%. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Incident physical disability in people with lower extremity peripheral arterial disease: the role of cardiovascular disease.

PubMed

Brach, Jennifer S; Solomon, Cam; Naydeck, Barbara L; Sutton-Tyrrell, Kim; Enright, Paul L; Jenny, Nancy Swords; Chaves, Paulo M; Newman, Anne B

2008-06-01

To evaluate the risk of incident physical disability and the decline in gait speed over a 6-year follow-up associated with a low ankle-arm index (AAI) in older adults. Observational cohort study. Forsyth County, North Carolina; Sacramento County, California; Washington County, Maryland; and Allegheny County, Pennsylvania. Four thousand seven hundred five older adults, 58% women and 17.6% black, participating in the Cardiovascular Health Study. AAI was measured in 1992/93 (baseline). Self-reported mobility, activity of daily living (ADL), and instrumental activity of daily living (IADL) disability and gait speed were recorded at baseline and at 1-year intervals over 6 years of follow-up. Mobility disability was defined as any difficulty walking half a mile and ADL and IADL disability was defined as any difficulty with 11 specific ADL and IADL tasks. Individuals with mobility, ADL, or IADL disability at baseline were excluded from the respective incident disability analyses. Lower baseline AAI values were associated with increased risk of mobility disability and ADL/IADL disability. Clinical cardiovascular disease (CVD), diabetes mellitus, and interim CVD events partially explained these associations for mobility disability and clinical CVD and diabetes mellitus partially explained these associations for ADL and IADL disability. Individuals with an AAI less than 0.9 had on average a mean decrease in gait speed of 0.02 m/s per year, or a decline of 0.12 m/s over the 6-year follow-up. Prevalent CVD partly explained this decrease but interim CVD events did not further attenuate it. Low AAI serves as marker of future disability risk. Reduction of disability risk in patients with a low AAI should consider cardiovascular comorbidity and the prevention of additional disabling CVD events.

Participation after acquired brain injury: Associations with everyday technology and activities in daily life.

PubMed

Fallahpour, Mandana; Kottorp, Anders; Nygård, Louise; Lund, Maria Larsson

2015-01-01

The development of the information society has led to increased use of everyday technology and changed the conditions for participation. Enabling participation in everyday life situations is an important rehabilitation goal after acquired brain injury (ABI). Identifying factors associated with individuals' experienced participation and problems therein is therefore essential. This study aimed at exploring the relationship between perceived difficulty in everyday technology use, perceived ability in the activities of daily living (ADL), and perceived participation, and participation problems in persons with ABI. Eighty-one persons with ABI participated in the study and were assessed by the Impact on Participation and Autonomy questionnaire, the Everyday Technology Use Questionnaire, and the ADL taxonomy. Findings showed that the combined model of difficulty in everyday technology (ET) use, ADL ability, and the interaction between them explained both participation in various domains of everyday life, and also overall level of perceived participation and the perceived problems. The findings underscore the importance of evaluating individuals' ability in both ET use and ADL after ABI to increase the probability of explaining these persons' participation in desired everyday life situations and, also, for rehabilitation design.

Systematic review of the effects of exercise on activities of daily living in people with Alzheimer's disease.

PubMed

Rao, Ashwini K; Chou, Aileen; Bursley, Brett; Smulofsky, Jaclyn; Jezequel, Joel

2014-01-01

OBJECTIVE. Alzheimer's disease (AD) results in a loss of independence in activities of daily living (ADLs), which in turn affects the quality of life of affected people and places a burden on caretakers. Limited research has examined the influence of physical training (aerobic, balance, and strength training) on ADL performance of people with AD. METHOD. Six randomized controlled trials (total of 446 participants) fit the inclusion criteria. For each study, we calculated effect sizes for primary and secondary outcomes. RESULTS. Average effect size (95% confidence interval) for exercise on the primary outcome (ADL performance) was 0.80 (p < .001). Exercise had a moderate impact on the secondary outcome of physical function (effect size = 0.53, p = .004). CONCLUSION. Occupational therapy intervention that includes aerobic and strengthening exercises may help improve independence in ADLs and improve physical performance in people with AD. Additional research is needed to identify specific components of intervention and optimal dosage to develop clinical guidelines. Copyright © 2014 by the American Occupational Therapy Association, Inc.

What Drives Country Differences in Cost of Alzheimer's Disease? An Explanation from Resource Use in the GERAS Study.

PubMed

Reed, Catherine; Happich, Michael; Argimon, Josep Maria; Haro, Josep Maria; Wimo, Anders; Bruno, Giuseppe; Dodel, Richard; Jones, Roy W; Vellas, Bruno; Belger, Mark

2017-01-01

Country differences in resource use and costs of Alzheimer's disease (AD) may be driven by differences in health care systems and resource availability. To compare country resource utilization drivers of societal costs for AD dementia over 18 months. GERAS is an observational study in France (n = 419), Germany (n = 550), and the UK (n = 526). Resource use of AD patients and caregivers contributing to >1% of total societal costs (year 2010) was assessed for country differences, adjusting for participant characteristics. Mean 18-month societal costs per patient were France €33,339, Germany €38,197, and UK €37,899 (£32,501). Caregiver time spent on basic and instrumental activities of daily living (ADL) contributed the most to societal costs (54% France, 64% Germany, 65% UK). Caregivers in France spent less time on ADL than UK caregivers and missed fewer work days than in other countries. Compared with other countries, patients in France used more community care services overall and were more likely to use home aid. Patients in Germany were least likely to use temporary accommodation or to be institutionalized at 18 months. UK caregivers spent the most time on instrumental ADL, UK patients used fewest outpatient resources, and UK patients/caregivers were most likely to receive financial support. Caregiver time on ADL contributed the most to societal costs and differed across countries, possibly due to use of community care services and institutionalization. Other resources had different patterns of use across countries, reflecting country-specific health and social care systems.

[The Profile of Leisure Activities, a promising instrument in occupational therapy].

PubMed

Dutil, Elisabeth; Bier, Nathalie; Gaudreault, Céline

2007-10-04

Although the benefits of leisure activities are well known, few instruments have been specifically designed to measure a person's engagement in their leisure activities and to assess the personal or environmental factors affecting their capacity to participate in leisure activities. The purpose of this paper is to present the steps leading to the development of the Profil du Loisir between 1990 and 2002. The planning, construction, and validation of the tool were done according to the steps suggested by Benson and Clark (1982). The first versions were tested by occupational therapists on individuals with traumatic brain injuries. The validation led to the development of the final version (3.0). The inter-rater reliability of the instrument was rated from acceptable (kappa 0.21-0.4) to very good (0.61-0.80) and the test-retest reliability was rated from acceptable to moderate (0.41-0.60). The Profil du Loisir is a promising tool that invites occupational therapists to systematically consider and assess client leisure time in their practice.

A population-based study of demographical variables and ability to perform activities of daily living in adults with osteogenesis imperfecta.

PubMed

Wekre, Lena Lande; Frøslie, Kathrine Frey; Haugen, Lena; Falch, Jan A

2010-01-01

To describe demographical variables, and to study functional ability to perform activities of daily life in adults with osteogenesis imperfecta (OI). Population-based study. Ninety-seven patients aged 25 years and older, 41 men and 56 women, were included. For the demographical variables, comparison was made to a matched control-group (475 persons) from the Norwegian general population. Structured interviews concerning social conditions, employment and educational issues and clinical examination were performed. The Sunnaas Activities of Daily Living (ADL) Index was used to assess the ability to perform ADL. The prevalence of clinical manifestations according to Sillence was in accordance with other studies. Demographical variables showed that most adults with OI are married and have children. They had a higher educational level than the control group, but the employment rate was significantly lower. However, the rate of employed men was similar in both groups. Adult persons with OI achieved a high score when tested for ADL. Adults with OI are well educated compared with the general population, and most of them are employed. High scores when tested for ADL indicate that most of them are able to live their lives independently, even though there are some differences according to the severity of the disorder.

Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study.

PubMed

Giebel, Clarissa M; Sutcliffe, Caroline; Stolt, Minna; Karlsson, Staffan; Renom-Guiteras, Anna; Soto, Maria; Verbeek, Hilde; Zabalegui, Adelaida; Challis, David

2014-08-01

Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries. Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD. ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries. Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia.

Screening for frailty in community-dwelling elderly subjects: Predictive validity of the modified SEGA instrument.

PubMed

Oubaya, N; Dramé, M; Novella, J-L; Quignard, E; Cunin, C; Jolly, D; Mahmoudi, R

2017-11-01

To study the capacity of the SEGAm instrument to predict loss of independence among elderly community-dwelling subjects. The study was performed in four French departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5 or 6 in the AGGIR autonomy evaluation scale were included. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument at baseline. Subjects had follow-up visits at home at 6 and 12 months. During follow-up, vital status and level of independence were recorded. Logistic regression was used to study predictive validity of the SEGAm instrument. Among the 116 subjects with complete follow-up, 84 (72.4%) were classed as not very frail at baseline, 23 (19.8%) as frail, and 9 (7.8%) as very frail; 63 (54.3%) suffered loss of at least one ADL or IADL at 12 months. By multivariable analysis, frailty status at baseline was significantly associated with loss of independence during the 12 months of follow-up (OR=4.52, 95% CI=1.40-14.68; p=0.01). We previously validated the SEGAm instrument in terms of feasibility, acceptability, internal structure validity, reliability, and discriminant validity. This instrument appears to be a suitable tool for screening frailty among community-dwelling elderly subjects, and could be used as a basis to plan early targeted interventions for subjects at risk of adverse outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

Trajectories of limitations in activities of daily living among older adults in Mexico, 2001-2012.

PubMed

Díaz-Venegas, Carlos; Wong, Rebeca

2016-07-01

Trajectories of disability are an essential component to understand the burden of disability at the societal level. Longitudinal studies, compared to cross-national studies, enable a better analysis of the progression of physical limitations among the elderly. However, information on disability dynamics in developing countries is limited. This paper examines the changes in activities of daily living (ADLs) in an 11-yr. period in the Mexican elderly population aged 60 or older and identifies how sociodemographic variables alter these trajectories. The data come from the Mexican Health and Aging Study (MHAS), a national sample of adults born in 1951 or earlier, including a baseline survey in 2001 and follow-ups in 2003 and 2012. The ADL score increased on average by 0.03 for every year respondents aged after 60. In contrast, the ADL score was reduced by 0.06 for every additional year of education. Age, gender, and years of education were confirmed to influence the trajectories of ADL limitations. Understanding the patterns of deterioration of functional limitations will help public health policies to better serve the population. Copyright © 2016 Elsevier Inc. All rights reserved.

Functional impairment and hospital readmission in Medicare seniors.

PubMed

Greysen, S Ryan; Stijacic Cenzer, Irena; Auerbach, Andrew D; Covinsky, Kenneth E

2015-04-01

Medicare currently penalizes hospitals for high readmission rates for seniors but does not account for common age-related syndromes, such as functional impairment. To assess the effects of functional impairment on Medicare hospital readmissions given the high prevalence of functional impairments in community-dwelling seniors. We created a nationally representative cohort of 7854 community-dwelling seniors in the Health and Retirement Study, with 22,289 Medicare hospitalizations from January 1, 2000, through December 31, 2010. Outcome was 30-day readmission assessed by Medicare claims. The main predictor was functional impairment determined from the Health and Retirement Study interview preceding hospitalization, stratified into the following 5 levels: no functional impairments, difficulty with 1 or more instrumental activities of daily living, difficulty with 1 or more activities of daily living (ADL), dependency (need for help) in 1 to 2 ADLs, and dependency in 3 or more ADLs. Adjustment variables included age, race/ethnicity, sex, annual income, net worth, comorbid conditions (Elixhauser score from Medicare claims), and prior admission. We performed multivariable logistic regression to adjust for clustering at the patient level to characterize the association of functional impairments and readmission. Patients had a mean (SD) age of 78.5 (7.7) years (range, 65-105 years); 58.4% were female, 84.9% were white, 89.6% reported 3 or more comorbidities, and 86.0% had 1 or more hospitalizations in the previous year. Overall, 48.3% had some level of functional impairment before admission, and 15.5% of hospitalizations were followed by readmission within 30 days. We found a progressive increase in the adjusted risk of readmission as the degree of functional impairment increased: 13.5% with no functional impairment, 14.3% with difficulty with 1 or more instrumental activities of daily living (odds ratio [OR], 1.06; 95% CI, 0.94-1.20), 14.4% with difficulty with 1 or more

Risk factors for a 6-year decline in physical disability and functional limitations among elderly people with type 2 diabetes in the Japanese Elderly Diabetes Intervention Trial.

PubMed

Sakurai, Takashi; Iimuro, Satoshi; Sakamaki, Kentaro; Umegaki, Hiroyuki; Araki, Atsushi; Ohashi, Yasuo; Ito, Hideki

2012-04-01

Type 2 diabetes increases the risk of disability. The purpose of this study was to clarify the explanatory factors for disability in Japanese diabetic elderly. The 6-year decline in physical disability and functional limitations was investigated among 317 elderly people with type 2 diabetes recruited in a large-scale prospective study of the Japanese Elderly Diabetes Intervention Trial. Information about diabetes, blood examinations and complications was obtained, and basic activities of daily living (ADL) and instrumental ADL (IADL) were assessed by total score of the Barthel index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. After 6 years of follow up, 13.6% of patients had developed a new ADL disability and 38.3% had developed a new functional impairment. In the 65-74 years age group, basic ADL decreased only in males, whereas females became functionally impaired. In the 75-84 years age group, basic and IADL decreased in both males and females. Older age and metabolic syndrome were prognostic for impairment of basic ADL, whereas baseline IADL problems, lower cognitive function, physical inactivity and insulin therapy were significant predictors of a future decline in the IADL. This study identified several factors predicting the future decline of basic ADL and IADL in diabetic elderly patients, and provided a conceptual framework that might help to clarify the pathways leading to disability. Because the specific causes of each functional problem are modifiable, comprehensive treatment and care are needed to allow Japanese diabetic elderly patients to have more favorable living conditions. © 2012 Japan Geriatrics Society.

Limitation of activities of daily living accompanying reduced neck mobility after laminoplasty preserving or reattaching the semispinalis cervicis into axis.

PubMed

Takeuchi, Kazunari; Yokoyama, Toru; Ono, Atsushi; Numasawa, Takuya; Wada, Kanichiro; Itabashi, Taito; Toh, Satoshi

2008-03-01

Although difficulties with neck mobility often interfere with patients' activities of daily living (ADL) after cervical laminoplasty, there was no detailed study on the relation between the limitations of ADL accompanying postoperative reduced neck mobility and the cervical posterior approach. The aim of this study was to compare retrospectively the frequency of limitations of ADL accompanying neck mobility after laminoplasty preserving the semispinalis cervicis inserted into the C2 spinous process with that after laminoplasty reattaching the muscle to C2. Forty-nine patients after C4-C7 laminoplasty with C3 laminectomy preserving the semispinalis cervicis inserted into C2 (Group A) and 24 patients after C3-C7 laminoplasty reattaching the muscle (Group B) were evaluated. The frequency of postoperative limitations of ADL accompanying each of three neck movements of extension, flexion and rotation were investigated. The postoperative O-C7 angles at extension and flexion was measured on lateral extension and flexion radiographs of the cervical spine, respectively. The postoperative cervical range of motion in rotation was measured in the cranial view using a digital camera. Frequency of limitations of ADL accompanying extension was lower (P = 0.037) in Group A (2%) than in Group B (17%). Frequency of limitations of ADL accompanying flexion was similar in Group A (8%) and Group B (4%). Frequency of limitations of ADL accompanying rotation was lower (P = 0.031) in Group A (12%) than in Group B (33%). Average O-C7 angle at extension was significantly larger (P = 0.002) in Group A (147 degrees ) than in Group B (136 degrees ). Average O-C7 angle at flexion was similar in Group A (93 degrees ) and Group B (91 degrees ). Average range of motion in rotation was significantly larger (P = 0.004) in Group A (110 degrees ) than in Group B (91 degrees ). This retrospective study suggested that the frequency of limitations of ADL accompanying neck extension or rotation was lower

Trajectories of Limitations in Activities of Daily Living among Older Adults in Mexico, 2001–2012

PubMed Central

Wong, Rebeca

2016-01-01

Background Trajectories of disability are an essential component to understand the burden of disability at the societal level. Longitudinal studies, compared to cross-national studies, enable a better analysis of the progression of physical limitations among the elderly. However, information on disability dynamics in developing countries is limited. Objectives This paper examines the changes in activities of daily living (ADLs) in an 11-yr. period in the Mexican elderly population aged 60 or older and identifies how sociodemographic variables alter these trajectories. Methods The data come from the Mexican Health and Aging Study (MHAS), a national sample of adults born in 1951 or earlier, including a baseline survey in 2001 and follow-ups in 2003 and 2012. Results The ADL score increased on average by 0.03 for every year respondents aged after 60. In contrast, the ADL score was reduced by 0.06 for every additional year of education. Conclusions Age, gender, and years of education were confirmed to influence the trajectories of ADL limitations. Understanding the patterns of deterioration of functional limitations will help inform public health policies to better serve the population. PMID:26993585

Activities of daily living in nursing home and home care settings: a retrospective 1-year cohort study.

PubMed

Lee, Tae Wha; Cho, Eunhee; Yim, Eun Shil; Lee, Hye Sun; Ko, Yu Kyung; Kim, Bok Nam; Kim, Sinhye

2015-02-01

Korea introduced universal long-term care insurance (LTCI) for physically dependent older adults in 2008. Older adults, their family members, and policy makers in Korea want to know patient outcomes in different care modalities because older adults who have a similar functional status and LTC needs can choose either nursing home care or home care. The aim of this study was to compare activities of daily living (ADLs) in nursing home care and home care settings for physically dependent older adults in Korea. A retrospective 1-year cohort study using national LTCI data. This study used the LTCI dataset from the National Health Insurance Service in Korea. Participants were identified from among those in the LTCI dataset who enrolled from July 2008 to June 2010. We extracted a sample consisting of 22,557 older adults who consistently received either nursing home care (n = 11,678) or home care (n = 10,879) for 1 year. The outcome variable was change in ADLs after 1 year. Covariates were an older adult's home geographical region, LTC level, age, sex, primary caregiver, Medicaid beneficiary status, bedridden status, medical diagnosis, baseline ADLs, cognitive function, behavioral problems, nursing and special treatment, and rehabilitation needs. Multiple regression analysis of all participants unmatched and a paired t-test with a propensity-score-matched cohort were performed to explain the association of changes in ADLs with the types of LTC. Multiple regression analysis with all participants (n = 22,557) unmatched showed that compared with older adults who received home care, those who received nursing home care had deteriorated further in terms of ADLs after 1 year (β = 0.44108, P < .0001). After propensity-score matching, paired t-test analysis also found that the ADLs of older adults had deteriorated less in the home care group compared with the nursing home group after 1 year (P < .0001). The ADLs of older adults who received home care showed significantly less

Performance of PROMIS Physical Function Compared with KOOS, SF-36, Eq5d And Marx Activity Scale in Patients Who Undergo ACL Reconstruction

PubMed Central

Scott, Elizabeth; Glass, Natalie; Wolf, Brian R.; Hettrich, Carolyn M.; Bollier, Matthew

2018-01-01

Objectives: Anterior cruciate ligament reconstruction is a commonly performed orthopaedic procedure. PROMIS (Patient-Reported Outcome Measurement Information System) was developed by the National Institutes of Health in an effort to advance patient-reported outcome (PRO) instruments by developing question banks for major health domains. Our goal was to compare the responsiveness and construct validity of the PROMIS physical function (PF) computer adaptive test (CAT) with current PRO instruments utilized in patients who undergo anterior cruciate ligament reconstruction. Methods: A total of 174 patients ages 14-53 scheduled to undergo anterior cruciate ligament reconstruction were asked to complete PROMIS PF-CAT, Short Form-36 Health Survey (SF36-PF and -GH), Marx activity rating scale (Marx), Knee Injury and Osteoarthritis Score (KOOS-ADL, -Sport, -QOL), and the EuroQol five dimensions questionnaire (EQ5D) at their preoperative visit. These surveys were repeated at six weeks and six months after surgery. Correlations between PRO instruments was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3) using Spearman Correlation Coefficients. The effect size (Cohen d) and standardized response mean (SRM) were used to describe the responsiveness of each PRO at the 6 week and 6 month follow-up visits and were defined as small (0.2), medium (0.5) and large (0.8). Ceiling and floor effects were defined as present if ≥15% of participants scored the highest or lowest score on a PRO, respectively. Subgroup analyses were performed comparing change in PRO scores at follow-up between participants with and without additional arthroscopic procedures (meniscal debridement and/or repair, microfracture, or OATS vs ACL reconstruction only) using linear mixed models. Results: There were excellent and excellent-good correlations between the PROMIS PF-CAT and physical function PROs including the SF36-PF (r=0.75-0.80, p<.01), KOOS-ADL (r=0.62-0.70, p

Hand disorders, hand function, and activities of daily living in elderly men with type 2 diabetes.

PubMed

Cederlund, Ragnhild I; Thomsen, Niels; Thrainsdottir, Soley; Eriksson, Karl-Fredrik; Sundkvist, Göran; Dahlin, Lars B

2009-01-01

This study aimed to examine hand disorders, symptoms, overall hand function, activities of daily living (ADLs), and life satisfaction in elderly men with type 2 diabetes mellitus (DM), impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). Subjects were interviewed and evaluated with a battery of clinical and laboratory tests, including hand assessment, and a questionnaire. HbA1c differed between groups (highest in DM, especially in long-term DM). Limited joint motion (LJM), for example, prayer sign and Dupuytren's contracture, was most common in individuals with DM, followed by individuals with IGT, as compared to those with NGT. Vibrotactile sense was impaired symmetrically in the index and little fingers in DM. However, there were no differences for sensibility, dexterity, grip strength, and cold intolerance between groups. Individuals with long-term (>15 years) DM were more affected regarding sensibility and ADL than individuals with short-term DM, who had more sleep disturbances. ADL difficulties were less among IGT subjects. Vibrotactile sense showed correlations with Semmes-Weinstein monofilament test and static two-point discrimination. Dupuytren's contracture and impaired vibrotactile sense in finger pulps occurred in patients with DM but not in those with IGT, although LJM occurred in both IGT and DM patients. A longer duration of DM was associated with more severe neuropathy and ADL difficulties. Life satisfaction was high, and hand disorders did not have a significant impact on ADL.

Gender differences in life expectancy with and without disability among older adults in Ecuador.

PubMed

Egüez-Guevara, Pilar; Andrade, Flávia Cristina Drumond

2015-01-01

Knowledge on disability's impact among older women and men in Ecuador is limited. This paper provides gender-specific estimates of disability prevalence, life expectancy with and without disability, and the factors associated with gender differences in disability at older age in Ecuador (2009-2010). Data from the Health, Well-Being, and Aging Survey (SABE) Ecuador 2009 was used. Participants were 4480 men and women aged 60 and over. Life expectancy with and without disability was calculated using the Sullivan method. Logistic regression analyses were used to explore gender differences in disability prevalence. Two disability measures, indicating limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), were used. 60-year-old women in Ecuador can expect to live 16.3 years without ADL limitations compared to 16.9 years for men. Life expectancy without IADL limitations was 12.5 years for women and 15.5 years for men. At age 60, women's length of life with ADL and IADL disability was higher (7.9 years for women vs. 4.9 years for men with ADL, and 11.7 years for women vs. 6.3 years for men with IADL). After controlling for socioeconomic characteristics, chronic conditions and lifestyle factors, gender differences in ADL disability were not statistically significant. However, older women were 58% more likely (OR=1.58, 95% CI 1.27, 1.95) to report having IADL limitations than men, even after including control variables. Interventions should tackle chronic disease, physical inactivity, and socioeconomic differences to reduce women's vulnerability to disability in older age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Costs explained by function rather than diagnosis--results from the SNAC Nordanstig elderly cohort in Sweden.

PubMed

Lindholm, C; Gustavsson, A; Jönsson, L; Wimo, A

2013-05-01

Because the prevalence of many brain disorders rises with age, and brain disorders are costly, the economic burden of brain disorders will increase markedly during the next decades. The purpose of this study is to analyze how the costs to society vary with different levels of functioning and with the presence of a brain disorder. Resource utilization and costs from a societal viewpoint were analyzed versus cognition, activities of daily living (ADL), instrumental activities of daily living (IADL), brain disorder diagnosis and age in a population-based cohort of people aged 65 years and older in Nordanstig in Northern Sweden. Descriptive statistics, non-parametric bootstrapping and a generalized linear model (GLM) were used for the statistical analyses. Most people were zero users of care. Societal costs of dementia were by far the highest, ranging from SEK 262,000 (mild) to SEK 519,000 per year (severe dementia). In univariate analysis, all measures of functioning were significantly related to costs. When controlling for ADL and IADL in the multivariate GLM, cognition did not have a statistically significant effect on total cost. The presence of a brain disorder did not impact total cost when controlling for function. The greatest shift in costs was seen when comparing no dependency in ADL and dependency in one basic ADL function. It is the level of functioning, rather than the presence of a brain disorder diagnosis, which predicts costs. ADLs are better explanatory variables of costs than Mini mental state examination. Most people in a population-based cohort are zero users of care. Copyright © 2012 John Wiley & Sons, Ltd.

Real-world implications of apathy among older adults: Independent associations with activities of daily living and quality of life.

PubMed

Tierney, Savanna M; Woods, Steven Paul; Weinborn, Michael; Bucks, Romola S

2018-03-13

Apathy is common in older adults and has been linked to adverse health outcomes. The current study examined whether apathy contributes to problems managing activities of daily living (ADLs) and lower quality of life (QoL) in older adults. Participants included 83 community-dwelling older adults. Apathy was assessed using a composite of the self and family-rating scales from the Frontal Systems Behavioral Scale (FrSBe). A knowledgeable informant completed the Activities of Daily Living Questionnaire (ADLQ), and participants completed the World Health Organization Quality of Life (WHOQol) scale. Nominal logistic regressions controlling for age, anxiety and depression symptoms, chronic medical conditions, and global cognition revealed that higher levels of apathy were significantly associated with a wide range of mild ADL problems. In parallel, a multiple linear regression indicated that greater apathy was significantly associated with lower QoL independent of ADL problems, anxious and depressive symptomology, chronic medical conditions, global cognition and age. Findings suggest that apathy confers an increased risk of problems in the independent management of daily activities and poorer well-being among community-dwelling older adults. Neurobehavioral and pharmacological interventions to improve apathy may have beneficial effects on the daily lives of older adults.

Optimization of PET instrumentation for brain activation studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dahlbom, M.; Cherry, S.R.; Hoffman, E.J.

By performing cerebral blood flow studies with positron emission tomography (PET), and comparing blood flow images of different states of activation, functional mapping of the brain is possible. The ability of current commercial instruments to perform such studies is investigated in this work, based on a comparison of noise equivalent count (NEC) rates. Differences in the NEC performance of the different scanners in conjunction with scanner design parameters, provide insights into the importance of block design (size, dead time, crystal thickness) and overall scanner design (sensitivity and scatter fraction) for optimizing data from activation studies. The newer scanners with removablemore » septa, operating with 3-D acquisition, have much higher sensitivity, but require new methodology for optimized operation. Only by administering multiple low doses (fractionation) of the flow tracer can the high sensitivity be utilized.« less

Caregivers' reported functional limitations in activities of daily living among middle-aged adults with intellectual disabilities.

PubMed

Lin, Lan-Ping; Hsia, Yi-Chen; Hsu, Shang-Wei; Loh, Ching-Hui; Wu, Chia-Ling; Lin, Jin-Ding

2013-12-01

This study was conducted to describe the functioning of Activities of Daily Living (ADL) and to examine socio-economic effects on ADL functioning among adults with intellectual disabilities (ID) aged 45 years and older (N=480) in Taiwan. The Barthel Index (BI) was used to determine a baseline level of ADL functioning in the study participants. There are five categories of functional impairment using the following cut-off values in Taiwan: total dependence (BI score 0-20), severe (BI score 21-60), moderate (BI score 61-90), mild (BI score 91-99), and total independence (BI score 100) (Taiwan Department of Health, 2012). The results revealed that 2.3% of adults with ID were in total dependence, 11.9% were in severe dependence, 27.9% were in moderate dependence, 8.1% had a mild dependence, and 49.8% were totally independent. In the multiple linear regression model of the ADL score, we determined that educational level, comorbid Down's syndrome, and disability level are the variables able to significantly predict ADL score (R(2)=0.190) after controlling for the factors of age, marital status, and other comorbidity conditions. Those ID adults with a lower education level (primary vs. literate, β=4.780, p=0.031; intermediate vs. literate, β=6.642, p=0.030), with comorbid Down's syndrome (β=-7.135, p=0.063), and with a more severe disability condition (severe vs. mild, β=-7.650, p=0.007; profound vs. mild, β=-19.169, p<0.001) had significantly lower ADL scores. The present study highlights the need to support mobility in older adults with ID as much as possible to optimize independence in this group. Copyright © 2013 Elsevier Ltd. All rights reserved.

Validity of the Foot and Ankle Ability Measure in athletes with chronic ankle instability.

PubMed

Carcia, Christopher R; Martin, RobRoy L; Drouin, Joshua M

2008-01-01

The Foot and Ankle Ability Measure (FAAM) is a region-specific, non-disease-specific outcome instrument that possesses many of the clinimetric qualities recommended for an outcome instrument. Evidence of validity to support the use of the FAAM is available in individuals with a wide array of ankle and foot disorders. However, additional evidence to support the use of the FAAM for those with chronic ankle instability (CAI) is needed. To provide evidence of construct validity for the FAAM based on hypothesis testing in athletes with CAI. Between-groups comparison. Athletic training room. Thirty National Collegiate Athletic Association Division II athletes (16 men, 14 women) from one university. The FAAM including activities of daily living (ADL) and sports subscales and the global and categorical ratings of function. For both the ADL and sports subscales, FAAM scores were greater in healthy participants (100 +/- 0.0 and 99 +/- 3.5, respectively) than in subjects with CAI (88 +/- 7.7 and 76 +/- 12.7, respectively; P < .001). Similarly, for both ADL and sports subscales, FAAM scores were greater in athletes who indicated that their ankles were normal (98 +/- 6.3 and 96 +/- 6.9, respectively) than in those who classified their ankles as either nearly normal or abnormal (87 +/- 6.6 and 71 +/- 11.1, respectively; P < .001). We found relationships between FAAM scores and self-reported global ratings of function for both ADL and sports subscales. Relationships were stronger when all athletes, rather than just those with CAI, were included in the analyses. The FAAM may be used to detect self-reported functional deficits related to CAI.

Necessity to Develop a Tool to Evaluate Activity of Daily Living for Electric Powered Indoor/Outdoor Chair Users

PubMed Central

Lee, Jiwon; Lim, Jae Kuk; Lee, Min Jun; Jo, Yoon-Sik; Park, Jae Sung; Kim, Jong Moon

2015-01-01

Objective To evaluate changes in activity of daily living before and after provision of electric-powered indoor/outdoor chair (EPIOC), discuss problems of current activities of daily living (ADL) evaluating tools for EPIOC users, and provide preliminary data to develop ADL evaluation tool for EPIOC user. Methods A total of 70 users who were prescribed EPIOC and had been using for more than 1 year were recruited in this study. Before and after provision of EPIOC, MBI and FIM scores were measured and a questionnaire consisting of six categories (general socioeconomic states, currently using state, whether EPIOC was helpful for social participation and occupational chances, psychiatric influences, self-reported degrees of independency, and barriers of using EPIOC) was used. Results No difference in MBI scores before and after provision of EPIOC was observed. However, the wheelchair ambulation category showed a significant difference. While motor FIM was not significantly different from MBI, FIM score were significantly (p<0.05) higher than MBI. For questions regarding social participation frequency, helpfulness of EPIOC on confidence, refreshing patients' emotions and self-reported degrees of independence, all of them showed positive responses. Especially, EPIOC users' self-reported degree of independency showed favorable results. There was discrepancy in MBI or FIM measured by physicians. Conclusion Our study showed that there was a gap between the existing ADL evaluation tool and the ADL level that EPIOC users were actually feeling. Thus, it is necessary to develop an evaluation tool specifically for EPIOC. PMID:25932425

The Relationship between Older Adults’ Risk for a Future Fall and Difficulty Performing Activities of Daily Living

PubMed Central

Mamikonian-Zarpas, Ani; Laganá, Luciana

2016-01-01

Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984–1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with

Activities of daily living in children with hemiparesis: influence of cognitive abilities and motor competence.

PubMed

Adler, Caroline; Rauchenzauner, Markus; Staudt, Martin; Berweck, Steffen

2014-12-01

The aim of the article is to investigate whether motor competence and cognitive abilities influence the quality of performance of activities of daily living (ADL) in children with hemiparesis. Patients and A total of 20 children with hemiparesis (age, 6-12 years; 11 congenital, 9 acquired during childhood) were studied. Motor competence was assessed with the Assisting Hand Assessment, cognitive abilities with the German version of the Wechsler Intelligence Scale for Children IV, and the quality of ADL performance with the Assessment of Motor and Process Skills (AMPS). The motor skills scale of the AMPS correlated with motor competence, and the process skills scale of the AMPS correlated with cognitive abilities. The quality of ADL performance is influenced not only by motor competence but also by the cognitive abilities of a hemiparetic child. This suggests that, in addition to motor-oriented training programs, an optimal therapy for hemiparetic children should also consider cognitive approaches. Georg Thieme Verlag KG Stuttgart · New York.

Do nursing staff encourage functional activity among nursing home residents? A cross-sectional study of nursing staff perceived behaviors and associated factors.

PubMed

Kuk, Nienke O; den Ouden, Mirre; Zijlstra, G A Rixt; Hamers, Jan P H; Kempen, Gertrudis I J M; Bours, Gerrie J J W

2017-01-14

Nursing home residents are mainly inactive. Nursing staff can encourage residents to perform functional activities during daily care activities. This study examines 1) the extent to which nursing staff perceive that they encourage functional activity in nursing home residents and 2) the associations between these nursing behaviors and professional characteristics, contextual factors, and information-seeking behaviors. In this cross-sectional study, 368 registered nurses and certified nurse assistants, working in somatic and psychogeriatric wards of forty-one nursing homes throughout the Netherlands participated. Self-reported data were collected with a questionnaire, comprising the MAINtAIN-behaviors, which assesses the extent to which nursing staff encourage functional activities, including different activities of daily living (ADL), household activities, and miscellaneous encouraging activities (e.g., discouraging informal caregivers from taking over activities residents can do themselves). Additional data collected included professional characteristics (e.g., age), contextual factors (e.g., ward type), and information-seeking behaviors (e.g., reading professional journals). Descriptive statistics were used to determine the extent to which functional activities were encouraged. Hierarchical linear regression analyses were performed to determine the associations between the encouragement of functional activities and other factors. Nursing staff perceived that household activities (mean 4.1 (scale range 1-9), SD 1.9) were less often encouraged than ADL (mean 6.9, SD 1.2) or miscellaneous activities (mean 6.7, SD 1.5). The percentage of nursing staff stating that different household activities, ADL, or miscellaneous activities were almost always encouraged ranged from 11 to 45%, 41 to 86%, and 50 to 83% per activity, respectively. The extent to which these activities were encouraged differed for some of the professional characteristics, contextual factors, or

Prevalence, characteristics, and acute care utilization of disabled older adults with an absence of help for activities of daily living: Findings from a nationally representative survey.

PubMed

Wang, Hui-Hsuan; Shyu, Yea-Ing Lotus; Chang, Hsing-Yi; Bai, Yuh-Bin; Stanaway, Fiona; Lin, Jen-Der; Li, Chia-Lin

2016-01-01

The aim of this study was to investigate the prevalence, characteristics, and acute care utilization of community dwelling disabled older adults with an absence of help for activities of daily living (ADL). We analyzed cross-sectional data from a nationally representative sample of people aged 65 years and over (n=2904) participating in the 2009 National Health Interview Survey in Taiwan. Disability was defined as self-reporting a lot of difficulty or complete inability to carry out one or more ADL tasks. Participants with disability were asked whether they received help in the form of personal assistance or assistive devices to complete ADL tasks, with a yes response indicating the presence of help and a no response indicating the absence of help. Hospitalization and emergency department visits was assessed as a dichotomous variable (any or none), respectively. An absence of available help for ADL disability was reported in 16.6% of disabled older adults. Disabled older adults reporting an absence of help were more likely to be female. After adjustment for other factors, compared to older adults without disability, older adults with disability not receiving help for ADL tasks were highly related to hospitalization (OR=4.57; 95%CI=[1.51-13.82]) and emergency department visits (OR=3.52; 95%CI=[1.15-10.76]) during the past year, respectively. We found that there is high prevalence of absence of help to perform ADL tasks in older adults with disability, and that this absence of help for ADL disability is associated with a greater burden of acute care utilization than those without disability. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Optimal Levels of All Major Cardiovascular Risk Factors in Younger Age and Functional Disability in Older Age: The Chicago Heart Association Detection Project in Industry (CHA) 32-Year Follow-up Health Survey

PubMed Central

Vu, Thanh-Huyen T.; Lloyd-Jones, Donald M.; Liu, Kiang; Stamler, Jeremiah; Garside, Daniel B.; Daviglus, Martha L.

2016-01-01

Background The associations of optimal levels of all major cardiovascular disease (CVD) risk factors, i.e., low-risk, in younger age with subsequent CVD morbidity and mortality have been well documented. However, little is known about associations of low-risk profiles in younger age with functional disability in older age. Methods and Results The sample included 6,014 participants from the CHA Study. Low-risk status, defined as untreated SBP/DBP ≤120/≤80 mmHg, untreated serum total cholesterol <5.18 mmol/l, not smoking, BMI < 25 kg/m2, and no diabetes, was assessed at baseline (1967–73). Functional disability, categorized as: 1) any disability in activities of daily living (ADLs), 2) any disability in instrumental ADLs (IADLs) but no ADL, or 3) no disability, was assessed from the 2003 health survey. There were 39% women, 4% Black, with a mean age of 43 and 6% low-risk status at baseline. After 32 years, 7% reported having limitations in performing any ADL and 11% in any IADL only. The prevalence of any ADL limitation was lowest in low-risk persons and increased in a graded fashion with less favorable risk-factor groups (p-trend <0.001). Compared to those with 2+ high-risk factors, the multivariable-adjusted odds of having any disability in ADLs vs. no disability in persons with low-risk, any moderate-risk, and 1 high-risk factor at baseline were lower by 58%, 48%, and 37%, respectively. Results were similar for IADLs, in both men and women. Conclusions Having an optimal CVD risk factor profile at younger age is associated with the lowest rate of functional disability in older age. PMID:27382089

Predicting Use of Nurse Care Coordination by Older Adults With Chronic Conditions.

PubMed

Vanderboom, Catherine E; Holland, Diane E; Mandrekar, Jay; Lohse, Christine M; Witwer, Stephanie G; Hunt, Vicki L

2017-07-01

To be effective, nurse care coordination must be targeted at individuals who will use the service. The purpose of this study was to identify variables that predicted use of care coordination by primary care patients. Data on the potential predictor variables were obtained from patient interviews, the electronic health record, and an administrative database of 178 adults eligible for care coordination. Use of care coordination was obtained from an administrative database. A multivariable logistic regression model was developed using a bootstrap sampling approach. Variables predicting use of care coordination were dependence in both activities of daily living (ADL) and instrumental activities of daily living (IADL; odds ratio [OR] = 5.30, p = .002), independent for ADL but dependent for IADL (OR = 2.68, p = .01), and number of prescription medications (OR = 1.12, p = .002). Consideration of these variables may improve identification of patients to target for care coordination.

Ethnic disparities in disability among middle-aged and older israeli adults: the role of socioeconomic disadvantage and traumatic life events.

PubMed

Osman, Amira; Walsemann, Katrina M

2013-04-01

We examined the contribution of socioeconomic disadvantage and traumatic life events to ethnic disparities in disability among Israeli adults. We used data from the Survey of Health, Aging and Retirement in Europe (SHARE-Israel), a sample of Israeli adults aged 50 or older (N = 1,546). Disability measures included functional limitations, limitations in activities of daily living (ADL), and limitations in instrumental activities of daily living (IADL). Arabs and immigrants from the Former Soviet Union (FSU) experienced higher rates of functional limitations and limitations in IADLs compared to veteran Jews. The rate of having limitations in ADLs was similar for Arabs and veteran Jews, but was higher for FSU immigrants compared to veteran Jews. Inclusion of education, income, and traumatic life events attenuated, but did not eliminate ethnic disparities in disability. Identifying factors driving ethnic health disparities in Israel is imperative if we hope to achieve health equity.

Policy Concerns Raised by the Growing U.S. Population Aging with Disability

PubMed Central

Iezzoni, Lisa I.

2014-01-01

Narrative Summary The number of Americans aging with disabilities will grow substantially in coming decades. Promulgating policies and practices to improve their independent functioning within communities and participation in daily life is therefore imperative, but the most effective approaches for meeting various needs are generally unknown. Historically, research addressing approaches targeting elderly individuals have differed in important ways (e.g., underlying models of disability) from studies involving younger persons aging with disabilities. Participants in a conference addressing this discordance identified six major areas requiring study: (1) resources to support independent living; (2) improving quality of life and participation in daily activities; (3) performing activities of daily living (ADL) and instrumental ADLs; (4) role of families; (5) medical care; and (6) concerns transcending sectors. As these investigations move forward, bridging the divide between approaches addressing elderly individuals versus persons with disabilities will be critical. PMID:24456688

Mental health among younger and older caregivers of dementia patients.

PubMed

Koyama, Asuka; Matsushita, Masateru; Hashimoto, Mamoru; Fujise, Noboru; Ishikawa, Tomohisa; Tanaka, Hibiki; Hatada, Yutaka; Miyagawa, Yusuke; Hotta, Maki; Ikeda, Manabu

2017-03-01

Caregiver burden in dementia is an important issue, but few studies have examined the mental health of younger and older family caregivers by comparing them with age- and gender-matched community residents. We aimed to compare the mental health of dementia caregivers with that of community residents and to clarify factors related to mental health problems in younger and older caregivers. We studied 104 dementia caregivers; 46 were younger (<65 years) and 58 were older (≥65 years). A total of 104 community residents who were matched for age and gender were selected. We compared depression (Center for Epidemiologic Studies Depression Scale for younger participants; Geriatric Depression Scale for older participants), health-related quality of life (QOL) short-form health survey (SF-8), sleep problems, and suicidal ideation between the caregivers and community residents by age. Behavioural and psychological symptoms of dementia, activities of daily living (ADL), and instrumental ADL were assessed among patients with dementia using the Neuropsychiatric Inventory, Physical Self-Maintenance Scale, and Lawton Instrumental ADL Scale, respectively. According to SF-8 results, both younger and older caregivers had significantly worse mental QOL than community residents (younger caregivers: 46.3 vs community residents: 49.7, P = 0.017; older caregivers: 48.2 vs community residents: 51.1, P = 0.024) but were not more depressive. Sleep problems were significantly more frequent in younger caregivers (39.1%) than in community residents (17.0%) (P = 0.017). Multiple regression analysis revealed that caregivers' deteriorated mental QOL was associated with patients' behavioural and psychological symptoms of dementia in younger caregivers and with dementia patients' instrumental ADL and female gender in older caregivers. Dementia caregivers had a lower mental QOL than community residents. To maintain caregivers' mental QOL, it is necessary to provide younger

Hospitalization and development of dependence in activities of daily living in a cohort of disabled older women: the Women's Health and Aging Study I.

PubMed

Boyd, Cynthia M; Xue, Qian-Li; Guralnik, Jack M; Fried, Linda P

2005-07-01

Changes in self-reported function in older adults are known to occur in the 2 weeks prior to, during, and in the first few months after hospitalization. The long-term outcome of hospitalization on functional status in disabled older adults is not known. The objective of this study was to determine whether hospitalization predicts long-term Activities of Daily Living (ADL) dependence in previously ADL independent, although disabled, older women. The Women's Health and Aging Study I is a population-based, prospective cohort study of disabled, community-dwelling women > or =65 years old. We evaluated participants who were independent in ADLs at baseline and excluded women with incident stroke, lower extremity joint surgery, amputation, or hip fracture. We examined the association between self-reported incident hospitalization at three consecutive 6-month intervals and incident dependence in at least one ADL at 18 months (n = 595). Of 595 women evaluated, 32% had at least one hospitalization. Women who were hospitalized were more likely to become dependent in ADLs than were women who were not hospitalized (17% vs 8%, p =.001). In a multivariate model, hospitalization was independently predictive of development of ADL dependence that persisted at 18 months after baseline (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.7-5.8), adjusting for age, race, education, baseline walking speed, difficulty with ADLs, self-reported health status, depressive symptoms, cognitive status, and presence of congestive heart failure, diabetes, or pulmonary disease. Increasing numbers of 6-month intervals with hospitalizations were independently predictive of higher risk in an adjusted model: one (OR, 2.3; 95% CI, 1.1-4.6), two (OR, 5.8; 95% CI, 2.4-14.4), and three (OR, 12.5; 95% CI, 2.7-57.6). These results suggest that hospitalization has an independent and dose-response effect on loss of ADL independence in disabled older women over an 18-month period.

Design of a novel instrument for active neutron interrogation of artillery shells.

PubMed

Bélanger-Champagne, Camille; Vainionpää, Hannes; Peura, Pauli; Toivonen, Harri; Eerola, Paula; Dendooven, Peter

2017-01-01

The most common explosives can be uniquely identified by measuring the elemental H/N ratio with a precision better than 10%. Monte Carlo simulations were used to design two variants of a new prompt gamma neutron activation instrument that can achieve this precision. The instrument features an intense pulsed neutron generator with precise timing. Measuring the hydrogen peak from the target explosive is especially challenging because the instrument itself contains hydrogen, which is needed for neutron moderation and shielding. By iterative design optimization, the fraction of the hydrogen peak counts coming from the explosive under interrogation increased from [Formula: see text]% to [Formula: see text]% (statistical only) for the benchmark design. In the optimized design variants, the hydrogen signal from a high-explosive shell can be measured to a statistics-only precision better than 1% in less than 30 minutes for an average neutron production yield of 109 n/s.

Validation of the force and frequency characteristics of the activator adjusting instrument: effectiveness as a mechanical impedance measurement tool.

PubMed

Keller, T S; Colloca, C J; Fuhr, A W

1999-02-01

To determine the dynamic force-time and force-frequency characteristics of the Activator Adjusting Instrument and to validate its effectiveness as a mechanical impedance measurement device; in addition, to refine or optimize the force-frequency characteristics of the Activator Adjusting Instrument to provide enhanced dynamic structural measurement reliability and accuracy. An idealized test structure consisting of a rectangular steel beam with a static stiffness similar to that of the human thoracolumbar spine was used for validation of a method to determine the dynamic mechanical response of the spine. The Activator Adjusting Instrument equipped with a load cell and accelerometer was used to measure forces and accelerations during mechanical excitation of the steel beam. Driving point and transfer mechanical impedance and resonant frequency of the beam were determined by use of a frequency spectrum analysis for different force settings, stylus masses, and stylus tips. Results were compared with beam theory and transfer impedance measurements obtained by use of a commercial electronic PCB impact hammer. The Activator Adjusting Instrument imparted a very complex dynamic impact comprising an initial high force (116 to 140 N), short duration pulse (<0.1 ms) followed by several lower force (30 to 100 N), longer duration impulses (1 to 5 ms). The force profile was highly reproducible in terms of the peak impulse forces delivered to the beam structure (<8% variance). Spectrum analysis of the Activator Adjusting Instrument impulse indicated that the Activator Adjusting Instrument has a variable force spectrum and delivers its peak energy at a frequency of 20 Hz. Added masses and different durometer stylus tips had very little influence on the Activator Adjusting Instrument force spectrum. The resonant frequency of the beam was accurately predicted by both the Activator Adjusting Instrument and electronic PCB impact hammer, but variations in the magnitude of the driving

Activities of Daily Living Scale in Hoarding Disorder

PubMed Central

Frost, Randy O.; Hristova, Veselina; Steketee, Gail; Tolin, David F.

2013-01-01

Research on hoarding over the last two decades has shown that hoarding disorder appears to be a distinct disorder that burdens the individual, the community and the families of people who hoard. Although hoarding clearly interferes with the daily functioning, especially in the context of extensive clutter, no validated measures of this interference have been developed. The present research examined the psychometric properties of the Activities of Daily Living in Hoarding scale (ADL-H) in two large samples of individuals with significant hoarding problems, one identified through the internet (n=363) and a second through clinical diagnostic interviews (n=202). The ADL-H scale test-retest (1–12 weeks), interrater and internal reliabilities ranged from 0.79 to 0.96. Convergent and discriminant validity were established through analyses of correlational data collected for measures of hoarding severity and non-hoarding psychopathology (obsessive compulsive disorder [OCD], mood state, attention deficit, and perfectionism/uncertainty), as well as through comparisons of scores among individuals with hoarding, hoarding plus OCD, OCD without hoarding, and community controls. The ADL-H scale appears to have strong psychometric properties and to be useful in clinical and research settings. Suggestions are made for expansion of the scale, and study limitations are noted. PMID:23482436

Active Neutron and Gamma-Ray Instrumentation for In Situ Planetary Science Applications

NASA Technical Reports Server (NTRS)

Parsons, A.; Bodnarik, J.; Evans, L.; Floyd, A.; Lim, L.; McClanahan, T.; Namkung, M.; Nowicki, S.; Schweitzer, J.; Starr, R.;

Comparison of physical activity using questionnaires (leisure time physical activity instrument and physical activity at home and work instrument) and accelerometry in fibromyalgia patients: the Al-Ándalus project.

PubMed

Segura-Jiménez, Víctor; Alvarez-Gallardo, Inmaculada C; Romero-Zurita, Alejandro; Camiletti-Moirón, Daniel; Munguía-Izquierdo, Diego; Carbonell-Baeza, Ana; Ruiz, Jonatan R

2014-10-01

To compare the levels of physical activity (PA) assessed with questionnaires (Leisure Time Physical Activity Instrument [LTPAI], Physical Activity at Home and Work Instrument [PAHWI]) and accelerometry in patients with fibromyalgia; and to analyze the test-retest reliability of these questionnaires. Cross-sectional study. Local fibromyalgia association. Participants (N=99; 5 men) with fibromyalgia with a mean age of 50.2±9.5 years. Not applicable. Participants carried an accelerometer for 1 week and completed the LTPAI and PAHWI twice (separated by a 1-wk interval). The LTPAI and PAHWI were summed to obtain overall values of PA. Time spent in total, moderate, and moderate-vigorous PA was higher (P<.01) when assessed by the LTPAI and PAHWI compared with accelerometry. The Bland-Altman method showed an absence of agreement between the LTPAI and PAHWI and the accelerometer for moderate, moderate-vigorous, and total PA. The test-retest reliability for the workplace subscale and total score of the PAHWI showed high and moderate intraclass correlation coefficients (ICCs), respectively, but also manifested high SE of measurements (up to 179min/d). The LTPAI showed low to moderate ICCs and high SE of measurements (up to 79min/d). For the LTPAI and PAHWI, the ICCs for total activity across the population were low to moderate, and the Bland-Altman method confirmed this lack of agreement. The LTPAI and PAHWI and the accelerometer differ greatly when assessing PA. Furthermore, the LTPAI and PAHWI did not show good levels of test-retest reliability. Therefore, the self-administered LTPAI and PAHWI show questionable usefulness to assess PA in populations with fibromyalgia. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effect of a medical food on body mass index and activities of daily living in patients with Alzheimer's disease: secondary analyses from a randomized, controlled trial.

PubMed

Kamphuis, P J G H; Verhey, F R J; Olde Rikkert, M G M; Twisk, J W R; Swinkels, S H N; Scheltens, P

2011-08-01

To investigate the effect of a medical food (Souvenaid) on body mass index (BMI) and functional abilities in patients with mild Alzheimer's disease (AD). DESIGN/SETTING/PARTICIPANTS/INTERVENTION /MEASUREMENTS: These analyses were performed on data from a 12-week, double-blind, randomized, controlled, multicenter, proof-of-concept study with a similarly designed and exploratory 12-week extension period. Patients with mild AD (Mini-Mental State Examination score of 20-26) were randomized to receive either the active product or an iso-caloric control product. While primary outcomes included measures of cognition, the 23-item Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale was included as a secondary outcome. Both ADCS-ADL and BMI were assessed at baseline and Weeks 6, 12 and 24. Data were analyzed using a repeated-measures mixed model. Overall, data suggested an increased BMI in the active versus the control group at Week 24 (ITT: p = 0.07; PP: p = 0.03), but no treatment effect on ADCS-ADL was observed. However, baseline BMI was found to be a significant treatment effect modifier (ITT: p = 0.04; PP: p = 0.05), and an increase in ADCS-ADL was observed at Week 12 in patients with a 'low' baseline BMI (ITT: p = 0.02; PP: p = 0.04). These data indicate that baseline BMI significantly impacts the effect of Souvenaid on functional abilities. In addition, there was a suggestion that Souvenaid increased BMI.

The effects of Snoezelen (multi-sensory behavior therapy) and psychiatric care on agitation, apathy, and activities of daily living in dementia patients on a short term geriatric psychiatric inpatient unit.

PubMed

Staal, Jason A; Sacks, Amanda; Matheis, Robert; Collier, Lesley; Calia, Tina; Hanif, Henry; Kofman, Eugene S

2007-01-01

A randomized, controlled, single-blinded, between group study of 24 participants with moderate to severe dementia was conducted on a geriatric psychiatric unit. All participants received pharmacological therapy, occupational therapy, structured hospital environment, and were randomized to receive multi sensory behavior therapy (MSBT) or a structured activity session. Greater independence in activities of daily living (ADLs) was observed for the group treated with MSBT and standard psychiatric inpatient care on the Katz Index of Activities of Daily Living (KI-ADL; P = 0.05) than standard psychiatric inpatient care alone. The combination treatment of MSBT and standard psychiatric care also reduced agitation and apathy greater than standard psychiatric inpatient care alone as measured with the Pittsburgh Agitation Scale and the Scale for the Assessment of Negative Symptoms in Alzheimer's Disease (P = 0.05). Multiple regression analysis predicted that within the multi-sensory group, activities of daily living (KI-ADL) increased as apathy and agitation reduced (R2 = 0.42; p = 0.03). These data suggest that utilizing MSBT with standard psychiatric inpatient care may reduce apathy and agitation and additionally improve activities of daily living in hospitalized people with moderate to severe dementia more than standard care alone.

Providing instrumental social support is more beneficial to reduce mortality risk among the elderly with low educational level in Taiwan: a 12-year follow-up national longitudinal study.

PubMed

Liao, C C; Yeh, C J; Lee, S H; Liao, W C; Liao, M Y; Lee, M C

2015-04-01

To evaluate whether the effects of providing or receiving social support are more beneficial to reduce mortality risk among the elderly with different educational levels. In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was initiated from 1996 until 2007. The complete data from 1492 males and 1177 females aged ≥67 years were retrieved. Participants received financial, instrumental, and emotional support, and they actively provided instrumental and emotional support to others and involved in social engagement. Education attainment was divided into two levels: high and low. The low education level included illiterate and elementary school. The high education level included junior high school to senior high school and above college. Cox regression analysis was used to examine the association between providing or receiving social support on mortality with different educational levels. The average age of the participants in 1996 was 73.0 (IQR=8.0) years, and the median survival following years (1996-2007) of participants was 10.3 (IQR=6.7) years. Most participants were low educational level including illiterate (39.3%) and elementary school (41.2%). Participants with high educational level tend to be younger and more male significantly. On the contrary, participants with low educational level tend to have significant more poor income, more depression, more cognition impairment, more with IADL and ADL disability than high educational level. Most participants received instrumental support from others (95.5%) and also provided emotional support to others (97.7%). Providing instrumental support can reduce 17% of mortality risk among the elderly with a low level of education after adjusting several covariates [Hazard ratio (HR) = 0.83; 95% confidence interval (CI) = 0.70-0.99; p = 0.036]. Providing instrumental social support to others confer benefits to the giver and prolong life expectancy among the

Fabrication of Rare-earth Aluminate (ReAlO3) Glass and Crystalline phases by Aerodynamic Levitation (ADL)

NASA Astrophysics Data System (ADS)

Basavalingu, B.; Yoda, Shinichi; Kumar, M. S. Vijaya

2012-07-01

Containerless processing by levitation technique has been extensively used for material science and engineering because it suppresses inhomogeneous nucleation from the container wall and helps to produce stable, metastable and glass phases. The containerless levitation technique is widely explored for material processing because of its technological and scientific advantages. Recently, research on bulk glass and glass-ceramics have attracted the attention of material scientists as they are considered as low cost optical materials of the future. In the present study, the formation of bulk spherical glass and crystalline ReAlO _{3}(Re=La-Lu,Y) phases has been investigated due to their unique features in terms of the solidification process from an undercooled melt, glass structure and optical properties. An Aerodynamic levitation (ADL) was used to undercool the melt well below the melting temperature. Sintered bits of ReAlO _{3} sample with a diameter of ~2.5 mm and mass of ~20-25 mg was levitated by an ADL and completely melted by a CO _{2} laser and then the droplet was cooled by turning off the CO _{2} laser and solidified. The surface temperature and solidification process of the levitated droplet was monitored using pyrometer and high speed video camera, respectively. Among the rare earth aluminum perovskites Lanthanum, Neodymium and samarium aluminum perovskites solidified as glass and others YAlO _{3} and Europium to Lutetium aluminum perovskites solidified as crystalline phases. The scanning electron microscopy (SEM) images of cross-sectioned samples, TG/DTA, Transmittance and Refractive Index studies were performed for both glass and crystalline phases. The results of the above studies revealed the formation of glass and crystalline phases directly from the undercooled melt. The glass transition temperature (Tg) gradually increased with increasing ionic radius of the rare-earth elements. The NdAlO _{3} glass phase showed a high refractive index of ~1

SVM-based multimodal classification of activities of daily living in Health Smart Homes: sensors, algorithms, and first experimental results.

PubMed

Fleury, Anthony; Vacher, Michel; Noury, Norbert

2010-03-01

By 2050, about one third of the French population will be over 65. Our laboratory's current research focuses on the monitoring of elderly people at home, to detect a loss of autonomy as early as possible. Our aim is to quantify criteria such as the international activities of daily living (ADL) or the French Autonomie Gerontologie Groupes Iso-Ressources (AGGIR) scales, by automatically classifying the different ADL performed by the subject during the day. A Health Smart Home is used for this. Our Health Smart Home includes, in a real flat, infrared presence sensors (location), door contacts (to control the use of some facilities), temperature and hygrometry sensor in the bathroom, and microphones (sound classification and speech recognition). A wearable kinematic sensor also informs postural transitions (using pattern recognition) and walk periods (frequency analysis). This data collected from the various sensors are then used to classify each temporal frame into one of the ADL that was previously acquired (seven activities: hygiene, toilet use, eating, resting, sleeping, communication, and dressing/undressing). This is done using support vector machines. We performed a 1-h experimentation with 13 young and healthy subjects to determine the models of the different activities, and then we tested the classification algorithm (cross validation) with real data.

Design of a novel instrument for active neutron interrogation of artillery shells

PubMed Central

Vainionpää, Hannes; Peura, Pauli; Toivonen, Harri; Eerola, Paula; Dendooven, Peter

2017-01-01

The most common explosives can be uniquely identified by measuring the elemental H/N ratio with a precision better than 10%. Monte Carlo simulations were used to design two variants of a new prompt gamma neutron activation instrument that can achieve this precision. The instrument features an intense pulsed neutron generator with precise timing. Measuring the hydrogen peak from the target explosive is especially challenging because the instrument itself contains hydrogen, which is needed for neutron moderation and shielding. By iterative design optimization, the fraction of the hydrogen peak counts coming from the explosive under interrogation increased from 53-7+7% to 74-10+8% (statistical only) for the benchmark design. In the optimized design variants, the hydrogen signal from a high-explosive shell can be measured to a statistics-only precision better than 1% in less than 30 minutes for an average neutron production yield of 109 n/s. PMID:29211773

Activity classification based on inertial and barometric pressure sensors at different anatomical locations.

PubMed

Moncada-Torres, A; Leuenberger, K; Gonzenbach, R; Luft, A; Gassert, R

2014-07-01

Miniature, wearable sensor modules are a promising technology to monitor activities of daily living (ADL) over extended periods of time. To assure both user compliance and meaningful results, the selection and placement site of sensors requires careful consideration. We investigated these aspects for the classification of 16 ADL in 6 healthy subjects under laboratory conditions using ReSense, our custom-made inertial measurement unit enhanced with a barometric pressure sensor used to capture activity-related altitude changes. Subjects wore a module on each wrist and ankle, and one on the trunk. Activities comprised whole body movements as well as gross and dextrous upper-limb activities. Wrist-module data outperformed the other locations for the three activity groups. Specifically, overall classification accuracy rates of almost 93% and more than 95% were achieved for the repeated holdout and user-specific validation methods, respectively, for all 16 activities. Including the altitude profile resulted in a considerable improvement of up to 20% in the classification accuracy for stair ascent and descent. The gyroscopes provided no useful information for activity classification under this scheme. The proposed sensor setting could allow for robust long-term activity monitoring with high compliance in different patient populations.

SOCIOECONOMIC INEQUALITIES IN SELF-REPORTED HEALTH AND PHYSICAL FUNCTIONING IN ARGENTINA: FINDINGS FROM THE NATIONAL SURVEY ON QUALITY OF LIFE OF OLDER ADULTS 2012 (ENCaViAM).

PubMed

Rodríguez López, Santiago; Colantonio, Sonia E; Celton, Dora E

2017-09-01

This study aimed to evaluate educational and income inequalities in self-reported health (SRH), and physical functioning (limitations in Activities of Daily Living (ADL)/Instrumental Activities of Daily Living (IADL)), among 60-year-old and older adults in Argentina. Using cross-sectional data from the Argentinian National Survey on Quality of Life of Older Adults 2012 (Encuesta Nacional sobre Calidad de Vida de Adultos Mayores, ENCaViAM), gender-specific socioeconomic inequalities in SRH and ADL and IADL limitations were studied in relation to educational level and household per capita income. The Relative Index of Inequality (RII) - an index of the relative size of socioeconomic inequalities in health - was used. Socioeconomic inequalities in the studied health indicators were found - except for limitations in ADL among women - favouring socially advantaged groups. The results remained largely significant after full adjustment, suggesting that educational and income inequalities, mainly in SRH and IADL, were robust and somehow independent of age, marital status, physical activity, the use of several medications, depression and the occurrence of falls. The findings add to the existing knowledge on the relative size of the socioeconomic inequalities in subjective health indicators among Argentinian older adults, which are to the detriment of lower socioeconomic groups. The results could be used to inform planning interventions aimed at decreasing socioeconomic inequalities in health, to the benefit of socially disadvantaged adults.

Observing the onset of disability in older adults.

PubMed

Reynolds, Sandra L; Silverstein, Merril

2003-11-01

One of the greatest threats to the ability of older adults to live independently is the onset of disability in activities adults perform in their daily lives, such as dressing, eating, toileting, managing one's money, preparing meals and so on. This article examines the onset of disability in older adult Americans using three waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (1993, 1995, 1998; n=4228). We use medical/demographic factors (arthritis, heart disease, diabetes; age, gender, race/ethnicity, wealth), baseline characteristics (affect, cognition, health behaviors, medical insurance), and time-varying covariates (changes in chronic conditions and baseline characteristics) to predict the onset of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) disability, individually and in the aggregate, over time. We find the onset of ADL and IADL disability is a complex process, suggesting important roles for medical, demographic, social, psychological, and behavioral triggers, specifically negative affect, higher body weight, and by the lack of vigorous exercise. We also find that individual ADL and IADL impairments are predicted by a variety of different factors, suggesting that summary measures of disability may be masking a wealth of potentially useful interventions. In general, public health efforts in the area of controlling obesity and treating depressive symptoms should be supported.

Effects of Androgen Blockade on Cognitive Function and Quality of Life in Men with Prostate Cancer

DTIC Science & Technology

2006-08-01

especially among older adults , for whom cognitive impairment may be associated with impaired performance of activities of daily living (ADL), instrumental...is needed for performance of concurrent tasks) is often impaired among older adults (Raz, 2000). Among older men, working memory has been shown to...in a number of populations--especially older adults , who will be the primary target of this study--and has some experience with the cognitive effects

Evaluation of Three State-of-the-Art Classifiers for Recognition of Activities of Daily Living from Smart Home Ambient Data

PubMed Central

Nef, Tobias; Urwyler, Prabitha; Büchler, Marcel; Tarnanas, Ioannis; Stucki, Reto; Cazzoli, Dario; Müri, René; Mosimann, Urs

2012-01-01

Smart homes for the aging population have recently started attracting the attention of the research community. The “health state” of smart homes is comprised of many different levels; starting with the physical health of citizens, it also includes longer-term health norms and outcomes, as well as the arena of positive behavior changes. One of the problems of interest is to monitor the activities of daily living (ADL) of the elderly, aiming at their protection and well-being. For this purpose, we installed passive infrared (PIR) sensors to detect motion in a specific area inside a smart apartment and used them to collect a set of ADL. In a novel approach, we describe a technology that allows the ground truth collected in one smart home to train activity recognition systems for other smart homes. We asked the users to label all instances of all ADL only once and subsequently applied data mining techniques to cluster in-home sensor firings. Each cluster would therefore represent the instances of the same activity. Once the clusters were associated to their corresponding activities, our system was able to recognize future activities. To improve the activity recognition accuracy, our system preprocessed raw sensor data by identifying overlapping activities. To evaluate the recognition performance from a 200-day dataset, we implemented three different active learning classification algorithms and compared their performance: naive Bayesian (NB), support vector machine (SVM) and random forest (RF). Based on our results, the RF classifier recognized activities with an average specificity of 96.53%, a sensitivity of 68.49%, a precision of 74.41% and an F-measure of 71.33%, outperforming both the NB and SVM classifiers. Further clustering markedly improved the results of the RF classifier. An activity recognition system based on PIR sensors in conjunction with a clustering classification approach was able to detect ADL from datasets collected from different homes. Thus

Evaluation of Three State-of-the-Art Classifiers for Recognition of Activities of Daily Living from Smart Home Ambient Data.

PubMed

Nef, Tobias; Urwyler, Prabitha; Büchler, Marcel; Tarnanas, Ioannis; Stucki, Reto; Cazzoli, Dario; Müri, René; Mosimann, Urs

2015-05-21

Smart homes for the aging population have recently started attracting the attention of the research community. The "health state" of smart homes is comprised of many different levels; starting with the physical health of citizens, it also includes longer-term health norms and outcomes, as well as the arena of positive behavior changes. One of the problems of interest is to monitor the activities of daily living (ADL) of the elderly, aiming at their protection and well-being. For this purpose, we installed passive infrared (PIR) sensors to detect motion in a specific area inside a smart apartment and used them to collect a set of ADL. In a novel approach, we describe a technology that allows the ground truth collected in one smart home to train activity recognition systems for other smart homes. We asked the users to label all instances of all ADL only once and subsequently applied data mining techniques to cluster in-home sensor firings. Each cluster would therefore represent the instances of the same activity. Once the clusters were associated to their corresponding activities, our system was able to recognize future activities. To improve the activity recognition accuracy, our system preprocessed raw sensor data by identifying overlapping activities. To evaluate the recognition performance from a 200-day dataset, we implemented three different active learning classification algorithms and compared their performance: naive Bayesian (NB), support vector machine (SVM) and random forest (RF). Based on our results, the RF classifier recognized activities with an average specificity of 96.53%, a sensitivity of 68.49%, a precision of 74.41% and an F-measure of 71.33%, outperforming both the NB and SVM classifiers. Further clustering markedly improved the results of the RF classifier. An activity recognition system based on PIR sensors in conjunction with a clustering classification approach was able to detect ADL from datasets collected from different homes. Thus, our

Active upper limb prosthesis based on natural movement trajectories.

PubMed

Ramírez-García, Alfredo; Leija, Lorenzo; Muñoz, Roberto

2010-03-01

The motion of the current prostheses is sequential and does not allow natural movements. In this work, complex natural motion patterns from a healthy upper limb were characterized in order to be emulated for a trans-humeral prosthesis with three degrees of freedom at the elbow. Firstly, it was necessary to define the prosthesis workspace, which means to establish a relationship using an artificial neural network (ANN), between the arm-forearm (3-D) angles allowed by the prosthesis, and its actuators length. The 3-D angles were measured between the forearm and each axis of the reference system attached at the elbow. Secondly, five activities of daily living (ADLs) were analyzed by means of the elbow flexion (EF), the forearm prono-supination (FPS) and the 3-D angles, from healthy subjects, by using a video-based motion analysis system. The 3-D angles were fed to the prosthesis model (ANN) in order to analyze which ADLs could be emulated by the prosthesis. As a result, a prosthesis kinematics approximation was obtained. In conclusion, in spite of the innovative mechanical configuration of the actuators, it was possible to carry out only three of the five ADLs considered. Future work will include improvement of the mechanical configuration of the prosthesis to have greater range of motion.

78 FR 40427 - Foreign-Trade Zone (FTZ) 32-Miami, Florida; Notification of Proposed Production Activity; Almod...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-05

... facility is used for the production (restoration and repair) of jewelry comprised of precious metals and..., Florida; Notification of Proposed Production Activity; Almod Diamonds, Ltd. (Jewelry and Precious Stones... of proposed production activity to the FTZ Board on behalf of Almod Diamonds, Ltd. (ADL), located in...

Validity of the Foot and Ankle Ability Measure in Athletes With Chronic Ankle Instability

PubMed Central

Carcia, Christopher R; Martin, RobRoy L; Drouin, Joshua M

2008-01-01

Context: The Foot and Ankle Ability Measure (FAAM) is a region-specific, non–disease-specific outcome instrument that possesses many of the clinimetric qualities recommended for an outcome instrument. Evidence of validity to support the use of the FAAM is available in individuals with a wide array of ankle and foot disorders. However, additional evidence to support the use of the FAAM for those with chronic ankle instability (CAI) is needed. Objective: To provide evidence of construct validity for the FAAM based on hypothesis testing in athletes with CAI. Design: Between-groups comparison. Setting: Athletic training room. Patients or Other Participants: Thirty National Collegiate Athletic Association Division II athletes (16 men, 14 women) from one university. Main Outcome Measure(s): The FAAM including activities of daily living (ADL) and sports subscales and the global and categorical ratings of function. Results: For both the ADL and sports subscales, FAAM scores were greater in healthy participants (100 ± 0.0 and 99 ± 3.5, respectively) than in subjects with CAI (88 ± 7.7 and 76 ± 12.7, respectively; P < .001). Similarly, for both ADL and sports subscales, FAAM scores were greater in athletes who indicated that their ankles were normal (98 ± 6.3 and 96 ± 6.9, respectively) than in those who classified their ankles as either nearly normal or abnormal (87 ± 6.6 and 71 ± 11.1, respectively; P < .001). We found relationships between FAAM scores and self-reported global ratings of function for both ADL and sports subscales. Relationships were stronger when all athletes, rather than just those with CAI, were included in the analyses. Conclusions: The FAAM may be used to detect self-reported functional deficits related to CAI. PMID:18345343

Multi-instrument assessment of physical activity in female office workers.

PubMed

Can, Sema; Gündüz, Nevin; Arslan, Erşan; Biernat, Elżbieta; Ersöz, Gülfem; Kilit, Bülent

2016-11-18

The aim of this study was to examine the multi-instrument assessment of physical activity in female office workers. Fifty healthy women (age (mean ± standard deviation): 34.8±5.9 years, body height: 158±0.4 cm, body weight: 61.8±7.5 kg, body mass index: 24.6±2.7 kg/m²) workers from the same workplace volunteered to participate in the study. Physical activity was measured with the 7-day Physical Activity Assessment Questionnaire (7-d PAAQ), an objective multi-sensor armband tool, and also a waist-mounted pedometer, which were both worn for 7 days. A significant correlation between step numbers measured by armband and pedometer was observed (r = 0.735), but the step numbers measured by these 2 methods were significantly different (10 941±2236 steps/ day and 9170±2377 steps/day, respectively; p < 0.001). There was a weak correlation between the value of 7-d PAAQ total energy expenditure and the value of armband total energy expenditure (r = 0.394, p = 0.005). However, total energy expenditure values measured by armband and 7-d PAAQ were not significantly different (2081±370 kcal/ day and 2084±197 kcal/day, respectively; p = 0.96). In addition, physical activity levels (average daily metabolic equivalents (MET)) measured by armband and 7-d PAAQ were not significantly different (1.45±0.12 MET/day and 1.47±0.24 MET/day, respectively; p = 0.44). The results of this study showed that the correlation between pedometer and armband measurements was higher than that between armband measurements and 7-d PAAQ selfreports. Our results suggest that none of the assessment methods examined here, 7-d PAAQ, pedometer, or armband, is sufficient when used as a single tool for physical activity level determination. Therefore, multi-instrument assessment methods are preferable. Int J Occup Med Environ Health 2016;29(6):937-945. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Measurement of activity limitations and participation restrictions: examination of ICF-linked content and scale properties of the FIM and PC-PART instruments.

PubMed

Darzins, Susan W; Imms, Christine; Di Stefano, Marilyn

2017-05-01

To explore the operationalization of activity and participation-related measurement constructs through comparison of item phrasing, item response categories and scoring (scale properties) for two separate instruments targeting activities of daily living. Personal Care Participation Assessment and Resource Tool (PC-PART) item content was linked to ICF categories using established linking rules. Previously reported ICF-linked FIM content categories and ICF-linked PC-PART content categories were compared to identify common ICF categories between the instruments. Scale properties of both instruments were compared using a patient scenario to explore the instruments' separate measurement constructs. The PC-PART and FIM shared 15 of the 53 level two ICF-linked categories identified across both instruments. Examination of the instruments' scale properties for items with overlapping ICF content, and exploration through a patient scenario, provided supportive evidence that the instruments measure different constructs. While the PC-PART and FIM share common ICF-linked content, they measure separate constructs. Measurement construct was influenced by the instruments' scale properties. The FIM was observed to measure activity limitations and the PC-PART measured participation restrictions. Scrutiny of instruments' scale properties in addition to item content is critical in the operationalization of activity and participation-related measurement constructs. Implications for Rehabilitation When selecting outcome measures for use in rehabilitation it is necessary to examine both the content of the instruments' items and item phrasing, response categories and scoring, to clarify the construct being measured. Measurement of activity limitations as well as participation restrictions in activities of daily living required for community life provides a more comprehensive measurement of rehabilitation outcomes than measurement of either construct alone. To measure the effects of

Intensity, Chronicity, Circumstances, and Consequences of HIV-Related Fatigue: A Longitudinal Study

PubMed Central

Barroso, Julie; Harmon, James L.; Madison, Jane Leserman; Pence, Brian Wells

2013-01-01

HIV-related fatigue remains the most troubling complaint of seropositive people. Researchers often use tools to measure fatigue that were developed for other patient populations; thus, the measurement of fatigue specific to HIV is needed. This article describes results from the HIV-Related Fatigue Scale (HRFS) including: (a) the variability in intensity and chronicity of HIV-related fatigue, (b) the circumstances surrounding changes in fatigue, (c) the impact of fatigue on activities of daily living (ADLs), and (d) the consequences of HIV-related fatigue. We collected data every 3 months over a 3-year period from 128 people. HIV-related fatigue was chronic and did not appear to remit spontaneously; those who were the most fatigued at the beginning of the study remained the most fatigued over 3 years. Fatigue interfered more with instrumental activities of daily living than basic ADLs; it also interfered with work, family, and social life. Stress and depression increased fatigue. PMID:23814175

Extended Occupational Therapy Reintegration Strategies for a Woman With Guillain-Barré Syndrome: Case Report.

PubMed

Tomita, Machiko R; Buckner, Kathryn; Saharan, Sumandeep; Persons, Kimberley; Liao, Sheng Hui

2016-01-01

This case report describes a unique long-term functional recovery process to promote successful community reintegration for a woman with Guillain-Barré syndrome (GBS), a rare autoimmune disease. Her main symptoms were very limited mobility and depressive symptoms due to the unknown cause of and cure for the illness. Holistic occupational strategies helped the client stabilize her emotional state, create a safe home environment, improve a communication method, increase physical activity, and promote social participation. Participation in a fall prevention clinical trial lowered her risk of falling; at 9 mo, she reached 75% of the maximum Social Integration score; at 13 mo, she reached near-normal level for activities of daily living (ADLs) and her fastest time for the Timed Up and Go test; and at 2 yr, she achieved a 100% score in instrumental ADLs. For community integration of clients with GBS, a comprehensive strategic self-management approach should be prescribed for long-term recovery. Copyright © 2016 by the American Occupational Therapy Association, Inc.

Trends in late-life disability in Taiwan: The roles of education, environment, and technology

PubMed Central

Martin, Linda G.; Zimmer, Zachary; Hurng, Baai-Shyun

2011-01-01

This analysis offers the first strong evidence of trends in late-life disability in an emerging economy. Consistent measures of limitations in seeing, hearing, physical functions, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) were available for three to six survey waves, depending on the outcome, from 1989 to 2007 for the population of Taiwan aged 65 and older. Limitations in seeing, hearing, and IADLs declined substantially, but trends were mixed for physical functions and flat for ADLs. The remarkable reduction in difficulty phoning, an IADL, may reflect changes in telecommunications infrastructure and highlights the roles of environment and technology in disability outcomes. Trends for urban residents were more advantageous than those for rural residents for seeing and hearing, but less so for physical functions and IADLs. Were it not for the substantial increase in educational attainment, trends in all outcomes would have been less favorable. PMID:21923619

Physiological Requirements to Perform the Glittre Activities of Daily Living Test by Subjects With Mild-to-Severe COPD.

PubMed

Souza, Gérson F; Moreira, Graciane L; Tufanin, Andréa; Gazzotti, Mariana R; Castro, Antonio A; Jardim, José R; Nascimento, Oliver A

2017-08-01

The Glittre activities of daily living (ADL) test is supposed to evaluate the functional capacity of COPD patients. The physiological requirements of the test and the time taken to perform it by COPD patients in different disease stages are not well known. The objective of this work was to compare the metabolic, ventilatory, and cardiac requirements and the time taken to carry out the Glittre ADL test by COPD subjects with mild, moderate, and severe disease. Spirometry, Medical Research Council questionnaire, cardiopulmonary exercise test, and 2 Glittre ADL tests were evaluated in 62 COPD subjects. Oxygen uptake (V̇ O 2 ), carbon dioxide production, pulmonary ventilation, breathing frequency, heart rate, S pO 2 , and dyspnea were analyzed before and at the end of the tests. Maximum voluntary ventilation, Glittre peak V̇ O 2 /cardiopulmonary exercise test (CPET) peak V̇ O 2 , Glittre V̇ E /maximum voluntary ventilation, and Glittre peak heart rate/CPET peak heart rate ratios were calculated to analyze their reserves. Subjects carried out the Glittre ADL test with similar absolute metabolic, ventilatory, and cardiac requirements. Ventilatory reserve decreased progressively from mild to severe COPD subjects ( P < .001 for Global Initiative for Chronic Obstructive Lung Disease [GOLD] 1 vs GOLD 2, P < .001 for GOLD 1 vs GOLD 3, and P < .001 for GOLD 2 vs GOLD 3). Severe subjects with COPD presented a significantly lower metabolic reserve than the mild and moderate subjects ( P = .006 and P = .043, respectively) and significantly lower Glittre peak heart rate/CPET peak heart rate than mild subjects ( P = .01). Time taken to carry out the Glittre ADL test was similar among the groups ( P = .82 for GOLD 1 vs GOLD 2, P = .19 for GOLD 1 vs GOLD 3, and P = .45 for GOLD 2 vs GOLD 3). As the degree of air-flow obstruction progresses, the COPD subjects present significant lower ventilatory reserve to perform the Glittre ADL test. In addition, metabolic and cardiac reserves

Motor function and activities of daily living capacity of patients with fractures sustained during the Wenchuan earthquake.

PubMed

Zhang, Jin-Long; He, Hong-Chen; Lin, Hai-Dan; Luo, Qing-Lu; Xia, Lu; Li, Sha-Sha; He, Cheng-Qi

2011-05-01

On the afternoon of May 12, 2008, a 8.0-magnitude earthquake hit Sichuan Province, a mountainous region in Western China, killing about 70 000 people and leaving over 18 000 missing. What about the survivors motor functions and activities of daily living (ADL) capacity, especially for fractures? We need the data to guide the rehabilitation for the seismic wounded and it's important to collect the data for the future. We study the survivors to understand the motor functions and ADL capacity of patients with fractures sustained in the Wenchuan earthquake, to provide a basis for rehabilitation and treatment. We used the Manual Muscle Testing method to evaluate muscle strength, the joint angle scale to measure joint range of motion (ROM), and the Barthel index to evaluate the activities of daily living status. SPSS 13.0 software was used to analyze the data and the results were tested using one-way analysis of variance (ANOVA). The number of seismic wounded amounted to 487; 81.1% of patients had fractures. Most of the injured had fractures in multiple regions (53.9% of all fracture patients), followed by fractures of the upper limb (34.0% of patients); cranial fractures were rare (2.3%). Totally 82.0% had restricted range of motion, 23.5% had decreased muscle force, and 72.2% of the patients had restricted activities of daily living capacities. With time the activities of daily living capacity of female increased (P < 0.05), compared with the male fracture patients who did not show any relative improvement (P > 0.05). The difference between the patients' ages and ADL capacities did not reach statistical significance (P > 0.05), nor was there a significant difference between their ages and the numbers of days in hospital (P > 0.05). Fractures were the main issue in the seismic wounded, many of them had reductions in the ROM, muscle force and ADL capacities. The physicians involved in rehabilitation should pay greater attention to muscle force exercises, joint

The Effects of Reflective Activities on Skill Adaptation in a Work-Related Instrumental Learning Setting

ERIC Educational Resources Information Center

Roessger, Kevin M.

2014-01-01

In work-related instrumental learning contexts, the role of reflective activities is unclear. Kolb's experiential learning theory and Mezirow's transformative learning theory predict skill adaptation as an outcome. This prediction was tested by manipulating reflective activities and assessing participants' response and error rates during novel…

Regional Instrumentation Centers.

ERIC Educational Resources Information Center

Cromie, William J.

1980-01-01

Focuses on the activities of regional instrumentation centers that utilize the state-of-the-art instruments and methodology in basic scientific research. The emphasis is on the centers involved in mass spectroscopy, magnetic resonance spectroscopy, lasers, and accelerators. (SA)

Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities.

PubMed

Furuta, Michiko; Komiya-Nonaka, Manae; Akifusa, Sumio; Shimazaki, Yoshihiro; Adachi, Munehisa; Kinoshita, Toshinori; Kikutani, Takeshi; Yamashita, Yoshihisa

2013-04-01

Malnutrition and cognitive impairment lead to declines in activities of daily living (ADL). Nutritional status and cognitive ability have been shown to correlate with oral health status and swallowing function. However, the complex relationship among the factors that affect decline in ADL is not understood. We examined direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in Japanese elderly people living at home and receiving home care services because of physical disabilities. Participants were 286 subjects aged 60 years and older (mean age, 84.5±7.9 years) living at home and receiving home care services. Oral health status (the number of teeth and wearing dentures) was assessed, and swallowing function was examined using cervical auscultation. Additionally, ADL, cognitive ability, and nutritional status were assessed using the Barthel Index, the Clinical Dementia Rating Scale, and the Mini Nutritional Assessment-Short Form, respectively. Path analysis was used to test pathways from these factors to ADL. The mean number of teeth present in the participants was 8.6±9.9 (edentates, 40.6%). Dysphagia, malnutrition, and severe cognitive impairment were found in 31.1%, 14.0%, and 21.3% of the participants, respectively. Path analysis indicated that poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition. Malnutrition as well as dysphagia and cognitive impairment directly limited ADL. A lower number of teeth are positively related to swallowing dysfunction, whereas denture wearing contributes to recovery of swallowing function. Dysphagia, cognitive impairment, and malnutrition directly and indirectly decreased ADL in elderly people living at home and receiving home nursing care. The findings suggest that preventing tooth loss and encouraging denture

Validity and reliability of the activPAL3 for measuring posture and stepping in adults and young people.

PubMed

Sellers, Ceri; Dall, Philippa; Grant, Margaret; Stansfield, Ben

2016-01-01

Characterisation of free-living physical activity requires the use of validated and reliable monitors. This study reports an evaluation of the validity and reliability of the activPAL3 monitor for the detection of posture and stepping in both adults and young people. Twenty adults (median 27.6y; IQR22.6y) and 8 young people (12.0y; IQR4.1y) performed standardised activities and activities of daily living (ADL) incorporating sedentary, upright and stepping activity. Agreement, specificity and positive predictive value were calculated between activPAL3 outcomes and the gold-standard of video observation. Inter-device reliability was calculated between 4 monitors. Sedentary and upright times for standardised activities were within ±5% of video observation as was step count (excluding jogging) for both adults and young people. Jogging step detection accuracy reduced with increasing cadence >150stepsmin(-1). For ADLs, sensitivity to stepping was very low for adults (40.4%) but higher for young people (76.1%). Inter-device reliability was either good (ICC(1,1)>0.75) or excellent (ICC(1,1)>0.90) for all outcomes. An excellent level of detection of standardised postures was demonstrated by the activPAL3. Postures such as seat-perching, kneeling and crouching were misclassified when compared to video observation. The activPAL3 appeared to accurately detect 'purposeful' stepping during ADL, but detection of smaller stepping movements was poor. Small variations in outcomes between monitors indicated that differences in monitor placement or hardware may affect outcomes. In general, the detection of posture and purposeful stepping with the activPAL3 was excellent indicating that it is a suitable monitor for characterising free-living posture and purposeful stepping activity in healthy adults and young people. Copyright © 2015 Elsevier B.V. All rights reserved.

Upper Atmospheric Effects of the HF Active Auroral Research Program Ionospheric Research Instrument (HAARP IRI)

DTIC Science & Technology

1993-05-01

RESEARCH INSTRUMENT ( HAARP IRI) V. Eccles R. Armstrong Mission Research Corporation One Tara Blvd Nashua, NH 03062-2801 May 1993 Scientific Report No...INSTRUMENT ( HAARP IRI) PR 2310 STA G3 WU BM6. AUTHOR(S) V. Eccles and R. Armstrong 7. PERFOR•IlNG ORGANIZATION NAME(S) AND AOORESS(ES) 8. PERFORMING...Because the HAARP (HF Active Auroral Research Program) facility is designed to mimic and investigate certain natural processes, a study of possible

Prediction of oxygen uptake dynamics by machine learning analysis of wearable sensors during activities of daily living.

PubMed

Beltrame, T; Amelard, R; Wong, A; Hughson, R L

2017-04-05

Currently, oxygen uptake () is the most precise means of investigating aerobic fitness and level of physical activity; however, can only be directly measured in supervised conditions. With the advancement of new wearable sensor technologies and data processing approaches, it is possible to accurately infer work rate and predict during activities of daily living (ADL). The main objective of this study was to develop and verify the methods required to predict and investigate the dynamics during ADL. The variables derived from the wearable sensors were used to create a predictor based on a random forest method. The temporal dynamics were assessed by the mean normalized gain amplitude (MNG) obtained from frequency domain analysis. The MNG provides a means to assess aerobic fitness. The predicted during ADL was strongly correlated (r = 0.87, P < 0.001) with the measured and the prediction bias was 0.2 ml·min -1 ·kg -1 . The MNG calculated based on predicted was strongly correlated (r = 0.71, P < 0.001) with MNG calculated based on measured data. This new technology provides an important advance in ambulatory and continuous assessment of aerobic fitness with potential for future applications such as the early detection of deterioration of physical health.

Prediction of oxygen uptake dynamics by machine learning analysis of wearable sensors during activities of daily living

PubMed Central

Beltrame, T.; Amelard, R.; Wong, A.; Hughson, R. L.

2017-01-01

Currently, oxygen uptake () is the most precise means of investigating aerobic fitness and level of physical activity; however, can only be directly measured in supervised conditions. With the advancement of new wearable sensor technologies and data processing approaches, it is possible to accurately infer work rate and predict during activities of daily living (ADL). The main objective of this study was to develop and verify the methods required to predict and investigate the dynamics during ADL. The variables derived from the wearable sensors were used to create a predictor based on a random forest method. The temporal dynamics were assessed by the mean normalized gain amplitude (MNG) obtained from frequency domain analysis. The MNG provides a means to assess aerobic fitness. The predicted during ADL was strongly correlated (r = 0.87, P < 0.001) with the measured and the prediction bias was 0.2 ml·min−1·kg−1. The MNG calculated based on predicted was strongly correlated (r = 0.71, P < 0.001) with MNG calculated based on measured data. This new technology provides an important advance in ambulatory and continuous assessment of aerobic fitness with potential for future applications such as the early detection of deterioration of physical health. PMID:28378815

German activities in optical space instrumentation

NASA Astrophysics Data System (ADS)

Hartmann, G.

2018-04-01

In the years of space exploration since the mid-sixties, a wide experience in optical space instrumentation has developed in Germany. This experience ranges from large telescopes in the 1 m and larger category with the accompanying focal plane detectors and spectrometers for all regimes of the electromagnetic spectrum (infrared, visible, ultraviolet, x-rays), to miniature cameras for cometary and planetary explorations. The technologies originally developed for space science. are now also utilized in the fields of earth observation and even optical telecommunication. The presentation will cover all these areas, with examples for specific technological or scientific highlights. Special emphasis will be given to the current state-of-the-art instrumentation technologies in scientific institutions and industry, and to the future perspective in approved and planned projects.

Assessing research activity and capacity of community-based organizations: development and pilot testing of an instrument.

PubMed

Humphries, Debbie L; Carroll-Scott, Amy; Mitchell, Leif; Tian, Terry; Choudhury, Shonali; Fiellin, David A

2014-01-01

Although awareness of the importance of the research capacity of community-based organizations (CBOs) is growing, a uniform framework of the research capacity domains within CBOs has not yet been developed. To develop a framework and instrument (the Community REsearch Activity assessment Tool [CREAT]) for assessing the research activity and capacity of CBOs that incorporates awareness of the different data collection and analysis priorities of CBOs. We conducted a review of existing tools for assessing research capacity to identify key capacity domains. Instrument items were developed through an iterative process with CBO representatives and community researchers. The CREAT was then pilot tested with 30 CBOs. The four primary domains of the CREAT framework include 1) organizational support for research, 2) generalizable experiences, 3) research specific experiences, and 4) funding. Organizations reported a high prevalence of activities in the research-specific experiences domain, including conducting literature reviews (70%), use of research terminology (83%), and primary data collection (100%). Respondents see research findings as important to improve program and service delivery, and to seek funds for new programs and services. Funders, board members, and policymakers are the most important dissemination audiences. The work reported herein advances the field of CBO research capacity by developing a systematic framework for assessing research activity and capacity relevant to the work of CBOs, and by developing and piloting an instrument to assess activity in these domains.

The Myosuit: Bi-articular Anti-gravity Exosuit That Reduces Hip Extensor Activity in Sitting Transfers.

PubMed

Schmidt, Kai; Duarte, Jaime E; Grimmer, Martin; Sancho-Puchades, Alejandro; Wei, Haiqi; Easthope, Chris S; Riener, Robert

2017-01-01

Muscle weakness-which can result from neurological injuries, genetic disorders, or typical aging-can affect a person's mobility and quality of life. For many people with muscle weakness, assistive devices provide the means to regain mobility and independence. These devices range from well-established technology, such as wheelchairs, to newer technologies, such as exoskeletons and exosuits. For assistive devices to be used in everyday life, they must provide assistance across activities of daily living (ADLs) in an unobtrusive manner. This article introduces the Myosuit, a soft, wearable device designed to provide continuous assistance at the hip and knee joint when working with and against gravity in ADLs. This robotic device combines active and passive elements with a closed-loop force controller designed to behave like an external muscle (exomuscle) and deliver gravity compensation to the user. At 4.1 kg (4.6 kg with batteries), the Myosuit is one of the lightest untethered devices capable of delivering gravity support to the user's knee and hip joints. This article presents the design and control principles of the Myosuit. It describes the textile interface, tendon actuators, and a bi-articular, synergy-based approach for continuous assistance. The assistive controller, based on bi-articular force assistance, was tested with a single subject who performed sitting transfers, one of the most gravity-intensive ADLs. The results show that the control concept can successfully identify changes in the posture and assist hip and knee extension with up to 26% of the natural knee moment and up to 35% of the knee power. We conclude that the Myosuit's novel approach to assistance using a bi-articular architecture, in combination with the posture-based force controller, can effectively assist its users in gravity-intensive ADLs, such as sitting transfers.

The Myosuit: Bi-articular Anti-gravity Exosuit That Reduces Hip Extensor Activity in Sitting Transfers

PubMed Central

Schmidt, Kai; Duarte, Jaime E.; Grimmer, Martin; Sancho-Puchades, Alejandro; Wei, Haiqi; Easthope, Chris S.; Riener, Robert

2017-01-01

Muscle weakness—which can result from neurological injuries, genetic disorders, or typical aging—can affect a person's mobility and quality of life. For many people with muscle weakness, assistive devices provide the means to regain mobility and independence. These devices range from well-established technology, such as wheelchairs, to newer technologies, such as exoskeletons and exosuits. For assistive devices to be used in everyday life, they must provide assistance across activities of daily living (ADLs) in an unobtrusive manner. This article introduces the Myosuit, a soft, wearable device designed to provide continuous assistance at the hip and knee joint when working with and against gravity in ADLs. This robotic device combines active and passive elements with a closed-loop force controller designed to behave like an external muscle (exomuscle) and deliver gravity compensation to the user. At 4.1 kg (4.6 kg with batteries), the Myosuit is one of the lightest untethered devices capable of delivering gravity support to the user's knee and hip joints. This article presents the design and control principles of the Myosuit. It describes the textile interface, tendon actuators, and a bi-articular, synergy-based approach for continuous assistance. The assistive controller, based on bi-articular force assistance, was tested with a single subject who performed sitting transfers, one of the most gravity-intensive ADLs. The results show that the control concept can successfully identify changes in the posture and assist hip and knee extension with up to 26% of the natural knee moment and up to 35% of the knee power. We conclude that the Myosuit's novel approach to assistance using a bi-articular architecture, in combination with the posture-based force controller, can effectively assist its users in gravity-intensive ADLs, such as sitting transfers. PMID:29163120

Introductory overview of research instruments for recording the electrical activity of neurons in the human brain

NASA Astrophysics Data System (ADS)

Garell, P. C.; Granner, M. A.; Noh, M. D.; Howard, M. A.; Volkov, I. O.; Gillies, G. T.

1998-12-01

Scientific advancement is often spurred by the development of new instruments for investigation. Over the last several decades, many new instruments have been produced to further our understanding of the physiology of the human brain. We present a partial overview of some of these instruments, paying particular attention to those which record the electrical activity of the human brain. We preface the review with a brief primer on neuroanatomy and physiology, followed by a discussion of the latest types of apparatus used to investigate various properties of the central nervous system. A special focus is on microelectrode investigations that employ both intracellular and extracellular methods of recording the electrical activity of single neurons; another is on the modern electroencephalographic, electrocorticographic, and magnetoencephalographic methods used to study the spontaneous and evoked field potentials of the brain. Some examples of clinical applications are included, where appropriate.

An introductory study of common grasps used by adults during performance of activities of daily living.

PubMed

Vergara, Margarita; Sancho-Bru, J L; Gracia-Ibáñez, V; Pérez-González, A

2014-01-01

This paper presents the results of a descriptive survey on human grasps. Sixty-four videos were selected to represent tasks performed in the main areas of activities of daily living (ADL) (personal care, meal preparation, eating, housekeeping, etc.). All the participants were right-handed. Elementary grasps were identified for each hand, and the grasp type (from a 9-type classification), the hands involved, and the duration were registered for each case. The results show that the most commonly used grasps are: pinch, non-prehensile, cylindrical, lateral pinch and lumbrical. The presence of these grasps in the areas of ADL is, however, very different (e.g., pinch is widely used in food preparation and very little in driving). Some grasps were used more frequently with one hand or when both hands were used simultaneously (e.g., special pinch was hardly used by the left hand). Knowing the grasp types most frequently used in ADL is essential to be able to assess grasp rehabilitation processes or hand prostheses development. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

CONTRIBUTION OF AXIAL MOTOR IMPAIRMENT TO PHYSICAL INACTIVITY IN PARKINSON'S DISEASE

PubMed Central

Bryant, Mon S; Hou, Jyhgong Gabriel; Collins, Robert L; Protas, Elizabeth J

2015-01-01

Objective To investigate the relationships between motor symptoms of Parkinson’s disease (PD) and activity limitations in persons with PD. Design/Methods Cross-sectional study of persons with mild to moderate PD (N=90). Associations among axial motor features, limb motor signs, the Physical Activity Scale for Elders (PASE), the ability to perform Activities of Daily Living (ADL) and level of ADL dependency were studied. A composite score of axial motor features included the following UPDRS items: speech, rigidity of the neck, arising from chair, posture, gait and postural stability. A composite score of limb motor signs included the following UPDRS items: tremor at rest of all extremities, action tremor, rigidity of all extremities, finger taps, hand movement, rapid alternating hand movements and foot tapping. Results Axial motor features of PD were significantly correlated with physical inactivity (p<.001), decreased ADL (p<.001) and increase in ADL dependency (p<.001). Limb motor signs significantly correlated with decreased ADL (p<.001) and level of ADL dependency (p=.035), but was not correlated with physical inactivity. After controlling for age, gender, disease duration and comorbidity, axial motor features contributed significantly to physical inactivity, decreased ADL and increase in ADL dependency, whereas the limb motor signs did not. Conclusions Axial motor impairment contributed to physical inactivity and decreased ability to perform ADLs in persons with PD. PMID:26368837

The prediction of disability by self-reported physical frailty components of the Tilburg Frailty Indicator (TFI).

PubMed

Gobbens, R J J; van Assen, M A L M; Schalk, M J D

2014-01-01

Disability is an important health outcome for older persons; it is associated with impaired quality of life, future hospitalization, and mortality. Disability also places a high burden on health care professionals and health care systems. Disability is regarded as an adverse outcome of physical frailty. The main objective of this study was to assess the predictive validity of the eight individual self-reported components of the physical frailty subscale of the TFI for activities of daily living (ADL) and instrumental activities of daily living (IADL) disability. This longitudinal study was carried out with a sample of Dutch citizens. At baseline the sample consisted at 429 people aged 65 years and older and a subset of all respondents participated again two and a half years later (N=355, 83% response rate). The respondents completed a web-based questionnaire comprising the TFI and the Groningen Activity Restriction Scale (GARS) for measuring disability. Five components together (unintentional weakness, weakness, poor endurance, slowness, low physical activity), referring to the phenotype of Fried et al., predicted disability, even after controlling for previous disability and other background characteristics. The other three components of the physical frailty subscale of the TFI (poor balance, poor hearing, poor vision) together did not predict disability. Low physical activity predicted both total and ADL disability, and slowness both total and IADL disability. In conclusion, self-report assessment using the physical subscale of the TFI aids the prediction of future ADL and IADL disability in older persons two and a half years later. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Activities of daily living and quality of life during treatment with neoadjuvant chemoradiotherapy and after surgery in patients with esophageal cancer.

PubMed

Haj Mohammad, Nadia; De Rooij, Sophia; Hulshof, Maarten; Ruurda, Jelle; Wijnhoven, Bas; Erdkamp, Frans; Sosef, Meindert; Gisbertz, Suzanne; van Berge Henegouwen, Mark; Sprangers, Mirjam; van Laarhoven, Hanneke

2016-11-01

Neoadjuvant chemoradiation (nCRT) followed by esophagectomy is a treatment with curative intent for resectable esophageal cancer. The aim of this study was to measure activities of daily living (ADL) and quality of life (QoL), and to examine correlates of changes in ADL and QoL. A prospective study was performed with three time points (baseline, 1 week after the end of nCRT, 3-months post-surgery) together with a cross-sectional post-treatment study. ADL was measured with the Amsterdam Linear Disability Score (ALDS), and QoL with the EORTC QLQ-C30 and the OES-18. Regression analysis was performed to identify factors associated with changes in ADL and QoL. Seventy-six patients were included in the prospective study, 79 in the cross-sectional study. After nCRT, ALDS decreased from 90 to 88 (P < 0.01) and remained stable after surgery. Global QoL decreased from 75 to 61 (P < 0.01); no significant changes were observed after surgery. Only timing of the measurement of ALDS was negatively associated with non-maximum ALDS (n = 155, based on both studies) and QoL (n = 76) (P < 0.01). Patients who undergo nCRT plus surgery should be prepared to experience a short-term decline in ADL and QoL. The findings of this study can support patients and healthcare workers to guide expectations. J. Surg. Oncol. 2016;114:684-690. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Aerobic Exercise Sustains Performance of Instrumental Activities of Daily Living in Early-Stage Alzheimer Disease.

PubMed

Vidoni, Eric D; Perales, Jaime; Alshehri, Mohammed; Giles, Abdul-Mannaan; Siengsukon, Catherine F; Burns, Jeffrey M

2017-12-28

Individuals with Alzheimer disease (AD) experience progressive loss of independence-performing activities of daily living. Identifying interventions to support independence and reduce the economic and psychosocial burden of caregiving for individuals with AD is imperative. The purpose of this analysis was to examine functional disability and caregiver time in individuals with early-stage AD. This was a secondary analysis of a randomized controlled trial of 26 weeks of aerobic exercise (AEx) versus stretching and toning (ST). We measured functional dependence using the Disability Assessment for Dementia, informal caregiver time required using the Resources Utilization in Dementia Lite, and cognition using a standard cognitive battery. We saw a stable function in the AEx group compared with a significant decline in the ST group (4%; F = 4.2, P = .04). This was especially evident in more complex, instrumental activities of daily living, with individuals in the AEx group increasing 1% compared with an 8% loss in the ST group over 26 weeks (F = 8.3, P = .006). Change in memory was a significant predictor of declining instrumental activities of daily living performance (r = 0.28, 95% confidence interval = 0.08 ∞, P = .01). Informal caregiver time was not different between the AEx and ST groups. Our analysis extends recent work by revealing specific benefits for instrumental activities of daily living for individuals in the early stages of AD and supports the value of exercise for individuals with cognitive impairment.

Impact of Balance Confidence on Daily Living Activities of Older People with Knee Osteoarthritis with Regard to Balance, Physical Function, Pain, and Quality of Life - A Preliminary Report.

PubMed

Bobić Lucić, Lana; Grazio, Simeon

2018-01-01

The objective of this study was to explore the impact of balance confidence on different activities of daily living (ADL) in older people with knee osteoarthritis (OA). Forty-seven consecutive participants with knee OA were included in this cross-sectional study. They were divided according to the results of the Activities-specific Balance Confidence (ABC) Scale into a group with a low level of confidence in physical functioning (ABC < 50, n = 22) and a group with moderate and high levels of confidence (ABC ≥ 50, n = 25). In the ABC < 50 group, the effect of pain on ADL, the physician's global assessment of the disease, and the Western Ontario and McMaster Universities Osteoarthritis Index scores were significantly higher, while quality of life (Short form-36) was lower compared to the ABC ≥ 50 group. No significant difference was found between the two groups regarding the static and dynamic balance measurements. Older people with knee OA who were less confident in their daily physical activities had more physical difficulties and a greater effect of pain on ADL, lower quality of life, and a higher physician's global assessment, but no differences were obtained in balance tests. In people with knee OA, decreased balance confidence is associated with more physical difficulties, an increased effect of pain on ADL, and lower quality of life. An improved awareness of decreased balance confidence may lead to more effective management of older people with knee OA by improving their mobility and QOL through rehabilitation. Furthermore, future research in that direction is warranted.

Elastic Band Exercises Improved Activities of Daily Living and Functional Fitness of Wheelchair-bound Older Adults with Cognitive Impairment: A Cluster Randomized Controlled Trial.

PubMed

Chen, Meng-Chun; Chen, Kuei-Min; Chang, Chu-Lin; Chang, Ya-Hui; Cheng, Yin-Yin; Huang, Hsin-Ting

2016-11-01

The purpose of this study was to test the effects of a 6-month Wheelchair-bound Senior Elastic Band (WSEB) exercise program on the activities of daily living (ADL) and functional fitness of wheelchair-bound older adults with cognitive impairment. Cluster randomized controlled trial was used. A convenience sample of 138 wheelchair-bound older adults with cognitive impairment were recruited from 8 nursing homes in southern Taiwan and were randomly assigned based on the nursing homes they lived to the experimental (4 nursing homes; n = 73) or the control group (4 nursing homes; n = 65). The experimental group performed WSEB exercises 3 times per week and 40 minutes per session for 6 months. The ADL and functional fitness (cardiopulmonary function, body flexibility, range of joint motion, and muscle strength and endurance) were examined at baseline, 3 months, and the end of 6-month study. The ADL and functional fitness indicators of participants in the experimental group showed significant improvements compared to the control group (all P < 0.05). The WSEB exercises have positive benefits for the ADL and functional fitness of wheelchair-bound older adults with cognitive impairment. It is suggested that WSEB exercises be included as a routine activity in nursing homes. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCMECME OBJECTIVES:: Upon completion of this article the reader should be able to: (1) Understand the risk factors for functional decline in older adults with dementia; (2) Articulate the benefits of structured activities and exercises in the older adult with dementia; and (3) Incorporate elastic band exercises into the treatment plan of wheelchair bound older adults with dementia. AdvancedACCREDITATION:: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic

The Self-Presentation Motives for Physical Activity Questionnaire: Instrument Development and Preliminary Construct Validity Evidence.

PubMed

Howle, Timothy C; Dimmock, James A; Whipp, Peter R; Jackson, Ben

2015-06-01

With the aim of advancing the literature on impression management in physical activity settings, we developed a theoretically derived 2 by 2 instrument that was designed to measure different types of context-specific self-presentation motives. Following item generation and expert review (Study 1), the instrument was completed by 206 group exercise class attendees (Study 2) and 463 high school physical education students (Study 3). Our analyses supported the intended factor structure (i.e., reflecting acquisitive-agentic, acquisitive-communal, protective-agentic, and protective-communal motives). We found some support for construct validity, and the self-presentation motives were associated with variables of theoretical and applied interest (e.g., impression motivation and construction, social anxiety, social and achievement goals, efficacy beliefs, engagement). Taken together, the results indicate that the Self-presentation Motives for Physical Activity Questionnaire (SMPAQ) may be useful for measuring various types of self-presentation motives in physical activity settings.

Evaluation of Instrumental Activities of Daily Living in Greek Patients with Advanced Cancer

ERIC Educational Resources Information Center

Mystakidou, Kyriaki; Parpa, Efi; Tsilika, Eleni; Panagiotoua, Irene; Roumeliotou, Anna; Symeonidi, Matina; Galanos, Antonis; Kouvaris, Ioannis

2013-01-01

Translation of the instrumental activities of daily living (IADL) was carried out and its psychometric properties were assessed in a Greek sample of patients with advanced cancer. The scale was translated with the forward-backward procedure into the Greek language. It was initially administered to 136 advanced cancer patients. To assess…

Evaluating the utility of existing patient-reported outcome scales in novel patient populations with pancreatic cancer, lung cancer, and myeloproliferative neoplasms using medicare current beneficiary survey data.

PubMed

Ivanova, Jasmina I; Mytelka, Daniel S; Duh, Mei Sheng; Birnbaum, Howard G; Cummings, Alice Kate; San Roman, Alexandra M; Price, Gregory L; Swindle, Ralph W

2013-01-01

While there are validated patient-reported outcomes (PRO) instruments for use in specific cancer populations, no validated general instruments exist for use in conditions common to multiple cancers, such as muscle wasting and consequent physical disability. The Medicare Current Beneficiary Survey (MCBS), a survey in a nationally representative sample of Medicare beneficiaries, includes items from three well known scales with general applicability to cancer patients: Katz activities of daily living (ADL), Rosow-Breslau instrumental ADL (IADL), and a subset of physical performance items from the Nagi scale. This study evaluated properties of the Katz ADL, Rosow-Breslau IADL, and a subset of the Nagi scale in patients with pancreatic cancer, lung cancer, and myeloproliferative neoplasms (MPN) using data from MCBS linked with Medicare claims in order to understand the potential utility of the three scales in these populations; understanding patient-perceived significance was not in scope. The study cohorts included Medicare beneficiaries aged ≥65 years as of 1 January of the year of their first cancer diagnosis with one or more health assessments in a community setting in the MCBS Access to Care data from 1991 to 2009. Beneficiaries had at least two diagnoses in de-identified Medicare claims data linked to the MCBS for one of the following cancers: pancreatic, lung, or MPN. The Katz ADL, Rosow-Breslau IADL, and Nagi scales were calculated to assess physical functioning over time from cancer diagnosis. Psychometric properties for each scale in each cohort were evaluated by testing for internal consistency, test-retest reliability, and responsiveness by comparing differences in mean scale scores over time as cancer progresses, and differences in mean scale scores before and after hospitalization (for lung cancer cohort). The study cohorts included 90 patients with pancreatic cancer, 863 with lung cancer, and 135 with MPN. Among each cancer cohort, the Katz ADL, Rosow

Activities of Daily Living in patients with Hunter syndrome: Impact of enzyme replacement therapy and hematopoietic stem cell transplantation

PubMed Central

Tanjuakio, Julian; Suzuki, Yasuyuki; Patel, Pravin; Yasuda, Eriko; Kubaski, Francyne; Tanaka, Akemi; Yabe, Hiromasa; Mason, Robert W.; Montaño, Adriana M.; Orii, Kenji E.; Orii, Koji O.; Fukao, Toshiyuki; Orii, Tadao; Tomatsu, Shunji

2014-01-01

The aim of this study was to assess the Activities of Daily Living (ADL) in patients with Hunter syndrome (mucopolysaccharidosis II; MPS II) using a newly designed ADL questionnaire. We applied the questionnaire to evaluate clinical phenotypes and therapeutic efficacies of enzyme replacement therapy (ERT) and hematopoietic stem cell transplantation (HSCT). We also explored early signs and symptoms to make early diagnosis feasible. We devised a new ADL questionnaire with three domains: “Movement,” “Movement with Cognition,” and “Cognition.” Each domain has four subcategories rated on a 5-point scale based on level of assistance. We also scored signs and symptoms unique to MPS by 12 subcategories (five points per category), providing 60 points in total. The questionnaire was first administered to 138 healthy Japanese controls (0.33 – 50 years), and successively, to 74 Japanese patients with Hunter syndrome (4 – 49 years). The patient cohort consisted of 51 severe and 23 attenuated phenotypes; 20 patients treated with HSCT, 23 patients treated early with ERT (≤ 8 years), and 25 patients treated late with ERT (> 8 years), and 4 untreated patients. Among 18 severe phenotypic patients treated by HSCT, 10 were designated as early HSCT (≤ 5 years), while 8 were designated as late HSCT (> 5 years). Scores from patients with severe phenotypes were lower than controls and attenuated phenotypes in all categories. Among patients with severe phenotypes, there was a trend that HSCT provides a higher ADL score than early ERT, and there was a significant difference in ADL scores between late ERT and HSCT groups. Early ERT and early HSCT provided a higher score than late ERT and late HSCT, respectively. In conclusion, we have evaluated the feasibility of a new questionnaire in control population and patients with Hunter syndrome, leading to a novel evaluation method for clinical phenotypes and therapeutic efficacy. Early treatment with HSCT provides a better

Instrumentation at Paranal Observatory: maintaining the instrument suite of five large telescopes and its interferometer alive

NASA Astrophysics Data System (ADS)

Gillet, Gordon; Alvarez, José Luis; Beltrán, Juan; Bourget, Pierre; Castillo, Roberto; Diaz, Álvaro; Haddad, Nicolás; Leiva, Alfredo; Mardones, Pedro; O'Neal, Jared; Ribes, Mauricio; Riquelme, Miguel; Robert, Pascal; Rojas, Chester; Valenzuela, Javier

2010-07-01

This presentation provides interesting miscellaneous information regarding the instrumentation activities at Paranal Observatory. It introduces the suite of 23 instruments and auxiliary systems that are under the responsibility of the Paranal Instrumentation group, information on the type of instruments, their usage and downtime statistics. The data is based on comprehensive data recorded in the Paranal Night Log System and the Paranal Problem Reporting System whose principles are explained as well. The work organization of the 15 team members around the high number of instruments is laid out, which includes: - Maintaining older instruments with obsolete components - Receiving new instruments and supporting their integration and commissioning - Contributing to future instruments in their developing phase. The assignments of the Instrumentation staff to the actual instruments as well as auxiliary equipment (Laser Guide Star Facility, Mask Manufacturing Unit, Cloud Observation Tool) are explained with respect to responsibility and scheduling issues. The essential activities regarding hardware & software are presented, as well as the technical and organizational developments within the group towards its present and future challenges.

Cross-cultural adaptation and construct validity of the Korean version of a physical activity measure for community-dwelling elderly.

PubMed

Choi, Bongsam

2018-01-01

[Purpose] This study aimed to cross-cultural adapt and validate the Korean version of an physical activity measure (K-PAM) for community-dwelling elderly. [Subjects and Methods] One hundred and thirty eight community-dwelling elderlies, 32 males and 106 female, participated in the study. All participants were asked to fill out a fifty-one item questionnaire measuring perceived difficulty in the activities of daily living (ADL) for the elderly. One-parameter model of item response theory (Rasch analysis) was applied to determine the construct validity and to inspect item-level psychometric properties of 51 ADL items of the K-PAM. [Results] Person separation reliability (analogous to Cronbach's alpha) for internal consistency was ranging 0.93 to 0.94. A total of 16 items was misfit to the Rasch model. After misfit item deletion, 35 ADL items of the K-PAM were placed in an empirically meaningful hierarchy from easy to hard. The item-person map analysis delineated that the item difficulty was well matched for the elderlies with moderate and low ability except for high ceilings. [Conclusion] Cross-cultural adapted K-PAM was shown to be sufficient for establishing construct validity and stable psychometric properties confirmed by person separation reliability and fit statistics.

[Development of an instrument to measure psychosocial determinants of physical activity behavior among coronary heart disease patients].

PubMed

Mendez, Roberto Della Rosa; Rodrigues, Roberta Cunha Matheus; Cornélio, Marilia Estevam; Gallani, Maria Cecília Bueno Jayme; Godin, Gaston

2010-09-01

The aim of this study was to report the development and the analysis of content validity and reliability of the Psychosocial Determinants of Physical Activity among Coronary Heart Disease Patients Questionnaire, based on an extension of the Theory of Planned Behavior. In the content validity step, three experts evaluated the instrument which was, afterwards, pre-tested with five subjects in order to obtain a conceptually appropriate and easily understood instrument. Fifty-one patients participated in the evaluation of internal consistency of the reviewed instrument. Cronbach's alpha coefficients above 0.75 were observed for the constructs: Intention, Attitude, Subjective Norm, Self-efficacy and Habit. The new instrument demonstrated acceptable evidence of content validity and reliability.

Cross-cultural Adaptation and Validation of the Simplified Chinese Version of the Knee Outcome Survey Activities of Daily Living Scale.

PubMed

Jia, Zhen-Yu; Wang, Wei; Nian, Xin-Wen; Zhang, Xiao-Xi; Huang, Zhi-Ping; Cui, Jin; Xu, Wei-Dong

2016-10-01

To perform a cross-cultural adaptation and translation of the original version of the Activities of Daily Living Scale of the Knee Outcome Survey into Simplified Chinese and validate of the Simplified Chinese version. The original version was translated and cross-culturally adapted into Simplified Chinese according to the guidelines and the recommendations of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 213 patients (96 male, 117 female) were selected to participate in our investigation. The inclusion criteria were as follows: 18 years of age and older, able to speak Chinese Mandarin and read Simplified Chinese, and referred to physical therapy for evaluation and treatment for a knee disorder. The exclusion criteria were as follows: patients who had disorders or impairments involving both knees, patients who had other conditions that could affect lower extremity function, patients with physical therapy related to the knee in the previous 1 month, and patients with psychological problems. Each participant was asked to complete the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS), International Knee Documentation Committee Subjective Knee Form, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form 36 forms and to provide baseline demographic data. Each participant completed the KOS-ADLS twice on 2 nonconsecutive days for reliability evaluation. A portion of the participants (n = 161) finished the KOS-ADLS a third time 4 weeks after physical treatment to test responsiveness. The original version of the KOS-ADLS was well adapted and translated into Simplified Chinese. Simplified Chinese of KOS-ADLS was shown to have good internal consistency (Cronbach's alpha = 0.855 to 0.929), great test-retest reliability (intraclass correlation coefficient = 0.935 to 0.961), high construct validity as we hypothesized (significant correlations with Short Form 36 subscales, Western Ontario and Mc

Do attitudes toward exercise vary with differences in mobility and disability status? - a study among low-income seniors.

PubMed

Bean, Jonathan F; Bailey, Allison; Kiely, Dan K; Leveille, Suzanne G

2007-08-15

To examine attitudes toward exercise among a vulnerable aged population characterized by low socioeconomic status, poor functional status and lack of available therapeutic exercise resources. This cross-sectional survey among public low-income housing residents (n = 94), aged > 70 years utilizes these assessments: Physician-based Assessment & Counseling for Exercise (PACE) scale, exercise self-efficacy score, Short Physical Performance Battery (SPPB), Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) scales. Readiness to exercise differed significantly (p < 0.001) across physical performance levels, and ADL and IADL groups. Exercise self-efficacy also differed significantly (p < 0.001) across performance levels. The highest performance level (score 7 - 12) had a significantly (p < 0.05) higher self-efficacy score (x=7.0+/-2.8) than the medium performance level (score 4 - 6) (x=5.3+/-2.8) and the lowest performance level (0 - 3) (x=4.3+/-2.5) groups. Exercise self-efficacy also differed significantly (p < 0.001) across ADL and IADL groups. However, interest in home-based or class-based exercise participation was high among all groups. More than 70% of subjects reported interest with no significant difference noted among groups. Attitudes toward exercise are significantly associated with observed physical function and self-reported disability among vulnerable older adults living in public low-income housing.

Neuropsychological Profile and Dementia Symptom Recognition in Help-Seekers in a Community Early-Detection Program in Hong Kong.

PubMed

Tang, Jennifer Y-M; Wong, Gloria H-Y; Ng, Carmen K-M; Kwok, Dorothy T-S; Lee, Maggie N-Y; Dai, David L-K; Lum, Terry Y-S

2016-03-01

To examine the neuropsychological and clinical profile of help-seekers in an early-detection community dementia program and to explore any relationship between profiles and time to seek help. Cross-sectional. Early-detection community dementia program. Help-seekers (N = 1,005) with subjective cognitive complaints or complaints from an informant. Neurocognitive testing, including the Cantonese Mini-Mental State Examination (MMSE), Clock Drawing Test, Digit Span, and Fuld Object Memory Evaluation and other clinical and functioning assessments, including the Clinical Dementia Rating (CDR), activities of daily living (ADLs), instrumental ADLs (IADLs), and depressive symptoms. Time since the person or an informant reported that they first noticed symptoms. Eighty-six percent of help-seekers had at least very mild dementia (CDR score ≥0.5). Cognitive performance was moderately impaired (mean MMSE score 18.4 ± 6.1). They required some assistance with IADLs, had very mild ADL impairments, and had few depressive symptoms. Median time to seek assessment was 12 months (interquartile range 7-30 months) according to the person or the informant (an adult child in 75% of the sample). Using the median-split method, time to seek assessment was classified as early (0-12 months) and late (>12 months). Worse cognitive and IADL performance but not ADL performance or depressive symptoms were observed in late than in early help-seekers. Longer time intervals between symptom recognition and early assessment showed a trend of further impairments on all measures except ADLs. A time interval of more than 12 months between symptom recognition and early assessment appears to be associated with worse cognitive function upon presentation. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Acquisition of an instrumental activity of daily living in patients with Korsakoff's syndrome: a comparison of trial and error and errorless learning.

PubMed

Oudman, Erik; Nijboer, Tanja C W; Postma, Albert; Wijnia, Jan W; Kerklaan, Sandra; Lindsen, Karen; Van der Stigchel, Stefan

2013-01-01

Patients with Korsakoff's syndrome show devastating amnesia and executive deficits. Consequently, the ability to perform instrumental activities such as making coffee is frequently diminished. It is currently unknown whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities. A good candidate for an effective teaching technique in Korsakoff's syndrome is errorless learning as it is based on intact implicit memory functioning. Therefore, the aim of the current study was two-fold: to investigate whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities, and to compare the effectiveness of errorless learning with trial and error learning in the acquisition and maintenance of an instrumental activity, namely using a washing machine to do the laundry. Whereas initial learning performance in the errorless learning condition was superior, both intervention techniques resulted in similar improvement over eight learning sessions. Moreover, performance in a different spatial layout showed a comparable improvement. Notably, in follow-up sessions starting after four weeks without practice, performance was still elevated in the errorless learning condition, but not in the trial and error condition. The current study demonstrates that (re)learning and maintenance of an instrumental activity is possible in patients with Korsakoff's syndrome.

Kinematic measures of Arm-trunk movements during unilateral and bilateral reaching predict clinically important change in perceived arm use in daily activities after intensive stroke rehabilitation.

PubMed

Chen, Hao-ling; Lin, Keh-chung; Liing, Rong-jiuan; Wu, Ching-yi; Chen, Chia-ling

2015-09-21

Kinematic analysis has been used to objectively evaluate movement patterns, quality, and strategies during reaching tasks. However, no study has investigated whether kinematic variables during unilateral and bilateral reaching tasks predict a patient's perceived arm use during activities of daily living (ADL) after an intensive intervention. Therefore, this study investigated whether kinematic measures during unilateral and bilateral reaching tasks before an intervention can predict clinically meaningful improvement in perceived arm use during ADL after intensive poststroke rehabilitation. The study was a secondary analysis of 120 subjects with chronic stroke who received 90-120 min of intensive intervention every weekday for 3-4 weeks. Reaching kinematics during unilateral and bilateral tasks and the Motor Activity Log (MAL) were evaluated before and after the intervention. Kinematic variables explained 22 and 11 % of the variance in actual amount of use (AOU) and quality of movement (QOM), respectively, of MAL improvement during unilateral reaching tasks. Kinematic variables also explained 21 and 31 % of the variance in MAL-AOU and MAL-QOM, respectively, during bilateral reaching tasks. Selected kinematic variables, including endpoint variables, trunk involvement, and joint recruitment and interjoint coordination, were significant predictors for improvement in perceived arm use during ADL (P < 0.05). Arm-trunk kinematics may be used to predict clinically meaningful improvement in perceived arm use during ADL after intensive rehabilitation. Involvement of interjoint coordination and trunk control variables as predictors in bilateral reaching models indicates that a high level of motor control (i.e., multijoint coordination) and trunk stability may be important in obtaining treatment gains in arm use, especially for bilateral daily activities, in intensive rehabilitation after stroke.

Nutritional variables predict chances of returning home and activities of daily living in post-acute geriatric care

PubMed Central

Maeda, Keisuke; Koga, Takayuki; Akagi, Junji

2018-01-01

Background Little is known about the association between malnutrition and the chances of returning home from post-acute facilities in older adult patients. This study aimed to understand whether malnutrition and malnutrition-related factors would be determinants for returning home and activities of daily living (ADL) at discharge after post-acute care. Methods Patients aged ≥65 years living at home before the onset of an acute disease and admitted to a post-acute ward were enrolled (n=207) in this prospective observational study. Malnutrition was defined based on the criteria of the European Society for Clinical Nutrition and Metabolism. Nutritional parameters included the nutritional intake at the time of admission and oral conditions evaluated by the Oral Health Assessment Tool (OHAT). The Barthel Index was used to assess daily activities. A Cox regression analysis of the length of stay was performed. Multivariable linear regression analyses to determine associations between malnutrition, returning home, and ADL at discharge were performed, after adjusting the variables of acute care setting. Results The mean patient age was 84.7±6.7 years; 38% were men. European Society for Clinical Nutrition and Metabolism-defined malnutrition was observed in 129 (62.3%) patients, and 118 (57.0%) of all patients returned home. Multivariable regression analyses showed that malnutrition was a negative predictor of returning home (hazard ratio: 0.517 [0.351–0.761], p=0.001), and an increase in the nutritional intake (kcal/kg/d) was a positive predictor of the Barthel Index at discharge (coefficient: 0.34±0.15, p=0.021). The OHAT was not associated with returning home and ADL. Conclusion Malnutrition and nutritional intake are associated with returning home and ADL at discharge, respectively, after post-acute care. Further studies investigating the effects of a nutritional intervention for post-acute patients would be necessary. PMID:29416323

Work ability as a determinant of old age disability severity: evidence from the 28-year Finnish Longitudinal Study on Municipal Employees.

PubMed

von Bonsdorff, Mikaela B; Seitsamo, Jorma; Ilmarinen, Juhani; Nygård, Clas-Håkan; von Bonsdorff, Monika E; Rantanen, Taina

2012-08-01

Lower occupational class correlates with a higher disability risk later in life. However, it is not clear whether the demands made by mental and physical work relative to individual resources in midlife predict well-being in old age. This study investigated prospectively whether work ability in midlife predicts disability severity in activities of everyday living in old age. Data come from the population-based 28-year follow-up called Finnish Longitudinal Study of Municipal Employees. A total of 2879 occupationally active persons aged 44-58 years answered a questionnaire on work ability at baseline in 1981 and activities of daily living in 2009. At baseline, perceived work ability relative to lifetime best was categorized into excellent, moderate, and poor work ability. At follow-up, disability scales were constructed based on the severity and frequency of difficulties reported in self-care activities of daily living (ADL) and instrumental activities of daily living (IADL). There was a graded prevalence of ADL and IADL disability severity, according to excellent, moderate and poor midlife work ability (p<0.001). Employees with moderate midlife work ability had an 11 to 20% higher mean ADL or IADL disability severity score, compared with those with excellent midlife work ability (reference), incidence rate ratios (IRR) ranging from 1.11 (95% CI 1.01-1.22) to 1.20 (95% CI 1.10-1.30). Those with poor midlife work ability had a mean ADL or IADL disability severity score 27 to 38% higher than the referent, IRRs ranging from 1.27 (95% CI 1.09-1.47) to 1.38 (95% CI 1.25-1.53). Adjusting for socio-economics, lifestyle factors and chronic diseases only slightly attenuated the associations. Work ability, an indicator of the de- mands made by mental and physical work relative to individuals' mental and physical resources, predicted disability severity 28 years later among middle-aged municipal employees.

Prevalence of self-reported stroke and disability in the French adult population: a transversal study.

PubMed

Schnitzler, Alexis; Woimant, France; Tuppin, Philippe; de Peretti, Christine

2014-01-01

In France, the prevalence of stroke and the level of disability of stroke survivors are little known. The aim of this study was to evaluate functional limitations in adults at home and in institutions, with and without self-reported stroke. A survey named "the Disability Health survey" was carried out in people's homes (DHH) and in institutions (DHI). Medical history and functional level (activities-of-daily-living, ADL and instrumented-activities-of-daily-living IADL) were collected through interviews. The modified Rankin score (mRS) and the level of dependence and disability were compared between participants with and without stroke. 33896 subjects responded. The overall prevalence of stroke was 1.6% (CI95% [1.4%-1.7%]). The mRS was over 2 for 34.4% of participants with stroke (28.7% of participants at home and 87.8% of participants in institutions) versus respectively 3.9%, 3.1% and 71.6% without stroke. Difficulty washing was the most frequently reported ADL for those with stroke (30.6% versus 3% for those without stroke). Difficulty with ADL and IADL increased with age but the relative risk was higher below the age of 60 (17 to 25) than over 85 years (1.5 to 2.2), depending on the ADL. In the overall population, 22.6% of those confined to bed or chair reported a history of stroke. These results thus demonstrate a high national prevalence of stroke. Older people are highly dependent, irrespective of stroke history and the relative risk of dependence in young subjects with a history of stroke is high compared with those without.

Recovery of sensorimotor function and activities of daily living after cervical spinal cord injury: the influence of age.

PubMed

Wirz, Markus; Dietz, Volker

2015-02-01

This retrospective study was designed to examine the influence of age on the outcome of motor function and activities of daily living (ADLs) in patients with a cervical spinal cord injury (SCI). The study is based on the data registry of the European Multicenter Study of Spinal Cord Injury (EMSCI) study group. Initial upper-extremity motor score (UEMS) and its change over 5 months, as well as the initial Spinal Cord Independence Measure (SCIM) score, did not differ between younger adults (20-39 years) and elderly (60-79 years) patients. However, the change in SCIM score over 5 months was significantly greater in the younger patient group. Initial UEMS, SCIM, and ulnar compound motor action potentials (CMAP), reflecting peripheral nerve damage (motoneurons and roots), were significantly greater in incomplete, compared to complete, SCI, regardless of age group. The initial assessment of UEMS in combination with CMAP recordings allows an early prediction of ADLs outcomes in both younger adults and elderly subjects. The impaired translation of gain in motor score into increased ADL independence in elderly patients requires specifically tailored rehabilitation programs.

Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia

PubMed Central

Toots, Annika; Littbrand, Håkan; Lindelöf, Nina; Wiklund, Robert; Holmberg, Henrik; Nordström, Peter; Lundin-Olsson, Lillemor; Gustafson, Yngve; Rosendahl, Erik

2016-01-01

Objectives To investigate the effects of a high-intensity functional exercise program on independence in activities of  daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. Design Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. Setting Residential care facilities, Umeå, Sweden. Participants Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186). Intervention Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. Measurements Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. Results Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=−1.6–4.3; BI=0.6, 95% CI=−0.2–1.4) or 7 (FIM=0.8, 95% CI=−2.2–3.8; BI=0.6, 95% CI=−0.3–1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8–6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. Conclusion In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia. PMID:26782852

Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia.

PubMed

Toots, Annika; Littbrand, Håkan; Lindelöf, Nina; Wiklund, Robert; Holmberg, Henrik; Nordström, Peter; Lundin-Olsson, Lillemor; Gustafson, Yngve; Rosendahl, Erik

2016-01-01

To investigate the effects of a high-intensity functional exercise program on independence in activities of daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. Residential care facilities, Umeå, Sweden. Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N=186). Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=-1.6-4.3; BI=0.6, 95% CI=-0.2-1.4) or 7 (FIM=0.8, 95% CI=-2.2-3.8; BI=0.6, 95% CI=-0.3-1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8-6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

10 CFR 35.2060 - Records of calibrations of instruments used to measure the activity of unsealed byproduct material.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Records of calibrations of instruments used to measure the activity of unsealed byproduct material. 35.2060 Section 35.2060 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2060 Records of calibrations of instruments used to measure...

10 CFR 35.2060 - Records of calibrations of instruments used to measure the activity of unsealed byproduct material.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Records of calibrations of instruments used to measure the activity of unsealed byproduct material. 35.2060 Section 35.2060 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2060 Records of calibrations of instruments used to measure...

10 CFR 35.2060 - Records of calibrations of instruments used to measure the activity of unsealed byproduct material.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Records of calibrations of instruments used to measure the activity of unsealed byproduct material. 35.2060 Section 35.2060 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2060 Records of calibrations of instruments used to measure...

10 CFR 35.2060 - Records of calibrations of instruments used to measure the activity of unsealed byproduct material.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Records of calibrations of instruments used to measure the activity of unsealed byproduct material. 35.2060 Section 35.2060 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2060 Records of calibrations of instruments used to measure...

10 CFR 35.2060 - Records of calibrations of instruments used to measure the activity of unsealed byproduct material.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Records of calibrations of instruments used to measure the activity of unsealed byproduct material. 35.2060 Section 35.2060 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL Records § 35.2060 Records of calibrations of instruments used to measure...

A comparison of respiratory and peripheral muscle strength, functional exercise capacity, activities of daily living and physical fitness in patients with cystic fibrosis and healthy subjects.

PubMed

Arikan, Hulya; Yatar, İlker; Calik-Kutukcu, Ebru; Aribas, Zeynep; Saglam, Melda; Vardar-Yagli, Naciye; Savci, Sema; Inal-Ince, Deniz; Ozcelik, Ugur; Kiper, Nural

2015-01-01

There are limited reports that compare muscle strength, functional exercise capacity, activities of daily living (ADL) and parameters of physical fitness of cystic fibrosis (CF) patients with healthy peers in the literature. The purpose of this study was to assess and compare respiratory and peripheral muscle strength, functional exercise capacity, ADL and physical fitness in patients with CF and healthy subjects. Nineteen patients with CF (mean forced expiratory volume in one second-FEV1: 86.56±18.36%) and 20 healthy subjects were included in this study. Respiratory (maximal inspiratory pressure-MIP and maximal expiratory pressure-MEP) and peripheral muscle strength (quadriceps, shoulder abductors and hand grip strength) were evaluated. Functional exercise capacity was determined with 6min walk test (6MWT). ADL was assessed with Glittre ADL test and physical fitness was assessed with Munich fitness test (MFT). There were not any statistically significant difference in MIP, %MIP, MEP and %MEP values between two groups (p>0.05). %Peripheral muscle strength (% quadriceps and shoulder abductors strength), 6MWT distance and %6MWT distance were significantly lower in patients with CF than those of healthy subjects (p<0.05). Glittre ADL-test time was significantly longer in patients with CF than healthy subjects (p<0.05). According to Munich fitness test, the number of bouncing a ball, hanging score, distance of standing vertical jumping and standing vertical jumping score were significantly lower in patients with CF than those of healthy subjects (p<0.05). Peripheral muscle strength, functional exercise capacity, ADL performance and speed, coordination, endurance and power components of physical fitness are adversely affected in mild-severe patients with CF compared to healthy peers. Evaluations must be done in comprehensive manner in patients with CF with all stages. Copyright © 2015 Elsevier Ltd. All rights reserved.

An exploratory analysis of the self-reported goals of individuals with chronic upper-extremity paresis following stroke.

PubMed

Waddell, Kimberly J; Birkenmeier, Rebecca L; Bland, Marghuretta D; Lang, Catherine E

2016-01-01

To classify the self-identified goals of individuals post-stroke with chronic upper extremity (UE) paresis, and determine if age, UE functional capacity and pre-stroke hand dominance influence overall goal selection. Sixty-five subjects participated. Using the Canadian Occupational Performance Measure (COPM) to establish treatment goals, the top five goals were categorized using the Occupational Therapy Practice Framework into five categories: activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure, work and general UE movement. A Chi-square analysis determined if age, UE functional capacity (measured by the Action Research Arm Test) and UE hand dominance influenced individual goal selection. The majority of goals were in the ADL (37%) and IADL (40%) categories. A small percentage (12%) was related to general UE movement. Individuals with moderate UE functional capacity identified more ADL goals than those with higher UE functional capacity. There was not a difference between age and UE dominance across all five goal areas. Individuals with chronic UE paresis had specific goals that were not influenced by age or hand dominance, but partially influenced by severity. General UE movement goals were identified less than goals related to specific activities. Considering the specificity of individual goals following stroke, it is recommended that clinicians regularly utilize a goal setting tool to help establish client goals. It is recommended that clinicians further inquire about general goals in order to link upper extremity deficits to functional activity limitations. Age, upper extremity functional capacity and hand dominance have little influence on the rehabilitation goals for individuals with chronic paresis after stroke.

Disentangling the Roles of Approach, Activation and Valence in Instrumental and Pavlovian Responding

PubMed Central

Huys, Quentin J. M.; Cools, Roshan; Gölzer, Martin; Friedel, Eva; Heinz, Andreas; Dolan, Raymond J.; Dayan, Peter

2011-01-01

Hard-wired, Pavlovian, responses elicited by predictions of rewards and punishments exert significant benevolent and malevolent influences over instrumentally-appropriate actions. These influences come in two main groups, defined along anatomical, pharmacological, behavioural and functional lines. Investigations of the influences have so far concentrated on the groups as a whole; here we take the critical step of looking inside each group, using a detailed reinforcement learning model to distinguish effects to do with value, specific actions, and general activation or inhibition. We show a high degree of sophistication in Pavlovian influences, with appetitive Pavlovian stimuli specifically promoting approach and inhibiting withdrawal, and aversive Pavlovian stimuli promoting withdrawal and inhibiting approach. These influences account for differences in the instrumental performance of approach and withdrawal behaviours. Finally, although losses are as informative as gains, we find that subjects neglect losses in their instrumental learning. Our findings argue for a view of the Pavlovian system as a constraint or prior, facilitating learning by alleviating computational costs that come with increased flexibility. PMID:21556131

Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: a network meta-analysis of randomised controlled trials.

PubMed

Elsner, Bernhard; Kwakkel, Gert; Kugler, Joachim; Mehrholz, Jan

2017-09-13

Transcranial Direct Current Stimulation (tDCS) is an emerging approach for improving capacity in activities of daily living (ADL) and upper limb function after stroke. However, it remains unclear what type of tDCS stimulation is most effective. Our aim was to give an overview of the evidence network regarding the efficacy and safety of tDCS and to estimate the effectiveness of the different stimulation types. We performed a systematic review of randomised trials using network meta-analysis (NMA), searching the following databases until 5 July 2016: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, Web of Science, and four other databases. We included studies with adult people with stroke. We compared any kind of active tDCS (anodal, cathodal, or dual, that is applying anodal and cathodal tDCS concurrently) regarding improvement of our primary outcome of ADL capacity, versus control, after stroke. CRD42016042055. We included 26 studies with 754 participants. Our NMA showed evidence of an effect of cathodal tDCS in improving our primary outcome, that of ADL capacity (standardized mean difference, SMD = 0.42; 95% CI 0.14 to 0.70). tDCS did not improve our secondary outcome, that of arm function, measured by the Fugl-Meyer upper extremity assessment (FM-UE). There was no difference in safety between tDCS and its control interventions, measured by the number of dropouts and adverse events. Comparing different forms of tDCS shows that cathodal tDCS is the most promising treatment option to improve ADL capacity in people with stroke.

Traceability of radiation protection instruments

NASA Astrophysics Data System (ADS)

Hino, Y.; Kurosawa, T.

2007-08-01

Radiation protection instruments are used in daily measurement of dose and activities in workplaces and environments for safety management. The requirements for calibration certificates with traceability are increasing for these instruments to ensure the consistency and reliabilities of the measurement results. The present traceability scheme of radiation protection instruments for dose and activity measurements is described with related IEC/ISO requirements. Some examples of desirable future calibration systems with recent new technologies are also discussed to establish the traceability with reasonable costs and reliabilities.

Performance evaluation of the Personal Mobility and Manipulation Appliance (PerMMA).

PubMed

Wang, Hongwu; Xu, Jijie; Grindle, Garrett; Vazquez, Juan; Salatin, Ben; Kelleher, Annmarie; Ding, Dan; Collins, Diane M; Cooper, Rory A

2013-11-01

The Personal Mobility and Manipulation Appliance (PerMMA) is a recently developed personal assistance robot created to provide people with severe physical disabilities enhanced assistance in both mobility and manipulation. PerMMA aims to improve functional independence when a personal care attendant is not available on site. PerMMA integrates both a smart powered wheelchair and two dexterous robotic arms to assist its users in completing essential mobility and manipulation tasks during basic and instrumental activities of daily living (ADL). Two user interfaces were developed: a local control interface and a remote operator controller. This paper reports on the evaluation of PerMMA with end users completing basic ADL tasks. Participants with both lower and upper extremity impairments (N=15) were recruited to operate PerMMA and complete up to five ADL tasks in a single session of no more than two hours (to avoid fatigue or frustration of the participants). The performance of PerMMA was evaluated by participants completing ADL tasks with two different control modes: local mode and cooperative control. The users' task completion performance and answers on pre/post-evaluation questionnaires demonstrated not only the ease in learning and usefulness of PerMMA, but also their attitudes toward assistance from advanced technology like PerMMA. As a part of the iterative development process, results of this work will serve as supporting evidence to identify design criteria and other areas for improvement of PerMMA. Copyright © 2013 IPEM. All rights reserved.

IMMEDIATE AND FOLLOW-UP EFFECTS OF A POSTURE EDUCATION PROGRAM FOR ELEMENTARY SCHOOL STUDENTS

PubMed Central

dos Santos, Natália Brites; Sedrez, Juliana Adami; Candotti, Cláudia Tarragô; Vieira, Adriane

2017-01-01

ABSTRACT Objective: To assess the short- and medium-term effects of the posture education program (PEP) for students of elementary school regarding theoretical knowledge and posture during activities of daily living (ADLs). Methods: The sample consisted of 38 students (aged 8-12 years) in the third grade of elementary school in Porto Alegre, Rio Grande do Sul (Southern Brazil). The children were evaluated in three moments: prior to attending the PEP (pretest); after attending the PEP (post-test); and five months after the conclusion of the PEP, immediately after a learning review of four lessons (five months follow-up). The posture during ADLs and the theoretical knowledge about spine and body posture were assessed, based on specific instruments (layout for assessing the dynamic posture - LADy; and questionnaire). The Friedman test, post hoc Wilcoxon test, and Bonferroni correction were applied to identify the differences among the evaluative moments, as they are statistically significant at α<0.05. Results: No statistically significant difference was found between the post-test and follow-up concerning the theoretical knowledge. In addition, no statistically significant difference was found between post-test and follow-up in relation to ADLs; however, the performance of students was higher in the post-test and follow-up, when compared with the pretest. Conclusions: Immediately after the PEP’s conclusion, the students improved their posture in ADLs. These positive effects and the theoretical knowledge were retained in the follow-up (after the review lessons). PMID:28977326

Expressive social support buffers the impact of care-related work interruptions on caregivers' depressive symptoms.

PubMed

Ang, Shannon; Malhotra, Rahul

2018-06-01

To assess if expressive and instrumental social support from family and friends moderate the association of care-related work interruptions (e.g. leaving work for the older adult's doctor appointment) with depressive symptoms among working family caregivers of older adults. Data were from the Singapore Survey on Informal Caregiving (SSIC). A subsample of 662 dyads, each comprising an older care-recipient [home-dwelling Singaporean aged 75 and older receiving human assistance for at least one activity of daily living (ADL)] and his/her working family caregiver, was analysed. Caregiver depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale. Care-related work interruptions were scaled through the Mokken scaling procedure. Expressive social support was assessed using a scale by Pearlin and co-workers. Instrumental social support was based on the hours of ADL help provided to the care-recipient by any family member or friend, on behalf of the primary caregiver. A linear regression model, with interaction terms, assessed expressive and instrumental social support as moderators of the association of care-related work interruptions with caregiver depressive symptoms. More care-related work interruptions were associated with more caregiver depressive symptoms. And, this association was moderated by expressive, but not instrumental, social support. Our findings conform to previous qualitative work suggesting that caregivers' mental health may not benefit from instrumental support, but from receiving expressive support instead. Initiatives for improving the care experience of working caregivers of older adults should focus on promoting expressive support from their friends and family.

Oral temperatures of the elderly in nursing homes in summer and winter in relation to activities of daily living

NASA Astrophysics Data System (ADS)

Nakamura, K.; Tanaka, Masatoshi; Motohashi, Yutaka; Maeda, Akira

This study was conducted to clarify the seasonal difference in body temperature in summer and winter, and to document the thermal environment of the elderly living in nursing homes. The subjects were 57 healthy elderly people aged >=63 years living in two nursing homes in Japan. One of the homes was characterized by subjects with low levels of activities of daily living (ADL). Oral temperatures were measured in the morning and afternoon, with simultaneous recording of ambient temperature and relative humidity. Oral temperatures in summer were higher than in winter, with statistically significant differences (P<0.05) of 0.25 (SD 0.61) °C in the morning and 0.24 (SD 0.50) °C in the afternoon. Differences between oral temperatures in summer and winter tended to be greater in subjects with low ADL scores, even when their room temperature was well-controlled. In conclusion, the oral temperatures of the elderly are lower in winter than summer, particularly in physically inactive people. It appears that those with low levels of ADL are more vulnerable to large changes in ambient temperature.

Prosthesis use in adult acquired major upper-limb amputees: patterns of wear, prosthetic skills and the actual use of prostheses in activities of daily life.

PubMed

Østlie, Kristin; Lesjø, Ingrid Marie; Franklin, Rosemary Joy; Garfelt, Beate; Skjeldal, Ola Hunsbeth; Magnus, Per

2012-11-01

To describe patterns of prosthesis wear and perceived prosthetic usefulness in adult acquired upper-limb amputees (ULAs). To describe prosthetic skills in activities of daily life (ADL) and the actual use of prostheses in the performance of ADL tasks. To estimate the influence of prosthetic skills on actual prosthesis use and the influence of background factors on prosthetic skills and actual prosthesis use. Cross-sectional study analysing population-based questionnaire data (n = 224) and data from interviews and clinical testing in a referred/convenience sample of prosthesis-wearing ULAs (n = 50). Effects were analysed using linear regression. 80.8% wore prostheses. 90.3% reported their most worn prosthesis as useful. Prosthetic usefulness profiles varied with prosthetic type. Despite demonstrating good prosthetic skills, the amputees reported actual prosthesis use in only about half of the ADL tasks performed in everyday life. In unilateral amputees, increased actual use was associated with sufficient prosthetic training and with the use of myoelectric vs cosmetic prostheses, regardless of amputation level. Prosthetic skills did not affect actual prosthesis use. No background factors showed significant effect on prosthetic skills. Most major ULAs wear prostheses. Individualised prosthetic training and fitting of myoelectric rather than passive prostheses may increase actual prosthesis use in ADL.

Geoazur's contribution in instrumentation to monitor seismic activity of the Earth

NASA Astrophysics Data System (ADS)

Yates, B.; Hello, Y.; Anglade, A.; Desprez, O.; Ogé, A.; Charvis, P.; Deschamps, A.; Galve, A.; Nolet, G.; Sukhovich, A.

2011-12-01

Seismic activity in the earth is mainly located near the tectonic plate boundaries, in the deep ocean (expansion centers) or near their margins (subduction zones). Travel times and waveforms of recorded seismograms can be used to reconstruct the three-dimensional wave speed distribution in the earth with seismic tomography or to image specific boundaries in the deep earth. Because of the lack of permanent sea-bottom seismometers these observation are conducted over short period of time using portable ocean bottom seismometers. Geaozur has a long experience and strong skills in designing and deploying Ocean Bottom Seismometers all over the world. We have developed two types of ocean bottom instruments. The "Hippocampe" for long deployment and "Lady bug" for aftershock monitoring or for fast overlaps during wide angle experiments. Early warning systems for tsunamis and earthquakes have been developed in recent years but these need real time data transmission and direct control of the instrument. We have developed a permanent real time Broad Band instrument installed in the Mediterranean Sea and connected to the Antares Neutrinos telescope. This instrument offers all the advantages of a very heavy and costly installation, such as the ability to do real-time seismology on the seafloor. Such real-time seafloor monitoring is especially important for seismic hazard. Major earthquakes cause human and economic losses directly related to the strong motion of the ground or by induced phenomena such as tsunamis and landslides. Fiber optical cables provide a high-capacity lightweight alternative to traditional copper cables. Three-component sensors analyze permanently the noise signal and detect the events to record. Major events can force the network to transmit data with almost zero lag time. The optical link also allows us to retrieve events at a later date. However, OBSs alone can never provide the density and long term, homogeneous data coverage needed for local and global

Associations Between Asthma Control and Airway Obstruction and Performance of Activities of Daily Living in Older Adults with Asthma.

PubMed

Woods, Eric C; O'Conor, Rachel; Martynenko, Melissa; Wolf, Michael S; Wisnivesky, Juan P; Federman, Alex D

2016-05-01

To determine the effect of asthma on functional limitations of older adults in the United States. Analyses were conducted with data from the Asthma Beliefs and Literacy in the Elderly study, a prospective cohort study of people aged 60 and older with asthma. Participants were recruited from urban primary care and pulmonary specialty practices in New York City and Chicago between 2010 and 2012. Individuals aged 60 and older with asthma (380 women, 72 men, mean age 67.5 ± 6.8 (range 60-98), 40% Latino, 30% black). Characteristics of participants with and without activity of daily living (ADL) limitations were compared using the chi-square test. Generalized estimating equations were used to model the relationships between poor asthma control (Asthma Control Questionnaire (ACQ) score >1.5) and severity of airway obstruction (forced expiratory volume in 1-second (FEV1 )) and number of ADL limitations. Participants with one or more ADL limitations were more likely to be female (90% vs 81%, P = .02) and Latino (58% vs 32%, P < .001), have less than a high school education (53% vs 27%, P < .001) and an income of $1,350 per month or less (79% vs 46%, P < .001), and be unmarried (78% vs 64%, P = .003). In the adjusted analysis, poorer ACQ scores (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.0-2.4; P = .05) but not severity of airway obstruction (OR = 1.1, 95% CI = 0.6-1.9) was associated with greater ADL limitations. Older adults reporting poor asthma control are more likely to have ADL limitations than those with controlled asthma, although one-time spirometry may not adequately identify those at risk of physical impairment from asthma. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Intercomparison of active, passive and continuous instruments for radon and radon progeny measurements in the EML chamber and test facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

George, A.C.; Knutson, E.O.; Tu, K.W.

1995-12-01

The results from the May 1995 Intercomparison of Active, Passive and Continuous Instruments for Radon and Radon Progeny Measurement conducted in the EML radon exposure and test facility are presented. Represented were 13 participants that measure radon with open faced and diffusion barrier activated carbon collectors, 10 with nuclear alpha track detectors, 9 with short-term and long-term electret/ionization chambers, and 13 with active and passive commercial electronic continuous monitors. For radon progeny, there were four participants that came in person to take part in the grab sampling methodology for measuring individual radon progeny and the potential alpha energy concentration (PAEC).more » There were 11 participants with continuous and integrating commercial electronic instruments that are used for measuring the PAEC. The results indicate that all the tested instruments that measure radon fulfill their intended purpose. All instruments and methods used for grab sampling for radon progeny did very well. However, most of the continuous and integrating electronic instruments used for measuring the PAEC or working level appear to underestimate the potential risk from radon progeny when the concentration of particles onto which the radon progeny are attached is <5,000 cm{sup -3}.« less

Cross-cultural validation of a simple self-report instrument of physical activity in immigrants from the Middle East and native Swedes.

PubMed

Arvidsson, Daniel; Leijon, Matti; Sundquist, Jan; Sundquist, Kristina; Lindblad, Ulf; Bennet, Louise

2014-05-01

To investigate cross-cultural validity of a simple self-report instrument of physical activity intended to be used in Swedish health care. A validation study performed in 599 Iraqis (58% men) and 553 Swedes (53% men) aged 30-75 years living in the city of Malmö, Sweden. The self-report instrument by the Swedish National Board of Health and Welfare was compared to corresponding measures assessed from accelerometry as reference. The agreement between the methods in assessing the participants as sufficiently/insufficiently physically active (cut-point 150 min/week) was 65% in the Iraqis and 52% in the Swedes (p<0.001). The proportion disagreement where the self-reported physical activity was sufficient but insufficient according to the accelerometry was 26% and 45% in Iraqis and Swedes, respectively. Physical activity time (min/week) was overestimated by self-report compared to accelerometry by 71% in the Iraqis and 115% in the Swedes (p<0.001). The smallest and largest overestimation was seen in Iraqi (57%) and Swedish (139%) women, respectively. The deviation of the self-report instrument compared to accelerometry was related to the physical activity level, as the overestimation mainly occurred at lower physical activity. The self-report instrument proposed by the Swedish National Board of Health and Welfare may overestimate the proportion sufficiently physically active, but to an extent depending on cultural background and gender.

A Novel Detection Model and Its Optimal Features to Classify Falls from Low- and High-Acceleration Activities of Daily Life Using an Insole Sensor System

PubMed Central

Cates, Benjamin; Sim, Taeyong; Heo, Hyun Mu; Kim, Bori; Kim, Hyunggun; Mun, Joung Hwan

2018-01-01

In order to overcome the current limitations in current threshold-based and machine learning-based fall detectors, an insole system and novel fall classification model were created. Because high-acceleration activities have a high risk for falls, and because of the potential damage that is associated with falls during high-acceleration activities, four low-acceleration activities, four high-acceleration activities, and eight types of high-acceleration falls were performed by twenty young male subjects. Encompassing a total of 800 falls and 320 min of activities of daily life (ADLs), the created Support Vector Machine model’s Leave-One-Out cross-validation provides a fall detection sensitivity (0.996), specificity (1.000), and accuracy (0.999). These classification results are similar or superior to other fall detection models in the literature, while also including high-acceleration ADLs to challenge the classification model, and simultaneously reducing the burden that is associated with wearable sensors and increasing user comfort by inserting the insole system into the shoe. PMID:29673165

Investigating the Impact of Formal Reflective Activities on Skill Adaptation in a Work-Related Instrumental Learning Setting

ERIC Educational Resources Information Center

Roessger, Kevin M.

2013-01-01

In work-related, instrumental learning contexts the role of reflective activities is unclear. Kolb's (1985) experiential learning theory and Mezirow's transformative learning theory (2000) predict skill-adaptation as a possible outcome. This prediction was experimentally explored by manipulating reflective activities and assessing participants'…

Quality of life attenuates age-related decline in functional status of older adults.

PubMed

Palgi, Yuval; Shrira, Amit; Zaslavsky, Oleg

2015-08-01

In the present study, we aimed to examine the total and moderating effects of needs-satisfaction-driven quality-of-life (QoL) measure on age-related change in functional status. Participants in the Survey of Health and Retirement in Europe (N = 18,781 at Wave 1) completed a measure of QoL (CASP-12) at baseline and reported their functional status across subsequent three waves using activities of daily living (ADL), instrumental activities of daily living (IADL), and functional limitation indices. Growth-curve model estimates revealed that aged individuals with lower QoL scores at baseline had a steeper increase in disability deficits accumulation and functional limitation progression than their counterparts with a higher sense of QoL. The effects were more pronounced in ADL and IADL disability scales in which QoL moderated both linear and quadratic age-related changes. Higher QoL attenuates processes of functional decline in late adulthood. Practitioners may seek strategies for improving and enhancing patients' QoL, as its salutary effects diffuse beyond psychological experience and include long-term effects on physical functioning.

Relationships of Community and Individual Level Social Capital with Activities of Daily Living and Death by Gender.

PubMed

Imamura, Haruhiko; Hamano, Tsuyoshi; Michikawa, Takehiro; Takeda-Imai, Fujimi; Nakamura, Takahiro; Takebayashi, Toru; Nishiwaki, Yuji

2016-08-29

This study determined whether there is an association between social capital and a composite outcome of decline in Activities of Daily Living (ADL) and death by gender. A prospective 3.5 year cohort study was conducted in a rural town in Japan. The study participants were 984 individuals aged 65 years and older with not impaired on ADL at 2010 baseline survey. Social participation and generalized trust were measured as social capital. The individual level responses were dichotomized and aggregated into the community level (eight areas). Multilevel logistic regression adjusting for covariates revealed that social participation at the individual level was significantly associated with higher odds of composite outcome (OR of "not participate" = 1.97, 95% CI = 1.38-2.81). Regarding generalized trust, only in men, there was an inverse association at the community level (OR of "low" = 0.55, 95% CI = 0.32-0.96), and a positive association at the individual level (OR of "tend to be careful" = 2.22, 95% CI = 1.27-3.90). These results suggest that social capital were associated with a decline in ADL and death and that the association may differ by gender.

Recognition of Activities of Daily Living Based on Environmental Analyses Using Audio Fingerprinting Techniques: A Systematic Review

PubMed Central

Santos, Rui; Pombo, Nuno; Flórez-Revuelta, Francisco

2018-01-01

An increase in the accuracy of identification of Activities of Daily Living (ADL) is very important for different goals of Enhanced Living Environments and for Ambient Assisted Living (AAL) tasks. This increase may be achieved through identification of the surrounding environment. Although this is usually used to identify the location, ADL recognition can be improved with the identification of the sound in that particular environment. This paper reviews audio fingerprinting techniques that can be used with the acoustic data acquired from mobile devices. A comprehensive literature search was conducted in order to identify relevant English language works aimed at the identification of the environment of ADLs using data acquired with mobile devices, published between 2002 and 2017. In total, 40 studies were analyzed and selected from 115 citations. The results highlight several audio fingerprinting techniques, including Modified discrete cosine transform (MDCT), Mel-frequency cepstrum coefficients (MFCC), Principal Component Analysis (PCA), Fast Fourier Transform (FFT), Gaussian mixture models (GMM), likelihood estimation, logarithmic moduled complex lapped transform (LMCLT), support vector machine (SVM), constant Q transform (CQT), symmetric pairwise boosting (SPB), Philips robust hash (PRH), linear discriminant analysis (LDA) and discrete cosine transform (DCT). PMID:29315232

Patient-level clinically meaningful improvements in activities of daily living and pain after total hip arthroplasty: data from a large US institutional registry.

PubMed

Singh, Jasvinder A; Lewallen, David G

2013-06-01

To characterize patient-level clinically meaningful improvements in pain and limitation of key activities of daily living (ADLs) after primary or revision total hip arthroplasty (THA). We analysed prospectively collected data from the Mayo Clinic Total Joint Registry to study clinically meaningful improvements in index hip pain severity and limitation in seven key ADLs (walking, climbing stairs, putting on shoes/socks, picking up objects, getting in/out of car, rising from a chair and sitting), from preoperative to 2- and 5-year post-THA. The primary THA cohort consisted of 6168 responders preoperatively, 5707 at 2 years and 3289 at 5 years postoperatively. The revision THA cohort consisted of 2063 responders preoperatively, 2682 at 2 years and 1627 at 5 years postoperatively. In the primary THA cohort, clinically meaningful pain reduction to mild or no hip pain at 2 years was reported by 94% with moderate and 91% with severe preoperative pain; respective proportions were 91% and 89% at 5-year follow-up. For revision THA, respective proportions were 84% and 77% at 2 years and 80% and 78% at 5 years. In the primary THA cohort, up to 4% with moderate and 17% with severe preoperative ADL limitation reported severe limitation in the respective activity 2 years post-primary THA; at 5 years, the respective proportions were up to 7% and 20%. Respective proportions for revision THA were up to 10% and 26% at 2 years and 13% and 30% at 5 years. These comprehensive data for patient-level clinically meaningful improvements in pain and seven key ADLs can help patients set realistic goals for improvement after THA.

Prevalence of health conditions and predictors of mortality in oldest old Mexican Americans and non-Hispanic whites.

PubMed

Samper-Ternent, Rafael; Kuo, Yong Fang; Ray, Laura A; Ottenbacher, Kenneth J; Markides, Kyriakos S; Al Snih, Soham

2012-03-01

The oldest old represent a unique group of older adults. This group is rapidly growing worldwide and yet there are gaps in the knowledge related to their health condition. Ethnic differences in disease prevalence and mortality must be understood to better care for the oldest old. To compare prevalence of common health conditions and predictors of mortality in oldest old Mexican Americans and non-Hispanic whites. This study included 568 community-dwelling Mexican Americans (MA) aged 85 years and older from the Hispanic Established Population for the Epidemiological Study of the Elderly 2004-2005 and 933 non-Hispanic whites (NHW) of the same age from the Health and Retirement Study 2004. Measures included sociodemographic variables, self-reported medical conditions, activities of daily living (ADLs), and instrumental activities of daily living. Logistic regression analysis was used to examine 2-year mortality in both populations. Heart attack was significantly more prevalent in oldest old NHW compared with MA, regardless of gender. Conversely, diabetes was significantly more prevalent among MA men and women compared with their NHW counterparts. Compared with NHW men, MA men had significantly higher prevalence of cognitive impairment and hypertension. Additionally, prevalence of hip fracture was significantly higher for MA women compared with NHW women. Significant differences in ADL disability were observed only between both groups of women, whereas significant differences in instrumental activities of daily living disability were observed only between men. MA men and women had higher prevalence of obesity compared with NHW. Predictors of 2-year mortality for both ethnic groups included older age, male gender, and ADL disability. Cognitive impairment was a mortality predictor only for NHW. Similarly, lung disease was a predictor only for MA. Health-related conditions that affect the oldest old vary by gender and ethnicity and entail careful evaluation and monitoring

Space-borne survey instrument operations: lessons learned and new concepts for the Euclid NISP instrument

NASA Astrophysics Data System (ADS)

Valenziano, L.; Gregorio, A.; Butler, R. C.; Amiaux, J.; Bonoli, C.; Bortoletto, F.; Burigana, C.; Corcione, L.; Ealet, A.; Frailis, M.; Jahnke, K.; Ligori, S.; Maiorano, E.; Morgante, G.; Nicastro, L.; Pasian, F.; Riva, M.; Scaramella, R.; Schiavone, F.; Tavagnacco, D.; Toledo-Moreo, R.; Trifoglio, M.; Zacchei, A.; Zerbi, F. M.; Maciaszek, T.

2012-09-01

Euclid is the future ESA mission, mainly devoted to Cosmology. Like WMAP and Planck, it is a survey mission, to be launched in 2019 and injected in orbit far away from the Earth, for a nominal lifetime of 7 years. Euclid has two instruments on-board, the Visible Imager (VIS) and the Near- Infrared Spectro-Photometer (NISP). The NISP instrument includes cryogenic mechanisms, active thermal control, high-performance Data Processing Unit and requires periodic in-flight calibrations and instrument parameters monitoring. To fully exploit the capability of the NISP, a careful control of systematic effects is required. From previous experiments, we have built the concept of an integrated instrument development and verification approach, where the scientific, instrument and ground-segment expertise have strong interactions from the early phases of the project. In particular, we discuss the strong integration of test and calibration activities with the Ground Segment, starting from early pre-launch verification activities. We want to report here the expertise acquired by the Euclid team in previous missions, only citing the literature for detailed reference, and indicate how it is applied in the Euclid mission framework.

Satellite oceanography - The instruments

NASA Technical Reports Server (NTRS)

Stewart, R. H.

1981-01-01

It is pointed out that no instrument is sensitive to only one oceanographic variable; rather, each responds to a combination of atmospheric and oceanic phenomena. This complicates data interpretation and usually requires that a number of observations, each sensitive to somewhat different phenomena, be combined to provide unambiguous information. The distinction between active and passive instruments is described. A block diagram illustrating the steps necessary to convert data from satellite instruments into oceanographic information is included, as is a diagram illustrating the operation of a radio-frequency radiometer. Attention is also given to the satellites that carry the various oceanographic instruments.

Evaluation of Low-Cost, Objective Instruments for Assessing Physical Activity in 10-11-Year-Old Children

ERIC Educational Resources Information Center

Hart, Teresa L.; Brusseau, Timothy; Kulinna, Pamela Hodges; McClain, James J.; Tudor-Locke, Catrine

2011-01-01

This study compared step counts detected by four, low-cost, objective, physical-activity-assessment instruments and evaluated their ability to detect moderate-to-vigorous physical activity (MVPA) compared to the ActiGraph accelerometer (AG). Thirty-six 10-11-year-old children wore the NL-1000, Yamax Digiwalker SW 200, Omron HJ-151, and Walk4Life…

The Pool Activity Level (PAL) Instrument for Occupational Profiling Jackie Pool The Pool Activity Level (PAL) Instrument for Occupational Profiling Second edition Jessica Kingsley Publishers 96pp £22.50 1843100800 1843100800.

PubMed

2002-11-01

This easy-to-access introduction and workbook to cover the use of the Pool Activity Instrument is a useful addition to the growing resources available under the umbrella of the Bradford Dementia Group. In this second edition, it has been modified to account for suggestions from the field and this shows from its clear and practice-based approach.

Delirium as a Predictor of Physical and Cognitive Function in Individuals Aged 80 and Older After Transcatheter Aortic Valve Implantation or Surgical Aortic Valve Replacement.

PubMed

Eide, Leslie S P; Ranhoff, Anette H; Fridlund, Bengt; Haaverstad, Rune; Hufthammer, Karl Ove; Kuiper, Karel K J; Nordrehaug, Jan E; Norekvål, Tone M

2016-06-01

To determine how development of delirium after surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) could predict activity of daily living (ADL) and instrumental ADLs (IADL) disability, cognitive function, and self-reported health in individuals aged 80 and older. Prospective cohort study. Tertiary university hospital. Individuals aged 80 and older undergoing elective SAVR or TAVI (N = 136). Delirium was assessed for 5 days using the Confusion Assessment Method. The Barthel Index, Nottingham Extended ADL Scale, and SF-12 were used to determine ADL and IADL ability and self-reported health at baseline and 1- and 6-month follow-up. Cognition was assessed using the Mini-Mental State Examination at baseline and 6-month follow-up. Participants had lower IADL scores 1 month after SAVR than at baseline (baseline 58, 1 month: delirium 42, no delirium 50, P ≤ .02), but scores had returned to baseline levels at 6 months. The Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) Physical Component Summary (PCS) score was higher at 6-month follow-up (48) than at baseline (39), especially in participants who did not develop delirium (P < .001). No differences in other outcomes were found. Regression models suggest that delirium may help predict IADL disability 1 month after baseline (P ≤ .07) but does not predict large differences in ADL disability, cognitive function, or SF-12-scores. Individuals who underwent TAVI and developed delirium had lower ADL (baseline 19, 1-month 16, P < .001) and IADL (baseline 49, 1-month 40, P = .003) scores at 1-month follow-up. SF-12 PCS score (baseline 30) increased from baseline to 1- (35, P = .04) and 6- (35, P = .02) month follow-up in individuals who underwent TAVI and did not develop delirium. Delirium after TAVI predicted greater ADL and IADL disability at 1-month but not at 6-month follow-up. Individuals who develop delirium after SAVR and TAVI have poorer short-term IADL function but

Experiments and hands-on activities for geoscience observing and measuring by using low-priced instruments

NASA Astrophysics Data System (ADS)

Yang, S. S.; Lin, Y. Y.; Tang-Iunn, S. S.

2016-12-01

In this presentation, we will introduce five experiments and hands-on activities for geoscience observing and measuring by using low-priced and small-sized commercial instruments. The Black Box for Environmental Measuring (BBEM) system is based on Arduino platform, low-power consumption sensors are employed to measure meteorological and environmental parameters. Commercial GPS receiver is used to observe the influence of geomagnetic storms on GPS system. Webcam is an accessible instrument which is suitable for detecting and recording sprites, thunders, and the development of cumulonimbus. Real-time flight trackers and websites are employed to determine the altitude of cloud base. A simple VLF receiver is built by using the audio interface on computer, and the observed signals showed the variations of the D-region of the ionosphere. All these experiments and activities are practical and have been applied in classroom and science outreach in Taiwan.

Multiple, but not traditional risk factors predict mortality in older people: the Concord Health and Ageing in Men Project.

PubMed

Hirani, Vasant; Naganathan, Vasi; Blyth, Fiona; Le Couteur, David G; Gnjidic, Danijela; Stanaway, Fiona F; Seibel, Markus J; Waite, Louise M; Handelsman, David J; Cumming, Robert G

2014-01-01

This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005-2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors delete time until of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of delete time to time to mortality included in the final model (p < 0.05) were older age, body mass index < 20 kg m(2), high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong non-drinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a

The Geriatric Hand: Correlation of Hand-Muscle Function and Activity Restriction in Elderly

ERIC Educational Resources Information Center

Incel, Nurgul Arinci; Sezgin, Melek; As, Ismet; Cimen, Ozlem Bolgen; Sahin, Gunsah

2009-01-01

On the basis of the importance of hand manipulation in activities of daily living (ADL), deterioration of hand function because of various factors reduces quality and independence of life of the geriatric population. The aim of this study was to identify age-induced changes in manual function and to quantify the correlations between hand-muscle…

Fourth-Year Medical Student Charting of Older Persons' Cognitive and Functional Status.

PubMed

Agens, John; Appelbaum, Jonathan S; Baker, Suzanne; Brummel-Smith, Kenneth; Friedman, Eli; Harrison, Suzanne L; Kutner, Mitchell; McKenzie, Jonathan

2016-01-01

Functional and cognitive impairment correlates with medical outcomes in older persons, yet documentation in the medical record is often inadequate. The purpose of this pilot study was to evaluate fourth year (M4) medical students' charting performance of cognition and functional status in older persons during non-geriatric clerkships using an audit tool. The research assistants used a chart abstracting tool to retrospectively review patients' charts. The abstracting tool contained keywords and phrases to prompt the research assistants to look for any documentation of patient status in four domains: (1) delirium or acute confusional state, (2) chronic cognitive impairment, (3) activities of daily living, and (4) instrumental activities of daily living. The threshold was any mention of keywords in these domains. On non-geriatrics M4 clerkships in the hospital, students documented acute cognitive status (ACS) and presence or absence of chronic cognitive impairment (CCI) in 57% and 68% of cases respectively, with physicians and/or nurses doing it more often at 63% and 84%. Both students and other care providers documented ACS and CCI in the same charts 41% and 59% of the time, respectively. Students documented activities of daily living (ADLs) and instrumental activities of daily living (IADLs) 31% and 3% respectively, physicians and/or nurses 59% and 0%. Documentation of cognitive status in hospital charts for students and physicians was somewhat higher than in the literature. This may be because geriatrics is integrated into our 4-year curriculum. Documentation by both students and physicians was better for ADLs than IADLs and poor for IADLs overall.

THE RESPONSE OF SOME HEALTH PHYSICS INSTRUMENTS TO SODIUM-24 AND CHLORINE- 38 ACTIVITIES IN POLYTHENE MANPHANTOMS AND THE HUMAN BODY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Peabody, C.O.

1963-12-01

Measurements were made of the response of five commonly used health physics instruments when held near polythene man-phantoms filled with aqueous solutions containing sodium-24 and chlorine-38. The ratios of the wholebody chlorine-38 and sodium-24 activities are calculated for various periods of accidental human irradiation by neutrons. These ratios and the phantom results are used to estimate the response of the five instruments when held near the human body at various times after irradiation. Relative contributions of the chlorine-38 and sodium-24 to the instrument indications are listed. The tabulated data enable the instrument readings to be converted to wholebody sodium- 24more » activity at the time of irradiation. This may be used as a quick estimate of the degree of neutron irradiation. (auth)« less

The Active Role of Instruments in Articulating Knowing and Knowledge: The Case of Animal Qualification Practices in Breeding Organisations

ERIC Educational Resources Information Center

Labatut, Julie; Aggeri, Franck; Astruc, Jean-Michel; Bibe, Bernard; Girard, Nathalie

2009-01-01

Purpose: The purpose of this paper is to investigate the role of instruments defined as artefacts, rules, models or norms, in the articulation between knowing-in-practice and knowledge, in learning processes. Design/methodology/approach: The paper focuses on a distributed, knowledge-intensive and instrumented activity at the core of any collective…

Impact of neuropsychological rehabilitation on activities of daily living and community reintegration of patients with traumatic brain injury.

PubMed

Kanchan, Amrita; Singh, Amool Ranjan; Khan, Nawab Akhtar; Jahan, Masroor; Raman, Rajesh; Sathyanarayana Rao, T S

2018-01-01

The present study was targeted to observe the impact of neuropsychological rehabilitation on activities of daily living (ADL) and community reintegration of patients with traumatic brain injury (TBI). Based on purposive sampling technique, ten patients with TBI falling in the age range of 20-40 years and fulfilling the inclusion and exclusion criteria were chosen from All India Institute of Speech and Hearing, Mysuru, India. A quasi-experimental design, i.e., nonequivalent control group design was chosen for the study. Patients were assessed on Luria-Nebraska Neuropsychological Battery for Adults, Cognitive Symptoms Checklist, and Community Integration Questionnaire. Patients in experimental group were given neuropsychological rehabilitation for 6 months. Brainwave-R and Talking Pen were used as rehabilitative tools. Patients with TBI have significant neuropsychological deficits observed in memory, visuo-spatial organization, arithmetic, spelling, writing, fine motor coordination, and executive functioning. Neuropsychological deficits have a major impact on ADL and community reintegration. Neuropsychological rehabilitation is effective in rehabilitating neuropsychological deficits, which in turn leads to improvement in ADL and community reintegration. Neuropsychological rehabilitation should be one of the major goals in rehabilitation procedures for patients with TBI in order to bring overall improvement in them.

Everyday Functioning in Huntington's Disease: A Laboratory-Based Study of Financial Management Capacity.

PubMed

Sheppard, David P; Pirogovsky-Turk, Eva; Woods, Steven Paul; Holden, Heather M; Nicoll, Diane R; Filoteo, J Vincent; Corey-Bloom, Jody; Gilbert, Paul E

2017-01-01

One important limitation of prior studies examining functional decline in Huntington's disease (HD) has been the reliance on self-reported measures of ability. Since report-based methods can be biased by lack of insight, depression, and cognitive impairment, contrasting self-reported ability with measures that assess capacity may lead to a more comprehensive estimation of real-world functioning. The present study examined self-reported ability to perform instrumental activities of daily living (iADLs) and performance-based financial management capacity in 20 patients diagnosed with mild-moderate Huntington's disease (HD) and 20 demographically similar healthy adults. HD patients reported significantly greater declines in their ability to manage finances. On the capacity measure of financial management, HD patients performed significantly below healthy adults. Additionally, in the HD group there were no significant correlations between self-reported ability and capacity measures of financial management. HD patients endorsed declines in global iADL ability and exhibited deficits in functional capacity when performing a financial management task. Capacity measures may aid in assessing the extent to which HD patients accurately estimate real-world iADL performance, and the present findings suggest that such measures of capacity may be related to the cognitive, but not motor or affective, symptoms of HD.

Early-versus Late-Onset Alzheimer Disease: Long-Term Functional Outcomes, Nursing Home Placement, and Risk Factors for Rate of Progression.

PubMed

Wattmo, Carina; Wallin, Åsa K

2017-01-01

Whether age at onset influences functional deterioration in Alzheimer disease (AD) is unclear. We, therefore, investigated risk factors for progression in activities of daily living (ADL) and nursing home placement (NHP) in cholinesterase inhibitor (ChEI)-treated patients with early-onset AD (EOAD) versus late-onset AD (LOAD). This 3-year, prospective, observational, multicenter study included 1,017 participants with mild-to-moderate AD; 143 had EOAD (onset <65 years) and 874 LOAD (onset ≥65 years). Possible sociodemographic and clinical factors that could affect functional outcome and NHP were analyzed using mixed-effects models and logistic regression, respectively. Younger individuals exhibited longer illness duration before AD diagnosis, whereas 6-month functional response to ChEI therapy, 3-year changes in ADL capacities, time from diagnosis to NHP, and survival time in nursing homes were similar between the groups. In LOAD, a higher ChEI dose, no antidepressant use, and lower education level were protective factors for slower instrumental ADL (IADL) decline. In EOAD, antihypertensives/cardiac therapy implied faster IADL progression but lower risk of NHP. This study highlights the clinical importance of an earlier diagnosis and treatment initiation and the need for functional evaluations in EOAD. Despite the age differences between EOAD and LOAD, a similar need for nursing homes was observed.

Patient satisfaction, empowerment, and health and disability status effects of a disease management-health promotion nurse intervention among Medicare beneficiaries with disabilities.

PubMed

Friedman, Bruce; Wamsley, Brenda R; Liebel, Dianne V; Saad, Zabedah B; Eggert, Gerald M

2009-12-01

To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. The Medicare Primary and Consumer-Directed Care Demonstration was a 24-month randomized controlled trial that included a nurse intervention. The present study (N = 766) compares the nurse (n = 382) and control (n = 384) groups. Generalized linear models for repeated measures, linear regression, and ordered logit regression were used. The patients whose activities of daily living (ADL) were reported by the same respondent at baseline and 22 months following baseline had significantly fewer dependencies at 22 months than did the control group (p = .038). This constituted the vast majority of respondents. In addition, patient satisfaction significantly improved for 6 of 7 domains, whereas caregiver satisfaction improved for 2 of 8 domains. However, the intervention had no effect on empowerment, self-rated health, the SF-36 physical and mental health summary scores, and the number of dependencies in instrumental ADL. If confirmed in other studies, this intervention holds the potential to reduce the rate of functional decline and improve satisfaction for Medicare beneficiaries with ADL dependence.

Level of Need, Divertibility, and Outcomes of Newly Admitted Nursing Home Residents.

PubMed

Tanuseputro, Peter; Hsu, Amy; Kuluski, Kerry; Chalifoux, Mathieu; Donskov, Melissa; Beach, Sarah; Walker, Peter

2017-07-01

To describe the level of need and divertibility of newly admitted nursing home residents, describe the factors that drive need, and describe the outcomes of residents across different levels of need. Retrospective cohort study. A total of 640 publicly funded nursing homes (also known as long-term care facilities) in Ontario, Canada. All newly admitted residents between January 1, 2010 and March 1, 2012. We categorized residents into 36 groups based on different levels of (1) cognitive impairment, (2) difficulty in activities of daily living (ADL), (3) difficulty in instrumental ADLs, and (4) whether or not they had a caregiver at home. Residents were then categorized as having low, intermediate, or high needs; applying results from previous "Balance of Care" studies, we also captured the proportion who could have been cost-effectively diverted into the community. We then contrasted the characteristics of residents across the needs and divertible groupings, and compared 4 outcomes among these groups: hospital admissions, emergency department visits, mortality, and return to home. A population-level cohort of 64,105 incident admissions was captured. About two-thirds had great difficulty performing ADLs (65%) and had mild to severe cognitive impairment (66%); over 90% had great difficulty with instrumental ADLs. Just less than 50% of the new admissions were considered to be residents with high care needs (cognitively impaired with great ADL difficulty), while only 4.5% (2880 residents) had low care needs (cognition and ADL intact). Those with dementia (71.0%) and previous stroke (21.5%) were over-represented in the high needs group. Those that cannot be divertible to anywhere else but an institution with 24 hour nursing care comprised 41.3% (n = 26,502) of residents. Only 5.4% (n = 3483), based on community resources available, could potentially be cost-effectively diverted to the community. Those at higher needs experienced higher rates of mortality, higher

Predicting activities of daily living for cancer patients using an ontology-guided machine learning methodology.

PubMed

Min, Hua; Mobahi, Hedyeh; Irvin, Katherine; Avramovic, Sanja; Wojtusiak, Janusz

2017-09-16

Bio-ontologies are becoming increasingly important in knowledge representation and in the machine learning (ML) fields. This paper presents a ML approach that incorporates bio-ontologies and its application to the SEER-MHOS dataset to discover patterns of patient characteristics that impact the ability to perform activities of daily living (ADLs). Bio-ontologies are used to provide computable knowledge for ML methods to "understand" biomedical data. This retrospective study included 723 cancer patients from the SEER-MHOS dataset. Two ML methods were applied to create predictive models for ADL disabilities for the first year after a patient's cancer diagnosis. The first method is a standard rule learning algorithm; the second is that same algorithm additionally equipped with methods for reasoning with ontologies. The models showed that a patient's race, ethnicity, smoking preference, treatment plan and tumor characteristics including histology, staging, cancer site, and morphology were predictors for ADL performance levels one year after cancer diagnosis. The ontology-guided ML method was more accurate at predicting ADL performance levels (P < 0.1) than methods without ontologies. This study demonstrated that bio-ontologies can be harnessed to provide medical knowledge for ML algorithms. The presented method demonstrates that encoding specific types of hierarchical relationships to guide rule learning is possible, and can be extended to other types of semantic relationships present in biomedical ontologies. The ontology-guided ML method achieved better performance than the method without ontologies. The presented method can also be used to promote the effectiveness and efficiency of ML in healthcare, in which use of background knowledge and consistency with existing clinical expertise is critical.

Increased muscle strength improves managing in activities of daily living in fall-prone community-dwelling older women.

PubMed

Vaapio, Sari; Salminen, Marika; Vahlberg, Tero; Kivelä, Sirkka-Liisa

2011-02-01

The aim of this longitudinal study was to describe whether an increase in knee extension strength is associated with improvements in managing in activities of daily living (ADL) and in self-perceived physical condition in fall-prone community-dwelling older women. Subjects (n=417) aged ≥ 65 years belonged either to intervention or control groups in a 12-month randomized controlled fall prevention trial. Isometric muscle strength of knee extension was measured with an adjustable dynamometer chair. Managing in activities of daily living was measured with structured questions about abilities to climb stairs, walk at least 400 meters, toilet, bath, go to the sauna, do light or heavy housework, and carry heavy loads. A question of self-perceived physical condition was also asked. Positive associations were found between increased knee extension strength and an increase in walking at least 400 meters (p<0.001), carrying heavy loads (p=0.004), and climbing stairs (p=0.007), and in self perceived physical condition (p=0.005) over a 12- month follow-up. In addition, low age, non-use of a walking aid, low number of prescribed medications, and good functional balance at baseline were associated with an increase in performance of these ADL functions. An increase in knee extension strength during the 12-month follow-up was associated with improvement in some ADL functions and improvement in self-perceived physical condition during the same period in fall-prone community-dwelling women.

Education and disability trends of older Americans, 2000-2014.

PubMed

Tsai, Yuping

2017-09-01

Trends in disability among older Americans has declined since the 1980s. The study examines whether the trend continues to decline and whether educational disparities exist in the prevalence of functional limitations. I used the 2000-2014 National Health Interview Survey and included adults aged ≥65 years. Functional limitations was measured by three outcomes: the need for help with activities of daily living (ADLs) or instrumental activities of daily living (IADLs) and physical function limitations. I used a set of logistic models to estimate the average annual change rate of functional limitations. I examined whether the annual rate of change differed by education, age group and sex. During 2000-2014, the annual increase rate of ADL limitations was 1.7% (P < 0.001) and was 2.0% (P < 0.001) for physical function limitations; IADL limitation did not change significantly. All subgroups experienced an increase in ADL and physical function limitations except for adults with a more than high school education. The lower-educated group had a higher proportion and a higher annual rate of increase in all outcomes. Increasing trends in chronic conditions may contribute to the increasing trend in functional limitations. The study highlighted a large educational disparity in late-life disability among older Americans. Published by Oxford University Press on behalf of Faculty of Public Health 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Physical Exercise with Music Maintains Activities of Daily Living in Patients with Dementia: Mihama-Kiho Project Part 21.

PubMed

Satoh, Masayuki; Ogawa, Jun-Ichi; Tokita, Tomoko; Nakaguchi, Noriko; Nakao, Koji; Kida, Hirotaka; Tomimoto, Hidekazu

2017-01-01

Recent studies suggest that combined non-pharmacological interventions are more beneficial than single interventions for primary and secondary prevention of dementia. We previously reported enhanced effects of physical exercise with music (ExM) on cognitive function in normal elderly people compared to exercise alone. To identify if ExM improves cognitive function and activities of daily livings (ADLs) in dementia patients over cognitive stimulation (CS). We enrolled 85 patients with mild to moderate dementia. Forty-three subjects performed ExM developed by the Yamaha Music Foundation, and 42 subjects performed cognitive stimulation using portable game consoles and drills involving easy calculations, mazes, and mistake-searching in pictures. Interventions were performed once a week for 40 minutes. Before and after the six-month intervention, patients were assessed using neuropsychological batteries, and ADLs were assessed by patients' caregivers using the functional independence measure (FIM). Voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used to assess medial temporal lobe atrophy. Twenty-three subjects dropped out during the intervention. Thirty-one patients from each group were analyzed. Post-intervention, both groups showed significantly improved visuospatial function. Significant benefits were observed in psychomotor speed or memory in the ExM or CS groups, respectively. FIM scores, reflecting ADLs, and VSRAD scores were significantly preserved in the ExM group, but significantly worsened in the CS group. ExM produced greater positive effects on cognitive function and ADLs in patients with mild to moderate dementia than CS, excluding memory. Optimal interventions for dementia will likely be achieved by combining ExMand CS.

Assessing Human Activity in Elderly People Using Non-Intrusive Load Monitoring.

PubMed

Alcalá, José M; Ureña, Jesús; Hernández, Álvaro; Gualda, David

2017-02-11

The ageing of the population, and their increasing wish of living independently, are motivating the development of welfare and healthcare models. Existing approaches based on the direct heath-monitoring using body sensor networks (BSN) are precise and accurate. Nonetheless, their intrusiveness causes non-acceptance. New approaches seek the indirect monitoring through monitoring activities of daily living (ADLs), which proves to be a suitable solution. ADL monitoring systems use many heterogeneous sensors, are less intrusive, and are less expensive than BSN, however, the deployment and maintenance of wireless sensor networks (WSN) prevent them from a widespread acceptance. In this work, a novel technique to monitor the human activity, based on non-intrusive load monitoring (NILM), is presented. The proposal uses only smart meter data, which leads to minimum intrusiveness and a potential massive deployment at minimal cost. This could be the key to develop sustainable healthcare models for smart homes, capable of complying with the elderly people' demands. This study also uses the Dempster-Shafer theory to provide a daily score of normality with regard to the regular behavior. This approach has been evaluated using real datasets and, additionally, a benchmarking against a Gaussian mixture model approach is presented.

Impact of pain in vertebral column on activities of daily living in the Iranian amputees with bilateral lower limb amputation.

PubMed

Ashraf, Alireza; Shojaee, Hadi; Mousavi, Batool; Masoumi, Mehdi; Rezaei, Noushin; Azema, Hasan; Soroush, Mohammadreza

2012-01-01

To determine the impact of pain in the vertebral column on the activities of daily living (ADL) level of war victims with bilateral lower limb amputation. All the war-related bilateral lower limb amputees were invited. More than half of them (n = 335) participated and underwent a thorough assessment after giving informed consent. The majority of the participants were male (97.6%). Their mean age was 42 years and 97.6% of them were married. The most common causes of injury leading to amputation were shells of artillery and mortar (56.7%). The most common level of amputation was bilateral transtibial (37.6%) and 64% were wearing the prosthesis of both sides. The most ADL dependency were transfer activities (27.8%) and bathing (23.3%) and the most independent functioning was eating (97.6%). Upper cervical vertebral pain was associated with dependency in the bowel and bladder management and dressing (p < 0.03 and p < 0.04, respectively). Pain in the lower cervical vertebrae was associated with dependency in toileting and dressing (p < 0.01 and p < 0.01, respectively). There were significant relationships between pain in the thoracic vertebrae and dependency in bathing, transfer activities and toileting (p < 0.02, p < 0.003 and p < 0.03, respectively). Pain in the lumbosacral region had a relationship with the level of amputation, transfer activities and toileting (p < 0.006, p < 0.03 and p < 0.05, respectively). Vertebral pain in bilateral lower limb amputees, especially lumbosacral pain, was accompanied with higher dependency in ADL. Therefore, a multidisciplinary approach to the management of pain is required to minimize disability and maximize functioning.

Pain, activities of daily living and sport function at different time points after hip arthroscopy in patients with femoroacetabular impingement: a systematic review with meta-analysis.

PubMed

Kierkegaard, Signe; Langeskov-Christensen, Martin; Lund, Bent; Naal, Florian D; Mechlenburg, Inger; Dalgas, Ulrik; Casartelli, Nicola C

2017-04-01

To investigate pain, activities of daily living (ADL) function, sport function, quality of life and satisfaction at different time points after hip arthroscopy in patients with femoroacetabular impingement (FAI). Systematic review with meta-analysis. Weighted mean differences between preoperative and postoperative outcomes were calculated and used for meta-analysis. EMBASE, MEDLINE, SportsDiscus, CINAHL, Cochrane Library, and PEDro. Studies that evaluated hip pain, ADL function, sport function and quality of life before and after hip arthroscopy and postoperative satisfaction in patients with symptomatic FAI. Twenty-six studies (22 case series, 3 cohort studies, 1 randomised controlled trial (RCT)) were included in the systematic review and 19 in the meta-analysis. Clinically relevant pain and ADL function improvements were first reported between 3 and 6 months, and sport function improvements between 6 months and 1 year after surgery. It is not clear when quality of life improvements were first achieved. On average, residual mild pain and ADL and sport function scores lower than their healthy counterparts were reported by patients following surgery. Postoperative patient satisfaction ranged from 68% to 100%. On average, patients reported earlier pain and ADL function improvements, and slower sport function improvements after hip arthroscopy for FAI. However, average scores from patients indicate residual mild hip pain and/or hip function lower than their healthy counterparts after surgery. Owing to the current low level of evidence, future RCTs and cohort studies should investigate the effectiveness of hip arthroscopy in patients with FAI. CRD42015019649. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly.

PubMed

Bahat, Gulistan; Tufan, Fatih; Bahat, Zumrut; Aydin, Yucel; Tufan, Asli; Akpinar, Timur Selcuk; Erten, Nilgun; Karan, Mehmet Akif

2013-06-01

Functionality, comorbidities, polypharmacy, nutritional status and sarcopenia affect the prognosis of elderly excessively. These parameters are influenced by the population, living settings and age. We aimed to study these parameters in Turkish community-dwelling male elderly. We studied 274 male elderly ≥60 years of age admitted to our Geriatrics outpatient clinics. Mean age was 74.4 ± 7.1 years; 47.4% of the subjects were ≥75 years, 24.1% were ≥80 years. Mean activities-of-daily-living (ADL) and instrumental ADL (IADL) scores were 9.4 and 11.1, respectively. Patients with at least one-dependence at ADL-IADL were 22.6%-47.2%, and more than half-dependence at ADL-IADL were 2.8%-17.9%, respectively. Mean number of comorbidities were 2.6. Most common diagnosis was hypertension with 65%; mean number of drugs were 4.5; 55.3% were using ≥4 chronic drugs. Prevalences of malnutrition were 3.7%-6.9%, malnutrition risk were 23.5%-26.7% by the mini nutritional assessment test-long form and short form, respectively. Calf circumference was measured <31 cm in 10.5%. Our findings suggest that Turkish community-dwelling male elderly may have greater prevalences of functional dependence, sarcopenia but lower rates of malnutrition and similar rates of polypharmacy compared with the western developing countries and developed countries. This study emphasized the geographical differences in and/or between the individual countries highlighting the need for studies both country- and world-wide.

Functional Impairment and Hospital Readmission in Medicare Seniors

PubMed Central

Greysen, S. Ryan; Cenzer, Irena Stijacic; Auerbach, Andrew D.; Covinsky, Kenneth E.

2015-01-01

Importance Medicare currently penalizes hospitals for high rates of readmission for seniors but does not account for common age-related syndromes such as functional impairment. Objectives Given the high prevalence of functional impairments in community-dwelling seniors, we assessed effects of functional impairment on Medicare hospital readmissions. Study Design, Participants, and Setting We created a nationally-representative cohort of 7,854 community-dwelling seniors in the Health and Retirement Study (HRS) with 22,289 Medicare hospitalizations from 2000–2010. Main Outcome and Measurements Outcome was 30-day readmission, assessed by Medicare claims. Main predictor was functional impairment determined from HRS interview preceding hospitalization, stratified into 5 levels: no functional impairments, difficulty with ≥1 instrumental activity of daily living (IADL), difficulty with ≥1 activity of daily living (ADL), dependency (need for help) in 1–2 ADLs, and dependency in ≥3 ADLs. Adjustment variables included age, race, gender, income, and net worth and comorbid conditions (Elixhauser score from Medicare claims), and prior admission. We performed multivariable logistic regression adjusted for clustering at patient level to characterize the association of functional impairments and readmission. Results Mean age 79 (±8; 65–105), 58% female, 85% White, 90% reported ≥3 comorbidities, 86% had ≥1 hospitalization in previous year. Overall, 48% had some level of functional impairment prior to admission and 15% experienced a 30-day readmission. We found a progressive increase in adjusted risk of readmission as the degree of functional impairment increased: 13.5% with no functional impairment, 14.3% with ≥ 1 IADL difficulty (OR 1.06; 95% CI 0.94–1.20), 14.4% with ≥1 ADL difficulty (OR 1.08; 0.96–1.21), 16.5% with dependency in 1–2 ADLs (OR 1.26; 1.11–1.44), and 18.2% with dependency in ≥3 ADLs (1.42; 1.20–1.69). Sub-analysis restricted to

Limb-kinetic apraxia affects activities of daily living in Parkinson’s disease: a multi-center study

PubMed Central

Foki, T.; Vanbellingen, T.; Lungu, C.; Pirker, W.; Bohlhalter, S.; Nyffeler, T.; Kraemmer, J.; Haubenberger, D.; Fischmeister, F. Ph. S.; Auff, E.; Hallett, M.; Beisteiner, R.

2017-01-01

Background and purpose Impaired dexterity (fine hand movements) is often present in Parkinson’s disease (PD), even at early to moderate disease stages. It has a detrimental impact on activities of daily living (ADL) such as buttoning, contributing to reduced quality of life. Limb-kinetic apraxia, a loss of the ability to make precise, independent but coordinated finger and hand movements, may contribute to impaired dexterity even more than bradykinesia per se. However, the impact of limb-kinetic apraxia on ADL remains controversial. Our aim was to identify the strongest predictor of buttoning and unbuttoning in PD. It was hypothesized that coin rotation (a surrogate of limb-kinetic apraxia) represents the most important determinant. Methods Sixty-four right-handed, early to moderate PD patients were recruited from three movement disorder centers (Hoehn and Yahr stages 1–3). Buttoning, unbuttoning and coin rotation (right and left hand) represented the target tasks. Motor impairment was assessed according to the Unified Parkinson’s Disease Rating Scale. Results Multiple linear regression analysis showed that coin rotation with the right hand was the only significant predictor of buttoning (P < 0.001) and unbuttoning (P = 0.002). Notably, measures of bradykinesia or overall motor impairment did not represent significant predictors. Conclusions Constituting the novel key finding, limb-kinetic apraxia seems to be particularly relevant for ADL requiring dexterity skills in PD, even at early to moderate disease stages. Our results prompt research into the pathophysiological background and therapeutic options to treat limb-kinetic apraxia. The simple coin rotation test provides valuable information about ADL-related dexterity skills. PMID:27132653

Work station learning activities: a flexible and scalable instrument for integrating across basic subjects in biomedical education.

PubMed

González-Soltero, Rocío; Learte, Ana Isabel R; Sánchez, Ana Mª; Gal, Beatriz

2017-11-29

Establishing innovative teaching programs in biomedical education involves dealing with several national and supra-national (i.e. European) regulations as well as with new pedagogical and demographic demands. We aimed to develop and validate a suitable instrument to integrate activities across preclinical years in all Health Science Degrees while meeting requirements of national quality agencies. The new approach was conceived at two different levels: first, we identified potentially integrative units from different fields according to national learning goals established for each preclinical year (national quality agency regulations). Secondly, we implemented a new instrument that combines active methodologies in Work Station Learning Activities (WSLA), using clinical scenarios as a guiding common thread to instruct students from an integrated perspective. We evaluated students' perception through a Likert-type survey of a total of 118 students enrolled in the first year of the Bachelor's Degree in Medicine. Our model of integrated activities through WSLA is feasible, scalable and manageable with large groups of students and a minimum number of instructors, two major limitations in many medical schools. Students' perception of WSLA was positive in overall terms. Seventy nine percent of participants stated that WSLA sessions were more useful than non-integrated activities. Eighty three percent confirmed that the WSLA methodology was effective at integrating concepts covered by different subjects. The WSLA approach is a flexible and scalable instrument for moving towards integrated curricula, and it can be successfully adapted to teach basic subjects in preclinical years of Health Science degrees. WSLA can be applied to large groups of students in a variety of contexts or environments using clinical cases as connecting threads.

Reversal of diabetic peripheral neuropathy with phototherapy (MIRE) decreases falls and the fear of falling and improves activities of daily living in seniors.

PubMed

Powell, Mark W; Carnegie, Dale H; Burke, Thomas J

2006-01-01

to determine whether restoration of sensation, impaired due to diabetic peripheral neuropathy (DPN), would reduce the number of falls and the fear of falling and improve activities of daily living (ADL) in a Medicare-aged population. retrospective cohort study of patients with documented, monochromatic near-infrared phototherapy (MIRE)-mediated, symptomatic reversal of DPN. responses to a health status questionnaire following symptomatic reversal of DPN. 252 patients (mean age 76 years) provided health information following symptomatic reversal of diabetic neuropathy (mean duration 8.6 months). incidence of falls and fear of falling decreased within 1 month after reversal of peripheral neuropathy and remained low after 1 year. Likewise, improved ADL were evident soon after reversal of peripheral neuropathy and showed further improvement after 1 year. Overall, reversal of peripheral neuropathy in a clinician's office and subsequent use of MIRE at home was associated with a 78% reduction in falls, a 79% decrease in balance-related fear of falling and a 72% increase in ADL (P < 0.0002 for all results). reversal of peripheral neuropathy is associated with an immediate reduction in the absolute number of falls, a reduced fear of falling and improved ADL. These results suggest that symptomatic reversal of diabetic neuropathy will have a substantial favourable, long-term socioeconomic impact on patients with DPN and the Medicare system, and improve the quality of life for elderly patients with diabetes and peripheral neuropathy.

An Instrumental Perspective on CSCL Systems

ERIC Educational Resources Information Center

Lonchamp, Jacques

2012-01-01

The theory of instrumental genesis of Rabardel relates the social and the technical through the concept of instrument. An instrument is defined as a mixed entity made up by an artifact, the technical/material part, and a set of utilization schemes, the social/behavioural part, which both result from users' constructive activities. This theory is…

The transfer of skills from cognitive and physical training to activities of daily living: a randomised controlled study.

PubMed

Hagovska, Magdalena; Nagyova, Iveta

2017-06-01

Ageing is associated with the deterioration of all cognitive functions, including attention, memory and psychomotor speed. It has not yet been clearly confirmed whether the effects of cognitive and physical interventions can improve activities of daily living (ADL). This study compared the effectiveness of cognitive and physical training on cognitive functions and the transfer to ADL. Eighty older people with mild cognitive impairment (mean age 67.07 ± 4.3 years) were randomly divided into an experimental group ( n  = 40) and a control group ( n  = 40). Data were collected in an outpatient psychiatric clinic in a randomised controlled trial. Primary outcome measures included the following: cognitive functions were evaluated using the mini mental state examination, the AVLT-Auditory verbal learning test, the Stroop test, the TMT-trail making test, the DRT-disjunctive reaction time and the NHPT-nine hole peg test. Secondary outcome measure was the Bristol activities of daily living scale. The experimental group underwent a CogniPlus and physical training; consisting of 20 training sessions over 10 weeks. Both groups went through 30 min of daily physical training for 10 weeks. After the training, significant differences in favour of the experimental group were found in almost all the tests. In memory (AVLT) (p ≤ 0.0001, effect size (ES) η 2  = 0.218. In reduction of the response time on attention tasks (Stroop tasks) ( p  ≤ 0.006, ES = 0.092-0.115). In lower error rates in all tests: Stroop tasks, DRT, TMT, NHPT ( p  ≤ 0.02-0.001, ES = 0.062-0.176). In ADL ( p  ≤ 0.0001, ES = 0.176). The combined cognitive and physical training had better efficacy for most cognitive functions and for ADL when compared with the physical training only.

Validation of a computerized 24-hour physical activity recall (24PAR) instrument with pattern-recognition activity monitors.

PubMed

Calabro, Miguel A; Welk, Gregory J; Carriquiry, Alicia L; Nusser, Sarah M; Beyler, Nicholas K; Mathews, Charles E

2009-03-01

The purpose of this study was to examine the validity of a computerized 24-hour physical activity recall instrument (24PAR). Participants (n=20) wore 2 pattern-recognition activity monitors (an IDEEA and a SenseWear Pro Armband) for a 24-hour period and then completed the 24PAR the following morning. Participants completed 2 trials, 1 while maintaining a prospective diary of their activities and 1 without a diary. The trials were counterbalanced and completed within a week from each other. Estimates of energy expenditure (EE) and minutes of moderate-to-vigorous physical activity (MVPA) were compared with the criterion measures using 3-way (method by gender by trial) mixed-model ANOVA analyses. For EE, pairwise correlations were high (r>.88), and there were no differences in estimates across methods. Estimates of MVPA were more variable, but correlations were still in the moderate to high range (r>.57). Average activity levels were significantly higher on the logging trial, but there was no significant difference in the accuracy of self-report on days with and without logging. The results of this study support the overall utility of the 24PAR for group-level estimates of daily EE and MVPA.

Resident choice and the survey process: the need for standardized observation and transparency.

PubMed

Schnelle, John F; Bertrand, Rosanna; Hurd, Donna; White, Alan; Squires, David; Feuerberg, Marvin; Hickey, Kelly; Simmons, Sandra F

2009-08-01

To describe a standardized observation protocol to determine if nursing home (NH) staff offer choice to residents during 3 morning activities of daily living (ADL) and compare the observational data with deficiency statements cited by state survey staff. Morning ADL care was observed in 20 NHs in 5 states by research staff using a standardized observation protocol. The number of observations in which choice was not offered was documented for 3 morning ADL care activities and compared with deficiency statements made by surveyors. Staff failed to offer choice during morning ADL care delivery for at least 1 of 3 ADL care activities in all 20 NHs. Observational data showed residents were not offered choice about when to get out of bed (11%), what to wear (25%), and breakfast dining location (39%). In comparison, survey staff issued only 2 deficiencies in all 20 NHs relevant to choice in the targeted ADL care activities, and neither deficiency was based on observational data. Survey interpretative guidelines instruct surveyors to observe if residents are offered choice during daily care provision, but standardized observation protocols are not provided to surveyors to make this determination. The use of a standardized observation protocol in the survey process similar to that used by research staff in this study would improve the accuracy and transparency of the survey process.

Relationships of Community and Individual Level Social Capital with Activities of Daily Living and Death by Gender

PubMed Central

Imamura, Haruhiko; Hamano, Tsuyoshi; Michikawa, Takehiro; Takeda-Imai, Fujimi; Nakamura, Takahiro; Takebayashi, Toru; Nishiwaki, Yuji

2016-01-01

This study determined whether there is an association between social capital and a composite outcome of decline in Activities of Daily Living (ADL) and death by gender. A prospective 3.5 year cohort study was conducted in a rural town in Japan. The study participants were 984 individuals aged 65 years and older with not impaired on ADL at 2010 baseline survey. Social participation and generalized trust were measured as social capital. The individual level responses were dichotomized and aggregated into the community level (eight areas). Multilevel logistic regression adjusting for covariates revealed that social participation at the individual level was significantly associated with higher odds of composite outcome (OR of “not participate” = 1.97, 95% CI = 1.38–2.81). Regarding generalized trust, only in men, there was an inverse association at the community level (OR of “low” = 0.55, 95% CI = 0.32–0.96), and a positive association at the individual level (OR of “tend to be careful” = 2.22, 95% CI = 1.27–3.90). These results suggest that social capital were associated with a decline in ADL and death and that the association may differ by gender. PMID:27589773

Organizational member involvement in physical activity coalitions across the United States: development and testing of a novel survey instrument for assessing coalition functioning.

PubMed

Bornstein, Daniel B; Pate, Russell R; Beets, Michael W; Saunders, Ruth P; Blair, Steven N

2015-06-01

Coalitions are often composed of member organizations. Member involvement is thought to be associated with coalition success. No instrument currently exists for evaluating organizational member involvement in physical activity coalitions. This study aimed to develop a survey instrument for evaluating organizational member involvement in physical activity coalitions. The study was carried out in three phases: (a) developing a draft survey, (b) assessing the content validity of the draft survey, and (c) assessing the underlying factor structure, reliability, and validity of the survey. A cross-sectional design was employed. In Phase 1, a team of experts in survey development produced a draft survey. In Phase 2, the content validity of the draft survey was evaluated by a panel of individuals with expertise in physical activity coalitions. In Phase 3, the survey was administered to 120 individuals on local-, state-, and national-level physical activity coalitions. Responses were subjected to an exploratory factor analysis in order to determine the survey's underlying factor structure, reliability, and validity. Phases 1 and 2yielded a survey instrument with demonstrated content validity. Phase 3 yielded a three-factor model with three subscales: Strategic Alignment, Organizational Alignment, and Providing Input. Each subscale demonstrated high internal consistency reliability and construct validity. The survey instrument developed here demonstrated sound psychometric properties and provides new insight into organizational member involvement in physical activity coalitions. This instrument may be an important tool in developing a more complete picture of coalition functioning in physical activity coalitions specifically and health-based coalitions overall. © 2014 Society for Public Health Education.

The 24-h recall instrument for home nursing to measure the activity profile of home nurses: development and psychometric testing.

PubMed

De Vliegher, Kristel; Aertgeerts, Bert; Declercq, Anja; Gosset, Christiane; Heyden, Isabelle; Van Geert, Michel; Moons, Philip

2015-01-01

Home health care today is challenged by a shift from an acute to a chronic health-care model, moving the focus of care from the hospital to home-care setting. This increased focus on care at home emphasizes the need for an efficient, effective, and transparent management of home health care. However, it is not precisely known what home-care nurses do; what kind of care is received by patients; what the performance of home nurses is; and what the impact of the increasing need for home nursing is on the current and future role of home nurses. In this respect, it is necessary to gain a clear insight into the activity profile of home nurses, but there is no gold standard to measure their activities. This study reports on the development and psychometric testing of the '24-hour recall instrument for home nursing' to measure the activity profile of home nurses. Five home nurses in Belgium, simultaneously with the researcher, registered the performed activities in a total of 69 patients, using the 24-h recall instrument for home nursing. The validity and the interrater reliability of this instrument were high: the proportions that observed agreement were very high; the strength of kappa agreement was substantial to almost perfect; the prevalence index showed great variety; and the bias index was low. The findings in this study support the validity evidence based on test content and the interrater reliability of the 24-h recall instrument. This instrument can help to shape practice and policy by making the home nursing profession more transparent: a clear insight into the kind of care that is provided by home nurses and is received by the patients in primary care contributes to the development of a clear definition of the role of home nurses in health care.

Insomnia in long-term care facilities: a comparison of seven European countries and Israel: the Services and Health for Elderly in Long TERm care study.

PubMed

Gindin, Jacob; Shochat, Tamar; Chetrit, Angela; Epstein, Shulamit; Ben Israel, Yehoshua; Levi, Sarah; Onder, Graziano; Carpenter, Ian; Finne-Soveri, Harriet; van Hout, Hein; Henrard, Jean-Claude; Nikolaus, Thorsten; Topinkova, Eva; Fialová, Daniela; Bernabei, Roberto

2014-11-01

To assess insomnia and its correlates as part of the Services and Health for Elderly in Long TERm care (SHELTER) study, funded by the 7th Framework Programme of the European Union. Cross-cultural investigation. Long-term care facilities (LTCFs) in eight European countries (Czech Republic, France, Finland, Germany, England, the Netherlands, Italy) and one non-European country (Israel). Elderly residents (N = 4,156) of 57 LTCFs. Information on insomnia, age, sex, activities of daily living (ADLs), cognitive status, depression, major stressful life events, physical activity, fatigue, pain, and sleep medication use was extracted from the International Resident Assessment Instrument (interRAI)LTCF instrument. Rates of insomnia and its correlates were analyzed. Multivariate logistic regression was used to assess factors associated with insomnia, controlling for demographic variables. The prevalence of insomnia was 24% (range 13-30%), with significant differences between countries (P < .001). More insomnia complaints were reported in older than younger residents (P < .001). Higher rates of insomnia were associated with hypnosedatives and depression in all countries (P < .001) and with stressful life events, fatigue, and pain in most countries (P < .001). No associations were found between insomnia and ADLs, physical activity, or cognitive status. Age, depression, stressful life events, fatigue, pain and hypnosedatives were independent significant predictors of insomnia, controlling for all other variables and for country. Hypnosedatives and depression were strong predictors of insomnia beyond cultural differences. Overall, psychosocial variables were more strongly related to insomnia than functional and mental capacities. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Management Approach for Earth Venture Instrument

NASA Technical Reports Server (NTRS)

Hope, Diane L.; Dutta, Sanghamitra

2013-01-01

The Earth Venture Instrument (EVI) element of the Earth Venture Program calls for developing instruments for participation on a NASA-arranged spaceflight mission of opportunity to conduct innovative, integrated, hypothesis or scientific question-driven approaches to pressing Earth system science issues. This paper discusses the EVI element and the management approach being used to manage both an instrument development activity as well as the host accommodations activity. In particular the focus will be on the approach being used for the first EVI (EVI-1) selected instrument, Tropospheric Emissions: Monitoring of Pollution (TEMPO), which will be hosted on a commercial GEO satellite and some of the challenges encountered to date and corresponding mitigations that are associated with the management structure for the TEMPO Mission and the architecture of EVI.

[Ultrasonic scissors. New vs resterilized instruments].

PubMed

Gärtner, D; Münz, K; Hückelheim, E; Hesse, U

2008-02-01

The aim of this study was to compare reliability in handling and function of resterilized and single-use disposable ultrasonic scissors. In a prospective randomized study, the surgeon blindly tested new and resterilized ultrasonographic scissors. The parameters were force of activation, cutting effect, coagulation effect, error messages, and disturbing generator noise. Fifty-one new and 49 resterilized instruments in 94 operations were evaluated. The differences in force of activation, cutting effect, and coagulation were not significant. Error messages and disturbing noises were rare in both groups. Six new instruments and two resterilized instruments had to be exchanged because of problems during surgery. This study demonstrates comparable reliability in function and handling of resterilized and new ultrasonic scissors. The use of resterilized instruments leads to distinctly reduced costs and could contribute to efficiency in laparoscopic surgery.

Antimicrobial Activity of Photodynamic Therapy Against Enterococcus faecalis Before and After Reciprocating Instrumentation in Permanent Molars.

PubMed

Pinheiro, Sérgio Luiz; Azenha, Giuliana Rodrigues; Democh, Yasmin Marialva; Nunes, Daniela Camila; Provasi, Silvia; Fontanetti, Giovana Masiero; Duarte, Danilo Antônio; Fontana, Carlos Eduardo; da Silveira Bueno, Carlos Eduardo

2016-12-01

The present study sought to evaluate the antimicrobial activity against Enterococcus faecalis of photodynamic therapy applied before and after reciprocating instrumentation of permanent molars. Apical extrusion of debris can cause flare-ups due to introduction of bacteria into the periapical tissues. Eighteen mesial roots from permanent mandibular molars were selected. The crowns were removed to obtain a standard root length of 15 mm. The included mesial roots had an angulation of 10°-40° and canals with independent foramina. The orifice of each mesiolingual canal was sealed with light-curing resin, and the working length was established visually, 1 mm short of the apical foramen. The roots were rendered impermeable and sterilized, and the mesiobuccal canals were contaminated with a standard strain of E. faecalis for 21 days. Specimens were randomly divided into three groups (n = 6): G1, photodynamic therapy performed before instrumentation and irrigation with 0.9% NaCl (saline) solution; G2, photodynamic therapy performed after instrumentation and irrigation with 0.9% NaCl; and G3 (control), instrumentation and irrigation with 2.5% NaOCl (sodium hypochlorite) solution. Canals were shaped with a WaveOne primary file (25.08) and irrigated with 0.9% NaCl. E. faecalis samples were collected before and after each procedure, and the results were analyzed using descriptive statistics and the Kruskal-Wallis and Wilcoxon tests. Significant reductions in E. faecalis were observed when photodynamic therapy was performed before and after instrumentation of the root canal system (p < 0.05). Reciprocating instrumentation significantly reduced E. faecalis colonies in experimentally contaminated root canal systems (p < 0.05). Photodynamic therapy was effective in removing E. faecalis from the root canal system, whether performed before or after reciprocating instrumentation.

Instrumental neutron activation analysis for studying size-fractionated aerosols

NASA Astrophysics Data System (ADS)

Salma, Imre; Zemplén-Papp, Éva

1999-10-01

Instrumental neutron activation analysis (INAA) was utilized for studying aerosol samples collected into a coarse and a fine size fraction on Nuclepore polycarbonate membrane filters. As a result of the panoramic INAA, 49 elements were determined in an amount of about 200-400 μg of particulate matter by two irradiations and four γ-spectrometric measurements. The analytical calculations were performed by the absolute ( k0) standardization method. The calibration procedures, application protocol and the data evaluation process are described and discussed. They make it possible now to analyse a considerable number of samples, with assuring the quality of the results. As a means of demonstrating the system's analytical capabilities, the concentration ranges, median or mean atmospheric concentrations and detection limits are presented for an extensive series of aerosol samples collected within the framework of an urban air pollution study in Budapest. For most elements, the precision of the analysis was found to be beyond the uncertainty represented by the sampling techniques and sample variability.

A system for activity recognition using multi-sensor fusion.

PubMed

Gao, Lei; Bourke, Alan K; Nelson, John

2011-01-01

This paper proposes a system for activity recognition using multi-sensor fusion. In this system, four sensors are attached to the waist, chest, thigh, and side of the body. In the study we present two solutions for factors that affect the activity recognition accuracy: the calibration drift and the sensor orientation changing. The datasets used to evaluate this system were collected from 8 subjects who were asked to perform 8 scripted normal activities of daily living (ADL), three times each. The Naïve Bayes classifier using multi-sensor fusion is adopted and achieves 70.88%-97.66% recognition accuracies for 1-4 sensors.

Temperature performance of portable radiation survey instruments used for environmental monitoring and clean-up activities in Fukushima

NASA Astrophysics Data System (ADS)

Saegusa, Jun; Yanagisawa, Kayo; Hasumi, Atsushi; Shimizu, Takenori; Uchita, Yoshiaki

2017-08-01

Following the Fukushima Dai-ichi Nuclear Power Plant accident in March 2011, extensive radiation monitoring and environmental clean-up activities have been conducted throughout the Fukushima region. Outside air temperatures there reach 40 °C in summer and -20 °C in winter, which are beyond the quoted operational range of many radiation survey instruments. Herein, temperature performance of four types of portable Japanese radiation survey instruments widely used in Fukushima was experimentally investigated using a temperature-controlled chamber. They included two ionization chamber type instruments, Fuji NHA1 and Aloka ICS-323C, and two NaI(Tl) scintillation type ones, Fuji NHC7 and Aloka TCS-172B. Experimental results showed significantly diverse characteristics on the temperature dependences from one type of instrument to another. For example, NHA1 overestimated the ambient dose-equivalent rate by as much as 17% at -30 °C and 10% at 40 °C, whereas the TCS-172B readings underestimated the rate by 30% at -30 °C and 7% at 40 °C.

[Relationship between status of physical and mental function and quality of life among the elderly people admitted from long-term care insurance].

PubMed

Kim, Hyeong Seon; Bae, Nam Kyou; Kwon, In Sun; Cho, Young Chae

2010-07-01

This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. The mean scores of QOL among all the subjects was 55.4 ± 15.62 (Grade I: 49.7 ± 14.17, Grade II: 56.8 ± 14.62, Grade III: 59.4 ± 16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning

Family Caregiver Factors Associated with Unmet Needs for Care of Older Adults.

PubMed

Beach, Scott R; Schulz, Richard

2017-03-01

To examine caregiver factors associated with unmet needs for care of older adults. Population-based surveys of caregivers and older adult care recipients in the United States in 2011. 2011 National Health and Aging Trends Study and National Study of Caregiving. Family caregivers (n = 1,996) of community-dwelling older adults with disabilities (n = 1,366). Disabled care recipient reports of unmet needs for care in the past month with activities of daily living (ADLs; e.g., wet or soiled clothing), mobility (e.g., have to stay inside), or instrumental activities of daily living (IADLs; e.g., medication errors). Caregiver reported sociodemographic characteristics, caregiving intensity and tasks performed, health, and psychosocial effects. Of the care recipients, 44.3% reported at least one unmet need for care in the past month (38.2% ADL related, 14.6% IADL related). Younger caregivers, caregiving sons, caregivers not living with care recipients, and having supplemental paid caregivers were associated with more unmet needs. Caregivers with recipients reporting two or more unmet needs were more likely to spend more than 100 hours per month caregiving, help with skin care and wounds, report caregiving as emotionally and physically difficult, and report restricted participation in valued activities (all P < .001). Unmet ADL needs are prevalent among older adults with family caregivers. Caregivers experiencing high levels of burden, stress, and negative physical and psychosocial impacts may provide substandard or poor care to older adults, which may be a risk factor for neglect. Clinicians caring for disabled older adults should assess their unmet needs and the capacity of caregivers to address them. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Active Neutron and Gamma Ray Instrumentation for In Situ Planetary Science Applications

NASA Technical Reports Server (NTRS)

Parsons, A.; Bodnarik, J.; Evans, L.; Floyd, S.; Lim, L.; McClanahan, T.; Namkung, M.; Schweitzer, J.; Starr, R.; Trombka, J.

2010-01-01

The Pulsed Neutron Generator-Gamma Ray And Neutron Detectors (PNG-GRAND) experiment is an innovative application of the active neutron-gamma ray technology so successfully used in oil field well logging and mineral exploration on Earth. The objective of our active neutron-gamma ray technology program at NASA Goddard Space Flight Center (NASA-GSFC) is to bring the PNG-GRAND instrument to the point where it can be flown on a variety of surface lander or rover missions to the Moon, Mars, Menus, asteroids, comets and the satellites of the outer planets. Gamma-Ray Spectrometers (GRS) have been incorporated into numerous orbital planetary science missions and, especially its the case of the Mars Odyssey GRS, have contributed detailed maps of the elemental composition over the entire surface of Mars. However, orbital gamma ray measurements have low spatial sensitivity (100's of km) due to their low surface emission rates from cosmic rays and subsequent need to be averaged over large surface areas. PNG-GRAND overcomes this impediment by incorporating a powerful neutron excitation source that permits high sensitivity surface and subsurface measurements of bulk elemental compositions. PNG-GRAND combines a pulsed neutron generator (PNG) with gamma ray and neutron detectors to produce a landed instrument to determine subsurface elemental composition without needing to drill into a planet's surface a great advantage in mission design. We are currently testing PNG-GRAND prototypes at a unique outdoor neutron instrumentation test facility recently constructed at NASA/GSFC that consists of a 2 m x 2 in x 1 m granite structure placed outdoors in an empty field. Because an independent trace elemental analysis has been performed on the material, this granite sample is a known standard with which to compare both Monte Carlo simulations and our experimentally measured elemental composition data. We will present data from operating PNG-GRAND in various experimental configurations on a

Examining the Effects of Video Modeling and Prompts to Teach Activities of Daily Living Skills.

PubMed

Aldi, Catarina; Crigler, Alexandra; Kates-McElrath, Kelly; Long, Brian; Smith, Hillary; Rehak, Kim; Wilkinson, Lisa

2016-12-01

Video modeling has been shown to be effective in teaching a number of skills to learners diagnosed with autism spectrum disorders (ASD). In this study, we taught two young men diagnosed with ASD three different activities of daily living skills (ADLS) using point-of-view video modeling. Results indicated that both participants met criterion for all ADLS. Participants did not maintain mastery criterion at a 1-month follow-up, but did score above baseline at maintenance with and without video modeling. • Point-of-view video models may be an effective intervention to teach daily living skills. • Video modeling with handheld portable devices (Apple iPod or iPad) can be just as effective as video modeling with stationary viewing devices (television or computer). • The use of handheld portable devices (Apple iPod and iPad) makes video modeling accessible and possible in a wide variety of environments.

Weather Instruments.

ERIC Educational Resources Information Center

Brantley, L. Reed, Sr.; Demanche, Edna L.; Klemm, E. Barbara; Kyselka, Will; Phillips, Edwin A.; Pottenger, Francis M.; Yamamoto, Karen N.; Young, Donald B.

This booklet presents some activities to measure various weather phenomena. Directions for constructing a weather station are included. Instruments including rain gauges, thermometers, wind vanes, wind speed devices, humidity devices, barometers, atmospheric observations, a dustfall jar, sticky-tape can, detection of gases in the air, and pH of…

Individual and contextual determinants of resident-on-resident abuse in nursing homes: a random sample telephone survey of adults with an older family member in a nursing home.

PubMed

Schiamberg, Lawrence B; von Heydrich, Levente; Chee, Grace; Post, Lori A

2015-01-01

Few empirical investigations of elder abuse in nursing homes address the frequency and determinants of resident-on-resident abuse (RRA). A random sample of 452 adults with an older adult relative, ≥65 years of age, in a nursing home completed a telephone survey regarding elder abuse experienced by that elder family member. Using a Linear Structural Relations (LISREL) modeling design, the study examined the association of nursing home resident demographic characteristics (e.g., age, gender), health and behavioral characteristics (e.g., diagnosis of Alzheimer's Disease, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), types of staff abuse (e.g., physical, emotional), and factors beyond the immediate nursing home setting (e.g., emotional closeness of resident with family members) with RRA. Mplus statistical software was used for structural equation modeling. Main findings indicated that resident-on-resident mistreatment of elderly nursing home residents is associated with the age of the nursing home resident, all forms of staff abuse, all ADLs and IADLs, and emotional closeness of the older adult to the family. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The importance of negative predictive value (NPV) of vulnerable elderly survey (VES 13) as a pre-screening test in older patients with cancer.

PubMed

Castagneto, B; Di Pietrantonj, C; Stevani, I; Anfossi, A; Arzese, M; Giorcelli, L; Giaretto, L

2013-12-01

The importance of prognostic value of the comprehensive geriatric assessment (CGA) is well known in geriatric oncology, but there is no consensus on the use of alternative abbreviated screening methods for the evaluation of older patient disabilities. The participants in this study underwent vulnerable elderly survey 13 (VES 13) at first entry in Oncology Department and were later assessed by a geriatrician according to CGA. A score >3 for VES 13 identified patients as vulnerable. Aim of this study was to evaluate the specificity, sensibility, positive predictive value (PPV), and negative predictive value (NPV) of VES 13 versus cumulative illness rating scale (CIRS), activities of daily living (ADL), instrumental activities of daily living (IADL), and short portable mental status questionnaire (SPMSQ). Hundred and seventeen patients (mean age 78.8 years) entered the study. The NPV of VES was 74.6% for CIRS, 90.1% for IADL, 93.0% for ADL, and 100% for SPMSQ. As for PPV, the VES 13 showed no accuracy. We can conclude that VES 13 demonstrated sufficient accuracy as a screening test in identifying elderly "fit" patients in order to spare the more time-consuming CGA.

Transcranial direct current stimulation (tDCS) for improving function and activities of daily living in patients after stroke.

PubMed

Elsner, Bernhard; Kugler, Joachim; Pohl, Marcus; Mehrholz, Jan

2013-11-15

Stroke is one of the leading causes of disability worldwide. Functional impairment resulting in poor performance in activities of daily living (ADLs) among stroke survivors is common. Current rehabilitation approaches have limited effectiveness in improving ADL performance and function after stroke, but a possible adjunct to stroke rehabilitation might be non-invasive brain stimulation by transcranial direct current stimulation (tDCS) to modulate cortical excitability and hence to improve ADL performance and function. To assess the effects of tDCS on generic activities of daily living (ADLs) and motor function in people with stroke. We searched the Cochrane Stroke Group Trials Register (March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, May 2013), MEDLINE (1948 to May 2013), EMBASE (1980 to May 2013), CINAHL (1982 to May 2013), AMED (1985 to May 2013), Science Citation Index (1899 to May 2013) and four additional databases. In an effort to identify further published, unpublished and ongoing trials, we searched trials registers and reference lists, handsearched conference proceedings and contacted authors and equipment manufacturers. We included only randomised controlled trials (RCTs) and randomised controlled cross-over trials (from which we analysed only the first period as a parallel-group design) that compared tDCS versus control in adults with stroke for improving ADL performance and function. Two review authors independently assessed trial quality (JM and MP) and extracted data (BE and JM). If necessary, we contacted study authors to ask for additional information. We collected information on dropouts and adverse events from the trial reports. We included 15 studies involving a total of 455 participants. Analysis of six studies involving 326 participants regarding our primary outcome, ADL, showed no evidence of an effect in favour of tDCS at the end of the intervention phase (mean difference (MD) 5.31 Barthel

The Effects of Quality of Life and Ability to Perform Activities of Daily Living on Mild Cognitive Impairment in Older People Living in Publicly Managed Congregate Housing.

PubMed

Chang, Chun-Feng; Yang, Rea-Jeng; Chang, Shu-Fang; Chou, Yuan Hwa; Huang, Ean-Wen

2017-06-01

Mild cognitive impairment (MCI) is characterized by a decrease in cognitive abilities that does not affect the ability to perform activities of daily living (ADLs). Therefore, this condition is easily overlooked. The prevalence and factors of influence for MCI in older people living in publicly managed congregate housing are currently unknown. This study investigated the prevalence and distribution of MCI in older people living in publicly managed congregate housing and assessed the correlations among quality of life (QoL), ADL, and MCI. This study applied a correlational study design. The participants were older people who met the study criteria and who lived in public housing in Wanhua District, Taipei City, Taiwan. One-on-one interviews were conducted to measure the cognitive abilities of the participants, and 299 valid samples were collected. The prevalence of MCI in older people living in publicly managed congregate housing was 16.1%. The χ test was employed to evaluate the distribution of MCI prevalence and indicated that the group with higher MCI prevalence exhibited the following characteristics: older than 81 years; married; lived in public housing for more than 20 years; cohabiting; had a history of drinking; and exhibited severe memory regression, physical disabilities, psychological distress, and low QoL. The difference between the groups achieved statistical significance (p < .05). After performing logistical regression analysis to control demographic variables, we found that QoL and ADL were critical for predicting MCI. This study confirmed that QoL and ADL correlate significantly with MCI in older people. Maintaining an open and supportive community enables older people to maintain sufficient mental activity, which has been shown to reduce MCI. These findings may provide an important reference for policy makers, educators, researchers, and community practitioners in their development of service strategies for older people.

Prevalence and Correlates of Functional Status in an Older Community-Representative Sample in Brazil

PubMed Central

Blay, Sergio L; Andreoli, Sergio B; Gastal, Fábio L

2013-01-01

Objective Information on dependency level of elderly in rapidly aging developing countries is limited, but is needed to ascertain extent of need for help with activities of daily living (ADLs). Methods In-person information was obtained in 1995 from a statewide survey of representative community residents ≥60 years of age in the state of Rio Grande do Sul, Brazil (N=7040), on demographic characteristics, health conditions, social ties, health behaviors, and ADL performance. Results Nearly 40% needed help with one or more ADLs. In controlled analyses, need for help approximately doubled with each succeeding decade. Increased education and income and regular physical activity reduced risk. Selected health conditions (stroke, depression, poor self-rated health) were consistently associated with need for help, Discussion A large proportion of noninstitutionalized elderly have ADL problems. In addition to health care, interventions promoting equity of access to education and economic opportunity could reduce ADL dependency in coming generations. PMID:20147651

The impact of extracurricular activities participation on youth delinquent behaviors: An instrumental variables approach.

PubMed

Han, Sehee; Lee, Jonathan; Park, Kyung-Gook

2017-07-01

The purpose of this study was to examine the association between extracurricular activities (EA) participation and youth delinquency while tackling an endogeneity problem of EA participation. Using survey data of 12th graders in South Korea (n = 1943), this study employed an instrumental variables approach to address the self-selection problem of EA participation as the data for this study was based on an observational study design. We found a positive association between EA participation and youth delinquency based on conventional regression analysis. By contrast, we found a negative association between EA participation and youth delinquency based on an instrumental variables approach. These results indicate that caution should be exercised when we interpret the effect of EA participation on youth delinquency based on observational study designs. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

From burden to depressive symptoms: the case of Chinese-Canadian family caregivers for the elderly.

PubMed

Lai, Daniel W L

2009-01-01

This study aims to understand the effect of caregiving burden on depressive symptoms in Chinese-Canadian family caregivers, an area on which little research has been conducted. A random sample of 339 Chinese-Canadian caregivers for elderly family members completed a structured telephone survey. The results showed that depressive symptoms were predicted positively by caregiving burden, while caregiving burden was predicted negatively by financial adequacy and positively by the level of activities of daily living (ADL) and instrumental activities of daily living (IADL) caregiving assistance provided. Culturally appropriate strategies are needed to support Chinese family caregivers in order to properly manage caregiving responsibilities, financial needs, and psychological burden.

Factors associated with functional incapacity in elders living in long stay institutions in Brazil: a cross-sectional study.

PubMed

Mattos, Inês Echenique; do Carmo, Cleber Nascimento; Santiago, Lívia Maria; Luz, Laércio Lima

2014-04-15

The increase of the elderly population and the high prevalence of chronic diseases have contributed to the increasing importance of functional ability as a global public health problem. This study aimed to assess functional capacity in institutionalized elders, as well as undertake an exploratory analysis of its associated factors. This is a cross-sectional study with institutionalized Brazilian elders. Functional capacity was assessed using the Katz Index for Activities of Daily Living (ADL) and the Lawton Scale for Instrumental Activities of Daily Living (IADL). The characteristics of dependent individuals were described and logistic regression models were developed for both scales. Multiple models that included all selected variables were developed using a hierarchical approach. We considered the results from the Wald test (p <0.05) as a rule for progressing to the next level. A population of 760 elders was considered. The prevalence of dependence was 50.3% for ADL and 81.2% for IADL. We observed associations between ADL dependence and the following factors: self-report of stroke, difficulty of walking 400 meters, lower total scores in questions related to the temporal orientation section of the cognition test, and self-reports of frequently feeling upset. IADL dependence was associated with educational level, self-report of cancer, difficulty of walking 400 meters, use of glasses, and self-reported memory problems. Sociodemographic and health conditions were associated with functional incapacity in institutionalized elders. Based on these findings, we emphasize the importance of both prevention and treatment of chronic conditions as well as social support in the maintenance of individuals' autonomy.

Geriatric assessment of older patients with cancer in Australia--a multicentre audit.

PubMed

Lakhanpal, Roopa; Yoong, Jaclyn; Joshi, Sachin; Yip, Desmond; Mileshkin, Linda; Marx, Gavin M; Dunlop, Tracey; Hovey, Elizabeth J; Della Fiorentina, Stephen A; Venkateswaran, Lakshmi; Tattersall, Martin H N; Liew, Sem; Field, Kathryn; Singhal, Nimit; Steer, Christopher B

2015-05-01

The aim of this study is to determine the frequency of geriatric assessment in patients aged over 70 years in Australian medical oncology clinics. This was a multicentre audit in two parts: a retrospective file review of initial consultations with an oncologist and prospective audit of case presentations at multidisciplinary meetings (MDMs). Patients aged over 70 years presenting to a medical oncology clinic or being discussed at an MDM were eligible. Data was collected at six oncology centres in Victoria, NSW and Canberra from October 2009 to March 2010. Data was collected from 251 file reviews and 108 MDM discussions in a total of 304 patients. Median age was 76 years (range 70-95). The geriatric assessment (GA) domains most frequently assessed during an initial consultation were the presence of comorbidities (92%), social situation-living alone or with someone (80%), social supports (63%), any mention of at least one Activity of Daily Living (ADL) (50%) and performance status (49%). Less frequently assessed were any Instrumental Activity of Daily Living (IADL) (26%), presence of a geriatric syndrome (24%), polypharmacy (29%) and creatinine clearance (11%). Only one patient had all components of ADLs and IADLs assessed. During MDMs all the geriatric domains were comparatively less frequently assessed. No patients had all ADL and IADL components discussed formally in an MDM. This is the first multicentre audit that reveals the low rates of GA in Australian medical oncology practice and describes the GA domains considered important by oncology clinicians. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessing Human Activity in Elderly People Using Non-Intrusive Load Monitoring

PubMed Central

Alcalá, José M.; Ureña, Jesús; Hernández, Álvaro; Gualda, David

2017-01-01

The ageing of the population, and their increasing wish of living independently, are motivating the development of welfare and healthcare models. Existing approaches based on the direct heath-monitoring using body sensor networks (BSN) are precise and accurate. Nonetheless, their intrusiveness causes non-acceptance. New approaches seek the indirect monitoring through monitoring activities of daily living (ADLs), which proves to be a suitable solution. ADL monitoring systems use many heterogeneous sensors, are less intrusive, and are less expensive than BSN, however, the deployment and maintenance of wireless sensor networks (WSN) prevent them from a widespread acceptance. In this work, a novel technique to monitor the human activity, based on non-intrusive load monitoring (NILM), is presented. The proposal uses only smart meter data, which leads to minimum intrusiveness and a potential massive deployment at minimal cost. This could be the key to develop sustainable healthcare models for smart homes, capable of complying with the elderly people’ demands. This study also uses the Dempster-Shafer theory to provide a daily score of normality with regard to the regular behavior. This approach has been evaluated using real datasets and, additionally, a benchmarking against a Gaussian mixture model approach is presented. PMID:28208672

Functional Independence in Late-Life: Maintaining Physical Functioning in Older Adulthood Predicts Daily Life Function after Age 80

PubMed Central

Leng, Xiaoyan; La Monte, Michael J.; Tindle, Hilary A.; Cochrane, Barbara B.; Shumaker, Sally A.

2016-01-01

Abstract Background. We examined physical functioning (PF) trajectories (maintaining, slowly declining, and rapidly declining) spanning 15 years in older women aged 65–80 and protective factors that predicted better current levels and less decline in functional independence outcomes after age 80. Methods. Women’s Health Initiative extension participants who met criteria (enrolled in either the clinical trial or observational study cohort, >80 years at the data release cutoff, PF survey data from initial enrollment to age 80, and functional independence survey data after age 80) were included in these analyses (mean [ SD ] age = 84.0 [1.4] years; N = 10,478). PF was measured with the SF-36 (mean = 4.9 occasions). Functional independence was measured by self-reported level of dependence in basic and instrumental activities of daily living (ADLs and IADLs) (mean = 3.4 and 3.3 occasions). Results. Maintaining consistent PF in older adulthood extends functional independence in ADL and IADL in late-life. Protective factors shared by ADL and IADL include maintaining PF over time, self-reported excellent or very good health, no history of hip fracture after age 55, and no history of cardiovascular disease. Better IADL function is uniquely predicted by a body mass index less than 25 and no depression. Less ADL and IADL decline is predicted by better self-reported health, and less IADL decline is uniquely predicted by having no history of hip fracture after age 55. Conclusions. Maintaining or improving PF and preventing injury and disease in older adulthood (ages 65–80) has far-reaching implications for improving late-life (after age 80) functional independence. PMID:26858328

Examining Success of Communication Strategies Used by Formal Caregivers Assisting Individuals with Alzheimer's Disease during an Activity of Daily Living

ERIC Educational Resources Information Center

Wilson, Rozanne; Rochon, Elizabeth; Mihailidis, Alex; Leonard, Carol

2012-01-01

Purpose: To examine how formal (i.e., employed) caregivers' use verbal and nonverbal communication strategies while assisting individuals with moderate to severe Alzheimer's disease (AD) during the successful completion of an activity of daily living (ADL). Based on the literature, the authors hypothesized that caregivers' use of 1 proposition,…

Functional Assessment of Region-Specific Neglect: Are There Differential Behavioural Consequences of Peripersonal versus Extrapersonal Neglect?

PubMed Central

Nijboer, T. C. W.; ten Brink, A. F.; Kouwenhoven, M.; Visser-Meily, J. M. A.

2014-01-01

Background. Region-specific types of neglect (peripersonal and extrapersonal) have been dissociated, yet, differential behavioural consequences are unknown. Objective. The aim of the current study was to investigate behavioural consequences at the level of basic activities of daily living of region-specific neglect, using the Catherine Bergego Scale (CBS). Methods. 118 stroke patients were screened within the first two weeks after admission to the rehabilitation center for inpatient rehabilitation. Results. Patients with peripersonal neglect and patients with neglect for both regions had significantly higher total score on the CBS compared to nonneglect patients. Total scores for patients with extrapersonal neglect were comparable to non-neglect patients. ADL impairments were found across activities (e.g., looking towards one side, forgetting body parts, colliding) for both patients with peripersonal neglect and patients with neglect for both regions. Patients with extrapersonal neglect were only impaired on the item on way finding. Conclusions. When diagnosing neglect, it is relevant to distinguish the type of region-specific neglect and, where needed, to adjust the rehabilitation program accordingly. As the CBS is not developed to typically measure ADL in extrapersonal neglect, it would be of importance to add other (instrumental) activities that heavily rely on processing information in farther space. PMID:24825959

Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study.

PubMed

Langlet, Ketty; Van Der Linden, Thierry; Launois, Claire; Fourdin, Caroline; Cabaret, Philippe; Kerkeni, Nadia; Barbe, Coralie; Lebargy, François; Deslée, Gaetan

2012-10-18

Mechanical ventilation (MV) is imperative in many forms of acute respiratory failure (ARF) in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL) score may help to predict the outcome of these patients. We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68%) or failure (group B n = 8, 32%). We investigated the correlation between the ADL score and the outcome and mortality. The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p < 0.01). Weaning was achieved in 76.5% of the cases with an ADL score ≥ 4 and in 23.5% of the cases with an ADL score < 4 (p < 0.05). Pulmonary function test, arterial blood gases collected during period of clinical stability and at admission and nutritional status were similar in both groups. The mortality, at six months, was 36%. The ADL score was a significant predictor of 6-month mortality (80 with an ADL score <4, 20 with an ADL score ≥4, p < 0.01). Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.

Utility of the Care Dependency Scale in predicting care needs and health risks of elderly patients admitted to a geriatric unit: a cross-sectional study of 200 consecutive patients.

PubMed

Doroszkiewicz, Halina; Sierakowska, Matylda; Muszalik, Marta

2018-01-01

The aim of the study was to evaluate the usefulness of the Polish version of the Care Dependency Scale (CDS) in predicting care needs and health risks of elderly patients admitted to a geriatric unit. This was a cross-sectional study of 200 geriatric patients aged ≥60 years, chronologically admitted to a geriatrics unit in Poland. The study was carried out using the Polish version of the CDS questionnaire to evaluate biopsychosocial needs and the level of care dependency. The mean age of the participating geriatric patients was 81.8±6.6. The mean result of the sum of the CDS index for all the participants was 55.3±15.1. Detailed analysis of the results of evaluation of the respondents' functional condition showed statistically significant differences in the levels of care dependency. Evaluation of the patients' physical performance in terms of the ability to do basic activities of daily living (ADL) and instrumental ADL (I-ADL) showed statistically significant differences between the levels of care dependency. Patients with high dependency were more often prone to pressure ulcers - 13.1±3.3, falls (87.2%), poorer emotional state - 6.9±3.6, mental function - 5.1±2.8, and more often problems with locomotion, vision, and hearing. The results showed that locomotive disability, depression, advanced age, and problem with vision and hearing are connected with increasing care dependency. CDS evaluation of each admitted geriatric patient enables us to predict the care needs and health risks that need to be reduced and the disease states to be improved. CDS evaluation should be accompanied by the use of other instruments and assessments to evaluate pressure ulcer risk, fall risk, and actions toward the improvement of subjective well-being, as well as correction of vision and hearing problems where possible and assistive devices for locomotion.

Examining success of communication strategies used by formal caregivers assisting individuals with Alzheimer's disease during an activity of daily living.

PubMed

Wilson, Rozanne; Rochon, Elizabeth; Mihailidis, Alex; Leonard, Carol

2012-04-01

To examine how formal (i.e., employed) caregivers' use verbal and nonverbal communication strategies while assisting individuals with moderate to severe Alzheimer's disease (AD) during the successful completion of an activity of daily living (ADL). Based on the literature, the authors hypothesized that caregivers' use of 1 proposition, closed-ended questions, and repetition would be of most benefit. Twelve caregiver-AD dyads participated in this observational study. Each dyad was videorecorded on 6 separate occasions while completing handwashing. Handwashing sessions were transcribed and systematically coded for the use of communication strategies during completion of the ADL. Caregiver-AD dyads successfully completed 90% of all handwashing sessions, and caregivers employed a variety of communication strategies. Consistent with our hypotheses, during successful task completion, caregivers most frequently provided individuals with AD with 1 direction or idea (i.e., proposition) at a time, closed-ended questions, and paraphrased repetition. Caregivers also frequently used encouraging comments and the resident's name during the task; however, use of these strategies was not correlated to task success rate. This study adds to the limited body of evidence supporting the use of specific communication strategies by caregivers assisting individuals with moderate to severe AD during successful completion of ADLs.

A New Active Space Radiation Instruments for the International Space Station, A-DREAMS

NASA Astrophysics Data System (ADS)

Uchihori, Yukio; Kodaira, Satoshi; Kitamura, Hisashi; Kobayashi, Shingo

For future space experiments in the International Space Station (ISS) or other satellites, radiation detectors, A-DREAMS (Active Dosimeter for Radiation Environment and Astronautic Monitoring in Space), using single or multiple silicon semi-conductor detectors have been developed. The first version of the detectors were produced and calibrated with particle accelerators. National Institute of Radiological Sciences has a medical heavy ion accelerator (HIMAC) for cancer therapy and a cyclotron accelerator. The detector was irradiated with high energy heavy ions and protons in HIMAC and the cyclotron and calibrated the energy resolution and linearity for deposited energies of these particles. We are planned to be going to use the new instrument in an international project, the new MATROSHKA experiment which is directed by members in the Institute of Bio-Medical Problem (IBMP) in Russia and German Space Center (DLR) in Germany. In the project, the dose distribution in human torso phantom will be investigated for several months in the ISS. For the project, a new type of the instruments is under development in NIRS and the current situation will be reported in this paper.

Cardiovascular instrumentation for spaceflight

NASA Technical Reports Server (NTRS)

Schappell, R. T.; Polhemus, J. T.; Ganiaris, N. J.

1976-01-01

The observation mechanisms dealing with pressure, flow, morphology, temperature, etc. are discussed. The approach taken in the performance of this study was to (1) review ground and space-flight data on cardiovascular function, including earlier related ground-based and space-flight animal studies, Mercury, Gemini, Apollo, Skylab, and recent bed-rest studies, (2) review cardiovascular measurement parameters required to assess individual performance and physiological alternations during space flight, (3) perform an instrumentation survey including a literature search as well as personal contact with the applicable investigators, (4) assess instrumentation applicability with respect to the established criteria, and (5) recommend future research and development activity. It is concluded that, for the most part, the required instrumentation technology is available but that mission-peculiar criteria will require modifications to adapt the applicable instrumentation to a space-flight configuration.

Psychometric Properties of the Arabic Version of the Summary of Diabetes Self-Care Activities Instrument.

PubMed

Sukkarieh-Haraty, Ola; Howard, Elizabeth

2016-01-01

Translation of instruments needs to ensure equivalence between the source and the target language to establish the psychometric properties of the translated version. The purpose of this study was to examine the psychometric properties of the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument. The 12-item English version of the SDSCA was translated into Arabic using back translation on a sample of 140 Lebanese participants with Type 2 diabetes. Construct validity was measured using exploratory factor analysis with varimax rotation. Multitrait scaling analysis was used to test for item convergent and discriminant validity based on item-scale correlations. Conceptual and content validity were examined by an expert panel in diabetes. Internal consistency reliability R was assessed using interitem correlations. The average interitem correlation for the four subscales ranged between--.05 for Diet and .66 for Glucose Testing. Factor analysis identified four factors which accounted for 60% of the variance. The preliminary results of Summary of Diabetes Self-Care Activities-Arabic Version (SDSCA-Ar) are comparable to the psychometric properties the original SDSCA. SDSCA-Ar is a valid measure of diabetes self-care in Lebanese patients with diabetes.

Spacecraft instrument technology and cosmochemistry

PubMed Central

McSween, Harry Y.; McNutt, Ralph L.; Prettyman, Thomas H.

2011-01-01

Measurements by instruments on spacecraft have significantly advanced cosmochemistry. Spacecraft missions impose serious limitations on instrument volume, mass, and power, so adaptation of laboratory instruments drives technology. We describe three examples of flight instruments that collected cosmochemical data. Element analyses by Alpha Particle X-ray Spectrometers on the Mars Exploration Rovers have revealed the nature of volcanic rocks and sedimentary deposits on Mars. The Gamma Ray Spectrometer on the Lunar Prospector orbiter provided a global database of element abundances that resulted in a new understanding of the Moon’s crust. The Ion and Neutral Mass Spectrometer on Cassini has analyzed the chemical compositions of the atmosphere of Titan and active plumes on Enceladus. PMID:21402932

Unconventional function of an Achaete-Scute homolog as a terminal selector of nociceptive neuron identity

PubMed Central

Masoudi, Neda; Tavazoie, Saeed; Glenwinkel, Lori; Ryu, Leesun; Kim, Kyuhyung

2018-01-01

Proneural genes are among the most early-acting genes in nervous system development, instructing blast cells to commit to a neuronal fate. Drosophila Atonal and Achaete-Scute complex (AS-C) genes, as well as their vertebrate orthologs, are basic helix-loop-helix (bHLH) transcription factors with such proneural activity. We show here that a C. elegans AS-C homolog, hlh-4, functions in a fundamentally different manner. In the embryonic, larval, and adult nervous systems, hlh-4 is expressed exclusively in a single nociceptive neuron class, ADL, and its expression in ADL is maintained via transcriptional autoregulation throughout the life of the animal. However, in hlh-4 null mutants, the ADL neuron is generated and still appears neuronal in overall morphology and expression of panneuronal and pansensory features. Rather than acting as a proneural gene, we find that hlh-4 is required for the ADL neuron to function properly, to adopt its correct morphology, to express its unusually large repertoire of olfactory receptor–encoding genes, and to express other known features of terminal ADL identity, including neurotransmitter phenotype, neuropeptides, ion channels, and electrical synapse proteins. hlh-4 is sufficient to induce ADL identity features upon ectopic expression in other neuron types. The expression of ADL terminal identity features is directly controlled by HLH-4 via a phylogenetically conserved E-box motif, which, through bioinformatic analysis, we find to constitute a predictive feature of ADL-expressed terminal identity markers. The lineage that produces the ADL neuron was previously shown to require the conventional, transient proneural activity of another AS-C homolog, hlh-14, demonstrating sequential activities of distinct AS-C-type bHLH genes in neuronal specification. Taken together, we have defined here an unconventional function of an AS-C-type bHLH gene as a terminal selector of neuronal identity and we speculate that such function could be

Quantitative Evaluation of Ion-implanted Arsenic in Silicon by Instrumental Neutron Activation Analysis

NASA Astrophysics Data System (ADS)

Takatsuka, Toshiko; Hirata, Kouichi; Kobayashi, Yoshinori; Kuroiwa, Takayoshi; Miura, Tsutomu; Matsue, Hideaki

2008-11-01

Certified reference materials (CRMs) of shallow arsenic implants in silicon are now under development at the National Metrology Institute of Japan (NMIJ). The amount of ion-implanted arsenic atoms is quantified by Instrumental Neutron Activation Analysis (INAA) using research reactor JRR-3 in Japan Atomic Energy Agency (JAEA). It is found that this method can evaluate arsenic amounts of 1015 atoms/cm2 with small uncertainties, and is adaptable to shallower dopants. The estimated uncertainties can satisfy the industrial demands for reference materials to calibrate the implanted dose of arsenic at shallow junctions.

The Instrument for the Observation of Teaching Activities (IOTA) and Alternative Approaches to Remediation of Teacher Weaknesses.

ERIC Educational Resources Information Center

Richardson, Donald C.; Hatley, Richard V.

1980-01-01

Comparing the effectiveness of different strategies for remediating teacher weaknesses, as measured by the Instrument for Observation of Teaching Activities (IOTA), 99 elementary and junior high school teachers were observed. The study revealed that combining IOTA feedback with structured inservice workshops focusing on narrow specific weaknesses…

Instrument-related Skin Disorders in Musicians.

PubMed

Patruno, Cataldo; Napolitano, Maddalena; La Bella, Serena; Ayala, Fabio; Balato, Nicola; Cantelli, Mariateresa; Balato, Anna

2016-01-01

Among artists, musicians may suffer from occupational skin problems; notwithstanding, these conditions have been rarely reviewed. The characteristics of individual performer and the type of instrument will determine the kind of disease. Moreover, the hours that the musician spent to advance artistic skill may influence the severity. The frequency and risk factors of instrument-related skin disorders in musicians from southern Italy were analyzed. An observational study was conducted in 628 musicians. A questionnaire including questions related to age, sex, instrument played, musical activity, previous or current skin disorders, and impact of skin symptoms on music making was submitted. Of 628 musicians, 199 (31.7%) reported suffering from at least 1 skin disease. Cutaneous diseases likely directly correlated with the use of the musical instrument were found in 129 (20.5%) of the 628 subjects. In particular, different patterns of irritant contact dermatitis were found. Skin conditions may be a significant problem in professional instrumentalists. They are mainly related to musical activity. Preventive measures should be established.

Organizational Member Involvement in Physical Activity Coalitions across the United States: Development and Testing of a Novel Survey Instrument for Assessing Coalition Functioning

ERIC Educational Resources Information Center

Bornstein, Daniel B.; Pate, Russell R.; Beets, Michael W.; Saunders, Ruth P.; Blair, Steven N.

2015-01-01

Introduction: Coalitions are often composed of member organizations. Member involvement is thought to be associated with coalition success. No instrument currently exists for evaluating organizational member involvement in physical activity coalitions. This study aimed to develop a survey instrument for evaluating organizational member involvement…

Wideband Instrument for Snow Measurements (WISM)

NASA Technical Reports Server (NTRS)

Miranda, Felix A.; Lambert, Kevin M.; Romanofsky, Robert R.; Durham, Tim; Speed, Kerry; Lange, Robert; Olsen, Art; Smith, Brett; Taylor, Robert; Schmidt, Mark;

Gyroscopic Instruments for Instrument Flying

NASA Technical Reports Server (NTRS)

Brombacher, W G; Trent, W C

1938-01-01

The gyroscopic instruments commonly used in instrument flying in the United States are the turn indicator, the directional gyro, the gyromagnetic compass, the gyroscopic horizon, and the automatic pilot. These instruments are described. Performance data and the method of testing in the laboratory are given for the turn indicator, the directional gyro, and the gyroscopic horizon. Apparatus for driving the instruments is discussed.