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Sample records for adults living independently

  1. How Adults with Learning Disabilities View Living Independently

    ERIC Educational Resources Information Center

    Bond, Rebecca J.; Hurst, Jenni

    2010-01-01

    It is seen as increasingly important for people with learning disabilities to be supported to live independently and manage their own self care, productivity and leisure activities. This qualitative study explored the experiences of nine adults with mild learning disabilities who lived alone with minimal support. Their narratives were analysed…

  2. Independent Living.

    ERIC Educational Resources Information Center

    Nathanson, Jeanne H., Ed.

    1994-01-01

    This issue of "OSERS" addresses the subject of independent living of individuals with disabilities. The issue includes a message from Judith E. Heumann, the Assistant Secretary of the Office of Special Education and Rehabilitative Services (OSERS), and 10 papers. Papers have the following titles and authors: "Changes in the…

  3. Skill Activities for Independent Living (SAIL). A Curriculum for Developmentally Disabled Adolescents and Adults.

    ERIC Educational Resources Information Center

    California State Univ., Los Angeles. Center for Mental Retardation.

    This curriculum for developmentally disabled adolescents and adults contains assessment conditions and performance criteria for evaluating client acquisition of a total of 646 independent living skills in five areas. While the content of the curriculum is in an area known as independent living, it is also prevocational in as much as it covers a…

  4. Education, Employment, and Independent Living of Young Adults Who Are Deaf and Hard of Hearing

    ERIC Educational Resources Information Center

    Appelman, Karen I.; Callahan, Judy Ottren; Mayer, Margaret H.; Luetke, Barbara S.; Stryker, Deborah S.

    2012-01-01

    Little information is available on the education, employment, and independent living status of young deaf and hard of hearing adults who have transitioned from high school. The present article reports post-secondary outcomes of 46 young adults who had attended for at least 4 years a non-public agency school in the northwestern United States…

  5. Education, employment, and independent living of young adults who are deaf and hard of hearing.

    PubMed

    Appelman, Karen I; Callahan, Judy Ottren; Mayer, Margaret H; Luetke, Barbara S; Stryker, Deborah S

    2012-01-01

    Little information is available on the education, employment, and independent living status of young deaf and hard of hearing adults who have transitioned from high school. The present article reports postsecondary outcomes of 46 young adults who had attended for at least 4 years a non-public agency school in the northwestern United States specializing in deaf education. School administrators had developed a specific philosophy and operationalized it in an academic and literacy-based curriculum incorporating a grammatically accurate signing system. The researchers found that most or all participants had finished high school, had earned a college degree, were employed, and were living independently. Findings are discussed in terms of the available literature and the study's contribution to a limited body of recent research on young postsecondary deaf and hard of hearing adults.

  6. The Relationship between Autistic Symptomatology and Independent Living Skills in Adolescents and Young Adults with Fragile X Syndrome

    ERIC Educational Resources Information Center

    Hustyi, Kristin M.; Hall, Scott S.; Quintin, Eve-Marie; Chromik, Lindsay C.; Lightbody, Amy A.; Reiss, Allan L.

    2015-01-01

    Few studies have examined the relationship between autistic symptomatology and competence in independent living skills in adolescents and young adults with fragile X syndrome (FXS). In this study, 70 individuals with FXS, aged 15-25 years, and 35 matched controls were administered direct measures of independent living skills and autistic…

  7. Intra-couple Caregiving of Older Adults Living Apart Together: Commitment and Independence.

    PubMed

    De Jong Gierveld, Jenny

    2015-09-01

    Recently, rising numbers of mid-life and older adults are starting a "living apart together" (LAT) relationship following divorce or widowhood. LAT describes an intimate relationship wherein partners maintain separate households. This study investigated the characteristics of care arrangements in older long-term LAT couples and elicited personal comments about intra-couple care. We interviewed 25 LAT partners and a comparison group of 17 remarried older adults in the Netherlands in a side study of the Netherlands Kinship Panel Study. Results showed that about half of the LAT partners intended to exchange care if needed (partnership commitment); the other half had ambiguous feelings or intentions to refuse care (independence orientation). However, for those LAT partners already confronted with illness in their current relationship, all provided care to the partner in need. The minority of LAT partners who would not exchange care reciprocally are more likely to give as opposed to receive care.

  8. Peer-Mentored Preparedness (PM-Prep): A New Disaster Preparedness Program for Adults Living Independently in the Community

    ERIC Educational Resources Information Center

    Eisenman, David Paul; Bazzano, Alicia; Koniak-Griffin, Deborah; Tseng, Chi-hong; Lewis, Mary-Ann; Lamb, Kerry; Lehrer, Danise

    2014-01-01

    The authors studied a health promotion program called PM-Prep (Peer-Mentored Prep), which was designed to improve disaster preparedness among adults living independently in the community. PM-Prep consists of four 2-hour classes co-taught by a health educator and peer-mentors. Adults were randomly assigned to an experimental arm or a wait-list…

  9. Detection and Proportion of Very Early Dental Caries in Independent Living Older Adults

    PubMed Central

    Holtzman, Jennifer S.; Kohanchi, Daniel; Biren-Fetz, John; Fontana, Margherita; Ramchandani, Manisha; Osann, Kathryn; Hallajian, Lucy; Mansour, Stephanie; Nabelsi, Tasneem; Chung, Na Eun; Wilder-Smith, Petra

    2015-01-01

    Background and Objectives Dental caries is an important healthcare challenge in adults over 65 years of age. Integration of oral health screening into non-dental primary care practice may improve access to preventive dental care for vulnerable populations such as the elderly. Such integration would require easy, fast, and accurate early caries detection tools. Primary goal of this study was to evaluate the diagnostic performance of optical coherence tomography (OCT) imaging for detecting very early caries in the elderly living in community-based settings. The International Caries Detection and Assessment System (ICDAS) served as gold standard. Secondary goal of this study was to provide baseline prevalence data of very early caries lesions in independent living adults aged 65+ years. Materials and Methods Seventy-two subjects were recruited from three sites in Southern California: a retirement community, a senior health fair, and a convalescent hospital. Clinical examination was performed using the ICDAS visual criteria and this was followed by OCT imaging. The two-dimensional OCT images (B-scan) were analyzed with simple software. Locations with a log of back-scattered light intensity (BSLI) below 2.9 were scored as sound, and areas equaling or exceeding 2.9 BSLI were considered carious. Diagnostic performance of OCT imaging was compared with ICDAS score. Results OCT-based diagnosis demonstrated very good sensitivity (95.1%) and good specificity (85.8%). 54.7% of dentate subjects had at least one tooth with very early coronal caries. Conclusions Early coronal decay is prevalent in the unrestored pits and fissures of coronal surfaces of teeth in independent living adults aged 65+ years. Though OCT imaging coupled with a simple diagnostic algorithm can accurately detect areas of very early caries in community-based settings, existing devices are expensive and not well-suited for use by non-dental health care providers. Simple, inexpensive, fast, and accurate tools

  10. Independent Living: A Study of Rehabilitation of Physically Handicapped Adults Living in Foster Homes; Social Work Intervention in the Adaptation to Family Environment. Final Report.

    ERIC Educational Resources Information Center

    Young, Howard D.

    As an alternative to unnecessary inpatient care of adults with orthopedic disabilities, the Independent Living Project (ILP) placed persons who were institutionalized without need and persons who were living in the community under unsatisfactory circumstances in foster homes. Information is presented on the intake procedures, homefinding…

  11. TRAINING FOR INDEPENDENT LIVING, A COMMUNITY PROGRAM FOR SEVERELY RETARDED ADULTS. A THREE YEAR REPORT.

    ERIC Educational Resources Information Center

    TOBIAS, JACK

    AN OCCUPATIONAL DAY CENTER FOR MENTALLY RETARDED ADULTS WAS ESTABLISHED TO PROVIDE COMMUNITY SERVICES FOR RETARDED PERSONS WHO LIVE AT HOME AND, ALTHOUGH BEYOND SCHOOL AGE, ARE UNABLE TO PARTICIPATE IN SHELTERED WORKSHOP ACTIVITIES. THE STAFF INCLUDES A DIRECTOR, A SOCIAL WORKER, FIVE INSTRUCTORS, A TRAINING SUPERVISOR, AN OFFICE WORKER, AND A…

  12. Native American Independent Living.

    ERIC Educational Resources Information Center

    Clay, Julie Anna

    1992-01-01

    Examines features of independent living philosophy with regard to compatibility with Native American cultures, including definition or conceptualization of disability; self-advocacy; systems advocacy; peer counseling; and consumer control and involvement. Discusses an actualizing process as one method of resolving cultural conflicts and…

  13. Fine tuning recommendations for older adults with memory complaints: using the Independent Living Scales with the Dementia Rating Scale.

    PubMed

    Baird, Anne

    2006-12-01

    The purpose of this study was to describe how functional test performance changed as global cognitive functioning dropped, as well as to examine the relationship of demographic variables and depression with functional test results. We found that level of performance on the Independent Living Scales (ILS) correlated highly with Dementia Rating Scale (DRS) scores in 83 older adults presenting for clinical neuropsychological assessment, while correlations with demographic factors and depression were nonsignificant or modest. Based on DRS scores, we divided our sample into four groups: normal cognitive status, borderline cognitive impairment, likely mild dementia, and likely moderate dementia. ILS profiles of the borderline impairment and mild dementia groups were similar and reflected particularly poor performance on subscales tapping financial management and everyday memory. Individuals with likely moderate dementia were markedly impaired on all subscales.

  14. Caring about Independent Lives

    ERIC Educational Resources Information Center

    Christensen, Karen

    2010-01-01

    With the rhetoric of independence, new cash for care systems were introduced in many developed welfare states at the end of the 20th century. These systems allow local authorities to pay people who are eligible for community care services directly, to enable them to employ their own careworkers. Despite the obvious importance of the careworker's…

  15. Technology for Independent Living: Sourcebook.

    ERIC Educational Resources Information Center

    Enders, Alexandra, Ed.

    This sourcebook provides information for the practical implementation of independent living technology in the everyday rehabilitation process. "Information Services and Resources" lists databases, clearinghouses, networks, research and development programs, toll-free telephone numbers, consumer protection caveats, selected publications, and…

  16. Steps to Independent Living Series.

    ERIC Educational Resources Information Center

    Lobb, Nancy

    This set of six activity books and a teacher's guide is designed to help students from eighth grade to adulthood with special needs to learn independent living skills. The activity books have a reading level of 2.5 and address: (1) "How to Get Well When You're Sick or Hurt," including how to take a temperature, see a doctor, and use medicines…

  17. Oral conditions and dysphagia in Japanese, community-dwelling middle- and older- aged adults, independent in daily living

    PubMed Central

    Inui, Akinari; Takahashi, Ippei; Kurauchi, Sizuka; Soma, Yuki; Oyama, Toshiaki; Tamura, Yoshihiro; Noguchi, Takao; Murashita, Kouichi; Nakaji, Shigeyuki; Kobayashi, Wataru

    2017-01-01

    Purpose Prevention, early detection and effective rehabilitation of dysphagia are important issues to be considered in an aging society. Previous studies have shown conflicting findings regarding the association between dysphagia and its potential risk factors, including age, malnutrition, oral conditions, lifestyle and medical history. Herein, we assessed the prevalence and association of dysphagia with potential risk factors in 50- to 79-year-old adults dwelling in a community in Japan. Patients and methods In this study, there were 532 participants (185 males and 347 females). Participants who responded positively to the question “Do you sometimes choke on drinks/food such as tea and soup?” or those who presented with abnormal repetitive saliva swallowing test findings were diagnosed with dysphagia. The data collected from these participants included the following: number of teeth, occurrence of oral dryness, age, body mass index, serum albumin concentration, smoking, drinking and exercise habits, presence of diseases, such as diabetes mellitus and hypertension, and questions from the Mini–Mental State Examination. Results Dysphagia was observed in 33 males (17.8%) and 76 females (21.9%). To explore the effect of the potential risk factors on the prevalence of dysphagia, a model was built by multivariate logistic regression analysis. Using the forced entry method, oral dryness (odds ratio [OR] =3.683 and P=0.003 in males; OR =1.797 and P=0.032 in females) and the number of teeth (OR =0.946 and P=0.038 in males) were found to be significantly related to dysphagia. Conclusion This cross-sectional study demonstrated associations between oral conditions and dysphagia. Factors such as oral dryness and number of teeth may contribute to dysphagia more so than aging, lifestyle and comorbidity in community-dwelling adults over the age of 50. PMID:28352164

  18. Assessing older persons' readiness to move to independent congregate living.

    PubMed

    Rossen, Eileen K

    2007-01-01

    Older adults are increasingly choosing to relocate to congregate-type independent living communities. Relocation to an independent living community is a late-life transition that is considered a stressful life event. Although relocation to an independent living community offers potential benefits, many older persons have difficulties during this transition, including poor adjustment, loneliness, and depression. All of these are associated with poorer health, higher healthcare costs, increased risk of institutionalization, and increased morbidity and mortality. This article provides guidelines for assessing the readiness of an older person to move to an independent living community and implications for advanced practice nurses whose role encompasses promoting the health and well-being of older adults. Using the assessment guidelines, the advanced practice nurse can identify older persons at risk for difficulty during relocation and intervene with guidance and strategies to promote positive relocation adjustment.

  19. The Independent Living Behavior Checklist: Experimental Edition.

    ERIC Educational Resources Information Center

    Walls, Richard T.; And Others

    The document describes independent living skills, and provides information on how they can be measured. It is explained in an introductory chapter that the checklist is an extensive list of 343 independent living skill objectives specified in terms of conditions (antecedents or givens), behaviors, and standards. Objectives are classified and…

  20. Prompting Sequences in Teaching Independent Living Skills.

    ERIC Educational Resources Information Center

    Walls, Richard T.; And Others

    1981-01-01

    The effects of three prompting sequences on the acquisition of independent living skills with 14 mild and moderately mentally retarded vocational rehabilitation clients (16 to 50 years old) are examined. (Author)

  1. 38 CFR 21.6160 - Independent living services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... independent living services which may be furnished include: (1) Training in independent living skills; (2) Health management programs; (3) Identification of appropriate housing accommodations; and (4)...

  2. An intervention to help older adults maintain independence safely.

    PubMed

    Ganong, Lawrence H; Coleman, Marilyn; Benson, Jacquelyn J; Snyder-Rivas, Linley A; Stowe, James D; Porter, Eileen J

    2013-05-01

    Older adults who live alone are at risk for problems (e.g., falling, sudden illness). To maintain themselves safely at home they may benefit from planning to prevent problems. The purpose of this study was to evaluate an intervention designed to train family members or friends as to how to help older adults who were living alone make plans to maintain independence safely in their homes and to make behavioral and household changes to enhance safety. Support network members of 19 older adults randomly assigned to the intervention group were taught to use multiple segment vignettes to assist the older adults in creating plans for living safely. Older adults in the control group (n = 21) were asked to engage in an unstructured discussion about home safety with their network members. Older adults in the intervention group developed safer plans and made more household and behavioral changes than did control group adults.

  3. Independent Living Training. A Guide to Programming. Volume I [and] Volume II.

    ERIC Educational Resources Information Center

    Timmins, Tippy; And Others

    Information on curriculum offerings and program planning and administration of a community-based work and living program for deaf-blind and other severely disabled adolescents and young adults is presented in two volumes. Volume I, an administrative manual independently titled "Community Based Training. Work and Independent Living Training for…

  4. Student Problems. Adult Literacy Independent Learning Packet.

    ERIC Educational Resources Information Center

    Koefer, Ann M.

    This independent learning packet, which is designed for administrators, teachers, counselors, and tutors in Pennsylvania's Region 7 Tri-Valley Literacy Staff Development area as well as for their adult students, examines the following seven problems encountered by students: the job market, child care, single parenting/parenting skills, divorce,…

  5. 38 CFR 21.160 - Independent living services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... independent living services is to assist eligible veterans whose ability to function independently in family, community, or employment is so limited by the severity of disability (service and nonservice-connected) that... others, to live and function within the veteran's family and community. (Authority: 38 U.S.C. 3101(2))...

  6. The Independent Living Movement in Asia: Solidarity from Japan

    ERIC Educational Resources Information Center

    Hayashi, Reiko; Okuhira, Masako

    2008-01-01

    Independent living movements of disabled people are emerging in Asian countries, supported by independent living centres (ILCs) in Japan. A study was conducted in Japan to explore the impact of the training program offered by Japanese ILCs to disabled people from other Asian countries. A sample of 35 people was selected by a snowballing method.…

  7. Adult and Family Living. Teacher Edition.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This curriculum guide for teachers is designed for use with 11th- and 12th-grade students who have had no more than 1 year of vocational home economics. It focuses on providing young adults with the knowledge and skills they need for healthy and positive adult and family lives. It includes 27 units in 8 sections as follows: (1) personal…

  8. Good Ideas for Teaching Daily Adult Living.

    ERIC Educational Resources Information Center

    Leigh, Robert K.

    Intended for practicing Adult Basic Education teachers, this handbook provides materials for teaching specific coping skills in the area of daily adult living. Three areas of study are explored: (1) community, which includes organizations, health, nutrition, safety, money management, and media; (2) government and law, which includes citizenship,…

  9. 38 CFR 21.90 - Individualized independent living plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... independent in daily living within the family and community. (Authority: 38 U.S.C. 3109, 3120) (b) Elements of the plan. The IILP shall follow the same structure as the IWRP. The plan will include: (1)...

  10. Independent Living Evaluation-Training Program. Reprint Series No. 16.

    ERIC Educational Resources Information Center

    Van Soest, Eileen; And Others

    Intended to be used both as a guide for general program direction and as an individual evaluation and training tool this rehabilitation training guide includes materials and evaluation devices for use with mentally and/or physically handicapped clients on basic, intermediate and advanced living center levels. The eight independent living skill…

  11. Older adult drivers living in residential care facilities

    PubMed Central

    Lum, Hillary D.; Ginde, Adit A.; Betz, Marian E.

    2015-01-01

    Residential care facilities (RCF) provide assistance to older adults who cannot live independently, but it is unclear whether these residents have retired from driving. Here, we characterize older adults living in RCFs who still drive from a national cross-sectional survey of residents (2010 National Survey of Residential Care Facilities), representing ~733,000 adults living in RCFs such as assisted living facilities and personal care homes. Key resident characteristics were health, function, mobility and community activity indicators, which could be associated with increased driving risk. Of 8,087 residents, 4.5% (95%CI=3.9-5.1) were current drivers. Many drivers were older than 80 years (74%, 95%CI=67-79), in very good health (31%, 95%CI=25-38) or good health (35%, 95%CI=29-42), and had a median of two medical conditions. Most were independent with activities of daily living, though some needed assistance with walking and used gait devices. Given these results, RCF staff and healthcare providers need a heightened awareness of factors associated with driving risk to promote safety of older drivers and provide resources for likely transition to other transportation. PMID:26366125

  12. Independent Living & Disability Policy in the Netherlands: Three Models of Residential Care & Independent Living. Monograph Number Twenty-Seven.

    ERIC Educational Resources Information Center

    DeJong, Gerben

    The monograph examines the way in which the Netherlands' three-part system of residential care and independent living (IL) for people with physical disabilities interacts with the country's health and social welfare systems. The three-part system comprises: the residential center model, the clustered housing model, and the independent housing…

  13. The Managing Independent Living Program and the Development of Reasoning Processes.

    ERIC Educational Resources Information Center

    Thomas, Ruth G.

    The Managing Independent Living Program provides instruction in reasoning skills to analyze career and life planning, housing, and consumer needs of persons in transition. Although the program was implemented and tested with adult female offenders, it is readily adaptable to both institutionalized and noninstitutionalized persons and for secondary…

  14. The Summary of Performance as Transition "Passport" to Employment and Independent Living

    ERIC Educational Resources Information Center

    Kochhar-Bryant, Carol A.

    2007-01-01

    Individuals with moderate to significant disabilities experience the most serious challenges in accessing employment and independent living when they exit high school. Therefore, the process of transition assessment conducted in school should be structured to provide relevant information for adult service providers and employers. For individuals…

  15. Predicting the stroke patient's ability to live independently.

    PubMed

    DeJong, G; Branch, L G

    1982-01-01

    The objective of this paper is to identify those variables that best predict a stroke patient's ability to live independently following his/her discharge from medical rehabilitation. The paper draws heavily on a formal research model grounded in independent living (IL) theory. Independent living is defined and operationalized as (1) the patient's ability to live in a nonrestrictive environment and (2) the patient's ability to live productively--not only in terms of gainful employment but also in terms of other contributions to community and family life. The main data source for the study is an extensive computer file of 84 stroke patients discharged from 8 medical rehabilitation centers. The multivariate statistical analysis indicates that 56 to 80 percent of the variance in a patient's ability to live independently can be explained or predicted mainly by the patient's marital status, age, Barthel score, communication impairments, and the ability to get into a motor vehicle. The paper concludes by discussing the implications of the findings for medical rehabilitation and public policy.

  16. Independent Living Services and the Educational Motivation of Foster Youth

    ERIC Educational Resources Information Center

    Eriamiatoe, Osarumen Rachel

    2011-01-01

    The purpose of this qualitative study was to examine the components of independent living training and services to determine their effectiveness in preparing foster youth in Tennessee for adulthood, and whether the youth's perceived effectiveness of these services affected their educational motivation. Support factors (i.e., family, financial,…

  17. Action Now for Older Americans: Toward Independent Living.

    ERIC Educational Resources Information Center

    Thorson, James A., Ed.

    The collection of conference papers given by representatives of State, Federal, and voluntary agencies, and university faculty, discusses information and planning strategies aimed at maximizing independent living for the elderly. Introductory and welcoming remarks by James A. Thorson, Virginia Smith, and Frank Groschelle are included along with…

  18. The Economics of Independent Living: Efficiency, Equity and Ethics.

    ERIC Educational Resources Information Center

    O'Shea, E.; Kennelly, B.

    1996-01-01

    This article explores the meaning of efficiency and equity in the context of independent living programs for people with disabilities. Conflicts in costs and trade-offs in various scenarios of the efficiency/equity equation are examined in terms of theories of utilitarianism, contractarianism, justice and mutual advantage, and justice as…

  19. Independent Living Training: A Student-Based Intervention Model.

    ERIC Educational Resources Information Center

    Rehabilitation Counseling Bulletin, 1982

    1982-01-01

    Describes a rehabilitation counselor training program, the Independent Living Project, that attempts to meet the needs of a community agency while simultaneously providing students with a paid work experience, direct client contact, and an opportunity to integrate the knowledge and skills learned in counselor education programs. (Author/RC)

  20. Technology-based innovation for independent living: policy and innovation in the United Kingdom, Scandinavia, and the United States.

    PubMed

    Berridge, Clara; Furseth, Peder Inge; Cuthbertson, Richard; Demello, Steven

    2014-01-01

    Interest in utilizing technology to help older adults remain living at home is growing; however, uptake remains low. We present a conceptual framework for understanding independent living technology innovation within health and social services. Public policy and innovation in the United States, the United Kingdom, and Scandinavia are profiled as case studies. In all profiled countries, independent living technology is more rapidly advancing than associated state policy, regulation, and payment systems. The findings from this comparative analysis reveal areas for further exploration, including policy subsystem environments in which technologies and services are regulated, as well as trends and desires of older adults and their caregivers within particular cultural contexts.

  1. Women's well-being after relocation to independent living communities.

    PubMed

    Rossen, Eileen K; Knafl, Kathleen A

    2007-03-01

    Late-life relocation to independent living communities is increasing, especially among women. This study described the impact of relocation on the health and well-being of 31 older women who moved from a private residence to an independent living community. Schumacher and Meleis' (1994) nursing model of transition guided the study. Health status, social activity, self-esteem, depression, and quality of life were measured pre- and postmove. Post-move women reported a significant increase in engagement in social activities and higher quality of life. Participants' levels of self-esteem, depression, and quality of life were found to correspond with three relocation transition styles: full integration, partial integration, and minimal integration. These preliminary findings suggest that nurses who identify older women with low self-esteem, high depressive symptoms, and low quality of life pre-move may be at risk for poor relocation outcomes. Interventions to ease the transition process and improve relocation adjustment are needed.

  2. Social marketing strategies for reaching older people with disabilities: findings from a survey of centers for independent living participants.

    PubMed

    Moone, Rajean Paul; Lightfoot, Elizabeth

    2009-01-01

    Centers for independent living (CILs) provide critical supports, services, and advocacy for assisting people with disabilities in living independently. As there is a rapidly increasing population of older people with disabilities, many CILs are now considering how to actively engage older adults in their organizations. This study utilized a survey of older people with disabilities to help identify social marketing techniques that community organizations like CILs can use to effectively reach older people with disabilities. Utilizing the components of the social marketing mix in designing outreach efforts, including a critical examination of product, place, price, participants, and partnering, CILs and other community agencies can better reach older adults with disabilities.

  3. The Independent Living Donor Advocate: An Essential Role for Living Kidney Donation.

    PubMed

    Robbins, Karen C

    2014-01-01

    Prior to 2007, living kidney donors who donated a kidney to a person with chronic kidney disease were screened, educated, and cared for by the same healthcare team caring for the recipient of the transplant. The independent living donor advocate or advocate team was created out of the need to ensure that the rights of the person donating a kidney are protected, respected, and maintained. Transplant programs must now have an advocate or advocate team who is separate from the recipient healthcare team to provide objective support for the donor, without regard for the recipient, and avoid any perception of a conflict of interest between the donor and recipient.

  4. Adaptive behavior among adults with intellectual disabilities and its relationship to community independence.

    PubMed

    Woolf, Steve; Woolf, Christine Merman; Oakland, Thomas

    2010-06-01

    This study examined relationships between general adaptive behavior and the degree of community independence displayed by 272 adults with intellectual disabilities. Specifically, the Adaptive Behavior Assessment System--Second Edition (ABAS-II; Harrison & Oakland, 2003 ) was completed for each participant and compared with actual levels of work and residential independence. The participants' adaptive behavior accounted for 40%-43% of the variance in their work and residence independence. The results from this field-based study indicated that participants who displayed higher levels of adaptive behavior generally worked and lived more independently. Participants with the lowest general adaptive behavior required the highest degree of community supports. Implications of these findings are discussed.

  5. A Study of Activities of Daily Living and Employment in Adults with Autism Spectrum Disorders in Taiwan

    ERIC Educational Resources Information Center

    Lin, Ling-Yi; Yu, Shu-Ning; Yu, Ya-Tsu

    2012-01-01

    Research on daily living activities and employment levels of adults with autism spectrum disorders (ASD) in Taiwan is limited. The aims of the study were to investigate outcomes related to functional independence and employment among people with ASD in Taiwan. We investigated the daily living activities and the employment status of 81 adults (age…

  6. Childhood living arrangements and adult children's relations with their parents.

    PubMed

    Lye, D N; Klepinger, D H; Hyle, P D; Nelson, A

    1995-05-01

    We examine the relationship of childhood living arrangements to adult child-parent relations. Compared with adult children raised in intact families, adult children whose parents divorced have less frequent contact with their parents and report a lower-quality relationship with their parents. We observe these negative effects for both custodial and noncustodial parents, although the effects are larger for noncustodial parents. Remarriage of the custodial parent tends to offset the negative impacts of divorce on relations with the custodial parent and to amplify the negative impacts on relations with noncustodial parents. Further, the longer the adult child lived apart from the parent, the weaker the relations with noncustodial parents.

  7. Identifying the Potential for Robotics to Assist Older Adults in Different Living Environments

    PubMed Central

    Mitzner, Tracy L.; Chen, Tiffany L.; Kemp, Charles C.; Rogers, Wendy A.

    2014-01-01

    As the older adult population grows and becomes more diverse, so will their needs and preferences for living environments. Many adults over 65 years of age require some assistance [1, 2]; yet it is important for their feelings of well-being that the assistance not restrict their autonomy [3]. Not only is autonomy correlated with quality of life [4], autonomy enhancement may improve functionality [2, 5]. The goal of this paper is to provide guidance for the development of technology to enhance autonomy and quality of life for older adults. We explore the potential for robotics to meet these needs. We evaluated older adults' diverse living situations and the predictors of residential moves to higher levels of care in the United States. We also examined older adults' needs for assistance with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and medical conditions when living independently or in a long-term care residence. By providing support for older adults, mobile manipulator robots may reduce need-driven, undesired moves from residences with lower levels of care (i.e., private homes, assisted living) to those with higher levels of care (i.e., skilled nursing). PMID:24729800

  8. Living with Multiple Health Problems: What Older Adults Should Know

    MedlinePlus

    ... High Blood Pressure Managing Multiple Health Problems Nutrition Osteoporosis Stroke Related Documents PDF Living With Multiple Health Problems: What Older Adults Should Know Download Join our e-newsletter! Resources ...

  9. Liver regeneration after living donor transplantation: adult-to-adult living donor liver transplantation cohort study.

    PubMed

    Olthoff, Kim M; Emond, Jean C; Shearon, Tempie H; Everson, Greg; Baker, Talia B; Fisher, Robert A; Freise, Chris E; Gillespie, Brenda W; Everhart, James E

    2015-01-01

    Adult-to-adult living donors and recipients were studied to characterize patterns of liver growth and identify associated factors in a multicenter study. Three hundred and fifty donors and 353 recipients in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) receiving transplants between March 2003 and February 2010 were included. Potential predictors of 3-month liver volume included total and standard liver volumes (TLV and SLV), Model for End-Stage Liver Disease (MELD) score (in recipients), the remnant and graft size, remnant-to-donor and graft-to-recipient weight ratios (RDWR and GRWR), remnant/TLV, and graft/SLV. Among donors, 3-month absolute growth was 676 ± 251 g (mean ± SD), and percentage reconstitution was 80% ± 13%. Among recipients, GRWR was 1.3% ± 0.4% (8 < 0.8%). Graft weight was 60% ± 13% of SLV. Three-month absolute growth was 549 ± 267 g, and percentage reconstitution was 93% ± 18%. Predictors of greater 3-month liver volume included larger patient size (donors and recipients), larger graft volume (recipients), and larger TLV (donors). Donors with the smallest remnant/TLV ratios had larger than expected growth but also had higher postoperative bilirubin and international normalized ratio at 7 and 30 days. In a combined donor-recipient analysis, donors had smaller 3-month liver volumes than recipients adjusted for patient size, remnant or graft volume, and TLV or SLV (P = 0.004). Recipient graft failure in the first 90 days was predicted by poor graft function at day 7 (HR = 4.50, P = 0.001) but not by GRWR or graft fraction (P > 0.90 for each). Both donors and recipients had rapid yet incomplete restoration of tissue mass in the first 3 months, and this confirmed previous reports. Recipients achieved a greater percentage of expected total volume. Patient size and recipient graft volume significantly influenced 3-month volumes. Importantly, donor liver volume is a

  10. Observational Learning among Older Adults Living in Nursing Homes

    ERIC Educational Resources Information Center

    Story, Colleen D.

    2010-01-01

    The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…

  11. Adventure with Adults Living with Psychiatric Disabilities.

    ERIC Educational Resources Information Center

    Roberts, Bridget; Horwood, Shane; Aunger, Nic; Wong, Michele

    Out Doors Inc. is a community-managed mental health organization in Victoria (Australia) that provides psychosocial rehabilitation to adults with mental health needs through outdoor adventure and other recreation experiences. This paper focuses on Out Door Inc.'s Going Places Program. The program, which ranges from 1 day to 4 months, is based on…

  12. Attitudes towards and Limitations to ICT Use in Assisted and Independent Living Communities: Findings from a Specially-Designed Technological Intervention

    ERIC Educational Resources Information Center

    Berkowsky, Ronald W.; Cotton, Shelia R.; Yost, Elizabeth A.; Winstead, Vicki P.

    2013-01-01

    Much literature has been devoted to theoretical explanations of the learning processes of older adults and to the methods of teaching best utilized in older populations. However, there has been less focus on the education of older adults who reside in assisted and independent living communities (AICs), especially with regards to information and…

  13. Functional Outcomes and Consumer Satisfaction in the Independent Living Program for Older Individuals Who Are Blind

    ERIC Educational Resources Information Center

    Moore, J. Elton; Steinman, Bernard A.; Giesen, J. Martin; Frank, John J.

    2006-01-01

    This study of a national sample of elders served by the Independent Living Program for Older Individuals Who Are Blind found that, overall, they were highly satisfied with the quality and timeliness of services and help in achieving independent living goals. A slight improvement was found in their perceptions of functional outcomes from 1999 to…

  14. 75 FR 34249 - Centers for Independent Living Program-Training and Technical Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-16

    ... Education Centers for Independent Living Program--Training and Technical Assistance; Notices #0;#0;Federal... for Independent Living Program--Training and Technical Assistance Catalog of Federal Domestic...--Training and Technical Assistance. The Assistant Secretary may use this priority for competitions in...

  15. First Voice: The Circle of Courage and Independent Living

    ERIC Educational Resources Information Center

    Reid, Jennifer S.; Ross, Jean W.

    2005-01-01

    Adolescents in foster care must have a voice and play an active role in envisioning and planning for successful adulthood. This principle serves as the philosophy of First Voice, a training package for anyone who works with youth in foster care. The philosophy corresponds with the four parts of the Circle of Courage--Independence, Belonging,…

  16. Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living.

    PubMed

    Berridge, Clara

    2017-03-01

    Passive monitoring technology is beginning to be reimbursed by third-party payers in the United States of America. Given the low voluntary uptake of these technologies on the market, it is important to understand the concerns and perspectives of users, former users and non-users. In this paper, the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. This includes experiences of adoption, non-adoption, discontinuation and creative 'misuse'. The analysis of interviews reveals three key insights. First, assumptions built into the technology about how older adults live present a problem for many users who experience unwanted disruptions and threats to their behavioural autonomy. Second, resident response is varied and challenges the dominant image of residents as passive subjects of a passive monitoring system. Third, the priorities of older adults (e.g. safety, autonomy, privacy, control, contact) are more diverse and multi-faceted than those of the housing organisation staff and family members (e.g. safety, efficiency) who drive the passive monitoring intervention. The tension between needs, desires and the daily lives of older adults and the technological solutions offered to them is made visible by their active responses, including resistance to them. This exposes the active and meaningful qualities of older adults' decisions and practices.

  17. Ethnic Clusters in Public Housing and Independent Living of Elderly Immigrants from the Former Soviet Union.

    PubMed

    Vinokurov, Andrey; Trickett, Edison J

    2015-12-01

    The study examines the effects of ethnic clusters and independent living arrangements on adaptation of elderly immigrants from the Former Soviet Union. The multigenerational living arrangements were compared with independent living in a dispersed ethnic community and in an ethnic cluster of public housing. The residents of the ethnic clusters of public housing reported poorer health, were more reliant on government resources, and experienced greater acculturative hassles. However, public housing residents reported significantly larger Russian-speaking and American social networks, greater American acculturation, higher social support from neighbors, as well as lower cultural alienation. In contrast, the multigenerational living arrangements were related to greater social support from extended family and higher extended family satisfaction. While, the independent living in the dispersed ethnic community was associated with smaller American social networks and higher levels of cultural alienation. The results highlight how the ecologies of different living arrangements are reflected in the nature of acculturative, social, and psychological experiences of elderly immigrants.

  18. It Takes a Village: Moving Forward Towards Independence Offers Hope and Life Lessons to Young Adults with Learning Disabilities

    ERIC Educational Resources Information Center

    Exceptional Parent, 2010

    2010-01-01

    Moving Forward Towards Independence, a California-based nonprofit organization founded in 1998 by a group of parents, is a unique residential program where young adults with disabilities learn to enjoy productive, fulfilling and healthy lives within a caring, responsive community made up of fellow residents, trained staff members, parents and…

  19. Discover the World of Independent Living: An Independent Living Skills Curriculum and a Guide to the Implementation of the Curriculum. October 1, 1981-December 31, 1984.

    ERIC Educational Resources Information Center

    Leavitt, Karen J.; Terrell, Glenn J.

    This independent living skills curriculum addresses the needs of developmentally handicapped students ages 13-19. Designed to supplement the existing curriculum, nine units focus on the following skill areas: social skills (self-esteem, self-identity, social communication and interaction, goal development, problem solving, developing sexual…

  20. Accuracy of Step Recording in Free-Living Adults

    ERIC Educational Resources Information Center

    Behrens, Timothy K.; Dinger, Mary K.; Vesely, Sara K.; Fields, David A.

    2007-01-01

    The purpose of this study was to investigate how accurately free-living adults record their pedometer steps on step logs. Researchers used three different methods to examine the accuracy of participant-recorded steps: tests of equivalence, correlation coefficients, and Bland-Altman plots. Findings indicate that participant-recorded steps…

  1. Women Studying Childcare: Integrating Lives through Adult Education

    ERIC Educational Resources Information Center

    Wright, Hazel R.

    2011-01-01

    Most studies of adult education align it with life change, but this research-based book tells a different story. It reveals how mature women who are training to work in childcare within the voluntary sector seek continuity in their lives. They engage with activities that connect aspects of their family, workplace and educational experience, and…

  2. How to live independently with or without technology?

    PubMed

    Kärki, Anne; Sallinen, Merja; Kuusinen, Jere

    2015-01-01

    This qualitative study aims to identify how Finnish elderly, aged 65-82, consider technology as part of their life and how the learning of using technology is happening. Thematic interviews were carried out and transcribed to text. Content analysis was done and common elements were found. The analysis was done in researcher triangulation to enhance the reliability of the data extraction. Two main categories were named: lived life and the role of ICT/ICT AT, ICT support and education. We can conclude that the results showed that there is a need to integrate ICT/ICT AT education into the daily life and rehabilitation of elderly. The most common need to use ICT is to be connected and to be able to follow the society. Also open discussion is needed concerning the divide between older and younger citizens. Based on the results the non-users who don't want to use technology also need to be considered in society by developing new service solutions for all. If being positive towards using technology this study showed that ICT skills can positively affect feeling of self-determination and quality of life.

  3. Loneliness and depression in independent living retirement communities: risk and resilience factors.

    PubMed

    Adams, K B; Sanders, S; Auth, E A

    2004-11-01

    Socio-emotional selectivity theory posits that as individuals age, they desire less social stimulation and novelty, and tend to select close, reliable relationships to meet their emotional needs. Residence in congregate facilities affords social exposure, yet does not guarantee access to close relationships, so that loneliness may be a result. Further, the gerontology literature has suggested that loneliness in late life may be a risk factor for serious mental health concerns such as depression. This article examined data on loneliness and depressive symptoms from older adults aged 60-98, residing in two age-segregated independent living facilities. Overlap between those scoring in the depressed range on the Geriatric Depression Scale and those scoring more than one standard deviation above the mean on the UCLA Loneliness Scale was less than 50%, although zero-order correlation of the two continuous scores was moderately high. Potential risk and resilience factors were regressed on the continuous scores of the two scales in separate hierarchical multiple regression analyses. Depression was predicted by being older, number of chronic health conditions, grieving a recent loss, fewer neighbor visitors, less participation in organized social activities and less church attendance. Grieving a recent loss, receiving fewer visits from friends, and having a less extensive social network predicted loneliness. In addition, loneliness scores explained about 8% of the unique variance in depression scores, suggesting it is an independent risk factor for depressive symptoms. Loneliness scores were seen to be more widely dispersed in these respondents, with less variance explained by the available predictors. Suggestions are made for addressing loneliness in older adults as a means of preventing more serious mental health consequences.

  4. Active subjects of passive monitoring: responses to a passive monitoring system in low-income independent living

    PubMed Central

    BERRIDGE, CLARA

    2016-01-01

    Passive monitoring technology is beginning to be reimbursed by third-party payers in the United States of America. Given the low voluntary uptake of these technologies on the market, it is important to understand the concerns and perspectives of users, former users and non-users. In this paper, the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. This includes experiences of adoption, non-adoption, discontinuation and creative ‘misuse’. The analysis of interviews reveals three key insights. First, assumptions built into the technology about how older adults live present a problem for many users who experience unwanted disruptions and threats to their behavioural autonomy. Second, resident response is varied and challenges the dominant image of residents as passive subjects of a passive monitoring system. Third, the priorities of older adults (e.g. safety, autonomy, privacy, control, contact) are more diverse and multi-faceted than those of the housing organisation staff and family members (e.g. safety, efficiency) who drive the passive monitoring intervention. The tension between needs, desires and the daily lives of older adults and the technological solutions offered to them is made visible by their active responses, including resistance to them. This exposes the active and meaningful qualities of older adults’ decisions and practices. PMID:28239211

  5. Living-Learning Communities and Independent Higher Education. Innovations in Teaching and Learning. Research Brief 4

    ERIC Educational Resources Information Center

    Katz, Philip M.

    2015-01-01

    Living-learning communities combine curricular, co-curricular, and residential components of college life. They are a relatively new variation on the residential education that has been part of the undergraduate experience at America's independent colleges and universities for centuries. Research suggests that living-learning communities have a…

  6. Transition to Independent Living and Substance Involvement of Treated and High Risk Youth

    ERIC Educational Resources Information Center

    Kypri, Kypros; McCarthy, Denis M.; Coe, Michael T.; Brown, Sandra A.

    2004-01-01

    National studies indicate that alcohol and drug involvement increases during transition from adolescence to young adulthood. The present study evaluated change in alcohol and drug use as youth move from living with their family of origin to independent living environments. Two samples of youth, those who had previously been treated for alcohol and…

  7. Middle-Aged Independent-Living African Americans' Selections for Advance Directives: A Case Study

    ERIC Educational Resources Information Center

    McDaniel, Brenda J.

    2013-01-01

    The purpose of this collective embedded qualitative case study was to examine the perspectives of three middle-aged independent-living African Americans who had participated in the process of advance care planning (ACP) and completed at least two advance directives (ADs), a Durable Power of Attorney for Health Care (DPAHC) and a Living Will (LW).…

  8. Social networks of older adults living with HIV in Finland.

    PubMed

    Nobre, Nuno Ribeiro; Kylmä, Jari; Kirsi, Tapio; Pereira, Marco

    2016-01-01

    The aim of this study was to explore the social networks of older adults living with HIV. Interviews were conducted with nine individuals aged 50 or older living with HIV in Helsinki, Finland. Analysis of transcripts was analysed by inductive qualitative content analysis. Results indicated that these participants' networks tended to be large, including those both aware and unaware of the participants' health status. Analysis identified three main themes: large multifaceted social networks, importance of a support group, and downsizing of social networks. Support received appeared to be of great importance in coping with their health condition, especially since the time of diagnosis. Friends and family were the primary source of informal support. The majority of participants relied mostly on friends, some of whom were HIV-positive. Formal support came primarily from the HIV organisation's support group. In this study group, non-disclosure did not impact participants' well-being. In years to come, social networks of older adults living with HIV may shrink due to personal reasons other than HIV-disclosure. What is of primary importance is that healthcare professionals become knowledgeable about psychosocial issues of older adults living with HIV, identifying latent problems and developing adequate interventions in the early stages of the disease; this would help prevent social isolation and foster successful ageing with HIV.

  9. Sexual Behavior of Older Adults Living with HIV in Uganda.

    PubMed

    Negin, Joel; Geddes, Louise; Brennan-Ing, Mark; Kuteesa, Monica; Karpiak, Stephen; Seeley, Janet

    2016-02-01

    Sexual behavior among older adults with HIV in Sub-Saharan Africa has been understudied despite the burgeoning of this population. We examined sexual behavior among older adults living with HIV in Uganda. Participants were eligible for the study if they were 50 years of age or older and living with HIV. Quantitative data were collected through face-to-face interviews, including demographic characteristics, health, sexual behavior and function, and mental health. Of respondents, 42 were men and 59 women. More than one-quarter of these HIV-positive older adults were sexually active. A greater proportion of older HIV-positive men reported being sexually active compared to women (54 vs. 15%). Among those who are sexually active, a majority never use condoms. Sixty-one percent of men regarded sex as at least somewhat important (42%), while few women shared this opinion (20%). Multivariate logistic regression analyses revealed that odds of sexual activity in the past year were significantly increased by the availability of a partner (married/cohabitating), better physical functioning, and male gender. As more adults live longer with HIV, it is critical to understand their sexual behavior and related psychosocial variables in order to improve prevention efforts.

  10. A Guide for the Personal Care Attendant: Independent Living with Attendant Care.

    ERIC Educational Resources Information Center

    Board, Mary Ann; And Others

    The first of three booklets on attendant care of severely disabled persons is addressed to the personal care attendants (PCAs). An introductory section reviews the basic concepts of independent living, noting the role of PCAs in promoting independence. Discussions of congenital and acquired disability are followed by information on equipment and…

  11. Robotics to Enable Older Adults to Remain Living at Home

    PubMed Central

    Pearce, Alan J.; Adair, Brooke; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E.

    2012-01-01

    Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving. PMID:23304507

  12. Improving life satisfaction for the elderly living independently in the community: care recipients' perspective of volunteers.

    PubMed

    Wilson, Anne

    2012-01-01

    With an aging population who wish to remain living in the community, this article explores the experiences and benefits of receiving volunteer services from a home support program established to assist people with increasing needs to remain living independently. Face to face interviews explored how the services of informal carers (volunteers) provided through the program made a difference to the daily lives of 16 recipients. Improved life satisfaction was identified through the themes of being helped with daily activities, positive human contact, and fear of a poorer quality of life. It was found that addressing recipients' social, emotional, and mobility needs supported them to remain living at home.

  13. Acting Independently While Living Alone: The Strategies and Struggles of Cancer Patients.

    PubMed

    Benoot, Charlotte; Deschepper, Reginald; Grypdonck, Maria; Saelaert, Marlies; Bilsen, Johan

    2015-08-01

    Cancer patients who live alone place specific importance on acting independently during treatment. We want to describe what it means to act independently and which strategies patients use to continue to act independently. We used a qualitative design, based on grounded theory. We interviewed 32 patients, 17 of them a second time. Patients who live alone defined acting independently in two different ways: It meant not only doing things alone but also using the help of others in a controlled way. These two meanings lead to two types of strategies. As treatment evolves, patients needed to change their preferred type of strategies to continue acting independently. Succeeding to change led to a feeling of mastery and success. However, failing to change led to struggling, whereby patients' needs became invisible. Health care providers should anticipate patients' inability to change strategies during cancer treatment, thereby preventing the patient's struggle from only becoming visible during crisis.

  14. Preoperative Thromboelastometry as a Predictor of Transfusion Requirements during Adult Living Donor Liver Transplantation

    PubMed Central

    Fayed, Nirmeen; Mourad, Wessam; Yassen, Khaled; Görlinger, Klaus

    2015-01-01

    Background The ability to predict transfusion requirements may improve perioperative bleeding management as an integral part of a patient blood management program. Therefore, the aim of our study was to evaluate preoperative thromboelastometry as a predictor of transfusion requirements for adult living donor liver transplant recipients. Methods The correlation between preoperative thromboelastometry variables in 100 adult living donor liver transplant recipients and intraoperative blood transfusion requirements was examined by univariate and multivariate linear regression analysis. Thresholds of thromboelastometric parameters for prediction of packed red blood cells (PRBCs), fresh frozen plasma (FFP), platelets, and cryoprecipitate transfusion requirements were determined with receiver operating characteristics analysis. The attending anesthetists were blinded to the preoperative thromboelastometric analysis. However, a thromboelastometry-guided transfusion algorithm with predefined trigger values was used intraoperatively. The transfusion triggers in this algorithm did not change during the study period. Results Univariate analysis confirmed significant correlations between PRBCs, FFP, platelets or cryoprecipitate transfusion requirements and most thromboelastometric variables. Backward stepwise logistic regression indicated that EXTEM coagulation time (CT), maximum clot firmness (MCF) and INTEM CT, clot formation time (CFT) and MCF are independent predictors for PRBC transfusion. EXTEM CT, CFT and FIBTEM MCF are independent predictors for FFP transfusion. Only EXTEM and INTEM MCF were independent predictors of platelet transfusion. EXTEM CFT and MCF, INTEM CT, CFT and MCF as well as FIBTEM MCF are independent predictors for cryoprecipitate transfusion. Thromboelastometry-based regression equation accounted for 63% of PRBC, 83% of FFP, 61% of cryoprecipitate, and 44% of platelet transfusion requirements. Conclusion Preoperative thromboelastometric analysis is

  15. Live Imaging of Adult Neural Stem Cells in Rodents

    PubMed Central

    Ortega, Felipe; Costa, Marcos R.

    2016-01-01

    The generation of cells of the neural lineage within the brain is not restricted to early development. New neurons, oligodendrocytes, and astrocytes are produced in the adult brain throughout the entire murine life. However, despite the extensive research performed in the field of adult neurogenesis during the past years, fundamental questions regarding the cell biology of adult neural stem cells (aNSCs) remain to be uncovered. For instance, it is crucial to elucidate whether a single aNSC is capable of differentiating into all three different macroglial cell types in vivo or these distinct progenies constitute entirely separate lineages. Similarly, the cell cycle length, the time and mode of division (symmetric vs. asymmetric) that these cells undergo within their lineage progression are interesting questions under current investigation. In this sense, live imaging constitutes a valuable ally in the search of reliable answers to the previous questions. In spite of the current limitations of technology new approaches are being developed and outstanding amount of knowledge is being piled up providing interesting insights in the behavior of aNSCs. Here, we will review the state of the art of live imaging as well as the alternative models that currently offer new answers to critical questions. PMID:27013941

  16. Sarcopenia and physical independence in older adults: the independent and synergic role of muscle mass and muscle function

    PubMed Central

    dos Santos, Leandro; Cyrino, Edilson S.; Antunes, Melissa; Santos, Diana A.

    2016-01-01

    Abstract Background The loss of skeletal muscle mass (MM) or muscle function (MF) alone increases the risk for losing physical independence in older adults. We aimed to examine the independent and synergic associations of low MM and low MF, both criteria of sarcopenia, with the risk for losing projected physical independence in later life (+90 years old). Methods Cross‐sectional analyses were conducted in 3493 non‐institutionalized older adults (1166 males). Physical independence was assessed with a 12‐item composite physical function scale. Logistic regression was used to estimate the odds‐ratio (OR) for being at risk for losing physical independence. Results Approximately 30% of the participants were at risk for losing physical independence at 90 years of age. Independent analysis demonstrated that participants with low MM had 1.65 (95%CI: 1.27–2.31) increased odds for being at risk for losing physical independence and participants with low MF had 6.19 (95%CI 5.08–7.53) increased odds for being at risk. Jointly, having a low MM and a low MF increased the risk for losing physical independence to 12.28 (95%CI 7.95 to 18.96). Conclusions Although low MM represents a risk factor for losing physical independence, low MF seems to play a more dominant role in this relationship, with the presence of both sarcopenia criteria representing a substantial risk for losing physical independence in later life. PMID:27897417

  17. The Lived Experience of the Adult African American Female Who Has Lived in Multiple Foster Care Placements

    ERIC Educational Resources Information Center

    Johnson, Avonda C.

    2012-01-01

    The purpose of the study was to examine and describe the lived experiences of the adult African American woman who had lived in multiple foster care placements. Eleven adult African American women ages 22-25 participated in semi-structured, face-to-face interviews to tell their stories and provide data of the memories of the experience. The…

  18. The notion of precariousness among older adults living alone in the U.S.

    PubMed

    Portacolone, Elena

    2013-04-01

    This paper argues that older adults living alone in the U.S. face a set of unique challenges, as they are likely to experience a sense of precariousness. The term precariousness points to an intrinsic sense of instability and insecurity stemming from a lack of, or difficulty to, access essential resources. During a two-year ethnography of 47 older solo dwellers, this term captured one of the distinctive traits of the experience of living alone in older age in the U.S. The findings from semi-structured interviews and participant observation highlight the emergence of the notion of precariousness along three levels of analysis. First, on the micro and subjective level of analysis, older solo dwellers may struggle to perform the chores related to their household as they may deal with a failing body, faltering memory, and fixed if not shrinking income. Second, on the meso and institutional level of analysis, older adults living alone need to navigate the complex, scattered, and ever-changing landscape of services and understand their eligibility criteria, accessibility, fees, and conditions. At the same time they may have to deal with family issues. Finally, the macro level examines the pressure on older solo dwellers of a prevalent ideology that prizes independent behaviors and personal responsibility. In conclusion, the notion of precariousness illustrates the unique position of older adults living alone as they face different type of challenges on a micro, meso, and macro dimension. The paper ends with an invitation to create social policies that accommodate the needs of a growing number of older adults living alone.

  19. Academic Autonomy for Adult Degree Programs: Independence with Integration

    ERIC Educational Resources Information Center

    Curry, Judson

    2012-01-01

    North Park University's adult program has moved steadily from a centralized governance structure toward a more distributed structure in many ways. The School of Adult Learning hires its own faculty, some of whom are full time in the adult program. The school also has autonomy over academic policy. Ultimately, this academic autonomy has fostered…

  20. Independent Living Skills Can Be Fun! How One Mom Took Matters into Her Own Hands

    ERIC Educational Resources Information Center

    Schoenfeld, Jane

    2006-01-01

    Jane Schoenfeld's eighteen-year-old daughter and five of her daughter's friends have major learning differences. After searching fruitlessly for a summer class in independent living skills, Shoenfeld relates how she and the parents of her daughter's friends decided to set up their own summer program. They found a facilitator and invited two…

  1. 34 CFR 364.27 - What are the requirements for coordinating Independent Living (IL) services?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What are the requirements for coordinating Independent Living (IL) services? 364.27 Section 364.27 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  2. 34 CFR 364.27 - What are the requirements for coordinating Independent Living (IL) services?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What are the requirements for coordinating Independent Living (IL) services? 364.27 Section 364.27 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  3. 34 CFR 366.1 - What is the Centers for Independent Living (CIL) program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What is the Centers for Independent Living (CIL) program? 366.1 Section 366.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION CENTERS FOR...

  4. 34 CFR 366.1 - What is the Centers for Independent Living (CIL) program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false What is the Centers for Independent Living (CIL) program? 366.1 Section 366.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION CENTERS...

  5. 34 CFR 365.1 - What is the State Independent Living Services (SILS) program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true What is the State Independent Living Services (SILS) program? 365.1 Section 365.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  6. 34 CFR 365.1 - What is the State Independent Living Services (SILS) program?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true What is the State Independent Living Services (SILS) program? 365.1 Section 365.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  7. 34 CFR 366.1 - What is the Centers for Independent Living (CIL) program?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true What is the Centers for Independent Living (CIL) program? 366.1 Section 366.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION CENTERS FOR...

  8. 34 CFR 366.1 - What is the Centers for Independent Living (CIL) program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Centers for Independent Living (CIL) program? 366.1 Section 366.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION CENTERS...

  9. 34 CFR 365.1 - What is the State Independent Living Services (SILS) program?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false What is the State Independent Living Services (SILS) program? 365.1 Section 365.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  10. 34 CFR 365.1 - What is the State Independent Living Services (SILS) program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false What is the State Independent Living Services (SILS) program? 365.1 Section 365.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  11. 34 CFR 366.1 - What is the Centers for Independent Living (CIL) program?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false What is the Centers for Independent Living (CIL) program? 366.1 Section 366.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION CENTERS...

  12. 34 CFR 365.1 - What is the State Independent Living Services (SILS) program?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the State Independent Living Services (SILS) program? 365.1 Section 365.1 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  13. 38 CFR 21.192 - “Independent living program” status.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... independent living program status during periods in which: (1) The provisions of § 21.282 for induction into a program are met, but the veteran is pending induction into the facility at which rehabilitation services... date of induction into a rehabilitation program, 21.322 Commencing date, and 21.324 Reduction...

  14. 38 CFR 21.192 - “Independent living program” status.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... independent living program status during periods in which: (1) The provisions of § 21.282 for induction into a program are met, but the veteran is pending induction into the facility at which rehabilitation services... date of induction into a rehabilitation program, 21.322 Commencing date, and 21.324 Reduction...

  15. Facing the World. An Independent Living/Pre-Employment Curriculum for Refugee Youths.

    ERIC Educational Resources Information Center

    Bateman, Mary Jo; And Others

    This document, a curriculum guide focusing on both independent living skills and job readiness skills, is based on the experience of the Bilingual Vocational Education program in Virginia. The lessons are sequenced to increase in difficulty as students acquire more English skills, but individual units do not necessarily require competencies…

  16. Supporting Homeless Youth during the Transition to Adulthood: Housing-Based Independent Living Programs

    ERIC Educational Resources Information Center

    Dworsky, Amy

    2010-01-01

    While many young people depend on parental financial and emotional support well past the age of 18, those who are homeless must make the transition to adulthood without that support. This article discusses the needs of homeless youth as they transition to adulthood. It then describes three housing-based independent living programs designed to…

  17. Housing and Independent Living for Individuals with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Leach, Debra

    2016-01-01

    This manuscript provides a review of housing and independent living options for individuals with intellectual and developmental disabilities (I/DD). While there has certainly been an increased emphasis on community integration and inclusion for people with I/DD, barriers to delivering housing supports and services in natural, integrated settings…

  18. Full Participation in Independent Living: What Does It Mean? A National Teleconference (September 25, 2002). Participant's Manual.

    ERIC Educational Resources Information Center

    Nary, Dot; White, Glen; Jones, Darrell Lynn; Buppapong, Raweewan; Petty, Richard; Heinsohn, Dawn; Langbehn, Kristy

    This manual contains training materials on full participation in independent living for a national conference for personnel in agencies concerned with independent living for people with disabilities. Preliminary materials include the conference agenda, background information about the trainers, and organizational information on Independent Living…

  19. Factors related to unmet oral health needs in older adults living in Chile.

    PubMed

    Mariño, Rodrigo; Giacaman, Rodrigo A

    2014-01-01

    To assess the oral health status and treatment needs of an ambulant population of older adults, living in the Maule Region, Chile, and provide descriptive information on its distribution by selected socio-demographic characteristics. The source of primary data was the Regional Oral Health Survey. A stratified random sample of 438 older adults, aged 65-74 years, living independently in the community was orally examined, and underwent an oral health interview. The sample was largely a dentate one (74.9%); with a mean DMFT score of 25.7 (s.d. 6.5) and an average number of missing teeth of 22.4 (s.d. 5.8). Dentate participants had 41% of their restorative care needs unmet, and 68.4% needed oral hygiene instruction plus removal of calculus on their teeth. Almost 30.1% required complex periodontal therapy. 21% of those fully edentulous were in need of full dentures. Comparing these findings with existing data on the oral health of older adults in Chile, participants in this study appear to have lower missing teeth scores and less need for complex periodontal treatment. Inequities were apparent in the proportion of unmet restorative and prosthetics needs. Community-based preventive care programs specifically tailored to older adults are needed to address this challenge.

  20. Cancer Screening Practices among Amish and Non-Amish Adults Living in Ohio Appalachia

    ERIC Educational Resources Information Center

    Katz, Mira L.; Ferketich, Amy K.; Paskett, Electra D.; Harley, Amy; Reiter, Paul L.; Lemeshow, Stanley; Westman, Judith A.; Clinton, Steven K.; Bloomfield, Clara D.

    2011-01-01

    Purpose: The Amish, a unique community living in Ohio Appalachia, have lower cancer incidence rates than non-Amish living in Ohio Appalachia. The purpose of this study was to examine cancer screening rates among Amish compared to non-Amish adults living in Ohio Appalachia and a national sample of adults of the same race and ethnicity in an effort…

  1. Adult Living Donor Liver Transplantation Across ABO-Incompatibility.

    PubMed

    Lee, Chen-Fang; Cheng, Chih-Hsien; Wang, Yu-Chao; Soong, Ruey-Shyang; Wu, Tsung-Han; Chou, Hong-Shiue; Wu, Ting-Jung; Chan, Kun-Ming; Lee, Ching-Song; Lee, Wei-Chen

    2015-10-01

    The objective of this study was to evaluate the results of adult ABO-incompatible living donor liver transplantation (LDLT).ABO-incompatible LDLT is an aggressive treatment that crosses the blood-typing barrier for saving lives from liver diseases. Although graft and patient survival have been improved recently by various treatments, the results of adult ABO-incompatible LDLT require further evaluation.Two regimens were designed based on isoagglutinin IgG and IgM titers and the time course of immunological reactions at this institute. When isoagglutinin IgG and IgM titers were ≤64, liver transplantation was directly performed and rituximab (375 mg/m) was administrated on postoperative day 1 (regimen I). When isoagglutinin titers were >64, rituximab (375 mg/m) was administered preoperatively with or without plasmapheresis and boosted on postoperative day 1 (regimen II). Immunosuppression was achieved by administration of mycophenolate mofetil, tacrolimus, and steroids.Forty-six adult ABO-incompatible and 340 ABO-compatible LDLTs were performed from 2006 to 2013. The Model for End-Stage Liver Disease scores for ABO-incompatible recipients ranged from 7 to 40, with a median of 14. The graft-to-recipient weight ratio ranged from 0.61% to 1.61% with a median of 0.91%. The 1-, 3-, and 5-year survival rates were 81.7%, 75.7%, and 71.0%, respectively, for ABO-incompatible LDLT recipients, compared to 81.0%, 75.2%, and 71.5% for ABO-C recipients (P = 0.912). The biliary complication rate was higher in ABO-incompatible LDLT recipients than in the ABO-compatible recipients (50.0% vs 29.7%, P = 0.009).In the rituximab era, the blood type barrier can be crossed to achieve adult ABO-incompatible LDLT with survival rates comparable to those of ABO-compatible LDLT, but with more biliary complications.

  2. The transition experience of developmentally impaired young adults living in a structured apartment setting.

    PubMed

    Pearson, Geraldine S

    2012-01-01

    The purpose of this qualitative descriptive study was to identify the lived experience of young adults with a history of pervasive developmental disorder and associated difficulties with aggressive behavior transitioning into independent living through a transitional apartment program. Nine men and 1 woman, aged 18 to 24 years, were interviewed. Nine were interviewed in their apartment, and 1 was interviewed in an adjacent staff office. Individuals were dealing with normative transition issues of adolescence compounded by significant developmental and psychiatric impairments that tended to delay their developmental trajectories. Themes of poor physical health and loss were identified. The research emphasized the need for individually tailored transition services based on needs and level of disability.

  3. Former foster youth's perspectives on independent living preparation six months after discharge.

    PubMed

    Jones, Loring P

    2014-01-01

    Research findings have developed a troubling narrative of youth leaving foster care. Congress attempted to address the post-discharge difficulties of foster youth by passing the Independent Living Initiative in 1986, which mandated that the states develop services that would prepare youth for life after foster care. However, it is unclear what effect these programs have on post-foster care trajectories. This largely qualitative study examined the perceptions of a sample of discharged foster six months after leaving care. Most youth felt prepared for life and foster care. They were also for the most part were satisfied with their independent living program, but had significant dissatisfactions with elements of the program. These satisfactions and dissatisfactions are reported along with suggestions for improvement. The policy and practice implications of these suggestions are considered.

  4. Adult-to-adult living donor liver transplantation: Operative techniques to optimize the recipient's outcome

    PubMed Central

    Koh, Peng Soon; Chan, See Ching

    2017-01-01

    Adult-to-adult living donor liver transplantation (LDLT) is widely accepted today with good outcomes and safety reported worldwide for both donor and recipient. Nonetheless, it remained a highly demanding technical and complex surgery if undertaken. The last two decades have seen an increased in adult-to-adult LDLT following our first report of right lobe LDLT in overcoming graft size limitation in adults. In this article, we discussed the operative techniques and challenges of adult right lobe LDLT incorporating the middle hepatic vein, which is practiced in our center for the recipient operation. The various issues and challenges faced by the transplant surgeon in ensuring good recipient outcome are explored and discussed here as well. Hence, it is important to understand that a successful recipient operation is dependent of multifactorial events starting at the preoperative stage of planning, understanding the intraoperative technical challenges and the physiology of flow modulation that goes hand-in-hand with the operation. Therefore, one needs to arm oneself with all the possible knowledge in overcoming these technical challenges and the ability to be flexible and adaptable during LDLT by tailoring the needs of each patient individually. PMID:28250667

  5. A study of stairs in the housing of independently-living elderly people.

    PubMed

    Smith, D W; Brett, A W; Straker, J K; Snell, J; Jackson, F W; Ulmer, M E

    1994-01-01

    This survey study focuses on stairs in the homes of a substantial number of independently living elderly (60+) residents of a community in which there are mostly multistory houses and apartment buildings with stairs. While the majority could climb their stairs without problems, a substantial minority lived with stairs despite difficulty and even inability in climbing them. Most people were satisfied with their homes, and many were unwilling to admit that stairs were a present or potential problem. Most people, including most with stair problems, had no plans to move from their homes, however, a majority was willing to concede under questioning that stair-free living in a presently unplanned next home would be desirable. There is a plea that stairs be of increased concern in the housing of elderly people, and that there be increased planning for stair-free homes.

  6. IL 201: History & Philosophy of the Independent Living Movement--A National Teleconference (August 8, 2002). Participant's Manual.

    ERIC Educational Resources Information Center

    Sain, Julia; Jones, Darrell Lynn; Buppapong, Raweewan; Langbehn, Kristy; George, Carri; Petty, Richard; Heinsohn, Dawn

    The participant's manual contains training materials for a national teleconference on the history and philosophy of the independent living movement for agency personnel. Preliminary materials include the conference agenda, background information about the trainers, and organizational information on Independent Living Research Utilization and the…

  7. 34 CFR 365.11 - How is the allotment of Federal funds for State independent living (IL) services computed?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... independent living (IL) services computed? 365.11 Section 365.11 Education Regulations of the Offices of the... the allotment of Federal funds for State independent living (IL) services computed? (a) The allotment of Federal funds for State IL services for each State is computed in accordance with the...

  8. The Work Incentive Program: Making Adults Economically Independent. Volume I.

    ERIC Educational Resources Information Center

    Klausner, Samuel Z.; And Others

    In an examination of the role of the Work Incentive (WIN) Program, particularly its training activities, in adult resocialization, data were gathered by questionnaires administered, one year apart, to a panel of husbandless mothers receiving Aid to Families with Dependent Children (AFDC) and a panel of husbandless mothers who had participated in a…

  9. Making Space for Adult Education in Independent Namibia

    ERIC Educational Resources Information Center

    Ellis, Justin

    2004-01-01

    Namibia is a vast and arid African country neighbouring South Africa, Botswana, Zimbabwe, Zambia, Angola and the Atlantic Ocean, with a population of only two million. Namibia achieved its independence in 1990 after a protracted and brutal struggle, latterly against South African occupation, but rooted in the resistance to German colonisation that…

  10. Factors associated with falls among older adults living in institutions

    PubMed Central

    2013-01-01

    Background Falls have enormous impact in older adults. Yet, there is insufficient evidence regarding the effectiveness of preventive interventions in this setting. The objectives were to measure the frequency of falls and associated factors among older people living institutions. Methods Data were obtained from a survey on a probabilistic sample of residents aged ≥65 years, drawn in 1998-99 from institutions of Madrid (Spain). Residents, their caregivers, and facility physicians were interviewed. Fall rates were computed based on the number of physician-reported falls in the preceding 30 days. Adjusted rate ratios were computed using negative binomial regression models, including age, sex, cognitive status, functional dependence, number of diseases, and polypharmacy. Results The final sample comprised 733 residents. The fall rate was 2.4 falls per person-year (95% confidence interval [CI], 2.04-2.82). The strongest risk factor was number of diseases, with an adjusted rate ratio (RR) of 1.32 (95% CI, 1.17-1.50) for each additional diagnosis. Other variables associated with falls were: urinary incontinence (RR = 2.56 [95% CI, 1.32-4.94]); antidepressant use (RR = 2.32 [95% CI, 1.22-4.40]); arrhythmias (RR = 2.00 [95% CI, 1.05-3.81]); and polypharmacy (RR = 1.07 [95% CI, 0.95-1.21], for each additional medication). The attributable fraction for number of diseases (with reference to those with ≤ 1 condition) was 84% (95% CI, 45-95%). Conclusions Number of diseases was the main risk factor for falls in this population of institutionalized older adults. Other variables associated with falls, probably more amenable to preventive action, were urinary incontinence, antidepressants, arrhythmias, and polypharmacy. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3916151157277337 PMID:23320746

  11. Enhancing health and independent living for veterans with disabilities by leveraging community-based resources

    PubMed Central

    Hale-Gallardo, Jennifer; Jia, Huanguang; Delisle, Tony; Levy, Charles E; Osorio, Valentina; Smith, Jennifer A; Hannold, Elizabeth M

    2017-01-01

    The number of US veterans with disabilities has increased in recent years as service members have returned home with extensive injuries and veterans from previous wars acquire functional limitations as a consequence of aging with chronic diseases. Veterans with severe disabilities need assistance and support to maintain independence at home and to avoid institutionalization. The US Department of Veterans Affairs (VA) strives to network with community organizations to achieve the best possible outcomes for veterans. Key community resources in the US for individuals with disabilities are Centers for Independent Living (CILs) that provide a wide range of services, promoting independent living and well-being for people across disabilities. The widespread availability and services of CILs nationwide suggest their potential as a community-based resource for veterans, particularly for those with limited access to VA care. In this article, we discuss long-term needs of veterans with disabilities, efforts to address veterans’ rehabilitation needs at the VA and opportunities for leveraging the strengths of community-based organizations for veterans. More research is warranted to investigate CIL services and potential for CIL–VA partnerships. PMID:28182140

  12. Age, Gender, and Reasons for Living among Australian Adults

    ERIC Educational Resources Information Center

    McLaren, Suzanne

    2011-01-01

    Reasons for living have been identified as protective factors in relation to suicide, and much research has documented gender differences in reasons for living. In contrast, little research has investigated age differences in reasons for living. In the current study, the relationship of age to reasons for living was investigated, as was whether…

  13. Multimodal and ubiquitous computing systems: supporting independent-living older users.

    PubMed

    Perry, Mark; Dowdall, Alan; Lines, Lorna; Hone, Kate

    2004-09-01

    We document the rationale and design of a multimodal interface to a pervasive/ubiquitous computing system that supports independent living by older people in their own homes. The Millennium Home system involves fitting a resident's home with sensors--these sensors can be used to trigger sequences of interaction with the resident to warn them about dangerous events, or to check if they need external help. We draw lessons from the design process and conclude the paper with implications for the design of multimodal interfaces to ubiquitous systems developed for the elderly and in healthcare, as well as for more general ubiquitous computing applications.

  14. Pain and Cognitive Function Among Older Adults Living in the Community

    PubMed Central

    van der Leeuw, Guusje; Eggermont, Laura H. P.; Shi, Ling; Milberg, William P.; Gross, Alden L.; Hausdorff, Jeffrey M.; Bean, Jonathan F.

    2016-01-01

    Background. Pain related to many age-related chronic conditions is a burdensome problem in elderly adults and may also interfere with cognitive functioning. The purpose of this study was to examine the cross-sectional relationship between measures of pain severity and pain interference and cognitive performance in community-living older adults. Methods. We studied 765 participants in the Maintenance of Balance Independent Living Intellect and Zest (MOBILIZE) Boston Study, a population-based study of persons aged 70 and older. Global pain severity and interference were measured using the Brief Pain Inventory subscales. The neuropsychological battery included measures of attentional capacity (Trail Making Test A, WORLD Test), executive function (Trail Making Test B and Delta, Clock-in-a-Box, Letter Fluency), memory (Hopkins Verbal Learning Test), and a global composite measure of cognitive function. Multivariable linear regression models were used to analyze the relationship between pain and cognitive functioning. Results. Elderly adults with more severe pain or more pain interference had poorer performance on memory tests and executive functioning compared to elders with none or less pain. Pain interference was also associated with impaired attentional capacity. Additional adjustment for chronic conditions, behaviors, and psychiatric medication resulted in attenuation of many of the observed associations. However, the association between pain interference and general cognitive function persisted. Conclusions. Our findings point to the need for further research to understand how chronic pain may contribute to decline in cognitive function and to determine strategies that may help in preventing or managing these potential consequences of pain on cognitive function in older adults. PMID:26433218

  15. The Intersection of Black Lives Matter and Adult Education: One Community College Initiative

    ERIC Educational Resources Information Center

    Miller, Brian; Schwartz, Joni

    2016-01-01

    This chapter is a call to action for adult educators to critically engage the Black Lives Matter Movement through pedagogy, community engagement and scholarly activism. It explores the intersection of the Black Lives Matter movement and adult education by highlighting the response of one community college initiative.

  16. (Instrumental) Activities of Daily Living in Older Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    2011-01-01

    Daily living skills are important to ageing adults with intellectual disabilities (ID). The purpose of this study was to investigate the level of these skills in older adults with ID and to investigate the influence of gender, age, level of ID and mobility on these skills. Daily living skills were measured with the Barthel Index (for Activities of…

  17. The Role of the Public Libraries in Adult Independent Learning. Part II. Final Report.

    ERIC Educational Resources Information Center

    Mavor, Anne S.; And Others

    Part two of the final report on the adult independent learning program focuses on the following: (1) discussion of the 11 data collection categories developed to meet the information needs of specific groups--advisors working with adult learners, planners monitoring service performance, library policy decision makers responsible for determining…

  18. Adult Education and Aging: Perspectives on Research at a Private Independent Research Organization.

    ERIC Educational Resources Information Center

    Russ-Eft, Darlene

    As part of a symposium on challenges and problems of adult education researchers in different settings, recent research activities at one private independent research organization were examined. Three projects of the American Instituties for Research (AIR) were reviewed, all relating to adult development and aging. The first examined career…

  19. Development of Independence: Locus of Control, Achievement Motivation and Self vs. Adult Evaluation.

    ERIC Educational Resources Information Center

    Dickie, Jane R.; Mast, Vicki A.

    The development and interrelationship of various measures of independence in children ages 3-12 are examined. Subjects were scored on measures of locus of control and achievement motivation and were rated by teachers on independence and achievement. Subjects were also scored on reliance on adult evaluation and self-evaluation. The results showed…

  20. Notch-independent RBPJ controls angiogenesis in the adult heart

    PubMed Central

    Díaz-Trelles, Ramón; Scimia, Maria Cecilia; Bushway, Paul; Tran, Danh; Monosov, Anna; Monosov, Edward; Peterson, Kirk; Rentschler, Stacey; Cabrales, Pedro; Ruiz-Lozano, Pilar; Mercola, Mark

    2016-01-01

    Increasing angiogenesis has long been considered a therapeutic target for improving heart function after injury such as acute myocardial infarction. However, gene, protein and cell therapies to increase microvascularization have not been successful, most likely because the studies failed to achieve regulated and concerted expression of pro-angiogenic and angiostatic factors needed to produce functional microvasculature. Here, we report that the transcription factor RBPJ is a homoeostatic repressor of multiple pro-angiogenic and angiostatic factor genes in cardiomyocytes. RBPJ controls angiogenic factor gene expression independently of Notch by antagonizing the activity of hypoxia-inducible factors (HIFs). In contrast to previous strategies, the cardiomyocyte-specific deletion of Rbpj increased microvascularization of the heart without adversely affecting cardiac structure or function even into old age. Furthermore, the loss of RBPJ in cardiomyocytes increased hypoxia tolerance, improved heart function and decreased pathological remodelling after myocardial infarction, suggesting that inhibiting RBPJ might be therapeutic for ischaemic injury. PMID:27357444

  1. The Life Course of Children Born to Unmarried Mothers: Childhood Living Arrangements and Young Adult Outcomes.

    ERIC Educational Resources Information Center

    Aquilino, William S.

    1996-01-01

    Explored living arrangements among children born to unmarried mothers and the impact of childhood living arrangements on the young adult's life course. Analyses showed that living arrangement patterns after birth to a single mother influenced the likelihood of high school completion, post secondary education, and other conditions. (RJM)

  2. Nursing Strategies for Promoting and Maintaining Function among Community-Living Older Adults: The CAPABLE Intervention

    PubMed Central

    Pho, Anthony T.; Tanner, Elizabeth K.; Roth, Jill; Greeley, Meghan E.; Dorsey, Carmalyn D.; Szanton, Sarah L.

    2012-01-01

    Although many programs aim to help older adults age in place, few target both the home environment and individual physical function. We present an inter-professional intervention called CAPABLE, Community Aging in Place: Advancing Better Living for Elders. CAPABLE’s innovative approach incorporates a nurse, occupational therapist (OT) and handyman to address both individual and environmental factors that contribute to disability. The nurse component of CAPABLE addresses key barriers to functional independence such as pain, depression, strength and balance, medication management and poor communication with the primary care provider. This article focuses primarily on the nursing aspect of the intervention and how it inter-relates with the content and processes of the OT and handyman. PMID:22651978

  3. A decision-support framework for promoting independent living and ageing well.

    PubMed

    Billis, Antonis S; Papageorgiou, Elpiniki I; Frantzidis, Christos A; Tsatali, Marianna S; Tsolaki, Anthoula C; Bamidis, Panagiotis D

    2015-01-01

    Artificial intelligence and decision support systems offer a plethora of health monitoring capabilities in ambient assisted living environment. Continuous assessment of health indicators for elderly people living on their own is of utmost importance, so as to prolong their independence and quality of life. Slow varying, long-term deteriorating health trends are not easily identifiable in seniors. Thus, early sign detection of a specific condition, as well as, any likely transition from a healthy state to a pathological one are key problems that the herein proposed framework aims at resolving. Statistical process control concepts offer a personalized approach toward identification of trends that are away from the atypical behavior or state of the seniors, while fuzzy cognitive maps knowledge representation and inference schema have proved to be efficient in terms of disease classification. Geriatric depression is used as a case study throughout the paper, so to prove the validity of the framework, which is planned to be pilot tested with a series of lone-living seniors in their own homes.

  4. Early and adult social environments have independent effects on individual fitness in a social vertebrate.

    PubMed

    Berger, Vérane; Lemaître, Jean-François; Allainé, Dominique; Gaillard, Jean-Michel; Cohas, Aurélie

    2015-08-22

    Evidence that the social environment at critical stages of life-history shapes individual trajectories is accumulating. Previous studies have identified either current or delayed effects of social environments on fitness components, but no study has yet analysed fitness consequences of social environments at different life stages simultaneously. To fill the gap, we use an extensive dataset collected during a 24-year intensive monitoring of a population of Alpine marmots (Marmota marmota), a long-lived social rodent. We test whether the number of helpers in early life and over the dominance tenure length has an impact on litter size at weaning, juvenile survival, longevity and lifetime reproductive success (LRS) of dominant females. Dominant females, who were born into a group containing many helpers and experiencing a high number of accumulated helpers over dominance tenure length showed an increased LRS through an increased longevity. We provide evidence that in a wild vertebrate, both early and adult social environments influence individual fitness, acting additionally and independently. These findings demonstrate that helpers have both short- and long-term effects on dominant female Alpine marmots and that the social environment at the time of birth can play a key role in shaping individual fitness in social vertebrates.

  5. Early and adult social environments have independent effects on individual fitness in a social vertebrate

    PubMed Central

    Berger, Vérane; Lemaître, Jean-François; Allainé, Dominique; Gaillard, Jean-Michel; Cohas, Aurélie

    2015-01-01

    Evidence that the social environment at critical stages of life-history shapes individual trajectories is accumulating. Previous studies have identified either current or delayed effects of social environments on fitness components, but no study has yet analysed fitness consequences of social environments at different life stages simultaneously. To fill the gap, we use an extensive dataset collected during a 24-year intensive monitoring of a population of Alpine marmots (Marmota marmota), a long-lived social rodent. We test whether the number of helpers in early life and over the dominance tenure length has an impact on litter size at weaning, juvenile survival, longevity and lifetime reproductive success (LRS) of dominant females. Dominant females, who were born into a group containing many helpers and experiencing a high number of accumulated helpers over dominance tenure length showed an increased LRS through an increased longevity. We provide evidence that in a wild vertebrate, both early and adult social environments influence individual fitness, acting additionally and independently. These findings demonstrate that helpers have both short- and long-term effects on dominant female Alpine marmots and that the social environment at the time of birth can play a key role in shaping individual fitness in social vertebrates. PMID:26246552

  6. Dietary patterns of adults living in Ouagadougou and their association with overweight

    PubMed Central

    2010-01-01

    Background Urbanization in developing countries comes along with changes in food habits and living conditions and with an increase in overweight and associated health risks. The objective of the study was to describe dietary patterns of adults in Ouagadougou and to study their relationship with anthropometric status of the subjects. Methods A qualitative food frequency questionnaire was administered to 1,072 adults living in two contrasted districts of Ouagadougou. Dietary patterns were defined by principal component analysis and described by multivariate analysis. Logistic regression was used to study their association with overweight. Results The diet was mainly made of cereals, vegetables and fats from vegetable sources. The two first components of the principal component analysis were interpreted respectively as a "snacking" score and as a "modern foods" score. Both scores were positively and independently associated with the economic level of households and with food expenditures (p ≤ 0.001 for both). The "snacking" score was higher for younger people (p = 0.004), for people having a formal occupation (p = 0.006), for those never married (p = 0.005), whereas the "modern foods" score was associated with ethnic group (p = 0.032) and district of residence (p < 0.001). Thirty-six percent of women and 14.5% of men were overweight (Body Mass Index > 25 kg/m2). A higher "modern foods" score was associated with a higher prevalence of overweight when confounding factors were accounted for (OR = 1.19 [95% CI 1.03-1.36]) but there was no relationship between overweight and the "snacking" score. Conclusions Modernisation of types of foods consumed was associated with the living conditions and the environment and with an increased risk of overweight. This should be accounted for to promote better nutrition and prevent non communicable diseases. PMID:20307296

  7. Adult to adult right lobe living donor liver transplantation: does biological relationship matter?

    PubMed Central

    Zhang, Wei; Tan, Yifei; Shen, Shu; Jiang, Li; Yan, Lunan; Yang, Jiayin; Li, Bo; Wen, Tianfu; Zeng, Yong; Wang, WenTao; Xu, Mingqing

    2017-01-01

    Abstract The influence of the biological relationship between the donor and the recipient is rarely discussed in living donor liver transplantation (LDLT), although it is believed to be an important risk factor in other types of organ transplantations. A total of 272 consecutive patients undergoing adult to adult right lobe LDLT were retrospectively analyzed and stratified into a nonbiologically related (NBR) group (69 patients) and a biologically related (BR) group (203 patients). The preoperative data and postoperative outcomes of both recipients and donors were evaluated. More than two-thirds of the recipients had histories of HBV infection, and hepatocellular carcinoma (HCC) was the main reason for the patients undergoing LDLT in both groups. The percentage of female donors in the NBR group was more than the percentage in the BR group (P = 0.000). There were no differences between the groups in postoperative laboratory testing or daily immunosuppression dose, and the complication rates in both the recipient and donor surgeries showed no significant differences. For patients with benign diseases, the cumulative 1-, 3-, 5-, and 10-year survival rate were 92.9% in the 4 periods in the NBR group and 89.1%, 87.6%, 83.7%, and 83.7%, respectively, in BR group, while for the patients diagnosed as HCC, if patients exceeding the Milan criteria were involved, the 5-year survival rate was 41.2%, compared to 82% for patients within the Milan criteria, which was nearly the same as for those with the benign disease. In conclusion, our findings suggested that the biological relationship between the donor and the recipient in adult to adult LDLT was not associated with the short- and long-term outcomes of recipients diagnosed with benign liver diseases and early stage HCC. Moreover, the criteria for patients diagnosed with HCC to undergo LDLT should be restrictively selected. PMID:28121912

  8. Evaluation in the Older Blind Independent Living Program: Advantages of a Structural Equation Modeling Approach. Research Report

    ERIC Educational Resources Information Center

    Giesen, Martin J.; Cavenaugh, Brenda S.

    2006-01-01

    Rehabilitation Services Administration (RSA) requires that independent living programs annually report demographic information on consumers receiving services and the numbers receiving specific types of services. Although some states collect information on consumer outcomes (for example, improvement in daily living skills), RSA does not request…

  9. Physical activity and functional fitness in institutionalized vs. independently living elderly: a comparison of 70-80-year-old city-dwellers.

    PubMed

    Król-Zielińska, Magdalena; Kusy, Krzysztof; Zieliński, Jacek; Osiński, Wiesław

    2011-01-01

    The purpose of the study was to compare the level of energy expenditure due to physical activity (EEPA) and functional fitness (FF) in 59 women and 82 men aged 70-80 years, divided into three groups: permanent residents in assisted-living facilities (ALFs), participants in adult day care centers (DCCs) and older people living independently, members in community senior centers (CSCs). EEPA and FF were analyzed taking into consideration sex differences. The energy expenditure tended to be lower in DCCs and ALFs subjects than in CSCs members, but significant differences were obtained only in women. Women in different living settings differed only in endurance. In men, the differences were clear in most tests (endurance, strength, agility/dynamic balance) except for flexibility. Institutionalization was connected with a significantly lower level of FF and equalization of sex differences. Education seemed to be an important factor influencing the level of FF in men.

  10. Social participation and independence in activities of daily living: a cross sectional study

    PubMed Central

    Rubio, Encarnación; Lázaro, Angelina; Sánchez-Sánchez, Antonio

    2009-01-01

    Background It is today widely accepted that participation in social activities contributes towards successful ageing whilst, at the same time, maintaining independence in the activities of daily living (ADLs) is the sine qua non for achieving that end. This study looks at people aged 65 and over living in an urban area in Spain who retain the ability to attend Social Centres providing recreational facilities. The aim of this paper is to quantify independence and identify the risk factors involved in its deterioration. Methods The sample size was calculated using the equation for proportions in finite populations based on a random proportional sample type, absolute error (e) = 0.05, α = 0.05, β = 0.1, p = q = 0.5. Two-stage sampling was used. In the first place, the population was stratified by residence and a Social Centre was randomly chosen for each district. In the second stage, individuals were selected in a simple random sample without replacement in proportion to the number of members at each social centre. A multivariate logistical regression analysis takes functional ADL capacity as the dependent variable. The choice of predictive variables was made using a bivariate correlation matrix. Among the estimators obtained, Nagelkerke's R2 coefficient, and the Odds ratio (CI 95%) were considered. Sensitivity and 1-specificity were adopted to present the results in graphic form. Results Out of this sample, 63.7% were fully capable of carrying out ADLs, while the main factors contributing to deterioration, identified on the basis of a logistic regression model, are in order of importance, poor physical health, poor mental health, age (above 75 years) and gender (female). The model employed has a predictive value of 88% and 92% (depending on the age range considered) with regard to the independence in ADLs. Conclusion A review of the few Spanish works using similar methodology shows that the percentage of non-institutionalised persons who are independent enough to

  11. Design and Evaluation of a Medication Adherence Application with Communication for Seniors in Independent Living Communities

    PubMed Central

    Dasgupta, Dipanwita; Johnson, Reid A.; Chaudhry, Beenish; Reeves, Kimberly G.; Willaert, Patty; Chawla, Nitesh V.

    2016-01-01

    Medication non-adherence is a pressing concern among seniors, leading to a lower quality of life and higher healthcare costs. While mobile applications provide a viable medium for medication management, their utility can be limited without tackling the specific needs of seniors and facilitating the active involvement of care providers. To address these limitations, we are developing a tablet-based application designed specifically for seniors to track their medications and a web portal for their care providers to track medication adherence. In collaboration with a local Aging in Place program, we conducted a three-month study with sixteen participants from an independent living facility. Our study found that the application helped participants to effectively track their medications and improved their sense of wellbeing. Our findings highlight the importance of catering to the needs of seniors and of involving care providers in this process, with specific recommendations for the development of future medication management applications. PMID:28269843

  12. An Approach to Life Skills Group Work with Youth in Transition to Independent Living: Theoretical, Practice, and Operational Considerations

    ERIC Educational Resources Information Center

    Allen, Terrence T.; Williams, Larry D.

    2012-01-01

    Group work is fundamental to working with youth learning about independent living and in making the tough and challenging transition to independence. The authors, seasoned and experienced group workers and researchers with youth leaving the child welfare system, will present a conceptual framework and set of practices for helping youth gain those…

  13. Age, stress, and isolation in older adults living with HIV.

    PubMed

    Webel, Allison R; Longenecker, Chris T; Gripshover, Barbara; Hanson, Jan E; Schmotzer, Brian J; Salata, Robert A

    2014-01-01

    People living with HIV (PLWH) have increasingly longer life spans. This age group faces different challenges than younger PLWH, which may include increased stress and social isolation. The purpose of this study was to determine whether the age and sex of PLWH are associated with measures of physiologic stress, perceived stress, and social isolation. In this cross-sectional study, we enrolled 102 PLWH equally into four groups divided by age (younger or older than 50 years) and gender. Participants completed well-validated survey measurements of stress and isolation, and their heart rate variability over 60 minutes was measured by Holter monitor. The mean (SD) Perceived Stress Scale score was 17.4 (6.94), mean Visual Analog Stress Scale score was 3.51 (2.79), and mean Hawthorne Friendship Scale score, a measure of social isolation, was 17.03 (4.84). Mean heart rate variability expressed as the SD of successive N-N intervals was 65.47 (31.16) msec. In multivariable regression models that controlled for selected demographic variables, there was no relationship between the Perceived Stress Scale and age (coefficient = -0.09, p =-0.23) or female gender (coefficient = -0.12, p = 0.93); however, there was a modest relationship between female gender and stress using the Visual Analog Stress Scale (coefficient = 1.24, p = 0.05). Perceived Stress was negatively associated with the Hawthorne Friendship score (coefficient = -0.34, p = 0.05). Hawthorne Friendship score was positively associated with younger age (coefficient = 0.11, p = 0.02). Age was the only independent predictor of physiologic stress as measured by heart rate variability (coefficient = -1.3, p < 0.01). Our findings suggest that younger PLWH may experience more social isolation; however, age-related changes in heart rate variability do not appear to be related to perceived stress or social isolation. Future longitudinal research is required to more thoroughly understand this relationship and its impact on the

  14. A pH-independent DNA nanodevice for quantifying chloride transport in organelles of living cells

    NASA Astrophysics Data System (ADS)

    Saha, Sonali; Prakash, Ved; Halder, Saheli; Chakraborty, Kasturi; Krishnan, Yamuna

    2015-07-01

    The concentration of chloride ions in the cytoplasm and subcellular organelles of living cells spans a wide range (5-130 mM), and is tightly regulated by intracellular chloride channels or transporters. Chloride-sensitive protein reporters have been used to study the role of these chloride regulators, but they are limited to a small range of chloride concentrations and are pH-sensitive. Here, we show that a DNA nanodevice can precisely measure the activity and location of subcellular chloride channels and transporters in living cells in a pH-independent manner. The DNA nanodevice, called Clensor, is composed of sensing, normalizing and targeting modules, and is designed to localize within organelles along the endolysosomal pathway. It allows fluorescent, ratiometric sensing of chloride ions across the entire physiological regime. We used Clensor to quantitate the resting chloride concentration in the lumen of acidic organelles in Drosophila melanogaster. We showed that lumenal lysosomal chloride, which is implicated in various lysosomal storage diseases, is regulated by the intracellular chloride transporter DmClC-b.

  15. Community Living and Housing Options for Adults with Disabilities

    ERIC Educational Resources Information Center

    Reinke, Thomas

    2009-01-01

    Data indicates that people with intellectual and developmental disabilities (ID/DD) are increasingly receiving community based services in lieu of institutionalization. The Research and Training Center on Community Living at the University of Minnesota reports that the number of people living in large state run institutions decreased from 117,147…

  16. Teaching Social Living Skills; Adult Basic Education, a Teacher's Manual.

    ERIC Educational Resources Information Center

    Safran, Herbert

    A variety of methods in instructing adults is presented in this teacher's manual which also mentions the availability of packets of instructional materials and lists the subject areas covered. To this is added comments on the background material for the adult teacher, and on the importance of aims, motivation, and development in lesson plans for…

  17. ICT services for active ageing and independent living: identification and assessment.

    PubMed

    Christophorou, Christophoros; Kleanthous, Styliani; Georgiadis, Dimosthenis; Cereghetti, Donato M; Andreou, Panayiotis; Wings, Cindy; Christodoulou, Eleni; Samaras, George

    2016-09-01

    Based on the demographic changes and the rapid increase of older population in Europe, major challenges are expected to rise, both in the economy as well as the society, whether the dominant care model for supporting elderly in living independently at home continues to rely on informal and formal caregivers' assistance. To respond to the above challenges, assistive technologies are called to develop Information and Communication Technology (ICT) services for supporting seniors to remain active and independent, for as long as possible, in their chosen home environment. The work described in this Letter is based on the Miraculous-Life project and it emphasises the identification and assessment of a set of services that an ICT system for Ageing Well should support, in an actual end-users setting. The outcome of this work may inform fellow researchers and other projects in the area of Ageing Well in: (i) understanding which ICT services can be the most valuable for end-users' Quality of Life, (ii) prioritising the development of related ICT services and (iii) facilitating better recourse allocation in order to reduce any risks associated to implementation failures of these services within their respective projects. A final trial phase is planned, aiming to validate the Miraculous Life prototype longitudinally in a naturalistic environment with a larger sample size. During this trial, it will be investigated if perceived usefulness, satisfaction and motivation could be predicted by sociodemographic variables and personality.

  18. Independence and shared decision making: the role of smart home technology in empowering older adults.

    PubMed

    Demiris, George

    2009-01-01

    This study aims to explore the concepts of independence and shared decision making in the context of smart home technologies for older adults. We conducted a Delphi study with three rounds involving smart home designers, and researchers as well as community dwelling older adults. While there were differences in the way different stakeholders define these concepts, the study findings provide clear implications for the design, implementation and evaluation of smart home applications.

  19. Cigarette Smoking and Alcohol Consumption among Chinese Older Adults: Do Living Arrangements Matter?

    PubMed Central

    Zhang, Jiaan; Wu, Liyun

    2015-01-01

    This study used five waves of the Chinese Longitudinal Healthy Longevity Survey to examine the relationship between living arrangements, smoking, and drinking among older adults in China from 1998–2008. We found that living arrangements had strong implications for cigarette smoking and alcohol consumption among the elderly. First, the likelihood of smoking was lower among older men living with children, and older women living either with a spouse, or with both a spouse and children; and the likelihood of drinking was lower among both older men, and women living with both a spouse and children, compared with those living alone. Second, among dual consumers (i.e., being a drinker and a smoker), the amount of alcohol consumption was lower among male dual consumers living with children, while the number of cigarettes smoked was higher among female dual consumers living with others, compared with those living alone. Third, among non-smoking drinkers, the alcohol consumption was lower among non-smoking male drinkers in all types of co-residential arrangements (i.e., living with a spouse, living with children, living with both a spouse and children, or living with others), and non-smoking female drinkers living with others, compared with those living alone. Results highlighted the importance of living arrangements to cigarette smoking and alcohol consumption among Chinese elderly. Co-residential arrangements provided constraints on Chinese older adults’ health-risk behaviors, and had differential effects for men and women. PMID:25711361

  20. Progress in ambient assisted systems for independent living by the elderly.

    PubMed

    Al-Shaqi, Riyad; Mourshed, Monjur; Rezgui, Yacine

    2016-01-01

    One of the challenges of the ageing population in many countries is the efficient delivery of health and care services, which is further complicated by the increase in neurological conditions among the elderly due to rising life expectancy. Personal care of the elderly is of concern to their relatives, in case they are alone in their homes and unforeseen circumstances occur, affecting their wellbeing. The alternative; i.e. care in nursing homes or hospitals is costly and increases further if specialized care is mobilized to patients' place of residence. Enabling technologies for independent living by the elderly such as the ambient assisted living systems (AALS) are seen as essential to enhancing care in a cost-effective manner. In light of significant advances in telecommunication, computing and sensor miniaturization, as well as the ubiquity of mobile and connected devices embodying the concept of the Internet of Things (IoT), end-to-end solutions for ambient assisted living have become a reality. The premise of such applications is the continuous and most often real-time monitoring of the environment and occupant behavior using an event-driven intelligent system, thereby providing a facility for monitoring and assessment, and triggering assistance as and when needed. As a growing area of research, it is essential to investigate the approaches for developing AALS in literature to identify current practices and directions for future research. This paper is, therefore, aimed at a comprehensive and critical review of the frameworks and sensor systems used in various ambient assisted living systems, as well as their objectives and relationships with care and clinical systems. Findings from our work suggest that most frameworks focused on activity monitoring for assessing immediate risks, while the opportunities for integrating environmental factors for analytics and decision-making, in particular for the long-term care were often overlooked. The potential for

  1. Is Childhood Socioeconomic Status Independently Associated with Adult BMI after Accounting for Adult and Neighborhood Socioeconomic Status?

    PubMed Central

    2017-01-01

    Childhood socioeconomic status (SES) is inversely associated with adult weight in high income countries. Whether the influence of childhood SES on adult weight is best described using a critical period model or an accumulation of risk model is not yet settled. This research tests whether childhood SES is associated with adult BMI and likelihood of obesity independent of adult socioeconomic status and neighborhood characteristics. Data on individual childhood and adult characteristics come from the Health and Retirement Study (N = 13,545). Data on neighborhood characteristics come from the 2000 Decennial Census and American Community Survey (2005–2009). In the fully adjusted models, perceived financial hardship before the age of sixteen and having a father who was unemployed are associated with higher BMI among males and, among females, paternal education remains associated with adult BMI. However, childhood SES is not associated with likelihood of obesity after fully adjusting for adult SES and neighborhood characteristics, suggesting that the direct effects of early childhood SES on BMI are small relative to the other factors associated with obesity in adulthood. PMID:28095430

  2. How Living or Traveling to Foreign Locations Influences Adults' Worldviews and Impacts Personal Identity

    ERIC Educational Resources Information Center

    Yelich Biniecki, Susan M.; Conceição, Simone C. O.

    2014-01-01

    People are living and traveling to places all over the world. An exploration of how this movement influences learners' worldviews has implications for adult development, identity, and learning. The purpose of this paper is to present a phenomenological study conducted in the U.S. that examined how individuals' living or traveling…

  3. Spirituality: A Coping Mechanism in the Lives of Adults with Congenital Disabilities

    ERIC Educational Resources Information Center

    Specht, Jacqueline A.; King, Gillian A.; Willoughby, Colleen; Brown, Elizabeth G.; Smith, Linda

    2005-01-01

    The purpose of this study was to gain insight into the perspective of individuals with congenital disabilities about spirituality as a coping mechanism during crucial times in their lives, Qualitative analysis of interviews assessing turning points in the lives of 15 adults (6 women and 9 men; M = 37 years) with spina bifida, cerebral palsy, or…

  4. Adaptive Behavior among Adults with Intellectual Disabilities and Its Relationship to Community Independence

    ERIC Educational Resources Information Center

    Woolf, Steve; Woolf, Christine Merman; Oakland, Thomas

    2010-01-01

    This study examined relationships between general adaptive behavior and the degree of community independence displayed by 272 adults with intellectual disabilities. Specifically, the Adaptive Behavior Assessment System-Second Edition (ABAS-II; Harrison & Oakland, 2003) was completed for each participant and compared with actual levels of work and…

  5. Determinants of Domain Knowledge and Independent Study Learning in an Adult Sample

    ERIC Educational Resources Information Center

    Ackerman, Phillip L.; Beier, Margaret E.

    2006-01-01

    The ability (fluid and crystallized intelligence) and nonability (personality, interests, self-concept, etc.) determinants of domain knowledge before and after an independent learning opportunity were evaluated in the context of a study of 141 adults between the ages of 18 and 69. The domain knowledge under consideration included an array of…

  6. Adults Must Be College-Ready Too: ABE-to-College Transition Project Inspires Lives

    ERIC Educational Resources Information Center

    Wilson, Blenda J.

    2006-01-01

    In this article, the author shares the voices of adults whose lives have been changed by their enrollment in a set of innovative college readiness programs geared toward adults. These women and men have overcome obstacles between them and college that they believed were insurmountable--fear, inadequate academic preparation, lack of information…

  7. Social Cohesion and the Smoking Behaviors of Adults Living with Children

    PubMed Central

    Sharif, Mienah Z.; Albert, Stephanie L.

    2015-01-01

    Introduction The smoking behavior of adults can negatively impact children through exposure to environmental tobacco smoke and by modeling this unhealthy behavior. Little research has examined the role of the social environment in smoking behaviors of adults living with children. The present study specifically analyzed the relationship between social cohesion and smoking behaviors of adults living with children. Methods Data from the 2009 California Health Interview Survey, a random-digit dial cross-sectional survey of California Adults, were used. Adults living with children reported their levels of social cohesion and smoking behaviors (N=13,978). Logistic regression models were used to predict odds of being a current smoker or living in a household in which smoking was allowed, from social cohesion. Results Overall, 13% of the sample was current smokers and 3.74% lived in households in which smoking was allowed. Logistic regression models showed that each one-unit increase in social cohesion is associated with reduced odds of being a current smoker (AOR= 0.92; 95% CI= 0.85–0.99) and reduced odds of living in a household in which smoking is allowed (AOR= 0.84; 95% CI= 0.75–0.93), after controlling for sociodemographic characteristics. Conclusions Among adults living with children, higher social cohesion is associated with a lower likelihood of both being and smoker and living in a home where smoking is allowed. Thus, future research is needed to better understand mechanisms that explain the relationship between social cohesion and smoking-related behavior in order to prevent smoking-related health consequences and smoking initiation among children and adults. PMID:26562680

  8. Children Living with HIV-Infected Adults: Estimates for 23 Countries in sub-Saharan Africa

    PubMed Central

    Short, Susan E.; Goldberg, Rachel E.

    2015-01-01

    Background In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children’s health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children’s health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children. Methods Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households. Results The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent. Conclusion Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct

  9. Relationship between physical activity and markers of oxidative stress in independent community-living elderly individuals.

    PubMed

    Fraile-Bermúdez, A B; Kortajarena, M; Zarrazquin, I; Maquibar, A; Yanguas, J J; Sánchez-Fernández, C E; Gil, J; Irazusta, A; Ruiz-Litago, F

    2015-10-01

    The aim of the present study was to examine the relationship between objective data of physical activity and markers of oxidative stress in older men and women. Participants were old adults, aged≥60years (61 women and 34 men) who were all capable of performing basic daily activities by themselves and lived on their own. To describe physical activity we used objective data measured by accelerometers which record active and sedentary periods during everyday life for five days. Determination of oxidative stress was conducted from three perspectives: determination plasma total antioxidant status (TAS), plasma antioxidant enzyme activities, i.e., glutathione peroxidase (GPx), catalase (CAT) and superoxide dismutase (SOD), and membrane lipid peroxidation (TBARS). In the group of women, those who met physical activity recommendations (WR) had lower level of TAS. In addition, the moderate to vigorous physical activity (MVPA) was negatively correlated with TAS. Simultaneously, MVPA was correlated with increase in the GPx antioxidant enzyme activity, and the counts per minute were positively correlated with CAT activity. In the group of men, the cpm and the MVPA were negatively correlated with lipid peroxidation while lifestyle physical activity was positively correlated with CAT activity. These findings suggest that MVPA in the elderly although it is related to a decrease in the TAS in women, induces adaptive increase in antioxidant enzyme activity and decreases lipid peroxidation in both women and men. These results suggest that at this time of life, it is not only the amount of physical activity performed that is important but also its intensity.

  10. Fitness but not weight status is associated with projected physical independence in older adults.

    PubMed

    Sardinha, Luis B; Cyrino, Edilson S; Santos, Leandro Dos; Ekelund, Ulf; Santos, Diana A

    2016-06-01

    Obesity and fitness have been associated with older adults' physical independence. We aimed to investigate the independent and combined associations of physical fitness and adiposity, assessed by body mass index (BMI) and waist circumference (WC) with the projected ability for physical independence. A total of 3496 non-institutionalized older adults aged 65 and older (1167 male) were included in the analysis. BMI and WC were assessed and categorized according to established criteria. Physical fitness was evaluated with the Senior Fitness Test and individual test results were expressed as Z-scores. Projected ability for physical independence was assessed with the 12-item composite physical function scale. Logistic regression was used to estimate the odds ratio (OR) for being physically dependent. A total of 30.1 % of participants were classified as at risk for losing physical independence at age 90 years. Combined fitness and fatness analysis demonstrated that unfit older adults had increased odds ratio for being physically dependent in all BMI categories (normal: OR = 9.5, 95 %CI = 6.5-13.8; overweight: OR = 6.0, 95 %CI = 4.3-8.3; obese: OR = 6.7, 95 %CI = 4.6-10.0) and all WC categories (normal: OR = 10.4, 95%CI = 6.5-16.8; middle: OR = 6.2, 95 %CI = 4.1-9.3; upper: OR = 7.0, 95 %CI = 4.8-10.0) compared to fit participants that were of normal weight and fit participants with normal WC, respectively. No increased odds ratio was observed for fit participants that had increased BMI or WC. In conclusion, projected physical independence may be enhanced by a normal weight, a normal WC, or an increased physical fitness. Adiposity measures were not associated with physical independence, whereas fitness is independently related to physical independence. Independent of their weight and WC status, unfit older adults are at increased risk for losing physical independence.

  11. 77 FR 50090 - Notice of Proposed Information Collection Requests; State Plan for Independent Living (SPIL)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-20

    ... systems advocacy--to maximize the leadership, empowerment, independence and productivity of individuals..., empowerment, independence and productivity of individuals with significant disabilities and to promote...

  12. Data-driven model-independent searches for long-lived particles at the LHC

    NASA Astrophysics Data System (ADS)

    Coccaro, Andrea; Curtin, David; Lubatti, H. J.; Russell, Heather; Shelton, Jessie

    2016-12-01

    Neutral long-lived particles (LLPs) are highly motivated by many beyond the Standard Model scenarios, such as theories of supersymmetry, baryogenesis, and neutral naturalness, and present both tremendous discovery opportunities and experimental challenges for the LHC. A major bottleneck for current LLP searches is the prediction of Standard Model backgrounds, which are often impossible to simulate accurately. In this paper, we propose a general strategy for obtaining differential, data-driven background estimates in LLP searches, thereby notably extending the range of LLP masses and lifetimes that can be discovered at the LHC. We focus on LLPs decaying in the ATLAS muon system, where triggers providing both signal and control samples are available at LHC run 2. While many existing searches require two displaced decays, a detailed knowledge of backgrounds will allow for very inclusive searches that require just one detected LLP decay. As we demonstrate for the h →X X signal model of LLP pair production in exotic Higgs decays, this results in dramatic sensitivity improvements for proper lifetimes ≳10 m . In theories of neutral naturalness, this extends reach to glueball masses far below the b ¯b threshold. Our strategy readily generalizes to other signal models and other detector subsystems. This framework therefore lends itself to the development of a systematic, model-independent LLP search program, in analogy to the highly successful simplified-model framework of prompt searches.

  13. A Living Spiral of Understanding: Community-Based Adult Education

    ERIC Educational Resources Information Center

    Cueva, Melany

    2010-01-01

    What does it mean to provide community-based health education that respects adults of diverse cultures and ways of being in the world? How does one nurture meaningful learning opportunities that awaken possibilities as a catalyst for understanding, conversation, and action? In this article, nurturing place, sharing power, heart listening, talking…

  14. Living with Cystic Fibrosis: A Guide for the Young Adult.

    ERIC Educational Resources Information Center

    Cystic Fibrosis Foundation, Atlanta, GA.

    Intended for the young adult with cystic fibrosis, the booklet provides information on dealing with problems and on advances in treatment and detection related to the disease. Addressed are the following topics: description of cystic fibrosis; inheritance of cystic fibrosis; early diagnosis; friends, careers, and other matters; treatment;…

  15. Living Adult Education. Freire in Scotland. Innovations in Education.

    ERIC Educational Resources Information Center

    Kirkwood, Gerri; Kirkwood, Colin

    This document describes and assesses the process of adapting Paulo Friere's ideas in a Western European urban context. The Adult Learning Project (ALP), in the Gorgie Dalry section of Edinburgh, Scotland, is a sustained experiment in the application of Freire's educational principles. Following an introduction, chapter 1 describes the history of…

  16. Married Couples in Assisted Living: Adult Children's Experiences Providing Support

    ERIC Educational Resources Information Center

    Kemp, Candace L.

    2012-01-01

    Being married in later life often prevents relocation to long-term care settings, but couples do relocate to these environments. Typically, this transition does not mark the end of support provided by families, especially adult children. Little is known about children's experiences providing support in care settings when both parents are involved.…

  17. Writing Our Lives: An Adult Basic Skills Program.

    ERIC Educational Resources Information Center

    Stasz, Bird B.; And Others

    1991-01-01

    Describes a two-year literacy project: an innovative adult basic skills class designed and orchestrated by the students themselves, where Head Start mothers and college-student volunteer tutors worked together. Attributes the project's enormous success to combining the whole-language approach with oral history and the writing process, resulting in…

  18. Attitudes Towards and Limitations to ICT Use in Assisted and Independent Living Communities: Findings from a Specially-Designed Technological Intervention

    PubMed Central

    Berkowsky, Ronald W.; Cotten, Shelia R.; Yost, Elizabeth A.; Winstead, Vicki P.

    2012-01-01

    While much literature has been devoted to theoretical explanations of the learning processes of older adults and to the methods of teaching best utilized in older populations, less has focused on the education of older adults who reside in assisted and independent living communities (AICs), especially with regards to information and communication technology (ICT) education. The purpose of this study is to determine whether participants’ attitudes and views towards computers and the Internet are affected as a result of participating in an eight-week training program designed to enhance computer and Internet use among older adults in such communities. Specifically, we examine if ICT education specially designed for AIC residents results in more positive attitudes towards ICTs and a perceived decrease in factors that may limit or prevent computer and Internet use. We discuss the implications of these results for enhancing the quality of life for older adults in AICs and make recommendations for those seeking to decrease digital inequality among older adults in these communities through their own ICT classes. PMID:24244065

  19. Attitudes Towards and Limitations to ICT Use in Assisted and Independent Living Communities: Findings from a Specially-Designed Technological Intervention.

    PubMed

    Berkowsky, Ronald W; Cotten, Shelia R; Yost, Elizabeth A; Winstead, Vicki P

    2013-11-01

    While much literature has been devoted to theoretical explanations of the learning processes of older adults and to the methods of teaching best utilized in older populations, less has focused on the education of older adults who reside in assisted and independent living communities (AICs), especially with regards to information and communication technology (ICT) education. The purpose of this study is to determine whether participants' attitudes and views towards computers and the Internet are affected as a result of participating in an eight-week training program designed to enhance computer and Internet use among older adults in such communities. Specifically, we examine if ICT education specially designed for AIC residents results in more positive attitudes towards ICTs and a perceived decrease in factors that may limit or prevent computer and Internet use. We discuss the implications of these results for enhancing the quality of life for older adults in AICs and make recommendations for those seeking to decrease digital inequality among older adults in these communities through their own ICT classes.

  20. Effects of Living Alone on Social Capital and Health Among Older Adults in China.

    PubMed

    Xu, Qingwen; Norstrand, Julie A; Du, Yan

    2015-12-01

    Social capital has been connected with positive health outcomes across countries, including China. Given the rise in the number of seniors living alone, there is a need to examine the health benefits of social capital, accounting for living arrangements. Data from the 2005 Chinese General Social Survey were used to test research hypotheses. Controlling for demographics, elders living alone possessed similar level of social capital compared with elders living with others. While bonding and linking social capital were significant factors in urban areas and linking social capital was a significant factor in rural areas, the relationship between living alone and health did not differ based on the level of social capital possession. When the traditional intergenerational living arrangement has not been a valid option for many older adults in China, seeking new way of family caring, and developing appropriate social and institutional structures to assist elders living alone, becomes critical.

  1. Factors influencing life satisfaction of Korean older adults living with family.

    PubMed

    Sok, Sohyune R

    2010-03-01

    The purpose of this study was to identify the factors influencing life satisfaction of Korean older adults living with family. Participants included 267 adults age 65 and older who met eligibility criteria. Analyses showed that the prediction model of the life satisfaction of older adults who are living with their family was significant (F=24.429, p<0.001). The value of the adjusted R(2) was 0.306, which corresponds to the explanatory power of 30.6%. The factor found to have the greatest influence on these adults' life satisfaction was depression (beta=0.090), monthly pocket money (beta=0.060), and age (beta=0.040). It is possible that older adults' life satisfaction increases when they are provided with nursing interventions and are able to effectively manage their health. Nursing interventions must strive to improve their self-esteem and address their depression.

  2. Detecting delirium in older adults living at home.

    PubMed

    Malenfant, Priscilla; Voyer, Philippe

    2012-01-01

    The aim of this study was to determine whether in-home care nurses had the necessary knowledge to detect delirium in older adults. To this end, 87 home care nurses from 2 sites in the greater Quebec City region in Canada answered a questionnaire. The results showed nurses had limited level of knowledge about the diagnostic criteria for delirium, the main signs and symptoms of delirium, and the tools for its detection. Moreover, 54.4% of the in-home care nurses were able to recognize delirium, from structured clinical vignettes.

  3. 34 CFR 364.25 - What are the requirements for a statewide network of centers for independent living?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... of centers for independent living? (a) The State plan must include a design for the establishment of... (c) of the Act and subparts F and G of 34 CFR part 366. (b) The design required by paragraph (a) of... serving these areas. (Approved by the Office of Management and Budget under control number...

  4. 38 CFR 21.45 - Extending the period of eligibility for a program of independent living beyond basic period of...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... period of eligibility. A Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) may... veteran's basic period of eligibility if the CP or VRC determines that an extension is necessary for the veteran to achieve maximum independence in daily living. The extension may be for such period as the CP...

  5. 38 CFR 21.45 - Extending the period of eligibility for a program of independent living beyond basic period of...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... period of eligibility. A Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) may... veteran's basic period of eligibility if the CP or VRC determines that an extension is necessary for the veteran to achieve maximum independence in daily living. The extension may be for such period as the CP...

  6. 38 CFR 21.45 - Extending the period of eligibility for a program of independent living beyond basic period of...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... period of eligibility. A Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) may... veteran's basic period of eligibility if the CP or VRC determines that an extension is necessary for the veteran to achieve maximum independence in daily living. The extension may be for such period as the CP...

  7. 38 CFR 21.45 - Extending the period of eligibility for a program of independent living beyond basic period of...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... period of eligibility. A Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) may... veteran's basic period of eligibility if the CP or VRC determines that an extension is necessary for the veteran to achieve maximum independence in daily living. The extension may be for such period as the CP...

  8. 38 CFR 21.45 - Extending the period of eligibility for a program of independent living beyond basic period of...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... period of eligibility. A Counseling Psychologist (CP) or Vocational Rehabilitation Counselor (VRC) may... veteran's basic period of eligibility if the CP or VRC determines that an extension is necessary for the veteran to achieve maximum independence in daily living. The extension may be for such period as the CP...

  9. 34 CFR 365.11 - How is the allotment of Federal funds for State independent living (IL) services computed?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true How is the allotment of Federal funds for State... Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING SERVICES How Does the Secretary Make a Grant to a State? § 365.11 How...

  10. 34 CFR 365.11 - How is the allotment of Federal funds for State independent living (IL) services computed?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false How is the allotment of Federal funds for State... Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION STATE INDEPENDENT LIVING SERVICES How Does the Secretary Make a Grant to a State? § 365.11 How...

  11. Unmet Needs: Habilitation, Rehabilitation, and Independent Living Services for Persons Who Are Blind or Have Low Vision

    ERIC Educational Resources Information Center

    Crudden, Adele; Sansing, William

    2011-01-01

    A statewide assessment of stakeholders' needs was conducted for a state agency providing habilitation, rehabilitation, and independent living services to persons of all ages who are visually impaired (that is, those who are are blind or have low vision). This needs assessment was designed to acquire an accurate and thorough picture of the agency's…

  12. Community Based Training--Non-Traditional Curriculum Options for Work and Independent Living Training of Secondary Deaf-Blind Adolescents.

    ERIC Educational Resources Information Center

    Dildy, Dennis

    Age appropriate training programs in natural environments for deaf-blind adolescents help to develop functional skills, with the ultimate goal of independent living and work placement. Other approaches to the education of handicapped children entail activity for the sake of activity, or babysitting and fun activities. The actual training of a…

  13. Mobilizing Resources for Independent Living: A National Conference (New Orleans, Louisiana, August 5-7, 2002). Participant's Manual.

    ERIC Educational Resources Information Center

    Male, Richard; Schulz, Lee; Jones, Darrell Lynn; Buppapong, Raweewan; Langbehn, Kristy; George, Carri; Petty, Richard; Heinsohn, Dawn

    The participant's manual contains training materials for a national conference on mobilizing resources and fund raising in agencies concerned with promoting independent living for people with disabilities. Preliminary materials include the conference agenda, background information about the trainers, organizational information on Independent…

  14. Evidence-informed recommendations for rehabilitation with older adults living with HIV: a knowledge synthesis

    PubMed Central

    O'Brien, Kelly K; Solomon, Patricia; Trentham, Barry; MacLachlan, Duncan; MacDermid, Joy; Tynan, Anne-Marie; Baxter, Larry; Casey, Alan; Chegwidden, William; Robinson, Greg; Tran, Todd; Wu, Janet; Zack, Elisse

    2014-01-01

    Objective Our aim was to develop evidence-informed recommendations for rehabilitation with older adults living with HIV. Design We conducted a knowledge synthesis, combining research evidence specific to HIV, rehabilitation and ageing, with evidence on rehabilitation interventions for common comorbidities experienced by older adults with HIV. Methods We included highly relevant HIV-specific research addressing rehabilitation and ageing (stream A) and high-quality evidence on the effectiveness of rehabilitation interventions for common comorbidities experienced by older adults ageing with HIV (stream B). We extracted and synthesised relevant data from the evidence to draft evidence-informed recommendations for rehabilitation. Draft recommendations were refined based on people living with HIV (PLHIV) and clinician experience, values and preferences, reviewed by an interprofessional team for Grading of Recommendations Assessment, Development, and Evaluation (GRADE) (quality) rating and revision and then circulated to PLHIV and clinicians for external endorsement and final refinement. We then devised overarching recommendations to broadly guide rehabilitation with older adults living with HIV. Results This synthesis yielded 8 overarching and 52 specific recommendations. Thirty-six specific recommendations were derived from 108 moderate-level or high-level research articles (meta-analyses and systematic reviews) that described the effectiveness of rehabilitation interventions for comorbidities that may be experienced by older adults with HIV. Recommendations addressed rehabilitation interventions across eight health conditions: bone and joint disorders, cancer, stroke, cardiovascular disease, mental health challenges, cognitive impairments, chronic obstructive pulmonary disease and diabetes. Sixteen specific recommendations were derived from 42 research articles specific to rehabilitation with older adults with HIV. The quality of evidence from which these

  15. Adult Learners' Perceptions of a Professional Development Program Comparing Live Distance Learning versus Live Local Learning

    ERIC Educational Resources Information Center

    Buxton, Eric; De Muth, James

    2012-01-01

    Reduced corporate training budgets require cost efficiencies in professional development. Distance learning, with its lower intrinsic costs, will likely become more prevalent. Therefore, the educational experience will change for many professionals. The objective of this study was to examine the perceptions of adult learners attending a drug…

  16. Left lobe living donor liver transplantation in adults: What is the safety limit?

    PubMed

    Ikegami, Toru; Yoshizumi, Tomoharu; Sakata, Kazuhito; Uchiyama, Hideaki; Harimoto, Norifumi; Harada, Noboru; Itoh, Shinji; Nagatsu, Akihisa; Soejima, Yuji; Maehara, Yoshihiko

    2016-12-01

    Small-for-size syndrome (SFSS) is the most significant cause of graft loss after living donor liver transplantation (LDLT), especially after left lobe (LL) LDLT in adults. The safety limit of applying LL-LDLT in adults without severe SFSS with a high rate of lethality needs to be determined. A total of 207 LL-LDLTs in adults since September 2005 were evaluated to analyze the risk factors for severe SFSS, defined as a serum total bilirubin concentration of ≥20.0 mg/dL after LDLT. Although there were no significant differences in cumulative graft survival after LDLT between medium grafts (graft volume [GV] to standard liver volume [SLV] ratio ≥ 40.0%), small grafts (35.0% ≤ GV/SLV < 40.0%), and extra small grafts (GV/SLV < 35.0%), patients with severe SFSS showed a significantly lower 5-year graft survival rate than those without (42.9% versus 94.3%, respectively; P < 0.001). Multivariate analysis for severe SFSS after LL-LDLT showed that donor age of ≥48 years (P = 0.01), Model for End-Stage Liver Disease (MELD) score of ≥ 19 (P < 0.01), and end portal venous pressure of ≥19 mm Hg (P = 0.04) were the significant and independent factors for severe SFSS after LL-LDLT. Within such high-risk subgroups of patients with a donor age of ≥48 years or MELD score of ≥ 19 before LDLT, operative blood loss volume of ≥8.0 L was a risk factor for severe SFSS. LL-LDLT in adults could be indicated and provide acceptable outcomes for the combinations of donors aged < 48 years and recipients with a MELD score of <19. Smaller grafts might yield acceptable outcomes in appropriately selected donor-recipient combinations. Liver Transplantation 22 1666-1675 2016 AASLD.

  17. Identification of asthma clusters in two independent Korean adult asthma cohorts.

    PubMed

    Kim, Tae-Bum; Jang, An-Soo; Kwon, Hyouk-Soo; Park, Jong-Sook; Chang, Yoon-Seok; Cho, Sang-Heon; Choi, Byoung Whui; Park, Jung-Won; Nam, Dong-Ho; Yoon, Ho-Joo; Cho, Young-Joo; Moon, Hee-Bom; Cho, You Sook; Park, Choon-Sik

    2013-06-01

    Asthma is a heterogeneous airway disease with various clinical phenotypes. It is crucial to clearly identify clinical phenotypes to achieve better asthma management. We used cluster analysis to classify the clinical groups of 724 asthmatic patients from the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA), and in 1843 subjects from another independent Korean asthma cohort of Soonchunhyang University Asthma Genome Research Centre (SCH) (Bucheon, Republic of Korea). Hierarchical cluster analysis was performed by Ward's method, followed by κ-means cluster analysis. Cluster analysis of the COREA cohort indicated four asthma subtypes: 1) smoking asthma; 2) severe obstructive asthma; 3) early-onset atopic asthma; and 4) late-onset mild asthma. An independent cluster analysis of the SCH cohort also indicated four clusters that were similar to the COREA clusters. Our results indicate that adult Korean asthma patients can be classified into four distinct clusters.

  18. Obesity and Disability: Relation Among Older Adults Living in Latin America and the Caribbean

    PubMed Central

    Al Snih, Soham; Graham, James E.; Kuo, Yong-Fang; Goodwin, James S.; Markides, Kyriakos S.; Ottenbacher, Kenneth J.

    2010-01-01

    The prevalence and incidence of both obesity and disability are projected to increase in the coming decades. The authors examined the relation between obesity and disability in older adults from 6 Latin American cities participating in the Health, Well-Being and Aging in Latin America and the Caribbean (SABE) Study (1999–2000). The sample included 6,166 participants aged 65 years or more. Data on sociodemographic factors, smoking status, medical conditions, body mass index (BMI; weight (kg)/height (m)2), and self-reported activities of daily living (ADL) were obtained. The prevalence of obesity (BMI ≥ 30) ranged from 13.3% in Havana, Cuba, to 37.6% in Montevideo, Uruguay. Using a BMI of 18.5–<25 as the reference category and controlling for all covariates, the lowest odds ratio for ADL limitation was for a BMI of 25–<30 (odds ratio = 1.10, 95% confidence interval: 0.93, 1.30), and the highest odds ratio for ADL limitation was for a BMI of 35 or higher (odds ratio = 1.63, 95% confidence interval: 1.26, 2.11). The results indicated that obesity is an independent factor contributing to ADL disability in these populations and should be included in future planning to reduce the impact of disability on global health. PMID:20472569

  19. Estimation of Physical Activity Energy Expenditure during Free-Living from Wrist Accelerometry in UK Adults

    PubMed Central

    Westgate, Kate; Wareham, Nicholas J.; Brage, Soren

    2016-01-01

    Background Wrist-worn accelerometers are emerging as the most common instrument for measuring physical activity in large-scale epidemiological studies, though little is known about the relationship between wrist acceleration and physical activity energy expenditure (PAEE). Methods 1695 UK adults wore two devices simultaneously for six days; a combined sensor and a wrist accelerometer. The combined sensor measured heart rate and trunk acceleration, which was combined with a treadmill test to yield a signal of individually-calibrated PAEE. Multi-level regression models were used to characterise the relationship between the two time-series, and their estimations were evaluated in an independent holdout sample. Finally, the relationship between PAEE and BMI was described separately for each source of PAEE estimate (wrist acceleration models and combined-sensing). Results Wrist acceleration explained 44–47% between-individual variance in PAEE, with RMSE between 34–39 J•min-1•kg-1. Estimations agreed well with PAEE in cross-validation (mean bias [95% limits of agreement]: 0.07 [-70.6:70.7]) but overestimated in women by 3% and underestimated in men by 4%. Estimation error was inversely related to age (-2.3 J•min-1•kg-1 per 10y) and BMI (-0.3 J•min-1•kg-1 per kg/m2). Associations with BMI were similar for all PAEE estimates (approximately -0.08 kg/m2 per J•min-1•kg-1). Conclusions A strong relationship exists between wrist acceleration and PAEE in free-living adults, such that irrespective of the objective method of PAEE assessment, a strong inverse association between PAEE and BMI was observed. PMID:27936024

  20. Companionship in the neighborhood context: older adults' living arrangements and perceptions of social cohesion.

    PubMed

    Bromell, Lea; Cagney, Kathleen A

    2014-03-01

    This study investigated the impact of neighborhood social cohesion on the perceived companionship of nearly 1,500 community-dwelling older adults from the Neighborhood, Organization, Aging and Health project (NOAH), a Chicago-based study of older adult well-being in the neighborhood context. We hypothesized that the relationship between neighborhood-level social cohesion and individual residents' reports of companionship would be more pronounced among those who lived alone than those who resided with others. Controlling for age, gender, education, race, marital status, length of neighborhood residence, and self-rated health, neighborhood social cohesion predicted companionship among those who lived alone; for a one-unit increase in neighborhood social cohesion, the odds of reporting companionship increased by half. In contrast, social cohesion did not predict the companionship of those who resided with others. The results suggest that older adults who live alone particularly profit from the benefits of socially cohesive neighborhood environments.

  1. Antibody Response to Live Attenuated Vaccines in Adults in Japan

    PubMed Central

    Uchiyama-Nakamura, Fukumi; Sugata-Tsubaki, Aiko; Yamada, Yutaka; Uno, Kenji; Kasahara, Kei; Maeda, Koichi; Konishi, Mitsuru; Mikasa, Keiichi

    2016-01-01

    Abstract The purpose of this study was to examine the efficacy rendered with a single dose of live attenuated measles, rubella, mumps, and varicella containing vaccine. We inoculated healthcare workers (HCWs) with a single dose of vaccine to a disease lacking in antibody titer for those not meeting the criteria of our hospital (measles: <16.0 (IgG enzyme immunoassay (EIA)), rubella: ≤1:32 (hemagglutination-inhibition), mumps: <4.0 (IgG EIA), and varicella: <4.0 (IgG EIA)). At 28–60 days after vaccination, the antibody titer was tested again. We included 48 HCWs. A total of 32, 15, 31, and 10 individuals were inoculated with a single dose of measles-containing, rubella-containing, mumps, or varicella vaccine, respectively, and showed significant antibody elevation (9.2 ± 12.3 to 27.6 ± 215.6, p<0.001; 8 ± 1.2 to 32 ± 65.5, p<0.001; 3.0 ± 1.0 to 13.1 ± 8.6, p<0.05; and 2.6 ± 1.3 to 11.8 ± 8.1, p<0.001, respectively). Major side effects were not observed. In a limited population, a single dose of live attenuated vaccine showed elevation of antibody titer without any severe adverse reactions. However, whether the post-vaccination response rate criteria of our university was fulfilled could not be determined owing to limited sample size. PMID:28352840

  2. [The influence of pathogen threat on ageism in Japan: The role of living with older adults].

    PubMed

    Ishii, Kunio; Tado'oka, Yoshika

    2015-08-01

    Previous research has suggested that Western European individuals exhibit negative attitudes toward older adults under pathogen threat. The present study investigated whether Japanese individuals exhibited ageism when pathogen threat was salient. Additionally, the study determined whether pathogen threat would have less of an impact on ageism among individuals with experience living with older adults. Study 1 showed that when pathogen threat was chronically and contextually salient, Japanese university students who had no experience living with older adults exhibited ageism, while those with such experience did not. Study 2 showed similar findings among Japanese nursing students. We argue that familiarity with older adults is essential for diminishing ageism in the event of a pathogen threat.

  3. History of falling and visual ability among independently living elderly in Sweden

    PubMed Central

    Källstrand-Eriksson, Jeanette; Hildingh, Cathrine; Bengtsson, Boel

    2016-01-01

    Purpose The aim of this study was to assess the performance-based visual ability among independently living elderly subjects and to investigate whether there was any association between visual ability and falls. Subjects and methods A total of 298 randomly selected subjects aged 70–85 years were invited for an examination including monocular and binocular visual acuity (VA), contrast sensitivity (CS), stereoscopic vision, and monocular visual fields (VFs), which were integrated to estimate the binocular VFs. Type of lenses used in their habitual correction was noted. Results Out of the 212 subjects who were examined, 38% reported at least one fall and 48% of these reported at least two falls during the last 2 years. Most subjects had normal results; 90% had normal binocular VA, 85% had normal binocular CS, and ~80% had positive stereopsis. Twenty-nine subjects had VF defects in the lower quadrants of the binocular VF, and 14 of these reported at least one fall. A significant association was seen between one fall or more and VA better eye, the odds ratio (OR) was 2.26, P=0.013, and between recurrent falls and lack of stereoscopic vision, the OR was 3.23, P=0.002; no other functional test showed any significant association with recurrent falls. The ORs were 1.58 for worse binocular VA, 0.60 for worse binocular CS, and 0.71 for non-normal stereoscopic vision for at least one fall, but wide confidence intervals made it difficult to draw firm conclusions about any association. Bifocal or progressive spectacles were worn by 71% with no significant difference between fallers and nonfallers (P=0.078). Conclusion Even though ~40% of the total sample had experienced one or more falls, the only visual function test significantly associated with falls were VA better eye, lack of stereoscopic vision, and recurrent falls. Our results suggest that there may be more powerful predictors of falling than decreased visual ability. PMID:27468223

  4. A comparative analysis of Center for Independent Living staff and board of directors regarding CIL services and consumer participation.

    PubMed

    Ravesloot, Craig; White, Glen W; Gonda-Kotani, Chiaki; Shinnick, Kelsey

    2017-01-01

    Community living of people with disabilities spans independent living and community engagement. Consumer choice and control of their level of community participation requires community accessibility, resources and supports. Some people with disabilities have difficulties procuring and maintaining these resources. Centers for Independent Living (CIL) are advocacy and service agencies that have been empowering consumers to meet their needs for over 40 years. Despite this history, little is known about the value of CIL services for increasing community participation of people with disabilities. We administered the CIL Participation Service Survey to 420 CIL staff members and 107 CIL board members to examine their opinions about the relative value of different CIL services for increasing community participation of their consumers. Results indicated that both staff and board members have very high regard for the value and quality of CIL services. The Independent Living (IL) philosophy of consumer choice and control was among the most highly rated aspects of CIL service delivery for both staff and board members. Overall, staff and board member responses were very consistent in terms of the top-rated strengths and weaknesses of CIL services for increasing participation among consumers. Differences appeared to reflect the daily staff focus on specific consumer need versus board members' view of larger community issues.

  5. Acute Pain and Depressive Symptoms: Independent Predictors of Insomnia Symptoms among Adults with Sickle Cell Disease

    PubMed Central

    Moscou-Jackson, Gyasi; Allen, Jerilyn; Kozachik, Sharon; Smith, Michael T.; Budhathoki, Chakra; Haywood, Carlton

    2015-01-01

    Background No studies to-date have systematically investigated insomnia symptoms among adults with sickle cell disease (SCD). The purpose of this study was to 1) describe the prevalence of insomnia symptoms and 2) identify bio-psychosocial predictors in community-dwelling adults with Sickle Cell Disease. Methods Cross-sectional analysis of baseline data from 263 African-American adults with SCD (aged 18 years or older). Measures included the Insomnia Severity Index (ISI), Center for Epidemiologic Studies in Depression scale, Urban Life Stress Scale, Brief Pain Inventory, and a chronic pain item. SCD genotype was extracted from the medical record. Results A slight majority (55%) of the sample reported clinically significant insomnia symptomatology (ISI ≥10), which suggests that insomnia symptoms are prevalent among community-dwelling African-American adults with SCD. While insomnia symptoms were associated with a number of bio-psychosocial characteristics, depressive symptoms and acute pain were the only independent predictors. Conclusion Given the high number of participants reporting clinically significant insomnia symptoms, nurses should screen for insomnia symptoms and to explore interventions to promote better sleep among adults with SCD with an emphasis on recommending treatment for pain and depression. In addition, current pain and depression interventions in this population could add insomnia measures and assess the effect of the intervention on insomnia symptomatology as a secondary outcome. PMID:26673730

  6. 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.

  7. A Tool for Change: Young Adult Literature in the Lives of Young Adult African-Americans.

    ERIC Educational Resources Information Center

    Collins, Carol Joan

    1993-01-01

    Discusses the role of young adult literature written from an authentic black cultural perspective in helping black young adults achieve the skills and knowledge they require to succeed in this society. Examples of relevant titles are given in the genres of realistic fiction, biography, autobiography, and folklore. (Contains 35 references.) (LRW)

  8. Large-scale live imaging of adult neural stem cells in their endogenous niche.

    PubMed

    Dray, Nicolas; Bedu, Sébastien; Vuillemin, Nelly; Alunni, Alessandro; Coolen, Marion; Krecsmarik, Monika; Supatto, Willy; Beaurepaire, Emmanuel; Bally-Cuif, Laure

    2015-10-15

    Live imaging of adult neural stem cells (aNSCs) in vivo is a technical challenge in the vertebrate brain. Here, we achieve long-term imaging of the adult zebrafish telencephalic neurogenic niche and track a population of >1000 aNSCs over weeks, by taking advantage of fish transparency at near-infrared wavelengths and of intrinsic multiphoton landmarks. This methodology enables us to describe the frequency, distribution and modes of aNSCs divisions across the entire germinal zone of the adult pallium, and to highlight regional differences in these parameters.

  9. Factors Related to Pertussis and Tetanus Vaccination Status Among Foreign-Born Adults Living in the United States.

    PubMed

    Sánchez-González, Liliana; Rodriguez-Lainz, Alfonso; O'Halloran, Alissa; Rowhani-Rahbar, Ali; Liang, Jennifer L; Lu, Peng-Jun; Houck, Peter M; Verguet, Stephane; Williams, Walter W

    2016-11-12

    Pertussis is a common vaccine-preventable disease (VPD) worldwide. Its reported incidence has increased steadily in the United States, where it is endemic. Tetanus is a rare but potentially fatal VPD. Foreign-born adults have lower tetanus-diphtheria-pertussis (Tdap) and tetanus-diphtheria (Td) vaccination coverage than do U.S.-born adults. We studied the association of migration-related, socio-demographic, and access-to-care factors with Tdap and Td vaccination among foreign-born adults living in the United States. The 2012 and 2013 National Health Interview Survey data for foreign-born respondents were analyzed. Multivariable logistic regression was conducted to calculate prevalence ratios and 95% confidence intervals, and to identify variables independently associated with Tdap and Td vaccination among foreign-born adults. Tdap and Td vaccination status was available for 9316 and 12,363 individuals, respectively. Overall vaccination coverage was 9.1% for Tdap and 49.8% for Td. Younger age, higher education, having private health insurance (vs. public insurance or uninsured), having visited a doctor in the previous year, and region of residence were independently associated with Tdap and Td vaccination. Among those reporting a doctor visit, two-thirds had not received Tdap. This study provides further evidence of the need to enhance access to health care and immunization services and reduce missed opportunities for Tdap and Td vaccination for foreign-born adults in the United States. These findings apply to all foreign-born, irrespective of their birthplace, citizenship, language and years of residence in the United States. Addressing vaccination disparities among the foreign-born will help achieve national vaccination goals and protect all communities in the United States.

  10. The independent living donor advocate: a guidance document from the American Society of Transplantation's Living Donor Community of Practice (AST LDCOP).

    PubMed

    Hays, R E; LaPointe Rudow, D; Dew, M A; Taler, S J; Spicer, H; Mandelbrot, D A

    2015-02-01

    The independent living donor advocate (ILDA) serves a mandated and supportive role in the care of the living organ donor, yet qualifications and role requirements are not clearly defined. Guidance comes from Centers for Medicare and Medicaid Services (CMS) Conditions for Transplant Center Participation and interpretive guidelines, Organ Procurement and Transplantation Network (OPTN) Policy and CMS and OPTN site surveys, yet interpretation of regulations varies. Herein, the AST Living Donor Community of Practice (LDCOP) offers seven recommendations to clarify and optimize the ILDA role: (a) the ILDA must have a certain skill set rather than a specific profession, (b) the ILDA must be educated and demonstrate competence in core knowledge components, (c) the ILDA's primary role is to assess components of informed consent, (d) centers must develop a transparent system to define ILDA independence, (e) the ILDA should have a reporting structure outside the transplant center, (f) the ILDA's role should be integrated throughout the donor care continuum, (g) the ILDA role should include a narrow "veto power." We address controversies in ILDA implementation, and offer pathways to maximize benefits and minimize limitations of approaches that may each meet regulatory requirements but confer different practice benefits. We propose a research agenda to explore the impact of the ILDA.

  11. Examination of Emerging Adults' Emotional Autonomy and Parental Monitoring under Varying Living Arrangements

    ERIC Educational Resources Information Center

    Fozio-Thielk, Lisa

    2016-01-01

    The current trends of increasing community college enrollments and large numbers of emerging adults living with their parents suggest the need to examine patterns of adjustment and competence, in particular, emotional autonomy during college years. However, there has been little research focus on the role of extended parental monitoring on…

  12. Survey on Dysfunctional Eating Behavior in Adult Persons with Intellectual Disability Living in the Community

    ERIC Educational Resources Information Center

    Hove, Oddbjorn

    2007-01-01

    Prevalence of dysfunctional eating behavior was investigated in 311 adult persons with mental retardation living in the West Coast of Norway. Reports from a questionnaire filled out by health workers were used as observational data. The main finding was that 64.3% of the clients showed indices of dysfunctional eating behavior. The five most…

  13. Prevalence of Eating Disorders in Adults With Mental Retardation Living in the Community

    ERIC Educational Resources Information Center

    Hove, Oddbjorn

    2004-01-01

    The prevalence of eating disorders among 311 adults with mental retardation living in the West Coast of Norway was investigated. Reports stemming from a questionnaire completed by health workers were the data source. Diagnostic criteria adapted for persons with mental retardation were used. The main finding was that 27% of cases showed indices of…

  14. The Form and Function of Attachment Behavior in the Daily Lives of Young Adults

    ERIC Educational Resources Information Center

    Campa, Mary I.; Hazan, Cindy; Wolfe, Jared E.

    2009-01-01

    Central to attachment theory is the postulation of an inborn system to regulate attachment behavior. This system has been well studied in infancy and childhood, but much less is known about its functioning at later ages. The goal of this study was to explore the form and function of attachment behavior in the daily lives of young adults. Twenty…

  15. Practitioners’ Opinions on Food and Nutrition Care Indicators (FANCI) in Assisted Living Facilities for Older Adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study assessed the utility of the 57 indicator FANCI checklist for assessing food and nutrition services in assisted living facilities (ALFs) for older adults among dietitians. They were members of two American Dietetic Association practice groups focusing on aging and long term care and were a...

  16. An Exploration of Gender Differences on the Reasons for Living Inventory among Older Adults

    ERIC Educational Resources Information Center

    Segal, Daniel L.; Needham, Tracy N.

    2007-01-01

    This study evaluated gender differences on the Reasons for Living Inventory (RFL) specifically among older adults, a population known to have the highest suicide rate among all age groups, with older men being disproportionately at risk. Community-dwelling women (n = 175; M age = 69.0 years; 81% Caucasian) and men (n = 145; M age = 69.5 years; 76%…

  17. Adults Living with Limited Literacy and Chronic Illness: Patient Education Experiences

    ERIC Educational Resources Information Center

    King, Judy; Taylor, Maurice C.

    2010-01-01

    The purpose of this study was to investigate how Canadian adults living with limited literacy and chronic illness made meaning of their patient education experiences. The study used a hermeneutic phenomenological research design and employed three data sources over a nine-month period. Data was interpreted and analyzed as it was collected,…

  18. New Television Documentary Underscores Challenges Faced by Adults Living with Autism

    ERIC Educational Resources Information Center

    Exceptional Parent, 2011

    2011-01-01

    Over the next 10 to 15 years, an estimated 800,000 children with autism will age out of their school systems and look to state and federal governments for support services and resources to meet their many needs. "Autism: Coming of Age" provides an inside look at the lives of three adults with autism and their families. The film delves into the…

  19. Effects of Parental Suicide on the Adolescent Survivors' Lives When They Are Adults

    ERIC Educational Resources Information Center

    Saatci, Yesim

    2013-01-01

    This qualitative inquiry, phenomenology, purported to provide insight into the role of parental suicide on the adolescent survivors' adult lives between 18 and 40. This study described the survivors' coping strategies, self-esteem, and effects of their grief and bereavement as a result of parental suicide on their emotional wellness or…

  20. Psychiatric Morbidity and Social Functioning among Adults with Borderline Intelligence Living in Private Households

    ERIC Educational Resources Information Center

    Hassiotis, A.; Strydom, A.; Hall, I.; Ali, A.; Lawrence-Smith, G.; Meltzer, H.; Head, J; Bebbington, P.

    2008-01-01

    Background: Approximately one-eighth of the population will have DSM-IV borderline intelligence. Various mental disorders and social disability are associated with it. Method: The paper uses data (secondary analysis) from a UK-wide cross-sectional survey of 8450 adults living in private households. Data were collected on psychiatric disorders,…

  1. Retrospective Reports by Healthy Intelligent Elderly People of Personal Events of Their Adult Lives.

    ERIC Educational Resources Information Center

    Field, Dorothy

    Psychologists generally agree on the importance of early events in personality development, yet until now there has not been an opportunity to look at the personal lives of a group of adults over a considerable time. Subjects examined were 16 men and 44 women, parents of the subjects of the Guidance Study, a longitudinal study of the Institute of…

  2. A Reason To Rise Each Morning: The Meaning of Volunteering in the Lives of Older Adults.

    ERIC Educational Resources Information Center

    Bradley, Dana Burr

    2000-01-01

    Discusses the value that volunteering by older adults brings to individual lives and the benefits to society. Suggests that volunteering provides an enhanced sense of purpose by doing things for others and that understanding why elders volunteer will help identify better ways to support their efforts. (JOW)

  3. 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…

  4. Public Pedagogy, Private Lives: Self-Help Books and Adult Learning

    ERIC Educational Resources Information Center

    McLean, Scott

    2013-01-01

    Self-help literature has become an important domain of adult learning in North America. Self-help books offer readers advice on how to take charge of their lives and achieve goals such as prosperity, love, happiness, wellness, and self-actualization. Despite the popularity of self-help books, there has been little research about them from scholars…

  5. Seed after-ripening and dormancy determine adult life history independently of germination timing.

    PubMed

    de Casas, Rafael Rubio; Kovach, Katherine; Dittmar, Emily; Barua, Deepak; Barco, Brenden; Donohue, Kathleen

    2012-05-01

    • Seed dormancy can affect life history through its effects on germination time. Here, we investigate its influence on life history beyond the timing of germination. • We used the response of Arabidopsis thaliana to chilling at the germination and flowering stages to test the following: how seed dormancy affects germination responses to the environment; whether variation in dormancy affects adult phenology independently of germination time; and whether environmental cues experienced by dormant seeds have an effect on adult life history. • Dormancy conditioned the germination response to low temperatures, such that prolonged periods of chilling induced dormancy in nondormant seeds, but stimulated germination in dormant seeds. The alleviation of dormancy through after-ripening was associated with earlier flowering, independent of germination date. Experimental dormancy manipulations showed that prolonged chilling at the seed stage always induced earlier flowering, regardless of seed dormancy. Surprisingly, this effect of seed chilling on flowering time was observed even when low temperatures did not induce germination. • In summary, seed dormancy influences flowering time and hence life history independent of its effects on germination timing. We conclude that the seed stage has a pronounced effect on life history, the influence of which goes well beyond the timing of germination.

  6. Living arrangements and socio-demographic conditions of older adults in Cambodia.

    PubMed

    Zimmer, Z; Kim, S K

    2001-01-01

    Since the takeover of Cambodia by the Khmer Rouge in 1975, the social conditions within the country have been understudied. Only recently has dependable socio-demographic data become available. We use some these data to examine living arrangements and other socio-demographic conditions among Cambodia's older population. We compare results to those recently found in Thailand and Vietnam, two neighboring countries, in order to place Cambodia within a regional context. On balance, living arrangements in Cambodia are similar to those in neighboring countries. Older adults are likely to be living with a child and in a variety of diverse arrangements involving different family members. We attempt to get at gender preference for coresident children indirectly by adjusting living arrangement patterns for Cambodia's unique sex and marital status structure. We find a predominance of elders living with never married children of either sex and a slight daughter preference. Older adults in Cambodia may face particular challenges due to the influences of the past decades of instability and violence. We conclude our paper with a discussion of how future research might assist in developing a national policy for older adults.

  7. Olfactory function and the social lives of older adults: a matter of sex

    PubMed Central

    Boesveldt, Sanne; Yee, Jason R.; McClintock, Martha K.; Lundström, Johan N.

    2017-01-01

    Social factors play a critical role in a panoply of health processes, including, as recently demonstrated, olfaction. Here, we investigated sex-dependent differences in the relationship between social lives and ability to identify odors in a large sample of nationally representative older US adults (n = 3005, National Social Life and Aging Project (NSHAP)). Social life was measured by the number of friends and close relatives as well as frequency of socializing. We here confirm the association between social lives and olfactory function and extend the notion by showing specifically that olfactory identification ability is modulated by sex in older adults. The connection between olfactory performance and social lives could reflect social modulation of aging as has been reported for health in general. Future studies are necessary to elucidate the precise mechanisms underlying this association and sex difference. PMID:28327569

  8. Olfactory function and the social lives of older adults: a matter of sex.

    PubMed

    Boesveldt, Sanne; Yee, Jason R; McClintock, Martha K; Lundström, Johan N

    2017-03-22

    Social factors play a critical role in a panoply of health processes, including, as recently demonstrated, olfaction. Here, we investigated sex-dependent differences in the relationship between social lives and ability to identify odors in a large sample of nationally representative older US adults (n = 3005, National Social Life and Aging Project (NSHAP)). Social life was measured by the number of friends and close relatives as well as frequency of socializing. We here confirm the association between social lives and olfactory function and extend the notion by showing specifically that olfactory identification ability is modulated by sex in older adults. The connection between olfactory performance and social lives could reflect social modulation of aging as has been reported for health in general. Future studies are necessary to elucidate the precise mechanisms underlying this association and sex difference.

  9. Implementation of a Positive Development, Evidence-Supported Practice for Emerging Adults with Serious Mental Health Conditions: The Transition to Independence Process (TIP) Model.

    PubMed

    Dresser, Karyn; Clark, Hewitt B; Deschênes, Nicole

    2015-04-01

    Transition into adulthood represents a particularly challenging period for youth and young adults with serious mental health conditions and related needs. The Transition to Independence Process (TIP) model is based on a positive development approach and has been demonstrated to be an evidence-supported practice for preparing emerging adults in their movement into employment/career, education, living situation, personal effectiveness/well-being, and community-life functioning--and to be responsive to their families. This article describes the TIP model from a positive youth development framework, its empirical underpinnings, and the fidelity and outcome tracking tools that have been developed for use with transition sites for implementation and sustainability. A research study on the fidelity tools showed their reliability and validity and a second study presents progress and outcome findings for youth and young adults at a new TIP model site. The implications of the TIP model and these findings are discussed.

  10. Activities of Daily Living Curriculum for Handicapped Adults. Materials Development Center Reprint #20.

    ERIC Educational Resources Information Center

    Wisconsin Univ. - Stout, Menomonie. Dept. of Rehabilitation and Manpower Services. Materials Development Center.

    Designed for use in group and shelter homes, this curriculum is intended to impart the necessary skills for independent living. It should also better prepare mentally and physically handicapped individuals with the training required to handle the responsibilities accompanying competitive employment. These fourteen courses are included: money…

  11. Vocational Rehabilitation Services in Independent Living Centers. Report from the Study Group. Annual Institute on Rehabilitation Issues (17th, Las Vegas, Nevada, October, 1990).

    ERIC Educational Resources Information Center

    Thayer, Ted M.; Rice, B. Douglas

    This report explores ramifications of vocational rehabilitation services being provided in independent living programs through tracing the development of disability rights and independent living movements from their inception to the present. Comparisons are drawn between the programmatic approaches of state rehabilitation agencies and independent…

  12. A Comparison of Activity Levels among Adults with Intellectual Disabilities Living in Family Homes and Out-of-Family Placements

    ERIC Educational Resources Information Center

    Felce, David; Perry, Jonathan; Kerr, Michael

    2011-01-01

    Background: The quality of life of adults with intellectual disabilities living in the family home is an under-researched area. The current study compared indicators of household and community activity between adults living in family homes and those in out-of-family placements. Methods: Four datasets were merged to produce information on the…

  13. Adults with Autism Living at Home or in Non-Family Settings: Positive and Negative Aspects of Residential Status

    ERIC Educational Resources Information Center

    Krauss, M. W.; Seltzer, M. M.; Jacobson, H. T.

    2005-01-01

    Very little is known about the context of caregiving by parents of adults with autism or about the perceived impacts of continued patterns of co-residence vs. out-of-family living. In the present study, maternal assessments of residential status, involvement with adult children living in a non-family setting, and the impacts on mothers of their…

  14. An Examination of the Social Networks and Social Isolation in Older and Younger Adults Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Emlet, Charles A.

    2006-01-01

    This study examined social networks and social isolation in older (50 years or more) and younger (ages 20 to 39) adults with HIV/AIDS. The author conducted interviews with 88 individuals living with HIV/AIDS in the Pacific Northwest. Both groups' social networks had similar patterns; however, older adults were more likely to live alone. More than…

  15. Development and Psychometric Evaluation of the Reasons for Living-Older Adults Scale: A Suicide Risk Assessment Inventory

    ERIC Educational Resources Information Center

    Edelstein, Barry A.; Heisel, Marnin J.; McKee, Deborah R.; Martin, Ronald R.; Koven, Lesley P.; Duberstein, Paul R.; Britton, Peter C.

    2009-01-01

    Purpose: The purposes of these studies were to develop and initially evaluate the psychometric properties of the Reasons for Living Scale-Older Adult version (RFL-OA), an older adults version of a measure designed to assess reasons for living among individuals at risk for suicide. Design and Methods: Two studies are reported. Study 1 involved…

  16. Free Agent Nation: How America's New Independent Workers Are Transforming the Way We Live.

    ERIC Educational Resources Information Center

    Pink, Daniel H.

    This book provides a comprehensive examination of the rise of free agent workers, how free agency is transforming the lives of free agents and those around them, problems encountered by free agents, and the future of free agency. The following are among the topics discussed in the book's 19 chapters: (1) the numbers and nuances of free agency; (2)…

  17. Independently Living Rural Seniors and Emergency Preparedness: A Pilot Study in Southern Illinois

    ERIC Educational Resources Information Center

    Whitney, Emily; Visker, Joseph; Haithcox-Dennis, Melissa J.; DeWeese, Amanda

    2012-01-01

    Rural-dwelling older adults often have difficulty obtaining needed medical and social services due to factors such as physician shortages, lack of transportation, and financial limitations. These factors are further exacerbated during an emergency. Understanding these challenges is important to implement successful health promotion interventions…

  18. Home: The place the older adult can not imagine living without

    PubMed Central

    2011-01-01

    Background Rapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden. Methods Hermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and prejudices and proceeded through several readings which integrated the text with the reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge. Results Two main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying threat of loosing one's home. Conclusions Home has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care

  19. Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden.

    PubMed

    Berner, Jessica; Rennemark, Mikael; Jogréus, Claes; Anderberg, Peter; Sköldunger, Anders; Wahlberg, Maria; Elmståhl, Sölve; Berglund, Johan

    2015-09-01

    Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.

  20. Serum uric acid is independently and linearly associated with risk of nonalcoholic fatty liver disease in obese Chinese adults

    PubMed Central

    Liu, Chang-Qin; He, Chun-Mei; Chen, Ning; Wang, Dongmei; Shi, Xiulin; Liu, Yongwen; Zeng, Xin; Yan, Bing; Liu, Suhuan; Yang, Shuyu; Li, Xiaoying; Li, Xuejun; Li, Zhibin

    2016-01-01

    The present study aimed to explore the independent association and potential pathways between serum uric acid (SUA) and nonalcoholic fatty liver disease (NAFLD). 1365 community-living obese Chinese adults who received hepatic ultrasonography scanning were included. The prevalence rates of NAFLD were 71.5% for men and 53.8% for women. Compared with controls, NAFLD subjects showed significantly increased SUA levels (333.3 ± 84.9 v.s. 383.4 ± 93.7 μmol/L) and prevalence rate of hyperuricemia (HUA) (25.7% v.s. 47.3%, p < 0.001). After adjustment for insulin resistance (IR), components of metabolic syndrome (MetS) and other potential confounders, elevated SUA is independently associated with increased risk of NAFLD, with the adjusted OR of 1.528–2.031 (p < 0.001). By using multivariable fractional polynomial (MFP) modeling, the best FP transformation model shows that SUA was independently and linearly associated with risk of NAFLD. The one-pathway model by using structural equation modeling (SEM) about the relationships among SUA, IR, components of metabolic syndrome and NAFLD fits well (χ2 = 57.367, p < 0.001; CFI = 0.998; TLI = 0.992; and RMSEA = 0.048) and shows SUA might increase the risk of NAFLD directly besides of the indirect effects through increasing fasting insulin, blood pressure, triglyceride and decreasing HDL-C levels. Our results imply that elevated SUA may play an important role in NAFLD pathogenesis. PMID:27924915

  1. Sedentary behavior and physical activity are independently related to functional fitness in older adults.

    PubMed

    Santos, Diana A; Silva, Analiza M; Baptista, Fátima; Santos, Rute; Vale, Susana; Mota, Jorge; Sardinha, Luís B

    2012-12-01

    The last decades of life have been traditionally viewed as a time of inevitable disease and frailty. Sedentary living and physical activity may influence capacity to perform activities that are needed to maintain physical independence in daily living. A total of 117 males and 195 females, aged 65-103years, were assessed for physical activity and sedentary time with accelerometers and for functional fitness with the Senior Fitness Test battery. Based on the individual scores for each fitness item, a Z-score was created. Associations between functional fitness with sedentary time and moderate-to-vigorous physical activity (MVPA) were analyzed. A negative association was found between the composite Z-score for functional fitness and the sedentary time, even adjusting for MVPA and other confounders. On the other hand, MVPA was positively associated with the composite Z-score for functional fitness, independently of the sedentary time. In conclusion elderly who spend more time in physical activity or less time in sedentary behaviors exhibit improved functional fitness and other confounders. The results reinforce the importance of promoting both the reduction of sedentary behaviors and the increase of MVPA in this age group, as it may interfere at older ages in order to preserve functional fitness and performance of daily functioning tasks.

  2. 77 FR 20369 - Applications for New Awards; Centers for Independent Living-Training and Technical Assistance

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... within a local community by individuals with disabilities and that provides an array of independent... topics. The CILs T&TA Center must make available to all CILs a broad array of resources, training, and... by the CFDA number. Do not include ] the CFDA number's alpha suffix in your search (e.g., search...

  3. Home-based rehabilitation interventions for adults living with HIV: a scoping review.

    PubMed

    Cobbing, Saul; Hanass-Hancock, Jill; Myezwa, Hellen

    2016-01-01

    Home-based rehabilitation (HBR) has been shown to improve the lives of people living with a wide range of chronic diseases in resource-rich settings. This may also be a particularly effective strategy in resource-poor settings, where access to institution-based rehabilitation is limited. This review aimed to summarise and discuss the evidence related to the effectiveness of home-based rehabilitation (HBR) interventions designed specifically for adults living with HIV. A scoping review methodology was employed, involving systematic search techniques and appraisal of appropriate evidence. English-language journal articles that assessed the quality of life or functional ability outcomes of HBR interventions for adults living with HIV were considered for this review. Out of an initial 1 135 publications retrieved from the search of databases, six articles met this review's inclusion criteria. While this review highlights the scarcity of empirical evidence related to HBR interventions for adults living with HIV, the findings of these six articles are that HBR is a safe management option that may confer a number of physical and psychological benefits for this population. Future research on HBR interventions should include a wider range of assessment measures, including cost-benefit analyses and specific tools designed to assess the functional ability and participation in activities of daily living of participants involved in these programmes. In particular, more research on HBR is required in resource-poor environments, such as sub-Saharan Africa where HIV is endemic, to assess whether this is a feasible strategy that is both effective and practical in the areas that may need it most.

  4. Practitioners' opinions on Food and Nutrition Care Indicators in assisted living facilities for older adults.

    PubMed

    Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Tennstedt, Sharon; Jacques, Paul

    2008-09-01

    This study assessed the utility of the 57-indicator Food and Nutrition Care Indicators Checklist for assessing food and nutrition services in assisted-living facilities for older adults among registered dietitians (RDs). They were members of two American Dietetic Association practice groups focusing on aging and long-term care and were also employed in assisted-living facilities. The 1,281 respondents rated the importance of each checklist item and provided their views on the role of assisted-living facilities and their level of agreement with statements regarding the importance of residents' autonomy for making food choices and their ability to make wise dietary choices. Registered dietitians practicing in assisted-living facilities considered all of the domains on food and nutrition quality indicators on the Food and Nutrition Care Indicators Checklist to be highly important (92% of dining room environment items, 83% of foodservice operations, 92% of general nutrition, and 89% of therapeutic nutrition items). They preferred a service style that included both health and amenities, as did national health and aging experts. Registered dietitians should work with other professionals to further validate the checklist, promote its use, and establish optimal service models for food and nutrition services in assisted-living facilities for older adults.

  5. Protective efficacy afforded by live Pasteurella multocida vaccines in chickens is independent of lipopolysaccharide outer core structure.

    PubMed

    Harper, Marina; John, Marietta; Edmunds, Mark; Wright, Amy; Ford, Mark; Turni, Conny; Blackall, P J; Cox, Andrew; Adler, Ben; Boyce, John D

    2016-03-29

    Pasteurella multocida is a major animal pathogen that causes a range of diseases including fowl cholera. P. multocida infections result in considerable losses to layer and breeder flocks in poultry industries worldwide. Both killed whole-cell and live-attenuated vaccines are available; these vaccines vary in their protective efficacy, particularly against heterologous strains. Moreover, until recently there was no knowledge of P. multocida LPS genetics and structure to determine precisely how LPS structure affects the protective capacity of these vaccines. In this study we show that defined lipopolysaccharide (LPS) mutants presented as killed whole-cell vaccines elicited solid protective immunity only against P. multocida challenge strains expressing highly similar or identical LPS structures. This finding indicates that vaccination of commercial flocks with P. multocida killed cell formulations will not protect against strains producing an LPS structure different to that produced by strains included in the vaccine formulation. Conversely, protective immunity conferred by vaccination with live P. multocida strains was found to be largely independent of LPS structure. Birds vaccinated with a range of live mutants belonging to the L1 and L3 LPS genotypes, each expressing a specific truncated LPS structure, were protected against challenge with the parent strain. Moreover, birds vaccinated with any of the five LPS mutants belonging to the L1 LPS genotype were also protected against challenge with an unrelated strain and two of the five groups vaccinated with live LPS mutants belonging to the L3 genotype were protected against challenge with an unrelated strain. In summary, vaccination with live P. multocida aroA mutants producing full-length L1 or L3 LPS or vaccination with live strains producing shortened L1 LPS elicited strong protective immunity against both homologous and heterologous challenge.

  6. AmI and Deployment Considerations in AAL Services Provision for Elderly Independent Living: The MonAMI Project

    PubMed Central

    Falcó, Jorge L.; Vaquerizo, Esteban; Lain, Luis; Artigas, Jose Ignacio; Ibarz, Alejandro

    2013-01-01

    The MonAMI project aims to investigate the feasibility of the deployment of open platforms for Ambient Assisted Living (AAL) services provision based on Ambient Intelligence (AmI) and to test user acceptance and the usability of the services. Services were designed to provide support in the areas of environmental control, security, well-being and leisure. These services were installed and evaluated in a Spanish geriatric residence. The participants included elderly persons with disabilities, nursing home care givers and informal carers. The concept of the open platform proved to be satisfactory for the provision of the services in a context aware framework. Furthermore, the usability of the technology was viewed positively and the overall results indicate that this system has the potential to prolong independent living at home for elderly people with disabilities. Deployment was proven successful and awareness of open-platform AAL service delivery was raised in local communities throughout Europe. PMID:23857262

  7. Cerebrovascular correlates of vitamin D deficiency in older adults living near the Equator: results from the Atahualpa Project.

    PubMed

    Del Brutto, Oscar H; Mera, Robertino M; Macias, Jorge; Morales, Gabriela; Zambrano, Mauricio

    2015-12-01

    All studies attempting to find an association between vitamin D deficiency and cerebrovascular diseases have been conducted at latitudes far away from the Equator, where living conditions, cardiovascular risk factors, and sunshine exposure are different from tropical regions. We aimed to assess cerebrovascular correlates of vitamin D deficiency in community-dwelling older adults living in Atahualpa, a village located in rural coastal Ecuador. Out of 267 individuals enrolled in the neuroimaging substudy of the Atahualpa Project, 220 (82%) signed the informed consent. Mean age of participants was 70·9 ± 7·8 years, and 126 (57%) were women. Fifty-four (25%) persons have vitamin D levels <20 ng/ml, 47 (21%) had ischemic strokes, and 53 (24%) had moderate-to-severe white matter hyperintensities of presumed vascular origin. Exposure effect models constructed with vitamin D deficiency as the exposure, white matter hyperintensities and ischemic stroke as the outcomes, and confounders--age, gender, body mass index, physical activity, blood pressure, fasting glucose, total cholesterol, ionized calcium, phosphorus, intact parathormone, and serum creatinine--as independent variables revealed a significant association of vitamin D deficiency with white matter hyperintensities (P = 0·006) but not with ischemic strokes (P = 0·359). This study shows an association of vitamin D deficiency with diffuse subcortical brain damage in older adults living in a tropical region. Lack of awareness of the importance of vitamin D deficiency might be one of the factors influencing the high prevalence of white matter hyperintensities of presumed vascular origin in underserved Latin American populations.

  8. A Qualitative Examination of Stigma Among Formerly Incarcerated Adults Living With HIV.

    PubMed

    Swan, Holly

    2016-01-01

    The over-representation of people with stigmatized characteristics in the U.S. criminal justice population, including adults living with HIV, makes formerly incarcerated adults susceptible to multiple stigmas. Yet, the experience of HIV-related stigma, especially among individuals who have an additional compromising status in society (i.e., a criminal record) is understudied. This study used qualitative data from 30 interviews with formerly incarcerated adults living with HIV to explore the contexts within which one of these statuses becomes more salient than another for these individuals. Anticipated stigma was the primary barrier to disclosure of either status. The salience of anticipated stigma depended on the context within which disclosure may occur, including social interactions, employment, and engaging in HIV care. Communities with a high prevalence of HIV and incarceration, and health care providers within those communities should be targeted for stigma reduction efforts. Practitioners should work to empower individuals living with HIV, especially in the face of multiple potential stigmas.

  9. A Qualitative Examination of Stigma Among Formerly Incarcerated Adults Living With HIV

    PubMed Central

    Swan, Holly

    2016-01-01

    The over-representation of people with stigmatized characteristics in the U.S. criminal justice population, including adults living with HIV, makes formerly incarcerated adults susceptible to multiple stigmas. Yet, the experience of HIV-related stigma, especially among individuals who have an additional compromising status in society (i.e., a criminal record) is understudied. This study used qualitative data from 30 interviews with formerly incarcerated adults living with HIV to explore the contexts within which one of these statuses becomes more salient than another for these individuals. Anticipated stigma was the primary barrier to disclosure of either status. The salience of anticipated stigma depended on the context within which disclosure may occur, including social interactions, employment, and engaging in HIV care. Communities with a high prevalence of HIV and incarceration, and health care providers within those communities should be targeted for stigma reduction efforts. Practitioners should work to empower individuals living with HIV, especially in the face of multiple potential stigmas. PMID:27182459

  10. The Women Independently Living Alone with a Medical Alert Device (WILMA) Trial

    PubMed Central

    Morgenstern, Lewis B.; Adelman, Eric E.; Hughes, Rebecca; Wing, Jeffrey J.; Lisabeth, Lynda D.

    2015-01-01

    Background Women are more likely to live alone compared with men, and therefore have more difficulty activating emergency medical systems for stroke. The goal of this study was to examine the benefit of wearing medical alert devices to activate emergency medical systems for elderly women living alone. Methods This was a randomized, controlled pilot trial. Women over 60 with at least 1 stroke risk factor were recruited from Southeast Michigan. Subjects received either a medical alert device or control. The primary outcome was change in Health-Related Quality of Life (HRQOL) from baseline to 90 days of wearing the device or control. Results A planned sample size of 320 could not be reached and the trial was stopped at 265 women randomized prior to data examination. On average, the treatment group was older, reported lower prevalence of high cholesterol, and was less likely to complete follow-up. There was a non-significant smaller loss of healthy days in the past month in the intervention group (0.46) compared with the control group (2.23), (p=0.213). Similarly, the secondary outcomes of changes in anxiety, depression and changes in perceived isolation did not differ by treatment and control groups. Conclusions This study did not establish improvement in HRQOL among women who wore the device compared with those that did not, nor the feasibility of a trial to study the efficacy of medical alert devices in elderly women. Newer devices that use cellular technology may be more accepted than the land-line based system used in this study. PMID:26031786

  11. Vitamin D status of older adults of diverse ancestry living in the greater Toronto area

    PubMed Central

    2013-01-01

    Background Physiological and lifestyle factors put older adults at an increased risk of vitamin D insufficiency and resulting negative health outcomes. Here we explore the vitamin D status in a sample of community dwelling older adults of diverse ancestry living in the Greater Toronto area (GTA). Methods Two hundred and twenty-four (224) adults over 60 years of age were recruited from the Square One Older Adult Centre, in Mississauga, Ontario. Circulating 25-hydroxyvitamin D (25(OH)D) concentrations were measured from dried blood spot cards. Dietary and supplemental intakes of vitamin D were assessed via questionnaires. Skin pigmentation was assessed quantitatively by measuring melanin levels using a reflectometer. Results The mean 25(OH)D concentration in the total sample was 82.4 nmol/L. There were no statistically significant differences in serum 25(OH)D concentrations, supplemental or dietary vitamin D intakes between the three major ancestral groups (East Asians, Europeans and South Asians). Females had significantly higher 25(OH)D concentrations than males (84.5 nmol/L vs. 72.2 nmol/L, p = 0.012). The proportion of participants with 25(OH)D concentrations below 50 nmol/L and 75 nmol/L were 12.1%, and 38.8%, respectively. The mean daily supplemental intake of vitamin D was 917 IU/day. Vitamin D intake from supplements was the major factor determining 25(OH)D concentrations (p < 0.001). Conclusions Mean concentration of 25(OH)D in a sample of older adults of diverse ancestry living in the GTA exceeded 80 nmol/L, and there were no significant differences in 25(OH)D levels between ancestral groups. These results sharply contrast with our recent study focused on young adults of diverse ancestry living in the same geographic area, in which we found substantially lower 25(OH)D concentrations (mean 39.5 nmol/L), low supplemental vitamin D intake (114 IU/day), and significant differences in 25(OH)D levels between ancestral groups. High daily intake

  12. Religion, Alcohol Use and Risk Drinking Among Canadian Adults Living in Ontario.

    PubMed

    Tuck, Andrew; Robinson, Margaret; Agic, Branka; Ialomiteanu, Anca R; Mann, Robert E

    2016-12-19

    This research examines (1) the association between risk drinking and religious affiliation and (2) differences between religions for risk drinking among adults living in Ontario, Canada, for Christians, Buddhists, Sikhs, Muslims, Hindus, Jews, other religious groups and the non-religious. Data are based on telephone interviews with 16,596 respondents and are derived from multiple cycles (2005-2011) of the Centre for Addiction and Mental Health's (CAMH) Monitor survey, an ongoing cross-sectional survey of adults in Ontario, Canada, aged 18 years and older. Data were analysed using bivariate cross-tabulations, Mann-Whitney U nonparametric test and logistic regression. Alcohol use and risk drinking occur among members of all religious groups; however, the rate of drinking ranges widely. Risk drinking is significantly associated with religion. When compared to the No religion/Atheist group, several religious groups (Baptist, Christian, Hindu, Jehovah's Witness, Jewish, Muslim/Islam, Non-denominational, Pentecostal, Sikh and Other religion) in our sample have significantly lower odds of risk drinking. Risk drinkers also attended significantly fewer services among several religions. Results suggest that there are differences in the risk drinking rates among Canadian adults, living in Ontario, by religion. It appears that religious traditions of prohibition and abstention do hold sway among Canadian adults for some religious groups.

  13. Living with an adult family member using advanced medical technology at home.

    PubMed

    Fex, Angelika; Flensner, Gullvi; Ek, Anna-Christina; Söderhamn, Olle

    2011-12-01

    Living with an adult family member using advanced medical technology at home An increased number of chronically ill adults perform self-care while using different sorts of advanced medical technology at home. This hermeneutical study aimed to gain a deeper understanding of the meaning of living with an adult family member using advanced medical technology at home. Eleven next of kin to adults performing self-care at home, either using long-term oxygen from a cylinder or ventilator, or performing peritoneal or haemodialysis, were interviewed. The qualitative interviews were analysed using a Gadamerian methodology. The main interpretation explained the meaning as rhythmical patterns of connectedness versus separation, and of sorrow versus reconciliation. Dependence on others was shown in the need for support from healthcare professionals and significant others. In conclusion, next of kin took considerable responsibility for dependent-care. All next of kin were positive to the idea of bringing the technology home, even though their own needs receded into the background, while focusing on the best for the patient. The results were discussed in relation to dependent-care and transition, which may have an influence on the self-care of next of kin and patients. The study revealed a need for further nursing attention to next of kin in this context.

  14. Pigment patterns in adult fish result from superimposition of two largely independent pigmentation mechanisms.

    PubMed

    Ceinos, Rosa M; Guillot, Raúl; Kelsh, Robert N; Cerdá-Reverter, José M; Rotllant, Josep

    2015-03-01

    Dorso-ventral pigment pattern differences are the most widespread pigmentary adaptations in vertebrates. In mammals, this pattern is controlled by regulating melanin chemistry in melanocytes using a protein, agouti-signalling peptide (ASIP). In fish, studies of pigment patterning have focused on stripe formation, identifying a core striping mechanism dependent upon interactions between different pigment cell types. In contrast, mechanisms driving the dorso-ventral countershading pattern have been overlooked. Here, we demonstrate that, in fact, zebrafish utilize two distinct adult pigment patterning mechanisms - an ancient dorso-ventral patterning mechanism, and a more recent striping mechanism based on cell-cell interactions; remarkably, the dorso-ventral patterning mechanism also utilizes ASIP. These two mechanisms function largely independently, with resultant patterns superimposed to give the full pattern.

  15. Adult-to-adult living related donor renal transplantation in Yemen: the first experience.

    PubMed

    El-Nono, Ibrahiem H; Al-Ba'adani, Tawfiq H; Ghilan, Abdulilah M; Asba, Nagieb W Abu; Al-Alimy, Gamil M; Al-Massani, Mokhtar M; Noman, Morshed A; Al-Shargabe, Soliman; Al-Mansour, Mohamed M; Nassar, Mogahed Y

    2007-06-01

    Between May 1998 and June 2006, 31 patients (21 males and 10 females) received a renal allograft from live-related donors at the Urology and Nephrology Center in the Al-Thawra Modern General Hospital Sana'a, Republic of Yemen. The cold ischemia time ranged between 48 and 68 minutes. The immunosuppressive protocol was double therapy (steroids and mycophenolate) in the first 8 cases. The subsequent cases received triple therapy with steroids, cyclosporine and mycophenolate. Episodes of acute rejection were treated with high dose steroids while anti-thymocyte globulin (ATG) was also used in cases of vascular or steroid resistant rejection. Primary graft function was achieved in 29 recipients (93.5%). The post-transplant complications, either surgical or medical, were comparable to those reported in the literature. The kidney transplantation program started sporadically in Yemen since 1998. However, a well-established program has been running regularly since the beginning of 2005.

  16. Oncogenetics and minimal residual disease are independent outcome predictors in adult patients with acute lymphoblastic leukemia.

    PubMed

    Beldjord, Kheira; Chevret, Sylvie; Asnafi, Vahid; Huguet, Françoise; Boulland, Marie-Laure; Leguay, Thibaut; Thomas, Xavier; Cayuela, Jean-Michel; Grardel, Nathalie; Chalandon, Yves; Boissel, Nicolas; Schaefer, Beat; Delabesse, Eric; Cavé, Hélène; Chevallier, Patrice; Buzyn, Agnès; Fest, Thierry; Reman, Oumedaly; Vernant, Jean-Paul; Lhéritier, Véronique; Béné, Marie C; Lafage, Marina; Macintyre, Elizabeth; Ifrah, Norbert; Dombret, Hervé

    2014-06-12

    With intensified pediatric-like therapy and genetic disease dissection, the field of adult acute lymphoblastic leukemia (ALL) has evolved recently. In this new context, we aimed to reassess the value of conventional risk factors with regard to new genetic alterations and early response to therapy, as assessed by immunoglobulin/T-cell receptor minimal residual disease (MRD) levels. The study was performed in 423 younger adults with Philadelphia chromosome-negative ALL in first remission (265 B-cell precursor [BCP] and 158 T-cell ALL), with cumulative incidence of relapse (CIR) as the primary end point. In addition to conventional risk factors, the most frequent currently available genetic alterations were included in the analysis. A higher specific hazard of relapse was independently associated with postinduction MRD level ≥10(-4) and unfavorable genetic characteristics (ie, MLL gene rearrangement or focal IKZF1 gene deletion in BCP-ALL and no NOTCH1/FBXW7 mutation and/or N/K-RAS mutation and/or PTEN gene alteration in T-cell ALL). These 2 factors allowed definition of a new risk classification that is strongly associated with higher CIR and shorter relapse-free and overall survival. These results indicate that genetic abnormalities are important predictors of outcome in adult ALL not fully recapitulated by early response to therapy. Patients included in this study were treated in the multicenter GRAALL-2003 and GRAALL-2005 trials. Both trials were registered at http://www.clinicaltrials.gov as #NCT00222027 and #NCT00327678, respectively.

  17. Independent Living Capacity Evaluation in Home-Based Primary Care: Considerations and Outcomes of a Quality Improvement Project

    PubMed Central

    Feng, Michelle C.; Murphy, Margaret R.; Mlinac, Michelle

    2016-01-01

    Objectives This article describes results of a quality improvement project review of 5 years of capacity evaluations for independent living conducted in one Home-Based Primary Care (HBPC) Program. Methods A retrospective chart review was conducted for all patients evaluated for independent living capacity through the Boston VA HBPC Program (N = 25) to identify differences in outcomes for those with and without capacity. Descriptive information included referral sources, capacity decisions, time remaining in the home, and trajectory of patients following evaluation. Results All patients evaluated had been diagnosed with a cognitive disorder, and on average, a relatively lower prevalence of mental illness compared with the national HBPC population. Referrals were made primarily by the HBPC team. Patients with capacity were found to have remained in their home longer than those who lacked capacity. Conclusions Referral for a higher level of care was typically only recommended when no further intervention could be implemented and active risk in the home could not be managed. Clinical Implications In home capacity evaluations are complex and challenging, yet results help family and HBPC team support patients’ preferences for staying in their own home as long as possible. PMID:28111494

  18. Successful aging: Advancing the science of physical independence in older adults.

    PubMed

    Anton, Stephen D; Woods, Adam J; Ashizawa, Tetso; Barb, Diana; Buford, Thomas W; Carter, Christy S; Clark, David J; Cohen, Ronald A; Corbett, Duane B; Cruz-Almeida, Yenisel; Dotson, Vonetta; Ebner, Natalie; Efron, Philip A; Fillingim, Roger B; Foster, Thomas C; Gundermann, David M; Joseph, Anna-Maria; Karabetian, Christy; Leeuwenburgh, Christiaan; Manini, Todd M; Marsiske, Michael; Mankowski, Robert T; Mutchie, Heather L; Perri, Michael G; Ranka, Sanjay; Rashidi, Parisa; Sandesara, Bhanuprasad; Scarpace, Philip J; Sibille, Kimberly T; Solberg, Laurence M; Someya, Shinichi; Uphold, Connie; Wohlgemuth, Stephanie; Wu, Samuel Shangwu; Pahor, Marco

    2015-11-01

    The concept of 'successful aging' has long intrigued the scientific community. Despite this long-standing interest, a consensus definition has proven to be a difficult task, due to the inherent challenge involved in defining such a complex, multi-dimensional phenomenon. The lack of a clear set of defining characteristics for the construct of successful aging has made comparison of findings across studies difficult and has limited advances in aging research. A consensus on markers of successful aging is furthest developed is the domain of physical functioning. For example, walking speed appears to be an excellent surrogate marker of overall health and predicts the maintenance of physical independence, a cornerstone of successful aging. The purpose of the present article is to provide an overview and discussion of specific health conditions, behavioral factors, and biological mechanisms that mark declining mobility and physical function and promising interventions to counter these effects. With life expectancy continuing to increase in the United States and developed countries throughout the world, there is an increasing public health focus on the maintenance of physical independence among all older adults.

  19. Successful Aging: Advancing the Science of Physical Independence in Older Adults

    PubMed Central

    Anton, Stephen D.; Woods, Adam J.; Ashizawa, Tetso; Barb, Diana; Buford, Thomas W.; Carter, Christy S.; Clark, David J.; Cohen, Ronald A.; Corbett, Duane B.; Cruz-Almeida, Yenisel; Dotson, Vonetta; Ebner, Natalie; Efron, Philip A.; Fillingim, Roger B.; Foster, Thomas C.; Gundermann, David M.; Joseph, Anna-Maria; Karabetian, Christy; Leeuwenburgh, Christiaan; Manini, Todd M.; Marsiske, Michael; Mankowski, Robert T.; Mutchie, Heather L.; Perri, Michael G.; Ranka, Sanjay; Rashidi, Parisa; Sandesara, Bhanuprasad; Scarpace, Philip J.; Sibille, Kimberly T.; Solberg, Laurence M.; Someya, Shinichi; Uphold, Connie; Wohlgemuth, Stephanie; Wu, Samuel Shangwu; Pahor, Marco

    2015-01-01

    The concept of ‘Successful Aging’ has long intrigued the scientific community. Despite this long-standing interest, a consensus definition has proven to be a difficult task, due to the inherent challenge involved in defining such a complex, multi-dimensional phenomenon. The lack of a clear set of defining characteristics for the construct of successful aging has made comparison of findings across studies difficult and has limited advances in aging research. The domain in which consensus on markers of successful aging is furthest developed is the domain of physical functioning. For example, walking speed appears to be an excellent surrogate marker of overall health and predicts the maintenance of physical independence, a cornerstone of successful aging. The purpose of the present article is to provide an overview and discussion of specific health conditions, behavioral factors, and biological mechanisms that mark declining mobility and physical function and promising interventions to counter these effects. With life expectancy continuing to increase in the United States and developed countries throughout the world, there is an increasing public health focus on the maintenance of physical independence among all older adults. PMID:26462882

  20. Factors Influencing Food Choice for Independently Living Older People-A Systematic Literature Review.

    PubMed

    Host, Alison; McMahon, Anne-Therese; Walton, Karen; Charlton, Karen

    2016-01-01

    Unyielding, disproportionate growth in the 65 years and older age group has precipitated serious concern about the propensity of health and aged-care services to cope in the very near future. Preservation of health and independence for as long as possible into later life will be necessary to attenuate demand for such services. Maintenance of nutritional status is acknowledged as fundamental for achievement of this aim. Determinants of food choice within this age group need to be identified and better understood to facilitate the development of pertinent strategies for encouraging nutritional intakes supportive of optimal health. A systematic review of the literature consistent with PRISMA guidelines was performed to identify articles investigating influences on food choice among older people. Articles were limited to those published between 1996 and 2014 and to studies conducted within countries where the dominant cultural, political and economic situations were comparable to those in Australia. Twenty-four articles were identified and subjected to qualitative analysis. Several themes were revealed and grouped into three broad domains: (i) changes associated with ageing; (ii) psychosocial aspects; and (iii) personal resources. Food choice among older people is determined by a complex interaction between multiple factors. Findings suggest the need for further investigations involving larger, more demographically diverse samples of participants, with the inclusion of a direct observational component in the study design.

  1. The lived experience of visual creative expression for young adult cancer survivors.

    PubMed

    Green, A R; Young, R A

    2015-09-01

    Engaging in visual creative expression individually and in a therapeutic setting can be a beneficial experience for cancer survivors; however, most research in this field has been conducted with older adults. The current study aimed to address this gap by utilising van Manen's hermeneutic phenomenology to answer the following question: 'What is the lived experience and meaning of visual creative expression for young adult cancer survivors?' Seven young adults, diagnosed with cancer between the ages of 18 and 35, were interviewed about creative expression experiences, which they engaged in individually and/or in a therapeutic setting. Data analysis included a thematic reflection, guided existential reflection, and a process of writing and rewriting. Two superordinate themes were identified: increased self-understanding and a healing experience. Seven subthemes were also identified and included the following: being in the flow, allowing the body to express itself, renegotiating control, changing one's environment, being seen, respect for art as a separate entity and giving back. Findings suggest that visual creative expression can be a meaningful experience for young adult cancer survivors, and that this experience espouses both similarities and differences from experiences of older adult survivors. Recommendations are made for future research, in addition to implications for practitioners.

  2. How old am I? Age estimation in living adults: a case report.

    PubMed

    Cattaneo, C; De Angelis, D; Ruspa, M; Gibelli, D; Cameriere, R; Grandi, M

    2008-12-01

    Age estimation is a common task in forensic medicine. Odontologists are frequently involved in the age assessment of human remains or living juveniles. The need to estimate the age of living individuals is becoming more frequent, because of the increasing number of immigrants (illegal or otherwise) without acceptable identification documents and with missing or uncertain birth dates. Whereas age estimation in subadults is usually performed by methods based on the physiological growth of bones and teeth, in the case of living adults age determination is more difficult, because body maturation has come to an end and the most commonly used procedures in forensics on human remains are too invasive for the living individual. The following case report aims at highlighting the difficulties of performing age estimation in the living adult and the importance of a multidisciplinary approach including forensic odontology: a middle-aged woman from Ethiopia who was supposed to be 62 years old (according to one set of documents), was removed from employment lists as she had reached the retirement age for Italy. However another set of documents indicated a younger age (46 years). Hormonal dosage of E2 (17-β estradiol) and FSH (Follicle Stimulating Hormone) showed an age close to the begininng of menopause. An experimental dental method, based on the decrease of canine pulp chamber with age, was performed in order to obtain more information: the result was an estimation of a 47-57 age range. Combined results suggested that it was more likely that the actual age of the woman was closer to 46 than to 62.

  3. Disability in instrumental activities of daily living among older adults: gender differences

    PubMed Central

    Alexandre, Tiago da Silva; Corona, Ligiana Pires; Nunes, Daniella Pires; Santos, Jair Lício Ferreira; Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia

    2014-01-01

    OBJECTIVE To analyze gender differences in the incidence and determinants of disability regarding instrumental activities of daily living among older adults. METHODS The data were extracted from the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Ageing) study. In 2000, 1,034 older adults without difficulty in regarding instrumental activities of daily living were selected. The following characteristics were evaluated at the baseline: sociodemographic and behavioral variables, health status, falls, fractures, hospitalizations, depressive symptoms, cognition, strength, mobility, balance and perception of vision and hearing. Instrumental activities of daily living such as shopping and managing own money and medication, using transportation and using the telephone were reassessed in 2006, with incident cases of disability considered as the outcome. RESULTS The incidence density of disability in instrumental activities of daily living was 44.7/1,000 person/years for women and 25.2/1,000 person/years for men. The incidence rate ratio between women and men was 1.77 (95%CI 1.75;1.80). After controlling for socioeconomic status and clinical conditions, the incidence rate ratio was 1.81 (95%CI 1.77;1.84), demonstrating that women with chronic disease and greater social vulnerability have a greater incidence density of disability in instrumental activities of daily living. The following were determinants of the incidence of disability: age ≥ 80 and worse perception of hearing in both genders; stroke in men; and being aged 70 to 79 in women. Better cognitive performance was a protective factor in both genders and better balance was a protective factor in women. CONCLUSIONS The higher incidence density of disability in older women remained even after controlling for adverse social and clinical conditions. In addition to age, poorer cognitive performance and conditions that adversely affect communication disable both genders. Acute events, such as a stroke

  4. Disability in instrumental activities of daily living among older adults: gender differences.

    PubMed

    Alexandre, Tiago da Silva; Corona, Ligiana Pires; Nunes, Daniella Pires; Santos, Jair Lício Ferreira; Duarte, Yeda Aparecida de Oliveira; Lebrão, Maria Lúcia

    2014-06-01

    OBJECTIVE To analyze gender differences in the incidence and determinants of disability regarding instrumental activities of daily living among older adults. METHODS The data were extracted from the Saúde, Bem-Estar e Envelhecimento (SABE - Health, Wellbeing and Ageing) study. In 2000, 1,034 older adults without difficulty in regarding instrumental activities of daily living were selected. The following characteristics were evaluated at the baseline: sociodemographic and behavioral variables, health status, falls, fractures, hospitalizations, depressive symptoms, cognition, strength, mobility, balance and perception of vision and hearing. Instrumental activities of daily living such as shopping and managing own money and medication, using transportation and using the telephone were reassessed in 2006, with incident cases of disability considered as the outcome. RESULTS The incidence density of disability in instrumental activities of daily living was 44.7/1,000 person/years for women and 25.2/1,000 person/years for men. The incidence rate ratio between women and men was 1.77 (95%CI 1.75;1.80). After controlling for socioeconomic status and clinical conditions, the incidence rate ratio was 1.81 (95%CI 1.77;1.84), demonstrating that women with chronic disease and greater social vulnerability have a greater incidence density of disability in instrumental activities of daily living. The following were determinants of the incidence of disability: age ≥ 80 and worse perception of hearing in both genders; stroke in men; and being aged 70 to 79 in women. Better cognitive performance was a protective factor in both genders and better balance was a protective factor in women. CONCLUSIONS The higher incidence density of disability in older women remained even after controlling for adverse social and clinical conditions. In addition to age, poorer cognitive performance and conditions that adversely affect communication disable both genders. Acute events, such as a stroke

  5. Cytokine polymorphisms are associated with fatigue in adults living with HIV/AIDS.

    PubMed

    Lee, Kathryn A; Gay, Caryl L; Lerdal, Anners; Pullinger, Clive R; Aouizerat, Bradley E

    2014-08-01

    Fatigue has been associated with inflammation and cytokine activity among adults, but this relationship has not been evaluated among adults living with HIV. Diurnal patterns of fatigue have been previously identified in adults with HIV/AIDS. Thus, the purpose of this study was to describe these fatigue patterns in relation to cytokine plasma concentrations and gene polymorphisms. A convenience sample of 317 adults living with HIV/AIDS completed a measure of fatigue in the morning and evening for three consecutive days; participants reporting low levels of both morning and evening fatigue (n=110) or high levels of fatigue in the morning and evening (n=114) were included in the analysis, resulting in a final sample of 224 adults (151 men, 55 women, and 18 transgender). Plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB-1 and -2), and tumor necrosis factor alpha (TNFA). Demographic and clinical variables were evaluated as potential covariates. Controlling for genomic estimates of ancestry and self-reported race/ethnicity and gender, the high fatigue pattern was associated with five single nucleotide polymorphisms (SNPs): IL1B rs1071676 and rs1143627, IL4 rs2243274, and TNFA rs1800683 and rs1041981. The IL1B and TNFA polymorphisms were not associated with plasma levels of IL-1β or TNFα, respectively. This study strengthens the evidence for an association between inflammation and fatigue. In this chronic illness population, the cytokine polymorphisms associated with high levels of morning and evening fatigue provide direction for future personalized medicine intervention research.

  6. Exploring the lived experience of adults using prescription opioids to manage chronic noncancer pain

    PubMed Central

    Brooks, Erica A; Unruh, Anita; Lynch, Mary E

    2015-01-01

    BACKGROUND: Chronic noncancer pain (CNCP) and prescription opioid use is a highly complex and growing health care issue in Canada. Many quantitative research studies have investigated the effectiveness of opioids for chronic pain; however, gaps remain in the literature regarding the personal experience of using opioids and their impact on those experiencing CNCP. OBJECTIVE: To explore the lived experience of adults using prescription opioids to manage CNCP, focusing on how opioid medication affected their daily lives. METHODS: In-depth qualitative interviews were conducted with nine adults between 40 and 68 years of age who were using prescription opioids daily for CNCP. Interviews were audiorecorded and transcribed, and subsequently analyzed using interpretive phenomenological analysis. RESULTS: Six major themes identified positive and negative aspects of opioid use associated with social, physical, emotional and psychological dimensions of pain management. These themes included the process of decision making, and physical and psychosocial consequences of using opioids including pharmacological side effects, feeling stigmatized, guilt, fears, ambivalence, self-protection and acceptance. CONCLUSION: Although there were many negative aspects to using opioids daily, the positive effects outweighed the negative for most participants and most of the negative aspects were socioculturally induced rather than caused by the drug itself. The present study highlighted the complexities involved in using prescription opioids daily for management of CNCP for individuals living with pain. PMID:25562838

  7. Injuries Reported and Recorded for Adults with Intellectual Disabilities Who Live with Paid Support in Scotland: A Comparison with Scottish Adults in the General Population

    ERIC Educational Resources Information Center

    Petropoulou, Evangelia; Finlayson, Janet; Hay, Margaret; Spencer, Wendy; Park, Richard; Tannock, Hugh; Galbraith, Erin; Godwin, Jon; Skelton, Dawn A.

    2017-01-01

    Background: Providers of supported living services to adults with intellectual disabilities (IDs) in the United Kingdom have procedures in place to monitor injuries; this provides opportunity to learn about the injuries being reported and recorded. The aim was to determine the incidence, causes and types of injuries experienced by 593 adults with…

  8. Subjective well-being in older adults: folate and vitamin B12 independently predict positive affect.

    PubMed

    Edney, Laura C; Burns, Nicholas R; Danthiir, Vanessa

    2015-10-28

    Vitamin B12, folate and homocysteine have long been implicated in mental illness, and growing evidence suggests that they may play a role in positive mental health. Elucidation of these relationships is confounded due to the dependence of homocysteine on available levels of vitamin B12 and folate. Cross-sectional and longitudinal relationships between vitamin B12, folate, homocysteine and subjective well-being were assessed in a sample of 391 older, community-living adults without clinically diagnosed depression. Levels of vitamin B12, but not folate, influenced homocysteine levels 18 months later. Vitamin B12, folate and their interaction significantly predicted levels of positive affect (PA) 18 months later, but had no impact on the levels of negative affect or life satisfaction. Cross-sectional relationships between homocysteine and PA were completely attenuated in the longitudinal analyses, suggesting that the cross-sectional relationship is driven by the dependence of homocysteine on vitamin B12 and folate. This is the first study to offer some evidence of a causal link between levels of folate and vitamin B12 on PA in a large, non-clinical population.

  9. Sleep, Fatigue, and Problems With Cognitive Function in Adults Living With HIV.

    PubMed

    Byun, Eeeseung; Gay, Caryl L; Lee, Kathryn A

    2016-01-01

    Up to 50% of people living with HIV have some neurocognitive impairment. We examined associations of sleep and fatigue with self-reported cognitive problems in 268 adults living with HIV. Multivariate regression was used to examine associations between cognitive problems, self-reported sleep quality, actigraphy-measured total sleep time and wake after sleep onset, and fatigue severity. Poorer self-reported sleep quality (p < .001), short or long total sleep time (<7 or >8 vs. 7-8 hours, p = .015), and greater fatigue (p < .001) were associated with lower self-reported cognitive function scores after controlling for demographic and clinical characteristics. However, objective measure of wake after sleep onset was unrelated to self-reported cognitive function scores. Findings suggest that assessing and treating poor sleep and complaints about fatigue would be areas for intervention that could have a greater impact on improving cognition function than interventions that target only cognitive problems.

  10. Sleep, Fatigue, and Problems with Cognitive Function in Adults Living with HIV

    PubMed Central

    Gay, Caryl L.; Lee, Kathryn A.

    2015-01-01

    Up to 50% of people living with HIV have some neurocognitive impairment. We examined associations of sleep and fatigue with self-reported cognitive problems in 268 adults living with HIV. Multivariate regression was used to examine associations between cognitive problems, self-reported sleep quality, actigraphy-measured total sleep time and wake after sleep onset, and fatigue severity. Poorer self-reported sleep quality (p < .001), short or long total sleep time (< 7 or > 8 vs. 7–8 hours, p = .015), and greater fatigue (p < .001) were associated with lower self-reported cognitive function scores after controlling for demographic and clinical characteristics. However, objective measure of wake after sleep onset was unrelated to self-reported cognitive function scores. Findings suggest that assessing and treating poor sleep and complaints about fatigue would be areas for intervention that could have a greater impact on improving cognition function than interventions that only target cognitive problems. PMID:26547298

  11. Breaking through Limbo: Experiences of Adults Living with Obstructive Sleep Apnea

    PubMed Central

    Rodgers, Beth

    2013-01-01

    Obstructive sleep apnea (OSA) is a potentially devastating condition that diminishes quality of life and leads to serious consequences without treatment. Diagnosis often is delayed and, once diagnosed, adherence to prescribed therapy tends to be a major barrier to management. This grounded theory study was focused on the experiences of a diverse group of 82 adults who were at various points in the process of obtaining a diagnosis and living with OSA. Participants described being in “limbo” and needing to break through that limbo to be successful at managing their OSA. Results provide new insights into the experience of living with OSA that can be beneficial in promoting treatment and shaping effective management of the condition. PMID:23570652

  12. Childhood cancer camps: their role in adults surviving childhood cancers lives.

    PubMed

    Beckwitt, Asher E

    2014-01-01

    This study investigates the role that childhood cancer camps continue to play in the lives of adults surviving childhood cancers (ASCCs). Specifically, the purpose of this study is to understand the roles these camps play in enhancing ASCCs' psychosocial and emotional well-being and access to information. Twenty-three ASCCs participated in this study. Illness narratives were used to understand ASCCs' camp experiences. Three themes emerged from the data analysis to reflect ASCCs' experiences: (1) normalcy, (2) meaningful camp experiences, and (3) access to information. Results show that in the years following camp participation, childhood cancer camps continue to play an important role in ASCCs' lives, providing them with ongoing social and emotional support and access to resources.

  13. Back pain in adults living in quilombola territories of Bahia, Northeastern Brazil

    PubMed Central

    Santos, Luis Rogério Cosme Silva; Assunção, Ada Ávila; Lima, Eduardo de Paula

    2014-01-01

    OBJECTIVE To analyze the factors associated with back pain in adults who live in quilombola territories. METHODS A population-based survey was performed on quilombola communities of Vitória da Conquista, state of Bahia, Northeastern Brazil. The sample (n = 750) was established via a raffle of residences. Semi-structured interviews were conducted to investigate sociodemographics and employment characteristics, lifestyle, and health conditions. The outcome was analyzed as a dichotomous variable (Poisson regression). RESULTS The prevalence of back pain was of 39.3%. Age ≥ 30 years and being a smoker were associated with the outcome. The employment status was not related to back pain. CONCLUSIONS The survey identified a high prevalence of back pain in adults. It is suggested to support the restructuring of the local public service in order to outline programs and access to healthy practices, assistance, diagnosis, and treatment of spine problems. PMID:25372165

  14. Depression, Social Isolation, and the Lived Experience of Dancing in Disadvantaged Adults.

    PubMed

    Murrock, Carolyn J; Graor, Christine Heifner

    2016-02-01

    This qualitative study described the lived experience of dancing as it related to depression and social isolation in 16 disadvantaged adults who completed a 12-week dance intervention. It is the first qualitative study to explore the experience of dance as an adjunct therapy, depression, and social isolation. A descriptive phenomenological framework consisted of two focus groups using semi-structured interviews. A Giorgian approach guided thematic analysis. Four themes emerged: (1) dance for myself and health, (2) social acceptance, (3) connection with others: a group, and (4) not wanting to stop: unexpected benefits from dancing. As the participants continued to dance, they developed a sense of belonging and group identity, which may have maintained group involvement and contributed to reducing depression and social isolation. Thus, dancing is a complementary therapy that should be considered when working with adults with depression and social isolation.

  15. Andragogy for Teen and Young Adult Learners with Intellectual Disabilities: Learning, Independence, and Best Practices

    ERIC Educational Resources Information Center

    Bowman, Stephanie L.; Plourde, Lee A.

    2012-01-01

    Teens and young adults with Intellectual Disabilities (ID) meet the criteria of teen and adult learners chronologically, but may be deficient in many other areas of teen and adult learning. The spectrum of intellectual and adaptive capabilities among teens and adults with ID is vast, with each individual being unique. There are specific teaching…

  16. The Relationship between Self-Determination and Quality of Life among Individuals with Disabilities Involved with a Center for Independent Living

    ERIC Educational Resources Information Center

    Bekemeier, Karsten

    2009-01-01

    Individuals with disabilities have historically been compromised in their ability to assert independence with respect to concepts of independent living and self-determination. In turn this may potentially impact an individual's overall quality of life. Community integration and availability of a full quality of life and to be self-determined has…

  17. Putting Children on the Path to Becoming Responsible Adults: The Perspective of One Parent Living in the United Arab Emirates

    ERIC Educational Resources Information Center

    Baker, Fiona S.

    2013-01-01

    Many parents seeking a sound education for their children are looking beyond the narrow boundaries of test scores into the realm of character education. This article explores how parenting approaches can help children live fulfilling lives in the present and also prepare them for future adult roles in personal, social, and professional spheres.…

  18. Recruiting Older Adults into a Physical Activity Promotion Program: "Active Living Every Day" Offered in a Naturally Occurring Retirement Community

    ERIC Educational Resources Information Center

    Hildebrand, Mary; Neufeld, Peggy

    2009-01-01

    Purpose: This article explores recruitment strategies based on the transtheoretical model (TTM) with older adults living in a naturally occurring retirement community (NORC) to encourage enrollment in a physical activity promotion program, "Active Living Every Day" (ALED). Reasons for participation or nonparticipation are identified. Design and…

  19. 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

  20. Socioeconomic Indicators Are Independently Associated with Nutrient Intake in French Adults: A DEDIPAC Study.

    PubMed

    Si Hassen, Wendy; Castetbon, Katia; Cardon, Philippe; Enaux, Christophe; Nicolaou, Mary; Lien, Nanna; Terragni, Laura; Holdsworth, Michelle; Stronks, Karien; Hercberg, Serge; Méjean, Caroline

    2016-03-10

    Studies have suggested differential associations of specific indicators of socioeconomic position (SEP) with nutrient intake and a cumulative effect of these indicators on diet. We investigated the independent association of SEP indicators (education, income, occupation) with nutrient intake and their effect modification. This cross-sectional analysis included 91,900 French adults from the NutriNet-Santé cohort. Nutrient intake was estimated using three 24-h records. We investigated associations between the three SEP factors and nutrient intake using sex-stratified analysis of covariance, adjusted for age and energy intake, and associations between income and nutrient intake stratified by education and occupation. Low educated participants had higher protein and cholesterol intakes and lower fibre, vitamin C and beta-carotene intakes. Low income individuals had higher complex carbohydrate intakes, and lower magnesium, potassium, folate and vitamin C intakes. Intakes of vitamin D and alcohol were lower in low occupation individuals. Higher income was associated with higher intakes of fibre, protein, magnesium, potassium, beta-carotene, and folate among low educated persons only, highlighting effect modification. Lower SEP, particularly low education, was associated with lower intakes of nutrients required for a healthy diet. Each SEP indicator was associated with specific differences in nutrient intake suggesting that they underpin different social processes.

  1. Fluorescent labelling of intestinal epithelial cells reveals independent long-lived intestinal stem cells in a crypt

    SciTech Connect

    Horita, Nobukatsu; Tsuchiya, Kiichiro; Hayashi, Ryohei; Fukushima, Keita; Hibiya, Shuji; Fukuda, Masayoshi; Kano, Yoshihito; Mizutani, Tomohiro; Nemoto, Yasuhiro; Yui, Shiro; Okamoto, Ryuichi; Nakamura, Tetsuya; Watanabe, Mamoru

    2014-11-28

    Highlights: • Lentivirus mixed with Matrigel enables direct infection of intestinal organoids. • Our original approach allows the marking of a single stem cell in a crypt. • Time-lapse imaging shows the dynamics of a single stem cell. • Our lentivirus transgene system demonstrates plural long-lived stem cells in a crypt. - Abstract: Background and aims: The dynamics of intestinal stem cells are crucial for regulation of intestinal function and maintenance. Although crypt stem cells have been identified in the intestine by genetic marking methods, identification of plural crypt stem cells has not yet been achieved as they are visualised in the same colour. Methods: Intestinal organoids were transferred into Matrigel® mixed with lentivirus encoding mCherry. The dynamics of mCherry-positive cells was analysed using time-lapse imaging, and the localisation of mCherry-positive cells was analysed using 3D immunofluorescence. Results: We established an original method for the introduction of a transgene into an organoid generated from mouse small intestine that resulted in continuous fluorescence of the mCherry protein in a portion of organoid cells. Three-dimensional analysis using confocal microscopy showed a single mCherry-positive cell in an organoid crypt that had been cultured for >1 year, which suggested the presence of long-lived mCherry-positive and -negative stem cells in the same crypt. Moreover, a single mCherry-positive stem cell in a crypt gave rise to both crypt base columnar cells and transit amplifying cells. Each mCherry-positive and -negative cell contributed to the generation of organoids. Conclusions: The use of our original lentiviral transgene system to mark individual organoid crypt stem cells showed that long-lived plural crypt stem cells might independently serve as intestinal epithelial cells, resulting in the formation of a completely functional villus.

  2. Comparison between psychosocial long-term outcomes of recipients and donors after adult-to-adult living donor liver transplantation.

    PubMed

    Noma, Shun'ichi; Hayashi, Akiko; Uehara, Minako; Uemoto, Shinji; Murai, Toshiya

    2011-01-01

    The purpose of this study was to examine psychosocial states of recipients and donors several years after living donor liver transplantation (LDLT) and to find out the pre-transplant predictors of desirable post-transplant psychosocial states. The recipients and donors of adult-to-adult LDLT at Kyoto University Hospital, Japan, from November 2001 through July 2003 were interviewed and examined by means of questionnaires about anxiety, depression, and quality of life (QOL), and the participants were evaluated by the same test batteries sent by mail three to five yr after LDLT. Twenty-seven pairs of recipients and donors, 13 recipients, and three donors participated in this study. The recipients and the donors had a decline in social QOL. The main predictor of psychosocial states of the recipients was the length of wait for LDLT, and the predictors of the donors were family or support system availability and recipients' depressive states at LDLT. The donors who were spouses of the recipients had better QOL than other donors. It might be better to perform LDLT as soon as possible once LDLT has been judged to be necessary, and the relative who is on close terms with the recipient should be selected as donor.

  3. Risk Factors for Intractable Ascites After Adult-to-Adult Living Donor Liver Transplantation Using Left Lobe

    PubMed Central

    Matsudaira, Shinichi; Ishizaki, Yoichi; Yoshimoto, Jiro; Fujiwara, Noriko; Kawasaki, Seiji

    2017-01-01

    Background Intractable ascites is one of the causes of graft loss after adult-to-adult living donor liver transplantation (LDLT) using a small graft. Identification of factors associated with increasing posttransplant ascites has important implications for prevention and treatment. Methods All 59 consecutive adult patients who underwent left lobe LDLT without portal inflow modulation between October 2002 and February 2016 were prospectively enrolled. Factors associated with the average daily amount of ascites for 2 weeks after LDLT were assessed. Results The median daily amount of ascites during the 2 weeks was 1052 mL (range, 52-3480 mL). Although 16 of the 59 patients developed intractable ascites, exceeding 1500 mL daily (massive ascites group), the remaining 43 patients produced less than 1500 mL of ascites daily (nonmassive ascites group). The presence of pretransplant ascites (P = 0.001), albumin (P = 0.011), albumin/globulin ratio (P = 0.026), cold ischemia time (P = 0.004), operation time (P = 0.022), and pretransplant portal vein pressure (PVP) (P = 0.047) differed significantly between the 2 groups. Neither posttransplant PVP nor portal vein flow differed between the 2 groups. The variables associated with intractable ascites that remained significant after logistic regression analysis were pretransplant PVP (P = 0.047) and cold ischemia time (P = 0.049). After appropriate fluid resuscitation for intractable ascites, 58 (98%) of the 59 recipients were discharged from hospital after removal of the indwelling drains. Conclusions It is important to shorten the scold ischemia time to reduce massive ascites after LDLT. Pretransplant portal hypertension is more closely associated with ascites production than posttransplant hemodynamic status. PMID:28361122

  4. Personalized technology to support older adults with and without cognitive impairment living at home.

    PubMed

    Kerssens, Chantal; Kumar, Renu; Adams, Anne E; Knott, Camilla C; Matalenas, Laura; Sanford, Jon A; Rogers, Wendy A

    2015-02-01

    Although persons with dementia (PWD) and their family caregivers need in-home support for common neuropsychiatric symptoms (NPS), few if any assistive technologies are available to help manage NPS. This implementation study tested the feasibility and adoption of a touch screen technology, the Companion, which delivers psychosocial, nondrug interventions to PWD in their home to address individual NPS and needs. Interventions were personalized and delivered in home for a minimum of 3 weeks. Postintervention measures indicated the technology was easy to use, significantly facilitated meaningful and positive engagement, and simplified caregivers' daily lives. Although intervention goals were met, caregivers had high expectations of their loved one's ability to regain independence. Care recipients used the system independently but were limited by cognitive and physical impairments. We conclude the Companion can help manage NPS and offer caregiver respite at home. These data provide important guidance for design and deployment of care technology for the home.

  5. Personalized Technology to Support Older Adults With and Without Cognitive Impairment Living at Home

    PubMed Central

    Kerssens, Chantal; Kumar, Renu; Adams, Anne E.; Knott, Camilla C.; Matalenas, Laura; Sanford, Jon A.; Rogers, Wendy A.

    2015-01-01

    Although persons with dementia (PWD) and their family caregivers need in-home support for common neuropsychiatric symptoms (NPS), few if any assistive technologies are available to help manage NPS. This implementation study tested the feasibility and adoption of a touch screen technology, the Companion, that delivers psychosocial, nondrug interventions to PWD in their home to address individual NPS and needs. Interventions were personalized and delivered in-home for a minimum of 3 weeks. Post-intervention measures indicated the technology was easy to use, significantly facilitated meaningful and positive engagement, and simplified caregivers’ daily lives. Although intervention goals were met, caregivers had high expectations of their loved-one’s ability to regain independence. Care recipients used the system independently, but were limited by cognitive and physical impairments. We conclude the Companion can help manage NPS and offer caregiver respite at home. These data provide important guidance for design and deployment of care technology for the home. PMID:25614507

  6. Factors that influence emotional disturbance in adults living in extreme poverty.

    PubMed

    Palomar-Lever, Joaquina; Victorio-Estrada, Amparo

    2012-04-01

    Living in poverty conditions implies exposure to severe circumstances of social disadvantage, associated with greater propensity to contract illnesses. A negative correlation has consistently been observed between health and poverty. The chronic exposure to stress affects people's well-being through the development of symptoms of anxiety and depression. The suffering of these symptoms for a long time period may be considered as part of a more general syndrome of emotional disturbance, in detriment to a person's mental health. The objective of this study is to identify psychological factors that influence emotional disturbance, measured as symptoms of anxiety and depression, in adults living in poverty conditions in Mexico's central region. A total of 913 adults, 65.2% female, were surveyed. The mean age of the participants was 43.71 (±12.58) years and the mean number of years of schooling was 4.04 (±3.36). Variables corresponding to personal characteristics were measured. The results indicate that the most important risk factor for depression is anxiety and vice versa. Additionally, gender, negative self-esteem, lack of adequate strategies for confronting and resolving difficulties, and lack of self-regulation predicted depression, whereas stress, lack of self-regulation, and coping style predicted anxiety. These variables were better predictors than optimism, locus of control, sense of humor or religiosity.

  7. Adult Living Donor Liver Transplantation with ABO-Incompatible Grafts: A German Single Center Experience

    PubMed Central

    Goralczyk, Armin D.; Obed, Aiman; Schnitzbauer, Andreas; Doenecke, Axel; Tsui, Tung Yu; Scherer, Marcus N.; Ramadori, Giuliano; Lorf, Thomas

    2009-01-01

    Adult living donor liver transplantations (ALDLTs) across the ABO blood group barrier have been reported in Asia, North Americas, and Europe, but not yet in Germany. Several strategies have been established to overcome the detrimental effects that are attached with such a disparity between donor and host, but no gold standard has yet emerged. Here, we present the first experiences with three ABO-incompatible adult living donor liver transplantations in Germany applying different immunosuppressive strategies. Four patient-donor couples were considered for ABO-incompatible ALDLT. In these patients, resident ABO blood group antibodies (isoagglutinins) were depleted by plasmapheresis or immunoadsorption and replenishment was inhibited by splenectomy and/or B-cell-targeted immunosuppression. Despite different treatments ALDLT could safely be performed in three patients and all patients had good initial graft function without signs for antibody-mediated rejection (AMR). Two patients had long-term graft survival with stable graft function. We thus propose the feasibility of ABO-incompatible ALDLT with these protocols and advocate further expansion of ABO incompatible ALDLT in multicenter trials to improve efficacy and safety. PMID:20148072

  8. Research on rehabilitation interventions for adults living with HIV: a scoping review.

    PubMed

    Stevens, Marianne E; Nixon, Stephanie A

    2016-06-01

    The aim of this paper is to use a scoping review to investigate the extent, range, and nature of research on rehabilitation interventions for adults living with HIV. Electronic databases (MEDLINE, EMBASE, CINAHL, AMED, and PsychINFO) and reference lists of the included articles were searched. Authors were emailed when possible for unavailable articles. A total of 897 titles and abstracts were retrieved. Thirty-three articles were included. There were 27 different rehabilitation interventions delivered by 18 professions. The studies were completed in four different countries. Most studies were published in 2008. A randomized-controlled trial was the most used method. The nature of the studies was analyzed according to the three-core concepts of the International Classification of Functioning, Disability and Health: 28 studies addressed impairments; six studies addressed activity limitations; and 14 studies addressed participation restrictions. This scoping study advances the knowledge of research on rehabilitation interventions for adults living with HIV. More research on rehabilitation interventions is needed in sub-Saharan Africa and other low-income and middle-income countries to ensure that these individuals are receiving the best possible care. There is a need for the HIV field to recognize the important contribution of rehabilitation toward the HIV care continuum.

  9. Eating frequency and energy regulation in free-living adults consuming self-selected diets.

    PubMed

    McCrory, Megan A; Howarth, Nancy C; Roberts, Susan B; Huang, Terry T-K

    2011-01-01

    The relative importance of eating frequency to weight control is poorly understood. This review examines the evidence to date on the role of eating frequency in weight control in free-living adults. The majority of cross-sectional studies in free-living adults show an inverse relationship between eating frequency and adiposity; however, this is likely an artifact produced by the underreporting of eating frequency concurrent with underreporting of energy intake. When implausible energy intake reporting (which is mostly underreporting) is taken into account, the association between eating frequency and adiposity becomes positive. In studies in which eating frequency is prescribed and food intake is mostly self-selected, there is either no effect or a minor positive effect of eating frequency on energy intake. Most of those studies have been short-term and lack the necessary dietary biomarkers to validate reported energy intakes and eating frequencies. In conclusion, there is some suggestion from cross-sectional studies in which energy intake underreporting is taken into account and from experimental studies to date that greater eating frequency may promote positive energy balance. However, experimental studies of longer-term duration that include objective dietary biomarkers are necessary before firm conclusions about the relative importance of eating frequency in weight control can be made.

  10. ABO-Incompatible Adult Living Donor Liver Transplantation Under the Desensitization Protocol With Rituximab.

    PubMed

    Song, G-W; Lee, S-G; Hwang, S; Kim, K-H; Ahn, C-S; Moon, D-B; Ha, T-Y; Jung, D-H; Park, G-C; Kim, W-J; Sin, M-H; Yoon, Y-I; Kang, W-H; Kim, S-H; Tak, E-Y

    2016-01-01

    ABO incompatibility is no longer considered a contraindication for adult living donor liver transplantation (ALDLT) due to various strategies to overcome the ABO blood group barrier. We report the largest single-center experience of ABO-incompatible (ABOi) ALDLT in 235 adult patients. The desensitization protocol included a single dose of rituximab and total plasma exchange. In addition, local graft infusion therapy, cyclophosphamide, or splenectomy was used for a certain time period, but these treatments were eventually discontinued due to adverse events. There were three cases (1.3%) of in-hospital mortality. The cumulative 3-year graft and patient survival rates were 89.2% and 92.3%, respectively, and were comparable to those of the ABO-compatible group (n = 1301). Despite promising survival outcomes, 17 patients (7.2%) experienced antibody-mediated rejection that manifested as diffuse intrahepatic biliary stricture; six cases required retransplantation, and three patients died. ABOi ALDLT is a feasible method for expanding a living liver donor pool, but the efficacy of the desensitization protocol in targeting B cell immunity should be optimized.

  11. Rehabilitation For Independent Living

    ERIC Educational Resources Information Center

    Forecast for Home Economics, 1975

    1975-01-01

    The focus of the homemaking program at the Institute of Rehabilitation Medicine is twofold--to retrain disabled homemakers in basic skills and to replan the patients' homes to fit their new physical needs. (Author/BP)

  12. Vitamin D status and resistance exercise training independently affect glucose tolerance in older adults.

    PubMed

    Kobza, Vanessa M; Fleet, James C; Zhou, Jing; Conley, Travis B; Peacock, Munro; IglayReger, Heidi B; DePalma, Glen; Campbell, Wayne W

    2013-05-01

    We assessed the influence of serum 25-hydroxyvitamin D (25[OH]D) and parathyroid hormone (PTH) concentrations on oral glucose tolerance, body composition, and muscle strength in older, nondiabetic adults who performed resistance exercise training (RT) while consuming diets with either 0.9 or 1.2 g protein kg(-1) d(-1). We hypothesized that individuals with insufficient 25(OH)D and/or high PTH would have less improvement in glucose tolerance after 12 weeks of RT compared with individuals with sufficient 25(OH)D and lower PTH. Sixteen men and 19 women (aged 61 ± 8 years; range, 50-80 years; body mass index, 26.3 ± 3.6 kg/m(2)) performed RT 3 times/wk for 12 weeks, with oral glucose tolerance tests done at baseline and postintervention. Protein intake did not influence the responses described below. Plasma glucose area under the curve (P = .02) and 2-hour plasma glucose concentration (P = .03) were higher for vitamin D-insufficient subjects (25[OH]D <50 nmol/L, n = 7) vs vitamin D-sufficient subjects (25[OH]D ≥50 nmol/L, n = 28). These differences remained significant after adjustment for age and body mass index. Resistance exercise training reduced fat mass (mean ± SD, -6% ± 7%; P < .001) and increased lean body mass (2% ± 3%, P < .001) and whole-body muscle strength (32% ± 17%, P < .001) in these weight-stable subjects but did not affect 25(OH)D or PTH concentrations. Oral glucose tolerance improved after RT (-10% ± 16% in glucose area under the curve and -21% ± 40% in 2-hour glucose, P = .001), but baseline 25(OH)D and PTH did not influence these RT-induced changes. These findings indicate that vitamin D status and RT independently affect glucose tolerance, and a training-induced improvement in glucose tolerance does not offset the negative effect of insufficient vitamin D status in older, nondiabetic adults.

  13. Culture of Adult Transgenic Zebrafish Retinal Explants for Live-cell Imaging by Multiphoton Microscopy.

    PubMed

    Lahne, Manuela; Gorsuch, Ryne A; Nelson, Craig M; Hyde, David R

    2017-02-24

    An endogenous regeneration program is initiated by Müller glia in the adult zebrafish (Danio rerio) retina following neuronal damage and death. The Müller glia re-enter the cell cycle and produce neuronal progenitor cells that undergo subsequent rounds of cell divisions and differentiate into the lost neuronal cell types. Both Müller glia and neuronal progenitor cell nuclei replicate their DNA and undergo mitosis in distinct locations of the retina, i.e. they migrate between the basal Inner Nuclear Layer (INL) and the Outer Nuclear Layer (ONL), respectively, in a process described as Interkinetic Nuclear Migration (INM). INM has predominantly been studied in the developing retina. To examine the dynamics of INM in the adult regenerating zebrafish retina in detail, live-cell imaging of fluorescently-labeled Müller glia/neuronal progenitor cells is required. Here, we provide the conditions to isolate and culture dorsal retinas from Tg[gfap:nGFP](mi2004) zebrafish that were exposed to constant intense light for 35 h. We also show that these retinal cultures are viable to perform live-cell imaging experiments, continuously acquiring z-stack images throughout the thickness of the retinal explant for up to 8 h using multiphoton microscopy to monitor the migratory behavior of gfap:nGFP-positive cells. In addition, we describe the details to perform post-imaging analysis to determine the velocity of apical and basal INM. To summarize, we established conditions to study the dynamics of INM in an adult model of neuronal regeneration. This will advance our understanding of this crucial cellular process and allow us to determine the mechanisms that control INM.

  14. [Immune status of adult population of the Bryansk region living in territory polluted by radionuclides].

    PubMed

    Oradovskaia, I V; Fadeeva, I D; Ul'ianova, N V; Nikonova, M F; Litvina, M M; Lavdovskaia, M V; Chernetsova, L F; Khoroshilova, N V

    1995-01-01

    Clinical and immunological investigation with immune status evaluation of three groups of adult population of Bryansk Region was performed. The first group included 165 persons living in Vyshkov (settlement of town type in Bryansk Region) contaminated with radionuclides as a result of Chernobyl accident. The second group included 68 persons living in Vyshkov, immunological monitoring of those was performed. The third group consisted of 114 persons living on the "clean" area of Pochep (Bryansk Region). On both areas (contaminated Vyshkov and "clean" Pochep) the large percent of persons (three quarters of all investigated ones) had clinical manifestations of immune deficiency. The immune status of Vyshkov inhabitants was characterized by T-helper/inductor activation. That was expressed in significant increase of CD4+, CD4+/CD8+ in comparison of control group of primary donors and to "clean" Pochep inhabitants and in stable decrease of average values of serum IgG in comparison to control group, IgG and IgM in comparison to Pochep group. Maximum high values of T-helpers under lowest T-suppressor/killer values were observed at clinical symptoms which may be stipulated by radiation factor (loss of hair and teeth, surplus weight, predisposition to bleedings) and in persons working in cattle-breeding.

  15. Impaired endothelium independent vasodilation in the cutaneous microvasculature of young obese adults.

    PubMed

    Patik, Jordan C; Christmas, Kevin M; Hurr, Chansol; Brothers, R Matthew

    2016-03-01

    Microvascular dysfunction contributes to the development of cardiovascular and metabolic disease. This study tested the hypothesis that young obese (BMI>30 kg m(-2)), otherwise healthy, adults (N=15) have impaired microvascular function relative to age and sex matched, lean (BMI<25 kg m(-2)) individuals (N=14). Participants were instrumented with two microdialysis probes in the cutaneous vasculature of one forearm; one for a wide dose range of infusions of the endothelium-dependent vasodilator methacholine (MCh) and the other for the endothelium-independent vasodilator sodium nitroprusside (SNP). Local temperature at each site was clamped at 33 °C and cutaneous blood flow was indexed by laser Doppler flowmetry (LDF). LDF was recorded while 7 doses of each drug (MCh: 10(-6)-1M; SNP: 5 × 10(-8)-5 × 10(-2)M) were infused at a rate of 2 μl/min for 8 min per dose. Both sites finished with heating to 43 °C and 5 × 10(-2)M SNP to achieve site specific maximal vasodilation. Mean arterial blood pressure (MAP) was assessed in the last minute of each dose and was used for subsequent calculation of cutaneous vascular conductance (CVC; LDF/MAP) and responses were normalized to each individual site's maximal response (%CVCmax). Group four-parameter dose response curves were compared with an extra sum of squares F-test. SNP EC50 was greater in obese relative to lean (-2.931 ± 0.10 vs -3.746 ± 0.18 Log[SNP]M, P<0.001); however, there was no difference in MCh EC50 between groups (-3.796 ± 0.23 vs -3.852 ± 0.25 Log[MCh]M, P=0.81). Additionally, baseline and maximal CVC in both sites were similar between groups (all P>0.05). These results suggest attenuated endothelium-independent response to nitric oxide while endothelium-dependent vasodilation function is maintained.

  16. Depressive Symptoms of Older Adults Living Alone: The Role of Community Characteristics.

    PubMed

    Kim, Kyeongmo; Lee, Minhong

    2015-03-01

    Although some evidence suggests that community characteristics may play an important role in the development of depressive symptoms among older adults, current literature has not attended to the role of community characteristics in depression in South Korea. This study begins to address this gap in the literature by examining the relationship of community characteristics and depressive symptoms, controlling for individual characteristics. Using a cross-sectional design and probability sampling, we surveyed 949 older adults living alone in 70 communities in the Busan metropolitan area in South Korea in 2012. A multilevel logistic regression analysis was conducted to test the hypothesis that community characteristics are predictive of depressive symptoms. We find that both the proportion of older adults and the number of senior citizen facilities in a community are associated with depressive symptoms, whereas community poverty is not related to depressive symptoms. Men with lower income, with lower levels of functional abilities, and without stronger family and friend social networks have a higher risk of depressive symptoms. Implications for research, practice, and policy are discussed.

  17. An examination of the social networks and social isolation in older and younger adults living with HIV/AIDS.

    PubMed

    Emlet, Charles A

    2006-11-01

    This study examined social networks and social isolation in older (50 years or more) and younger (ages 20 to 39) adults with HIV/AIDS. The author conducted interviews with 88 individuals living with HIV/AIDS in the Pacific Northwest. Both groups' social networks had similar patterns; however, older adults were more likely to live alone. More than 38 percent of older adults and 54 percent of older adults of color were at risk of social isolation compared with 25 percent of those 20 to 39 years of age. Older men and older adults of color had significantly lower scores on the social network scale than others. Having a confidant and receiving instrumental support were significantly correlated with reduced HIV stigma. Implications for social work practitioners are discussed.

  18. Donor Safety in Adult-Adult Living Donor Liver Transplantation: A Single-Center Experience of 356 Cases

    PubMed Central

    Meng, Haipeng; Yang, Jiayin; Yan, Lunan

    2016-01-01

    Background As an important means to tackle the worldwide shortage of liver grafts, adult-adult living donor liver transplantation (A-ALDLT) is the most massive operation a healthy person could undergo, so donor safety is of prime importance. However, most previous research focused on recipients, while complications in donors have not been fully described or investigated. Material/Methods To investigate donor safety in terms of postoperative complications, the clinical data of 356 A-ALDLT donors in our center from January 2002 to September 2015 were retrospectively analyzed. These patients were divided into a pre-2008 group (before January 2008) and a post-2008 group (after January 2008). Donor safety was evaluated with regard to the type, frequency, and severity of postoperative complications. Results There were no donor deaths in our center during this period. The overall complication rate was 23.0% (82/356). The proportion of Clavien I, II, III, and IV complications was 51.2% (42/82), 25.6% (21/82), 22.0% (18/82), and 1.2% (1/82), respectively. In all the donors, the incidence of Clavien I, II, III, and IV complications was 11.8% (42/356), 5.9% (21/356), 5.1% (18/356), and 0.3% (1/356), respectively. The overall complication rate in the post-2008 group was significantly lower than that in the pre-2008 group (18.1% (41/227) vs. 32.6% (42/129), P<0.01). Biliary complications were the most common, with an incidence of 8.4% (30/356). Conclusions The risk to A-ALDLT donors is controllable and acceptable with improvement in preoperative assessment and liver surgery. PMID:27178367

  19. Trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh.

    PubMed

    ALFaris, Nora A; Al-Tamimi, Jozaa Z; Al-Jobair, Moneera O; Al-Shwaiyat, Naseem M

    2015-01-01

    Background : Saudi Arabia has passed through lifestyle changes toward unhealthy dietary patterns such as high fast food consumption. Adolescents and young adults, particularly girls, are the main groups exposed to and affected by these adverse eating behaviors. Objective : The aim of this study was to examine the trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh, and to compare between them. Design : In a cross-sectional survey, 127 adolescent Saudi girls (13-18 years) and 69 young adult Saudi girls (19-29 years) were randomly recruited to participate in this study. Weight, height, waist circumference, and hip circumference were measured using standardized methods. Twenty-four-hour diet recall and a face-to-face interview food questionnaire were performed. Results : Most of the participants had adequate intake of protein, riboflavin, iron, and sodium, but exhibited low intake for several other nutrients. Among study participants, 95.4% consume restaurants' fast food and 79.1% eat fast food at least once weekly. Burgers and carbonated soft drinks were the main kinds of fast food meals and beverages usually eaten by girls. Adolescent girls who usually ate large portion sizes of fast food had significantly higher mean waist circumference and hip circumference. Participants eat fast food primarily for enjoying the delicious taste, followed by convenience. Restaurants' hygiene and safety standards were the main concern regarding fast food for 62.2% of girls. Finally, international restaurants were preferable by participants to buy fast food compared with local restaurants (70.9% vs. 29.1%). Conclusion : Our findings provide evidence on the high prevalence of fast food consumption among Saudi girls, suggesting an urgent need for community-based nutrition interventions that consider the trends of fast food consumption and targeted eating behaviors of adolescent and young adult girls.

  20. Trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh

    PubMed Central

    ALFaris, Nora A.; Al-Tamimi, Jozaa Z.; Al-Jobair, Moneera O.; Al-Shwaiyat, Naseem M.

    2015-01-01

    Background Saudi Arabia has passed through lifestyle changes toward unhealthy dietary patterns such as high fast food consumption. Adolescents and young adults, particularly girls, are the main groups exposed to and affected by these adverse eating behaviors. Objective The aim of this study was to examine the trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh, and to compare between them. Design In a cross-sectional survey, 127 adolescent Saudi girls (13–18 years) and 69 young adult Saudi girls (19–29 years) were randomly recruited to participate in this study. Weight, height, waist circumference, and hip circumference were measured using standardized methods. Twenty-four-hour diet recall and a face-to-face interview food questionnaire were performed. Results Most of the participants had adequate intake of protein, riboflavin, iron, and sodium, but exhibited low intake for several other nutrients. Among study participants, 95.4% consume restaurants’ fast food and 79.1% eat fast food at least once weekly. Burgers and carbonated soft drinks were the main kinds of fast food meals and beverages usually eaten by girls. Adolescent girls who usually ate large portion sizes of fast food had significantly higher mean waist circumference and hip circumference. Participants eat fast food primarily for enjoying the delicious taste, followed by convenience. Restaurants’ hygiene and safety standards were the main concern regarding fast food for 62.2% of girls. Finally, international restaurants were preferable by participants to buy fast food compared with local restaurants (70.9% vs. 29.1%). Conclusion Our findings provide evidence on the high prevalence of fast food consumption among Saudi girls, suggesting an urgent need for community-based nutrition interventions that consider the trends of fast food consumption and targeted eating behaviors of adolescent and young adult girls. PMID:25792229

  1. Assistive Technology Needs and Measurement of the Psychosocial Impact of Assistive Technologies for Independent Living of Older Hispanics: Lessons Learned

    PubMed Central

    Orellano-Colón, Elsa M.; Jutai, Jeffrey; Santiago, Angélica; Torres, Víctor; Benítez, Keyla; Torres, Mayra

    2016-01-01

    (1) Knowledge about the assistive technology (AT) needs and psychosocial impact of AT in different populations is needed because the adoption, retention, or abandonment of AT may be influenced by the psychosocial impact that AT has on its users. The aims of this study were to: (a) identify the AT needs of a sample of Hispanic older adults with functional limitations, (b) describe the psychosocial impact of these technologies on the sample’s quality of life, and (c) describe the methodological challenges in using the Puerto Rican version of the Psychosocial Impact of Assistive Device Scale (PR-PIADS) with a Hispanic sample. (2) Methods: This study used a cross-sectional design conducted with a sample of 60 participants. Data was collected using the Assistive Technology Card Assessment Questionnaire (ATCAQ) and the PR-PIADS. Data analyses included descriptive statistics and bivariate analysis. (3) Results: The sample’s most frequently reported needs for AT devices were in the areas of cooking, home tasks, and home safety activities. The sample reported a positive impact of AT use in their quality of life. Several methodological challenges of the PIADS were identified. (4) Conclusions: The sample has unmet needs for using AT devices to overcome difficulties in daily living activities. PMID:27695688

  2. Assistive Technology Needs and Measurement of the Psychosocial Impact of Assistive Technologies for Independent Living of Older Hispanics: Lessons Learned.

    PubMed

    Orellano-Colón, Elsa M; Jutai, Jeffrey; Santiago, Angélica; Torres, Víctor; Benítez, Keyla; Torres, Mayra

    2016-09-01

    (1) Knowledge about the assistive technology (AT) needs and psychosocial impact of AT in different populations is needed because the adoption, retention, or abandonment of AT may be influenced by the psychosocial impact that AT has on its users. The aims of this study were to: (a) identify the AT needs of a sample of Hispanic older adults with functional limitations, (b) describe the psychosocial impact of these technologies on the sample's quality of life, and (c) describe the methodological challenges in using the Puerto Rican version of the Psychosocial Impact of Assistive Device Scale (PR-PIADS) with a Hispanic sample. (2) Methods: This study used a cross-sectional design conducted with a sample of 60 participants. Data was collected using the Assistive Technology Card Assessment Questionnaire (ATCAQ) and the PR-PIADS. Data analyses included descriptive statistics and bivariate analysis. (3) Results: The sample's most frequently reported needs for AT devices were in the areas of cooking, home tasks, and home safety activities. The sample reported a positive impact of AT use in their quality of life. Several methodological challenges of the PIADS were identified. (4) Conclusions: The sample has unmet needs for using AT devices to overcome difficulties in daily living activities.

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

    PubMed

    Mamikonian-Zarpas, Ani; Laganá, Luciana

    2015-12-01

    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 walking

  4. Similar Representations of Sequence Knowledge in Young and Older Adults: A Study of Effector Independent Transfer

    PubMed Central

    Barnhoorn, Jonathan S.; Döhring, Falko R.; Van Asseldonk, Edwin H. F.; Verwey, Willem B.

    2016-01-01

    Older adults show reduced motor performance and changes in motor skill development. To better understand these changes, we studied differences in sequence knowledge representations between young and older adults using a transfer task. Transfer, or the ability to apply motor skills flexibly, is highly relevant in day-to-day motor activity and facilitates generalization of learning to new contexts. By using movement types that are completely unrelated in terms of muscle activation and response location, we focused on transfer facilitated by the early, visuospatial system. We tested 32 right-handed older adults (65–75) and 32 young adults (18–30). During practice of a discrete sequence production task, participants learned two six-element sequences using either unimanual key-presses (KPs) or by moving a lever with lower arm flexion-extension (FE) movements. Each sequence was performed 144 times. They then performed a test phase consisting of familiar and random sequences performed with the type of movements not used during practice. Both age groups displayed transfer from FE to KP movements as indicated by faster performance on the familiar sequences in the test phase. Only young adults transferred their sequence knowledge from KP to FE movements. In both directions, the young showed higher transfer than older adults. These results suggest that the older participants, like the young, represented their sequences in an abstract visuospatial manner. Transfer was asymmetric in both age groups: there was more transfer from FE to KP movements than vice versa. This similar asymmetry is a further indication that the types of representations that older adults develop are comparable to those that young adults develop. We furthermore found that older adults improved less during FE practice, gained less explicit knowledge, displayed a smaller visuospatial working memory capacity and had lower processing speed than young adults. Despite the many differences between young and

  5. Down on the upside: redemption, contamination, and agency in the lives of adult children of alcoholics.

    PubMed

    McCoy, Tara P; Dunlop, William L

    2017-05-01

    We investigated differences in the nature and implications of Adult Children of Alcoholics (ACOAs; n = 53) and non-ACOAs' (n = 80) narrative identities. Participants described six autobiographical narratives and completed measures of emotional functioning. Narratives were coded for redemptive (bad things turning good), contaminated (good things turning bad), and agentic (perceived control) imagery. ACOAs exhibited similar levels of redemptive and contaminated imagery, and lower levels of agency in their narratives, relative to non-ACOAs. In addition, themes of redemption, contamination, and agency corresponded divergently with emotional functioning. Among ACOAs, narrative redemption and agency were related to poorer emotional functioning whereas, among non-ACOAs, narrative contamination predicted poorer emotional functioning. These findings provide indication of the manner in which ACOAs story their lives. They also align with the emerging area of research noting that, among certain vulnerable populations, redemptive and agentic imagery serve as predictors of maladaptive functioning.

  6. Coping with chronic pain among younger, middle-aged, and older adults living with neurological injury and disease.

    PubMed

    Molton, Ivan; Jensen, Mark P; Ehde, Dawn M; Carter, Gregory T; Kraft, George; Cardemas, Diana D

    2008-01-01

    Objective. This article compares use of pain coping strategies among older, middle-aged, and younger adults living with chronic pain and seeks to determine whether the relationship between pain severity and coping is moderated by age. Method. Participants were 464 adults reporting chronic pain secondary to multiple sclerosis, spinal cord injury, or neuromuscular disease. Participants completed a survey including measures of pain severity and the Chronic Pain Coping Inventory. Results. After controlling for clinical and demographic variables, older adults (older than 60) reported a wider range of frequently used strategies and significantly more frequent engagement in activity pacing, seeking social support, and use of coping self-statements than did younger or middle-aged adults. Moderation analyses suggest that, for younger adults, efforts at coping generally increased with greater pain severity, whereas this relationship did not exist for older adults. Discussion. These data suggest differences in the quantity and quality of pain coping among age groups.

  7. Evidence of reduced individual heterogeneity in adult survival of long-lived species.

    PubMed

    Péron, Guillaume; Gaillard, Jean-Michel; Barbraud, Christophe; Bonenfant, Christophe; Charmantier, Anne; Choquet, Rémi; Coulson, Tim; Grosbois, Vladimir; Loison, Anne; Marzolin, Gilbert; Owen-Smith, Norman; Pardo, Déborah; Plard, Floriane; Pradel, Roger; Toïgo, Carole; Gimenez, Olivier

    2016-12-01

    The canalization hypothesis postulates that the rate at which trait variation generates variation in the average individual fitness in a population determines how buffered traits are against environmental and genetic factors. The ranking of a species on the slow-fast continuum - the covariation among life-history traits describing species-specific life cycles along a gradient going from a long life, slow maturity, and low annual reproductive output, to a short life, fast maturity, and high annual reproductive output - strongly correlates with the relative fitness impact of a given amount of variation in adult survival. Under the canalization hypothesis, long-lived species are thus expected to display less individual heterogeneity in survival at the onset of adulthood, when reproductive values peak, than short-lived species. We tested this life-history prediction by analysing long-term time series of individual-based data in nine species of birds and mammals using capture-recapture models. We found that individual heterogeneity in survival was higher in species with short-generation time (< 3 years) than in species with long generation time (> 4 years). Our findings provide the first piece of empirical evidence for the canalization hypothesis at the individual level from the wild.

  8. Resistance training increases total energy expenditure and free-living physical activity in older adults.

    PubMed

    Hunter, G R; Wetzstein, C J; Fields, D A; Brown, A; Bamman, M M

    2000-09-01

    The purpose of this study was to determine what effects 26 wk of resistance training have on resting energy expenditure (REE), total free-living energy expenditure (TEE), activity-related energy expenditure (AEE), engagement in free-living physical activity as measured by the activity-related time equivalent (ARTE) index, and respiratory exchange ratio (RER) in 61- to 77-yr-old men (n = 8) and women (n = 7). Before and after training, body composition (four-compartment model), strength, REE, TEE (doubly labeled water), AEE (TEE - REE + thermic response to meals), and ARTE (AEE adjusted for energy cost of standard activities) were evaluated. Strength (36%) and fat-free mass (2 kg) significantly increased, but body weight did not change. REE increased 6.8%, whereas resting RER decreased from 0.86 to 0.83. TEE (12%) and ARTE (38%) increased significantly, and AEE (30%) approached significance (P = 0.06). The TEE increase remained significant even after adjustment for the energy expenditure of the resistance training. In response to resistance training, TEE increased and RER decreased. The increase in TEE occurred as a result of increases in both REE and physical activity. These results suggest that resistance training may have value in increasing energy expenditure and lipid oxidation rates in older adults, thereby improving their metabolic profiles.

  9. Association Between Food Insecurity and Serious Psychological Distress Among Hispanic Adults Living in Poverty

    PubMed Central

    Sis-Medina, Reacheal Connie; Reyes, Alexa; Becerra, Monideepa B.

    2015-01-01

    Introduction Food insecurity has been associated with negative health outcomes, but the relationship between psychological distress and food insecurity among ethnic minorities has not been extensively examined in the literature. The goal of this study was to evaluate whether low food security and very low food security were significantly associated with past month serious psychological distress (SPD) among Hispanic adults living in poverty. Methods We studied 10,966 Hispanic respondents to the California Health Interview Survey for 2007, 2009, and 2011–2012 whose income was below 200% of the federal poverty level. The relationship between food insecurity and SPD was evaluated by using survey-weighted univariate and logistic regression analyses. Results Nearly 30% of the study population had low food security and 13% had very low food security. Low food security and very low food security were associated with 1.99 and 4.43 odds of past month SPD, respectively, and perceived low neighborhood safety was related to 1.47 odds of past month SPD. Conclusions We found that food insecurity was prevalent among Hispanic people living in poverty and was significantly associated with past month SPD. These results demonstrate the need for further targeted public health efforts, such as community gardens led by promotores, faith-based initiatives, and initiatives to reduce barriers to participation in food-assistance programs. PMID:26605706

  10. Autovideography: The Lived Experience of Recovery for Adults with Serious Mental Illness.

    PubMed

    Petros, Ryan; Solomon, Phyllis; Linz, Sheila; DeCesaris, Marissa; Hanrahan, Nancy P

    2016-09-01

    Mental health services have been transforming toward a recovery orientation for more than a decade, yet a robust understanding of recovery eludes many providers, and consensus on a conceptual definition has yet to be reached. This article examines mental health consumers' lived experience of recovery and evaluates the usefulness and comprehensiveness of CHIME, a major framework conceptually defining recovery for adults with serious mental illness. Researchers partnered with a mental health association in a major US city to engage in research with graduates of a recovery and education class for adults diagnosed with serious mental illness. Twelve participants were loaned video cameras and invited to "Tell us about your recovery" through autovideography. Of the 12 participants, six produced videos directly responding to the overall research question and were subsequently included in the present analysis. Data were analyzed thematically, and CHIME adequately represented the major domains presented in consumer videos with two notable modifications: subdomains of "reciprocity" within relationships and "contributing to others" were added to comprehensively represent consumer perspectives about recovery. Adding two subdomains to CHIME more effectively represents consumer narratives about recovery, contributes to the social construction of the personhood of people with serious mental illness, and offers a more robust description of the process of recovery.

  11. Eat Smart, Live Strong intervention increases fruit and vegetable consumption among low-income older adults.

    PubMed

    Hersey, James C; Cates, Sheryl C; Blitstein, Jonathan L; Kosa, Katherine M; Santiago Rivera, Olga J; Contreras, Dawn A; Long, Valerie A; Singh, Anita; Berman, Danielle A

    2015-01-01

    This study evaluated the impact of a four-session interactive nutrition education program-Eat Smart, Live Strong (ESLS)-on the consumption of fruit and vegetables by low-income older adults. A pre-post quasi-experimental design study was conducted with a longitudinal sample of 614 low-income Supplemental Nutrition Assistance Program (SNAP) participants and those eligible for SNAP, aged 60 to 80 years, in 17 intervention and 16 comparison senior centers in Michigan. The study compared participants' self-reports of their consumption of fruit and vegetables using a modified version of the University of California Cooperative Extension Food Behavior Checklist. ESLS increased participants' average daily consumption of fruit by 0.2 cups (P < 0.05) and vegetables by 0.31 cups (P < 0.01). ESLS, a four-session, cognitive-behavioral nutrition education program is an effective curriculum for helping low-income older adults eat more fruit and vegetables.

  12. An Active Lifestyle is Associated with Better Neurocognitive Functioning in Adults Living with HIV-infection

    PubMed Central

    Fazeli, Pariya L.; Woods, Steven Paul; Heaton, Robert K.; Umlauf, Anya; Gouaux, Ben; Rosario, Debra; Moore, Raeanne C.; Grant, Igor; Moore, David J.

    2014-01-01

    Studies of healthy adults show that engagement in physical, social, and mental activities is associated with better cognitive outcomes, suggesting these activities may increase cognitive reserve. Given the prevalence and real-world impact of HIV-associated neurocognitive disorders (HAND), the present study examined the association between neurocognitive outcomes and self-reported proxies for physical exercise, social activity, and mental activity (employment was used as a proxy for mental activity) among 139 HIV-infected adults (Mage = 48.7; 48% age 50+). Participants completed a neuromedical and neuropsychological battery and were classified based on the number of self-reported active lifestyle factors (ALFs; 0 to 3), including physical exercise, social activity, and current employment. The association between ALFs and both demographically-adjusted average neuropsychological T-scores and HAND diagnoses were examined. Results revealed that an increased number of ALFs was associated with better global neurocognitive performance as well as a lower prevalence of HAND. These cross-sectional findings suggest that an active engagement in life may bolster neurocognitive functioning, perhaps by enhancing cognitive and/or brain reserve. However, an alternative explanation might be that persons with better neurocognitive functioning are more inclined and able to engage in these life activities. Future studies should utilize neuroimaging methodology, longitudinal data, and interventional approaches to establish cause-effect relationships and uncover the neural mechanisms whereby physical, social, and mental stimulation may protect neurocognition via cognitive reserve among those living with HIV. PMID:24554483

  13. Quality of Life for Diverse Older Adults in Assisted Living: The Centrality of Control.

    PubMed

    Koehn, Sharon D; Mahmood, Atiya N; Stott-Eveneshen, Sarah

    This pilot project asked: How do ethnically diverse older adult residents of assisted living (AL) facilities in British Columbia (BC) experience quality of life? And, what role, if any, do organizational and physical environmental features play in influencing how quality of life is experienced? The study was conducted at three AL sites in BC: two ethnoculturally targeted and one nontargeted. Environmental audits at each site captured descriptive data on policies, fees, rules, staffing, meals, and activities, and the built environment of the AL building and neighborhood. Using a framework that understands the quality of life of older adults to be contingent on their capability to pursue 5 conceptual attributes-attachment, role, enjoyment, security, and control-we conducted 3 focus groups with residents (1 per site) and 6 interviews with staff (2 per site). Attributes were linked to the environmental features captured in the audits. All dimensions of the environment, especially organizational, influence tenants' capability to attain the attributes of quality of life, most importantly control. Although many tenants accept the trade-off between increased safety and diminished control that accompanies a move into AL, more could be done to minimize that loss. Social workers can advocate for the necessary multi-sectoral changes.

  14. RelAte: pilot study of the effects of a mealtime intervention on social cognitive factors and energy intake among older adults living alone.

    PubMed

    McHugh Power, Joanna E; Lee, Olga; Aspell, Niamh; McCormack, Emma; Loftus, Michelle; Connolly, Leona; Lawlor, Brian; Brennan, Sabina

    2016-11-01

    Mealtime interventions typically focus on institutionalised older adults, but we wanted to investigate whether they may also be effective among those living independently. Using a randomised controlled trial design, we assessed the effects of a novel mealtime intervention on self-efficacy, food enjoyment and energy intake. A total of 100 adults living alone aged over 60 years were randomised to the treatment or control conditions: all received a guidebook on nutrition and culinary skills. Treatment group participants received a weekly visit from a trained volunteer who prepared and shared a meal with them. Participants in the treatment group showed improvements relative to those in the control group at borderline significance (P=0·054) for self-efficacy and at significance for food enjoyment. Significant improvements were observed in female participants in the treatment but not in the control group in energy intake (although following corrections for multiple comparisons, only the effect on food enjoyment remained significant). These findings will inform the design of future complex interventions. For this type of intervention to be successful, more focus has to be placed on making interventions more personalised, potentially according to sex. Findings are important for nutritional sciences as they indicate that, in order to improve energy intake and food enjoyment among older adults, multimodal nutritional interventions including social components may be successful.

  15. Tracking through Life Stages: Adult, Immature and Juvenile Autumn Migration in a Long-Lived Seabird

    PubMed Central

    Péron, Clara; Grémillet, David

    2013-01-01

    Seasonal long-distance migration is likely to be experienced in a contrasted manner by juvenile, immature and adult birds, leading to variations in migratory routes, timing and behaviour. We provide the first analysis of late summer movements and autumn migration in these three life stages, which were tracked concurrently using satellite tags, geolocators or GPS recorders in a long-ranging migratory seabird, the Scopoli’s shearwater (formerly named Cory’s shearwater, Calonectrisdiomedea) breeding on two French Mediterranean islands. During the late breeding season, immatures foraged around their colony like breeding adults, but they were the only group showing potential prospecting movements around non-natal colonies. Global migration routes were broadly comparable between the two populations and the three life stages, with all individuals heading towards the Atlantic Ocean through the strait of Gibraltar and travelling along the West African coast, up to 8000 km from their colony. However, detailed comparison of timing, trajectory and oceanographic conditions experienced by the birds revealed remarkable age-related differences. Compared to adults and immatures, juveniles made a longer stop-over in the Balearic Sea (10 days vs 4 days in average), showed lower synchrony in crossing the Gibraltar strait, had more sinuous pathways and covered longer daily distances (240 km.d-1 vs 170 km.d-1). Analysis of oceanographic habitats along migratory routes revealed funnelling selection of habitat towards coastal and more productive waters with increasing age. Younger birds may have reduced navigational ability and learn progressively fine-scale migration routes towards the more profitable travelling and wintering areas. Our study demonstrates the importance of tracking long-lived species through the stages, to better understand migratory behavior and assess differential exposure to at-sea threats. Shared distribution between life stages and populations make Scopoli

  16. Social resources and disordered living conditions: evidence from a national sample of community-residing older adults.

    PubMed

    York Cornwell, Erin

    2014-07-01

    For older adults aging in the community, living conditions can promote health, enhance coping, and reduce disablement--but they can also create stress and increase risks of illness, accidents, and decline. Although socioeconomic disparities in housing likely contribute to inequalities in interior conditions, I argue that living conditions are also shaped by social resources such as coresidential relationships, social network ties, and social support. In this article, I examine the distribution of a set of risky or stressful physical and ambient living conditions including structural disrepair, clutter, lack of cleanliness, noise, and odor. Using data from the National Social Life, Health, and Aging Project (NSHAP), I find that low-income and African American older adults have more disordered living conditions as do those with poorer physical and mental health. In addition, older adults who have a coresident partner, more nonresidential network ties, and more sources of instrumental support are exposed to fewer risky or harmful living conditions. This suggests that living conditions are an important, though overlooked, mechanism through which household composition, social networks, and social support affect health and well-being in later life.

  17. Social Resources and Disordered Living Conditions: Evidence from a National Sample of Community-Residing Older Adults

    PubMed Central

    Cornwell, Erin York

    2015-01-01

    For older adults aging in the community, living conditions can promote health, enhance coping, and reduce disablement – but they can also create stress and increase risks of illness, accidents, and decline. While socioeconomic disparities in housing likely contribute to inequalities in interior conditions, I argue that living conditions are also shaped by social resources such as co-residential relationships, social network ties, and social support. In this paper, I examine the distribution of a set of risky or stressful physical and ambient living conditions including structural disrepair, clutter, lack of cleanliness, noise, and odor. Using data from the National Social Life, Health, and Aging Project (NSHAP), I find that low income and African American older adults have more disordered living conditions, as do those with poorer physical and mental health. In addition, older adults who have a co-resident partner, more non-residential network ties, and more sources of instrumental support are exposed to fewer risky or harmful living conditions. This suggests that living conditions are an important, though overlooked, mechanism through which household composition, social networks, and social support affect health and well being in later life. PMID:25651314

  18. Conflictual Independence, Adult Attachment Orientation, and Career Indecision among Asian American Students

    ERIC Educational Resources Information Center

    Keller, Chad J.; Brown, Chris

    2014-01-01

    Due to prior research suggesting that relational variables are related to the career development process, we sought to understand how maternal conflictual independence, paternal conflictual independence, attachment anxiety, and attachment avoidance influence the career decision status of Asian American undergraduate students (N = 113). The…

  19. "We're Not Going to Suffer Like This in the Mud": Educational Aspirations, Social Mobility and Independent Child Migration among Populations Living in Poverty

    ERIC Educational Resources Information Center

    Boyden, Jo

    2013-01-01

    This article examines the association between formal education, social mobility and independent child migration in Ethiopia, India (Andhra Pradesh), Peru and Vietnam and draws on data from Young Lives, a longitudinal study of childhood poverty and schooling. It argues that among resource-poor populations, child migration sustains kin relations…

  20. Event-Based Prospective Memory Is Independently Associated with Self-Report of Medication Management in Older Adults

    PubMed Central

    Woods, Steven Paul; Weinborn, Michael; Maxwell, Brenton R.; Gummery, Alice; Mo, Kevin; Ng, Amanda R. J.; Bucks, Romola S.

    2014-01-01

    Background Identifying potentially modifiable risk factors for medication non-adherence in older adults is important in order to enhance screening and intervention efforts designed to improve medication-taking behavior and health outcomes. The current study sought to determine the unique contribution of prospective memory (i.e., “remembering to remember”) to successful self-reported medication management in older adults. Methods Sixty-five older adults with current medication prescriptions completed a comprehensive research evaluation of sociodemographic, psychiatric, and neurocognitive functioning, which included the Memory for Adherence to Medication Scale (MAMS), Prospective and Retrospective Memory Questionnaire (PRMQ), and a performance-based measure of prospective memory that measured both semantically-related and semantically-unrelated cue-intention (i.e., when-what) pairings. Results A series of hierarchical regressions controlling for biopsychosocial, other neurocognitive, and medication-related factors showed that elevated complaints on the PM scale of the PRMQ and worse performance on an objective semantically-unrelated event-based prospective memory task were independent predictors of poorer medication adherence as measured by the MAMS. Conclusions Prospective memory plays an important role in self-report of successful medication management among older adults. Findings may have implications for screening for older individuals “at risk” of non-adherence, as well as the development of prospective memory-based interventions to improve medication adherence and, ultimately, long-term health outcomes in older adults. PMID:24410357

  1. Mechanisms in Psychosocial Interventions for Adults Living with Cancer: Opportunity for Integration of Theory, Research, and Practice

    ERIC Educational Resources Information Center

    Stanton, Annette L.; Luecken, Linda J.; MacKinnon, David P.; Thompson, Elizabeth H.

    2013-01-01

    Objective: The diagnosis and treatment of cancer are highly stressful experiences that can profoundly affect emotional and physical well-being. Hundreds of longitudinal investigations that identify risk and protective factors for psychological and physical adjustment in adults living with cancer and numerous randomized controlled psychosocial…

  2. Living in Chaos and Striving for Control: How Adults with Attention Deficit Hyperactivity Disorder Deal with Their Disorder

    ERIC Educational Resources Information Center

    Toner, Michele; O'Donoghue, Thomas; Houghton, Stephen

    2006-01-01

    This article reports a Grounded Theory of "Living in Chaos and Striving for Control" developed in response to the central research question of how adults diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) deal with their disorder. Semi-structured interviews were conducted with 10 males diagnosed with ADHD in adulthood.…

  3. Metro College for Living, Working Curricula, 1975-76. Ongoing Classes for Developmentally Disabled Adults in the Denver Area.

    ERIC Educational Resources Information Center

    Kreps, Alice Roelofs; Redden, Cora

    This curriculum consists of fourteen courses based upon basic life problems which are designed to provide volunteers in the College for Living (CFL) program with materials to teach survival skills to developmentally disabled adults. CFL is intended to supplement residential programs in and around Denver and aid institutions in orienting…

  4. Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There has been no consensus on best practices in food and nutrition services in assisted living facilities (ALFs) for older adults. We documented experts’ views on optimal food and nutrition services emphases in ALFs, and factors affecting their views. One hundred thirty-five national experts speci...

  5. Cluster Randomized-Controlled Trial of Interventions to Improve Health for Adults with Intellectual Disability Who Live in Private Dwellings

    ERIC Educational Resources Information Center

    Lennox, Nicholas; Bain, Chris; Rey-Conde, Therese; Taylor, Miriam; Boyle, Frances M.; Purdie, David M.; Ware, Robert S.

    2010-01-01

    Background: People with intellectual disability who live in the community often have poor health and healthcare, partly as a consequence of poor communication, recall difficulties and incomplete patient health information. Materials and Methods: A cluster randomized-controlled trial with 2 x 2 factorial design was conducted with adults with…

  6. What Mathematics Calculations Do Adults Do in Their Everyday Lives? Part 1 of a Report on the Everyday Mathematics Project

    ERIC Educational Resources Information Center

    Northcote, Maria; Marshall, Linda

    2016-01-01

    The type of mathematics taught in schools is often criticised for being irrelevant to students' lives and not based in "real life". This article is Part 1 of a three part report that documents the findings of a research project that investigated the mathematical calculations completed by adults in their everyday, non-occupational lives…

  7. A Profile of Adults Needing Assistance with Activities of Daily Living, 1991-1992. Disability Statistics Report 11.

    ERIC Educational Resources Information Center

    Kennedy, Jae; LaPlante, Mitchell P.

    This report uses data from the 1990 and 1991 samples of the Survey of Income and Program Participation to construct a profile of the U.S. noninstitutionalized adult population needing assistance with activities of daily living (ADL) and to estimate the size of the population eligible for federal personal assistance services (PAS) under different…

  8. Standing balance and strength measurements in older adults living in residential care communities.

    PubMed

    Alqahtani, Bader A; Ferchak, Mary Ann; Huppert, Theodore J; Sejdic, Ervin; Perera, Subashan; Greenspan, Susan L; Sparto, Patrick J

    2016-12-20

    Research on balance and mobility in older adults has been conducted primarily in lab-based settings in individuals who live in the community. Although they are at greater risk of falls, residents of long-term care facilities, specifically residential care communities (RCCs), have been investigated much less frequently. We sought to determine the feasibility of using portable technology-based measures of balance and muscle strength (i.e., an accelerometer and a load cell) that can be used in any RCC facility. Twenty-nine subjects (age 87 ± 6 years) living in RCCs participated. An accelerometer placed on the back of the subjects measured body sway during different standing conditions. Sway in antero-posterior and mediolateral directions was calculated. Lower extremity strength was measured with a portable load cell and the within-visit reliability was determined. Assessments of grip strength, gait speed, frailty, and comorbidity were also examined. A significant increase in postural sway in both the AP and ML directions occurred as the balance conditions became more difficult due to alteration of sensory feedback (p < 0.001) or reducing the base of support (p < 0.001). There was an association between increased sway and increased frailty, more comorbidities and slower gait speed. All strength measurements were highly reliable (ICC = 0.93-0.99). An increase in lower extremity strength was associated with increased grip strength and gait speed. The portable instruments provide inexpensive ways for measuring balance and strength in the understudied RCC population, but additional studies are needed to examine their relationship with functional outcomes.

  9. Immunogenicity and Safety of a Live Attenuated Zoster Vaccine (ZOSTAVAX™) in Korean Adults.

    PubMed

    Choi, Won Suk; Choi, Jung-Hyun; Choi, Jun Yong; Eom, Joong Sik; Kim, Sang Il; Pai, Hyunjoo; Peck, Kyong Ran; Sohn, Jang Wook; Cheong, Hee Jin

    2016-01-01

    A live attenuated zoster vaccine (ZOSTAVAX™, Merck & Co., Inc.) was approved by the Korea Ministry of Food and Drug Safety in 2009. However, the immunogenicity and safety of the vaccine has not been assessed in Korean population. This is multi-center, open-label, single-arm study performed with 180 healthy Korean adults ≥ 50 yr of age. The geometric mean titer (GMT) and geometric mean fold rise (GMFR) of varicella zoster virus (VZV) antibodies were measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) at 4 weeks post-vaccination. Subjects were followed for exposure to varicella or herpes zoster (HZ), the development of any varicella/varicella-like or HZ/HZ-like rashes, and any other clinical adverse experiences (AEs) for 42 days post-vaccination. For the 166 subjects included in the per-protocol population, the GMT at Day 1 was 66.9. At 4 weeks post-vaccination, the GMT for this population was 185.4, with a GMFR of 2.8 (95% CI, 2.5-3.1). Of the 180 subjects vaccinated, 62.8% experienced ≥ 1 AE, with 53.3% of subjects reporting injection-site AEs. The most frequently reported injection-site AEs were erythema (45.0%) with the majority being mild in intensity. Overall, 44 (24.4%) subjects experienced ≥ 1 systemic AE, 10 (5.5%) subjects experienced a systemic vaccine-related AE, and 3 (1.7%) subjects experienced ≥ 1 serious AE not related to vaccine. No subjects reported a VZV-like rash. There was no subject of death and no subject discontinued due to an adverse event. A single dose of zoster vaccine induced VZV-specific gpELISA antibody response and was generally well-tolerated in healthy Korean adults ≥50 yr of age (registry at www.clinicaltrial.gov No. NCT01556451).

  10. Energy Expenditures for Activities of Daily Living in Korean Young Adults: A Preliminary Study

    PubMed Central

    2016-01-01

    Objective To investigate the energy expenditure (EE) of Korean young adults based on activities refined to a deskbound lifestyle. Methods Sixty-four healthy office workers aged between 25 and 46 years participated in this study. EE was expressed as metabolic equivalent of task (MET). Participants were evaluated in terms of their EE during physical activities of sleeping (n=22), typing (n=37), folding laundry (n=34), dishwashing (n=32), studying (n=18), mopping (n=35), walking (n=33), stair climbing (n=23), and running (n=29). Volume of oxygen consumption was measured by indirect calorimetry K4b2 (COSMED). The results were compared to the established Compendium MET. Results The MET of activities were: sleeping, 1.24±0.43; typing, 1.35±0.25; folding laundry, 1.58±0.51; dishwashing, 2.20±0.51; studying, 2.11±0.90; mopping, 2.72±0.69; walking at 4 km/hr, 3.48±0.65; stair climbing of five stories, 6.18±1.08; and running at 8 km/hr, 7.57±0.57. The values of typing and mopping were similar to those in the Compendium, whereas those of sleeping, folding laundry, dishwashing, studying, walking, stair climbing and running were different. Conclusion To our knowledge, this estimation of EE in MET during activities of daily living is the first data of young adults in Korea. These data could be used as a reference to modify the guidelines of physical activities for the age group examined in this study. PMID:27606280

  11. Rehabilitation needs for older adults with stroke living at home: perceptions of four populations

    PubMed Central

    Vincent, Claude; Deaudelin, Isabelle; Robichaud, Line; Rousseau, Jacqueline; Viscogliosi, Chantal; Talbot, Lise R; Desrosiers, Johanne

    2007-01-01

    Background Many people who have suffered a stroke require rehabilitation to help them resume their previous activities and roles in their own environment, but only some of them receive inpatient or even outpatient rehabilitation services. Partial and unmet rehabilitation needs may ultimately lead to a loss of functional autonomy, which increases utilization of health services, number of hospitalizations and early institutionalization, leading to a significant psychological and financial burden on the patients, their families and the health care system. The aim of this study was to explore partially met and unmet rehabilitation needs of older adults who had suffered a stroke and who live in the community. The emphasis was put on needs that act as obstacles to social participation in terms of personal factors, environmental factors and life habits, from the point of view of four target populations. Methods Using the focus group technique, we met four types of experts living in three geographic areas of the province of Québec (Canada): older people with stroke, caregivers, health professionals and health care managers, for a total of 12 groups and 72 participants. The audio recordings of the meetings were transcribed and NVivo software was used to manage the data. The process of reducing, categorizing and analyzing the data was conducted using themes from the Disability Creation Process model. Results Rehabilitation needs persist for nine capabilities (e.g. related to behaviour or motor activities), nine factors related to the environment (e.g. type of teaching, adaptation and rehabilitation) and 11 life habits (e.g. nutrition, interpersonal relationships). The caregivers and health professionals identified more unmet needs and insisted on an individualized rehabilitation. Older people with stroke and the health care managers had a more global view of rehabilitation needs and emphasized the availability of resources. Conclusion Better knowledge of partially met or

  12. Whole Life Program. The Acculturation Model of Interdependent Apartment Living for Adults with Disabilities. Interfacing Individual Rights with the Responsibilities of Community Living. Continuing Education Courses through College for Living.

    ERIC Educational Resources Information Center

    Black, Jan L.; Roelofs, Alice R.

    This book is a resource for human service professionals with detailed information necessary to start, maintain, monitor, assess, and reevaluate a program targeting independence. It describes the Whole Life Program, an interdependent apartment program combined with continuing education for adults with developmental, physical, and emotional…

  13. 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

  14. Prenatal glucocorticoids and maternal smoking during pregnancy independently program adult nicotine dependence in daughters: A 40-year prospective study

    PubMed Central

    Stroud, Laura R.; Papandonatos, George; Shenassa, Edmond; Rodriguez, Daniel; Niaura, Raymond; LeWinn, Kaja; Lipsitt, Lewis P.; Buka, Stephen L.

    2013-01-01

    Background Maternal smoking during pregnancy (MSDP) is an independent risk factor for offspring nicotine dependence (ND), but mechanisms remain unknown. We investigated prenatal glucocorticoid (cortisol) and androgen (testosterone) associations with offspring ND over 40 years, and the possibility that prenatal glucocorticoids and androgens would mediate links between MSDP and offspring ND. Methods Participants were 1,086 mother-adult offspring pairs (59% female) from the New England Family Study, a 40-year longitudinal follow up of the Collaborative Perinatal Project. MSDP was assessed prospectively at each prenatal visit. Maternal cortisol, testosterone, and cotinine (nicotine metabolite), were assayed from third trimester maternal sera. Offspring lifetime ND was assessed via structured interview. Results Significant bivariate associations emerged for: a) MSDP/cotinine and lifetime ND, and b) maternal cortisol and lifetime ND, for daughters only. In multivariate models, maternal cortisol and MSDP/cotinine remained significantly and independently associated with increased odds of daughters’ lifetime ND. However, cortisol did not mediate the MSDP-lifetime ND relation. No associations emerged between maternal testosterone and offspring ND. Conclusions Results provide the first evidence in support of prenatal glucocorticoid programming of adult ND over 40 years in daughters only. Our study highlights two independent prenatal pathways leading to increased risk for ND in daughters: elevated prenatal glucocorticoids and MSDP/nicotine exposure. Daughter-specific effects of glucocorticoid and MSDP programming over 40 years highlight the breadth and persistence of sexually dimorphic programming effects in humans. Results do not support androgen programming of offspring ND. PMID:24034414

  15. Pulmonary complications of HIV-1 infection among adults living in Sub-Saharan Africa.

    PubMed

    Murray, J F

    2005-08-01

    Sub-Saharan Africa, which has just over 10% of the world's population, is home to more than 25 million people living with HIV/AIDS-two thirds of the global total. Opportunistic pulmonary infections are major causes of morbidity and mortality among HIV-infected adults in the subcontinent. Of these diseases, tuberculosis (TB) is by far the most prevalent and serious, and in some countries it causes one third or more of all AIDS-related deaths. Because it is so frequent and a major public health problem, TB tops the list of differential diagnoses of people-with or without coexisting HIV infection-who present to the health care system with chronic cough and other pulmonary symptoms. As HIV-induced immunosuppression worsens, the clinical and radiographic manifestations of TB become increasingly atypical. Second among HIV/AIDS-associated pulmonary complications is community-acquired pneumonia, most commonly caused by Streptococcus pneumoniae, which usually responds to standard beta-lactam antimicrobial agents. The prevalence of Pneumocystis jirovecii pneumonia is increasing, due to both improved recognition of its characteristic clinical and radiographic features and aggressive diagnostic interventions. Treatment outcome in most countries, however, has been poor. Combined infections, usually including TB, are common. Pulmonary nocardiosis, cryptococcosis, Kaposi's sarcoma, and (possibly) histoplasmosis appear to be infrequent, but probably underdiagnosed. Improved diagnosis, treatment, and prevention of all these diseases are urgently needed, but a greatly expanded antiretroviral treatment program will help most of all.

  16. Poverty indicators and mental health functioning among adults living with HIV in Delhi, India.

    PubMed

    Kang, Ezer; Delzell, Darcie A P; McNamara, Paul E; Cuffey, Joel; Cherian, Anil; Matthew, Saira

    2016-01-01

    Poor mental health functioning among persons living with HIV (PLHIV) has gained considerable attention particularly in low-income countries that disproportionately carry the global HIV/AIDS burden. Fewer studies, however, have examined the relationship between poverty indicators and mental health among PHLIV in India. Based on this cross-sectional study of 196 HIV-seropositive adults who received medical services at Shalom AIDS Project in Delhi, India, structural equation modeling and mediation analysis were employed to estimate the associations between poverty indices (household asset index, food security, unemployment, water treatment, sanitation), HIV-health factors (illness in the past 3 months, co-morbid medical conditions), and psychological distress. In the final model, ownership of fewer household assets was associated with higher levels of food insecurity, which in turn was associated with higher psychological distress. Also, the household asset index, food insecurity, and unemployment had a larger effect on psychological distress than new opportunistic infections. These findings build on increasing evidence that support concerted efforts to design, evaluate, and refine HIV mental health interventions that are mainstreamed with livelihood programming in high poverty regions in India.

  17. Vascular complications after adult living donor liver transplantation: Evaluation with ultrasonography

    PubMed Central

    Ma, Lin; Lu, Qiang; Luo, Yan

    2016-01-01

    Living donor liver transplantation (LDLT) has been widely used to treat end-stage liver disease with improvement in surgical technology and the application of new immunosuppressants. Vascular complications after liver transplantation remain a major threat to the survival of recipients. LDLT recipients are more likely to develop vascular complications because of their complex vascular reconstruction and the slender vessels. Early diagnosis and treatment are critical for the survival of graft and recipients. As a non-invasive, cost-effective and non-radioactive method with bedside availability, conventional gray-scale and Doppler ultrasonography play important roles in identifying vascular complications in the early postoperative period and during the follow-up. Recently, with the detailed vascular tracing and perfusion visualization, contrast-enhanced ultrasound (CEUS) has significantly improved the diagnosis of postoperative vascular complications. This review focuses on the role of conventional gray-scale ultrasound, Doppler ultrasound and CEUS for early diagnosis of vascular complications after adult LDLT. PMID:26819527

  18. Individualized Family Supports and Community Living for Adults: A Case Study of a For-Profit Agency in Minnesota.

    ERIC Educational Resources Information Center

    Racino, Julie Ann

    This report is based on a site visit to a private, for-profit agency that provides community support services to people with severe disabilities in six counties in Minnesota. The organization supports 25 families in its in-home program and 35 people in supportive and semi-independent living services. Services offered include minor physical…

  19. "You're Awfully Old to Have This Disease": Experiences of Stigma and Ageism in Adults 50 Years and Older Living with HIV/AIDS

    ERIC Educational Resources Information Center

    Emlet, Charles A.

    2006-01-01

    Purpose: Older adults living with HIV infection may be doubly stigmatized, as they are branded by both age as well as HIV status. Through semistructured interviews, this study sought to examine whether older adults with HIV/AIDS experience both ageism and HIV stigma and how those experiences manifest in their lives. Design and Methods: This was a…

  20. Literacy as a Treatment Modality for Young Chronic Mentally Ill Adults. "Independence through Literacy." Narrative Report.

    ERIC Educational Resources Information Center

    Laffey, Janet; Carlson, Sheila

    This report reviews the accomplishments of a literacy tutoring program--"Independence Through Literacy"--which was funded in its first year by a grant from the U.S. Department of Education, Title VI Library Literacy. This program had as its objective to demonstrate that literacy should be included among the basic skills that are…

  1. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk.

    PubMed

    Cappello, Silvia; Cereda, Emanuele; Rondanelli, Mariangela; Klersy, Catherine; Cameletti, Barbara; Albertini, Riccardo; Magno, Daniela; Caraccia, Marilisa; Turri, Annalisa; Caccialanza, Riccardo

    2016-12-23

    Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97.5), admitted to medical and surgical departments. Results: Three hundred and ninety-six (28.8%) patients presented vitamin B12 > 1000 pg/mL. Two hundred and four patients died in the hospital (14.9%). The adjusted odds ratio of in-hospital mortality in patients with high vitamin B12 was 2.20 (95% CI, 1.56-3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15-41) versus 23 days (IQR 14-36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions: An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation.

  2. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk

    PubMed Central

    Cappello, Silvia; Cereda, Emanuele; Rondanelli, Mariangela; Klersy, Catherine; Cameletti, Barbara; Albertini, Riccardo; Magno, Daniela; Caraccia, Marilisa; Turri, Annalisa; Caccialanza, Riccardo

    2016-01-01

    Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97.5), admitted to medical and surgical departments. Results: Three hundred and ninety-six (28.8%) patients presented vitamin B12 > 1000 pg/mL. Two hundred and four patients died in the hospital (14.9%). The adjusted odds ratio of in-hospital mortality in patients with high vitamin B12 was 2.20 (95% CI, 1.56–3.08; p < 0.001); it was independent of age, gender, body mass index, six-month previous unintentional weight loss, admission ward, presence of malignancy, renal function, C-reactive protein and prealbumin. Patients with high vitamin B12 also had a longer length of stay (LOS) than those with normal concentrations (median 25 days, (IQR 15–41) versus 23 days (IQR 14–36); p = 0.014), and elevated vitamin B12 was an independent predictor of LOS (p = 0.027). Conclusions: An independent association between elevated vitamin B12 concentrations, mortality and LOS was found in our sample of hospitalized adult patients at nutritional risk. Although the underlying mechanisms are still unknown and any cause-effect relation cannot be inferred, clinicians should be aware of the potential negative impact of high vitamin B12 concentrations in hospitalized patients at nutritional risk and avoid inappropriate vitamin supplementation. PMID:28025528

  3. Depressive symptoms, stress and resources among adult immigrants living with HIV.

    PubMed

    Noh, Marianne S; Rueda, Sergio; Bekele, Tsegaye; Fenta, Haile; Gardner, Sandra; Hamilton, Hayley; Hart, Trevor A; Li, Alan; Noh, Samuel; Rourke, Sean B

    2012-06-01

    Investigation on the mental health of HIV-positive immigrants is severely limited. We examine the independent and combined effects of HIV symptom and coping resources on depressive symptoms among HIV-positive immigrants (n = 259). Ordinary Least Squares regression models were estimated with data from a survey of clinical and social-psychological outcomes in people receiving treatment for HIV infection. We tested for the impact of two HIV-related stressors, one life events stressor and three buffering resources on depressive symptoms, controlling for thirteen demographic, clinical and acculturative factors. HIV-related stressors were found to be positively related to depressive symptom severity. Coping resources, namely self-mastery, mediate the relationships between HIV-related stressors and depressive symptoms. Results from this study provide the first empirical assessment of stress processes for immigrants living with HIV. Although more research is needed to understand mental health among HIV-positive immigrants, the study results suggest that health care providers focus on self-mastery enhancement among HIV-positive immigrants.

  4. Functional adult acetylcholine receptor develops independently of motor innervation in Sol 8 mouse muscle cell line.

    PubMed Central

    Pinset, C; Mulle, C; Benoit, P; Changeux, J P; Chelly, J; Gros, F; Montarras, D

    1991-01-01

    We have defined culture conditions, using a feeder layer of cells from the embryonic mesenchymal cell line, 10T1/2 and a serum-free medium, which allow cells from the mouse myogenic cell line Sol 8 to form contracting myotubes for two weeks. Under these culture conditions, Sol 8 myotubes undergo a maturation process characterized by a sequential expression of two phenotypes. An early phenotype is typified by the expression of the nicotinic acetylcholine receptor (AChR) gamma-subunit transcripts and the presence of low conductance ACh-activated channels, typical of embryonic AChR. A late phenotype is characterized by the expression of AChR epsilon-subunit transcripts, the decreased accumulation of gamma-subunit transcripts and the appearance of high conductance ACh-activated channels, typical of adult AChR. These results indicate that the expression of functional adult type AChR does not require the presence of the motor nerve and therefore represents an intrinsic feature of the Sol 8 muscle cells. Chronic exposure of the cells to the voltage-sensitive Na+ channel blocking agent tetrodotoxin does not affect the appearance of the AChR epsilon-subunit transcripts but prevents the reduction of the steady-state level of the AChR gamma-subunit transcripts and yields a reduced proportion of the adult type channels. Thus, activity seems to facilitate the switch from the embryonic to the adult phenotype of the AChR protein. The Sol 8 cell system might be useful to analyse further the genetic and epigenetic regulation of muscle fibre maturation in mammals. Images PMID:1868829

  5. Adverse Childhood Experiences and Adult Criminality: How Long Must We Live before We Possess Our Own Lives?

    PubMed Central

    Reavis, James A; Looman, Jan; Franco, Kristina A; Rojas, Briana

    2013-01-01

    Background: Empirical research associated with the Kaiser Permanente and Centers for Disease Control and Prevention Adverse Childhood Experiences (ACE) Study has demonstrated that ACE are associated with a range of negative outcomes in adulthood, including physical and mental health disorders and aggressive behavior. Methods: Subjects from 4 different offender groups (N = 151) who were referred for treatment at an outpatient clinic in San Diego, CA, subsequent to conviction in criminal court, completed the ACE Questionnaire. Groups (nonsexual child abusers, domestic violence offenders, sexual offenders, and stalkers) were compared on the incidence of ACE, and comparisons were made between the group offenders and a normative sample. Results: Results indicated that the offender group reported nearly four times as many adverse events in childhood than an adult male normative sample. Eight of ten events were found at significantly higher levels among the criminal population. In addition, convicted sexual offenders and child abusers were more likely to report experiencing sexual abuse in childhood than other offender types. Conclusions: On the basis of a review of the literature and current findings, criminal behavior can be added to the host of negative outcomes associated with scores on the ACE Questionnaire. Childhood adversity is associated with adult criminality. We suggest that to decrease criminal recidivism, treatment interventions must focus on the effects of early life experiences. PMID:23704843

  6. Tinea capitis: study of asymptomatic carriers and sick adolescents, adults and elderly who live with children with the disease.

    PubMed

    Bergson, C L; Fernandes, N C

    2001-01-01

    Tinea capitis is a dermatophyte infection that occurs mainly in childhood; there are few reports, in Brazil, in adolescents and adults. The detection of asymptomatic carriers is of great importance in the disease control. From February 1998 to February 1999, a study was performed at the outpatient Dermatologic Unit of Instituto de Puericultura e Pediatria Martagão Gesteira (Universidade Federal do Rio de Janeiro, Brasil) to verify the frequency of asymptomatic carriers and tinea capitis between 79 adolescents, adults and elderly who lived in the same household of 56 children (0-12 years) with tinea capitis. Of these, one female and one male adults (2.5%) were asymptomatic carriers and the cultures revealed Trichophyton tonsurans and Microsporum canis respectively. One female adolescent and two female adults (3.8%) had tinea capitis and all cultures revealed Trichophyton tonsurans. The study has shown that adolescents and adults who live in the same household of children with tinea capitis may be sick or asymptomatic carriers.

  7. Field Patterns of Leaf Plasticity in Adults of the Long-lived Evergreen Quercus coccifera

    PubMed Central

    Rubio De Casas, Rafael; Vargas, Pablo; Pérez-Corona, Esther; Manrique, Esteban; Quintana, José Ramón; García-Verdugo, Carlos; Balaguer, Luis

    2007-01-01

    Background and Aims Quercus coccifera, as a long-lived sprouter, responds plastically to environmental variation. In this study, the role of foliar plasticity as a mechanism of habitat selection and modification within the canopy and across contrasted habitats was characterized. An examination was made of the differential contribution of inner and outer canopy layers to the crown plasticity expressed in the field by adult individuals and its dependence on environmental and genetic factors. Methods Within-crown variation in eight foliar traits was examined in nine populations dominated by Q. coccifera. The difference between mean trait values at the inner and outer canopy layers was used as a proxy for crown plasticity to light. Correlations between geographic distances, environmental differences (climatic and edaphic) and phenotypic divergence (means and plasticities) were assessed by partial Mantel tests. A subset of field measurements was compared with data from a previous common garden experiment. Key Results Phenotypic adjustment of sun leaves contributed significantly to the field variation in crown plasticity. Plasticity in leaf angle, lobation, xanthophyll cycle pigments and β-carotene content was expressed in sun and shade leaves concurrently and in opposite directions. Phenotypic plasticity was more strongly correlated with environmental variation than mean trait values. Populations of taller plants with larger, thinner (higher specific leaf area) and less spiny leaves exhibited greater plasticity. In these populations, the midday light environment was more uniform at the inner than at the outer canopy layers. Field and common garden data ranked populations in the same order of plasticity. Conclusions The expression of leaf plasticity resulted in a phenotypic differentiation that suggests a mechanism of habitat selection through division of labour across canopy layers. Signs of plasticity-mediated habitat modification were found only in the most plastic

  8. Clinical Trial of an Oral Live Shigella sonnei Vaccine Candidate, WRSS1, in Thai Adults

    PubMed Central

    Islam, Dilara; Chamnanchanunt, Supat; Ruamsap, Nattaya; Khantapura, Patchariya; Kaewkungwal, Jaranit; Kittitrakul, Chatporn; Luvira, Viravarn; Dhitavat, Jittima; Venkatesan, Malabi M.; Mason, Carl J.; Bodhidatta, Ladaporn

    2016-01-01

    Live attenuated Shigella sonnei vaccine candidate WRSS1, previously tested in U.S. and Israeli volunteers, was evaluated in a population of adult Thai volunteers in which the organism is endemic. In a randomized placebo-controlled, double-blind design, inpatient participants received a single oral dose of 1.6 × 104 CFU of WRSS1. The vaccine was generally well tolerated, with equal numbers of vaccinees and placebo controls showing mild symptoms. Only 3 of 13 vaccinees (23%) had culture-positive stools, while a total of 9 vaccinees were positive by PCR. Lack of vaccine shedding in volunteers correlated with lack of clinical symptoms and immune responses, just as the duration of fecal shedding correlated directly with stronger immune responses. Two months following immunization, 10 vaccinees and 10 newly recruited naive controls received a challenge dose of 1,670 CFU of virulent S. sonnei strain 53G. This dose had previously demonstrated a 75% attack rate for dysentery in Thai volunteers. However, in this study the attack rate for dysentery in naive controls after challenge was 20%. Based on clinical record summaries, 3 vaccinees and 5 naive controls experienced clinically relevant illness (diarrhea/dysentery/fever/shigellosis), and a 40% vaccine efficacy was calculated. When these data are compared to those for the performance of this vaccine candidate in more naive populations, it is clear that a single oral dose of WRSS1 at 104 CFU failed to achieve its full potential in a population in which the organism is endemic. Higher doses and/or repeated immunizations may contribute to improved vaccine shedding and consequent elevation of protective immune responses in a population in which the organism is endemic. (The study has been registered at ClinicalTrials.gov under registration no. NCT01080716.) PMID:27146000

  9. Becoming Adults: One-Year Impact Findings from the Youth Villages Transitional Living Evaluation

    ERIC Educational Resources Information Center

    Valentine, Erin Jacobs; Skemer, Melanie; Courtney, Mark E.

    2015-01-01

    The "Youth Villages Transitional Living Evaluation" is testing whether the "Transitional Living" program, operated by the social service organization Youth Villages, makes a difference in the lives of young people with histories of foster care or juvenile justice custody. The program, which was renamed "YVLifeSet" in…

  10. Variability of doublecortin-associated dendrite maturation in adult hippocampal neurogenesis is independent of the regulation of precursor cell proliferation

    PubMed Central

    Plümpe, Tobias; Ehninger, Dan; Steiner, Barbara; Klempin, Friederike; Jessberger, Sebastian; Brandt, Moritz; Römer, Benedikt; Rodriguez, Gerardo Ramirez; Kronenberg, Golo; Kempermann, Gerd

    2006-01-01

    Background In the course of adult hippocampal neurogenesis most regulation takes place during the phase of doublecortin (DCX) expression, either as pro-proliferative effect on precursor cells or as survival-promoting effect on postmitotic cells. We here obtained quantitative data about the proliferative population and the dynamics of postmitotic dendrite development during the period of DCX expression. The question was, whether any indication could be obtained that the initiation of dendrite development is timely bound to the exit from the cell cycle. Alternatively, the temporal course of morphological maturation might be subject to additional regulatory events. Results We found that (1) 20% of the DCX population were precursor cells in cell cycle, whereas more than 70% were postmitotic, (2) the time span until newborn cells had reached the most mature stage associated with DCX expression varied between 3 days and several weeks, (3) positive or negative regulation of precursor cell proliferation did not alter the pattern and dynamics of dendrite development. Dendrite maturation was largely independent of close contacts to astrocytes. Conclusion These data imply that dendrite maturation of immature neurons is initiated at varying times after cell cycle exit, is variable in duration, and is controlled independently of the regulation of precursor cell proliferation. We conclude that in addition to the major regulatory events in cell proliferation and selective survival, additional micro-regulatory events influence the course of adult hippocampal neurogenesis. PMID:17105671

  11. Overview and Categorization of Robots Supporting Independent Living of Elderly People: What Activities Do They Support and How Far Have They Developed.

    PubMed

    Bedaf, Sandra; Gelderblom, Gert Jan; De Witte, Luc

    2015-01-01

    Over the past decades, many robots for the elderly have been developed, supporting different activities of elderly people. A systematic review in four scientific literature databases and a search in article references and European projects was performed in order to create an overview of robots supporting independent living of elderly people. The robots found were categorized based on their development stage, the activity domains they claim to support, and the type of support provided (i.e., physical, non-physical, and/or non-specified). In total, 107 robots for the elderly were identified. Six robots were still in a concept phase, 95 in a development phase, and six of these robots were commercially available. These robots claimed to provide support related to four activity domains: mobility, self-care, interpersonal interaction & relationships, and other activities. Of the many robots developed, only a small percentage is commercially available. Technical ambitions seem to be guiding robot development. To prolong independent living, the step towards physical support is inevitable and needs to be taken. However, it will be a long time before a robot will be capable of supporting multiple activities in a physical manner in the home of an elderly person in order to enhance their independent living.

  12. Descriptive Assessment of Sleep Patterns among Community-Living Adults with Mental Retardation

    ERIC Educational Resources Information Center

    Luiselli, James K.; Magee, Christine; Sperry, James M.; Parker, Shawn

    2005-01-01

    There is little information about the sleep patterns of adults who have mental retardation and are supported in the community. In the present study, direct-care staff recorded sleep behaviors of 59 adults residing in 16 suburban group homes. Based on direct observation and measurement procedures, the adults averaged 7.9 hours of sleep each evening…

  13. What can local authorities do to improve the social care-related quality of life of older adults living at home? Evidence from the Adult Social Care Survey.

    PubMed

    van Leeuwen, K M; Malley, J; Bosmans, J E; Jansen, A P D; Ostelo, R W; van der Horst, H E; Netten, A

    2014-09-01

    Local authorities spend considerable resources on social care at home for older adults. Given the expected growth in the population of older adults and budget cuts on local government, it is important to find efficient ways of maintaining and improving the quality of life of older adults. The ageing in place literature suggests that policies in other functions of local authorities may have a significant role to play. This study aims to examine the associations between social care-related quality of life (SCRQoL) in older adults and three potential policy targets for local authorities: (i) accessibility of information and advice, (ii) design of the home and (iii) accessibility of the local area. We used cross-sectional data from the English national Adult Social Care Survey (ASCS) 2010/2011 on service users aged 65 years and older and living at home (N=29,935). To examine the association between SCRQoL, as measured by the ASCOT, and three single-item questions about accessibility of information, design of the home and accessibility of the local area, we estimate linear and quantile regression models. After adjusting for physical and mental health factors and other confounders our findings indicate that SCRQoL is significantly lower for older adults who find it more difficult to find information and advice, for those who report that their home design is inappropriate for their needs and for those who find it more difficult to get around their local area. In addition, these three variables are as strongly associated with SCRQoL as physical and mental health factors. We conclude that in seeking to find ways to maintain and improve the quality of life of social care users living at home, local authorities could look more broadly across their responsibilities. Further research is required to explore the cost-effectiveness of these options compared to standard social care services.

  14. Activation of Human Monocytes by Live Borrelia burgdorferi Generates TLR2-Dependent and -Independent Responses Which Include Induction of IFN-β

    PubMed Central

    Salazar, Juan C.; Duhnam-Ems, Star; La Vake, Carson; Cruz, Adriana R.; Moore, Meagan W.; Caimano, Melissa J.; Velez-Climent, Leonor; Shupe, Jonathan; Krueger, Winfried; Radolf, Justin D.

    2009-01-01

    It is widely believed that innate immune responses to Borrelia burgdorferi (Bb) are primarily triggered by the spirochete's outer membrane lipoproteins signaling through cell surface TLR1/2. We recently challenged this notion by demonstrating that phagocytosis of live Bb by peripheral blood mononuclear cells (PBMCs) elicited greater production of proinflammatory cytokines than did equivalent bacterial lysates. Using whole genome microarrays, we show herein that, compared to lysates, live spirochetes elicited a more intense and much broader transcriptional response involving genes associated with diverse cellular processes; among these were IFN-β and a number of interferon-stimulated genes (ISGs), which are not known to result from TLR2 signaling. Using isolated monocytes, we demonstrated that cell activation signals elicited by live Bb result from cell surface interactions and uptake and degradation of organisms within phagosomes. As with PBCMs, live Bb induced markedly greater transcription and secretion of TNF-α, IL-6, IL-10 and IL-1β in monocytes than did lysates. Secreted IL-18, which, like IL-1β, also requires cleavage by activated caspase-1, was generated only in response to live Bb. Pro-inflammatory cytokine production by TLR2-deficient murine macrophages was only moderately diminished in response to live Bb but was drastically impaired against lysates; TLR2 deficiency had no significant effect on uptake and degradation of spirochetes. As with PBMCs, live Bb was a much more potent inducer of IFN-β and ISGs in isolated monocytes than were lysates or a synthetic TLR2 agonist. Collectively, our results indicate that the enhanced innate immune responses of monocytes following phagocytosis of live Bb have both TLR2-dependent and -independent components and that the latter induce transcription of type I IFNs and ISGs. PMID:19461888

  15. A review of instruments to measure interprofessional collaboration for chronic disease management for community-living older adults.

    PubMed

    Bookey-Bassett, Sue; Markle-Reid, Maureen; McKey, Colleen; Akhtar-Danesh, Noori

    2016-01-01

    It is acknowledged internationally that chronic disease management (CDM) for community-living older adults (CLOA) is an increasingly complex process. CDM for older adults, who are often living with multiple chronic conditions, requires coordination of various health and social services. Coordination is enabled through interprofessional collaboration (IPC) among individual providers, community organizations, and health sectors. Measuring IPC is complicated given there are multiple conceptualisations and measures of IPC. A literature review of several healthcare, psychological, and social science electronic databases was conducted to locate instruments that measure IPC at the team level and have published evidence of their reliability and validity. Five instruments met the criteria and were critically reviewed to determine their strengths and limitations as they relate to CDM for CLOA. A comparison of the characteristics, psychometric properties, and overall concordance of each instrument with salient attributes of IPC found the Collaborative Practice Assessment Tool to be the most appropriate instrument for measuring IPC for CDM in CLOA.

  16. Health Promotion Board-Ministry of Health Clinical Practice Guidelines: Falls Prevention among Older Adults Living in the Community.

    PubMed

    Shyamala, Thilagaratnam; Wong, Sweet Fun; Andiappan, Akila; Au Eong, Kah Guan; Bakshi, Anu Birla; Boey, Debbie; Chong, Tsung Wei; Eng, Hui Ping; Ismail, Noor Hafizah; Lau, Tang Ching; Lim, Wei-Yen; Lim, Hsin Wei Wendy; Seong, Lydia; Wong, Wei Chin; Yap, Kai Zhen; Yudah, Sri

    2015-05-01

    The Health Promotion Board (HPB) has developed the Clinical Practice Guidelines (CPG) on Falls Prevention among Older Adults Living in the Community to provide health professionals in Singapore with recommendations for evidence-based assessments and interventions for falls prevention. This article reproduces the introduction and executive summary of the key recommendations from the HPB-MOH CPG on Falls Prevention among Older Adults Living in the Community for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Health Promotion Board website: http://www.hpb.gov. sg/cpg-falls-prevention. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

  17. TV viewing time is associated with increased all-cause mortality in Brazilian adults independent of physical activity.

    PubMed

    Turi, Bruna Camilo; Monteiro, Henrique Luiz; Ribeiro Lemes, Ítalo; Codogno, Jamile Sanches; Lynch, Kyle Robinson; Asahi Mesquita, Camila Angélica; Fernandes, Rômulo Araújo

    2017-03-22

    The purpose of this study was to investigate the association between television (TV) viewing and all-cause mortality among Brazilian adults after six years of follow-up. This longitudinal study started in 2010 in the city of Bauru, SP, Brazil, and involved 970 adults aged ≥ 50 years. Mortality was reported by relatives and confirmed in medical records of the Brazilian National Health System. Physical activity (PA) and TV viewing were assessed by the Baecke questionnaire. Health status, sociodemographic and behavioural covariates were considered as potential confounders. After six years of follow-up, 89 deaths were registered (9.2% [95%CI= 7.4% to 11%]). Type 2 diabetes mellitus was associated with higher risk of mortality (p-value= 0.012). Deaths correlated significantly with age (rho= 0.188; p-value= 0.001), overall PA score (rho= -0.128; p-value= 0.001) and TV viewing (rho= 0.086; p-value= 0.007). Lower percentage of participants reported TV viewing time as often (16%) and very often (5.7%), but there was an association between higher TV viewing time ("often" and "very often" grouped together) and increased mortality after six years of follow-up (p-value= 0.006). The higher TV viewing time was associated with a 44.7% increase in all-cause mortality (HR= 1.447 [1.019 to 2.055]), independently of other potential confounders. In conclusion, the findings from this cohort study identified increased risk of mortality among adults with higher TV viewing time, independently of physical activity and other variables. This article is protected by copyright. All rights reserved.

  18. Timing of Expression of a Gene in the Adult Drosophila Is Regulated by Mechanisms Independent of Temperature and Metabolic Rate

    PubMed Central

    Rogina, B.; Helfand, S. L.

    1996-01-01

    The examination of β-galactosidase (β-gal) expression in the third segment of the antenna of the 2216 enhancer trap line in Drosophila melanogaster reveals two distinct spatial and temporal regulatory patterns of expression during adult life. Type I expression is characterized by a decline in the level of β-gal expression with increasing age. Starting from a maximal level of expression at the time of adult emergence, there is a decrease in the number of cells that express β-gal so that by 40-50 days of adult life few cells express β-gal. Varying the ambient temperature and using hyperactivity mutants (Hyperkinetic(1), Shaker(5)) demonstrates that the rate of this decline is independent of temperature and metabolic rate. Type II expression is distinctly different in spatial distribution and temporal regulation from the first pattern. Type II expression is restricted in the antenna to a small (<20-30) set of cells whose level of expression changes in a periodic manner with time. The regulation of this periodicity appears to be linked to ambient temperature. PMID:8844152

  19. The Independent Association of Hypertension with Cognitive Function Among Older Adults with Heart Failure

    PubMed Central

    Alosco, Michael L.; Brickman, Adam M.; Spitznagel, Mary Beth; van Dulmen, Manfred; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H.; Colbert, Lisa H.; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2012-01-01

    Objective Hypertension is the most common comorbidity among heart failure (HF) patients and has been independently linked with cognitive impairment. Cognitive impairment is prevalent among HF patients, though the extent to which hypertension contributes to cognitive function in this population is unclear. Methods 116 HF patients (31.0% women, 67.68 ± 11.16 years) completed neuropsychological testing and impedance cardiography. History of physician diagnosed hypertension, along with other medical characteristics, was ascertained through a review of participants’ medical charts. Results 69.8% of the HF patients had a diagnostic history of hypertension. After adjustment for demographic and medical characteristics (i.e., cardiac index, medication status, and resting blood pressure), hypertension was independently associated with attention/executive function/psychomotor speed (ΔF(1,103) = 10.85, ΔR2 = .07, p < .01) and motor functioning (ΔF(1,103) = 4.46, ΔR2 = .04, p < .05). HF patients with a diagnosed history of hypertension performed worse in these domains than those without such history. Conclusion The current findings indicate that diagnostic history of hypertension is an important contributor to cognitive impairment in HF. Hypertension frequently precedes HF and future studies should examine whether sustained hypertension compromises cerebral autoregulatory mechanisms to produce brain damage and exacerbate cognitive impairment in this population. PMID:23026535

  20. Case studies of technology for adults with multiple disabilities to make telephone calls independently.

    PubMed

    Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Boccasini, Adele; La Martire, Maria L; Lang, Russell

    2014-08-01

    Recent literature has shown the possibility of enabling individuals with multiple disabilities to make telephone calls independently via computer-aided telephone technology. These two case studies assessed a modified version of such technology and a commercial alternative to it for a woman and a man with multiple disabilities, respectively. The modified version used in Study 1 (a) presented the names of the persons available for a call and (b) reminded the participant of the response she needed to perform (i.e., pressing a microswitch) if she wanted to call any of those names/persons. The commercial device used in Study 2 was a Galaxy S3 (Samsung) equipped with the S-voice module, which allowed the participant to activate phone calls by uttering the word "Call" followed by the name of the persons he wanted to call. The results of the studies showed that the participants learned to make phone calls independently using the technology/device available. Implications of the results are discussed.

  1. How well does spirituality predict health status in adults living with HIV-Disease: A Neuman systems model study.

    PubMed

    Cobb, Rachel K

    2012-10-01

    The purpose of this study was to examine the relationship between spirituality and health status of 39 adult men and women living with HIV-disease. A model building approach was used to explore the associations among the five variables of the Neuman systems model, which was the guiding framework for the study. The model presented includes existential well-being, meaningfulness, age, and income.

  2. Sleep deprivation can inhibit adult hippocampal neurogenesis independent of adrenal stress hormones.

    PubMed

    Mueller, Anka D; Pollock, Michael S; Lieblich, Stephanie E; Epp, Jonathan R; Galea, Liisa A M; Mistlberger, Ralph E

    2008-05-01

    Sleep deprivation (SD) can suppress cell proliferation in the hippocampal dentate gyrus of adult male rodents, suggesting that sleep may contribute to hippocampal functions by promoting neurogenesis. However, suppression of cell proliferation in rats by the platform-over-water SD method has been attributed to elevated corticosterone (Cort), a potent inhibitor of cell proliferation and nonspecific correlate of this procedure. We report here results that do not support this conclusion. Intact and adrenalectomized (ADX) male rats were subjected to a 96-h SD using multiple- and single-platform methods. New cells were identified by immunoreactivity for 5-bromo-2'-deoxyuridine (BrdU) or Ki67 and new neurons by immunoreactivity for BrdU and doublecortin. EEG recordings confirmed a 95% deprivation of rapid eye movement (REM) sleep and a 40% decrease of non-REM sleep. Cell proliferation in the dentate gyrus was suppressed by up to 50% in sleep-deprived rats relative to apparatus control or home cage control rats. This effect was also observed in ADX rats receiving continuous low-dose Cort replacement via subcutaneous minipumps but not in ADX rats receiving Cort replacement via drinking water. In these latter rats, Cort intake via water was reduced by 60% during SD; upregulation of cell proliferation by reduced Cort intake may obscure inhibitory effects of sleep loss on cell proliferation. SD had no effect on the percentage of new cells expressing a neuronal phenotype. These results demonstrate that the Cort replacement method is critical for detecting an effect of SD on cell proliferation and support a significant role for sleep in adult neurogenesis.

  3. The Nesting Syndrome: Grown Children Living at Home.

    ERIC Educational Resources Information Center

    Wiener, Valerie

    Parents across the nation are experiencing the phenomenon of adult children returning home to live with their parents after brief or extended excursions into independent living, or of adult children reluctant to move out until their financial or lifestyle expectations are guaranteed. Referring to these grown children as "nesters," this…

  4. ACTIVE: A Cognitive Intervention Trial to Promote Independence in Older Adults

    PubMed Central

    Jobe, Jared B.; Smith, David M.; Ball, Karlene; Tennstedt, Sharon L.; Marsiske, Michael; Willis, Sherry L.; Rebok, George W.; Morris, John N.; Helmers, Karin F.; Leveck, Mary D.; Kleinman, Ken

    2010-01-01

    The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial is a randomized, controlled, single-masked trial designed to determine whether cognitive training interventions (memory, reasoning, and speed of information processing), which have previously been found to be successful at improving mental abilities under laboratory or small-scale field conditions, can affect cognitively based measures of daily functioning. Enrollment began during 1998; 2-year follow-up will be completed by January 2002. Primary outcomes focus on measures of cognitively demanding everyday functioning, including financial management, food preparation, medication use, and driving. Secondary outcomes include health-related quality of life, mobility, and health-service utilization. Trial participants (n = 2832) are aged 65 and over, and at entry into the trial, did not have significant cognitive, physical, or functional decline. Because of its size and the carefully developed rigor, ACTIVE may serve as a guide for future behavioral medicine trials of this nature. PMID:11514044

  5. Gait speed correlates in a multiracial population of community-dwelling older adults living in Brazil: a cross-sectional population-based study

    PubMed Central

    2013-01-01

    Background Gait speed is a strong predictor of a wide range of adverse health outcomes in older adults. Mean values for gait speed in community-dwelling older adults vary substantially depending on population characteristics, suggesting that social, biological, or health factors might explain why certain groups tend to self-select their gait speed in different patterns. The vast majority of studies reported in the literature present data from North American and European populations. There are few population-based studies from other regions with a different ethnicity and/or social and health conditions. To address this, the present study identified the mean usual and fast gait speeds in a representative multiracial population of community-dwelling older adults living in a developing country, and explored their association with sociodemographic, mental and physical health characteristics. Methods This was a cross-sectional population-based study of a sample of 137 men and 248 women, aged 65 years and over. Usual gait speed and fast gait speed were measured on a 4.6 m path. Participants were classified into slow, intermediate, and faster groups by cluster analysis. Logistic regression analysis was used to estimate the independent effect of each factor on the odds of presenting with a slower usual and slower fast gait speeds. Results Participants had a mean (SD) usual gait speed of 1.11 (0.27) m/s and a mean fast gait speed of 1.39 (0.34) m/s. We did not observe an independent association between gait speed and race/ethnicity, educational level, or income. The main contributors to present a slower usual gait speed were low physical activity level, stroke, diabetes, urinary incontinence, high concern about falling, and old age. A slower fast gait speed was associated with old age, low physical activity, urinary incontinence and high concern about falling. Conclusion A multiracial population of older adults living in a developing country showed a similar mean gait speed

  6. Building Groups and Independence: The Role of Food in the Lives of Young People in Danish Sports Centres

    ERIC Educational Resources Information Center

    Sylow, Mine; Holm, Lotte

    2009-01-01

    This article, based on an ethnographic study, examines the role of food in the social interaction of 11- to 17-year-old youths in sports centres in Denmark. The sports centres serve as a free space where young people receive no adult supervision. This is underlined by their understanding and use of food in this environment. Food serves as a medium…

  7. Early interactions with mother and peers independently build adult social skills and shape BDNF and oxytocin receptor brain levels

    PubMed Central

    Branchi, Igor; Curley, James P.; D’Andrea, Ivana; Cirulli, Francesca; Champagne, Frances A.; Alleva, Enrico

    2012-01-01

    The early social environment has a profound impact on developmental trajectories. Although an impoverished early environment can undermine the acquisition of appropriate social skills, the specific role played by the different components of an individual’s early environment in building social competencies has not been fully elucidated. Here we setup an asynchronous communal nesting paradigm in mice to disentangle the influence of maternal care and early peer interactions on adult social behavior and neural systems reportedly involved in the regulation of social interactions. The asynchronous communal nesting consists of three mothers giving birth three days apart, generating three groups of pups -- the Old, the Middle and the Young – all raised in a single nest from birth to weaning. We scored the amount of maternal and peer interactions received by these mice and by a fourth group reared under standard conditions. At adulthood, the four experimental groups have been investigated for social behavior in a social interaction test, i.e. facing an unfamiliar conspecific during five 20-min daily encounters, and for oxytocin receptor and BDNF levels. Results show that only individuals exposed to high levels of both maternal and peer interactions demonstrated elaborate adult agonistic competencies, i.e. the ability to promptly display a social status, and high BDNF levels in the hippocampus, frontal cortex and hypothalamus. By contrast, only individuals exposed to high levels of peer interactions showed enhanced adult affiliative behavior and enhanced oxytocin receptor levels in selected nuclei of the amygdala. Overall these findings indicate that early interactions with mother and peers independently shape specific facets of adult social behavior and neural systems involved in social interaction. PMID:22910688

  8. Early interactions with mother and peers independently build adult social skills and shape BDNF and oxytocin receptor brain levels.

    PubMed

    Branchi, Igor; Curley, James P; D'Andrea, Ivana; Cirulli, Francesca; Champagne, Frances A; Alleva, Enrico

    2013-04-01

    The early social environment has a profound impact on developmental trajectories. Although an impoverished early environment can undermine the acquisition of appropriate social skills, the specific role played by the different components of an individual's early environment in building social competencies has not been fully elucidated. Here we setup an asynchronous communal nesting paradigm in mice to disentangle the influence of maternal care and early peer interactions on adult social behavior and neural systems reportedly involved in the regulation of social interactions. The asynchronous communal nesting consists of three mothers giving birth three days apart, generating three groups of pups - the Old, the Middle and the Young - all raised in a single nest from birth to weaning. We scored the amount of maternal and peer interactions received by these mice and by a fourth group reared under standard conditions. At adulthood, the four experimental groups have been investigated for social behavior in a social interaction test, i.e. facing an unfamiliar conspecific during five 20-min daily encounters, and for oxytocin receptor and brain derived neurotrophic factor (BDNF) levels. Results show that only individuals exposed to high levels of both maternal and peer interactions demonstrated elaborate adult agonistic competencies, i.e. the ability to promptly display a social status, and high BDNF levels in the hippocampus, frontal cortex and hypothalamus. By contrast, only individuals exposed to high levels of peer interactions showed enhanced adult affiliative behavior and enhanced oxytocin receptor levels in selected nuclei of the amygdala. Overall these findings indicate that early interactions with mother and peers independently shape specific facets of adult social behavior and neural systems involved in social interaction.

  9. piRNA biogenesis during adult spermatogenesis in mice is independent of the ping-pong mechanism

    PubMed Central

    Beyret, Ergin; Liu, Na; Lin, Haifan

    2012-01-01

    piRNAs, a class of small non-coding RNAs associated with PIWI proteins, have broad functions in germline development, transposon silencing, and epigenetic regulation. In diverse organisms, a subset of piRNAs derived from repeat sequences are produced via the interplay between two PIWI proteins. This mechanism, termed “ping-pong” cycle, operates among the PIWI proteins of the primordial mouse testis; however, its involvement in postnatal testes remains elusive. Here we show that adult testicular piRNAs are produced independent of the ping-pong mechanism. We identified and characterized large populations of piRNAs in the adult and postnatal developing testes associated with MILI and MIWI, the only PIWI proteins detectable in these testes. No interaction between MILI and MIWI or sequence feature for the ping-pong mechanism among their piRNAs was detected in the adult testis. The majority of MILI- and MIWI-associated piRNAs originate from the same DNA strands within the same loci. Both populations of piRNAs are biased for 5′ Uracil but not for Adenine on the 10th nucleotide position, and display no complementarity. Furthermore, in Miwi mutants, MILI-associated piRNAs are not downregulated, but instead upregulated. These results indicate that the adult testicular piRNAs are predominantly, if not exclusively, produced by a primary processing mechanism instead of the ping-pong mechanism. In this primary pathway, biogenesis of MILI- and MIWI-associated piRNAs may compete for the same precursors; the types of piRNAs produced tend to be non-selectively dictated by the available precursors in the cell; and precursors with introns tend to be spliced before processed into piRNAs. PMID:22907665

  10. Independence of Hot and Cold Executive Function Deficits in High-Functioning Adults with Autism Spectrum Disorder

    PubMed Central

    Zimmerman, David L.; Ownsworth, Tamara; O'Donovan, Analise; Roberts, Jacqueline; Gullo, Matthew J.

    2016-01-01

    Individuals with autistic spectrum disorder (ASD) display diverse deficits in social, cognitive and behavioral functioning. To date, there has been mixed findings on the profile of executive function deficits for high-functioning adults (IQ > 70) with ASD. A conceptual distinction is commonly made between “cold” and “hot” executive functions. Cold executive functions refer to mechanistic higher-order cognitive operations (e.g., working memory), whereas hot executive functions entail cognitive abilities supported by emotional awareness and social perception (e.g., social cognition). This study aimed to determine the independence of deficits in hot and cold executive functions for high-functioning adults with ASD. Forty-two adults with ASD (64% male, aged 18–66 years) and 40 age and gender matched controls were administered The Awareness of Social Inference Test (TASIT; emotion recognition and social inference), Letter Number Sequencing (working memory) and Hayling Sentence Completion Test (response initiation and suppression). Between-group analyses identified that the ASD group performed significantly worse than matched controls on all measures of cold and hot executive functions (d = 0.54 − 1.5). Hierarchical multiple regression analyses revealed that the ASD sample performed more poorly on emotion recognition and social inference tasks than matched controls after controlling for cold executive functions and employment status. The findings also indicated that the ability to recognize emotions and make social inferences was supported by working memory and response initiation and suppression processes. Overall, this study supports the distinction between hot and cold executive function impairments for adults with ASD. Moreover, it advances understanding of higher-order impairments underlying social interaction difficulties for this population which, in turn, may assist with diagnosis and inform intervention programs. PMID:26903836

  11. When the mind wanders: Distinguishing stimulus-dependent from stimulus-independent thoughts during incidental encoding in young and older adults.

    PubMed

    Maillet, David; Schacter, Daniel L

    2016-06-01

    In recent years, several studies have indicated that healthy older adults exhibit a reduction in mind-wandering compared with young adults. However, relatively little research has examined the extent to which ongoing thoughts in young and older adults are dependent on environmental stimuli. In the current study, we assessed age-related differences in frequency of stimulus-dependent thoughts (SDTs) and stimulus-independent thoughts (SITs) during a slow-paced incidental encoding task. Based on previous research suggesting that older adults rely on external information to a greater extent than young adults, we hypothesized that ongoing thoughts in older adults may be more stimulus-dependent than in young adults. We found that although older adults reported overall fewer thoughts compared to young adults, they exhibited a reduction in proportion of SITs and an increase in proportion of SDTs. In both age groups, SDTs were more frequently about the past compared with SITs, while SITs were more frequently about the future. Finally, the extent to which both young and older adults reported SDTs, but not SITs, at encoding was positively correlated with how often they reported remembering thoughts at retrieval, and SDT frequency was positively correlated with overall performance on the memory task in older adults. Our results provide evidence that ongoing thoughts in older adults may be more dependent on environmental stimuli than young adults, and that these thoughts may impact performance in recognition tasks. (PsycINFO Database Record

  12. Nutritional care and support among adults living with HIV at Hawassa Referral Hospital, southern Ethiopia: A qualitative study.

    PubMed

    Tafese, Zelalem; Birhan, Yifru; Abebe, Hiwot

    2013-11-01

    Background Improving nutritional care and support for people living with HIV (PLHIV) is an integral part of comprehensive HIV treatment according to the National Nutritional Strategy of Ethiopia. However, there is no adequate published study that assesses the nutritional care and support services for adult people living with HIV/ AIDS (PLHIV) in this setting. Objective The objective of the study was to identify the existing nutritional care and support services and determine the challenges facing adults living with HIV at Hawassa Referral Hospital in southern Ethiopia. Methods A qualitative study was carried out using focus group discussions (FGDs), in-depth interviews and participant observation. Four FDGs were held and five in-depth interviews were conducted. A two-week participant observation was also conducted by trained nurses. All interviews and FDGs were tape-recorded and transcribed; those conducted in Amharic were translated back to English. Finally thematic analysis of the transcripts was performed. Results Most of the FDG participants were unsatisfied with their nutritional care and support services and expressed difficulty with disclosing their HIV status for fear of stigma and discrimination. The in-depth interviews and participant observation showed results similar to those of the FDG. Some key informants expressed a fear that such poor nutritional care and support may threaten the quality of life of people living with HIV and suggested that all stakeholders work on improving the services. Conclusion Current nutritional care and support services for people living with HIV are not well coordinated. They focus mainly on monthly supplementation of antiretroviral drugs and occasional handouts of food. The need to provide health education on antiretroviral drugs and nutrition, and to emphasise strategies aimed at improving the nutritional status of peoples living with HIV is critical. Furthermore, the study recommended strengthening the initiatives of some

  13. Learning from Our Lives: Using Educational Biographies with Adults. The Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Dominice, Pierre

    This nine-chapter book, written in Europe by a French-speaking Swiss educator, explores the rationale for using educational biography approaches in adult education and presents examples that illustrate various uses of these life history activities. Chapter 1 provides an introduction and overview of educational biography, and Chapter 2 describes…

  14. Prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia

    PubMed Central

    2017-01-01

    Purpose The aim of this study was to assess the prevalence and associated factors of pterygium among adults living in Gondar city, Northwest Ethiopia. Methods A cross sectional design study was carried out in 390 participants in Gondar city from April 15 to May 7, 2016. Basic ophthalmic examination was performed using portable slit lamb, 3.5x magnifying loop with torch light and a pretested and structured questionnaire was completed. The raw data has been entered into EPI INFO 3.5.1 and analyzed by SPPSS version 20. Descriptive statistics was summarized descriptive data. Logistic regression was used to summarize the predictors of pterygium. The variables with p-value less than 0.05 were considered as significant risks of pterygium. Result The prevalence of pterygium among study participants was 151(38.7% (95%CI; 33.8–43.8)). Among those who have pterygium, 149(98.7%) were developed pterygium on the nasal side and 15(9.9%) on temporal side of the either eye and 13(8.6%) have both. Age between 41-60(AOR = 2.20(95%CI: 1.22, 3.39)), age between 61-86(AOR = 7.97(95%CI: 2.74, 23.17)), male sex (AOR = 2.20(95%CI: 1.28, 3.82)), outdoor working area(AOR = 3.75(95%CI: 2.18, 6.46)), the use of traditional eye medication (AOR = 2.55 (95%CI: 1.04, 5.90)) and family history of pterygium (AOR = 6.68(95% CI: 2.53, 17.60)) were positively associated with pterygium whereas use of sunglass/hat (AOR = 0.40(95%CI:0.20, 0.78)) was negatively associated. Conclusion There is a high prevalence of pterygium in Gondar city northwest Ethiopia. Old age, male sex, outdoor working area, utilization of traditional eye medication and family history of pterygium were statistically significant predictors of pterygium. The use of sunglass/hat was protective against pterygium. PMID:28358813

  15. Factors Predicting Mortality in Midlife Adults with and without Down Syndrome Living with Family

    ERIC Educational Resources Information Center

    Esbensen, A. J.; Seltzer, M. M.; Greenberg, J. S.

    2007-01-01

    Background: Little is known about the mortality of individuals with Down syndrome who have lived at home with their families throughout their lives. The current study evaluates the predictors, causes and patterns of mortality among co-residing individuals in midlife with Down syndrome as compared with co-residing individuals with ID owing to other…

  16. Sense of Belonging as a Predictor of Reasons for Living in Older Adults

    ERIC Educational Resources Information Center

    Kissane, Melissa; McLaren, Suzanne

    2006-01-01

    In response to the high rate of suicide among aging people, this study investigated sense of belonging as a predictor of reasons for living in an aged sample. A community sample of 104 Australians aged 61 to 95 years completed The Reasons for Living Inventory and The Sense of Belonging Instrument. Results indicated that a higher sense of belonging…

  17. Acceptance of an assistive robot in older adults: a mixed-method study of human–robot interaction over a 1-month period in the Living Lab setting

    PubMed Central

    Wu, Ya-Huei; Wrobel, Jérémy; Cornuet, Mélanie; Kerhervé, Hélène; Damnée, Souad; Rigaud, Anne-Sophie

    2014-01-01

    Background There is growing interest in investigating acceptance of robots, which are increasingly being proposed as one form of assistive technology to support older adults, maintain their independence, and enhance their well-being. In the present study, we aimed to observe robot-acceptance in older adults, particularly subsequent to a 1-month direct experience with a robot. Subjects and methods Six older adults with mild cognitive impairment (MCI) and five cognitively intact healthy (CIH) older adults were recruited. Participants interacted with an assistive robot in the Living Lab once a week for 4 weeks. After being shown how to use the robot, participants performed tasks to simulate robot use in everyday life. Mixed methods, comprising a robot-acceptance questionnaire, semistructured interviews, usability-performance measures, and a focus group, were used. Results Both CIH and MCI subjects were able to learn how to use the robot. However, MCI subjects needed more time to perform tasks after a 1-week period of not using the robot. Both groups rated similarly on the robot-acceptance questionnaire. They showed low intention to use the robot, as well as negative attitudes toward and negative images of this device. They did not perceive it as useful in their daily life. However, they found it easy to use, amusing, and not threatening. In addition, social influence was perceived as powerful on robot adoption. Direct experience with the robot did not change the way the participants rated robots in their acceptance questionnaire. We identified several barriers to robot-acceptance, including older adults’ uneasiness with technology, feeling of stigmatization, and ethical/societal issues associated with robot use. Conclusion It is important to destigmatize images of assistive robots to facilitate their acceptance. Universal design aiming to increase the market for and production of products that are usable by everyone (to the greatest extent possible) might help to

  18. Development of a tool to describe overall health, social independence and activity limitation of adolescents and young adults with disability.

    PubMed

    Deroche, Chelsea B; Holland, Margaret M; McDermott, Suzanne; Royer, Julie A; Hardin, James W; Mann, Joshua R; Salzberg, Deborah; Ozturk, Orgul; Ouyang, Lijing

    2015-03-01

    There is a need for research that focuses on the correlation between self-perceived quality of life (QoL) and the health outcomes of adolescents with disability transitioning to adulthood. To better understand the transition experience of adolescents and young adults with disability, we developed a questionnaire to assess the impact of disability on QoL. We recruited 174 participants who were 15-24 years old and diagnosed with Fragile X syndrome (FXS), spina bifida (SB) or muscular dystrophy (MD) and conducted an exploratory factor analysis to identify factors that characterize QoL. Five factors emerged: emotional health, physical health, independence, activity limitation, and community participation. To validate the tool, we linked medical claims and other administrative data records and examined the association of the factor scores with health care utilization and found the questionnaire can be utilized among diverse groups of young people with disability.

  19. Development of a tool to describe overall health, social independence and activity limitation of adolescents and young adults with disability

    PubMed Central

    Deroche, Chelsea B.; Holland, Margaret M.; McDermott, Suzanne; Royer, Julie A.; Hardin, James W.; Mann, Joshua R.; Salzberg, Deborah; Ozturk, Orgul; Ouyang, Lijing

    2015-01-01

    There is a need for research that focuses on the correlation between self-perceived quality of life (QoL) and the health outcomes of adolescents with disability transitioning to adulthood. To better understand the transition experience of adolescents and young adults with disability, we developed a questionnaire to assess the impact of disability on QoL. We recruited 174 participants who were 15–24 years old and diagnosed with Fragile X syndrome (FXS), spina bifida (SB) or muscular dystrophy (MD) and conducted an exploratory factor analysis to identify factors that characterize QoL. Five factors emerged: emotional health, physical health, independence, activity limitation, and community participation. To validate the tool, we linked medical claims and other administrative data records and examined the association of the factor scores with health care utilization and found the questionnaire can be utilized among diverse groups of young people with disability. PMID:25577179

  20. Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse

    PubMed Central

    Rosen, Tony; Bloemen, Elizabeth M.; LoFaso, Veronica M.; Clark, Sunday; Flomenbaum, Neal; Lachs, Mark S.

    2015-01-01

    Background Elder abuse is under-recognized by Emergency Department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. Objective To describe patterns and circumstances surrounding elder abuse-related and potentially abuse-related injuries in ED patients independently known to be physical elder abuse victims. Methods ED utilization of community-dwelling victims of physical elder abuse in New Haven, CT from 1981-1994 was analyzed previously. Cases were identified using Elderly Protective Services data matched to ED records. 66 ED visits were judged to have high probability of being related to elder abuse and 244 of indeterminate probability. We re-examined these visits to assess whether they occurred due to injury. We identified and analyzed in detail 31 injury-associated ED visits from 26 patients with high probability of being related to elder abuse and 108 visits from 57 patients with intermediate probability and accidental injury. Results Abuse-related injuries were most common on upper extremities (45% of visits) and lower extremities (32%), with injuries on head or neck noted in 13 visits (42%). Bruising was observed in 39% of visits, most commonly on upper extremities. 42% of purportedly accidental injuries had suspicious characteristics, with the most common suspicious circumstance being injury occurring >1 day prior to presentation and the most common suspicious injury pattern being maxillofacial injuries. Conclusion Victims of physical elder abuse commonly have injuries on upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries. PMID:26810019

  1. Sustained satiety induced by food foams is independent of energy content, in healthy adults.

    PubMed

    Blom, Wendy A M; Koppenol, Wieneke P; Schuring, Ewoud A H; Abrahamse, Salomon L; Arnaudov, Luben N; Mela, David J; Stoyanov, Simeon D

    2016-02-01

    Our previous research demonstrated high, sustained satiety effects of stabilized food foams relative to their non-aerated compositions. Here we test if the energy and macronutrients in a stabilized food foam are critical for its previously demonstrated satiating effects. In a randomized, crossover design, 72 healthy subjects consumed 400 mL of each of four foams, one per week over four weeks, 150 min after a standardized breakfast. Appetite ratings were collected for 180 min post-foam. The reference was a normal energy food foam (NEF1, 280 kJ/400 mL) similar to that used in our previous research. This was compared to a very low energy food foam (VLEF, 36 kJ/400 mL) and 2 alternative normal energy foams (NEF2 and NEF3) testing possible effects of compositional differences other than energy (i.e. emulsifier and carbohydrate source). Appetite ratings were quantified as area under the curve (AUC) and time to return to baseline (TTRTB). Equivalence to NEF1 was predefined as the 90% confidence interval of between-treatment differences in AUC being within -5 to +5 mm/min. All treatments similarly affected appetite ratings, with mean AUC for fullness ranging between 49.1 and 52.4 mm/min. VLEF met the statistical criterion for equivalence to NEF1 for all appetite AUC ratings, but NEF2 and NEF3 did not. For all foams the TTRTB for satiety and fullness were consistently between 150 and 180 min, though values were shortest for NEF2 and especially NEF3 foams for most appetite scales. In conclusion, the high, sustained satiating effects of these food foams are independent of energy and macronutrient content at the volumes tested.

  2. Maternal Age at Holocaust Exposure and Maternal PTSD Independently Influence Urinary Cortisol Levels in Adult Offspring

    PubMed Central

    Bader, Heather N.; Bierer, Linda M.; Lehrner, Amy; Makotkine, Iouri; Daskalakis, Nikolaos P.; Yehuda, Rachel

    2014-01-01

    Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal posttraumatic stress disorder (PTSD) appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: Ninety-five Holocaust offspring and Jewish comparison subjects received diagnostic and psychological evaluations, and 24 h urinary cortisol was assayed by RIA. Offspring completed the parental PTSD questionnaire to assess maternal PTSD status. Maternal Holocaust exposure was identified as having occurred in childhood, adolescence, or adulthood and examined in relation to offspring psychobiology. Results: Urinary cortisol levels did not differ for Holocaust offspring and comparison subjects but differed significantly in offspring based on maternal age of exposure and maternal PTSD status. Increased maternal age of exposure and maternal PTSD were each associated with lower urinary cortisol in offspring, but did not exhibit a significant interaction. In addition, offspring PTSD-associated symptom severity increased with maternal age at exposure and PTSD diagnosis. A regression analysis of correlates of offspring cortisol indicated that both maternal age of exposure and maternal PTSD were significant predictors of lower offspring urinary cortisol, whereas childhood adversity and offspring PTSD symptoms were not. Conclusion: Offspring low cortisol and PTSD-associated symptom expression are related to maternal age of exposure, with the greatest effects associated with increased age at exposure. These effects are relatively independent of the negative consequences of being raised by a trauma survivor. These observations highlight the importance of maternal age of exposure in determining a psychobiology in offspring that is consistent with increased

  3. Older adults' experiences of living with cleft lip and palate: a qualitative study exploring aging and appearance.

    PubMed

    Hamlet, Claire; Harcourt, Diana

    2015-03-01

    Objective : To explore older adults' experiences of living with cleft lip and/or palate (CL/P), focusing on aging and appearance. Design : An exploratory-descriptive qualitative study. Participants : Individual semi-structured interviews (five via telephone, one face-to-face) conducted with six adults between the ages of 57 and 82 years. Results : Interview transcripts were analyzed using interpretative phenomenological analysis, which resulted in five themes: cleft across the life span, keeping up appearances, being one of a kind, resilience and protection, and cleft in an ever-changing society. A CL/P had an ongoing impact on participants' lives, although its relevance shifted over time and some aspects of life (e.g., romantic relationships, decisions about having children of their own) were particularly affected. Participants seemed at ease living with CL/P as an older adult and considered it an important aspect of their identity, yet they still described feeling isolated at times and had little contact with other people with a cleft. They felt that health care could be more considerate to the needs of older people with a cleft, particularly around dentistry and information provision. Participants thought societal attitudes toward visible differences had changed over the years, but not necessarily for the better. A paradox was evident between reports of being noticed by others because of their cleft and simultaneously feeling invisible or ignored because of their age. Conclusions : These findings have implications for provision of care for older adults with a CL/P and for younger people with a CL/P who will be the older generation of the future.

  4. The Social and Recreational Characteristics of Adults with Intellectual Disability and Pica Living in Institutions

    ERIC Educational Resources Information Center

    Ashworth, Melody; Hirdes, John P.; Martin, Lynn

    2009-01-01

    This paper reports on the social life of adults with intellectual disability (ID) who engage in pica behaviour (i.e., ingestion of non-food items). Secondary analyses were conducted on the population of adults residing in Ontario's three remaining specialized institutions for persons with ID (N = 1008); 220 individuals (21.8%) had pica. All…

  5. Private Lives/Public Spaces: Homeless Adults on the Streets of New York City.

    ERIC Educational Resources Information Center

    Baxter, Ellen; Hopper, Kim

    This paper reports the findings of a study which examined the problems of homeless adults in New York City. The goals of the study were twofold: (1) to document and analyze the life circumstances of homeless adults in New York City who are dependent upon the public sector for their sustenance; and (2) to develop explicit standards for the…

  6. The Lived Experience of Older Adult Learners in Community College: A Phenomenological Study

    ERIC Educational Resources Information Center

    Vermiller, Miriam M.

    2014-01-01

    This study investigated the experience of nine older adult students over 50 years old as they matriculated in the traditional multigenerational classroom at a community college in Central Florida. The college chosen for the study primarily serves traditional students and dual enrollees, but more and more, older adult students are enrolling while…

  7. Living independently as an ethnic minority elder: a relational perspective on the issues of aging and ethnic minorities.

    PubMed

    Shin, Jung-Hye

    2014-06-01

    This study examines the residential experiences of Korean ethnic elders in affordable housing in the greater Chicago area, focusing on how patterns of social relationships that evolved around a geographical location and its urban infrastructure enabled the elders to achieve their desire for residential independence. Based on the theoretical concept of activity settings and social capital, the study suggests an integrated theoretical model where social capital is understood as an embedded asset of an activity setting. Methodologically, this study uses a combined method of qualitative interviews with 138 Korean elders in affordable housing in the greater Chicago area and a geographic analysis of their social relationships in order to present associations among social relationships, urban infrastructures, and the shared value of independence within their residential communities. The study findings indicate that the elders mobilized ethnic businesses, urban infrastructures, and the collective efficacy of groups to achieve the shared goal of maintaining residential independence. In each community, a cultural broker acted as an important bridge between the community of ethnic minorities and the larger social networks coexisting within the community boundary. The relational perspective as a potent ground for understanding and further solving the issues of aging and ethnicity is highlighted.

  8. Pharmacogenetic polymorphism as an independent risk factor for frequent hospitalizations in older adults with polypharmacy: a pilot study

    PubMed Central

    Finkelstein, Joseph; Friedman, Carol; Hripcsak, George; Cabrera, Manuel

    2016-01-01

    metabolizer, VKORC1 low sensitivity, and CYP2D6 rapid metabolizer status in cases was 67%, 33%, 33%, and 17%, respectively, which significantly exceeded respective prevalence in general population. The mean number of major gene–drug interactions found in cases was 2.8±2.2, whereas no major drug–gene interactions were identified in controls. The difference in the number of major drug–gene interactions between cases and controls was statistically significant (p<0.05). The pilot data supported the hypothesis that pharmacogenetic polymorphism may represent an independent risk factor for frequent hospitalizations in older adults with polypharmacy. Due to small sample size, the results of this proof-of-concept study cannot be conclusive. Further work on the utility of pharmacogenetic testing for optimization of medication regimens in this vulnerable group of older adults is warranted. PMID:27789970

  9. Attachment style and coping in relation to posttraumatic stress disorder symptoms among adults living with HIV/AIDS.

    PubMed

    Gore-Felton, Cheryl; Ginzburg, Karni; Chartier, Maggie; Gardner, William; Agnew-Blais, Jessica; McGarvey, Elizabeth; Weiss, Elizabeth; Koopman, Cheryl

    2013-02-01

    Research indicates that a significant proportion of people living with HIV/AIDS report symptoms of posttraumatic stress disorder (PTSD). Moreover, attachment style has been associated with psychological and behavioral outcomes among persons living with HIV/AIDS. Attachment style may influence the ability to cope with traumatic stress and affect PTSD symptoms. To examine the association between attachment style and coping with PTSD symptoms, we assessed 94 HIV-positive adults on self-report measures of posttraumatic stress, coping, and attachment style. In multiple regression analysis, avoidant attachment and emotion-focused coping were positively and significantly associated with greater PTSD symptomatology. Support was also found for the moderating effects of avoidant and insecure attachment styles on emotion-focused coping in relation to greater PTSD symptoms. Taken altogether, these results suggest that interventions that develop adaptive coping skills and focus on the underlying construct of attachment may be particularly effective in reducing trauma-related symptoms in adults living with HIV/AIDS.

  10. Sexing Live Pupae and Adults of Two Wax Blooming Beetles, Colposcelis microderoides microderoides and Anatolica polita borealis

    PubMed Central

    Wang, Yan; Zhang, Fuchun; Ma, Ji

    2013-01-01

    The wax blooming beetles Colposcelis microderoides microderoides Reitter and Anatolica polita borealis Kaszab (Coleoptera: Tenebrionidae) are small, flightless beetles living in the Guerbantonggut desert in the northwestern region of China. These beetles were recently found to have wax blooms, and their short life cycle and ease of rearing under laboratory conditions make them excellent models for advanced studies on desert adaptation. To date, dissection has been used for sex identification in these species, whereas a nondestructive method is needed for further studies on sexual dimorphism. Microscopic examinations of pupae and adults revealed distinct differences between the sexes in the 8th abdominal sternites, including the presence of a setose cleft in adult males that is not visible in females, in which the 8th sternite forms a single semicircular plate. The female pupae have a pair of tan papillae and a tan genital orifice, which are absent on the male 8th sternite. These two sexual characteristics can be used to sex live adults and pupae. These methods are simple, nondestructive, 100% accurate, and useful for sex differentiation of dead beetles and some other tenebrionid species (including some pests) in both the field and the laboratory. PMID:24766472

  11. Neurophysiology of spontaneous facial expressions: I. Motor control of the upper and lower face is behaviorally independent in adults.

    PubMed

    Ross, Elliott D; Gupta, Smita S; Adnan, Asif M; Holden, Thomas L; Havlicek, Joseph; Radhakrishnan, Sridhar

    2016-03-01

    Facial expressions are described traditionally as monolithic entities. However, humans have the capacity to produce facial blends, in which the upper and lower face simultaneously display different emotional expressions. This, in turn, has led to the Component Theory of facial expressions. Recent neuroanatomical studies in monkeys have demonstrated that there are separate cortical motor areas for controlling the upper and lower face that, presumably, also occur in humans. The lower face is represented on the posterior ventrolateral surface of the frontal lobes in the primary motor and premotor cortices and the upper face is represented on the medial surface of the posterior frontal lobes in the supplementary motor and anterior cingulate cortices. Our laboratory has been engaged in a series of studies exploring the perception and production of facial blends. Using high-speed videography, we began measuring the temporal aspects of facial expressions to develop a more complete understanding of the neurophysiology underlying facial expressions and facial blends. The goal of the research presented here was to determine if spontaneous facial expressions in adults are predominantly monolithic or exhibit independent motor control of the upper and lower face. We found that spontaneous facial expressions are very complex and that the motor control of the upper and lower face is overwhelmingly independent, thus robustly supporting the Component Theory of facial expressions. Seemingly monolithic expressions, be they full facial or facial blends, are most likely the result of a timing coincident rather than a synchronous coordination between the ventrolateral and medial cortical motor areas responsible for controlling the lower and upper face, respectively. In addition, we found evidence that the right and left face may also exhibit independent motor control, thus supporting the concept that spontaneous facial expressions are organized predominantly across the horizontal facial

  12. Shallow Encoding and Forgetting Are Associated with Dependence in Instrumental Activities of Daily Living Among Older Adults Living with HIV Infection

    PubMed Central

    Fazeli, Pariya L.; Doyle, Katie L.; Scott, J. Cobb; Iudicello, Jennifer E.; Casaletto, Kaitlin B.; Weber, Erica; Moore, David J.; Morgan, Erin E.; Grant, Igor; Woods, Steven Paul; Hampton Atkinson, J.; Ellis, Ronald J.; Allen McCutchan, J.; Marcotte, Thomas D.; Marquie-Beck, Jennifer; Sherman, Melanie; Ellis, Ronald J.; Allen McCutchan, J.; Letendre, Scott; Capparelli, Edmund; Schrier, Rachel; Rosario, Debra; LeBlanc, Shannon; Heaton, Robert K.; Woods, Steven Paul; Cherner, Mariana; Moore, David J.; Morgan, Erin E.; Dawson, Matthew; Jernigan, Terry; Fennema-Notestine, Christine; Archibald, Sarah L.; Hesselink, John; Annese, Jacopo; Taylor, Michael J.; Masliah, Eliezer; Achim, Cristian; Everall, Ian; Richman, Douglas; Smith, David M.; Allen McCutchan, J.; Achim, Cristian; Lipton, Stuart; Hampton Atkinson, J.; Gamst, Anthony C.; Cushman, Clint; Abramson, Ian; Vaida, Florin; Deutsch, Reena; Umlauf, Anya

    2014-01-01

    Aging and HIV are both risk factors for memory deficits and declines in real-world functioning. However, we know little about the profile of memory deficits driving instrumental activities of daily living (IADL) declines across the lifespan in HIV. This study examined 145 younger (<50 years) and 119 older (≥50 years) adults with HIV who completed the California Verbal Learning Test-Second Edition (CVLT-II), the Wechsler Memory Scale-Third Edition Logical Memory subtest (WMS-III LM), and a modified Lawton and Brody ADL questionnaire. No memory predictors of IADL dependence emerged in the younger cohort. In the older group, IADL dependence was uniquely associated with worse performance on all primary CVLT-II variables, as well as elevated recency effects. Poorer immediate and delayed recall of the WMS-III LM was also associated with IADL dependence, although recognition was intact. Findings suggest older HIV-infected adults with shallow encoding and forgetting are at risk for IADL dependence. PMID:24695591

  13. Shallow encoding and forgetting are associated with dependence in instrumental activities of daily living among older adults living with HIV infection.

    PubMed

    Fazeli, Pariya L; Doyle, Katie L; Scott, J Cobb; Iudicello, Jennifer E; Casaletto, Kaitlin B; Weber, Erica; Moore, David J; Morgan, Erin E; Grant, Igor; Woods, Steven Paul

    2014-05-01

    Aging and HIV are both risk factors for memory deficits and declines in real-world functioning. However, we know little about the profile of memory deficits driving instrumental activities of daily living (IADL) declines across the lifespan in HIV. This study examined 145 younger (<50 years) and 119 older (≥50 years) adults with HIV who completed the California Verbal Learning Test-Second Edition (CVLT-II), the Wechsler Memory Scale-Third Edition Logical Memory subtest (WMS-III LM), and a modified Lawton and Brody ADL questionnaire. No memory predictors of IADL dependence emerged in the younger cohort. In the older group, IADL dependence was uniquely associated with worse performance on all primary CVLT-II variables, as well as elevated recency effects. Poorer immediate and delayed recall of the WMS-III LM was also associated with IADL dependence, although recognition was intact. Findings suggest older HIV-infected adults with shallow encoding and forgetting are at risk for IADL dependence.

  14. Safety and immunogenicity of a rederived, live-attenuated dengue virus vaccine in healthy adults living in Thailand: a randomized trial.

    PubMed

    Watanaveeradej, Veerachai; Gibbons, Robert V; Simasathien, Sriluck; Nisalak, Ananda; Jarman, Richard G; Kerdpanich, Angkool; Tournay, Elodie; De La Barrerra, Rafael; Dessy, Francis; Toussaint, Jean-François; Eckels, Kenneth H; Thomas, Stephen J; Innis, Bruce L

    2014-07-01

    Safety and immunogenicity of two formulations of a live-attenuated tetravalent dengue virus (TDEN) vaccine produced using rederived master seeds from a precursor vaccine were tested against a placebo control in a phase II, randomized, double blind trial (NCT00370682). Two doses were administered 6 months apart to 120 healthy, predominantly flavivirus-primed adults (87.5% and 97.5% in the two vaccine groups and 92.5% in the placebo group). Symptoms and signs reported after vaccination were mild to moderate and transient. There were no vaccine-related serious adverse events or dengue cases reported. Asymptomatic, low-level viremia (dengue virus type 2 [DENV-2], DENV-3, or DENV-4) was detected in 5 of 80 vaccine recipients. One placebo recipient developed a subclinical natural DENV-1 infection. All flavivirus-unprimed subjects and at least 97.1% of flavivirus-primed subjects were seropositive to antibodies against all four DENV types 1 and 3 months post-TDEN dose 2. The TDEN vaccine was immunogenic with an acceptable safety profile in flavivirus-primed adults.

  15. Metropolitan Social Environments and Pre-HAART/HAART Era Changes in Mortality Rates (per 10,000 Adult Residents) among Injection Drug Users Living with AIDS

    PubMed Central

    Friedman, Samuel R.; West, Brooke S.; Pouget, Enrique R.; Hall, H. Irene; Cantrell, Jennifer; Tempalski, Barbara; Chatterjee, Sudip; Hu, Xiaohong; Cooper, Hannah L. F.; Galea, Sandro; Des Jarlais, Don C.

    2013-01-01

    Background Among the largest US metropolitan areas, trends in mortality rates for injection drug users (IDUs) with AIDS vary substantially. Ecosocial, risk environment and dialectical theories suggest many metropolitan areas characteristics that might drive this variation. We assess metropolitan area characteristics associated with decline in mortality rates among IDUs living with AIDS (per 10,000 adult MSA residents) after highly active antiretroviral therapy (HAART) was developed. Methods This is an ecological cohort study of 86 large US metropolitan areas from 1993–2006. The proportional rate of decline in mortality among IDUs diagnosed with AIDS (as a proportion of adult residents) from 1993–1995 to 2004–2006 was the outcome of interest. This rate of decline was modeled as a function of MSA-level variables suggested by ecosocial, risk environment and dialectical theories. In multiple regression analyses, we used 1993–1995 mortality rates to (partially) control for pre-HAART epidemic history and study how other independent variables affected the outcomes. Results In multivariable models, pre-HAART to HAART era increases in ‘hard drug’ arrest rates and higher pre-HAART income inequality were associated with lower relative declines in mortality rates. Pre-HAART per capita health expenditure and drug abuse treatment rates, and pre- to HAART-era increases in HIV counseling and testing rates, were weakly associated with greater decline in AIDS mortality. Conclusions Mortality among IDUs living with AIDS might be decreased by reducing metropolitan income inequality, increasing public health expenditures, and perhaps increasing drug abuse treatment and HIV testing services. Given prior evidence that drug-related arrest rates are associated with higher HIV prevalence rates among IDUs and do not seem to decrease IDU population prevalence, changes in laws and policing practices to reduce such arrests while still protecting public order should be considered

  16. Executive function is independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke: implications for falls prevention

    PubMed Central

    Liu-Ambrose, Teresa; Pang, Marco; Eng, Janice J

    2015-01-01

    Background Stroke survivors have a high incidence of falls. Impaired executive-controlled processes are frequent in stroke survivors and are associated with falls in this population. Better understanding of the independent association between executive-controlled processes and physiological fall risk (i.e. performances of balance and mobility) could enhance future interventions that aim to prevent falls and to promote an independent lifestyle among stroke survivors. Methods Cross-sectional analysis of 63 adults who suffered a mild stroke >1 year prior to the study, aged > or =50 years. Results Cognitive flexibility was independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke, after accounting for age, quadriceps strength of the paretic side and current physical activity level. Conclusions Clinicians may need to consider cognitive function when assessing and treating impaired balance and mobility in community-dwelling older adults after mild stroke. PMID:17143004

  17. Review of the Literature: A Rural-Urban Comparison of Social Networks of Older Adults Living With HIV.

    PubMed

    Gannon, Brittany N; Stacciarini, Jeanne-Marie R

    2016-01-01

    Globally, aging populations and older persons living with HIV (OPLWH) are emerging socioeconomic and health care concerns. Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwelling OPLWH. The purpose of this integrative literature review was to compare emerging themes in the social network components of rural versus urban-dwelling OPLWH and network benefits and barriers. Overarching themes include: limited and/or fragile networks, social inclusion versus social isolation, social capital, and health outcomes. Results demonstrate an overall lack of rural-focused research on OPLWH and a universal lack of informal and formal networks due to isolation, lack of health care services, and omnipresent HIV stigma.

  18. Frequency of independent origins of viviparity among caecilians (Gymnophiona): evidence from the first 'live-bearing' Asian amphibian.

    PubMed

    Gower, D J; Giri, V; Dharne, M S; Shouche, Y S

    2008-09-01

    Viviparity is reported for Gegeneophis seshachari (Gymnophiona: Caeciliidae) from a gravid female containing four oviductal foetuses. The oviducts are highly vascularized and contain patches of thickened, layered tissue similar to foetal gut contents. Gegeneophis seshachari probably resemble other viviparous caecilians in having foetuses that ingest thickened oviduct lining using specialized deciduous teeth. This is the first report of viviparity in Asian amphibians and Indo-Seychellean caeciliids. Gegeneophis is the only caecilian genus known to include oviparous and viviparous species, and G. seshachari is the smallest known viviparous caecilian. Phylogenetic analysis of mitochondrial DNA sequences supports assignment of G. seshachari to a monophyletic Gegeneophis. Character optimization indicates that viviparity has evolved independently at least four times within Gymnophiona--a rate of incidence relative to the number of extant species that is higher than for other vertebrate groups except squamate reptiles. Our findings strengthen the proposal that caecilian reproduction demands further attention.

  19. Patterns and Predictors of Sexual Function After Liver Donation: the Adult to Adult Living Donor Liver Transplantation Cohort Study (A2ALL)

    PubMed Central

    DiMartini, AF.; Dew, MA.; Butt, Z.; Simpson, MA.; Ladner, DP.; Smith, AR.; Hill-Callahan, P.; Gillespie, BW.

    2015-01-01

    Although sexual functioning is an important facet of living donor quality of life, it has not received extensive evaluation in this population. Using data from the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, we examined donor sexual functioning across the donation process from the predonation evaluation to 3 months and 1 year postdonation. Donors (n=208) and a comparison group of non-donors (n=155) completed self-reported surveys with specific questions on sexual desire, satisfaction, orgasm, and (for men) erectile function. Across the three time points, donor sexual functioning was lower at the evaluation phase and 3 months postdonation than at one year postdonation. In the early recovery period, abdominal pain was associated with difficulty reaching orgasm (OR = 3.98, 95% CI 1.30–12.16), concerns over appearance with lower sexual desire (OR = 4.14, 95% CI 1.02–16.79), and not feeling back to normal was associated with dissatisfaction with sexual life (OR 3.58, 95% CI 1.43–8.99). Efforts to educate donors before the surgery and prepare them for the early recovery phase may improve recovery and reduce distress regarding sexual functioning. PMID:25779554

  20. [Integration in the workforce of Québec of adults living with Autism Spectrum Disorder or Asperger Syndrome].

    PubMed

    Sénéchal, Carole; Fontaine, Caroline; Larivée, Serge; Legault, Frédéric

    2011-01-01

    This article presents an exploratory study evaluating the impact of the program Employment Pact: Québec in full force (2008) aimed at the integration in the workforce of adults living with Autism Spectrum Disorder (ASD) or Asperger Syndrome (AS). This program is implemented in different regions in Québec. The evaluation takes into consideration working conditions, integration procedures, as well as receptivity of eventual employers. Results demonstrate that the working conditions for these individuals are relatively similar, however, the type and number of services offered, as well as the training of service agents vary from one centre to another.

  1. Exploring the use of social network analysis to measure social integration among older adults in assisted living.

    PubMed

    Abbott, Katherine M; Bettger, Janet Prvu; Hampton, Keith; Kohler, Hans-Peter

    2012-01-01

    Social integration is measured by a variety of social network indicators each with limitations in its ability to produce a complete picture of the variety and scope of interactions of older adults receiving long-term services and supports. The purpose of this study was to develop and evaluate the feasibility of collecting sociocentric (whole network) data among older adults in one assisted living neighborhood. The sociocentric approach is required to conduct social network analysis. Applying social network analysis is an innovative way to measure different facets of social integration among residents. Sociocentric data are presented for 12 residents. Network visualization or sociograms are used to illustrate the level of social integration among residents and between residents and staff. Measures of network centrality are reported to illustrate the number of personal connections and cohesion. The use of resident photographs helped residents with cognitive impairment to nominate individuals with whom they interacted. The sociocentric approach to data collection is feasible and allows researchers to measure levels and different aspects of social integration in assisted living environments. Residents with mild to moderate cognitive impairment were able to participate with the aid of resident and staff photographs. This approach is sensitive to capturing routine day-to-day interactions between residents and assisted living staff members that are often not reported in person-centered networks. This study contributes to the foundation for larger more representative studies of entire assisted living organizations that could in the future inform interventions aimed at improving social integration and cohesion among recipients of long-term services and supports.

  2. Strategic breakthrough in adult ABO-incompatible living donor liver transplantation: preliminary results of consecutive seven cases.

    PubMed

    Soejima, Yuji; Muto, Jyun; Matono, Rumi; Ninomiya, Mizuki; Ikeda, Tetsuo; Yoshizumi, Tomoharu; Uchiyama, Hideaki; Ikegami, Toru; Shirabe, Ken; Maehara, Yoshihiko

    2013-01-01

    ABO-incompatibility is a major obstacle to expanding exiguous donor pools in adult liver transplantation, especially in countries where grafts from deceased donors are uncommon. We present our preliminary results of ABO-incompatible (ABO-I) adult living donor liver transplantation (LDLT) using a new, simple protocol. Seven consecutive cases of ABO-I LDLT were managed by the same protocol including pre-operative administration of a single dose of rituximab (375 mg/m(2) ) followed by three to five sessions of plasma exchange before LDLT without portal infusion therapy. The triple immunosuppression protocol consisted of tacrolimus, mycophenolate mofetil and steroids, with mycophenolate mofetil starting seven d before LDLT. Splenectomy was performed for all cases. All patients are alive (100% survival) with a mean follow-up of 852 d (715-990 d). Neither antibody-mediated nor hyperacute rejection were encountered. There was only one episode of mild acute cellular rejection, for which steroid augmentation was effective. The median preformed isoagglutinin antibody titer before plasma exchange was 256, while the median antibody titer immediately before LDLT was 16. In conclusion, adult ABO-I LDLT results were excellent - comparable or even superior to those of ABO-compatible LDLT. ABO-I adult LDLT has now become a more applicable modality without the need for an appropriate donor.

  3. Depressive and conduct disorder symptoms in youth living with HIV: the independent and interactive roles of coping and neuropsychological functioning.

    PubMed

    Salama, Christina; Morris, Mary; Armistead, Lisa; Koenig, Linda J; Demas, Penelope; Ferdon, Corinne; Bachanas, Pamela

    2013-01-01

    Emerging research suggests the importance of psychosocial characteristics (e.g., coping and social support) for positive adaptation among youth with behaviorally acquired HIV. However, little is known about how these traits interact with cognitive abilities to impact emotional and behavioral adjustment. This study examined whether coping skills and executive functioning interact in their association with psychological adjustment in HIV-positive youth. Data from Project Adolescents Living with HIV/AIDS (ALPHA), a study to examine psychosocial, behavioral and neuropsychological functioning of youth with behaviorally acquired HIV, were used. Fifty-nine participants, aged 14-23, diagnosed with HIV prior to age 20 and receiving care in one of two HIV clinics in Atlanta or New York City, were recruited, consented and enrolled. Participants completed measures of depressive symptoms (Beck Depression Inventory), conduct disorder (Adolescent Symptom Index), and use of positive and negative coping strategies (Kidcope). The Wisconsin Card Sorting Test (WCST) assessed abstract reasoning (categories completed) and cognitive inflexibility (perseverative errors). In this sample of HIV-positive youth, depressive symptoms were best predicted by an interactive combination of negative coping skills and poor neuropsychological functioning. Neuropsychological functioning (cognitive inflexibility) and negative coping skills were directly associated with conduct disorder symptoms. Results highlight the importance of including neuropsychological assessment in the evaluation of HIV-positive youth, particularly those with emotional or behavioral problems.

  4. Age, gender, and living circumstances: discriminating older adults on death anxiety.

    PubMed

    Madnawat, A V Singh; Kachhawa, P Singh

    2007-09-01

    The present study examines the effect of age, gender, and living circumstances on elderly persons' death anxiety. For this purpose, 299 persons attending public parks (average age = 70 years) were interviewed using the Death Anxiety Survey Schedule, which is a set of 10 questions related to death anxiety from an Indian perspective. Women, those relatively older, and those living with family were significantly more anxious about the word death. The gender and age results in this Indian sample are similar to that in some western samples. The results that those living with family have significantly higher death anxiety are not in agreement with past western studies and may reflect cultural differences in anxiety about death.

  5. Trends in activities of daily living disability in a large sample of community-dwelling Chinese older adults in Hong Kong: an age-period-cohort analysis

    PubMed Central

    Yu, Ruby; Wong, Moses; Chang, Billy; Lai, Xin; Lum, C M; Auyeung, T W; Lee, Jenny; Tsoi, Kelvin; Lee, Ruby; Woo, Jean

    2016-01-01

    Background To examine the trends in activities of daily living (ADL) disability in older Chinese adults in Hong Kong between 2001 and 2012. Methods Using data from the Elderly Health Centres (EHCs) of the Department of Health comprising a total of 54 808 community-dwelling Chinese adults aged ≥65 years in 1 early cohort (1904–1917) and 10 3-year birth cohorts (1918–1920, 1921–1923, 1924–1926, 1927–1929, 1930–1932, 1933–1935, 1936–1938, 1939–1941, 1942–1944, 1945–1947), we examined trends in ADL disability by using age-period-cohort (APC) models. ADL disability was defined as being unable to perform at least 1 of 7 ADL activities (bathing, dressing, toileting, transferring, feeding, grooming, walking) independently. Cross-classified random-effects logistic regressions were performed for each of the APC trends with adjustment for age, period, cohort, sociodemographic, lifestyle, comorbidity and self-rated health. Results The mean age of the cohort was 70.9±4.7 (range 65–99) years. The prevalence rate of ADL disability was 1.6%. ADL disability increased with age (p<0.001) and the gradient of the increase was steeper in the older age groups. At the same age, women (1.7%) were more likely to report ADL disability than men (1.4%, p=0.001). For both genders, there was an increase in ADL disability between 2003 and 2012; adjustment for age, cohort and other covariates has diminished the trends observed among men. There was no cohort effect in ADL disability. Conclusions ADL disability in older adults has increased over the last decade. Further study is required to identify possible causes behind the disability trends. PMID:27979837

  6. Adherence decision making in the everyday lives of emerging adults with type 1 diabetes

    PubMed Central

    Pyatak, Elizabeth A; Florindez, Daniella; Weigensberg, Marc J

    2013-01-01

    Purpose The purpose of this study was to explore motivations underlying nonadherent treatment decisions made by young adults with type 1 diabetes. Methods Eight emerging adults each completed a series of semi-structured interviews concerning their approaches to diabetes care, relationships with clinicians, and everyday activities and routines. A narrative thematic analysis was used to develop initial themes and refine them through continued data collection and review of the research literature. Results Five themes were identified as motivating nonadherence: (1) efforts to mislead health care providers, (2) adherence to alternative standards, (3) treatment fatigue and burnout, (4) social support problems, and (5) emotional and self-efficacy problems. Conclusion Instances of nonadherence generally involved a combination of the five identified themes. Participants reporting nonadherence also described difficulties communicating with care providers regarding their treatment. Nonjudgmental communication between providers and emerging adults may be particularly important in promoting positive health outcomes in this population. PMID:23935361

  7. Walk the Talk: Characterizing Mobility in Older Adults Living on Low Income.

    PubMed

    Chudyk, Anna M; Sims-Gould, Joanie; Ashe, Maureen C; Winters, Meghan; McKay, Heather A

    2017-04-03

    We provide an in-depth description of the mobility (capacity and enacted function, i.e., physical activity and travel behaviour) of community-dwelling older adults of low socioeconomic status. Participants [n = 161, mean age (range) = 74 (65-96) years] completed interviewer-administered questionnaires and objective measures of mobility. Our findings did not generally indicate that older adults of low socioeconomic status have a reduced capacity to be mobile. Participants presented with positive profiles across physical, psychosocial, and social environment domains that influence the capacity to be mobile. They also made a high proportion of trips by foot, although these did not together serve to meet physical activity guidelines for most. We challenge future researchers to focus on innovative strategies to recruit this difficult-to-access population, to consider the influence of socioeconomic status across the lifespan, and the role of behaviour-driven agency when investigating the association between the person, environment, and older adult mobility.

  8. The abilities of improved schizophrenia patients to work and live independently in the community: a 10-year long-term outcome study from Mumbai, India

    PubMed Central

    Srivastava, Amresh Kumar; Stitt, Larry; Thakar, Meghana; Shah, Nilesh; Chinnasamy, Gurusamy

    2009-01-01

    Background The outcome of first episode schizophrenia has several determinants. Socioecological factors, particularly living conditions, migration, community and culture, not only affect the level of risk but also the outcome. Mega cities around the world show a unique socioecological condition that has several challenges for mental health. The present study reports on the long-term status of patients with schizophrenia in such a mega city: Mumbai, India. Aim This study aims to reveal the long-term outcome of patients suffering from schizophrenia with special reference to clinical symptoms and social functioning. Methods The cohort for this study was drawn from a 10-year follow-up of first episode schizophrenia. Patients having completed 10 years of consistent treatment after first hospitalisation were assessed on psychopathological and recovery criteria. Clinical as well as social parameters of recovery were evaluated. Descriptive statistics with 95% confidence intervals are provided. Results Of 200 patients recruited at the beginning of this study, 122 patients (61%) were present in the city of Mumbai at the end of 10-year follow-up study period. Among 122 available patients, 101 patients (50.5%) were included in the assessment at the end of 10-year follow-up study period, 6 patients (3.0%) were excluded from the study due to changed diagnosis, and 15 patients (7.5%) were excluded due to admission into long-term care facilities. This indicates that 107 out of 122 available patients (87.7%) were living in the community with their families. Out of 101 (50.5%) patients assessed at the end of 10 years, 61 patients (30.5%) showed improved recovery on the Clinical Global Impression Scale, 40 patients (20%) revealed no improvement in the recovery, 43 patients (72.9%) were able to live independently, and 24 patients (40%) were able to find employment. Conclusion With 10 years of treatment, the recovery rate among schizophrenia patients in Mumbai was 30.5%. Among the

  9. Nutrition and Osteoporosis: Preliminary data of Campania Region of European PERsonalised ICT Supported Service for Independent Living and Active Ageing

    PubMed Central

    Vuolo, L.; Barrea, L.; Savanelli, MC; Savastano, S.; Rubino, M.; Scarano, E.; Soprano, M.; Illario, M.; Colao, A.; Di Somma, C.

    2015-01-01

    Background: Bone impairment and malnutrition are associated with significant disability and mortality. PERSSILAA is an European project developing health services to detect and prevent frailty in older adults by addressing cognitive, physical and nutritional. Methods: Subjects underwent anthropometric measurements, calcaneal quantitative ultrasound (QUS) scan and PREDIMED (PREvención con DIeta MEDiterránea) questionnaire. Aim: To investigate the association between adherence to the Mediterranean Diet (MD) and bone health. Results: 87 subjects (4 males and 83 females) 70.1±4.9 aged, were examined. Mean Body Mass Index (BMI) was 28.7±4.7(kg/m2): in particular 28 subjects (32.2%) resulted obese, 42 (48.3%) overweight, and only 17 (19.5%) with normal weight. Mean T score was −1.2±1.2: in particular 13 subjects (14.9%) resulted osteoporotic; 43 (49.5%) osteopenic; and 31 (35.6%) with normal bone mineral density. Regarding adherence to MD, 9 subjects (10.3%) were poorly adherent; 41 (47.2%) average adherent; 37 (42.5%) highly adherent. T-score was associated with PREDIMED score and osteoporotic subjects presented the lowest PREDIMED score (5.8±2.2). Conclusions: These preliminary data show a significant correlation between the adherence to the MD and bone health parameters. The association between MD and bone health highlights the potential beneficial effects of nutritional interventions promoting a Mediterranean food pattern, as safe adjuvant treatment in ageing. PMID:27042428

  10. The Effect of Autism Spectrum Disorders on Adaptive Independent Living Skills in Adults with Severe Intellectual Disability

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Dempsey, Timothy; Fodstad, Jill C.

    2009-01-01

    Autism Spectrum Disorders are a class of conditions categorized by communication problems, ritualistic behaviors, and deficits in social behaviors. While evidence supporting a genetic component of Autism Spectrum Disorders (ASDs) is strong, no specific genetic marker has been identified. Thus, professionals have had to utilize intelligence tests…

  11. Waging a Living: Career Development and Long-Term Employment Outcomes for Young Adults with Disabilities

    ERIC Educational Resources Information Center

    Lindstrom, Lauren; Doren, Bonnie; Miesch, Jennifer

    2011-01-01

    Youth with disabilities face many barriers in making the transition from high school to stable long-term employment. Researchers used case study methodology to examine the career development process and postschool employment outcomes for a sample of individuals with disabilities who were working in living wage occupations 7 to 10 years after…

  12. Developmental Plan Handbook for Community Skills Training (TACL, Training Adults for Community Living).

    ERIC Educational Resources Information Center

    Roth, Martin R.; Hermus, Gary P.

    Based on behavioral principles, the handbook is designed as both an assessment tool and curriculum guide for training community living skills to mentally retarded and developmentally disabled individuals. Behavioral Programing Scales are provided to record baseline data, where the client receives no assistance. These scales cover all program…

  13. Weight Survey on Adult Persons with Mental Retardation Living in the Community

    ERIC Educational Resources Information Center

    Hove, Oddbjorn

    2004-01-01

    Prevalence of underweight and obesity were investigated in 282 mentally retarded persons living on the West Coast of Norway. Data collected in this survey suggest that people with severe mental retardation were more likely to be underweight and people with mild mental retardation were more likely to be obese. Compared to persons of average…

  14. Comparison of Reports by Relatives and Staff on Living Conditions of Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Umb-Carlsson, Oie; Sonnander, Karin

    2006-01-01

    Proxies typically serve as information providers in studies of persons with intellectual disabilities. However, little is known about the concordance between different proxy categories and how proxy characteristics influence the information provided. We compared 89 pairs of relative and staff reports on the living conditions of persons with…

  15. Age, Gender, and Living Circumstances: Discriminating Older Adults on Death Anxiety

    ERIC Educational Resources Information Center

    Madnawat, A. V. Singh; Kachhawa, P. Singh

    2007-01-01

    The present study examines the effect of age, gender, and living circumstances on elderly persons' death anxiety. For this purpose, 299 persons attending public parks (average age = 70 years) were interviewed using the Death Anxiety Survey Schedule, which is a set of 10 questions related to death anxiety from an Indian perspective. Women, those…

  16. Recall of a Live and Personally Experienced Eyewitness Event by Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Maras, Katie L.; Memon, Amina; Lambrechts, Anna; Bowler, Dermot M.

    2013-01-01

    The aim of the present study was to (a) extend previous eyewitness research in autism spectrum disorder (ASD) using a live and personally experienced event; (b) examine whether witnesses with ASD demonstrate a facilitative effect in memory for self- over other-performed actions; (c) explore source monitoring abilities by witnesses with ASD in…

  17. Living with Ambiguity: Toward Culture Exploration in Adult Second-Language Classrooms.

    ERIC Educational Resources Information Center

    Ilieva, Roumiana

    2001-01-01

    Outlines an approach to cultural instruction in adult second language education called "culture exploration," which calls for the recognition of ambiguity embedded in cross-cultural encounters. Culture exploration consists of employing techniques of ethnographic participant observation in and outside the classroom and holding reflective,…

  18. Learning a Living: First Results of the Adult Literacy and Life Skills Survey

    ERIC Educational Resources Information Center

    OECD Publishing (NJ1), 2005

    2005-01-01

    The Adult Literacy and Life Skills Survey (ALL) is a large-scale co-operative effort undertaken by governments, national statistics agencies, research institutions and multi-lateral agencies. The development and management of the study were co-ordinated by Statistics Canada and the Educational Testing Service (ETS) in collaboration with the…

  19. The Unknown City: Lives of Poor and Working-Class Young Adults.

    ERIC Educational Resources Information Center

    Fine, Michelle; Weis, Lois

    The deeply fractured nature of U.S. society is examined, focusing on poor and working class people in cities. Based on data from 154 poor and working class young adults aged 23 to 35, the study reveals the ways in which this urban generation has suffered from social change. The following chapters are included: (1) "Voices of Hope and Despair:…

  20. Broadening the Conceptualization of Literacy in the Lives of Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Morgan, Michelle F.; Cuskelly, Monica; Moni, Karen B.

    2011-01-01

    Current pedagogical approaches recognize literacy as a social practice and yet school-based conceptualizations continue to dominate understandings of literacy learning of individuals with intellectual disability. Such understandings lead to local or everyday literacy practices being devalued and overlooked. Thus, for adults with intellectual…

  1. Prevalence of cardiovascular disease risk factors among older Puerto Rican adults living in Massachusetts

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There remains limited research on cardiovascular disease (CVD) risk factors in Puerto Rican adults. We compared lifestyle and CVD risk factors in Puerto Rican men and women with normal fasting glucose (NFG), impaired fasting glucose (IFG), or type 2 diabetes (T2D), and investigated achievement of Am...

  2. Lived Experiences of Adult Children Who Have a Parent Diagnosed with Parkinson's Disease

    ERIC Educational Resources Information Center

    Blanchard, Amy; Hodgson, Jennifer; Lamson, Angela; Dosser, David

    2009-01-01

    Little is known about the experience among adult children who have a parent with Parkinson's Disease (PD). The purpose of this study was to explore, appreciate, and describe their experiences using a phenomenological methodology. Narratives were collected from seven participants who have a parent diagnosed with PD and analyzed according to…

  3. Focus-Group Evaluation of Nutrition Education Displays by Hispanic Adults Who Live in the USA

    ERIC Educational Resources Information Center

    Chambers, Delores H.; Munoz, Alejandra M.

    2009-01-01

    Purpose: The purpose of this paper is to examine the acceptability and effectiveness of visual displays of nutrition educational information for low-income Hispanic adults in the USA and to determine whether this population have different perceptions of the same nutrition education displays or express different needs than low-income Caucasian…

  4. Living in the Feudalism of Adult Basic and Literacy Education: Can We Negotiate a Literacy Democracy?

    ERIC Educational Resources Information Center

    Quigley, B. Allan

    2001-01-01

    Adult basic and literacy education (ABLE) is governed by political processes that impede practice. New trends that may help move ABLE toward democracy include the Internet as a site of policy debates and advocacy and use of the findings of practitioner action research. (Contains 16 references.) (SK)

  5. Popular Culture, Public Pedagogy and Perspective Transformation: "The Avengers" and Adult Learning in Living Rooms

    ERIC Educational Resources Information Center

    Wright, Robin Redmon; Sandlin, Jennifer A.

    2009-01-01

    The purpose of this study was to investigate the impact of popular culture, especially prime-time television, on women viewers' identity development. More specifically, this study explores one television show, the 1962-1964 Cathy Gale episodes of "The Avengers," as a portal to adult learning. We explored how television, as a form of public…

  6. In focus: The everyday lives of families of adult individuals with epilepsy.

    PubMed

    Saada, Fahed; Wang, Zizhao Selina; Bautista, Ramon Edmundo D

    2015-09-01

    Epilepsy is a multifaceted chronic neurological disorder with diverse effects on a patient's psychosocial well-being. The impact on quality of life has been well documented, and many studies have addressed the detrimental influences epilepsy has on an individual. However, the emotional impact and the influence of the condition on family members have not been well studied. Furthermore, the majority of the studies on this topic have been confined to childhood epilepsy, and there is only scarce literature that discusses the effects on family members caring for adult patients. The purpose of this literature review was to examine the influence of adult epilepsy on the psychological and social well-being of individual family members. We explored the psychological and physical well-being, satisfaction with social circumstances, and perceived level of support in families of adult patients with intractable epilepsy. The paper also suggests best practices on how to improve the family's quality of life, as well as future directions for research. Superior medical care and a positive family support system are important conditions that can help adult individuals with epilepsy best deal with their condition.

  7. Adults Living with Type 2 Diabetes: Kept Personal Health Information Items as Expressions of Need

    ERIC Educational Resources Information Center

    Whetstone, Melinda

    2013-01-01

    This study investigated personal information behavior and information needs that 21 adults managing life with Type 2 diabetes identify explicitly and implicitly during discussions of item acquisition and use of health information items that are kept in their homes. Research drew upon a naturalistic lens, in that semi-structured interviews were…

  8. The Lived Experience of How Adult Nursing Students Blend Lifestyle Obligations with Nursing School Expectations

    ERIC Educational Resources Information Center

    Coutrier, Karen A.

    2011-01-01

    Many adult nursing students have lifestyle obligations that require integration with nursing school programs in order to graduate and fulfill their dreams of becoming a nurse. Fourteen participants shared their stories of how they were able to blend their lifestyles commitments with nursing school. Student interaction between lifestyle obligations…

  9. The Mental Health of British Adults with Intellectual Impairments Living in General Households

    ERIC Educational Resources Information Center

    Hatton, Chris; Emerson, Eric; Robertson, Janet; Baines, Susannah

    2017-01-01

    Background: People with intellectual disability or borderline intellectual functioning may have poorer mental health than their peers. The present authors sought to (i) estimate the risk of poorer mental health among British adults with and without intellectual impairments and (ii) estimate the extent to which any between-group differences in…

  10. Physical Activity Measurement by Accelerometry Among Older Malay Adults Living in Semi-Rural Areas-A Feasibility Study.

    PubMed

    Zainol Abidin, Nurdiana; Brown, Wendy J; Clark, Bronwyn; Muhamed, Ahmad Munir Che; Singh, Rabindarjeet

    2016-10-01

    We evaluated feasibility of physical activity measurement by accelerometry among older Malay adults living in semi-rural areas in Malaysia. Results showed that 95% of 146 participants (aged [SD] 67.6 [6.4] years) were compliant in wearing the accelerometer for at least five days. Fifteen participants were asked for re-wear the accelerometer because they did not have enough valid days during the first assessment. Participants wore the accelerometer an average of 15.3 hr in a 24-hr day, with 6.5 (1.2) valid wear days. No significant difference in valid wear day and time was found between men and women. Participants who are single provide more valid wear days compared with married participants (p < .05), and participants with higher levels of education provide longer periods of accelerometer wearing hours (p < .01). Eighty-seven percent of participants reported 'no issues' with wearing the meter. This study suggests that accelerometry is a feasible method to assess the physical activity level among older Malay adults living in semi-rural areas.

  11. Role of domiciliary and family carers in individualised nutrition support for older adults living in the community.

    PubMed

    Marshall, Skye; Agarwal, Ekta; Young, Adrienne; Isenring, Elizabeth

    2017-04-01

    Protein-energy malnutrition is common amongst people aged 65 years and older, has a multifactorial aetiology, and numerous negative outcomes. Domiciliary carers (non-clinical paid carers) and family carers (including family, friends and neighbours) are required to support the increasing demand for in-home assistance with activities of daily living due to the ageing population. This review provides insight into the role of both domiciliary and family carers in providing individualised nutrition support for older, community-dwelling adults with malnutrition. Four electronic databases were searched for intervention studies from database inception to December 2016. Both domiciliary and family carers are well placed to monitor the dietary intake and nutritional status of older adults; to assist with many food-related tasks such as the sourcing and preparation of meals, and assisting with feeding when necessary; and to act as a conduit between the care recipient and formal nutrition professionals such as dietitians. There is moderate evidence to support the role of domiciliary carers in implementing nutrition screening and referral pathways, and emerging evidence suggests they may have a role in malnutrition interventions when supported by health professionals. Moderate evidence also supports the engagement of family carers as part of the nutrition care team for older adults with malnutrition. Interventions such as group education, skill-development workshops and telehealth demonstrate promise and have significantly improved outcomes in older adults with dementia. Further interventional and translational research is required to demonstrate the efficacy of engaging with domiciliary and family carers of older adults in the general community.

  12. Serum γ-glutamyltransferase level is associated with periodontal disease independent of drinking habits in Japanese adults.

    PubMed

    Morita, Toyoko; Yamazaki, Yoji; Fujiharu, Chika; Ishii, Takanori; Seto, Misae; Nishinoue, Norihide; Sasaki, Yoshiyuki; Kawato, Takayuki; Motohashi, Masafumi; Maeno, Masao

    2014-10-31

    Background Non-alcoholic fatty liver disease is considered a hepatic manifestation of metabolic syndrome. Periodontal disease is a mild chronic inflammatory disease with systemic effects, and many studies have indicated an association between metabolic syndrome and periodontitis. In the present study, we investigated the relationship between periodontitis and liver biochemical parameters according to alcohol drinking habits through a cross-sectional study based on data from Japanese people in occupational settings. Material and Methods The subjects were 1510 employees (1218 males, 292 females, mean age 50.4 years) who underwent dental and medical checkups in 2012. Associations between the presence of periodontal pockets and serum levels of liver biochemical parameters were assessed. Results Alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) levels were higher in subjects with than without periodontal pockets. Multiple logistic regression analysis (adjusting for age, gender, cigarette smoking, and alcohol drinking habits, and components of metabolic syndrome) with GGT or ALT as the dependent variable revealed that there was a significant association between periodontal pockets and GGT (odds ratio, OR=1.48), but not ALT. Similar associations were observed when an analysis was performed according to the presence or absence of alcohol drinking habits; the OR was higher in subjects without (OR=1.84) than with drinking habits (OR=1.41). Conclusions The presence of periodontal pockets was associated with serum levels of GGT, a liver biochemical parameter, in Japanese adults with no drinking habit, suggesting that periodontal disease is associated with liver function, independent of alcohol ingestion.

  13. Associations between active living-oriented zoning and no adult leisure-time physical activity in the U.S.

    PubMed

    Leider, Julien; Chriqui, Jamie F; Thrun, Emily

    2017-02-01

    Nearly one-third of adults report no leisure-time physical activity (LTPA). Governmental and authoritative bodies recognize the role that community design through zoning code changes can play in enabling LTPA. This study examined the association between zoning and no adult LTPA in the U.S. This study was conducted between 2012 and 2016, with analyses occurring in 2015-2016. Zoning codes effective as of 2010 were compiled for jurisdictions located in the 495 most populous U.S. counties and were evaluated for pedestrian-oriented code reform zoning, 11 active living-oriented provisions (e.g., sidewalks, bike-pedestrian connectivity, mixed use, bike lanes) and a summated zoning scale (max=12). Individual-level LTPA data were obtained from the 2012 CDC Behavioral Risk Factor Surveillance System (BRFSS). County-aggregated, population-weighted zoning variables were constructed for linking to BRFSS. Log-log multivariate regressions (N=147,517 adults), controlling for individual and county characteristics and with robust standard errors clustered on county, were conducted to examine associations between zoning and no LTPA. Relative risks (RR) compared predicted lack of LTPA at 0% and 100% county-level population exposure to each zoning predictor. Zoning code reforms were associated with a 13% lower probability of no LTPA (RR: 0.87, 95% CI: 0.82-0.92). Except for crosswalks, all zoning provisions were associated with an 11-16% lower probability of no LTPA. Having all 12 zoning provisions was associated with a 22% lower probability of no LTPA (RR: 0.78, 95% CI: 0.72-0.83). The results suggest that active living-oriented zoning is a policy lever available to communities seeking to reduce rates of no LTPA.

  14. Living related liver transplantation in adults: first year experience at the University of Liège.

    PubMed

    Detry, O; De Roover, A; Delwaide, J; Coimbra, C; Kaba, A; Joris, J; Damas, P; Meurisse, M; Honoré, P

    2004-04-01

    Living related liver transplantation (LRLT) in adult recipients has been recently developed to overcome the organ donor shortage, but LRLT leaves the healthy donors at risk of serious post-operative complications, or even death. The aim of this paper is to report the prospective evaluation of the initial experience of adult LRLT at the University of Liège. From March 2002 till March 2003, in a consecutive series of 35 adult liver transplantations, five recipients (mean age: 51 years) underwent LRLT, including one retransplantation. Indications for transplantation were autoimmune hepatitis, hepatitis B virus related cirrhosis with hepatocarcinoma (two cases), hepatitis C virus related cirrhosis with hepatocarcinoma, and ischemic intrahepatic bile duct necrosis 10 years after primary liver transplantation. Mean age of the donors was 34 years (range: 21-53 years). All donation cases were intra familial at first degree. The right lobe was used as a graft in four cases and the left lobe in one case. All right lobe donors developed transient hyperbilirubinemia and hypocoagulation for 4 to 6 days. No severe complication (transfusion, bile duct fistula, reintervention, rehospitalization) nor significant long-term sequelae were observed in the donors. In the recipients, graft function was immediate, and there was no small-for-size syndrome. One recipient developed biliary fistula treated by reoperation. One recipient died from invasive aspergillosis 11 days after the procedure. The four other recipients were alive without recurrence of the disease at follow-up. This report confirmed that LRLT may be a valuable alternative to cadaveric liver transplantation in the era of organ donor shortage. However, even if there was no severe complication for the donors in our preliminary experience, LRLT puts healthy living donors at risk of significant morbidity and even death.

  15. A Phase II, Randomized, Safety and Immunogenicity Trial of a Re-Derived, Live-Attenuated Dengue Virus Vaccine in Healthy Children and Adults Living in Puerto Rico

    PubMed Central

    Bauer, Kristen; Esquilin, Ines O.; Cornier, Alberto Santiago; Thomas, Stephen J.; Quintero del Rio, Ana I.; Bertran-Pasarell, Jorge; Morales Ramirez, Javier O.; Diaz, Clemente; Carlo, Simon; Eckels, Kenneth H.; Tournay, Elodie; Toussaint, Jean-Francois; De La Barrera, Rafael; Fernandez, Stefan; Lyons, Arthur; Sun, Wellington; Innis, Bruce L.

    2015-01-01

    This was a double-blind, randomized, controlled, phase II clinical trial, two dose study of re-derived, live-attenuated, tetravalent dengue virus (TDEN) vaccine (two formulations) or placebo in subjects 1–50 years of age. Among the 636 subjects enrolled, 331 (52%) were primed, that is, baseline seropositive to at least one dengue virus (DENV) type. Baseline seropositivity prevalence increased with age (10% [< 2 years], 26% [2–4 years], 60% [5–20 years], and 93% [21–50 years]). Safety profiles of TDEN vaccines were similar to placebo regardless of priming status. No vaccine-related serious adverse events (SAEs) were reported. Among unprimed subjects, immunogenicity (geometric mean antibody titers [GMT] and seropositivity rates) for each DENV increased substantially in both TDEN vaccine groups with at least 74.6% seropositive for four DENV types. The TDEN vaccine candidate showed an acceptable safety and immunogenicity profile in children and adults ranging from 1 to 50 years of age, regardless of priming status. ClinicalTrials.gov: NCT00468858. PMID:26175027

  16. A Phase II, Randomized, Safety and Immunogenicity Trial of a Re-Derived, Live-Attenuated Dengue Virus Vaccine in Healthy Children and Adults Living in Puerto Rico.

    PubMed

    Bauer, Kristen; Esquilin, Ines O; Cornier, Alberto Santiago; Thomas, Stephen J; Quintero Del Rio, Ana I; Bertran-Pasarell, Jorge; Morales Ramirez, Javier O; Diaz, Clemente; Carlo, Simon; Eckels, Kenneth H; Tournay, Elodie; Toussaint, Jean-Francois; De La Barrera, Rafael; Fernandez, Stefan; Lyons, Arthur; Sun, Wellington; Innis, Bruce L

    2015-09-01

    This was a double-blind, randomized, controlled, phase II clinical trial, two dose study of re-derived, live-attenuated, tetravalent dengue virus (TDEN) vaccine (two formulations) or placebo in subjects 1-50 years of age. Among the 636 subjects enrolled, 331 (52%) were primed, that is, baseline seropositive to at least one dengue virus (DENV) type. Baseline seropositivity prevalence increased with age (10% [< 2 years], 26% [2-4 years], 60% [5-20 years], and 93% [21-50 years]). Safety profiles of TDEN vaccines were similar to placebo regardless of priming status. No vaccine-related serious adverse events (SAEs) were reported. Among unprimed subjects, immunogenicity (geometric mean antibody titers [GMT] and seropositivity rates) for each DENV increased substantially in both TDEN vaccine groups with at least 74.6% seropositive for four DENV types. The TDEN vaccine candidate showed an acceptable safety and immunogenicity profile in children and adults ranging from 1 to 50 years of age, regardless of priming status. ClinicalTrials.gov: NCT00468858.

  17. Evaluation of substitute diets for live algae in the captive maintenance of adult and subadult unionidae

    USGS Publications Warehouse

    Nichols, S. Jerrine; Garling, D.

    2002-01-01

    Ten nonlive algal diets were evaluated as potential broodstock diets for adult and subadult unionids. These diets varied significantly in their ability to support growth, reproduction and survival. Growth, increase in glycogen stores, and limited glochidial formation were seen in most unionid species on two of the diets. However, long-term survival (>3 y) remained problematic, and the cause of mortality in these animals could not be determined. While two of the diets tested are potentially useful for supplemental feeding of adult unionids to increase glycogen levels during quarantine, or during short-term captive maintenance in the laboratory, none can be recommended without reservation for long-term maintenance because of the lack of survival after three years during this study.

  18. The role of caring adults in the lives of children of alcoholics.

    PubMed

    Werner, Emmy E; Johnson, Jeannette L

    2004-04-01

    Longitudinal studies of children of alcoholics in a community context are rare, but are of special interest because they provide the opportunity to study families with alcoholic parents who do not reach clinical settings and with offspring who do not receive professional help. The current study reports on the 65 offspring of alcoholics who participated in the Kauai Longitudinal Study. The extensive data on these analyses included questionnaires and interviews of both children and adults that were collected over a 30-year period. The data showed that individuals who coped effectively with the trauma of growing up in an alcoholic family and who became competent adults relied on a significantly larger number of sources of support in their childhood and youth than did the offspring of alcoholics with coping problems by age 32.

  19. Neurodevelopment. Live imaging of adult neural stem cell behavior in the intact and injured zebrafish brain.

    PubMed

    Barbosa, Joana S; Sanchez-Gonzalez, Rosario; Di Giaimo, Rossella; Baumgart, Emily Violette; Theis, Fabian J; Götz, Magdalena; Ninkovic, Jovica

    2015-05-15

    Adult neural stem cells are the source for restoring injured brain tissue. We used repetitive imaging to follow single stem cells in the intact and injured adult zebrafish telencephalon in vivo and found that neurons are generated by both direct conversions of stem cells into postmitotic neurons and via intermediate progenitors amplifying the neuronal output. We observed an imbalance of direct conversion consuming the stem cells and asymmetric and symmetric self-renewing divisions, leading to depletion of stem cells over time. After brain injury, neuronal progenitors are recruited to the injury site. These progenitors are generated by symmetric divisions that deplete the pool of stem cells, a mode of neurogenesis absent in the intact telencephalon. Our analysis revealed changes in the behavior of stem cells underlying generation of additional neurons during regeneration.

  20. Exploring the work lives of adults with serious mental illness from a vocational psychology perspective.

    PubMed

    Millner, Uma Chandrika; Rogers, Erna Sally; Bloch, Philippe; Costa, William; Pritchett, Sharon; Woods, Tracy

    2015-10-01

    Current vocational services for adults with serious mental illness remain largely atheoretical and disconnected from mainstream vocational psychology research and practice. This study explored the perspectives on work of adults with serious mental illness, compared perspectives of young and older adults, and assessed these perspectives for the applicability of a well-established theory of vocational psychology. A national sample of 76 individuals with mental illness engaged in the workforce completed a semistructured questionnaire. We applied the principles of a participatory approach to consensual qualitative research methodology in the study design and data analysis. Results yielded a large number of categories, which clustered under domains representative of the primary constructs of social cognitive career theory (SCCT; Lent, 2013). These domains included the antecedents of self-efficacy, namely, personal accomplishments, vicarious learning, social persuasion, and physical or emotional states as well as additional constructs of outcome expectations, personal goals, and contextual barriers. The SCCT model will likely provide a useful framework to bridge the gap between career development theory and vocational services for individuals with mental illness.

  1. The Elderly’s Independent Living in Smart Homes: A Characterization of Activities and Sensing Infrastructure Survey to Facilitate Services Development

    PubMed Central

    Ni, Qin; García Hernando, Ana Belén; de la Cruz, Iván Pau

    2015-01-01

    Human activity detection within smart homes is one of the basis of unobtrusive wellness monitoring of a rapidly aging population in developed countries. Most works in this area use the concept of “activity” as the building block with which to construct applications such as healthcare monitoring or ambient assisted living. The process of identifying a specific activity encompasses the selection of the appropriate set of sensors, the correct preprocessing of their provided raw data and the learning/reasoning using this information. If the selection of the sensors and the data processing methods are wrongly performed, the whole activity detection process may fail, leading to the consequent failure of the whole application. Related to this, the main contributions of this review are the following: first, we propose a classification of the main activities considered in smart home scenarios which are targeted to older people’s independent living, as well as their characterization and formalized context representation; second, we perform a classification of sensors and data processing methods that are suitable for the detection of the aforementioned activities. Our aim is to help researchers and developers in these lower-level technical aspects that are nevertheless fundamental for the success of the complete application. PMID:26007717

  2. Narrative and resilience: A comparative analysis of how older adults story their lives.

    PubMed

    Randall, William; Baldwin, Clive; McKenzie-Mohr, Sue; McKim, Elizabeth; Furlong, Dolores

    2015-08-01

    Of increasing interest to gerontologists is resilience: the capacity for coping with the challenges of later life with openness and positivity. An overlooked factor in resilience, however, is the narrative complexity of older persons' self-accounts. The research on which this article is based is part of a larger project aimed at assessing the role of narrative interventions in strengthening the stories that older people tell about their lives. Presented here are preliminary findings from analyses conducted by our multidisciplinary team (representing gerontology, social work, nursing, dementia studies, and literary theory) on open-ended life story interviews done with 20 community-dwelling individuals (15 F, 5M; aged 65-89 years) who completed the Connor Davidson Resilience Scale. Specifically, we compared the self-accounts of the 6 from these 20 who scored highest on the CDRS with the 7 who scored lowest to determine any patterns in how each group "stories" their lives. We conclude with certain observations of relevance to narrative care.

  3. Why do some adult birds skip breeding? A hormonal investigation in a long-lived bird

    PubMed Central

    Goutte, Aurélie; Kriloff, Marion; Weimerskirch, Henri; Chastel, Olivier

    2011-01-01

    Skipping reproduction is often observed in long-lived organisms, but proximate mechanisms remain poorly understood. Since young and/or very old snow petrels (Pagodroma nivea) commonly skip breeding, we tested whether they are physiologically able to breed during the pre-laying stage. To do so, we measured the ability of known-age (11–45 years old) petrels to release luteinizing hormone (LH, a crucial driver for breeding), by injecting exogenous gonadotropin-releasing hormone (GnRH). Although young petrels exhibited low baseline LH levels, they were able to elevate LH levels after a GnRH challenge. Moreover, young and very old petrels showed a stronger decrease in LH levels after the 10 min post-GnRH injection compared with middle-aged petrels. Birds that skipped breeding were as able as breeders to release LH after a GnRH challenge, indicating that they had functional pituitaries. However, the decision to skip reproduction was linked to a strong LH decrease after the 10 min post-GnRH injection. Our result suggests that the youngest and the oldest petrels fail to maintain elevated baseline LH levels, thereby do not initiate reproductive activities. Skipping reproduction in long-lived birds probably results from age-related changes in the dynamics of the hypothalamic–pituitary–gonadal (HPG) axis function. PMID:21508027

  4. Why do some adult birds skip breeding? A hormonal investigation in a long-lived bird.

    PubMed

    Goutte, Aurélie; Kriloff, Marion; Weimerskirch, Henri; Chastel, Olivier

    2011-10-23

    Skipping reproduction is often observed in long-lived organisms, but proximate mechanisms remain poorly understood. Since young and/or very old snow petrels (Pagodroma nivea) commonly skip breeding, we tested whether they are physiologically able to breed during the pre-laying stage. To do so, we measured the ability of known-age (11-45 years old) petrels to release luteinizing hormone (LH, a crucial driver for breeding), by injecting exogenous gonadotropin-releasing hormone (GnRH). Although young petrels exhibited low baseline LH levels, they were able to elevate LH levels after a GnRH challenge. Moreover, young and very old petrels showed a stronger decrease in LH levels after the 10 min post-GnRH injection compared with middle-aged petrels. Birds that skipped breeding were as able as breeders to release LH after a GnRH challenge, indicating that they had functional pituitaries. However, the decision to skip reproduction was linked to a strong LH decrease after the 10 min post-GnRH injection. Our result suggests that the youngest and the oldest petrels fail to maintain elevated baseline LH levels, thereby do not initiate reproductive activities. Skipping reproduction in long-lived birds probably results from age-related changes in the dynamics of the hypothalamic-pituitary-gonadal (HPG) axis function.

  5. CD45/CD11b Positive Subsets of Adult Lung Anchorage-Independent Cells Harness Epithelial Stem Cells

    PubMed Central

    Peter, Yakov; Sen, Namita; Levantini, Elena; Keller, Steven; Ingenito, Edward P; Ciner, Aaron; Sackstein, Robert; Shapiro, Steven D

    2015-01-01

    Compensatory growth is mediated by multiple cell types that interact during organ repair. To elucidate the relationship between the stem/progenitor cells that proliferate or differentiate and the somatic cells of lung, we utilized a novel ex vivo pneumoexplant system. Applying this technique, we identified a sustained culture of repopulating adult progenitors in the form of free floating anchorage-independent cells (AICs). AICs did not express integrin proteins α5, β3, and β7, and constituted 37% of the total culture at day 14, yielding a mixed yet conserved population that recapitulated RNA expression patterns of the healthy lung. AICs exhibited rapid proliferation manifested by a marked 60-fold increase in cell numbers by day 21. Over 50% of the AIC population was cKit+ or double-positive for CD45+ and CD11b+ antigenic determinants, consistent with cells of hematopoietic origin. The latter subset was found to be enriched with prosurfactant protein-C and SCGB1A1 expressing putative stem cells and with aquaporin-5 producing cells, characteristic of terminally differentiated alveolar epithelial type-1 pneumocytes. AICs undergo remodeling to form a cellular lining at the air/gel interface, and TGFβ1 treatment modifies protein expression, implying direct-differentiation of this population. These data confirm the active participation of clonogenic hematopietic stem cells in a mammalian model of lung repair and validate mixed stem/somatic cell cultures, which embrace sustained cell viability, proliferation, and differentiation, for use in studies of compensatory pulmonary growth. PMID:22585451

  6. Are social organizational factors independently associated with a current bacterial sexually transmitted infection among urban adolescents and young adults?

    PubMed

    Jennings, Jacky M; Hensel, Devon J; Tanner, Amanda E; Reilly, Meredith L; Ellen, Jonathan M

    2014-10-01

    This study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined.

  7. A Cross-Sectional Study of the Psychological Needs of Adults Living with Cystic Fibrosis

    PubMed Central

    Pakhale, Smita; Baron, Justine; Armstrong, Michael; Tasca, Georgio; Gaudet, Ena; Aaron, Shawn; Cameron, William; Balfour, Louise

    2015-01-01

    Background Depression and anxiety are prevalent in people with cystic fibrosis (CF), yet psychological services are rarely accessible in CF clinics. This cross-sectional single center study reports on a psychological needs assessment of people with CF. Methods We asked adults attending a CF clinic, without integrated psychological services, to complete a psychological needs assessment survey that included items on: a) past access to psychological services (via a CF referral service), b) concerns relevant to discuss with a psychologist, and c) their likelihood of accessing psychological services if available at the CF clinic, and standardized measures of depression (CES-D) and anxiety (GAD-7). Results We enrolled 49 participants and 45 (91.8%) completed the survey. Forty percent reported elevated symptoms of depression and 13% had elevated anxiety. A majority of individuals (72.2% and 83.3%, respectively) indicated they would be likely to use psychological services, if available at the clinic. Concerns considered most relevant to discuss with a psychologist were: 1) worries (51.1%), 2) mood (44.4%), 3) life stress (46.6%), 4) adjustment to CF (42.2%), 5) life transitions (42.2%) and 6) quality of life (42.2%). Conclusions This study highlights the rationale for screening adults with CF for depression and anxiety, and to facilitate provision of psychological services and preventative mental health interventions as an integral component of multi-disciplinary CF care. PMID:26102351

  8. Awareness of heart attack and stroke symptoms among Hispanic male adults living in the United States.

    PubMed

    Lutfiyya, May Nawal; Bardales, Ricardo; Bales, Robert; Aguero, Carlos; Brady, Shelly; Tobar, Adriana; McGrath, Cynthia; Zaiser, Julia; Lipsky, Martin S

    2010-10-01

    There is evidence that Hispanic men are a high risk group for treatment delay for both heart attack and stroke. More targeted research is needed to elucidate this specific population's knowledge of warning signs for these acute events. This study sought to describe within-group disparities in Hispanic men's knowledge of heart attack and stroke symptomology. Multivariate techniques were used to analyze a multi-year Behavioral Risk Factor Surveillance Heart and Stroke module database. The data were cross-sectional and focused on health risk factors and behaviors. The research participants were U.S. male Hispanic adults aged 18-99. The main outcome measure for the study was heart attack and stroke symptom knowledge score. Multivariate logistic regression analysis yielded that Hispanic men aged >or=18 years who earned low scores on the composite heart attack and stroke knowledge questions (range 0-8 points) were more likely to: have less than a high school education, have deferred medical care because of cost, not have an identified health care provider, and be uninsured. There were significant within-group differences. Targeting educational efforts toward older (>or=55 years) Hispanic men with less than high school education, those who do not have an identified health care provider or health insurance, and who defer health care because of cost could be ways to improve the outcome of acute vascular events among the U.S. Hispanic adult male population.

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

    PubMed

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

    2015-06-30

    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.

  10. 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

  11. Vitamin B12 status in older adults living in Ontario long-term care homes: prevalence and incidence of deficiency with supplementation as a protective factor.

    PubMed

    Pfisterer, Kaylen J; Sharratt, Mike T; Heckman, George G; Keller, Heather H

    2016-02-01

    Vitamin B12 (B12) deficiency, although treatable, impacts up to 43% of community-living older adults; long-term care (LTC) residents may be at greater risk. Recommendations for screening require further evidence on prevalence and incidence in LTC. Small, ungeneralizable samples provide a limited perspective on these issues. The purposes of this study were to report prevalence of B12 deficiency at admission to LTC, incidence 1 year post-admission, and identify subgroups with differential risk. This multi-site (8), retrospective prevalence study used random proportionate sampling of resident charts (n = 412). Data at admission extracted included demographics, B12 status, B12 supplementation, medications, diagnoses, functional independence, cognitive performance, and nutrition. Prevalence at admission of B12 deficiency (<156 pmol/L) was 13.8%; 47.6% had normal B12 (>300 pmol/L). One year post-admission incidence was 4%. Better B12 status was significantly associated with supplementation use prior to LTC admission. Other characteristics were not associated with status. This work provides a better estimate of B12 deficiency prevalence than previously available for LTC, upon which to base protocols and policy. Prospective studies are needed to establish treatment efficacy and effect on health related outcomes.

  12. Independent evolution of complex life history adaptations in two families of fishes, live-bearing halfbeaks (zenarchopteridae, beloniformes) and poeciliidae (cyprinodontiformes).

    PubMed

    Reznick, David; Meredith, Robert; Collette, Bruce B

    2007-11-01

    We have previously documented multiple, independent origins of placentas in the fish family Poeciliidae. Here we summarize similar analyses of fishes in the family Zenarchopteridae. This family includes three live-bearing genera. Earlier studies documented the presence of superfetation, or the ability to carry multiple litters of young in different stages of development in the same ovary, in some species in all three genera. There is also one earlier report of matrotrophy, or extensive postfertilization maternal provisioning, in two of these genera. We present detailed life-history data for approximately half of the species in all three genera and combine them with the best available phylogeny to make inferences about the pattern of life-history evolution within this family. Three species of Hemirhamphodon have superfetation but lack matrotrophy. Most species in Nomorhamphus and Dermogenys either lack superfetation and matrotrophy or have both superfetation and matrotrophy. Our phylogenetic analysis shows that matrotrophy may have evolved independently in each genus. In Dermogenys, matrotrophic species produce fewer, larger offspring than nonmatrotrophic species. In Nomorhamphus; matrotrophic species instead produce more and smaller offspring than lecithotrophic species. However, the matrotrophic species in both genera have significantly smaller masses of reproductive tissue relative to their body sizes. All aspects of these results are duplicated in the fish family Poeciliidae. We discuss the possible adaptive significance of matrotrophy in the light of these new results. The two families together present a remarkable opportunity to study the evolution of a complex trait because they contain multiple, independent origins of the trait that often include close relatives that vary in either the presence or absence of the matrotrophy or in the degree to which matrotrophy is developed. These are the raw materials that are required for either an analysis of the adaptive

  13. Determinants of health-related quality of life in adults living with HIV in Vietnam.

    PubMed

    Tran, Bach Xuan; Ohinmaa, Arto; Nguyen, Long Thanh; Nguyen, Thu Anh; Nguyen, Thao Huong

    2011-10-01

    Health-related quality of life (HRQL) is a good indicator to monitor and evaluate healthcare services for adults with HIV/AIDS. This study described HRQL of adults with HIV and its determinants, and compared it with HRQL for the general population. A cross-sectional study with a national multistage sampling of households with and without HIV-positive people was conducted in 2008. Six provinces were purposively selected to represent areas of the country and progressions of HIV epidemics. Households were sampled with probability-proportional-to-size, following the selection of rural and urban districts. A total of 820 HIV-positive and HIV-negative adults (mean age: 32.5; 38.7% female) were interviewed. Among 400 HIV-positive people, 52.3% had a history of injecting drugs, and 56.3% were at AIDS stage and receiving antiretroviral treatment (ART). HRQL was measured using the EuroQOL five-dimension questionnaire (EQ-5D). Multiple regression models were purposefully constructed to examine the determinants of HRQL. The EQ-5D index and visual analog scale (VAS) score in less advanced HIV people (0.90, 69.3) and AIDS patients (0.88, 65.2) were significantly lower than those of the general population (0.96, 81.6) (p<0.001). The frequency of reported problems across EQ-5D dimensions in the HIV population (2.4-30.9%) was significantly higher than in the general population (0.7-12.1%). Compared to ART patients, those at earlier HIV stages reported having problems at similar proportions across four HRQL dimensions, except pain/discomfort, where ART patients had a significantly higher proportion. Injecting drug users taking ART perceived lower HRQL score than non-injecting drug users. Multiple regression determined that joblessness (p<0.01) and inaccessibility to health services (p<0.05) were associated with lower HRQL. In addition, involvements in self-help groups significantly improved HRQL among HIV-positive participants (p<0.05). The findings highlight the need to improve the

  14. Development of a Nondestructive Method for Sexing Live Adult Sternoplax souvorowiana (Coleoptera: Tenebrionidae)

    PubMed Central

    Wang, Yan; Ma, Ji; Mao, Xinfang

    2015-01-01

    The darkling beetle, Sternoplax souvorowiana (Reitter) (Coleoptera: Tenebrionidae), is flightless and lives in the Guerbantonggut desert in northwestern China. Its special eggshell structure, day-active habit, large body size, short life cycle, and ease of rearing under laboratory conditions make it an excellent model for advanced studies on desert adaptation. Determining the sex of this beetle is usually complicated by the lack of a discreet, externally visible gender-specific character. To date, dissection has been used for sex identification in this species, whereas a nondestructive means is needed for further studies of sexual dimorphism. Here, a new method based on the difference of the pigmentation pattern on the eighth tergite of each sex is described and illustrated. This method can be quickly learned, is nondestructive, is 100% accurate, and is fast enough for most applications in both the field and the laboratory. Experienced users in our laboratory routinely sex 8–10 beetles per minute. PMID:25934924

  15. Development of a nondestructive method for sexing live adult Sternoplax souvorowiana (Coleoptera: Tenebrionidae).

    PubMed

    Wang, Yan; Ma, Ji; Mao, Xinfang

    2015-01-01

    The darkling beetle, Sternoplax souvorowiana (Reitter) (Coleoptera: Tenebrionidae), is flightless and lives in the Guerbantonggut desert in northwestern China. Its special eggshell structure, day-active habit, large body size, short life cycle, and ease of rearing under laboratory conditions make it an excellent model for advanced studies on desert adaptation. Determining the sex of this beetle is usually complicated by the lack of a discreet, externally visible gender-specific character. To date, dissection has been used for sex identification in this species, whereas a nondestructive means is needed for further studies of sexual dimorphism. Here, a new method based on the difference of the pigmentation pattern on the eighth tergite of each sex is described and illustrated. This method can be quickly learned, is nondestructive, is 100% accurate, and is fast enough for most applications in both the field and the laboratory. Experienced users in our laboratory routinely sex 8-10 beetles per minute.

  16. Quality of life among adults with epidermolysis bullosa living with a gastrostomy tube since childhood.

    PubMed

    Hubbard, Lynne D; Mayre-Chilton, Kattya

    2015-03-01

    Epidermolysis bullosa (EB) is a rare genetic condition characterized by blistering to the skin and internal mucous membranes arising from mild mechanical trauma. The impact on those affected can be significant. They might have increased nutritional requirements because of blistering, chronic wounds, infection, and loss of exudates, and nutritional intake might be compromised because of oropharyngeal blistering and strictures, resulting in malnutrition in many patients. Placement of gastrostomy tubes can help some patients meet nutritional requirements. We report a recent study on how EB patients and their families approached the issue of whether to have a gastrostomy tube placed and how such tubes affect quality of life. Our findings include important insights for clinicians and families about how patients experience life with a gastrostomy. We show how the process of consent can be improved and how patients with a gastrostomy tube can feel more in control of their lives.

  17. The Lived Experience of African American Caregivers Caring for Adult African American Patients With Heart Failure.

    PubMed

    Hamilton, Heather

    2016-04-01

    Assistance from informal caregivers such as family members, friends, or neighbors is crucial to adequately managing the complex care of heart failure (HF) patients. This study examined the lived experience of African American caregivers caring for African American patients with HF. Purposive sampling was used to recruit 10 participants who were formally interviewed. The interviews, analyzed using Colaizzi's steps, revealed six themes: layers of support, realization of self-neglect, experiencing the "blues," connecting with healthcare providers, unmet financial needs, and perception of nonadherence. The information regarding the experience of African American caregivers of HF patients obtained through this research will inform the delivery of culturally competent support to caregivers, thereby improving quality of life for both the HF patients and their caregivers.

  18. 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

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

    PubMed

    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.

  20. 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

  1. Communication and AAC in the lives of adults with autism: the stories of their older parents.

    PubMed

    Hines, Monique; Balandin, Susan; Togher, Leanne

    2011-12-01

    The aim of this study was to explore the communication experiences, particularly those related to augmentative and alternative communication (AAC), of older parents who had an adult son or daughter with autism. A narrative analysis of in-depth interviews with 16 older parents indicated that the majority had rarely spontaneously mentioned AAC or other communication interventions. Most did not express the need for such services. Yet, communication breakdown featured prominently in parents' narratives about interactions with their son or daughter. The quality of the communication between older parents and their offspring with autism constituted important sources of both gratification and strain in parents' roles as caregivers. Reasons for the current lack of communication interventions are discussed, along with implications for communication and AAC service provision.

  2. Emerging adults' lived experience of formative family stress: the family's lasting influence.

    PubMed

    Valdez, Carmen R; Chavez, Tom; Woulfe, Julie

    2013-08-01

    In this article, we use a phenomenology framework to explore emerging adults' formative experiences of family stress. Fourteen college students participated in a qualitative interview about their experience of family stress. We analyzed the interviews using the empirical phenomenological psychology method. Participants described a variety of family stressors, including parental conflict and divorce, physical or mental illness, and emotional or sexual abuse by a family member. Two general types of parallel processes were essential to the experience of family stress for participants. First, the family stressor was experienced in shifts and progressions reflecting the young person's attempts to manage the stressor, and second, these shifts and progressions were interdependent with deeply personal psychological meanings of self, sociality, physical and emotional expression, agency, place, space, project, and discourse. We describe each of these parallel processes and their subprocesses, and conclude with implications for mental health practice and research.

  3. Challenges and resilience in the lives of urban, multiracial adults: an instrument development study.

    PubMed

    Salahuddin, Nazish M; O'Brien, Karen M

    2011-10-01

    Multiracial Americans represent a rapidly growing population (Shih & Sanchez, 2009); however, very little is known about the types of challenges and resilience experienced by these individuals. To date, few psychological measures have been created specifically to investigate the experiences of multiracial people. This article describes 2 studies focused on the development and psychometric properties of the Multiracial Challenges and Resilience Scale (MCRS). The MCRS was developed using a nationwide Internet sample of urban, multiracial adults. Exploratory factor analyses revealed 4 Challenge factors (Others' Surprise and Disbelief Regarding Racial Heritage, Lack of Family Acceptance, Multiracial Discrimination, and Challenges With Racial Identity) and 2 Resilience factors (Appreciation of Human Differences and Multiracial Pride). A confirmatory factor analysis with data from a second sample provided support for the stability of this factor structure. The reliability and validity of the measure, implications of these findings, and suggestions for future research are discussed.

  4. Bursts of Self-Conscious Emotions in the Daily Lives of Emerging Adults

    PubMed Central

    Conroy, David E.; Ram, Nilam; Pincus, Aaron L.; Rebar, Amanda L.

    2015-01-01

    Self-conscious emotions play a role in regulating daily achievement strivings, social behavior, and health, but little is known about the processes underlying their daily manifestation. Emerging adults (n = 182) completed daily diaries for eight days and multilevel models were estimated to evaluate whether, how much, and why their emotions varied from day-to-day. Within-person variation in authentic pride was normally-distributed across people and days whereas the other emotions were burst-like and characterized by zero-inflated, negative binomial distributions. Perceiving social interactions as generally communal increased the odds of hubristic pride activation and reduced the odds of guilt activation; daily communal behavior reduced guilt intensity. Results illuminated processes through which meaning about the self-in-relation-to-others is constructed during a critical period of development. PMID:25859164

  5. Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting

    PubMed Central

    GOLDENBERG, Shira M.; CHETTIAR, Jill; SIMO, Annick; SILVERMAN, Jay G.; STRATHDEE, Steffanie A.; MONTANER, Julio; SHANNON, Kate

    2014-01-01

    Objectives To explore factors associated with early sex work initiation, and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs). Design Baseline data (2010–2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time-location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old. Methods SWs completed a questionnaire and HIV/STI testing. Using multivariate logistic regression, we identified associations with early sex work initiation (<18 years old) and constructed confounder models examining the independent effect of early initiation on HIV and prostitution arrests among adult SWs. Results Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian-born (Adjusted Odds Ratio (AOR): 6.8, 95% Confidence Interval (CI): 2.42–19.02), inject drugs (AOR: 1.6, 95%CI: 1.0–2.5), and to have worked for a manager (AOR: 2.22, 95%CI: 1.3–3.6) or been coerced into sex work (AOR: 2.3, 95%CI: 1.14–4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3–3.2) and prostitution arrests (AOR: 2.0, 95%CI: 1.3–3.2). Conclusions Adolescent sex work initiation is concentrated among marginalized, drug and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs. PMID:23982660

  6. Cognitive Impairment, Alzheimer's Disease, and Other Dementias in the Lives of Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults and Their Caregivers.

    PubMed

    Fredriksen-Goldsen, Karen I; Jen, Sarah; Bryan, Amanda E B; Goldsen, Jayn

    2016-10-01

    Cognitive impairment, Alzheimer's disease, and other dementias are important health concerns for older adults. As a marginalized and growing segment of the older adult population, lesbian, gay, bisexual, and transgender (LGBT) older adults face distinct risk factors related to cognitive impairment and dementias, including social isolation, discrimination, barriers to health care access, limited availability of and support for caregivers, and higher rates of certain chronic illnesses. We examine cognitive impairment and dementias among LGBT older adults, describe their unique risk factors, and outline key competencies for health care and human service providers to ensure culturally relevant care for LGBT older adults experiencing cognitive impairment, Alzheimer's disease, or other dementias, as well as their caregivers, families, and communities. Implications include developing an awareness of the context of LGBT older adults' lives and relationships, the importance of early detection and support, and the development of policies and practices that promote community-level advocacy and education.

  7. Prevalence of obesity and affecting factors in physically disabled adults living in the city centre of Malatya

    PubMed Central

    Bozkir, Çiğdem; Özer, Ali; Pehlivan, Erkan

    2016-01-01

    Objective The purpose of this study was to investigate the prevalence of obesity, and the risk factors associated with it, in physically disabled adults living in the city centre of Malatya, Turkey. Method This research was designed as a cross-sectional study conducted on physically disabled people aged 20–65 years living in the city centre of Malatya. The prevalence of obesity in disabled people was within 95% CIs, the power was calculated as 80%, and the sample size of our population was calculated as 258 individuals. Results The prevalence of obesity was found to be 13.2%. The relationship between disability type and obesity status was found to be significant. The prevalence of obesity was 21.3% in visually impaired people, 17.9% in speech-impaired people, 17.8% in hearing-impaired people and 6.5% in orthopaedically disabled people. Conclusions Educational interventions on nutrition and lifestyle can be effective considering the high prevalence of obesity in visually impaired people, the prevalence of weakness in orthopaedically disabled people and the risk related to the area in which body fat is localised even when body mass index is within the normal range. Training disabled people in sports appropriate to their disability type and building appropriate facilities for those sports might have a positive effect. PMID:27609842

  8. Held to ransom: Parents of self-harming adults describe their lived experience of professional care and caregivers

    PubMed Central

    Lindgren, Britt-Marie; Åström, Sture; Graneheim, Ulla Hällgren

    2010-01-01

    The aim of the study was to discover and describe lived experiences of professional care and caregivers among parents of adults who self-harm. Narrative interviews were conducted with six parents of daughters with self-harming behaviours and analysed using a phenomenological hermeneutic approach. The meanings of the parents' narratives of their lived experiences of professional care and caregivers were interpreted as their being involved in ‘limit situations’ comparable to hostage dramas. Several meaningful themes contributed to this interpretation: being trapped in a situation with no escape; being in the prisoner's dock; groping in the dark; and finding glimmers of hope. Parents of daughters who were in care because of self-harming often felt obliged to pay an emotional ransom, which included feelings of being accused, being ‘broken’, being confused, and feeling lost. Moments of peace occurred as welcome breaks offering a short time of rest for the parents. Situations that were understood by the parents and solved in a peaceful way were experienced as a respite and inspired parents with hope for their daughters' recovery. PMID:20877586

  9. Sighs, smiles, and worried glances: how the body reveals women caregivers' lived experiences of care to older adults.

    PubMed

    Silverman, Marjorie

    2013-08-01

    This article reports on findings from microethnographic research that examined the lived reality of women caregivers through detailed observation of their everyday, embodied experiences. The research, which was rooted in the trend in social gerontology to emphasize subjective experience, focused on five women who were providing care to an older adult with a chronic illness or impairment. Four of the five women were caring for a spouse; one was caring for a parent. Observing the women's daily realities revealed tensions and contradictions between their subjective lived experiences and the pressures of the system in which they were functioning. The data revealed a caregiver habitus characterized by the performance of emotional labor. Performance was visible through dissonance between the caregivers' verbal and nonverbal expressions, and pointed to a high degree of emotion and body management. The women consistently put aside their own needs, in what can be considered a divestment in health capital. There was also evidence of merging between the caregiver and care receiver, made visible through tandem movements. The findings lead to implications for practice and for future aging research, including the benefits of observation for enhancing understanding of clients' experiences.

  10. Higher perceived stress but lower cortisol levels found among young Greek adults living in a stressful social environment in comparison with Swedish young adults.

    PubMed

    Faresjö, Åshild; Theodorsson, Elvar; Chatziarzenis, Marios; Sapouna, Vasiliki; Claesson, Hans-Peter; Koppner, Jenny; Faresjö, Tomas

    2013-01-01

    The worldwide financial crisis during recent years has raised concerns of negative public health effects. This is notably evident in southern Europe. In Greece, where the financial austerity has been especially pronounced, the prevalence of mental health problems including depression and suicide has increased, and outbreaks of infectious diseases have risen. The main objective in this study was to investigate whether different indicators of health and stress levels measured by a new biomarker based on cortisol in human hair were different amongst comparable Greek and Swedish young adults, considering that Sweden has been much less affected by the recent economic crises. In this cross-sectional comparative study, young adults from the city of Athens in Greece (n = 124) and from the city of Linkoping in Sweden (n = 112) participated. The data collection comprised answering a questionnaire with different health indicators and hair samples being analyzed for the stress hormone cortisol, a biomarker with the ability to retrospectively measure long-term cortisol exposure. The Greek young adults reported significantly higher perceived stress (p<0.0001), had experienced more serious life events (p = 0.002), had lower hope for the future (p<0.0001), and had significantly more widespread symptoms of depression (p<0.0001) and anxiety (p<0.0001) than the Swedes. But, the Greeks were found to have significantly lower cortisol levels (p<0.0001) than the Swedes, and this difference was still significant in a multivariate regression (p<0.0001), after adjustments for potential intervening variables. A variety of factors related to differences in the physical or socio-cultural environment between the two sites, might possibly explain this finding. However, a potential biological mechanism is that long-term stress exposure could lead to a lowering of the cortisol levels. This study points out a possible hypothesis that the cortisol levels of the Greek young adults might have been

  11. Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: a Japanese multicenter study.

    PubMed

    Egawa, H; Teramukai, S; Haga, H; Tanabe, M; Mori, A; Ikegami, T; Kawagishi, N; Ohdan, H; Kasahara, M; Umeshita, K

    2014-01-01

    We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab.

  12. Allowing Brief Delays in Responding Improves Event-Based Prospective Memory for Young Adults Living with HIV Disease

    PubMed Central

    Loft, Shayne; Doyle, Katie L.; Naar-King, Sylvie; Outlaw, Angulique Y.; Nichols, Sharon L.; Weber, Erica; Blackstone, Kaitlin; Woods, Steven Paul

    2014-01-01

    Event-based prospective memory (PM) tasks require individuals to remember to perform an action when they encounter a specific cue in the environment, and have clear relevance for daily functioning for individuals with HIV. In many everyday tasks, the individual must not only maintain the intent to perform the PM task, but the PM task response also competes with the alternative and more habitual task response. The current study examined whether event-based PM can be improved by slowing down the pace of the task environment. Fifty-seven young adults living with HIV performed an ongoing lexical decision task while simultaneously performing a PM task of monitoring for a specific word (which was focal to the ongoing task of making lexical decisions) or syllable contained in a word (which was nonfocal). Participants were instructed to refrain from making task responses until after a tone was presented, which occurred at varying onsets (0–1600ms) after each stimulus appeared. Improvements in focal and non-focal PM accuracy were observed with response delays of 600ms. Furthermore, the difference in PM accuracy between the low demand focal PM task and the resource demanding non-focal PM task was reduced by half across increasingly longer delays, falling from 31% at 0ms delay to only 14% at 1600ms delay. The degree of ongoing task response slowing for the PM conditions, relative to a control condition that did not have a PM task and made lexical decisions only, also decreased with increased delay. Overall, the evidence indicates that delaying the task responses of younger HIV-infected adults increased the probability that the PM relevant features of task stimuli were adequately assessed prior to the ongoing task response, and by implication that younger HIV infected adults can more adequately achieve PM goals when the pace of the task environment is slowed down. PMID:25116075

  13. Seasonal Epidemiology of Serum 25-Hydroxyvitamin D Concentrations among Healthy Adults Living in Rural and Urban Areas in Mongolia

    PubMed Central

    Bromage, Sabri; Rich-Edwards, Janet W.; Tselmen, Daria; Baylin, Ana; Houghton, Lisa A.; Baasanjav, Nachin; Ganmaa, Davaasambuu

    2016-01-01

    Many factors put Mongolians at risk of vitamin D deficiency. Despite low levels observed in Mongolian children and pregnant women, there are few data published on the vitamin D status of non-pregnant adults. Between summer 2011 and winter 2013, paired summer and winter blood samples were collected from 320 healthy men and women (20–58 years) living in eight Mongolian provinces. Mean serum 25(OH)D concentrations were 22.5 ng/mL (95% CI: 14.5, 32.5) in summer and 7.7 ng/mL (95% CI: 4.6, 10.8) in winter, with a distribution (<10/10–20/20–30/≥30 ng/mL) of 3.1%/39.3%/39.6%/17.9% in summer and 80.1%/19.5%/0.3%/0.0% in winter. Residents of the capital, Ulaanbaatar, had lower levels in both seasons than any other region, whereas residents of the Gobi desert had the highest. In summer, indoor workers had significantly lower levels than outdoor workers (−2.3 ng/mL; 95% CI: −4.1, −5.7) while levels in males exceeded those in females (4.0 ng/mL; 95% CI: 2.3, 5.7). Effects of region, occupation, and sex were also significant in multivariable regression. In conclusion, Mongolian adults had extremely low serum 25(OH)D, particularly in winter, when 80.1% had concentrations below 10 ng/mL. These results indicate a need for effective vitamin D interventions for the Mongolian adult population, particularly among women and residents of Ulaanbaatar. PMID:27669291

  14. Living a secret: Disclosure among adolescents and young adults with chronic illnesses.

    PubMed

    Kaushansky, Daniel; Cox, Jarad; Dodson, Chaka; McNeeley, Miles; Kumar, Sinthu; Iverson, Ellen

    2017-03-01

    Objectives This qualitative study examines how and why adolescents living with visible and invisible chronic illnesses choose to share their condition with individuals within their social environments. Methods A sample of 25 adolescents were recruited from five subspecialty services: Spina bifida, rheumatology, cardiology, cystic fibrosis, and renal transplant/dialysis. Recruits completed a semi-structured interview designed to explore: (1) to whom adolescents disclose their conditions, (2) motivation and conditions under which they disclose, (3) content of disclosure, and (4) barriers to disclosure. Results Family members closely connected to treatment or management are most likely to be primary targets of disclosure. Regardless of social network size, respondents disclosed their illness to few peers. Common reasons for disclosure were perceived trust and shared experience with illness and disability. Reasons for withholding disclosure include perceived fear of rejection, pity, and perceptions of being seen as vulnerable or different. Discussion Disclosure was found to be influenced by (a) the visibility of a condition, (b) the anticipated response from the recipient, (c) practical needs, and (d) a decision that disclosure is justified. These findings inform clinical practice, warrant the need for further study, and insinuate practical solutions to combat the socio-emotional impact of nondisclosure among adolescents.

  15. Resilience, Stress, and Life Quality in Older Adults Living with HIV/AIDS

    PubMed Central

    Fang, Xindi; Vincent, Wilson; Calabrese, Sarah K.; Heckman, Timothy G.; Sikkema, Kathleen J.; Humphries, Debbie L.; Hansen, Nathan B.

    2015-01-01

    Objectives This study tested the mediating effect of resilience on the relationship between life stress and health-related quality of life (HRQoL) in older people living with HIV/AIDS (OPLWHA) 50 years of age and older. Method Data from 299 OPLWHA were analyzed using structural equation modeling (SEM) to define a novel resilience construct (represented by coping self-efficacy, active coping, hope/optimism and social support) and assess mediating effects of resilience on the association between life stress and HRQoL (physical, emotional, and functional/global well-being). Results SEM analyses showed satisfactory model fit for both resilience and mediational models, with resilience mediating the associations between life stress and physical, emotional, and functional/global well-being. Conclusion Resilience may reduce the negative influence of life stress on physical, emotional, and functional/global well-being in OPLWHA. Interventions that build personal capacity, coping skills, and social support may contribute to better management of HIV/AIDS and increase HRQoL. PMID:25633086

  16. 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.

  17. Changes in physical activity and cognitive decline in older adults living in the community.

    PubMed

    Lee, Yunhwan; Kim, Jinhee; Han, Eun Sook; Chae, Songi; Ryu, Mikyung; Ahn, Kwang Ho; Park, Eun Ju

    2015-01-01

    Accumulating evidence suggests that physical activity may be beneficial in preserving cognition in late life. This study examined the association between baseline and changes in physical activity and cognitive decline in community-dwelling older people. Data were from the Korean Longitudinal Study of Aging, with 2605 aged 65 years and older subjects interviewed in 2006 and followed up for 2 years. Cognitive decline was defined by calculating the Reliable Change Index using the Mini-Mental State Examination. Physical activity levels were categorized as sedentary, low, or high. Changes in physical activity were classified as inactive, decreaser, increaser, or active. Logistic regression analysis of baseline and changes in physical activity with cognitive decline was performed. Compared with the sedentary group at baseline, both the low and high activity groups were less likely to experience cognitive decline. The active (odds ratio [OR] = 0.40, 95 % confidence interval [CI] 0.23-0.68) and increaser (OR = 0.45, 95 % CI 0.27-0.74) group, compared with the inactive counterpart, demonstrated a significantly lower likelihood of cognitive decline. Older adults who remained active or increased activity over time had a reduced risk of cognitive decline. Engagement in physical activity in late life may have cognitive health benefits.

  18. Quantification of free-living activity patterns using accelerometry in adults with mental illness

    PubMed Central

    Chapman, Justin J.; Roberts, James A.; Nguyen, Vinh T.; Breakspear, Michael

    2017-01-01

    Physical activity is disrupted in many psychiatric disorders. Advances in everyday technologies – such as accelerometers in smart phones – opens exciting possibilities for non-intrusive acquisition of activity data. Successful exploitation of this opportunity requires the validation of analytical methods that can capture the full movement spectrum. The study aim was to demonstrate an analytical approach to characterise accelerometer-derived activity patterns. Here, we use statistical methods to characterize accelerometer-derived activity patterns from a heterogeneous sample of 99 community-based adults with mental illnesses. Diagnoses were screened using the Mini International Neuropsychiatric Interview, and participants wore accelerometers for one week. We studied the relative ability of simple (exponential), complex (heavy-tailed), and composite models to explain patterns of activity and inactivity. Activity during wakefulness was a composite of brief random (exponential) movements and complex (heavy-tailed) processes, whereas movement during sleep lacked the heavy-tailed component. In contrast, inactivity followed a heavy-tailed process, lacking the random component. Activity patterns differed in nature between those with a diagnosis of bipolar disorder and a primary psychotic disorder. These results show the potential of complex models to quantify the rich nature of human movement captured by accelerometry during wake and sleep, and the interaction with diagnosis and health. PMID:28266563

  19. Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems.

    PubMed

    Orwat, John; Saitz, Richard; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Samet, Jeffrey H

    2011-10-01

    This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR = 3.37, CI = 2.24-5.06), physical or sexual abuse (AOR = 2.12, CI = 1.22-3.69), social supports that help with sobriety (AOR = 1.92, CI = 1.28-2.87), homelessness (AOR = 2.40, CI = 1.60-3.62), drug dependence diagnosis (AOR = 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (AOR = 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified.

  20. Structural Determinants of Antiretroviral Therapy Use, HIV Care Attendance, and Viral Suppression among Adolescents and Young Adults Living with HIV

    PubMed Central

    Kahana, Shoshana Y.; Jenkins, Richard A.; Bruce, Douglas; Fernandez, Maria I.; Hightow-Weidman, Lisa B.; Bauermeister, Jose A.

    2016-01-01

    Background The authors examined associations between structural characteristics and HIV disease management among a geographically diverse sample of behaviorally and perinatally HIV-infected adolescents and young adults in the United States. Methods The sample included 1891 adolescents and young adults living with HIV (27.8% perinatally infected; 72.2% behaviorally infected) who were linked to care through 20 Adolescent Medicine Trials Network for HIV/AIDS Interventions Units. All completed audio computer–assisted self-interview surveys. Chart abstraction or blood draw provided viral load data. Geographic-level variables were extracted from the United States Census Bureau (e.g., socioeconomic disadvantage, percent of Black and Latino households, percent rural) and Esri Crime (e.g., global crime index) databases as Zip Code Tabulation Areas. AIDSVu data (e.g., prevalence of HIV among youth) were extracted at the county-level. Using HLM v.7, the authors conducted means-as-outcomes random effects multi-level models to examine the association between structural-level and individual-level factors and (1) being on antiretroviral therapy (ART) currently; (2) being on ART for at least 6 months; (3) missed HIV care appointments (not having missed any vs. having missed one or more appointments) over the past 12 months; and (4) viral suppression (defined by the corresponding assay cutoff for the lower limit of viral load at each participating site which denoted nondetectability vs. detectability). Results Frequencies for the 4 primary outcomes were as follows: current ART use (n = 1120, 59.23%); ART use for ≥6 months (n = 861, 45.53%); at least one missed HIV care appointment (n = 936, 49.50); and viral suppression (n = 577, 30.51%). After adjusting for individual-level factors, youth living in more disadvantaged areas (defined by a composite score derived from 2010 Census indicators including percent poverty, percent receiving public assistance, percent of female, single

  1. "What's the Next Stage?" Mothers of Young Adults with Down Syndrome Explore the Path to Independence: A Qualitative Investigation

    ERIC Educational Resources Information Center

    Docherty, Julie; Reid, Kate

    2009-01-01

    Background: An increased life expectancy for young adults with Down syndrome has coincided with legislative changes to improve access to housing and employment. This study explores the values and beliefs of mothers of young adults with Down syndrome currently involved in supporting their offspring in the possible transition from dependence to…

  2. University Adult Education in Independent Zambia: The Role of a Department of Extra-Mural Studies in National Development

    ERIC Educational Resources Information Center

    Okafor, Clement Abiazem

    1971-01-01

    Like other African countries, Zambia's most pragmatic approach to national development must lie in adult education. The University of Zambia is one agency involved toward this goal and its emphasis is on rapid expansion of university-type education and the training of adult educators. (Author/JB)

  3. Optimizing Tailored Health Promotion for Older Adults

    PubMed Central

    Marcus-Varwijk, Anne Esther; Koopmans, Marg; Visscher, Tommy L. S.; Seidell, Jacob C.; Slaets, Joris P. J.; Smits, Carolien H. M.

    2016-01-01

    Objective: This study explores older adults’ perspectives on healthy living, and their interactions with professionals regarding healthy living. This perspective is necessary for health professionals when they engage in tailored health promotion in their daily work routines. Method: In a qualitative study, 18 semi-structured interviews were carried out with older adults (aged 55-98) living in the Netherlands. The framework analysis method was used to analyze the transcripts. Results: Three themes emerged from the data—(a) healthy living: daily routines and staying active, (b) enacting healthy living: accepting and adapting, (c) interaction with health professionals with regard to healthy living: autonomy and reciprocity. Discussion: Older adults experience healthy living in a holistic way in which they prefer to live active and independent lives. Health professionals should focus on building an equal relationship of trust and focus on positive health outcomes, such as autonomy and self-sufficiency when communicating about healthy living. PMID:28138485

  4. Low-dose tertiary prophylactic therapy reduces total number of bleeds and improves the ability to perform activities of daily living in adults with severe haemophilia A: a single-centre experience from Beijing.

    PubMed

    Hua, Baolai; Lian, Xiaoyun; Li, Kuixing; Lee, Adrienne; Poon, Man-Chiu; Zhao, Yongqiang

    2016-03-01

    Full-dose prophylaxis treatment for persons with haemophilia is not affordable in China due to its economic constraints, particularly in adults requiring higher clotting factor (CFC) doses. Low-dose tertiary prophylaxis for adults with severe haemophilia A (SHA) in Beijing became feasible and implemented when government insurance covering 85% CFC cost in Beijing began in December 2009. The aim of this study was to evaluate the benefits of low-dose tertiary prophylaxis in SHA adults. Analysis of data on 33 patients on low-dose tertiary prophylaxis (5-10 IU/kg, two to three times per week) at the Haemophilia Treatment Center, Peking Union Medical College Hospital between December 2009 and December 2013. The 33 patients (age 18-60 years, mean 33.4) were on prophylaxis for 20.8 ± 9.9 months (compared with prior on-demand therapy for 20.0 ± 11.7 months). Prophylaxis resulted in significant decrease in annual bleeding rate (ABR, 11.8 ± 7.6 vs. 41.5 ± 20.7, 71.1% reduction, P < 0.0001), and significant improvement in Functional Independence Score in Haemophilia (FISH) measurement reflecting improvement in self-care and mobility. Radiologic (Pettersson) joint score was neither improved nor deteriorated. Ten of the 33 patients originally wheel chair and bed-bound began to walk and function independently in their daily lives. Low-dose tertiary prophylaxis for adults with SHA in China is feasible and beneficial. Although the average ABR remained high, a significant improvement in self-care and mobility measured by FISH was observed. These promising clinical experiences form the basis for further formal studies with more defined therapeutic protocol and outcome measures for affordable prophylaxis regimens in haemophilia adults in China.

  5. A Novel Predictor of Posttransplant Portal Hypertension in Adult-To-Adult Living Donor Liver Transplantation: Increased Estimated Spleen/Graft Volume Ratio

    PubMed Central

    Gyoten, Kazuyuki; Mizuno, Shugo; Kato, Hiroyuki; Murata, Yasuhiro; Tanemura, Akihiro; Azumi, Yoshinori; Kuriyama, Naohisa; Kishiwada, Masashi; Usui, Masanobu; Sakurai, Hiroyuki; Isaji, Shuji

    2016-01-01

    Background In adult living donor liver transplantation (ALDLT), graft-to-recipient weight ratio of less than 0.8 is incomplete for predicting portal hypertension (>20 mm Hg) after reperfusion. We aimed to identify preoperative factors contributing to portal venous pressure (PVP) after reperfusion and to predict portal hypertension, focusing on spleen volume-to-graft volume ratio (SVGVR). Methods In 73 recipients with ALDLT between 2002 and 2013, first we analyzed survival according to PVP of 20 mm Hg as the threshold, evaluating the efficacy of splenectomy. Second, we evaluated various preoperative factors contributing to portal hypertension after reperfusion. Results All of the recipients with PVP greater than 20 mm Hg (n = 19) underwent PVP modulation by splenectomy, and their overall survival was favorable compared with 54 recipients who did not need splenectomy (PVP ≤ 20 mm Hg). Graft-to-recipient weight ratio had no correlation with PVP. Multivariate analysis revealed that estimated graft and spleen volume were significant factors contributing to PVP after reperfusion (P < 0.0001 and P < 0.0001, respectively). Furthermore, estimated SVGVR showed a significant negative correlation to PVP after reperfusion (R = 0.652), and the best cutoff value for portal hypertension was 0.95. Conclusions In ALDLT, preoperative assessment of SVGVR is a good predictor of portal hypertension after reperfusion can be used to indicate the need for splenectomy before reperfusion. PMID:27472097

  6. Good Ol' Boys, Mean Girls, and Tyrants: A Phenomenological Study of the Lived Experiences and Survival Strategies of Bullied Women Adult Educators

    ERIC Educational Resources Information Center

    Sedivy-Benton, Amy; Strohschen, Gabriele; Cavazos, Nora; Boden-McGill, Carrie

    2015-01-01

    Bullying in higher education is an increasingly common phenomenon that negatively affects organizational climate, completed work's quality and quantity, and students' educational experiences. The purpose of this phenomenological study was to investigate the lived experiences of women adult educators who were targets of bullying. Six…

  7. Comparison of GT3X accelerometer and Yamax pedometer steps/day in a free-living sample of overweight and obese adults

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The purpose of this study was to compare steps/day detected by the YAMAX SW-200 pedometer versus the Actigraph GT3X accelerometer in free-living adults. Daily YAMAX and GT3X steps were collected from a sample of 23 overweight and obese participants (78% female; age = 52.6 +/- 8.4 yr.; BMI = 31.0 +/-...

  8. The Role of Important Non-Parental Adults (VIPs) in the Lives of Older Adolescents: A Comparison of Three Ethnic Groups

    ERIC Educational Resources Information Center

    Haddad, Eileen; Chen, Chuansheng; Greenberger, Ellen

    2011-01-01

    Previous research has consistently documented the importance of VIPs (mentors or important non-parental adults) in the lives of adolescents. Little is known, however, about whether VIPs play the same important roles across ethnic groups and whether VIPs remain influential when adolescents are older and involved in romantic relationships. The…

  9. The relationship between vitamin D status and muscle strength in young healthy adults from sunny climate countries currently living in the northeast of Scotland.

    PubMed

    Jamil, N A; Gray, S R; Fraser, W D; Fielding, S; Macdonald, H M

    2017-04-01

    The current study examined the relationship between vitamin D status and muscle strength in young healthy adults: residents (>6 months) and newcomers (0-3 months), originally from sunny climate countries but currently living in the northeast of Scotland. Our longitudinal data found a positive, albeit small, relationship between vitamin D status and knee extensor isometric strength.

  10. What do we know about children living with HIV-infected or AIDS-ill adults in Sub-Saharan Africa? A systematic review of the literature

    PubMed Central

    Goldberg, Rachel E.; Short, Susan E.

    2016-01-01

    ABSTRACT Millions of children in Sub-Saharan Africa live with adults, often parents, who are HIV-infected or ill due to AIDS. These children experience social, emotional, and health vulnerabilities that overlap with, but are not necessarily the same as, those of orphans or other vulnerable children. Despite their distinctive vulnerabilities, research aimed at understanding the situation of these children has been limited until very recently. This review summarizes the state of knowledge based on a systematic search of PubMed and Web of Science that identified 47 empirical research articles that examined either the population prevalence of children living with HIV-infected or AIDS-sick adults, or the consequences of adult HIV infection or AIDS illness for child well-being. This review confirms that this population of children is substantial in size, and that the vulnerabilities they experience are multi-faceted, spanning physical and emotional health and schooling. Mechanisms were examined empirically in only a small number of studies, but encompass poverty, transmission of opportunistic infections, care for unwell adults, adult distress, AIDS stigma, lack of social support, maternal breastfeeding issues, and vertical HIV transmission. Some evidence is provided that infants, adolescents, children with infected or ill mothers, and children living with severely ill adults are particularly vulnerable. Future research would benefit from more attention to causal inference and further characterization of processes and circumstances related to vulnerability and resilience. It would also benefit from further study of variation in observed associations between adult HIV/AIDS and child well-being based on characteristics such as age, sex, kinship, severity of illness, TB co-infection, disclosure, and serostatus awareness. Almost one-quarter of the studies reviewed did not investigate variation based on any of these factors. More nuanced understanding of the short- and long

  11. Evaluation of two live attenuated cold-adapted H5N1 influenza virus vaccines in healthy adults

    PubMed Central

    Karron, Ruth A.; Talaat, Kawsar; Luke, Catherine; Callahan, Karen; Thumar, Bhagvanji; DiLorenzo, Susan; McAuliffe, Josephine; Schappell, Elizabeth; Suguitan, Amorsolo; Mills, Kimberly; Chen, Grace; Lamirande, Elaine; Coelingh, Kathleen; Jin, Hong; Murphy, Brian R.; Kemble, George; Subbarao, Kanta

    2016-01-01

    Background Development of live attenuated influenza vaccines (LAIV) against avian viruses with pandemic potential is an important public health strategy. Methods and Findings We performed open-label trials to evaluate the safety, infectivity, and immunogenicity of H5N1 VN 2004 AA ca and H5N1 HK 2003 AA ca. Each of these vaccines contains a modified H5 hemagglutinin and unmodified N1 neuraminidase from the respective wild-type (wt) parent virus and the six internal protein gene segments of the A/Ann Arbor/6/60 cold-adapted (ca) master donor virus. The H5N1 VN 2004 AA ca vaccine virus was evaluated at dosages of 106.7 TCID50 and 107.5 TCID50, and the H5N1 HK 2003 AA ca vaccine was evaluated at a dosage of 107.5 TCID50. Two doses were administered intranasally to healthy adults in isolation at 4 to 8 week intervals. Vaccine safety was assessed through daily examinations and infectivity was assessed by viral culture and by realtime reverse transcription-polymerase chain reaction testing of nasal wash (NW) specimens. Immunogenicity was assessed by measuring hemagglutination-inhibition (HI) antibodies, neutralizing antibodies, and IgG or IgA antibodies to recombinant (r)H5 VN 2004 hemagglutinin (HA) in serum or NW. Fifty-nine participants were enrolled: 21 received 106.7 TCID50 and 21 received 107.5 TCID50 of H5N1 VN 2004 AA ca and 17 received H5N1 HK 2003 AA ca. Shedding of vaccine virus was minimal, as were HI and neutralizing antibody responses. Fifty-two percent of recipients of 107.5 TCID50 of H5N1 VN 2004 AA ca developed a serum IgA response to rH5 VN 2004 HA. Conclusions The live attenuated H5N1 VN 2004 and HK 2003 AA ca vaccines bearing avian H5 HA antigens were very restricted in replication and were more attenuated than seasonal LAIV bearing human H1, H3 or B HA antigens. The H5N1 AA ca LAIV elicited serum ELISA antibody but not HI or neutralizing antibody responses in healthy adults. (ClinicalTrials.gov Identifiers: NCT00347672 and NCT00488046). PMID:19540952

  12. More Active Living-oriented County and Municipal Zoning is Associated with Increased Adult Leisure Time Physical Activity-United States, 2011.

    PubMed

    Chriqui, Jamie F; Nicholson, Lisa M; Thrun, Emily; Leider, Julien; Slater, Sandy J

    2016-01-01

    Although zoning is recognized for its role in facilitating healthy communities, no study has examined whether active living-oriented zoning codes are associated with adult leisure time physical activity (PA). This study sought to fill this gap and hypothesized that adult leisure time PA would be greater in communities with more progressive zoning code reforms and more active living-oriented zoning. Zoning codes for 1,617 county and municipal jurisdictions located in 30 states (covering ~40% of the U.S. population) were evaluated for code reform zoning and 11 active living markers. County-aggregated zoning measures were created for linking with five adult PA behaviors obtained from the 2011 Behavioral Risk Factor Surveillance System controlling for individual and county sociodemographics. Zoning elements most associated with adult PA included requirements for mixed use, active and passive recreation, bike parking/street furniture, and bike-pedestrian trails/paths. This study provides new insights as to the role that zoning can play in facilitating adult PA.

  13. Design and Recruitment of the Chicago Healthy Living Study: A Study of Health Behaviors in a Diverse Cohort of Adult Childhood Cancer Survivors

    PubMed Central

    Stolley, Melinda R.; Sharp, Lisa K.; Arroyo, Claudia; Ruffin, Cherese; Restrepo, Jacqueline; Campbell, Richard

    2009-01-01

    Background Adult childhood cancer survivors are at higher risk for developing late medical effects related to their cancer treatments. Health promoting behaviors may reduce the risk of some late effects and the severity of others. This paper describes the design and recruitment of the Chicago Healthy Living Study (CHLS), an on-going study designed to examine the health behaviors and BMI of minority adult childhood cancer survivors as compared to non-minority survivors and non-cancer controls. Methods Survivors are identified by the hospital cancer registries at five treating institutions in the Chicago area, after which a multilevel recruitment plan is implemented with the goal of enrolling 450 adult survivors of childhood cancer (150 in each racial/ethnic group). Simultaneously, 300 African-American, Hispanic and Non-Hispanic White adult non-cancer controls (100 in each racial/ethnic group) living in the Chicago area are being recruited via listed, targeted digit dial. All participants complete a 2-hour interview of questionnaires related to diet, physical activity, smoking and associated mediators. Height and weight are also measured. Conclusions The Chicago Healthy Living Study will provide important information on the health behaviors of adult minority childhood cancer survivors that can be used to inform the development of interventions to improve modifiable risks. PMID:19731351

  14. Energy allocation during the maturation of adults in a long-lived insect: implications for dispersal and reproduction.

    PubMed

    David, G; Giffard, B; van Halder, I; Piou, D; Jactel, H

    2015-10-01

    Energy allocation strategies have been widely documented in insects and were formalized in the context of the reproduction process by the terms 'capital breeder' and 'income breeder'. We propose here the extension of this framework to dispersal ability, with the concepts of 'capital disperser' and 'income disperser', and explore the trade-off in resource allocation between dispersal and reproduction. We hypothesized that flight capacity was sex-dependent, due to a trade-off in energy allocation between dispersal and egg production in females. We used Monochamus galloprovincialis as model organism, a long-lived beetle which is the European vector of the pine wood nematode. We estimated the flight capacity with a flight mill and used the number of mature eggs as a proxy for the investment in reproduction. We used the ratio between dry weights of the thorax and the abdomen to investigate the trade-off. The probability of flying increased with the adult weight at emergence, but was not dependent on insect age or sex. Flight distance increased with age in individuals but did not differ between sexes. It was also positively associated with energy allocation to thorax reserves, which increased with age. In females, the abdomen weight and the number of eggs also increase with age with no negative effect on flight capacity, indicating a lack of trade-off. This long-lived beetle has a complex strategy of energy allocation, being a 'capital disperser' in terms of flight ability, an 'income disperser' in terms of flight performance and an 'income breeder' in terms of egg production.

  15. Cognitive and Physical Demands of Activities of Daily Living In Older Adults: Validation of Expert Panel Ratings

    PubMed Central

    Fong, Tamara G.; Gleason, Lauren J.; Wong, Bonnie; Habtemariam, Daniel; Jones, Richard N.; Schmitt, Eva M.; de Rooij, Sophia E.; Saczynski, Jane S.; Gross, Alden L.; Bean, Jonathan F.; Brown, Cynthia J.; Fick, Donna M.; Gruber-Baldini, Ann L.; O’Connor, Margaret; Tabloski, Patrica A.; Marcantonio, Edward R.; Inouye, Sharon K.

    2015-01-01

    Background Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living. Objectives To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults. Design Expert panel survey. Setting Web-based platform. Participants Eleven experts from eight academic medical centers and 300 community dwelling elderly adults age 70 and older scheduled for elective non-cardiac surgery from two academic medical centers. Methods Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study. Main Outcome Measurements Correlation between expert ratings and objective neuropsychological tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks. Results Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, while walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychological performance (r=0.13–0.23, p<.05) and largely physical activities correlated with physical performance (r=0.15–0.46, p<.05). Conclusions Quantifying the degree of cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, post-acute care needs, treatment plans, and caregiver education. PMID:25661463

  16. Distribution and Correlates of the Metabolic Syndrome in Adults Living in the San Juan Metropolitan Area of Puerto Rico

    PubMed Central

    Pérez, Cynthia M.; Ortiz, Ana P.; Guzmán, Manuel; Suárez, Erick

    2012-01-01

    Objectives This study evaluated correlates of the metabolic syndrome among adults living in Puerto Rico, a Hispanic subpopulation disproportionately affected by diabetes. Methods A probability cluster design was used to select a sample of households of the San Juan Metropolitan Area in Puerto Rico. A total of 858 persons aged 21–79 years completed a face-to-face interview, blood pressure and anthropometric measurements, blood sampling and spot urine. Logistic regression was employed to assess correlates of the metabolic syndrome. Results Of 368 (42.9%) of adults who met the criteria for metabolic syndrome, elevated fasting glucose (49.8%), abdominal obesity (48.6%), and reduced HDL cholesterol (45.8%) were the most prevalent diagnostic criteria. In a multivariable logistic model that simultaneously adjusted for sociodemographic characteristics and health behaviors, older age, high school educational attainment or less, no alcohol intake, and lack of moderate-to-vigorous physical activity remained significantly (p<0.05) associated to the metabolic syndrome. However, the associations for male gender, some college education, and current smoking ≥20 cigarettes/day had borderline significance. Further controlling for inflammatory markers slightly attenuated the strength of most of these associations but remained significantly (p<0.05) associated to the metabolic syndrome with only a few exceptions. Middle and upper tertiles of hs-CRP, fibrinogen, and PAI-1 and an elevated albumin-to-creatinine ratio were also associated (p<0.05) with the metabolic syndrome. Conclusions Enhancing public education regarding modifiable risk factors for the metabolic syndrome and providing optimal medical management of individual metabolic disturbances among those at risk through preventive lifestyle changes should be placed as a public health priority for Puerto Rico. PMID:23038883

  17. Cytokine polymorphisms and plasma levels are associated with sleep onset insomnia in adults living with HIV/AIDS.

    PubMed

    Gay, Caryl L; Zak, Rochelle S; Lerdal, Anners; Pullinger, Clive R; Aouizerat, Bradley E; Lee, Kathryn A

    2015-07-01

    Sleep disturbance has been associated with inflammation and cytokine activity, and we previously described genetic associations between cytokine polymorphisms and sleep maintenance and duration among adults with HIV/AIDS. Although sleep onset insomnia (SOI) is also a commonly reported sleep problem, associations between cytokine biomarkers and SOI have not been adequately studied. The purpose of this study was to describe SOI in relation to cytokine plasma concentrations and gene polymorphisms in a convenience sample of 307 adults (212 men, 72 women, and 23 transgender) living with HIV/AIDS. Based on the Pittsburgh Sleep Quality Index item that asks the time it usually took to fall asleep in the past month, participants were categorized as either >30min to fall asleep (n=70, 23%) or 30min or less to fall asleep (n=237). Plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL1R2, IL2, IL4, IL6, IL8, IL10, IL13, IL17A), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB1 and NFKB2), and tumor necrosis factor alpha (TNFA). Demographic and clinical variables were evaluated as potential covariates. After adjusting for genomic estimates of ancestry, self-reported race/ethnicity and viral load, SOI was associated with higher IL-13 plasma levels and with six single nucleotide polymorphisms (SNPs): IL1B rs1143642 and rs1143623, IL6 rs4719714, IL13 rs1295686, NFKB1 rs4648110, and TNFA rs2857602. In addition, the IL1B rs1143642 polymorphism was associated with plasma levels of IL-1β in adjusted analyses. This study strengthens the evidence for an association between inflammation and sleep disturbance, particularly self-report of habitual SOI. In this chronic illness population, the cytokine polymorphisms associated with SOI provide direction for future personalized medicine intervention research.

  18. Association Between Pain and Functional Independence in Older Adults During and After Admission to Rehabilitation After an Acute Illness or Injury

    PubMed Central

    Rodriguez, Juan C.; Dzierzewski, Joseph M.; Fung, Constance H.; Jouldjian, Stella; Josephson, Karen R.; Mitchell, Michael N.; Song, Yeonsu; Martin, Jennifer L.; Alessi, Cathy A.

    2016-01-01

    OBJECTIVES To investigate the association between pain and functional independence in older adults during and after admission to rehabilitation after an acute illness or injury. DESIGN Prospective, observational cohort study. SETTING One community and one Veterans Affairs rehabilitation center. PARTICIPANTS Individuals aged 65 and older admitted for rehabilitation after an acute illness or injury (postacute rehabilitation) (N = 245; mean age 80.6, 72% male)). MEASUREMENTS Pain was assessed using the Geriatric Pain Measure (GPM, score 0–100). Functional independence was measured using the motor component of the Functional Independence Measure (mFIM, score 13–91). Both scores were obtained at admission; discharge; and 3-, 6-, and 9-month follow-up. In bivariate analyses, discharge GPM and persistent pain (lasting >3 months) were evaluated as predictors of mFIM score at 9 months. Applying a multilevel modeling (MLM) approach, individual deviations in GPM scores were used to predict variations in mFIM. RESULTS At admission, 210 participants (87.9%) reported pain (16.3% mild (GPM<30); 49.3% moderate (GPM: 30–69); 22.1% severe (GPM>70)); 21.3% reported persistent pain after discharge. The bivariate analyses did not find statistically significant associations between discharge GPM or persistent pain and mFIM score at 9 months, but in the MLM analysis, deviations in GPM were significant predictors of deviations in mFIM score, suggesting that, when individuals experienced above-average levels of pain (GPM > their personal mean GPM), they also experienced worse functional independence (mFIM < their personal mean mFIM). CONCLUSION Twenty-one percent of older adults undergoing postacute rehabilitation reported persistent pain after discharge from rehabilitation. The bivariate analysis did not find association between pain and functional independence, but MLM analysis showed that, when participants experienced more pain than their average, they had less functional

  19. Flow experience in the daily lives of older adults: an analysis of the interaction between flow, individual differences, serious leisure, location, and social context.

    PubMed

    Heo, Jinmoo; Lee, Youngkhill; Pedersen, Paul M; McCormick, Bryan P

    2010-09-01

    This study examined how serious leisure, individual differences, social context, and location contribute to older adults' experiences of flow - an intense psychological state - in their daily lives. The Experience Sampling Method was used with 19 older adults in a Midwestern city in the United States. Experience of flow was the outcome measure, and the data were analyzed using hierarchical linear modeling. Results indicated that location and employment status influenced the subjects' flow experience. Furthermore, the findings revealed that retirement was negatively related to experiencing flow, and there was a significant association between home and the flow experience. The results of this study enhance the understanding of flow experiences in the everyday lives of older adults.

  20. The Experiences of Mothers of Young Adults with an Intellectual Disability Transitioning from Secondary School to Adult Life

    ERIC Educational Resources Information Center

    Dyke, Paula; Bourke, Jenny; Llewellyn, Gwynnyth; Leonard, Helen

    2013-01-01

    Background: The transition from school to adulthood for young adults with an intellectual disability involves movement from a generally secure and supported school environment to an emerging adult life that may be characterised by a wide variation in adoption of adult roles related to employment, independent living, friendships, and day…

  1. Age changes of facial measurements in European young adult males: implications for the identification of the living.

    PubMed

    Gibelli, D; Mapelli, A; Obertovà, Z; Poppa, P; Gabriel, P; Ratnayake, M; Tutkuviene, J; Sforza, C; Ritz-Timme, S; Cattaneo, C

    2012-12-01

    Metric and morphological analyses of facial features are currently applied in cases of personal identification of the living on images acquired from video surveillance systems. However, facial assessment in the forensic context needs to be based on reliable comparative data for facial measurements. Facial changes in the age range of early adulthood (20-30 years) have been rarely described so far, although such knowledge would be beneficial for comparative personal identification on images. This study investigates changes in facial measurements in European males aged between 20 and 30 years in order to identify metric characters that can be used for personal identification in young adults. A sample of 404 males of European ancestry, aged between 20 and 30 years from Germany, Italy and Lithuania were recruited for this project. Fourteen facial measurements were taken and correlation coefficients were calculated for each cranial measurement with age. Only two measurements - labial width and physiognomic ear length - seem to change between 20 and 30 years with a positive statistically significant correlation (p<0.05). These results suggest caution for what may concern personal identification by assessment of ear and mouth morphology.

  2. Clinical and serologic effects of live attenuated serum inhibitor-resistant influenza B vaccine in seronegative adults.

    PubMed

    Miller, L W; Togo, Y; Hornick, R B

    1977-01-01

    The clinical effects, nasal and serum antibody responses, and virus excretion of a live attenuated serum inhibitor-resistant influenza B virus vaccine, R75, was evaluated in 43 seronegative healthy adults by a random double-blind study. Symptom responses were minimal and were not significantly different between vaccine and placebo groups. No fevers, abnormalities in physical examination or laboratory testing developed during 4 weeks of observation. Among vaccinees, 10 (48%) developed serum hemagglutination-inhibition (HI) antibodies, 16 (76%) developed serum neutralization (N) antibodies and 4 (19%) developed nasal N antibodies. The GMT responses from study day 0 to day 28 were 4.0 to 10.4 for serum HI, 1.8 to 9.8 for serum N, and 1.0 to 1.4 for nasal N. There were no significant titer changes in the placebo group. No virus excretion was detected. Although there are some questions concerning the relationship of antibody levels to protection, the low antibody responses in this study are an indication that R75 is not sufficiently immunogenic.

  3. Using exploratory focus groups to establish a sampling strategy to investigate disability experienced by adults living with HIV.

    PubMed

    O'Brien, Kelly K; Bayoumi, Ahmed M; Davis, Aileen M; Young, Nancy L; Strike, Carol

    2009-11-01

    In HIV clinical research, participants are typically sampled based on demographic and/or disease characteristics. As little is known about HIV-specific disability, we did not know whether this purposive type of sampling would be helpful and what characteristics (if any) should guide our sampling strategy. We describe using exploratory focus groups to determine a sampling strategy to investigate disability from the perspective of adults living with HIV. We conducted 4 focus groups with 23 men and women and asked participants to describe their health-related challenges and impact on their overall health. We analyzed data to determine whether health-related challenges differed based on age, gender, ethnocultural background, length of time since HIV diagnosis and antiretroviral use and if these characteristics should be considered when sampling. Participants described seven health-related challenges that appeared not to vary based on demographic or disease characteristics. Variations emerged in the way health-related challenges manifested and the strategies participants used to deal with these challenges. Consequently, we decided upon a broad theoretical sampling strategy for the subsequent interview phase. Exploratory focus groups may be a useful technique to determine a sampling strategy when exploring a new phenomenon in HIV qualitative research.

  4. Physical exercise and functional fitness in independently living vs institutionalized elderly women: a comparison of 60- to 79-year-old city dwellers

    PubMed Central

    Furtado, Hélio L; Sousa, Nelson; Simão, Roberto; Pereira, Fabio Dutra; Vilaça-Alves, José

    2015-01-01

    Purpose To compare functional fitness (FF) levels among independent-living (IL) and day care (DC) elderly women of different age groups and to analyze changes in FF after 8 months of participation in an exercise program intervention for the IL elderly women. Materials and methods A total of 674 elderly women were divided into four IL groups with age in the range of 60–64 years (IL60–64, n=149), 65–69 years (IL65–69, n=138), 70–74 years (IL70–74, n=135), and 75–79 years (IL75–79, n=83), and four DC groups with age in the range of 60–64 years (DC60–64, n=35), 65–69 years (DC65–69, n=34), 70–74 years (DC70–74, n=47), and 75–79 years (DC75–79, n=53). The intervention consisted of a multimodal exercise training, 3 days per week for 8 months. Senior Fitness Test battery performances were obtained at baseline and after 8-month intervention. Results Significant differences were identified between all IL groups and DC groups in all FF tests (P<0.001), except between IL70–74 and DC70–74 in the chair sit-and-reach. Analysis of covariance (ANCOVA) identified significant improvements in all FF tests between pre- and posttests in the IL groups (P<0.001), except in the chair sit-and-reach for the IL70–74. ANCOVA also showed a significant declining performance in all FF tests for DC groups (P<0.001), except in the chair sit-and-reach for the DC70–74 and DC75–79. Conclusion IL women are more fit than institutionalized DC elderly women. The multimodal training was effective in improving all FF components related to daily living activities, in all age groups. In contrast, institutionalized elderly showed a clear tendency to worsen their FF over the time. PMID:25941443

  5. Physical fitness is predictive for a decline in the ability to perform instrumental activities of daily living in older adults with intellectual disabilities: Results of the HA-ID study.

    PubMed

    Oppewal, Alyt; Hilgenkamp, Thessa I M; van Wijck, Ruud; Schoufour, Josje D; Evenhuis, Heleen M

    2015-01-01

    The ability to perform instrumental activities of daily living (IADL) is important for one's level of independence. A high incidence of limitations in IADL is seen in older adults with intellectual disabilities (ID), which is an important determinant for the amount of support one needs. The aim of this study was to assess the predictive value of physical fitness for the ability to perform IADL, over a 3-year follow-up period, in 601 older adults with ID. At baseline, an extensive physical fitness assessment was performed. In addition, professional caregivers completed the Lawton IADL scale, both at baseline and at follow-up. The average ability to perform IADL declined significantly over the 3-year follow-up period. A decline in the ability to perform IADL was seen in 44.3% of the participants. The percentage of participants being completely independent in IADL declined from 2.7% to 1.3%. Manual dexterity, balance, comfortable and fast gait speed, muscular endurance, and cardiorespiratory fitness were significant predictors for a decline in IADL after correcting for baseline IADL and personal characteristics (age, gender, level of ID, and Down syndrome). This can be interpreted as representing the predictive validity of the physical tests for a decline in IADL. This study shows that even though older adults with ID experience dependency on others due to cognitive limitations, physical fitness also is an important aspect for IADL, which stresses the importance of using physical fitness tests and physical fitness enhancing programs in the care for older adults with ID.

  6. Exploring Older Adults' Health Information Seeking Behaviors

    ERIC Educational Resources Information Center

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…

  7. Independent effects of HIV infection and cocaine dependence on neurocognitive impairment in a community sample living in the Southern United States

    PubMed Central

    Meade, Christina S.; Towe, Sheri L.; Skalski, Linda M.; Robertson, Kevin R.

    2015-01-01

    Background Prior studies have established that methamphetamine and HIV can have additive deleterious effects on neurocognitive functioning, but there has been relatively little research on other stimulants like cocaine. This study investigated the effects of cocaine and HIV on neurocognitive impairment in a large, well-characterized sample. Methods The sample included 193 adults across four groups: HIV-positive cocaine users (n=48), HIV-negative cocaine users (n=53), HIV-positive non-drug users (n=60), and HIV-negative non-drug users (n=32). Cocaine users met criteria for lifetime dependence and had past-month cocaine use. A comprehensive battery assessed substance abuse and neurocognitive functioning. Results Participants were mostly male (66%) and African-American (85%), with a mean age of 46.09 years. The rate of global impairment was 33%, with no significant main effects across groups on likelihood of impairment. There were main effects for cocaine on processing speed and executive functioning, with cocaine users having greater impairment (F=9.33 and F=4.22, respectively), and for HIV on attention, with HIV-infected persons having greater impairment (F=5.55). There was an interaction effect for executive functioning, with the three patient groups having greater impairment than controls (F=5.05). Nonparametric analyses revealed significant additive impairment in the presence of both HIV and cocaine for processing speed. Conclusions While cocaine does not appear to increase vulnerability to global HIV-associated neurocognitive impairment, it does have independent adverse effects on executive functioning and processing speed. Given prior evidence that domain-specific deficits predict real-world impairments, our results may help explain the poorer behavioral and functional outcomes observed in HIV-infected cocaine users. PMID:25697913

  8. Use of Portable Electronic Assistive Technology to Improve Independent Job Performance of Young Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Collins, James C.

    2012-01-01

    Poor employment outcomes for persons with intellectual disabilities (ID) persist, despite the development of legal policies designed to enhance access to gainful employment and to promote increased community integration. Recent data suggest that only 37% of young adults with ID obtain paid employment outside of the home. Among persons with ID who…

  9. Restrictive lung disease is an independent predictor of exercise intolerance in the adult with congenital heart disease

    PubMed Central

    Ginde, Salil; Bartz, Peter J.; Hill, Garick D.; Danduran, Michael J.; Biller, Julie; Sowinski, Jane; Tweddell, James S.; Earing, Michael G.

    2016-01-01

    Background/Objectives Following repair of congenital heart disease (CHD), adult patients are at risk for reduced exercise capacity. Restrictive lung disease (RLD) may contribute to reduced exercise capacity in this population. The aim of this study was to determine the prevalence of RLD and its impact on exercise tolerance in the adult with congenital heart disease. Methods One hundred consecutive adult patients with CHD, who underwent routine cardiopulmonary exercise testing with spirometry, were evaluated. Clinical data was obtained by retrospective chart review. Results Patients from 10 major diagnostic groups were identified. The median age for the cohort was 31 years (range 18–63) and included 43 males and 57 females. Most patients, 79%, had at least one previous surgical procedure. Based on spirometry and flow/volume loops, 50 patients were classified as normal pulmonary function, 44 patients had patterns suggestive of RLD, 4 suggestive of mixed (obstructive and restrictive), and 2 indeterminate. Risk factors associated with RLD include history of multiple thoracotomies (odds ratio=9.01, p=0.05) and history of atrial arrhythmias (odd ratio=4.25, p=0.05). Overall, 56% of the patients had abnormal exercise capacity. Spirometry suggestive of RLD was a significant risk factor for decreased exercise capacity (odds ratio=3.65, p=0.03). Patients with spirometry suggesting RLD also had lower exercise duration (p=0.004) and a higher New York Heart Association Functional Class (p=0.02). History of previous surgery and decreased heart rate reserve were also significant risk factors for decreased exercise capacity. Conclusion Abnormal spirometry suggestive of RLD is common in the adult with CHD and is a significant risk factor for decreased exercise tolerance in this population. Further studies, are needed to evaluate the relationship between RLD and exercise intolerance and its relationship to mortality in the adult with CHD. PMID:23075089

  10. Adults Living with OI

    MedlinePlus

    ... Page to view all our online resources Miscellaneous: Web Communities Connect to others affected by OI through to the chat room or an instant messaging service, or leave your thoughts, ideas or solutions on one of the new message forums! Travel Tips Most of the information was compiled to ...

  11. Microglial CX3CR1 promotes adult neurogenesis by inhibiting Sirt 1/p65 signaling independent of CX3CL1.

    PubMed

    Sellner, Sabine; Paricio-Montesinos, Ricardo; Spieß, Alena; Masuch, Annette; Erny, Daniel; Harsan, Laura A; Elverfeldt, Dominik V; Schwabenland, Marius; Biber, Knut; Staszewski, Ori; Lira, Sergio; Jung, Steffen; Prinz, Marco; Blank, Thomas

    2016-09-17

    Homo and heterozygote cx3cr1 mutant mice, which harbor a green fluorescent protein (EGFP) in their cx3cr1 loci, represent a widely used animal model to study microglia and peripheral myeloid cells. Here we report that microglia in the dentate gyrus (DG) of cx3cr1 (-/-) mice displayed elevated microglial sirtuin 1 (SIRT1) expression levels and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) p65 activation, despite unaltered morphology when compared to cx3cr1 (+/-) or cx3cr1 (+/+) controls. This phenotype was restricted to the DG and accompanied by reduced adult neurogenesis in cx3cr1 (-/-) mice. Remarkably, adult neurogenesis was not affected by the lack of the CX3CR1-ligand, fractalkine (CX3CL1). Mechanistically, pharmacological activation of SIRT1 improved adult neurogenesis in the DG together with an enhanced performance of cx3cr1 (-/-) mice in a hippocampus-dependent learning and memory task. The reverse condition was induced when SIRT1 was inhibited in cx3cr1 (-/-) mice, causing reduced adult neurogenesis and lowered hippocampal cognitive abilities. In conclusion, our data indicate that deletion of CX3CR1 from microglia under resting conditions modifies brain areas with elevated cellular turnover independent of CX3CL1.

  12. Adipocyte amino acid sensing controls adult germline stem cell number via the amino acid response pathway and independently of Target of Rapamycin signaling in Drosophila.

    PubMed

    Armstrong, Alissa R; Laws, Kaitlin M; Drummond-Barbosa, Daniela

    2014-12-01

    How adipocytes contribute to the physiological control of stem cells is a critical question towards understanding the link between obesity and multiple diseases, including cancers. Previous studies have revealed that adult stem cells are influenced by whole-body physiology through multiple diet-dependent factors. For example, nutrient-dependent pathways acting within the Drosophila ovary control the number and proliferation of germline stem cells (GSCs). The potential role of nutrient sensing by adipocytes in modulating stem cells in other organs, however, remains largely unexplored. Here, we report that amino acid sensing by adult adipocytes specifically modulates the maintenance of GSCs through a Target of Rapamycin-independent mechanism. Instead, reduced amino acid levels and the consequent increase in uncoupled tRNAs trigger activation of the GCN2-dependent amino acid response pathway within adipocytes, causing increased rates of GSC loss. These studies reveal a new step in adipocyte-stem cell crosstalk.

  13. Vitamin A status of 20- to 59-year-old adults living in Seoul and the metropolitan area, Korea

    PubMed Central

    Kim, Sungah; Kim, Young-Nam

    2012-01-01

    Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of Korean adults living in Seoul and the metropolitan area. Three consecutive 24-h food recalls were collected from 106 healthy subjects (33 males and 73 females) aged 20-59 years. Fasting blood samples of the subjects were obtained and plasma retinol and carotenoids were analyzed. The daily vitamin A intakes (mean ± SD) were 887.77 ± 401.35 µg retinol equivalents or 531.84 ± 226.42 µg retinol activity equivalents. There were no significant differences in vitamin A intakes among age groups. The retinol intake of subjects was 175.92 ± 129.87 µg/day. The retinol intake of the subjects in their 50's was significantly lower than those in their 20's and 30's (P < 0.05). Provitamin A carotenoid intakes were 3,828.37 ± 2,196.29 µg/day β-carotene, 472.57 ± 316.68 µg/day α-carotene, and 412.83 ± 306.46 µg/day β-cryptoxanthin. Approximately 17% of the subjects consumed vitamin A less than the Korean Estimated Average Requirements for vitamin A. The plasma retinol concentration was 1.22 ± 0.34 µmol/L. There was no significant difference in plasma retinol concentrations among age groups. However, the concentrations of β-carotene, lycopene, and lutein of subjects in their 50's were significantly higher than those of in their 20's. Only one subject had a plasma retinol concentration < 0.70 µmol/L indicating marginal vitamin A status. Plasma retinol concentration in 30% of the subjects was 0.70- < 1.05 µmol/L, which is interpreted as the concentration possibly responsive to greater intake of vitamin A. In conclusion, dietary intakes and status of vitamin A were generally adequate in Korean adults examined in this study. PMID:22413040

  14. Gender and Age Differences in Hourly and Daily Patterns of Sedentary Time in Older Adults Living in Retirement Communities

    PubMed Central

    Bellettiere, John; Carlson, Jordan A.; Rosenberg, Dori; Singhania, Anant; Natarajan, Loki; Berardi, Vincent; LaCroix, Andrea Z.; Sears, Dorothy D.; Moran, Kevin; Crist, Katie; Kerr, Jacqueline

    2015-01-01

    Background Total sedentary time varies across population groups with important health consequences. Patterns of sedentary time accumulation may vary and have differential health risks. The purpose of this study is to describe sedentary patterns of older adults living in retirement communities and illustrate gender and age differences in those patterns. Methods Baseline accelerometer data from 307 men and women (mean age = 84±6 years) who wore ActiGraph GT3X+ accelerometers for ≥ 4 days as part of a physical activity intervention were classified into bouts of sedentary time (<100 counts per minute). Linear mixed models were used to account for intra-person and site-level clustering. Daily and hourly summaries were examined in mutually non-exclusive bouts of sedentary time that were 1+, 5+, 10+, 20+, 30+, 40+, 50+, 60+, 90+ and 120+ minutes in duration. Variations by time of day, age and gender were explored. Results Men accumulated more sedentary time than women in 1+, 5+, 10+, 20+, 30+, 40+, 50+ and 60+ minute bouts; the largest gender-differences were observed in 10+ and 20+ minute bouts. Age was positively associated with sedentary time, but only in bouts of 10+, 20+, 30+, and 40+ minutes. Women had more daily 1+ minute sedentary bouts than men (71.8 vs. 65.2), indicating they break up sedentary time more often. For men and women, a greater proportion of time was spent being sedentary during later hours of the day than earlier. Gender differences in intra-day sedentary time were observed during morning hours with women accumulating less sedentary time overall and having more 1+ minute bouts. Conclusions Patterns identified using bouts of sedentary time revealed gender and age differences in the way in which sedentary time was accumulated by older adults in retirement communities. Awareness of these patterns can help interventionists better target sedentary time and may aid in the identification of health risks associated with sedentary behavior. Future studies

  15. Weight Outcomes of Latino Adults and Children Participating in the Y Living Program, a Family-Focused Lifestyle Intervention, San Antonio, 2012–2013

    PubMed Central

    Liang, Yuanyuan; Yin, Zenong; Esparza, Laura; Lopez, Louis

    2015-01-01

    Introduction US Latinos have disproportionately higher rates of obesity and physical inactivity than the general US population, putting them at greater risk for chronic disease. This evaluation aimed to examine the impact of the Y Living Program (Y Living), a 12-week family-focused healthy lifestyle program, on the weight status of adult and child (aged ≥7 years) participants. Methods In this pretest–posttest evaluation, participants attended twice-weekly group education sessions and engaged in physical activity at least 3 times per week. Primary outcome measures were body mass index ([BMI], zBMI and BMI percentile for children), weight, waist circumference, and percentage body fat. Wilcoxon signed-rank tests and mixed effects models were used to evaluate pretest–posttest differences (ie, absolute change and relative change) for adults and children separately. Results BMI, weight, waist circumference, and percentage body fat improved significantly (both absolutely and relatively) among adults who completed the program (n = 180; all P ≤ .001). Conversely, child participants that completed the program (n = 72) showed no improvements. Intervention effects varied across subgroups. Among adults, women and participants who were obese at baseline had larger improvements than did children who were obese at baseline or who were in families that had an annual household income of $15,000 or more. Conclusion Significant improvements in weight were observed among adult participants but not children. This family-focused intervention has potential to prevent excess weight gain among high-risk Latino families. PMID:26652219

  16. Adults with X-linked agammaglobulinemia: impact of disease on daily lives, quality of life, educational and socioeconomic status, knowledge of inheritance, and reproductive attitudes.

    PubMed

    Winkelstein, Jerry A; Conley, Mary Ellen; James, Cynthia; Howard, Vanessa; Boyle, John

    2008-09-01

    Since many children with X-linked agammaglobulinemia (XLA) can now be expected to reach adulthood, knowledge of the status of adults with XLA would be of importance to the patients, their families, and the physicians caring for these patients. We performed the current study in adults with XLA to examine the impact of XLA on their daily lives and quality of life, their educational and socioeconomic status, their knowledge of the inheritance of their disorder, and their reproductive attitudes. Physicians who had entered adult patients with XLA in a national registry were asked to pass on a survey instrument to their patients. The patients then filled out the survey instrument and returned it directly to the investigators. Adults with XLA were hospitalized more frequently and missed more work and/or school than did the general United States population. However, their quality of life was comparable to that of the general United States population. They achieved a higher level of education and had a higher income than did the general United States population. Their knowledge of the inheritance of their disease was excellent. Sixty percent of them would not exercise any reproductive planning options as a result of their disease. The results of the current study suggest that although the disease impacts the daily lives of adults with XLA, they still become productive members of society and excel in many areas.

  17. Learning about the experience of living with chronic conditions: A framework analysis of nursing students' reflections on their conversations with older adults.

    PubMed

    Olson, Amanda; Reiland, Stephanie; Davies, Susan; Koehler, Amy Reitmaier

    2016-10-17

    Preparing nursing students to work effectively with older adults is an important element of undergraduate nursing education. Reflective journals written as course assignments represent a source of data about students' learning. The aim of this study was to analyze nursing students' reflective journals based on conversations with older adults who are community dwelling, to identify learning in relation to experiences of living with a chronic condition. This was one element of a wider study to evaluate learning partnerships between older adults who are community dwelling and nursing students as an alternative to traditional clinical placements in long-term care settings. Nursing students worked with faculty to complete a qualitative secondary analysis of 47 journals utilizing framework analysis. Students learned about three main aspects of living with chronic conditions: beliefs about chronic conditions, managing chronic conditions, and experiencing chronic conditions, with some evidence that these themes may be interconnected. Findings suggest that learning partnerships with older adults combined with reflective journaling enable nursing students to understand the experience of chronic conditions in later life as reflected within current literature and to identify interventions for gerontological nursing practice. Enabling nursing students to recognize the highly skilled nature of working with older adults with chronic illness has the potential to influence their future career choices.

  18. Independent and Interactive Effects of Smoking Bans and Tobacco Taxes on a Cohort of US Young Adults

    PubMed Central

    Kelly, Brian C.; Kadowaki, Joy

    2016-01-01

    Objectives. We examined the mutual effects of smoking bans and taxes on smoking among a longitudinal cohort of young adults. Methods. We combined a repository of US tobacco policies at the state and local level with the nationally representative geocoded National Longitudinal Survey of Youth 1997 (2004–2011) from ages 19 to 31 years and Census data, to examine the impact of tobacco policies on any current and daily pack smoking. The analytic sample amounts to 19 668 observations among 4341 individuals within 487 cities. Results. For current smoking, we found significant effects for comprehensive smoking bans, but not excise taxes. We also found an interaction effect, with bans being most effective in locales with no or low taxes. For daily pack smoking, we found significant effects for taxes, but limited support for bans. Conclusions. Social smoking among young adults is primarily inhibited by smoking bans, but excise taxes only deter such smoking in the absence of a ban. Heavy smokers are primarily deterred by taxes. Although both policies have an impact on young adult smoking behaviors, their dual presence does not intensify each policy’s efficacy. PMID:26691133

  19. Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults living with HIV: A controlled trial

    PubMed Central

    Brown, Larry K.; Kennard, Betsy D.; Emslie, Graham J.; Mayes, Taryn L.; Whiteley, Laura B.; Bethel, James; Xu, Jiahong; Thornton, Sarah; Tanney, Mary R.; Hawkins, Linda A.; Garvie, Patricia A.; Subramaniam, Geetha A.; Worrell, Carol J.; Stoff, Laura W.

    2015-01-01

    Objective Preliminary test of a manualized, measurement-guided treatment for depression for adolescents and young adults in care at four sites of the Adolescent Trials Network for HIV/AIDS Interventions (ATN). Design The U.S. sites were randomly assigned to either a 24-week, combination cognitive behavioral therapy and medication management algorithm (COMB) tailored for youth living with HIV (YLWH) or to treatment as usual (TAU). Methods Youth at TAU sites had access to therapists and medication management as needed. COMB site clinicians were trained in the manualized intervention and participated in supervision calls to monitor intervention fidelity. Results Over the course of the study with 44 participants, those in COMB, compared to those in TAU, reported fewer depressive symptoms, p<0.01 (as measured by the Quick Inventory for Depression Symptomatology) and were more likely to be in remission, p<0.001, (65% vs.10% at week 24 end of treatment, and 71% vs. 7% at week 48 final follow-up). A greater proportion of COMB participants received psychotherapy (95% vs. 45%, p<0.001) and attended more sessions (12.6 vs. 5, p<0.001) than those in TAU. Viral load decreased in both groups and was associated (p<0.05) with reduction in depressive symptoms. Conclusions A 24-week manualized, measurement-guided psychotherapy and medication management algorithm tailored for YLWH was more effective in achieving and sustaining remission from depression than treatment as usual at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics in order to successfully treat YLWH, who are at particular risk for depression. PMID:26761270

  20. Vitamin D status and its associated factors of free living Malay adults in a tropical country, Malaysia.

    PubMed

    Moy, Foong Ming

    2011-09-02

    Vitamin D status is influenced by sun exposure, geographic latitude, daily outdoor activities, body surface exposed to sunlight and dietary intakes. Malaysia, is sunny all year round. However, the vitamin D status of this population especially among the healthy and free living adults is not known. Therefore a study of vitamin D status and associated factors was initiated among an existing Malay cohort in Kuala Lumpur. A total of 380 subjects were sampled to have their vitamin D status assessed using 25-hydroxyvitamin D (25(OH)D). A short questionnaire enquiring socio-demographic characteristics, exposure to sunlight and clothing style was administered. Their mean age was 48.5±5.2years and the mean 25(OH)D for males and females were 56.2±18.9nmol/L and 36.2±13.4nmol/L respectively. There were significant positive correlation for sun exposure score (r=0.27, p<0.001) and negative correlation for sun protection score (r=-0.41, p<0.001) with 25(OH)D levels. In the logistic regression model, females (OR=2.93; 95% CI: 1.17, 7.31), BMI (1.1; 1.03, 1.20) and sun exposure score (0.998; 0.996, 0.999) were significantly associated with vitamin D status as represented by 25(OH)D levels. Our findings show that obesity, lifestyle behaviours and clothing style are directly associated with our participants especially females' low vitamin D status.