[German adaptation of the "Activities-Specific Balance Confidence (ABC) scale" for the assessment of falls-related self-efficacy].

PubMed

Schott, Nadja

2008-12-01

The present study investigates the psychometric properties and the factorial structure of the German adaptation of the Activities-Specific Balance Confidence (ABC) scale (Powell & Myers, 1995) for the evaluation of falls-related self-efficacy in community-dwelling older adults. The German adaptation of the ABC using a forward-backward procedure was administered to 113 older adults (age 68.9+/-8.5 years). The following internationally accepted instruments were used for validation: The Short Form Health Survey SF 36, the Geriatric Depression Scale (GDS), the Trail Making Test and the Letter Number Sequencing Test, and motor tests (balance, strength, mobility). The internal consistency (0.91-0.95) as well as the test-retest reliability of the subscales was excellent (0.94-0.98). The correlation coefficients with the validation instruments ranged between 0.33 and 0.58. Significant differences in the ABC-D scores were found in older adults with and without falls. Older adults with a recent fall history scored lower on the ABC-D than older adults without a recent fall history. To conclude, the German version of the ABC has properties analogous to the original English version and is apparently useful in assessing falls-related self-efficacy.

Functional Mobility Performance and Balance Confidence in Older Adults after Sensorimotor Adaptation Training

NASA Technical Reports Server (NTRS)

Buccello-Stout, Regina R.; Cromwell, Ronita L.; Bloomberg, Jacob J.; Weaver, G. D.

2010-01-01

Research indicates a main contributor of injury in older adults is from falling. The decline in sensory systems limits information needed to successfully maneuver through the environment. The objective of this study was to determine if prolonged exposure to the realignment of perceptual-motor systems increases adaptability of balance, and if balance confidence improves after training. A total of 16 older adults between ages 65-85 were randomized to a control group (walking on a treadmill while viewing a static visual scene) and an experimental group (walking on a treadmill while viewing a rotating visual scene). Prior to visual exposure, participants completed six trials of walking through a soft foamed obstacle course. Participants came in twice a week for 4 weeks to complete training of walking on a treadmill and viewing the visual scene for 20 minutes each session. Participants completed the obstacle course after training and four weeks later. Average time, penalty, and Activity Balance Confidence Scale scores were computed for both groups across testing times. The older adults who trained, significantly improved their time through the obstacle course F (2, 28) = 9.41, p < 0.05, as well as reduced their penalty scores F (2, 28) = 21.03, p < 0.05, compared to those who did not train. There was no difference in balance confidence scores between groups across testing times F (2, 28) = 0.503, p > 0.05. Although the training group improved mobility through the obstacle course, there were no differences between the groups in balance confidence.

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

PubMed

Bobić Lucić, Lana; Grazio, Simeon

2018-01-01

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

Balance ability measured with the Berg balance scale: a determinant of fall history in community-dwelling adults with leg amputation.

PubMed

Wong, Christopher Kevin; Chen, Christine C; Blackwell, Wren M; Rahal, Rana T; Benoy, Stephany A

2015-01-01

Falls are common among adults with leg amputations and associated with balance confidence. But subjective confidence is not equivalent with physical ability. This multivariate analyses of community-dwelling adults with leg amputations examined relationships among individual characteristics, falls, balance ability and balance confidence. Cross-sectional study. Community-dwelling adults with leg amputations recruited from a support group and prosthetic clinic. Subjects provided self-reported medical/fall history, prosthetic functional use, and Activities-specific Balance Confidence (ABC) questionnaire data. Balance ability was assessed with the Berg Balance Scale (BBS). Fall incidence was categorized as any fall (one or more) and recurrent falls (more than one). Multivariate logistic regression analyzed relationships within the two fall categories. Cross tabulations and ANOVA analyzed differences among subcategories. Fifty-four subjects (mean age 56.8) with various etiologies, amputation levels, and balance abilities participated. 53.7% had any fall; 25.9% had recurrent falls. Models for both fall categories correctly classified fall history in > 70% of subjects with combinations of the variables ABC, BBS, body-mass-index, and amputation level. Falls occurred regardless of clinical characteristics. Total BBS and select item scores were independent determinants of fall history. Unlike other balance-impaired populations, adults with leg amputation and better balance ability had greater odds of falling.

Sarcopenia and sarcopenic obesity in Spanish community-dwelling middle-aged and older women: Association with balance confidence, fear of falling and fall risk.

PubMed

Aibar-Almazán, Agustín; Martínez-Amat, Antonio; Cruz-Díaz, David; Jiménez-García, José D; Achalandabaso, Alexander; Sánchez-Montesinos, Indalecio; de la Torre-Cruz, Manuel; Hita-Contreras, Fidel

2018-01-01

To analyze the association of sarcopenia, obesity, and sarcopenic obesity (SO) with fear of falling (FoF) and balance confidence in a Spanish sample of middle-aged and older community-dwelling women. A total of 235 women (69.21±7.56 years) participated in this study. Body composition (bioelectrical impedance analysis), hand-grip strength, and physical performance (gait speed) were evaluated for the diagnosis of sarcopenia, obesity, and SO. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. The Activities-Specific Balance Confidence Scale (ABC) and the Falls Efficacy Scale-International (FES-I) were employed to assess FoF and balance confidence, respectively. Scores of >26 on the FES-I and <67% on the ABC were used to identify women at risk of falling. The independent associations of sarcopenia, obesity and SO with FoF, balance confidence, and fall risk were evaluated by multivariate linear and logistic regressions, adjusting for potential confounding variables. 27.23% and 18.72% of women presented with sarcopenia and SO, respectively. Gait speed, body mass index (BMI), and fall history were independently associated with ABC score (adjusted-R 2 =0.152) and fall risk (ABC) (adjusted-R 2 =0.115). FES-I score was independently associated (adjusted-R 2 =0.193) with fall history, gait speed, BMI, and depression, which, together with obesity (BMI) and SO, remained independent factors for fall risk measured as FES-I score (adjusted-R 2 =0.243). In community-dwelling middle-aged and older Spanish women, BMI, gait speed, and fall history were independently associated with FoF, balance confidence, and fall risk. Depression was related only to FoF, and, together with obesity (BMI) and SO, was an independent predictor of fall risk as assessed by the FES-I. Copyright © 2017 Elsevier B.V. All rights reserved.

Balance Confidence Improves with Resistance or Agility training: Increase is not Correlated with Objective Changes in Fall Risk and Physical Abilities

PubMed Central

Liu-Ambrose, Teresa; Khan, Karim M; Eng, Janice J; Lord, SR; McKay, HA

2012-01-01

Background While the fear of falling is a common psychological consequence of falling, older adults who have not fallen also frequently report this fear. Fear of falling can lead to activity restriction that is self-imposed rather than due to actual physical impairments. Evidence suggests that exercise can significantly improve balance confidence, as measured by falls-related self-efficacy scales. However, there are no prospective reports that correlate change in balance confidence with changes in fall risk and physical abilities as induced by participating in a group-based exercise program. Objective The primary purpose of this prospective study was to examine the relationship between the change in balance confidence and the changes in fall risk and physical abilities in older women with confirmed low bone mass after 13 weeks of exercise participation. The secondary purpose of this study was to examine the relationship between the change in balance confidence and the change in physical activity level. Methods The sample comprised 98 women aged 75 to 85 years old women with low bone mass. Participants were randomly assigned to one of three groups: Resistance Training (n=32), Agility Training (n=34), and Stretching (sham) exercises (n=32). The 50-minute exercise classes for each study arm were held twice weekly at a local YMCA community centre. Results Both resistance training and agility training significantly improved balance confidence by 6% from baseline after 13 weeks. However, the change in balance confidence was only weakly correlated with improved general physical function and not significantly correlated with the changes in fall risk score, postural stability, gait speed, or physical activity level. As well, we observed balance confidence enhancement in the presence of increased fall risk or deterioration in physical abilities. Conclusions Two different types of exercise training improved balance confidence in older women with low bone mass. This change in

The range of confidence scales does not affect the relationship between confidence and accuracy in recognition memory.

PubMed

Tekin, Eylul; Roediger, Henry L

2017-01-01

Researchers use a wide range of confidence scales when measuring the relationship between confidence and accuracy in reports from memory, with the highest number usually representing the greatest confidence (e.g., 4-point, 20-point, and 100-point scales). The assumption seems to be that the range of the scale has little bearing on the confidence-accuracy relationship. In two old/new recognition experiments, we directly investigated this assumption using word lists (Experiment 1) and faces (Experiment 2) by employing 4-, 5-, 20-, and 100-point scales. Using confidence-accuracy characteristic (CAC) plots, we asked whether confidence ratings would yield similar CAC plots, indicating comparability in use of the scales. For the comparisons, we divided 100-point and 20-point scales into bins of either four or five and asked, for example, whether confidence ratings of 4, 16-20, and 76-100 would yield similar values. The results show that, for both types of material, the different scales yield similar CAC plots. Notably, when subjects express high confidence, regardless of which scale they use, they are likely to be very accurate (even though they studied 100 words and 50 faces in each list in 2 experiments). The scales seem convertible from one to the other, and choice of scale range probably does not affect research into the relationship between confidence and accuracy. High confidence indicates high accuracy in recognition in the present experiments.

Clinimetric properties of the Tinetti Mobility Test, Four Square Step Test, Activities-specific Balance Confidence Scale, and spatiotemporal gait measures in individuals with Huntington's disease

PubMed Central

Kloos, Anne D.; Fritz, Nora E.; Kostyk, Sandra K.; Young, Gregory S.; Kegelmeyer, Deb A.

2014-01-01

Background and purpose Individuals with Huntington's disease (HD) experience balance and gait problems that lead to falls. Clinicians currently have very little information about the reliability and validity of outcome measures to determine the efficacy of interventions that aim to reduce balance and gait impairments in HD. This study examined the reliability and concurrent validity of spatiotemporal gait measures, the Tinetti Mobility Test (TMT), Four Square Step Test (FSST), and Activities-specific Balance Confidence (ABC) Scale in individuals with HD. Methods Participants with HD [n = 20; mean age ± SD = 50.9 ± 13.7; 7 male] were tested on spatiotemporal gait measures the TMT, FSST, and ABC Scale before and after a six week period to determine test–retest reliability and minimal detectable change (MDC) values. Linear relationships between gait and clinical measures were estimated using Pearson's correlation coefficients. Results Spatiotemporal gait measures, the TMT total and the FSST showed good to excellent test–retest reliability (ICC > 0.75). MDC values were 0.30 m/s and 0.17 m/s for velocity in forward and backward walking respectively, four points for the TMT, and 3 s for the FSST. The TMT and FSST were highly correlated with most spatiotemporal measures. The ABC Scale demonstrated lower reliability and less concurrent validity than other measures. Conclusions The high test–retest reliability over a six week period and concurrent validity between the TMT, FSST, and spatiotemporal gait measures suggest that the TMT and FSST may be useful outcome measures for future intervention studies in ambulatory individuals with HD. PMID:25128156

Clinimetric properties of the Tinetti Mobility Test, Four Square Step Test, Activities-specific Balance Confidence Scale, and spatiotemporal gait measures in individuals with Huntington's disease.

PubMed

Kloos, Anne D; Fritz, Nora E; Kostyk, Sandra K; Young, Gregory S; Kegelmeyer, Deb A

2014-09-01

Individuals with Huntington's disease (HD) experience balance and gait problems that lead to falls. Clinicians currently have very little information about the reliability and validity of outcome measures to determine the efficacy of interventions that aim to reduce balance and gait impairments in HD. This study examined the reliability and concurrent validity of spatiotemporal gait measures, the Tinetti Mobility Test (TMT), Four Square Step Test (FSST), and Activities-specific Balance Confidence (ABC) Scale in individuals with HD. Participants with HD [n = 20; mean age ± SD=50.9 ± 13.7; 7 male] were tested on spatiotemporal gait measures and the TMT, FSST, and ABC Scale before and after a six week period to determine test-retest reliability and minimal detectable change (MDC) values. Linear relationships between gait and clinical measures were estimated using Pearson's correlation coefficients. Spatiotemporal gait measures, the TMT total and the FSST showed good to excellent test-retest reliability (ICC > 0.75). MDC values were 0.30 m/s and 0.17 m/s for velocity in forward and backward walking respectively, four points for the TMT, and 3s for the FSST. The TMT and FSST were highly correlated with most spatiotemporal measures. The ABC Scale demonstrated lower reliability and less concurrent validity than other measures. The high test-retest reliability over a six week period and concurrent validity between the TMT, FSST, and spatiotemporal gait measures suggest that the TMT and FSST may be useful outcome measures for future intervention studies in ambulatory individuals with HD. Copyright © 2014 Elsevier B.V. All rights reserved.

The Berg Balance Scale has high intra- and inter-rater reliability but absolute reliability varies across the scale: a systematic review.

PubMed

Downs, Stephen; Marquez, Jodie; Chiarelli, Pauline

2013-06-01

What is the intra-rater and inter-rater relative reliability of the Berg Balance Scale? What is the absolute reliability of the Berg Balance Scale? Does the absolute reliability of the Berg Balance Scale vary across the scale? Systematic review with meta-analysis of reliability studies. Any clinical population that has undergone assessment with the Berg Balance Scale. Relative intra-rater reliability, relative inter-rater reliability, and absolute reliability. Eleven studies involving 668 participants were included in the review. The relative intrarater reliability of the Berg Balance Scale was high, with a pooled estimate of 0.98 (95% CI 0.97 to 0.99). Relative inter-rater reliability was also high, with a pooled estimate of 0.97 (95% CI 0.96 to 0.98). A ceiling effect of the Berg Balance Scale was evident for some participants. In the analysis of absolute reliability, all of the relevant studies had an average score of 20 or above on the 0 to 56 point Berg Balance Scale. The absolute reliability across this part of the scale, as measured by the minimal detectable change with 95% confidence, varied between 2.8 points and 6.6 points. The Berg Balance Scale has a higher absolute reliability when close to 56 points due to the ceiling effect. We identified no data that estimated the absolute reliability of the Berg Balance Scale among participants with a mean score below 20 out of 56. The Berg Balance Scale has acceptable reliability, although it might not detect modest, clinically important changes in balance in individual subjects. The review was only able to comment on the absolute reliability of the Berg Balance Scale among people with moderately poor to normal balance. Copyright © 2013 Australian Physiotherapy Association. Published by .. All rights reserved.

Wii Fit Balance Board Playing Improves Balance and Gait in Parkinson Disease

PubMed Central

Mhatre, Priya V.; Vilares, Iris; Stibb, Stacy M.; Albert, Mark V.; Pickering, Laura; Marciniak, Christina M.; Kording, Konrad; Toledo, Santiago

2014-01-01

Objective To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance board system on balance and gait in adults with Parkinson disease (PD). Design A prospective interventional cohort study. Setting An outpatient group exercise class. Participants Ten subjects with PD, Hoehn and Yahr stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. Interventions The subjects participated in supervised group exercise sessions 3 times per week for 8 weeks by practicing 3 different Wii balance board games (marble tracking, skiing, and bubble rafting) adjusted for their individualized function level. The subjects trained for 10 minutes per game, a total of 30 minutes training per session. Main Outcome Measurements Pre-and postexercise training, a physical therapist evaluated subjects’ function by using the Berg Balance Scale, Dynamic Gait Index, and Sharpened Romberg with eyes open and closed. Postural sway was assessed at rest and with tracking tasks by using the Wii balance board. The subjects rated their confidence in balance by using the Activities-specific Balance Confidence scale and depression on the Geriatric Depression Scale. Results Balance as measured by the Berg Balance Scale improved significantly, with an increase of 3.3 points (P = .016). The Dynamic Gait Index improved as well (mean increase, 2.8; P = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%; P = .049). Although the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (P = .07 versus P = .188). There were no significant changes on patient ratings for the Activities-specific Balance Confidence (mean decrease, −1%; P = .922) or the Geriatric Depression Scale (mean increase, 2.2; P = .188). Conclusions An 8-week exercise training class by using the Wii Fit balance board improved selective measures of

Analysis of confidence in continental-scale groundwater recharge estimates for Africa using a distributed water balance model

NASA Astrophysics Data System (ADS)

Mackay, Jonathan; Mansour, Majdi; Bonsor, Helen; Pachocka, Magdalena; Wang, Lei; MacDonald, Alan; Macdonald, David; Bloomfield, John

2014-05-01

There is a growing need for improved access to reliable water in Africa as population and food production increases. Currently approximately 300 million people do not have access to a secure source of safe drinking water. To meet these current and future demands, groundwater will need to be increasingly abstracted; groundwater is more reliable than surface water sources due to its relatively long response time to meteorological stresses and therefore is likely to be a more secure water resource in a more variable climate. Recent studies also quantified the volumes of groundwater potentially available which suggest that, if exploited, groundwater could help to meet the demand for fresh water. However, there is still considerable uncertainty as to how these resources may respond in the future due to changes in groundwater recharge and abstraction. Understanding and quantifying groundwater recharge is vital as it forms a primary indicator of the sustainability of underlying groundwater resources. Computational hydrological models provide a means to do this, but the complexity of recharge processes in Africa mean that these simulations are often highly uncertain. This study aims to evaluate our confidence in simulating groundwater recharge over Africa based on a sensitivity analysis using a distributed hydrological model developed by the British Geological Survey, ZOODRM. The model includes land surface, canopy, river, soil and groundwater components. Each component is able to exchange water and as such, forms a distributed water balance of Africa. The components have been parameterised using available spatial datasets of African vegetation, land-use, soil and hydrogeology while the remaining parameters have been estimated by calibrating the model to available river flow data. Continental-scale gridded precipitation and potential evapotranspiration datasets, based on remotely sensed and ground observations, have been used to force the model. Following calibration, the

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial.

PubMed

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-04-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke.

Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial

PubMed Central

Yatar, Gozde Iyigun; Yildirim, Sibel Aksu

2015-01-01

[Purpose] The aim of this study was to compare the effects of Wii Fit balance training (WBT) and progressive balance training (PBT) approaches on balance functions, balance confidence, and activities of daily living in chronic stroke patients. [Subjects] A total of 30 patients were randomized into the WBT (n=15) and PBT (n=15) groups. [Methods] All of the subjects received exercise training based on a neurodevelopemental approach in addition to either Wii Fit or progressive balance training for total of 1 hour a day, 3 days per week for 4 weeks. Primary measurements were static balance function measured with a Wii Balance Board and dynamic balance function assessed with the Berg Balance Scale, Timed Up and Go test, Dynamic Gait Index, and Functional Reach Test. Secondary measures were balance confidence assessed with the Activities-specific Balance Confidence scale and activities of daily living evaluated with the Frenchay Activity Index. [Results] There was not remarkable difference between the two treatments in dynamic balance functions, balance confidence, and activities of daily living. [Conclusion] Although both of the approaches were found to be effective in improving the balance functions, balance confidence, and activities of daily living, neither of them were more preferable than the other for the treatment of balance in patients with chronic stroke. PMID:25995576

Targeting Low Career Confidence Using the Career Planning Confidence Scale

ERIC Educational Resources Information Center

McAuliffe, Garrett; Jurgens, Jill C.; Pickering, Worth; Calliotte, James; Macera, Anthony; Zerwas, Steven

2006-01-01

The authors describe the development and validation of a test of career planning confidence that makes possible the targeting of specific problem issues in employment counseling. The scale, developed using a rational process and the authors' experience with clients, was tested for criterion-related validity against 2 other measures. The scale…

Wii Fit balance board playing improves balance and gait in Parkinson disease.

PubMed

Mhatre, Priya V; Vilares, Iris; Stibb, Stacy M; Albert, Mark V; Pickering, Laura; Marciniak, Christina M; Kording, Konrad; Toledo, Santiago

2013-09-01

To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance board system on balance and gait in adults with Parkinson disease (PD). A prospective interventional cohort study. An outpatient group exercise class. Ten subjects with PD, Hoehn and Yahr stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. The subjects participated in supervised group exercise sessions 3 times per week for 8 weeks by practicing 3 different Wii balance board games (marble tracking, skiing, and bubble rafting) adjusted for their individualized function level. The subjects trained for 10 minutes per game, a total of 30 minutes training per session. Pre-and postexercise training, a physical therapist evaluated subjects' function by using the Berg Balance Scale, Dynamic Gait Index, and Sharpened Romberg with eyes open and closed. Postural sway was assessed at rest and with tracking tasks by using the Wii balance board. The subjects rated their confidence in balance by using the Activities-specific Balance Confidence scale and depression on the Geriatric Depression Scale. Balance as measured by the Berg Balance Scale improved significantly, with an increase of 3.3 points (P = .016). The Dynamic Gait Index improved as well (mean increase, 2.8; P = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%; P = .049). Although the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (P = .07 versus P = .188). There were no significant changes on patient ratings for the Activities-specific Balance Confidence (mean decrease, -1%; P = .922) or the Geriatric Depression Scale (mean increase, 2.2; P = .188). An 8-week exercise training class by using the Wii Fit balance board improved selective measures of balance and gait in adults with PD. However, no significant changes were seen in mood or

Minimal Clinically Important Difference of Berg Balance Scale in People With Multiple Sclerosis.

PubMed

Gervasoni, Elisa; Jonsdottir, Johanna; Montesano, Angelo; Cattaneo, Davide

2017-02-01

To identify the minimal clinically important difference (MCID) to define clinically meaningful patient's improvement on the Berg Balance Scale (BBS) in people with multiple sclerosis (PwMS) in response to rehabilitation. Cohort study. Neurorehabilitation institute. PwMS (N=110). This study comprised inpatients and outpatients who participated in research on balance and gait rehabilitation. All received 20 rehabilitation sessions with different intensities. Inpatients received daily treatments over a period of 4 weeks, while outpatients received 2 to 3 treatments per week for 10 weeks. An anchor-based approach using clinical global impression of improvement in balance (Activities-specific Balance Confidence [ABC] Scale) was used to determine the MCID of the BBS. The MCID was defined as the minimum change in the BBS total score (postintervention - preintervention) that was needed to perceive at least a 10% improvement on the ABC Scale. Receiver operating characteristic curves were used to define the cutoff of the optimal MCID of the BBS discriminating between improved and not improved subjects. The MCID for change on the BBS was 3 points for the whole sample, 3 points for the inpatients, and 2 points for the outpatients. The area under the curve was .65 for the whole sample, .64 for inpatients, and .68 for outpatients. The MCID for improvement in balance as measured by the BBS was 3 points, meaning that PwMS are likely to perceive that as a reproducible and clinically important change in their balance performance. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

PubMed

Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

2018-04-01

The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

Balance models for equatorial planetary-scale dynamics

NASA Astrophysics Data System (ADS)

Chan, Ian Hiu-Fung

This thesis aims at advancing our understanding of large-scale dynamics in the tropics, specifically the characterization of slow planetary-scale motions through a balance theory; current balance theories in the tropics are unsatisfactory as they filter out Kelvin waves, which are an important component of variability, along with fast inertia-gravity (IG) waves. (Abstract shortened by UMI.).

The community balance and mobility scale alleviates the ceiling effects observed in the currently used gait and balance assessments for the community-dwelling older adults.

PubMed

Balasubramanian, Chitralakshmi K

2015-01-01

Currently used balance assessments show a ceiling effect and lack activities essential for community mobility in higher-functioning older adults. The aim of this study was to investigate the reliability and validity of the Community Balance and Mobility (CB&M) Scale in a high-functioning community-dwelling older adult population since the CB&M Scale includes assessment of several challenging tasks and may alleviate the ceiling effects observed in commonly used gait and balance assessments for this cohort. A convenience sample of 40 older adults (73.4 ± 6.9 years) participated in this cross-sectional study. Previously standardized balance and mobility assessments measuring similar constructs as the CB&M were used for validation. Outcomes included Timed Up and Go Test, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Functional Reach Test (FRT), Short Physical Performance Battery (SPPB), 6-Minute Walk Test (6MWT), Activities Specific Balance Confidence scale (ABC), gait speed, and intraindividual gait variability. A falls questionnaire documented the history of falls. Rater reliability (ICC > 0.95) and internal consistency (α= .97) of the CB&M scale were high. CB&M scores demonstrated strong correlations with DGI, BBS, SPPB, and 6MWT (ρ= 0.70-0.87; P < .01); moderate correlations with falls history, TUG, ABC, and gait speed (ρ= 0.44-0.65; P < .01); and low correlations with FRT, swing and stance time variability (ρ= 0.34-0.37; P < .05). Dynamic Gait Index, BBS, SPPB, and ABC assessments demonstrated ceiling effects (7.5%-32.5%), while no floor or ceiling effects were noted on the CB&M. Logistic regression model showed that the CB&M scores significantly predicted falls history (χ(2) = 6.66, odds ratio = 0.92; P < .01). Area under the curve for the CB&M scale was 0.80 (95% CI: 0.65-0.95). A score of CB&M ≤ 39 was the optimal trade-off between sensitivity and specificity (sensitivity = 79%, specificity = 76%) and a score of CB&M ≤ 45 maximized sensitivity

Fibromyalgia is Associated with Impaired Balance and Falls

PubMed Central

Jones, Kim D.; Horak, Fay B.; Winters, Kerri Stone; Morea, Jessica M.; Bennett, Robert M.

2010-01-01

Background/Objective The purpose of this study was to determine whether FM patients differ from matched healthy controls in clinical tests of balance ability and fall frequency. Methods 34 FM patients and 32 age matched controls were administered the Balance Evaluation-Systems Test (BESTest), rated their balance confidence with the Activities-Specific Balance Confidence Scale (ABC) and reported the number of falls in the last 6 months. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess FM severity. Results FM patients had significantly impaired balance in all components of the BESTest compared to controls. They also scored more poorly on balance confidence. Overall fibromyalgia severity (FIQ) correlated significantly with the BESTest, and the ABC scale. The BESTest and ABC correlated significantly with 6 commonly reported FM symptoms (excluding pain). FM patients reported a total of 37 falls over the last six-months compared to 6 falls in healthy controls. Conclusion Fibromyalgia is associated with balance problems and increased fall frequency. Patients were aware of their balance problems. These results suggest that FM may affect peripheral and/or central mechanisms of postural control. Further objective study is needed to identify the relative contributions of neural and musculoskeletal impairments to postural stability in FM, thus providing clinicians with exercise prescriptions that maximize postural stability. PMID:19125137

The effect of single-task and dual-task balance exercise programs on balance performance in adults with osteoporosis: a randomized controlled preliminary trial.

PubMed

Konak, H E; Kibar, S; Ergin, E S

2016-11-01

Osteoporosis is a serious disease characterized by muscle weakness in the lower extremities, shortened length of trunk, and increased dorsal kyphosis leading to poor balance performance. Although balance impairment increases in adults with osteoporosis, falls and fall-related injuries have been shown to occur mainly during the dual-task performance. Several studies have shown that dual-task performance was improved with specific repetitive dual-task exercises. The aims of this study were to compare the effect of single- and dual-task balance exercise programs on static balance, dynamic balance, and activity-specific balance confidence in adults with osteoporosis and to assess the effectiveness of dual-task balance training on gait speed under dual-task conditions. Older adults (N = 42) (age range, 45-88 years) with osteoporosis were randomly assigned into two groups. Single-task balance training group was given single-task balance exercises for 4 weeks, whereas dual-task balance training group received dual-task balance exercises. Participants received 45-min individualized training session, three times a week. Static balance was evaluated by one-leg stance (OLS) and a kinesthetic ability trainer (KAT) device. Dynamic balance was measured by the Berg Balance Scale (BBS), Time Up and Go (TUG) test, and gait speed. Self-confidence was assessed with the Activities-specific Balance Confidence (ABC-6) scale. Assessments were performed at baseline and after the 4-week program. At the end of the treatment periods, KAT score, BBS score, time in OLS and TUG, gait speeds under single- and dual-task conditions, and ABC-6 scale scores improved significantly in all patients (p < 0.05). However, BBS and gait speeds under single- and dual-task conditions showed significantly greater improvement in the dual-task balance training group than in the single-task balance training group (p < 0.05). ABC-6 scale scores improved more in the single-task balance training group than

Berg Balance Scale score at admission can predict walking suitable for community ambulation at discharge from inpatient stroke rehabilitation.

PubMed

Louie, Dennis R; Eng, Janice J

2018-01-10

This retrospective cohort study identified inpatient rehabilitation admission variables that predict walking ability at discharge and established Berg Balance Scale cut-off scores to predict the extent of improvement in walking. Participants (n=123) were assessed for various cognitive and physical outcomes at admission to inpatient stroke rehabilitation. Multivariate logistic regression identified admission predictors of regaining community ambulation (gait speed ≥0.8 m/s) or unassisted ambulation (no physical assistance) after 4 weeks. Receiver operating characteristic curve analysis identified cut-off admission Berg Balance Scale scores. Mini-Mental State Examination (odds ratio (OR) 1.60, 95% confidence interval (95% CI) 1.19-2.14) was a significant predictor when coupled with admission walking speed for regaining community ambulation speed; stroke type (haemorrhagic/ischaemic) was a significant predictor (OR=0.19, 95% CI 0.05-0.77) when coupled with Berg Balance Scale (OR 1.14, 95% CI 1.09-1.20). Only Berg Balance Scale was a significant predictor of regaining unassisted ambulation (OR 1.11, 95% CI 1.05-1.17). A cut-off Berg Balance Scale score of 29 on admission predicts that an individual will go on to achieve community walking speed (n=123, area under the curve (AUC)=0.88, 95% CI 0.81-0.95); a cut-off score of 12 predicts a non-ambulator to regain unassisted ambulation (n=84, AUC 0.73, 95% CI 0.62-0.84). The Berg Balance Scale can be used at rehabilitation admission to predict the degree of improvement in walking for patients with stroke.

Psychometric Analysis of the Work/Life Balance Self-Assessment Scale.

PubMed

Smeltzer, Suzanne C; Cantrell, Mary Ann; Sharts-Hopko, Nancy C; Heverly, Mary Ann; Jenkinson, Amanda; Nthenge, Serah

2016-01-01

This study investigated the psychometric properties of the Work/Life Balance Self-Assessment scale among nurse faculty involved in doctoral education. A national random sample of 554 respondents completed the Work/Life Balance Self-Assessment scale, which addresses 3 factors: work interference with personal life (WIPL), personal life interference with work (PLIW), and work/personal life enhancement (WPLE). A principal components analysis with varimax rotation revealed 3 internally consistent aspects of work-life balance, explaining 40.5% of the variance. The Cronbach's alpha coefficients for reliability of the scale were .88 for the total scale and for the subscales, .93 (WIPL), .85 (PLIW), and .69 (WPLE). The Work/Life Balance Self-Assessment scale appears to be a reliable and valid instrument to examine work-life balance among nurse faculty.

The Vaccination Confidence Scale: A Brief Measure of Parents’ Vaccination Beliefs

PubMed Central

Gilkey, Melissa B.; Magnus, Brooke E.; Reiter, Paul L.; McRee, Annie-Laurie; Dempsey, Amanda F.; Brewer, Noel T.

2015-01-01

Purpose The success of national immunization programs depends on the public’s confidence in vaccines. We sought to develop a scale for measuring confidence about adolescent vaccination in diverse populations of parents. Methods Data came from 9,623 parents who completed the 2010 National Immunization Survey-Teen, an annual, population-based telephone survey. Parents reported on a 13- to 17-year-old child in their households. We used exploratory and confirmatory factor analysis to identify latent constructs underlying parents’ responses to 8 vaccination belief survey items (response scale 0–10) conceptualized using the Health Belief Model. We assessed the scale’s psychometric properties overall and across demographic subgroups. Results Parents’ confidence about adolescent vaccination was generally high. Analyses provided support for three factors assessing benefits of vaccination (mean = 8.5), harms of vaccination (mean = 3.3), and trust in healthcare providers (mean = 9.0). The model showed good fit both overall (comparative fit index = 0.97) and across demographic subgroups, although internal consistency was variable for the three factors. We found lower confidence among several potentially vulnerable subpopulations, including mothers with lower levels of education and parents whose children were of Hispanic ethnicity (both p<.05). Conclusions Our brief, three-factor scale offers an efficient way to measure confidence in adolescent vaccination across demographic subgroups. Given evidence of lower confidence by educational attainment and race/ethnicity, program planners should consider factors such as health literacy and cultural competence when designing interventions to promote adolescent vaccination to ensure these programs are fully accessible. PMID:25258098

Comparison of the Fullerton Advanced Balance Scale, Mini-BESTest, and Berg Balance Scale to Predict Falls in Parkinson Disease.

PubMed

Schlenstedt, Christian; Brombacher, Stephanie; Hartwigsen, Gesa; Weisser, Burkhard; Möller, Bettina; Deuschl, Günther

2016-04-01

The correct identification of patients with Parkinson disease (PD) at risk for falling is important to initiate appropriate treatment early. This study compared the Fullerton Advanced Balance (FAB) scale with the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS) to identify individuals with PD at risk for falls and to analyze which of the items of the scales best predict future falls. This was a prospective study to assess predictive criterion-related validity. The study was conducted at a university hospital in an urban community. Eighty-five patients with idiopathic PD (Hoehn and Yahr stages: 1-4) participated in the study. Measures were number of falls (assessed prospectively over 6 months), FAB scale, Mini-BESTest, BBS, and Unified Parkinson's Disease Rating Scale. The FAB scale, Mini-BESTest, and BBS showed similar accuracy to predict future falls, with values for area under the curve (AUC) of the receiver operating characteristic (ROC) curve of 0.68, 0.65, and 0.69, respectively. A model combining the items "tandem stance," "rise to toes," "one-leg stance," "compensatory stepping backward," "turning," and "placing alternate foot on stool" had an AUC of 0.84 of the ROC curve. There was a dropout rate of 19/85 participants. The FAB scale, Mini-BESTest, and BBS provide moderate capacity to predict "fallers" (people with one or more falls) from "nonfallers." Only some items of the 3 scales contribute to the detection of future falls. Clinicians should particularly focus on the item "tandem stance" along with the items "one-leg stance," "rise to toes," "compensatory stepping backward," "turning 360°," and "placing foot on stool" when analyzing postural control deficits related to fall risk. Future research should analyze whether balance training including the aforementioned items is effective in reducing fall risk. © 2016 American Physical Therapy Association.

The effectiveness of Pilates on balance and falls in community dwelling older adults.

PubMed

Josephs, Sharon; Pratt, Mary Lee; Calk Meadows, Emily; Thurmond, Stephanie; Wagner, Amy

2016-10-01

The purpose of this study was to determine whether Pilates is more effective than traditional strength and balance exercises for improving balance measures, balance confidence and reducing falls in community dwelling older adults with fall risk. Thirty-one participants with fall risk were randomly assigned to the Pilates group (PG) or the traditional exercise group (TG). Both groups participated in 12 weeks of exercise, 2 times/week for 1 h. There was significant improvement in the Fullerton Advanced Balance Scale for both the PG (mean difference = 6.31, p < .05) and the TG (mean difference = 7.45, p = .01). The PG also showed significant improvement in the Activities-Specific Balance Confidence Scale (mean difference = 10.57, p = .008). Both Pilates and traditional balance programs are effective at improving balance measures in community dwelling older adults with fall risk, with the Pilates group showing improved balance confidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Enhancement of a prosthetic knee with a microprocessor-controlled gait phase switch reduces falls and improves balance confidence and gait speed in community ambulators with unilateral transfemoral amputation.

PubMed

Fuenzalida Squella, Sara Agueda; Kannenberg, Andreas; Brandão Benetti, Ângelo

2018-04-01

Despite the evidence for improved safety and function of microprocessor stance and swing-controlled prosthetic knees, non-microprocessor-controlled prosthetic knees are still standard of care for persons with transfemoral amputations in most countries. Limited feature microprocessor-control enhancement of such knees could stand to significantly improve patient outcomes. To evaluate gait speed, balance, and fall reduction benefits of the new 3E80 default stance hydraulic knee compared to standard non-microprocessor-controlled prosthetic knees. Comparative within-subject clinical study. A total of 13 young, high-functioning community ambulators with a transfemoral amputation underwent assessment of performance-based (e.g. 2-min walk test, timed ramp/stair tests) and self-reported (e.g. falls, Activities-Specific Balance Confidence scale, Prosthesis Evaluation Questionnaire question #1, Satisfaction with the Prosthesis) outcome measures for their non-microprocessor-controlled prosthetic knees and again after 8 weeks of accommodation to the 3E80 microprocessor-enhanced knee. Self-reported falls significantly declined 77% ( p = .04), Activities-Specific Balance Confidence scores improved 12 points ( p = .005), 2-min walk test walking distance increased 20 m on level ( p = .01) and uneven ( p = .045) terrain, and patient satisfaction significantly improved ( p < .01) when using the 3E80 knee. Slope and stair ambulation performance did not differ between knee conditions. The 3E80 knee reduced self-reported fall incidents and improved balance confidence. Walking performance on both level and uneven terrains also improved compared to non-microprocessor-controlled prosthetic knees. Subjects' satisfaction was significantly higher than with their previous non-microprocessor-controlled prosthetic knees. The 3E80 may be considered a prosthetic option for improving gait performance, balance confidence, and safety in highly active amputees. Clinical

Psychometric properties of the communication Confidence Rating Scale for Aphasia (CCRSA): phase 1.

PubMed

Cherney, Leora R; Babbitt, Edna M; Semik, Patrick; Heinemann, Allen W

2011-01-01

Confidence is a construct that has not been explored previously in aphasia research. We developed the Communication Confidence Rating Scale for Aphasia (CCRSA) to assess confidence in communicating in a variety of activities and evaluated its psychometric properties using rating scale (Rasch) analysis. The CCRSA was administered to 21 individuals with aphasia before and after participation in a computer-based language therapy study. Person reliability of the 8-item CCRSA was .77. The 5-category rating scale demonstrated monotonic increases in average measures from low to high ratings. However, one item ("I follow news, sports, stories on TV/movies") misfit the construct defined by the other items (mean square infit = 1.69, item-measure correlation = .41). Deleting this item improved reliability to .79; the 7 remaining items demonstrated excellent fit to the underlying construct, although there was a modest ceiling effect in this sample. Pre- to posttreatment changes on the 7-item CCRSA measure were statistically significant using a paired samples t test. Findings support the reliability and sensitivity of the CCRSA in assessing participants' self-report of communication confidence. Further evaluation of communication confidence is required with larger and more diverse samples.

Newton's Third Law on a Scale Balance

ERIC Educational Resources Information Center

Nopparatjamjomras, Suchai; Panijpan, Bhinyo; Huntula, Jiradawan

2009-01-01

We propose a series of experiments involving balance readings of an object naturally floating or forced to be partially or fully immersed in water contained in a beaker sitting on an electronic scale balance. Students were asked to predict, observe and explain each case. The teacher facilitated the learning by asking probing questions, giving…

Balance self-efficacy in older adults following inpatient rehabilitation.

PubMed

Kuys, Suzanne S; Donovan, Jacquelin; Mattin, Sarah; Low Choy, Nancy L

2015-06-01

Older adults discharging from inpatient rehabilitation were investigated to determine change in self-efficacy at 1 month after discharge, the relationship with discharge balance performance and physical function, and the influence of diagnosis. A prospective cohort of 101 adults older than 50 years of age, 43% men, average age 75.84 (SD 9.8) years, were recruited at discharge from inpatient rehabilitation. Balance self-efficacy was assessed using Activities-specific Balance Confidence (ABC) scale at discharge and 1 month following discharge. Balance and physical function were measured at discharge using the Functional Independence Measure, Balance Outcome Measure for Elder Rehabilitation, Modified Elderly Mobility Scale and gait speed. At discharge, balance self-efficacy was moderate (ABC score 62, SD 23) and did not change at follow-up. When grouped by discharge self-efficacy (ABC scores: low<50; moderate 51-80; high>80), significant between-group differences were found for balance (P=0.005) and physical function (P=0.035). At the 1-month follow-up, those with low discharge balance self-efficacy showed improvement (mean-change ABC score 12, 95% confidence interval 2-22) and those with high discharge balance self-efficacy had lower scores (mean-change ABC score 18, 95% confidence interval -8 to -28). Differences in ABC change scores were also found between diagnostic groups (F=3.740, P=0.03), with the orthopaedic group improving (ABC mean change=8) and the general frailty group showing a decrease in confidence (ABC mean change=10). The differences in balance self-efficacy change at 1 month following discharge were related to self-efficacy level at discharge and clinical group requiring rehabilitation. Clinicians need to be aware of these changes as patients are prepared for discharge.

Balance exercise program reduced falls in people with multiple sclerosis: a single-group, pretest-posttest trial.

PubMed

Nilsagård, Ylva Elisabet; von Koch, Lena Kristina; Nilsson, Malin; Forsberg, Anette Susanne

2014-12-01

To evaluate the effects of a balance exercise program on falls in people with mild to moderate multiple sclerosis (MS). Multicenter, single-blinded, single-group, pretest-posttest trial. Seven rehabilitation units within 5 county councils. Community-dwelling adults with MS (N=32) able to walk 100m but unable to maintain 30-second tandem stance with arms alongside the body. Seven weeks of twice-weekly, physiotherapist-led 60-minute sessions of group-based balance exercise targeting core stability, dual tasking, and sensory strategies (CoDuSe). Primary outcomes: number of prospectively reported falls and proportion of participants classified as fallers during 7 preintervention weeks, intervention period, and 7 postintervention weeks. Secondary outcomes: balance performance on the Berg Balance Scale, Four Square Step Test, sit-to-stand test, timed Up and Go test (alone and with cognitive component), and Functional Gait Assessment Scale; perceived limitations in walking on the 12-item MS Walking Scale; and balance confidence on the Activities-specific Balance Confidence Scale rated 7 weeks before intervention, directly after intervention, and 7 weeks later. Number of falls (166 to 43; P≤.001) and proportion of fallers (17/32 to 10/32; P≤.039) decreased significantly between the preintervention and postintervention periods. Balance performance improved significantly. No significant differences were detected for perceived limitations in walking, balance confidence, the timed Up and Go test, or sit-to-stand test. The CoDuSe program reduced falls and proportion of fallers and improved balance performance in people with mild to moderate MS but did not significantly alter perceived limitations in walking and balance confidence. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations.

PubMed

Bloem, Bastiaan R; Marinus, Johan; Almeida, Quincy; Dibble, Lee; Nieuwboer, Alice; Post, Bart; Ruzicka, Evzen; Goetz, Christopher; Stebbins, Glenn; Martinez-Martin, Pablo; Schrag, Anette

2016-09-01

Disorders of posture, gait, and balance in Parkinson's disease (PD) are common and debilitating. This MDS-commissioned task force assessed clinimetric properties of existing rating scales, questionnaires, and timed tests that assess these features in PD. A literature review was conducted. Identified instruments were evaluated systematically and classified as "recommended," "suggested," or "listed." Inclusion of rating scales was restricted to those that could be used readily in clinical research and practice. One rating scale was classified as "recommended" (UPDRS-derived Postural Instability and Gait Difficulty score) and 2 as "suggested" (Tinetti Balance Scale, Rating Scale for Gait Evaluation). Three scales requiring equipment (Berg Balance Scale, Mini-BESTest, Dynamic Gait Index) also fulfilled criteria for "recommended" and 2 for "suggested" (FOG score, Gait and Balance Scale). Four questionnaires were "recommended" (Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, and Fear of Falling in the Elderly-Modified). Four tests were classified as "recommended" (6-minute and 10-m walk tests, Timed Up-and-Go, Functional Reach). We identified several questionnaires that adequately assess freezing of gait and balance confidence in PD and a number of useful clinical tests. However, most clinical rating scales for gait, balance, and posture perform suboptimally or have been evaluated insufficiently. No instrument comprehensively and separately evaluates all relevant PD-specific gait characteristics with good clinimetric properties, and none provides separate balance and gait scores with adequate content validity for PD. We therefore recommend the development of such a PD-specific, easily administered, comprehensive gait and balance scale that separately assesses all relevant constructs. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder

Influence of spasticity on mobility and balance in persons with multiple sclerosis.

PubMed

Sosnoff, Jacob J; Gappmaier, Eduard; Frame, Amy; Motl, Robert W

2011-09-01

Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes that presumably affects mobility and balance. This investigation examined the hypothesis that persons with multiple sclerosis (MS) who have spasticity of the lower legs would have more impairment of mobility and balance compared to those without spasticity. Participants were 34 ambulatory persons with a definite diagnosis of MS. The expanded disability status scale (EDSS) was used to characterize disability in the study sample. All participants underwent measurements of spasticity in the gastroc-soleus muscles of both legs (modified Ashworth scale), walking speed (timed 25-foot walk), mobility (Timed Up and Go), walking endurance (6-minute walk test), self-reported impact of MS on walking ability (Multiple Sclerosis Walking Scale-12), and balance (Berg Balance Test and Activities-specific Balance Confidence Scale). Fifteen participants had spasticity of the gastroc-soleus muscles based on modified Ashworth scale scores. The spasticity group had lower median EDSS scores indicating greater disability (P=0.03). Mobility and balance were significantly more impaired in the group with spasticity compared to the group without spasticity: timed 25-foot walk (P = 0.02, d = -0.74), Timed Up and Go (P = 0.01, d = -0.84), 6-minute walk test (P < 0.01, d = 1.03), Multiple Sclerosis Walking Scale-12 (P = 0.04, d = -0.76), Berg Balance Test (P = 0.02, d = -0.84) and Activities-specific Balance Confidence Scale (P = 0.04, d = -0.59). Spasticity in the gastroc-soleus muscles appears to have negative effect on mobility and balance in persons with MS. The relationship between spasticity and disability in persons with MS requires further exploration.

Validation of the Italian Version of the Dizziness Handicap Inventory, the Situational Vertigo Questionnaire, and the Activity-Specific Balance Confidence Scale for Peripheral and Central Vestibular Symptoms.

PubMed

Colnaghi, Silvia; Rezzani, Cristiana; Gnesi, Marco; Manfrin, Marco; Quaglieri, Silvia; Nuti, Daniele; Mandalà, Marco; Monti, Maria Cristina; Versino, Maurizio

2017-01-01

Neurophysiological measurements of the vestibular function for diagnosis and follow-up evaluations provide an objective assessment, which, unfortunately, does not necessarily correlate with the patients' self-feeling. The literature provides many questionnaires to assess the outcome of rehabilitation programs for disequilibrium, but only for the Dizziness Handicap Inventory (DHI) is an Italian translation available, validated on a small group of patients suffering from a peripheral acute vertigo. We translated and validated the reliability and validity of the DHI, the Situational Vertigo Questionnaire (SVQ), and the Activities-Specific Balance Confidence Scale (ABC) in 316 Italian patients complaining of dizziness due either to a peripheral or to a central vestibular deficit, or in whom vestibular signs were undetectable by means of instrumental testing or clinical evaluation. Cronbach's coefficient alpha, the homogeneity index, and test-retest reproducibility, confirmed reliability of the Italian version of the three questionnaires. Validity was confirmed by correlation test between questionnaire scores. Correlations with clinical variables suggested that they can be used as a complementary tool for the assessment of vestibular symptoms. In conclusion, the Italian versions of DHI, SVQ, and ABC are reliable and valid questionnaires for assessing the impact of dizziness on the quality of life of Italian patients with peripheral or central vestibular deficit.

Validation of the Italian Version of the Dizziness Handicap Inventory, the Situational Vertigo Questionnaire, and the Activity-Specific Balance Confidence Scale for Peripheral and Central Vestibular Symptoms

PubMed Central

Colnaghi, Silvia; Rezzani, Cristiana; Gnesi, Marco; Manfrin, Marco; Quaglieri, Silvia; Nuti, Daniele; Mandalà, Marco; Monti, Maria Cristina; Versino, Maurizio

2017-01-01

Neurophysiological measurements of the vestibular function for diagnosis and follow-up evaluations provide an objective assessment, which, unfortunately, does not necessarily correlate with the patients’ self-feeling. The literature provides many questionnaires to assess the outcome of rehabilitation programs for disequilibrium, but only for the Dizziness Handicap Inventory (DHI) is an Italian translation available, validated on a small group of patients suffering from a peripheral acute vertigo. We translated and validated the reliability and validity of the DHI, the Situational Vertigo Questionnaire (SVQ), and the Activities-Specific Balance Confidence Scale (ABC) in 316 Italian patients complaining of dizziness due either to a peripheral or to a central vestibular deficit, or in whom vestibular signs were undetectable by means of instrumental testing or clinical evaluation. Cronbach’s coefficient alpha, the homogeneity index, and test–retest reproducibility, confirmed reliability of the Italian version of the three questionnaires. Validity was confirmed by correlation test between questionnaire scores. Correlations with clinical variables suggested that they can be used as a complementary tool for the assessment of vestibular symptoms. In conclusion, the Italian versions of DHI, SVQ, and ABC are reliable and valid questionnaires for assessing the impact of dizziness on the quality of life of Italian patients with peripheral or central vestibular deficit. PMID:29066999

Validation of the Work-Life Balance Culture Scale (WLBCS).

PubMed

Nitzsche, Anika; Jung, Julia; Kowalski, Christoph; Pfaff, Holger

2014-01-01

The purpose of this paper is to describe the theoretical development and initial validation of the newly developed Work-Life Balance Culture Scale (WLBCS), an instrument for measuring an organizational culture that promotes the work-life balance of employees. In Study 1 (N=498), the scale was developed and its factorial validity tested through exploratory factor analyses. In Study 2 (N=513), confirmatory factor analysis (CFA) was performed to examine model fit and retest the dimensional structure of the instrument. To assess construct validity, a priori hypotheses were formulated and subsequently tested using correlation analyses. Exploratory and confirmatory factor analyses revealed a one-factor model. Results of the bivariate correlation analyses may be interpreted as preliminary evidence of the scale's construct validity. The five-item WLBCS is a new and efficient instrument with good overall quality. Its conciseness makes it particularly suitable for use in employee surveys to gain initial insight into a company's perceived work-life balance culture.

Reliability and Validity of the Evidence-Based Practice Confidence (EPIC) Scale

ERIC Educational Resources Information Center

Salbach, Nancy M.; Jaglal, Susan B.; Williams, Jack I.

2013-01-01

Introduction: The reliability, minimal detectable change (MDC), and construct validity of the evidence-based practice confidence (EPIC) scale were evaluated among physical therapists (PTs) in clinical practice. Methods: A longitudinal mail survey was conducted. Internal consistency and test-retest reliability were estimated using Cronbach's alpha…

Evaluation of the reliability and validity for X16 balance testing scale for the elderly.

PubMed

Ju, Jingjuan; Jiang, Yu; Zhou, Peng; Li, Lin; Ye, Xiaolei; Wu, Hongmei; Shen, Bin; Zhang, Jialei; He, Xiaoding; Niu, Chunjin; Xia, Qinghua

2018-05-10

Balance performance is considered as an indicator of functional status in the elderly, a large scale population screening and evaluation in the community context followed by proper interventions would be of great significance at public health level. However, there has been no suitable balance testing scale available for large scale studies in the unique community context of urban China. A balance scale named X16 balance testing scale was developed, which was composed of 3 domains and 16 items. A total of 1985 functionally independent and active community-dwelling elderly adults' balance abilities were tested using the X16 scale. The internal consistency, split-half reliability, content validity, construct validity, discriminant validity of X16 balance testing scale were evaluated. Factor analysis was performed to identify alternative factor structure. The Eigenvalues of factors 1, 2, and 3 were 8.53, 1.79, and 1.21, respectively, and their cumulative contribution to the total variance reached 72.0%. These 3 factors mainly represented domains static balance, postural stability, and dynamic balance. The Cronbach alpha coefficient for the scale was 0.933. The Spearman correlation coefficients between items and its corresponding domains were ranged from 0.538 to 0.964. The correlation coefficients between each item and its corresponding domain were higher than the coefficients between this item and other domains. With the increase of age, the scores of balance performance, domains static balance, postural stability, and dynamic balance in the elderly declined gradually (P < 0.001). With the increase of age, the proportion of the elderly with intact balance performance decreased gradually (P < 0.001). The reliability and validity of the X16 balance testing scale is both adequate and acceptable. Due to its simple and quick use features, it is practical to be used repeatedly and routinely especially in community setting and on large scale screening.

The integrated model of sport confidence: a canonical correlation and mediational analysis.

PubMed

Koehn, Stefan; Pearce, Alan J; Morris, Tony

2013-12-01

The main purpose of the study was to examine crucial parts of Vealey's (2001) integrated framework hypothesizing that sport confidence is a mediating variable between sources of sport confidence (including achievement, self-regulation, and social climate) and athletes' affect in competition. The sample consisted of 386 athletes, who completed the Sources of Sport Confidence Questionnaire, Trait Sport Confidence Inventory, and Dispositional Flow Scale-2. Canonical correlation analysis revealed a confidence-achievement dimension underlying flow. Bias-corrected bootstrap confidence intervals in AMOS 20.0 were used in examining mediation effects between source domains and dispositional flow. Results showed that sport confidence partially mediated the relationship between achievement and self-regulation domains and flow, whereas no significant mediation was found for social climate. On a subscale level, full mediation models emerged for achievement and flow dimensions of challenge-skills balance, clear goals, and concentration on the task at hand.

Mental imagery. Effects on static balance and attentional demands of the elderly.

PubMed

Hamel, M F; Lajoie, Yves

2005-06-01

Several studies have demonstrated the effectiveness of mental imagery in improving motor performance. However, no research has studied the effectiveness of such a technique on static balance in the elderly. This study evaluated the efficiency of a mental imagery technique, aimed at improving static balance by reducing postural oscillations and attentional demands in the elderly. Twenty subjects aged 65 to 90 years old, divided into two groups (8 in Control group and 12 in Experimental group) participated in the study. The experimental participants underwent daily mental imagery training for a period of six weeks. Antero-posterior and lateral oscillations, reaction times during the use of the double-task paradigm were measured, and the Berg Balance Scale, Activities-specific Balance Confidence Scale, and VMIQ questionnaire were answered during both pre-test and post-test. Attentional demands and postural oscillations (antero-posterior) decreased significantly in the group with mental imagery training compared with those of the Control group. Subjects in the mental imagery group became significantly better in their aptitudes to generate clear vivid mental images, as indicated by the VMIQ questionnaire, whereas no significant difference was observed for the Activities-specific Balance Confidence Scale or Berg Scale. The results support psychoneuromuscular and motor coding theories associated with mental imagery.

Reliability, Validity, and Ability to Identify Fall Status of the Balance Evaluation Systems Test, Mini-Balance Evaluation Systems Test, and Brief-Balance Evaluation Systems Test in Older People Living in the Community.

PubMed

Marques, Alda; Almeida, Sara; Carvalho, Joana; Cruz, Joana; Oliveira, Ana; Jácome, Cristina

2016-12-01

To assess the reliability, validity, and ability to identify fall status of the Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest, compared with the Berg Balance Scale (BBS), in older people living in the community. Cross-sectional. Community centers. Older adults (N=122; mean age ± SD, 76±9y). Not applicable. Participants reported on falls history in the preceding year and completed the Activities-Specific Balance Confidence (ABC) Scale. The BBS, BESTest, and the Five Times Sit-To-Stand Test were administered. Interrater (2 physiotherapists) and test-retest relative (48-72h) and absolute reliabilities were explored with the intraclass correlation coefficient (ICC) equation (2,1) and the Bland and Altman method. Minimal detectable changes at the 95% confidence level (MDC 95 ) were established. Validity was assessed by correlating the balance tests with each other and with the ABC Scale (Spearman correlation coefficients-ρ). Receiver operating characteristics assessed the ability of each balance test to differentiate between people with and without a history of falls. All balance tests presented good to excellent interrater (ICC=.71-.93) and test-retest (ICC=.50-.82) relative reliability, with no evidence of bias. MDC 95 values were 4.6, 9, 3.8, and 4.1 points for the BBS, BESTest, Mini-BESTest, and Brief-BESTest, respectively. All tests were significantly correlated with each other (ρ=.83-.96) and with the ABC Scale (ρ=.46-.61). Acceptable ability to identify fall status (areas under the curve, .71-.78) was found for all tests. Cutoff points were 48.5, 82, 19.5, and 12.5 points for the BBS, BESTest, Mini-BESTest, and Brief-BESTest, respectively. All balance tests are reliable, valid, and able to identify fall status in older people living in the community. Therefore, the choice of which test to use will depend on the level of balance impairment, purpose, and time availability. Copyright © 2016. Published by Elsevier Inc.

Sensory integration balance training in patients with multiple sclerosis: A randomized, controlled trial.

PubMed

Gandolfi, Marialuisa; Munari, Daniele; Geroin, Christian; Gajofatto, Alberto; Benedetti, Maria Donata; Midiri, Alessandro; Carla, Fontana; Picelli, Alessandro; Waldner, Andreas; Smania, Nicola

2015-10-01

Impaired sensory integration contributes to balance disorders in patients with multiple sclerosis (MS). The objective of this paper is to compare the effects of sensory integration balance training against conventional rehabilitation on balance disorders, the level of balance confidence perceived, quality of life, fatigue, frequency of falls, and sensory integration processing on a large sample of patients with MS. This single-blind, randomized, controlled trial involved 80 outpatients with MS (EDSS: 1.5-6.0) and subjective symptoms of balance disorders. The experimental group (n = 39) received specific training to improve central integration of afferent sensory inputs; the control group (n = 41) received conventional rehabilitation (15 treatment sessions of 50 minutes each). Before, after treatment, and at one month post-treatment, patients were evaluated by a blinded rater using the Berg Balance Scale (BBS), Activities-specific Balance Confidence Scale (ABC), Multiple Sclerosis Quality of Life-54, Fatigue Severity Scale (FSS), number of falls and the Sensory Organization Balance Test (SOT). The experimental training program produced greater improvements than the control group training on the BBS (p < 0.001), the FSS (p < 0.002), number of falls (p = 0.002) and SOT (p < 0.05). Specific training to improve central integration of afferent sensory inputs may ameliorate balance disorders in patients with MS. Clinical Trial Registration (NCT01040117). © The Author(s), 2015.

Validity, Reliability, and Ability to Identify Fall Status of the Berg Balance Scale, BESTest, Mini-BESTest, and Brief-BESTest in Patients With COPD.

PubMed

Jácome, Cristina; Cruz, Joana; Oliveira, Ana; Marques, Alda

2016-11-01

The Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), Mini-BESTest, and Brief-BESTest are useful in the assessment of balance. Their psychometric properties, however, have not been tested in patients with chronic obstructive pulmonary disease (COPD). This study aimed to compare the validity, reliability, and ability to identify fall status of the BBS, BESTest, Mini-BESTest, and the Brief-BESTest in patients with COPD. A cross-sectional study was conducted. Forty-six patients (24 men, 22 women; mean age=75.9 years, SD=7.1) were included. Participants were asked to report their falls during the previous 12 months and to fill in the Activity-specific Balance Confidence (ABC) Scale. The BBS and the BESTest were administered. Mini-BESTest and Brief-BESTest scores were computed based on the participants' BESTest performance. Validity was assessed by correlating balance tests with each other and with the ABC Scale. Interrater reliability (2 raters), intrarater reliability (48-72 hours), and minimal detectable changes (MDCs) were established. Receiver operating characteristics assessed the ability of each balance test to differentiate between participants with and without a history of falls. Balance test scores were significantly correlated with each other (Spearman correlation rho=.73-.90) and with the ABC Scale (rho=.53-.75). Balance tests presented high interrater reliability (intraclass correlation coefficient [ICC]=.85-.97) and intrarater reliability (ICC=.52-.88) and acceptable MDCs (MDC=3.3-6.3 points). Although all balance tests were able to identify fall status (area under the curve=0.74-0.84), the BBS (sensitivity=73%, specificity=77%) and the Brief-BESTest (sensitivity=81%, specificity=73%) had the higher ability to identify fall status. Findings are generalizable mainly to older patients with moderate COPD. The 4 balance tests are valid, reliable, and valuable in identifying fall status in patients with COPD. The Brief-BESTest presented

Validity of Sex-Balanced Interest Inventory Scales

ERIC Educational Resources Information Center

Hanson, Gary R.; Rayman, Jack

1976-01-01

This study examines the effectiveness of sex-balanced and sex-restrictive raw score interest scales in discriminating among vocational preference groups. Analyses were conducted separately for 502 males in six vocational preference groups and 878 females in five vocational preference groups. Differences may restrict career suggestions provided to…

Estimating basin scale evapotranspiration (ET) by water balance and remote sensing methods

USGS Publications Warehouse

Senay, G.B.; Leake, S.; Nagler, P.L.; Artan, G.; Dickinson, J.; Cordova, J.T.; Glenn, E.P.

2011-01-01

Evapotranspiration (ET) is an important hydrological process that can be studied and estimated at multiple spatial scales ranging from a leaf to a river basin. We present a review of methods in estimating basin scale ET and its applications in understanding basin water balance dynamics. The review focuses on two aspects of ET: (i) how the basin scale water balance approach is used to estimate ET; and (ii) how ‘direct’ measurement and modelling approaches are used to estimate basin scale ET. Obviously, the basin water balance-based ET requires the availability of good precipitation and discharge data to calculate ET as a residual on longer time scales (annual) where net storage changes are assumed to be negligible. ET estimated from such a basin water balance principle is generally used for validating the performance of ET models. On the other hand, many of the direct estimation methods involve the use of remotely sensed data to estimate spatially explicit ET and use basin-wide averaging to estimate basin scale ET. The direct methods can be grouped into soil moisture balance modelling, satellite-based vegetation index methods, and methods based on satellite land surface temperature measurements that convert potential ET into actual ET using a proportionality relationship. The review also includes the use of complementary ET estimation principles for large area applications. The review identifies the need to compare and evaluate the different ET approaches using standard data sets in basins covering different hydro-climatic regions of the world.

Interpretability of Change Scores in Measures of Balance in People With COPD.

PubMed

Beauchamp, Marla K; Harrison, Samantha L; Goldstein, Roger S; Brooks, Dina

2016-03-01

Balance deficits and an increased fall risk are well documented in individuals with COPD. Despite evidence that balance training programs can improve performance on clinical balance tests, their minimal clinically important difference (MCID) is unknown. The aim of this study was to determine the MCID of the Berg Balance Scale (BBS), Balance Evaluation Systems Test (BESTest), and Activities-Specific Balance Confidence (ABC) scale in patients with COPD undergoing pulmonary rehabilitation. We performed a secondary analysis of data from two studies of balance training in COPD (n = 55). The MCID for each balance measure was estimated using the following anchor and distribution-based approaches: (1) mean change scores on a patient-reported global change in balance scale, (2) optimal cut-point from receiver operating characteristic curves (ROCs), and (3) the minimal detectable change with 95% confidence (MDC95). Data from 55 patients with COPD (mean age, 71.2 ± 7.1 y; mean FEV1, 39.2 ± 15.8% predicted) were used in the analysis. The smallest estimate of MCID was from the ROC method. Anchor-based estimates of the MCID ranged from 3.5 to 7.1 for the BBS, 10.2 to 17.4 for the BESTest, and 14.2 to 18.5 for the ABC scale; their MDC95 values were 5.0, 13.1, and 18.9, respectively. Among patients with COPD undergoing pulmonary rehabilitation, a change of 5 to 7 points for the BBS, 13 to 17 points for the BESTest, and 19 points for the ABC scale is required to be both perceptible to patients and beyond measurement error. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

The reliability of prayer-based self-efficacy scale to assess self-confidence of Muslims with low back pain.

PubMed

Al-Obaidi, Saud; Wall, James C; Mulekar, Madhuri S; Al-Mutairie, Rebecca

2012-06-01

Low back pain (LBP) may challenge an individual's self-confidence to perform usual daily activities such as Islamic daily prayer. Existing self-efficacy scales may not be appropriate to assess individual's self-confidence to perform Islamic prayers. This study aimed to develop a scale to assess self-confidence to prepare and perform Islamic prayer in the presence of LBP, the Islamic Prayer-based Self-efficacy Scale (IpbSeS), and to determine its consistency. The IpbSeS consists of three parts: pre-prayer preparation, getting to and from the mosque, and positions and movements during prayer. On a scale of 0 to 6, 0 indicates 'not at all confident' and 6 'fully confident'. Sixty individuals with LBP gave their responses on two different visits. Pain intensity was assessed by the Visual Analogue Scale (VAS), and the pain intensity changes were assessed using a seven-point global patient rating scale. Descriptive statistics, Pearson's correlation coefficient, Wilcoxon test and t-test were used in the analysis (alpha set at 0.05). VAS scores did not differ significantly between visits. No association was found between VAS and age (r = 0.039, p = 0.77) and between VAS and body mass index (BMI; r = 0.06, p = 0. 67). All 28 questions have consistent responses on two visits (0.75 ≤ r ≤ 0.99, p < 0.001 for all) indicating a very high reliability. IpbSeS appears to be a reliable instrument to assess the self-confidence of Muslims in the presence of LBP to pray. Copyright © 2011 John Wiley & Sons, Ltd.

Visual feedback training using WII Fit improves balance in Parkinson's disease.

PubMed

Zalecki, Tomasz; Gorecka-Mazur, Agnieszka; Pietraszko, Wojciech; Surowka, Artur D; Novak, Pawel; Moskala, Marek; Krygowska-Wajs, Anna

2013-01-01

Postural instability including imbalance is the most disabling long term problem in Parkinson's disease (PD) that does not respond to pharmacotherapy. This study aimed at investigating the effectiveness of a novel visual-feedback training method, using Wii Fit balance board in improving balance in patients with PD. Twenty four patients with moderate PD were included in the study which comprised of a 6-week home-based balance training program using Nintendo Wii Fit and balance board. The PD patients significantly improved their results in Berg Balance Scale, Tinnet's Performance-Oriented Mobility Assessment, Timed Up-and-Go, Sit-to-stand test, 10-Meter Walk test and Activities-specific Balance Confidence scale at the end of the programme. This study suggests that visual feedback training using Wii-Fit with balance board could improve dynamic and functional balance as well as motor disability in PD patients.

The Community Balance and Mobility Scale: A Pilot Study Detecting Impairments in Military Service Members With Comorbid Mild TBI and Psychological Health Conditions.

PubMed

Pape, Marcy M; Williams, Kathy; Kodosky, Paula N; Dretsch, Michael

2016-01-01

To compare the capacity of the Community Balance and Mobility Scale (CB&M) to identify balance and mobility deficits in Service Members (SMs) with mild traumatic brain injury and comorbid psychological health conditions (mTBI/PH) to other commonly used balance assessments. A clinical research institute that provides a 4-week, outpatient, interdisciplinary program for active-duty SMs with mTBI/PH. A nonrandomized, cross-sectional design that compared multiple measures between 2 groups-active duty SMs with (n = 8) and without (n = 8) the dual diagnosis of mTBI/PH. Gait speed, Activities-specific Balance Confidence scale (ABC), Functional Gait Assessment (FGA), and CB&M to assess functional balance among the community-dwelling, TBI population. Across all measures, the mTBI/PH group performed significantly worse (P ≤ .01) with the exception of the FGA. The abilities of all objective measures to distinguish participants with mTBI/PH from healthy controls ranged from fair to excellent (area under the curve [AUC] = 0.66-0.94). However, the CB&M showed the largest group differences in effect size (d = 2.6) and had the highest discriminate ability (AUC = 0.98; sensitivity 100%; specificity 88%). The CB&M appears to have higher sensitivity and specificity than other measures of balance in SMs with mTBI/PH. A higher cut score for the CB&M is needed for this population.

Scaling the metabolic balance of the oceans.

PubMed

López-Urrutia, Angel; San Martin, Elena; Harris, Roger P; Irigoien, Xabier

2006-06-06

Oceanic communities are sources or sinks of CO2, depending on the balance between primary production and community respiration. The prediction of how global climate change will modify this metabolic balance of the oceans is limited by the lack of a comprehensive underlying theory. Here, we show that the balance between production and respiration is profoundly affected by environmental temperature. We extend the general metabolic theory of ecology to the production and respiration of oceanic communities and show that ecosystem rates can be reliably scaled from theoretical knowledge of organism physiology and measurement of population abundance. Our theory predicts that the differential temperature-dependence of respiration and photosynthesis at the organism level determines the response of the metabolic balance of the epipelagic ocean to changes in ambient temperature, a prediction that we support with empirical data over the global ocean. Furthermore, our model predicts that there will be a negative feedback of ocean communities to climate warming because they will capture less CO2 with a future increase in ocean temperature. This feedback of marine biota will further aggravate the anthropogenic effects on global warming.

A focused exercise regimen improves clinical measures of balance in patients with peripheral neuropathy.

PubMed

Richardson, J K; Sandman, D; Vela, S

2001-02-01

To determine the effect of a specific exercise regimen on clinical measures of postural stability and confidence in a population with peripheral neuropathy (PN). Prospective, controlled, single blind study. Outpatient clinic of a university hospital. Twenty subjects with diabetes mellitus and electrodiagnostically confirmed PN. Ten subjects underwent a 3-week intervention exercise regimen designed to increase rapidly available distal strength and balance. The other 10 subjects performed a control exercise regimen. Unipedal stance time, functional reach, tandem stance time, and score on the activities-specific balance and confidence (ABC) scale. The intervention subjects, but not the control subjects, showed significant improvement in all 3 clinical measures of balance and nonsignificant improvement on the ABC scale. A brief, specific exercise regimen improved clinical measures of balance in patients with diabetic PN. Further studies are needed to determine if this result translates into a lower fall frequency in this high-risk population.

The reliability and validity of three questionnaires: The Student Satisfaction and Self-Confidence in Learning Scale, Simulation Design Scale, and Educational Practices Questionnaire.

PubMed

Unver, Vesile; Basak, Tulay; Watts, Penni; Gaioso, Vanessa; Moss, Jacqueline; Tastan, Sevinc; Iyigun, Emine; Tosun, Nuran

2017-02-01

The purpose of this study was to adapt the "Student Satisfaction and Self-Confidence in Learning Scale" (SCLS), "Simulation Design Scale" (SDS), and "Educational Practices Questionnaire" (EPQ) developed by Jeffries and Rizzolo into Turkish and establish the reliability and the validity of these translated scales. A sample of 87 nursing students participated in this study. These scales were cross-culturally adapted through a process including translation, comparison with original version, back translation, and pretesting. Construct validity was evaluated by factor analysis, and criterion validity was evaluated using the Perceived Learning Scale, Patient Intervention Self-confidence/Competency Scale, and Educational Belief Scale. Cronbach's alpha values were found as 0.77-0.85 for SCLS, 0.73-0.86 for SDS, and 0.61-0.86 for EPQ. The results of this study show that the Turkish versions of all scales are validated and reliable measurement tools.

The effect of virtual reality gaming on dynamic balance in older adults.

PubMed

Rendon, Abel Angel; Lohman, Everett B; Thorpe, Donna; Johnson, Eric G; Medina, Ernie; Bradley, Bruce

2012-07-01

physical therapy interventions that increase functional strength and balance have been shown to reduce falls in older adults. this study compared a virtual reality group (VRG) and a control group (CG). randomised controlled 6-week intervention with pre- and post-test evaluations. outpatient geriatric orthopaedic and balance physical therapy clinic. forty participants were randomised into two groups. the VRG received three different Nintendo® Wii FIT balance interventions three times per week for 6 weeks and the CG received no intervention. compared with the CG, post-intervention measurements showed significant improvements for the VRG in the 8-foot Up & Go test [median decrease of 1.0 versus -0.2 s, (P=0.038) and the Activities-specific Balance Confidence Scale (6.9 versus 1.3%) (P=0.038)]. virtual reality gaming provides clinicians with a useful tool for improving dynamic balance and balance confidence in older adults.

The effects of pilates on balance, mobility and strength in patients with multiple sclerosis.

PubMed

Guclu-Gunduz, Arzu; Citaker, Seyit; Irkec, Ceyla; Nazliel, Bijen; Batur-Caglayan, Hale Zeynep

2014-01-01

Although there are evidences as to Pilates developing dynamic balance, muscle strength and flexibility in healthy people, evidences related to its effects on Multiple Sclerosis patients are insufficient. The aims of this study were to investigate the effects of Pilates on balance, mobility, and strength in ambulatory patients with Multiple Sclerosis. Twenty six patients were divided into two groups as experimental (n = 18) and control (n = 8) groups for an 8-week treatment program. The experimental group underwent Pilates and the control group did abdominal breathing and active extremity exercises at home. Balance and mobility were measured with Berg Balance Scale and Timed up and go test, upper and lower muscle strength with hand-held dynamometer. Confidence in balance skills while performing daily activities was evaluated with Activities Specific Balance Confidence Scale. Improvements were observed in balance, mobility, and upper and lower extremity muscle strength in the Pilates group (p < 0.05). No significant differences in any outcome measures were observed in the control group (p > 0.05). Due to its structure which is made up of balance and strengthening exercises, Pilates training may develop balance, mobility and muscle strength of MS patients. For this reason, we think that, Pilates exercises which are appropriate for the disability level of the patient may be suggested.

Mass balances of dissolved gases at river network scales across biomes.

NASA Astrophysics Data System (ADS)

Wollheim, W. M.; Stewart, R. J.; Sheehan, K.

2016-12-01

Estimating aquatic metabolism and gas fluxes at broad spatial scales is needed to evaluate the role of aquatic ecosystems in continental carbon cycles. We applied a river network model, FrAMES, to quantify the mass balances of dissolved oxygen at river network scales across five river networks in different biomes. The model accounts for hydrology; spatially varying re-aeration rates due to flow, slope, and water temperature; gas inputs via terrestrial runoff; variation in light due to canopy cover and water depth; benthic gross primary production; and benthic respiration. The model was parameterized using existing groundwater information and empirical relationships of GPP, R, and re-aeration, and was tested using dissolved oxygen patterns measured throughout river networks. We found that during summers, internal aquatic production dominates the river network mass balance of Kings Cr., Konza Prairie, KS (16.3 km2), whereas terrestrial inputs and aeration dominate the network mass balance at Coweeta Cr., Coweeta Forest, NC (15.7 km2). At network scales, both river networks are net heterotrophic, with Coweeta more so than Kings Cr. (P:R 0.6 vs. 0.7, respectively). The river network of Kings Creek showed higher network-scale GPP and R compared to Coweeta, despite having a lower drainage density because streams are on average wider so cumulative benthic surface areas are similar. Our findings suggest that the role of aquatic systems in watershed carbon balances will depend on interactions of drainage density, channel hydraulics, terrestrial vegetation, and biological activity.

Balance Assessment in Deaf Children and Teenagers Prior to and Post Capoeira Practice through the Berg Balance Scale.

PubMed

Lima, Rubianne

2017-12-01

Hearing loss changes the functionality and body structure a disability that limits activity and restricts the participation of the individual in situations of daily life. It is believed that capoeira can help people with visual disabilities to minimize these deficits. BSE is a low specificity scale that evaluates objectively and functionally aspects of balance and risk of falls in the elderly and children, including the effect of environment on balance function. The objective of the research is to analyze deaf children and adolescents prior to and post-practice of capoeira using the Berg Balance Scale (BBS). Quantitative, clinical and observational studies. Twenty five deaf children between 10 and 16 years old of both genders were assessed. BBS was applied in two stages: before starting capoeira and after 6 months of training. The one-hour classes were held once a week for quantitative evaluation purposes. The subjects were divided and evaluated in two groups (10-13 years old and 14-16 years old). There was a significant statistical difference in BBS scores. The general group and the group of 10-13 years old (p = 0.0251) showed an increase in scores after practicing capoeira (p = 0.0039). There were no statistically significant differences in the group from 14 to 16 years of age (p = 0.0504). Using the Berg Balance Scale, it was possible to observe an improvement in the balance of the group of children and adolescents who practiced capoeira, and consequently, a decrease in the risk of falling.

Validation of the Vaccination Confidence Scale: A brief measure to identify parents at risk for refusing adolescent vaccines

PubMed Central

Reiter, Paul L.; Magnus, Brooke E.; McRee, Annie-Laurie; Dempsey, Amanda F.; Brewer, Noel T.

2015-01-01

Objective To support efforts to address vaccine hesitancy, we sought to validate a brief measure of vaccination confidence using a large, nationally representative sample of parents. Methods We analyzed weighted data from 9,018 parents who completed the 2010 National Immunization Survey-Teen, an annual, population-based telephone survey. Parents reported on the immunization history of a 13- to 17-year-old child in their households for vaccines including tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal, and human papillomavirus (HPV) vaccines. For each vaccine, separate logistic regression models assessed associations between parents’ mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. We repeated analyses for the scale’s 4-item short form. Results One quarter of parents (24%) reported refusal of any vaccine, with refusal of specific vaccines ranging from 21% for HPV to 2% for Tdap. Using the full 8-item scale, vaccination confidence was negatively associated with measures of vaccine refusal and positively associated with measures of vaccination status. For example, refusal of any vaccine was more common among parents whose scale scores were medium (odds ratio [OR] = 2.08, 95% confidence interval [CI], 1.75–2.47) or low (OR = 4.61, 95% CI, 3.51–6.05) versus high. For the 4-item short form, scores were also consistently associated with vaccine refusal and vaccination status. Vaccination confidence was inconsistently associated with vaccine delay. Conclusions The Vaccination Confidence Scale shows promise as a tool for identifying parents at risk for refusing adolescent vaccines. The scale’s short form appears to offer comparable performance. PMID:26300368

Falls and confidence related quality of life outcome measures in an older British cohort

PubMed Central

Parry, S; Steen, N; Galloway, S; Kenny, R; Bond, J

2001-01-01

Falls are common in older subjects and result in loss of confidence and independence. The Falls Efficacy Scale (FES) and the Activities-specific Balance Confidence scale (ABC) were developed in North America to quantify these entities, but contain idiom unfamiliar to an older British population. Neither has been validated in the UK. The FES and the ABC were modified for use within British culture and the internal consistency and test-retest reliability of the modified scales (FES-UK and ABC-UK) assessed. A total of 193 consecutive, ambulant, new, and return patients (n=119; 62%) and their friends and relatives ("visitors", n=74; 38%) were tested on both scales, while the last 60 subjects were retested within one week. Internal reliability was excellent for both scales (Cronbach's alpha 0.97 (FES-UK), and 0.98 (ABC-UK)). Test-retest reliability was good for both scales, though superior for the ABC-UK (intraclass correlation coefficient 0.58 (FES-UK), 0.89 (ABC-UK)). There was evidence to suggest that the ABC-UK was better than the FES-UK at distinguishing between older patients and younger patients (|tABC| = 4.4; |tFES| = 2.3); and between fallers and non-fallers (|tABC| = 8.7; |tFES| = 5.0) where the t statistics are based on the comparison of two independent samples. The ABC-UK and FES-UK are both reliable and valid measures for the assessment of falls and balance related confidence in older adults. However, better test-retest reliability and more robust differentiation of subgroups in whom falls related quality of life would be expected to be different make the ABC-UK the current instrument of choice in assessing this entity in older British subjects.


Keywords: quality of life; falls; elderly; health status measurement PMID:11161077

Normative scores on the Berg Balance Scale decline after age 70 years in healthy community-dwelling people: a systematic review.

PubMed

Downs, Stephen; Marquez, Jodie; Chiarelli, Pauline

2014-06-01

What is the mean Berg Balance Scale score of healthy elderly people living in the community and how does it vary with age? How much variability in Berg Balance Scale scores is present in groups of healthy elderly people and how does this vary with age? Systematic review with meta-analysis. Any group of healthy community-dwelling people with a mean age of 70 years or greater that has undergone assessment using the Berg Balance Scale. Mean and standard deviations of Berg Balance Scale scores within cohorts of elderly people of known mean age. The search yielded 17 relevant studies contributing data from a total of 1363 participants. The mean Berg Balance Scale scores ranged from 37 to 55 out of a possible maximum score of 56. The standard deviation of Berg Balance Scale scores varied from 1.0 to 9.2. Although participants aged around 70 years had very close to normal Berg Balance Scale scores, there was a significant decline in balance with age at a rate of 0.7 points on the 56-point Berg Balance Scale per year. There was also a strong association between increasing age and increasing variability in balance (R(2) = 0.56, p < 0.001). Healthy community-dwelling elderly people have modest balance deficits, as measured by the Berg Balance Scale, although balance scores deteriorate and become more variable with age. Copyright © 2014. Published by Elsevier B.V.

Combining Flux Balance and Energy Balance Analysis for Large-Scale Metabolic Network: Biochemical Circuit Theory for Analysis of Large-Scale Metabolic Networks

NASA Technical Reports Server (NTRS)

Beard, Daniel A.; Liang, Shou-Dan; Qian, Hong; Biegel, Bryan (Technical Monitor)

2001-01-01

Predicting behavior of large-scale biochemical metabolic networks represents one of the greatest challenges of bioinformatics and computational biology. Approaches, such as flux balance analysis (FBA), that account for the known stoichiometry of the reaction network while avoiding implementation of detailed reaction kinetics are perhaps the most promising tools for the analysis of large complex networks. As a step towards building a complete theory of biochemical circuit analysis, we introduce energy balance analysis (EBA), which compliments the FBA approach by introducing fundamental constraints based on the first and second laws of thermodynamics. Fluxes obtained with EBA are thermodynamically feasible and provide valuable insight into the activation and suppression of biochemical pathways.

Effect of pulmonary rehabilitation on balance in persons with chronic obstructive pulmonary disease.

PubMed

Beauchamp, Marla K; O'Hoski, Sachi; Goldstein, Roger S; Brooks, Dina

2010-09-01

To describe within-subject effects of pulmonary rehabilitation (PR) on balance in persons with chronic obstructive pulmonary disease (COPD) and to determine whether any observed changes in balance were associated with change in exercise tolerance or health-related quality of life. Single-arm longitudinal study. Inpatient PR center. Subjects with COPD (N=29; mean +/- SD age, 69.8+/-10.3y; forced expiratory volume in 1 second, 46.3%+/-22.3% predicted; 59% men [n=17]). A standardized 6-week multidisciplinary PR program (exercise training, breathing exercises, education, and psychologic support). Balance was assessed using the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and the Activities-Specific Balance Confidence (ABC) scale. Exercise tolerance was determined from the 6-minute walk test (6MWT), and health-related quality of life from the Chronic Respiratory Questionnaire (CRQ). Subjects showed small improvements in BBS (2.8+/-2.8 points; P<.001) and TUG (-1.5+/-2.4s; P=.003) scores, but not in ABC scores (4.8+/-15.4 points; P>.05). There was a weak relationship between change in BBS and change in CRQ scores (r=.40; P=.045) and no relationship with change in 6MWT. PR contributed to minor improvements in balance and had no effect on balance confidence in subjects with COPD. Further work is warranted to determine the optimal intervention for improving balance in this population.

Development of a Decisional Balance Scale for Young Adult Marijuana Use

PubMed Central

Elliott, Jennifer C.; Carey, Kate B.; Scott-Sheldon, Lori A. J.

2010-01-01

This study describes the development and validation of a decisional balance scale for marijuana use in young adults. Scale development was accomplished in four phases. First, 53 participants (70% female, 68% freshman) provided qualitative data that yielded content for an initial set of 47 items. In the second phase, an exploratory factor analysis on the responses of 260 participants (52% female, 68% freshman) revealed two factors, corresponding to pros and cons. Items that did not load well on the factors were omitted, resulting in a reduced set of 36 items. In the third phase, 182 participants (49% female, 37% freshmen) completed the revised scale and an evaluation of factor structure led to scale revisions and model respecification to create a good-fitting model. The final scales consisted of 8 pros (α = 0.91) and 16 cons (α = 0.93), and showed evidence of validity. In the fourth phase (N = 248, 66% female, 70% freshman), we confirmed the factor structure, and provided further evidence for reliability and validity. The Marijuana Decisional Balance Scale enhances our ability to study motivational factors associated with marijuana use among young adults. PMID:21261405

Validation to Portuguese of the Scale of Student Satisfaction and Self-Confidence in Learning.

PubMed

Almeida, Rodrigo Guimarães dos Santos; Mazzo, Alessandra; Martins, José Carlos Amado; Baptista, Rui Carlos Negrão; Girão, Fernanda Berchelli; Mendes, Isabel Amélia Costa

2015-01-01

Translate and validate to Portuguese the Scale of Student Satisfaction and Self-Confidence in Learning. Methodological translation and validation study of a research tool. After following all steps of the translation process, for the validation process, the event III Workshop Brazil - Portugal: Care Delivery to Critical Patients was created, promoted by one Brazilian and another Portuguese teaching institution. 103 nurses participated. As to the validity and reliability of the scale, the correlation pattern between the variables, the sampling adequacy test (Kaiser-Meyer-Olkin) and the sphericity test (Bartlett) showed good results. In the exploratory factorial analysis (Varimax), item 9 behaved better in factor 1 (Satisfaction) than in factor 2 (Self-confidence in learning). The internal consistency (Cronbach's alpha) showed coefficients of 0.86 in factor 1 with six items and 0.77 for factor 2 with 07 items. In Portuguese this tool was called: Escala de Satisfação de Estudantes e Autoconfiança na Aprendizagem. The results found good psychometric properties and a good potential use. The sampling size and specificity are limitations of this study, but future studies will contribute to consolidate the validity of the scale and strengthen its potential use.

Tests of stepping as indicators of mobility, balance, and fall risk in balance-impaired older adults.

PubMed

Cho, Be-long; Scarpace, Diane; Alexander, Neil B

2004-07-01

To determine the relationships between two tests of stepping ability (the maximal step length (MSL) and rapid step test (RST)) and standard tests of standing balance, gait, mobility, and functional impairment in a group of at-risk older adults. Cross-sectional study. University-based laboratory. One hundred sixty-seven mildly balance-impaired older adults recruited for a balance-training and fall-reduction program (mean age 78, range 65-90). Measures of stepping maximally (MSL, the ability to maximally step out and return to the initial position) and rapidly (RST, the time taken to step out and return in multiple directions as fast as possible); standard measures of balance, gait, and mobility including timed tandem stance (TS), tandem walk (TW, both timing and errors), timed unipedal stance (US), timed up and go (TUG), performance oriented mobility assessment (POMA), and 6-minute walk (SMW); measures of leg strength (peak knee and ankle torque and power at slow and fast speeds); self-report measures of frequent falls (>2 per 12 months), disability (Established Population for Epidemiologic Studies of the Elderly (EPESE) physical function), and confidence to avoid falls (Activity-specific Balance Confidence (ABC) Scale). Spearman and Pearson correlation, intraclass correlation coefficient, logistic regression, and linear regression were used for data analysis. MSL consistently predicted a number of self-report and performance measures at least as well as other standard balance measures. MSL correlations with EPESE physical function, ABC, TUG, and POMA scores; SMW; and peak maximum knee and ankle torque and power were at least as high as those correlations seen with TS, TW, or US. MSL score was associated with the risk of being a frequent faller. In addition, the six MSL directions were highly correlated (up to 0.96), and any one of the leg directions yielded similar relationships with functional measures and a history of falls. Relationships between RST and these

Computational Models of Consumer Confidence from Large-Scale Online Attention Data: Crowd-Sourcing Econometrics

PubMed Central

2015-01-01

Economies are instances of complex socio-technical systems that are shaped by the interactions of large numbers of individuals. The individual behavior and decision-making of consumer agents is determined by complex psychological dynamics that include their own assessment of present and future economic conditions as well as those of others, potentially leading to feedback loops that affect the macroscopic state of the economic system. We propose that the large-scale interactions of a nation's citizens with its online resources can reveal the complex dynamics of their collective psychology, including their assessment of future system states. Here we introduce a behavioral index of Chinese Consumer Confidence (C3I) that computationally relates large-scale online search behavior recorded by Google Trends data to the macroscopic variable of consumer confidence. Our results indicate that such computational indices may reveal the components and complex dynamics of consumer psychology as a collective socio-economic phenomenon, potentially leading to improved and more refined economic forecasting. PMID:25826692

Computational models of consumer confidence from large-scale online attention data: crowd-sourcing econometrics.

PubMed

Dong, Xianlei; Bollen, Johan

2015-01-01

Economies are instances of complex socio-technical systems that are shaped by the interactions of large numbers of individuals. The individual behavior and decision-making of consumer agents is determined by complex psychological dynamics that include their own assessment of present and future economic conditions as well as those of others, potentially leading to feedback loops that affect the macroscopic state of the economic system. We propose that the large-scale interactions of a nation's citizens with its online resources can reveal the complex dynamics of their collective psychology, including their assessment of future system states. Here we introduce a behavioral index of Chinese Consumer Confidence (C3I) that computationally relates large-scale online search behavior recorded by Google Trends data to the macroscopic variable of consumer confidence. Our results indicate that such computational indices may reveal the components and complex dynamics of consumer psychology as a collective socio-economic phenomenon, potentially leading to improved and more refined economic forecasting.

Validation of balance-quality assessment using a modified bathroom scale.

PubMed

Hewson, D J; Duchêne, J; Hogrel, J-Y

2015-02-01

The balance quality tester (BQT), based on a standard electronic bathroom scale has been developed in order to assess balance quality. The BQT includes automatic detection of the person to be tested by means of an infrared detector and bluetooth communication capability for remote assessment when linked to a long-distance communication device such as a mobile phone. The BQT was compared to a standard force plate for validity and agreement. The two most widely reported parameters in balance literature, the area of the centre of pressure (COP) displacement and the velocity of the COP displacement, were compared for 12 subjects, each of whom was tested on ten occasions on each of the 2 days. No significant differences were observed between the BQT and the force plate for either of the two parameters. In addition a high level of agreement was observed between both devices. The BQT is a valid device for remote assessment of balance quality, and could provide a useful tool for long-term monitoring of people with balance problems, particularly during home monitoring.

An Evaluation Tool for CONUS-Scale Estimates of Components of the Water Balance

NASA Astrophysics Data System (ADS)

Saxe, S.; Hay, L.; Farmer, W. H.; Markstrom, S. L.; Kiang, J. E.

2016-12-01

Numerous research groups are independently developing data products to represent various components of the water balance (e.g. runoff, evapotranspiration, recharge, snow water equivalent, soil moisture, and climate) at the scale of the conterminous United States. These data products are derived from a range of sources, including direct measurement, remotely-sensed measurement, and statistical and deterministic model simulations. An evaluation tool is needed to compare these data products and the components of the water balance they contain in order to identify the gaps in the understanding and representation of continental-scale hydrologic processes. An ideal tool will be an objective, universally agreed upon, framework to address questions related to closing the water balance. This type of generic, model agnostic evaluation tool would facilitate collaboration amongst different hydrologic research groups and improve modeling capabilities with respect to continental-scale water resources. By adopting a comprehensive framework to consider hydrologic modeling in the context of a complete water balance, it is possible to identify weaknesses in process modeling, data product representation and regional hydrologic variation. As part of its National Water Census initiative, the U.S. Geological survey is facilitating this dialogue to developing prototype evaluation tools.

Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study.

PubMed

Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E

2012-02-01

To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

German version of the Community Balance and Mobility Scale : Translation and evaluation of measurement properties.

PubMed

Gordt, Katharina; Mikolaizak, A Stefanie; Nerz, Corinna; Barz, Carolin; Gerhardy, Thomas; Weber, Michaela; Becker, Clemens; Schwenk, Michael

2018-02-12

Tools to detect subtle balance deficits in high-functioning community-dwelling older adults are lacking. The Community Balance and Mobility Scale (CBM) is a valuable tool to measure balance deficits in this group; however, it is not yet available in the German language. The aim was 1) to translate and cross-culturally adapt the CBM into the German language and 2) to investigate the measurement properties of the German CBM (G-CBM). The original CBM was translated into the German language according to established guidelines. A total of 51 older adults (mean age 69.9 ± 7.1 years) were recruited to measure construct validity by comparing the G‑CBM against standardized balance and/or mobility assessments including the Fullerton Advanced Balance Scale (FAB), Berg Balance Scale (BBS), 3 m Tandem Walk (3MTW), 8 Level Balance Scale (8LBS), 30 s Chair Stand Test (30CST), Timed Up and Go (TUG) test, gait speed, and the Falls Efficacy Scale International (FES-I). Intrarater and interrater reliability and internal consistency reliability were estimated using intraclass correlations (ICC) and Cronbach's alpha, respectively. Ceiling effects were calculated as the percentage of the sample scoring the maximum score. The G‑CBM correlated excellently with FAB and BBS (ρ = 0.78-0.85; P < 0.001), good with 3MTW, TUG, and FES-I (ρ = -0.55 to -0.61; P < 0.001), and moderately with 8LBS, 30CST, and habitual gait speed (ρ = 0.32-0.46; P < 0.001). Intrarater (ICC 3,k  = 0.998; P < 0.001) and interrater (ICC 2,k  = 0.996; P < 0.001) reliability, and internal consistency reliability (α = 0.998) were also high. The G‑CBM did not show ceiling effects. The G‑CBM is a valid and reliable tool for measuring subtle balance deficits in older high-functioning adults. The absence of ceiling effects emphasizes the use of this scale in this cohort. The G‑CBM can now be utilized in clinical practice.

Effects of balance-specific exercises on balance, physical activity and quality of life in adults with multiple sclerosis: a pilot investigation.

PubMed

Kasser, Susan L; Jacobs, Jesse V; Ford, Marley; Tourville, Timothy W

2015-01-01

To evaluate the efficacy of functional balance exercises on balance impairment, physical activity and quality of life (QOL) in adults with multiple sclerosis (MS). A multiple-baseline time-series design with an uncontrolled intervention. Ten subjects with MS completed assessments twice before and once after a 10-week balance intervention. ANOVA were used to evaluate the effects of testing session on the Brief-BESTest, instrumented stance and gait recordings by inertial motion sensors, lower-limb strength recorded by force transducers, accelerometry-based activity, the 12-item MS Walking Scale (MSWS-12), the Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire, the Modified Fatigue Impact scale (MFIS) and the Activity-specific Balance Confidence (ABC) scale. The intervention associated with significantly improved scores on the MSQOL-54 mental component, MFIS, MSWS-12 and Brief-BESTest. Sway amplitude significantly decreased and jerk significantly increased during instrumented standing on foam with eyes closed. Instrumented gait recordings of sagittal trunk range of motion also significantly decreased. ABC scores, strength measures and activity measures were not significantly changed. Ten weeks of functional balance exercises provided a feasible intervention for individuals with MS that improved components of balance, mental well-being and perceived fatigue impact and ambulation disability. A future randomized, controlled clinical trial should confirm these preliminary findings. Implications for Rehabilitation A balance-specific exercise program is both safe and feasible for individuals with mild-to-moderate MS. Comprehensive exercise interventions that are conceptually driven and employ well-designed progressive exercise across multiple contexts of balance control can facilitate improvements in balance impairments associated with MS. Functional balance exercises can positively impact clinical and objective measures of balance control and favorably

Tele-Assessment of the Berg Balance Scale: Effects of Transmission Characteristics.

PubMed

Venkataraman, Kavita; Morgan, Michelle; Amis, Kristopher A; Landerman, Lawrence R; Koh, Gerald C; Caves, Kevin; Hoenig, Helen

2017-04-01

To compare Berg Balance Scale (BBS) rating using videos with differing transmission characteristics with direct in-person rating. Repeated-measures study for the assessment of the BBS in 8 configurations: in person, high-definition video with slow motion review, standard-definition videos with varying bandwidths and frame rates (768 kilobytes per second [kbps] videos at 8, 15, and 30 frames per second [fps], 30 fps videos at 128, 384, and 768 kbps). Medical center. Patients with limitations (N=45) in ≥1 of 3 specific aspects of motor function: fine motor coordination, gross motor coordination, and gait and balance. Not applicable. Ability to rate the BBS in person and using videos with differing bandwidths and frame rates in frontal and lateral views. Compared with in-person rating (7%), 18% (P=.29) of high-definition videos and 37% (P=.03) of standard-definition videos could not be rated. Interrater reliability for the high-definition videos was .96 (95% confidence interval, .94-.97). Rating failure proportions increased from 20% in videos with the highest bandwidth to 60% (P<.001) in videos with the lowest bandwidth, with no significant differences in proportions across frame rate categories. Both frontal and lateral views were critical for successful rating using videos, with 60% to 70% (P<.001) of videos unable to be rated on a single view. Although there is some loss of information when using videos to rate the BBS compared to in-person ratings, it is feasible to reliably rate the BBS remotely in standard clinical spaces. However, optimal video rating requires frontal and lateral views for each assessment, high-definition video with high bandwidth, and the ability to carry out slow motion review. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Effect of a Virtual Reality Game Intervention on Balance for Patients with Stroke: A Randomized Controlled Trial.

PubMed

Lee, Hsin-Chieh; Huang, Chia-Lin; Ho, Sui-Hua; Sung, Wen-Hsu

2017-10-01

The aim of this study was to investigate the effects of virtual reality (VR) balance training conducted using Kinect for Xbox® games on patients with chronic stroke. Fifty patients with mild to moderate motor deficits were recruited and randomly assigned to two groups: VR plus standard treatment group and standard treatment (ST) group. In total, 12 training sessions (90 minutes a session, twice a week) were conducted in both groups, and performance was assessed at three time points (pretest, post-test, and follow-up) by a blinded assessor. The outcome measures were the Berg Balance Scale (BBS), Functional Reach Test, and Timed Up and Go Test (cognitive; TUG-cog) for balance evaluations; Modified Barthel Index for activities of daily living ability; Activities-specific Balance Confidence Scale for balance confidence; and Stroke Impact Scale for quality of life. The pleasure scale and adverse events were also recorded after each training session. Both groups exhibited significant improvement over time in the BBS (P = 0.000) and TUG-cog test (P = 0.005). The VR group rated the experience as more pleasurable than the ST group during the intervention (P = 0.027). However, no significant difference was observed in other outcome measures within or between the groups. No serious adverse events were observed during the treatment in either group. VR balance training by using Kinect for Xbox games plus the traditional method had positive effects on the balance ability of patients with chronic stroke. The VR group experienced higher pleasure than the ST group during the intervention.

Towards Better Computational Models of the Balance Scale Task: A Reply to Shultz and Takane

ERIC Educational Resources Information Center

van der Maas, Han L. J.; Quinlan, Philip T.; Jansen, Brenda R. J.

2007-01-01

In contrast to Shultz and Takane [Shultz, T.R., & Takane, Y. (2007). Rule following and rule use in the balance-scale task. "Cognition", in press, doi:10.1016/j.cognition.2006.12.004.] we do not accept that the traditional Rule Assessment Method (RAM) of scoring responses on the balance scale task has advantages over latent class analysis (LCA):…

The ability of clinical balance measures to identify falls risk in multiple sclerosis: a systematic review and meta-analysis.

PubMed

Quinn, Gillian; Comber, Laura; Galvin, Rose; Coote, Susan

2018-05-01

To determine the ability of clinical measures of balance to distinguish fallers from non-fallers and to determine their predictive validity in identifying those at risk of falls. AMED, CINAHL, Medline, Scopus, PubMed Central and Google Scholar. First search: July 2015. Final search: October 2017. Inclusion criteria were studies of adults with a definite multiple sclerosis diagnosis, a clinical balance assessment and method of falls recording. Data were extracted independently by two reviewers. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 scale and the modified Newcastle-Ottawa Quality Assessment Scale. Statistical analysis was conducted for the cross-sectional studies using Review Manager 5. The mean difference with 95% confidence interval in balance outcomes between fallers and non-fallers was used as the mode of analysis. We included 33 studies (19 cross-sectional, 5 randomised controlled trials, 9 prospective) with a total of 3901 participants, of which 1917 (49%) were classified as fallers. The balance measures most commonly reported were the Berg Balance Scale, Timed Up and Go and Falls Efficacy Scale International. Meta-analysis demonstrated fallers perform significantly worse than non-fallers on all measures analysed except the Timed Up and Go Cognitive ( p < 0.05), but discriminative ability of the measures is commonly not reported. Of those reported, the Activities-specific Balance Confidence Scale had the highest area under the receiver operating characteristic curve value (0.92), but without reporting corresponding measures of clinical utility. Clinical measures of balance differ significantly between fallers and non-fallers but have poor predictive ability for falls risk in people with multiple sclerosis.

Affordable, automatic quantitative fall risk assessment based on clinical balance scales and Kinect data.

PubMed

Colagiorgio, P; Romano, F; Sardi, F; Moraschini, M; Sozzi, A; Bejor, M; Ricevuti, G; Buizza, A; Ramat, S

2014-01-01

The problem of a correct fall risk assessment is becoming more and more critical with the ageing of the population. In spite of the available approaches allowing a quantitative analysis of the human movement control system's performance, the clinical assessment and diagnostic approach to fall risk assessment still relies mostly on non-quantitative exams, such as clinical scales. This work documents our current effort to develop a novel method to assess balance control abilities through a system implementing an automatic evaluation of exercises drawn from balance assessment scales. Our aim is to overcome the classical limits characterizing these scales i.e. limited granularity and inter-/intra-examiner reliability, to obtain objective scores and more detailed information allowing to predict fall risk. We used Microsoft Kinect to record subjects' movements while performing challenging exercises drawn from clinical balance scales. We then computed a set of parameters quantifying the execution of the exercises and fed them to a supervised classifier to perform a classification based on the clinical score. We obtained a good accuracy (~82%) and especially a high sensitivity (~83%).

Depression is a predictor for balance in people with multiple sclerosis.

PubMed

Alghwiri, Alia A; Khalil, Hanan; Al-Sharman, Alham; El-Salem, Khalid

2018-05-26

Balance impairments are common and multifactorial among people with multiple sclerosis (MS). Depression is the most common psychological disorder in MS population and is strongly correlated with MS disease. Depression might be one of the factors that contribute to balance deficits in this population. However, the relationship between depression and balance impairments has not been explored in people with MS. To investigate the association between depression and balance impairments in people with MS. Cross sectional design was used in patients with MS. The Activities-specific Balance Confidence scale (ABC) and Berg Balance Scale (BBS) was used to assess balance. Beck Depression Inventory (BDI-II) was used to quantify depression and Kurtizki Expanded Disability Status Scale (EDSS) was utilized for the evaluation of MS disability severity. Pearson correlation coefficient was used to examine the association between depression and balance measurements. Multiple linear stepwise regressions were also conducted to find out if depression is a potential predictor for balance deficits. Seventy-five individuals with MS (Female = 69%) with a mean age (SD) of 38.8 (10) and a mean (SD) EDSS score of 3.0 (1.4) were recruited in this study. Depression was present in 53% of the patients. Depression was significantly correlated with balance measurements and EDSS. However, multiple linear stepwise regressions found that only depression and age significantly predict balance. Depression and balance were found frequent and associated in people with MS. Importantly depression was a significant predictor for balance impairments in individuals with MS. Balance rehabilitation may be hindered by depression. Therefore, depression should be evaluated and treated properly in individuals with MS. Copyright © 2018 Elsevier B.V. All rights reserved.

Tinetti and Berg balance scales correlate with disability in hereditary peripheral neuropathies: a preliminary study.

PubMed

Monti Bragadin, M; Francini, L; Bellone, E; Grandis, M; Reni, L; Canneva, S; Gemelli, C; Ursino, G; Maggi, G; Mori, L; Schenone, A

2015-08-01

The combination of distal muscle weakness, sensory defects and feet deformities leads to disequilibrium in patients affected by Charcot-Marie-Tooth (CMT) neuropathy. Studies relating the outcome of balance scales and clinical severity of CMT are lacking. To evaluate the accuracy of the Tinetti Balance scale (TBS) and Berg Balance scale (BBS) in identifying balance disorders and quantifying disease severity in CMT patients. Observational study. University of Genoa-IRCCS AOU San Martino IST-Department of Neurology, Italy. Nineteen individuals with a diagnosis of CMT (12 females, 7 males, age 41.26±12.42). All subjects underwent an evaluation with both TBS and BBS. Disability was quantified with CMT neuropathy score (CMTNS). Moreover, a complete neurophysiological study was performed. Distal lower limbs strength was evaluated with MRC scale. Pearson rank order correlation was used to determine the correlation between the scores on the two tests and to identify an eventual correlation between TBS or BBS and the CMTNS. Both scales showed a highly significant negative correlation with the CMTNS (r=-0.78, P<0.0005 and r=-0.77, P<0.001, respectively) and distal weakness on the anterior tibial muscles (AT) (TBS: AT left: r=0.65, P<0.005 and AT right: 0.59, P<0.01; BBS: AT left r=+0.71, P<0.001 and AT right r=+0.66, P<0.005). We found also a highly significant, positive correlation between the two different balance scales (r=+0.9, P<0.0001). TBS and BBS strongly correlate with disease disability and distal muscular weakness. Both TBS and BBS may play a relevant role in the assessment of disability in patients affected by CMT. Further studies are needed to validate our results in a larger population.

Multi-scale kinetic description of granular clusters: invariance, balance, and temperature

NASA Astrophysics Data System (ADS)

Capriz, Gianfranco; Mariano, Paolo Maria

2017-12-01

We discuss a multi-scale continuum representation of bodies made of several mass particles flowing independently each other. From an invariance procedure and a nonstandard balance of inertial actions, we derive the balance equations introduced in earlier work directly in pointwise form, essentially on the basis of physical plausibility. In this way, we analyze their foundations. Then, we propose a Boltzmann-type equation for the distribution of kinetic energies within control volumes in space and indicate how such a distribution allows us to propose a definition of (granular) temperature along processes far from equilibrium.

Acquiescent Responding in Balanced Multidimensional Scales and Exploratory Factor Analysis

ERIC Educational Resources Information Center

Lorenzo-Seva, Urbano; Rodriguez-Fornells, Antoni

2006-01-01

Personality tests often consist of a set of dichotomous or Likert items. These response formats are known to be susceptible to an agreeing-response bias called acquiescence. The common assumption in balanced scales is that the sum of appropriately reversed responses should be reasonably free of acquiescence. However, inter-item correlation (or…

Validation to Portuguese of the Scale of Student Satisfaction and Self-Confidence in Learning1

PubMed Central

Almeida, Rodrigo Guimarães dos Santos; Mazzo, Alessandra; Martins, José Carlos Amado; Baptista, Rui Carlos Negrão; Girão, Fernanda Berchelli; Mendes, Isabel Amélia Costa

2015-01-01

Objective: translate and validate to Portuguese the Scale of Student Satisfaction and Self-Confidence in Learning. Material and Methods: methodological translation and validation study of a research tool. After following all steps of the translation process, for the validation process, the event III Workshop Brazil - Portugal: Care Delivery to Critical Patients was created, promoted by one Brazilian and another Portuguese teaching institution. Results: 103 nurses participated. As to the validity and reliability of the scale, the correlation pattern between the variables, the sampling adequacy test (Kaiser-Meyer-Olkin) and the sphericity test (Bartlett) showed good results. In the exploratory factorial analysis (Varimax), item 9 behaved better in factor 1 (Satisfaction) than in factor 2 (Self-confidence in learning). The internal consistency (Cronbach's alpha) showed coefficients of 0.86 in factor 1 with six items and 0.77 for factor 2 with 07 items. Conclusion: in Portuguese this tool was called: Escala de Satisfação de Estudantes e Autoconfiança na Aprendizagem. The results found good psychometric properties and a good potential use. The sampling size and specificity are limitations of this study, but future studies will contribute to consolidate the validity of the scale and strengthen its potential use. PMID:26625990

A catchment scale water balance model for FIFE

NASA Technical Reports Server (NTRS)

Famiglietti, J. S.; Wood, E. F.; Sivapalan, M.; Thongs, D. J.

1992-01-01

A catchment scale water balance model is presented and used to predict evaporation from the King's Creek catchment at the First ISLSCP Field Experiment site on the Konza Prairie, Kansas. The model incorporates spatial variability in topography, soils, and precipitation to compute the land surface hydrologic fluxes. A network of 20 rain gages was employed to measure rainfall across the catchment in the summer of 1987. These data were spatially interpolated and used to drive the model during storm periods. During interstorm periods the model was driven by the estimated potential evaporation, which was calculated using net radiation data collected at site 2. Model-computed evaporation is compared to that observed, both at site 2 (grid location 1916-BRS) and the catchment scale, for the simulation period from June 1 to October 9, 1987.

RSRA sixth scale wind tunnel test. Tabulated balance data, volume 2

NASA Technical Reports Server (NTRS)

Ruddell, A.; Flemming, R.

1974-01-01

Summaries are presented of all the force and moment data acquired during the RSRA Sixth Scale Wind Tunnel Test. These data include and supplement the data presented in curve form in previous reports. Each summary includes the model configuration, wing and empennage incidences and deflections, and recorded balance data. The first group of data in each summary presents the force and moment data in full scale parametric form, the dynamic pressure and velocity in the test section, and the powered nacelle fan speed. The second and third groups of data are the balance data in nondimensional coefficient form. The wind axis coefficient data corresponds to the parametric data divided by the wing area for forces and divided by the product of the wing area and wing span or mean aerodynamic chord for moments. The stability axis data resolves the wind axis data with respect to the angle of yaw.

Musculoskeletal strength, balance performance, and self-efficacy in elderly ving tsun chinese martial art practitioners: implications for fall prevention.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Pang, Marco Y C; Lee, H W; Chung, Joanne W Y; Lam, Priscillia L; Guo, X

2014-01-01

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = -0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.

Musculoskeletal Strength, Balance Performance, and Self-Efficacy in Elderly Ving Tsun Chinese Martial Art Practitioners: Implications for Fall Prevention

PubMed Central

Fong, Shirley S. M.; Ng, Shamay S. M.; Liu, Karen P. Y.; Pang, Marco Y. C.; Lee, H. W.; Chung, Joanne W. Y.; Lam, Priscillia L.; Guo, X.

2014-01-01

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = −0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly. PMID:25530782

Rule Following and Rule Use in the Balance-Scale Task

ERIC Educational Resources Information Center

Shultz, Thomas R.; Takane, Yoshio

2007-01-01

Quinlan et al. [Quinlan, p., van der Mass, H., Jansen, B., Booij, O., & Rendell, M. (this issue). Re-thinking stages of cognitive development: An appraisal of connectionist models of the balance scale task. "Cognition", doi:10.1016/j.cognition.2006.02.004] use Latent Class Analysis (LCA) to criticize a connectionist model of development on the…

Performance of Children on the Community Balance and Mobility Scale

ERIC Educational Resources Information Center

Wright, Marilyn J.; Bos, Cecily

2012-01-01

This study describes the performance of children 8-11 years of age on the Community Balance and Mobility Scale (CB&M) and associations between performance and age, body mass index (BMI), and sex. A convenience sample of 84 was recruited. The CB&M was administered using instructions we developed for children. Mean CB&M total scores (95%…

Multi-scale Modeling of Energy Balance Fluxes in a Dense Tamarisk Riparian Forest

NASA Astrophysics Data System (ADS)

Neale, C. M.; Santos, C. A.; Watts, D.; Osterberg, J.; Hipps, L. E.; Sritharan, S. I.

2008-12-01

Remote sensing of energy balance fluxes has become operationally more viable over the last 10 years with the development of more robust multi-layer models and the availability of quasi-real time satellite imagery from most sensors. Riparian corridors in semi-arid and arid areas present a challenge to satellite based techniques for estimating evapotranspiration due to issues of scale and pixel resolution, especially when using the thermal infrared bands. This paper will present energy balance measurement and modeling results over a Salt Cedar (Tamarix Ramosissima) forest in the Cibola National Wildlife Refuge along the Colorado River south of Blythe, CA. The research site encompasses a 600 hectare area populated by mostly Tamarisk stands of varying density. Three Bowen ratio systems are installed on tall towers within varying densities of forest cover in the upwind footprint and growing under varying depths to the water table. An additional eddy covariance tower is installed alongside a Bowen ratio system on one of the towers. Flux data has been gathered continuously since early 2007. In the summer of 2007, a Scintec large aperture scintillometer was installed between two of the towers over 1 km apart and has been working continuously along with the flux towers. Two intensive field campaigns were organized in June 2007 and May 2008 to coincide with LANDSAT TM5, MODIS and ASTER overpasses. High resolution multispectral and thermal imagery was acquired at the same time with the USU airborne system to provide information for the up- scaling of the energy balance fluxes from tower to satellite scales. The paper will present comparisons between the different energy balance measuring techniques under the highly advective conditions of the experimental site, concentrating on the scintillometer data. Preliminary results of remotely sensed modeling of the fluxes at different scales and model complexity will also be presented.

Virtual reality for improving balance in patients after stroke: A systematic review and meta-analysis.

PubMed

Li, Zhen; Han, Xiu-Guo; Sheng, Jing; Ma, Shao-Jun

2016-05-01

To evaluate the effectiveness of virtual reality interventions for improving balance in people after stroke. Systematic review and meta-analysis of randomized controlled trials. Studies were obtained by searching the following databases: MEDLINE, CINAHL, EMBASE, Web of Science and CENTRAL. Two reviewers assessed studies for inclusion, extracted data and assessed trial quality. Sixteen studies involving 428 participants were included. People who received virtual reality interventions showed marked improvements in Berg Balance Scale (mean difference: 1.46, 95% confidence interval: 0.09-2.83, P<0.05, I²=0%) and Timed Up and Go Test (mean difference: -1.62, 95% confidence interval: -3.07- -0.16, P<0.05, I²=24%) compared with controls. This meta-analysis of randomized controlled trials supports the use of virtual reality to improve balance after stroke. © The Author(s) 2015.

Balance in Representation - More Than One Way to Tip the Scales

NASA Astrophysics Data System (ADS)

Rowell, D. S.; Carlis, D. L.

2017-12-01

Too often diversity balance is seen as purely a numbers issue - one of influx and totals. And thus recruiting and retention being two sides of the same valuable coin. However, balance is not just numbers. There is more than one means to add diversity value to an organization. Numbers is one, but power is another. `Balance' is also reached through empowerment and voice. Whereas recruiting and retention can be seen as hard currency buying balanced demographics, empowerment is an investment that takes various forms and yields various dividends. Empowerment includes investment in people, and training, and systems, and pays dividends in performance, and voice, and careers, and service. In this way space is created for the benefits of diversity even where numbers and composition is statically unyielding. Equilibrium comes from tipping the scales with involvement, impact and affect. And finally in coming back full circle, empowerment has a bonus direct effect on the numbers, as it does improve diverse recruiting and retention. This presentation places a focus on balance in terms of gender efficacy. It will highlight the requirements to grow and mature gender empowerment investments and show how these investments have diversity dividends. And finally the presentation will note how NWS is taking a multi-faceted approach to diversity to achieve `balance' through empowerment, involvement, (gender) mainstreaming, training, etc…, and of course recruiting and retention.

Factor Structure and Psychometric Properties of the Work-Family Balance Scale in an Urban Chinese Sample.

PubMed

Zhang, Huiping; Yip, Paul S F; Chi, Peilian; Chan, Kinsun; Cheung, Yee Tak; Zhang, Xiulan

2012-02-01

The purpose of this study was to explore the factor structure of the Work-Family Balance Scale (WFBS) and examine its reliability and validity in use in the urban Chinese population. The scale was validated using a sample of 605 urban Chinese residents from 7 cities. Exploratory factor analysis identified two factors: work-family conflict and work-family enrichment. The WFBS showed adequate reliability and concurrent validity. The WFBS is a reliable and valid instrument to measure work-family balance for Chinese working parents. However, further examination of the scale is needed.

Sensory-Challenge Balance Exercises Improve Multisensory Reweighting in Fall-Prone Older Adults.

PubMed

Allison, Leslie K; Kiemel, Tim; Jeka, John J

2018-04-01

Multisensory reweighting (MSR) deficits in older adults contribute to fall risk. Sensory-challenge balance exercises may have value for addressing the MSR deficits in fall-prone older adults. The purpose of this study was to examine the effect of sensory-challenge balance exercises on MSR and clinical balance measures in fall-prone older adults. We used a quasi-experimental, repeated-measures, within-subjects design. Older adults with a history of falls underwent an 8-week baseline (control) period. This was followed by an 8-week intervention period that included 16 sensory-challenge balance exercise sessions performed with computerized balance training equipment. Measurements, taken twice before and once after intervention, included laboratory measures of MSR (center of mass gain and phase, position, and velocity variability) and clinical tests (Activities-specific Balance Confidence Scale, Berg Balance Scale, Sensory Organization Test, Limits of Stability test, and lower extremity strength and range of motion). Twenty adults 70 years of age and older with a history of falls completed all 16 sessions. Significant improvements were observed in laboratory-based MSR measures of touch gain (P = 0.006) and phase (P = 0.05), Berg Balance Scale (P = 0.002), Sensory Organization Test (P = 0.002), Limits of Stability Test (P = 0.001), and lower extremity strength scores (P = 0.005). Mean values of vision gain increased more than those for touch gain, but did not reach significance. A balance exercise program specifically targeting multisensory integration mechanisms improved MSR, balance, and lower extremity strength in this mechanistic study. These valuable findings provide the scientific rationale for sensory-challenge balance exercise to improve perception of body position and motion in space and potential reduction in fall risk.

Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients

PubMed Central

2017-01-01

Objective To determine the efficacy of aquatic treadmill training (ATT) as a new modality for stroke rehabilitation, by assessing changes in gait symmetry, balance function, and subjective balance confidence for the paretic and non-paretic leg in stroke patients. Methods Twenty-one subacute stroke patients participated in 15 intervention sessions of aquatic treadmill training. The Comfortable 10-Meter Walk Test (CWT), spatiotemporal gait parameters, Berg Balance Scale (BBS), and Activities-specific Balance Confidence scale (ABC) were assessed pre- and post-interventions. Results From pre- to post-intervention, statistically significant improvements were observed in the CWT (0.471±0.21 to 0.558±0.23, p<0.001), BBS (39.66±8.63 to 43.80±5.21, p<0.001), and ABC (38.39±13.46 to 46.93±12.32, p<0.001). The step-length symmetry (1.017±0.25 to 0.990±0.19, p=0.720) and overall temporal symmetry (1.404±0.36 to 1.314±0.34, p=0.218) showed improvement without statistical significance. Conclusion ATT improves the functional aspects of gait, including CWT, BBS and ABC, and spatiotemporal gait symmetry, though without statistical significance. Further studies are required to examine and compare the potential benefits of ATT as a new modality for stroke therapy, with other modalities. PMID:28758074

Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients.

PubMed

Lee, Mi Eun; Jo, Geun Yeol; Do, Hwan Kwon; Choi, Hee Eun; Kim, Woo Jin

2017-06-01

To determine the efficacy of aquatic treadmill training (ATT) as a new modality for stroke rehabilitation, by assessing changes in gait symmetry, balance function, and subjective balance confidence for the paretic and non-paretic leg in stroke patients. Twenty-one subacute stroke patients participated in 15 intervention sessions of aquatic treadmill training. The Comfortable 10-Meter Walk Test (CWT), spatiotemporal gait parameters, Berg Balance Scale (BBS), and Activities-specific Balance Confidence scale (ABC) were assessed pre- and post-interventions. From pre- to post-intervention, statistically significant improvements were observed in the CWT (0.471±0.21 to 0.558±0.23, p<0.001), BBS (39.66±8.63 to 43.80±5.21, p<0.001), and ABC (38.39±13.46 to 46.93±12.32, p<0.001). The step-length symmetry (1.017±0.25 to 0.990±0.19, p=0.720) and overall temporal symmetry (1.404±0.36 to 1.314±0.34, p=0.218) showed improvement without statistical significance. ATT improves the functional aspects of gait, including CWT, BBS and ABC, and spatiotemporal gait symmetry, though without statistical significance. Further studies are required to examine and compare the potential benefits of ATT as a new modality for stroke therapy, with other modalities.

Proposed Confidence Scale and ID Score in the Identification of Known-Unknown Compounds Using High Resolution MS Data

NASA Astrophysics Data System (ADS)

Rochat, Bertrand

2017-04-01

High-resolution (HR) MS instruments recording HR-full scan allow analysts to go further beyond pre-acquisition choices. Untargeted acquisition can reveal unexpected compounds or concentrations and can be performed for preliminary diagnosis attempt. Then, revealed compounds will have to be identified for interpretations. Whereas the need of reference standards is mandatory to confirm identification, the diverse information collected from HRMS allows identifying unknown compounds with relatively high degree of confidence without reference standards injected in the same analytical sequence. However, there is a necessity to evaluate the degree of confidence in putative identifications, possibly before further targeted analyses. This is why a confidence scale and a score in the identification of (non-peptidic) known-unknown, defined as compounds with entries in database, is proposed for (LC-) HRMS data. The scale is based on two representative documents edited by the European Commission (2007/657/EC) and the Metabolomics Standard Initiative (MSI), in an attempt to build a bridge between the communities of metabolomics and screening labs. With this confidence scale, an identification (ID) score is determined as [a number, a letter, and a number] (e.g., 2D3), from the following three criteria: I, a General Identification Category (1, confirmed, 2, putatively identified, 3, annotated compounds/classes, and 4, unknown); II, a Chromatography Class based on the relative retention time (from the narrowest tolerance, A, to no chromatographic references, D); and III, an Identification Point Level (1, very high, 2, high, and 3, normal level) based on the number of identification points collected. Three putative identification examples of known-unknown will be presented.

Understanding the pros and cons of organ donation decision-making: Decisional balance and expressing donation intentions among African Americans.

PubMed

Flemming, Shauna St Clair; Redmond, Nakeva; Williamson, Dana Hz; Thompson, Nancy J; Perryman, Jennie P; Patzer, Rachel E; Arriola, Kimberly Jacob

2018-04-01

Increasing public commitment to organ donation is critical to improving donor kidney availability for end-stage renal disease patients desiring transplant. This study surveyed ( N = 1339) African Americans, measuring perceived pros relative to cons of organ donation, to evaluate an existing Transtheoretical Model decisional balance scale and associations between decisional balance and expressing donation intentions. Findings supported the existing scale structure. More positive decisional balance ratios were associated with 1.76 times the odds of expressing intentions (95% confidence interval = 1.52-2.04). Pros were more strongly linked to donation intentions than cons. Greater understanding of organ donation decision-making is valuable for informing interventions that encourage donation.

Group- and Individual-Level Responsiveness of the 3-Point Berg Balance Scale and 3-Point Postural Assessment Scale for Stroke Patients.

PubMed

Huang, Yi-Jing; Lin, Gong-Hong; Lee, Shih-Chieh; Chen, Yi-Miau; Huang, Sheau-Ling; Hsieh, Ching-Lin

2018-03-01

To examine both group- and individual-level responsiveness of the 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) in patients with stroke, and to compare the responsiveness of both 3-point measures versus their original measures (Berg Balance Scale [BBS] and Postural Assessment Scale for Stroke Patients [PASS]) and their short forms (short-form Berg Balance Scale [SFBBS] and short-form Postural Assessment Scale for Stroke Patients [SFPASS]) and between the BBS-3P and PASS-3P. Data were retrieved from a previous study wherein 212 patients were assessed at 14 and 30 days after stroke with the BBS and PASS. Medical center. Patients (N=212) with first onset of stroke within 14 days before hospitalization. Not applicable. Group-level responsiveness was examined by the standardized response mean (SRM), and individual-level responsiveness was examined by the proportion of patients whose change scores exceeded the minimal detectable change of each measure. The responsiveness was compared using the bootstrap approach. The BBS-3P and PASS-3P had good group-level (SRM, .60 and SRM, .56, respectively) and individual-level (48.1% and 44.8% of the patients with significant improvement, respectively) responsiveness. Bootstrap analyses showed that the BBS-3P generally had superior responsiveness to the BBS and SFBBS, and the PASS-3P had similar responsiveness to the PASS and SFPASS. The BBS-3P and PASS-3P were equally responsive to both group and individual change. The responsiveness of the BBS-3P and PASS-3P was comparable or superior to those of the original and short-form measures. We recommend the BBS-3P and PASS-3P as responsive outcome measures of balance for individuals with stroke. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Performance on the Balance Scale by Two-Year Old Children.

ERIC Educational Resources Information Center

Halford, Graeme S.; Dalton, Cherie

Twenty-two children ranging in age from 2 to 3 years were tested on their abilities to apply weight and distance rules to the balance scale. This study was performed to test the prediction that 2-year-olds would be able to understand either a weight rule or a distance rule, but not be able to integrate the two. The sample group was instructed in…

Measuring practical knowledge about balanced meals: development and validation of the brief PKB-7 scale.

PubMed

Mötteli, S; Barbey, J; Keller, C; Bucher, T; Siegrist, M

2016-04-01

As a high-quality diet is associated with a lower risk for several diseases and all-cause mortality, current nutrition education tools provide people with information regarding how to build a healthy and a balanced meal. To assess this basic nutrition knowledge, the research aim was to develop and validate a brief scale to measure the Practical Knowledge about Balanced meals (PKB-7). A pool of 25 items was pretested with experts and laypeople before being tested on a random sample in Switzerland (n=517). For item selection, a Rasch model analysis was applied. The validity and reliability of the new scale were assessed by three additional studies including laypeople (n=597; n=145) and nutrition experts (n=59). The final scale consists of seven multiple-choice items, which met the assumptions of the Rasch model. The validity of the new scale was shown by several aspects: the Rasch model was replicated in a second study, and nutrition experts achieved significantly higher scores than laypeople (t(148)=20.27, P<0.001, d=1.78). In addition, the PKB-7 scale was correlated with other nutrition-related constructs and associated with reported vegetable consumption. Test-retest reliability (r=0.68, P<0.001) was acceptable. The PKB-7 scale is a reliable and a valid Rasch-based instrument in Swiss citizens aged between 18 and 80 years for measuring the practical knowledge about balanced meals based on current dietary guidelines. This brief and easy-to-use scale is intended for application in both research and practice.

Effects of phase proprioceptive training on balance in patients with chronic stroke.

PubMed

Chae, Seung Hun; Kim, You Lim; Lee, Suk Min

2017-05-01

[Purpose] This study aimed to investigate the effect of phase proprioceptive training on balance in patients with chronic stroke. [Subjects and Methods] Participants included 30 patients with stroke who were randomly assigned to the proprioceptive training group (n=15) or control group (n=15). Participants in the proprioceptive training group underwent proprioceptive training and received general physical therapy each for a total of 20 thirty-minute sessions, five times per week, during a period of four weeks; the control group received general physical therapy for a total of 20 sixty-minute sessions, five times per week, during a period of four weeks. [Results] All participants were evaluated with the Berg Balance Scale, Timed Up and Go (TUG) test, and Activities-specific Balance Confidence (ABC) Scale instrument before and after intervention. After training, the differences in BBS, TUG, and ABC scores in the proprioceptive group were significantly greater than those in the control group. [Conclusion] In conclusion, proprioceptive training was effective on balance ability. Therefore, proprioceptive training may be efficient when combining general physical therapy with phase proprioceptive training for patients with impairments of balance. Further research is needed to investigate proprioceptive training methods.

Importance of ecohydrological modelling approaches in the prediction of plant behaviour and water balance at different scales

NASA Astrophysics Data System (ADS)

García-Arias, Alicia; Ruiz-Pérez, Guiomar; Francés, Félix

2017-04-01

Vegetation plays a main role in the water balance of most hydrological systems. However, in the past it has been barely considered the effect of the interception and evapotranspiration for hydrological modelling purposes. During the last years many authors have recognised and supported ecohydrological approaches instead of traditional strategies. This contribution is aimed to demonstrate the pivotal role of the vegetation in ecohydrological models and that a better understanding of the hydrological systems can be achieved by considering the appropriate processes related to plants. The study is performed in two scales: the plot scale and the reach scale. At plot scale, only zonal vegetation was considered while at reach scale both zonal and riparian were taken into account. In order to assure the main role of the water on the vegetation development, semiarid environments have been selected for the case studies. Results show an increase of the capabilities to predict plant behaviour and water balance when interception and evapotranspiration are taken into account in the soil water balance

The effects of backward walking training on balance and mobility in an individual with chronic incomplete spinal cord injury: A case report.

PubMed

Foster, Hannah; DeMark, Lou; Spigel, Pamela M; Rose, Dorian K; Fox, Emily J

2016-10-01

Individuals with incomplete spinal cord injuries (ISCIs) commonly face persistent gait impairments. Backward walking training may be a useful rehabilitation approach, providing novel gait and balance challenges. However, little is known about the effects of this approach for individuals with ISCIs. The purpose of this case report was to describe the effects of backward walking training on strength, balance, and upright mobility in an individual with chronic ISCI. A 28-year-old female, 11-years post ISCI (C4, AIS D) completed 18-sessions of backward walking training on a treadmill with partial body-weight support and overground. Training emphasized stepping practice, speed, and kinematics. Outcome measures included: Lower Extremity Motor Score, Berg Balance Scale (BBS), Sensory Organization Test (SOT), 10-Meter Walk Test (10MWT), 3-meter backward walking test, Timed Up and Go (TUG), and Activities-Specific Balance Confidence (ABC) Scale. Strength did not change. Improved balance was evident based on BBS (20 to 37/56) and SOT scores (27 to 40/100). Upright mobility improved based on TUG times (57 to 32.7 s), increased 10MWT speed (0.23 to 0.31 m/s), and backward gait speed (0.07 to 0.12 m/s). Additionally, self-reported balance confidence (ABC Scale) increased from 36.9% to 49.6%. The results suggest that backward walking may be a beneficial rehabilitation approach; examination of the clinical efficacy is warranted.

The effects of backward walking training on balance and mobility in an individual with chronic incomplete spinal cord injury: A case report

PubMed Central

Foster, Hannah; DeMark, Lou; Spigel, Pamela M.; Rose, Dorian K.; Fox, Emily J.

2016-01-01

Background/Purpose Individuals with incomplete spinal cord injuries (ISCIs) commonly face persistent gait impairments. Backward walking training may be a useful rehabilitation approach, providing novel gait and balance challenges. However, little is known about the effects of this approach for individuals with ISCIs. The purpose of this case report was to describe the effects of backward walking training on strength, balance and upright mobility in an individual with chronic ISCI. Methods A 28-year-old female, 11-years post ISCI (C4, AIS D) completed 18-sessions of backward walking training on a treadmill with partial body-weight support and overground. Training emphasized stepping practice, speed, and kinematics. Outcome measures included: Lower Extremity Motor Score, Berg Balance Scale (BBS), Sensory Organization Test (SOT); 10-Meter Walk Test (10MWT), 3-meter backward walking test, Timed Up and Go (TUG), and Activities-Specific Balance Confidence (ABC) Scale. Results Strength did not change. Improved balance was evident based on BBS (20 to 37/56) and SOT scores (27 to 40/100). Upright mobility improved based on TUG times (57 to 32.7 s), increased 10MWT speed (0.23 to 0.31 m/s), and backward gait speed (0.07 to 0.12 m/s). Additionally, self-reported balance confidence (ABC Scale) increased from 36.9% to 49.6%. Conclusions The results suggest that backward walking may be a beneficial rehabilitation approach; examination of the clinical efficacy is warranted. PMID:27482619

Patients and medical statistics. Interest, confidence, and ability.

PubMed

Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert

2005-11-01

People are increasingly presented with medical statistics. There are no existing measures to assess their level of interest or confidence in using medical statistics. To develop 2 new measures, the STAT-interest and STAT-confidence scales, and assess their reliability and validity. Survey with retest after approximately 2 weeks. Two hundred and twenty-four people were recruited from advertisements in local newspapers, an outpatient clinic waiting area, and a hospital open house. We developed and revised 5 items on interest in medical statistics and 3 on confidence understanding statistics. Study participants were mostly college graduates (52%); 25% had a high school education or less. The mean age was 53 (range 20 to 84) years. Most paid attention to medical statistics (6% paid no attention). The mean (SD) STAT-interest score was 68 (17) and ranged from 15 to 100. Confidence in using statistics was also high: the mean (SD) STAT-confidence score was 65 (19) and ranged from 11 to 100. STAT-interest and STAT-confidence scores were moderately correlated (r=.36, P<.001). Both scales demonstrated good test-retest repeatability (r=.60, .62, respectively), internal consistency reliability (Cronbach's alpha=0.70 and 0.78), and usability (individual item nonresponse ranged from 0% to 1.3%). Scale scores correlated only weakly with scores on a medical data interpretation test (r=.15 and .26, respectively). The STAT-interest and STAT-confidence scales are usable and reliable. Interest and confidence were only weakly related to the ability to actually use data.

Comparison of Ai Chi and Impairment-Based Aquatic Therapy for Older Adults With Balance Problems: A Clinical Study.

PubMed

Covill, Laura G; Utley, Cynthia; Hochstein, Cheryl

Older adults with balance deficits often fear falling and limit their mobility. Poor balance is multifactorial, influenced by medication interactions, musculoskeletal and sensory system changes, and poor neuromuscular response to changes in body positions. Aquatic physical therapy (APT) is an intervention used to improve balance and decrease falls. Ai Chi is a water-based exercise program. It incorporates slow movements of progressive difficulty utilizing the upper and lower extremities and trunk coordinated with deep breathing. It is used for relaxation, strengthening, and balance training. The purpose of this study was to determine whether Ai Chi provides better results than conventional impairment-based aquatic therapy (IBAT) for older adults with balance deficits. Thirty-two community-dwelling adults, 65 to 85 years old, were referred to 2 different community pools for APT. Fifteen participants received Ai Chi-based aquatic interventions and 17 participants received an IBAT program. Physical therapists trained in both programs completed interventions and determined discharge. Physical balance measures, which included the Berg Balance Scale (BBS) and Timed Up and Go (TUG), were collected pre- and posttherapy. Self-reported outcome measures, the Activities-Specific Balance Confidence Scale (ABC) and Numerical Pain Rating Scale (NPRS), were collected pre- and posttherapy and 3- and 6-month postdischarge. A 2-way (group by time) mixed-model analysis of covariance with initial outcome scores as a covariate revealed no difference between groups in any of the outcome measures (BBS, P = .53; TUG, P = .39; ABC, P = .63; NPRS, P = .27). Repeated-measures analysis and dependent t tests showed significant improvements in the BBS (P = .00) and TUG (P = .03) after APT. The ABC and NPRS did not improve significantly (ABC, P = .27; NPRS, P = .77). There were no significant differences found in balance measures, balance confidence, or pain levels for community-dwelling older

Method of Harmonic Balance in Full-Scale-Model Tests of Electrical Devices

NASA Astrophysics Data System (ADS)

Gorbatenko, N. I.; Lankin, A. M.; Lankin, M. V.

2017-01-01

Methods for determining the weber-ampere characteristics of electrical devices, one of which is based on solution of direct problem of harmonic balance and the other on solution of inverse problem of harmonic balance by the method of full-scale-model tests, are suggested. The mathematical model of the device is constructed using the describing function and simplex optimization methods. The presented results of experimental applications of the method show its efficiency. The advantage of the method is the possibility of application for nondestructive inspection of electrical devices in the processes of their production and operation.

Balance measured by the sway balance smart-device application does not discriminate between older persons with and without a fall history.

PubMed

Vincenzo, Jennifer L; Glenn, Jordan M; Gray, Stephanie M; Gray, Michelle

2016-08-01

Clinical functional assessments of balance often lack specificity and sensitivity in discriminating and predicting falls among community-dwelling older adults. We determined the feasibility of using a smart-device application measuring balance to discriminate fall status among older adults. We also evaluated differences between smart-device balance measurements when secured with or without a harness. A cross-sectional study design to determine the ability of the Sway Balance smart-device application (SWAY) to discriminate older adults based on fall history. The Berg Balance Scale (BBS) and Activities-Specific Balance Confidence Scale (ABC) were used as comparative, clinically based assessments. Community-dwelling older adults with (n = 25) and without (n = 32) a history of fall(s) participated. Multivariate analysis of variance was used to determine differences among assessments based on fall history. Logistic regression models determined the ability of each assessment to discriminate fall history. Older adults with and without a history of falls were not significantly different on SWAY (P = 0.92) but were different on BBS (P = 0.01), and ABC (P < 0.001). Similarly, SWAY did not discriminate fall history (P = 0.92), while BBS and ABC both discriminated fall history (P < 0.01). Paired t tests between SWAY scores with and without a harness indicated no differences (P ≥ 0.05). Among the older adults studied, the BBS and ABC measures discriminated groups defined by fall history, while the SWAY smart-device balance application did not. Modifications to the application may improve the discriminating ability of the measure in the recognition of fall status in older adults.

Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson's disease: a randomized controlled pilot study.

PubMed

Volpe, Daniele; Giantin, Maria Giulia; Maestri, Roberto; Frazzitta, Giuseppe

2014-12-01

Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson's disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy. A randomized single-blind controlled trial. Outpatients. Thirty-four patients with Parkinson's disease in Hoehn-Yahr stage 2.5-3. Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months). The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson's Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson's Disease Questionnaire-39. Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change: 45.4 SD64.9 vs. 6.9 SD45.3, p = 0.05), Berg Balance Scale (51.2 SD3.1 vs. 6.0 SD3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD10.6 vs. 4.1 SD5.4, p = 0.0001), Falls Efficacy Scale (-5.9 SD4.8 vs. -1.9 SD1.4, p = 0.003), Parkinson's Disease Quetionnaire-39 (-18.4 SD12.9 vs. -8.0 SD7.0, p = 0.006) and falls diary (-2.4 SD2.2 vs. -0.4 SD0.5, p = 0.001). Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease. © The Author(s) 2014.

A dual-task home-based rehabilitation programme for improving balance control in patients with acquired brain injury: a single-blind, randomized controlled pilot study.

PubMed

Peirone, Eliana; Goria, Paolo Filiberto; Anselmino, Arianna

2014-04-01

To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury. Single-blind, randomized controlled pilot study. Single rehabilitation centre. Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score <10 seconds on the One-Leg Stance Test (eyes open). All participants received 50-minutes individualised traditional physiotherapy sessions three times a week for seven weeks. In addition, the intervention group (N = 8) performed an individualised dual-task home-based programme six days a week for seven weeks. The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling. At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63). This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.

Falls and Use of Assistive Devices in Stroke Patients with Hemiparesis: Association with Balance Ability and Fall Efficacy.

PubMed

Kim, Oksoo; Kim, Jung-Hee

2015-01-01

This study investigates balance ability and the fall efficacy with regard to the experiences of stroke patients with hemiparesis. The experience of falling, the use of assistive devices, and each disease-related characteristic were assessed using face-to-face interviews and a self-reported questionnaire. The Berg Balance Scale and Fall Efficacy Scale were used to measure balance ability and confidence. The fall efficacy was significantly lower in participants who had experienced falls than those who had not. The participants who used assistive devices exhibited low balance ability and fall efficacy compared to those who did not use assistive devices. Stroke patients with fall experience and walking aids might be considered at increased risk of falling. Preventive measures for individuals using walking aids may be beneficial in reducing the fall rate of community-dwelling stroke patients. © 2014 Association of Rehabilitation Nurses.

Concept analysis: confidence/self-confidence.

PubMed

Perry, Patricia

2011-01-01

Confidence and self-confidence are crucial practice elements in nursing education and practice. Nurse educators should have an understanding of the concept of confidence in order to assist in the accomplishment of nursing students and their learning of technical and nontechnical skills. With the aim of facilitating trusted care of patients in the healthcare setting, nursing professionals must exhibit confidence, and, as such, clarification and analysis of its meaning is necessary. The purpose of this analysis is to provide clarity to the meaning of the concept confidence/self-confidence, while gaining a more comprehensive understanding of its attributes, antecedents, and consequences. Walker and Avant's eight-step method of concept analysis was utilized for the framework of the analysis process with model, contrary, borderline, and related cases presented along with attributes, antecedents, consequences, and empirical referents identified. Understanding both the individualized development of confidence among prelicensure nursing students and the role of the nurse educator in the development of confident nursing practice, nurse educators can assist students in the development of confidence and competency. Future research surrounding the nature and development of confidence/self-confidence in the prelicensure nursing student experiencing human patient simulation sessions would assist to help educators further promote the development of confidence. © 2011 Wiley Periodicals, Inc.

Quantifying Tropical Glacier Mass Balance Sensitivity to Climate Change Through Regional-Scale Modeling and The Randolph Glacier Inventory

NASA Astrophysics Data System (ADS)

Malone, A.

2017-12-01

Quantifying mass balance sensitivity to climate change is essential for forecasting glacier evolution and deciphering climate signals embedded in archives of past glacier changes. Ideally, these quantifications result from decades of field measurement, remote sensing, and a hierarchy modeling approach, but in data-sparse regions, such as the Himalayas and tropical Andes, regional-scale modeling rooted in first principles provides a first-order picture. Previous regional-scaling modeling studies have applied a surface energy and mass balance approach in order to quantify equilibrium line altitude sensitivity to climate change. In this study, an expanded regional-scale surface energy and mass balance model is implemented to quantify glacier-wide mass balance sensitivity to climate change for tropical Andean glaciers. Data from the Randolph Glacier Inventory are incorporated, and additional physical processes are included, such as a dynamic albedo and cloud-dependent atmospheric emissivity. The model output agrees well with the limited mass balance records for tropical Andean glaciers. The dominant climate variables driving interannual mass balance variability differ depending on the climate setting. For wet tropical glaciers (annual precipitation >0.75 m y-1), temperature is the dominant climate variable. Different hypotheses for the processes linking wet tropical glacier mass balance variability to temperature are evaluated. The results support the hypothesis that glacier-wide mass balance on wet tropical glaciers is largely dominated by processes at the lowest elevation where temperature plays a leading role in energy exchanges. This research also highlights the transient nature of wet tropical glaciers - the vast majority of tropical glaciers and a vital regional water resource - in an anthropogenic warming world.

Psychometric Testing of the Chinese Version of the Decisional Balance Scale (CDBS)

ERIC Educational Resources Information Center

Chen, Huey-Shys; Sheu, Jiunn-Jye; Chen, W. William

2006-01-01

The purpose of this study was to conduct psychometric testing on the Chinese version of the decisional balance scale (CDBS) with Taiwanese seventh, eighth, and ninth graders who were recruited from the Taipei metropolitan area. A random cluster sampling method was used with 554 adolescents between the ages of 13 and 17 years. Factor analysis…

The functional assessment Berg Balance Scale is better capable of estimating fall risk in the elderly than the posturographic Balance Stability System.

PubMed

Pereira, Vanessa Vieira; Maia, Roberto Alcantara; Silva, Sonia Maria Cesar de Azevedo

2013-01-01

The purpose of this study was to verify which instrument better identifies recurrent falls in the elderly. Ninety-eight old people, with an average age of 80 ± 4 years, were submitted to an assessment of balance and fall risk by means of the Berg Balance Scale (BBS) and the posturographic Balance Stability System (BSS). The BBS was correlated with the BSS (r=-0.27; p=0.008), age (r=-0.38; p<0.001) and number of falls (r=-0.25; p=0.013) and the analysis of logistical regression showed that the elderly classified with fall risk on the BBS presented 2.5 (95%CI 1.08-5.78) more chance of identifying who had two falls or more over the last year. The BBS identified that the greater the age the worse the functional balance and demonstrated a greater capacity to identify falls risk suffered over the last year when compared with the BSS.

Landscape-scale water balance monitoring with an iGrav superconducting gravimeter in a field enclosure

NASA Astrophysics Data System (ADS)

Güntner, Andreas; Reich, Marvin; Mikolaj, Michal; Creutzfeldt, Benjamin; Schroeder, Stephan; Wziontek, Hartmut

2017-04-01

In spite of the fundamental role of the landscape water balance for the Earth's water and energy cycles, monitoring the water balance and its components beyond the point scale is notoriously difficult due to the multitude of flow and storage processes and their spatial heterogeneity. Here, we present the first deployment of an iGrav superconducting gravimeter (SG) in a minimized field enclosure on a grassland site for integrative monitoring of water storage changes. Results of the field SG were compared to data provided by a nearby SG located in the controlled environment of an observatory building. For wet-temperate climate conditions, the system proves to provide gravity time series that are similarly precise as those of the observatory SG. At the same time, the field SG is more sensitive to hydrological variations than the observatory SG. We demonstrate that the gravity variations observed by the field setup are almost independent of the depth below the terrain surface where water storage changes occur (contrary to SGs in buildings), and thus the field SG system directly observes the total water storage change, i.e., the water balance, in its surroundings in an integrative way. We provide a framework to single out the water balance components actual evapotranspiration and lateral subsurface discharge from the gravity time series on annual to daily time scales. With about 99% and 85% of the gravity signal originating within a radius of 4000 and 200 meter around the instrument, respectively, this setup paves the road towards gravimetry as a continuous hydrological field monitoring technique at the landscape scale.

Changes in balance in older adults based on use of physical therapy vs the Wii Fit gaming system: a preliminary study.

PubMed

Bateni, Hamid

2012-09-01

To determine the effectiveness of Wii Fit training on balance control in older adults compared with physical therapy training. Quasi-experimental design. Eight males and nine females aged 53 to 91 years. Participants were divided into three groups: one group received both physical therapy training and Wii Fit training (PW group), one group received Wii Fit training alone (WI group), and one group received physical therapy training alone (PT group). Training consisted of three sessions per week for 4 weeks. Berg Balance Scale (all groups) and Bubble Test (PW and WI groups) scores. Descriptive statistics, medians, interquartile ranges and 95% confidence intervals are reported to identify trends in balance control as a result of different types of training. All subjects showed improvement in the Berg Balance Scale and Bubble Test scores. The PT and PW groups tended to perform better than the WI group on the Berg Balance Scale following treatment. Although the differences in the Bubble Test score were not substantial between the PW and WI groups, the PW group performed slightly better than the WI group on the Berg Balance Scale. Wii Fit training appears to improve balance. However, physical therapy training on its own or in addition to Wii Fit training appears to improve balance to a greater extent than Wii Fit training alone. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Using the Nintendo Wii Fit and body weight support to improve aerobic capacity, balance, gait ability, and fear of falling: two case reports.

PubMed

Miller, Carol A; Hayes, Dawn M; Dye, Kelli; Johnson, Courtney; Meyers, Jennifer

2012-01-01

Lower limb amputation in older adults has a significant impact on balance, gait, and cardiovascular fitness, resulting in diminished community participation. The purpose of this case study was to describe the effects of a balance training program utilizing the Nintendo Wii™ Fit (Nintendo of America, Inc, Redmond, Washington) balance board and body-weight supported gait training on aerobic capacity, balance, gait, and fear of falling in two persons with transfemoral amputation. Participant A, a 62 year-old male 32 months post traumatic transfemoral amputation, reported fear of falling and restrictions in community activity. Participant B, a 58 year-old male 9 years post transfemoral amputation, reported limited energy and balance deficits during advanced gait activities. 6-weeks, 2 supervised sessions per week included 20 minutes of Nintendo™ Wii Fit Balance gaming and 20 minutes of gait training using Body Weight Support. Measures included oxygen uptake efficiency slope (OUES), economy of movement, dynamic balance (Biodex platform system), Activities-Specific Balance Confidence (ABC) Scale, and spatial-temporal parameters of gait (GAITRite). Both participants demonstrated improvement in dynamic balance, balance confidence, economy of movement, and spatial-temporal parameters of gait. Participant A reduced the need for an assistive device during community ambulation. Participant B improved his aerobic capacity, indicated by an increase in OUES. This case study illustrated that the use of Nintendo Wii™ Fit training and Body Weight Support were effective interventions to achieve functional goals for improving balance confidence, reducing use of assistive devices, and increasing energy efficiency when ambulating with a transfemoral prosthesis.

Basic Confidence Predictors of Career Decision-Making Self-Efficacy

ERIC Educational Resources Information Center

Paulsen, Alisa M.; Betz, Nancy E.

2004-01-01

The extent to which Basic Confidence Scales predicted career decision-making self-efficacy was studied in a sample of 627 undergraduate students. Six confidence variables accounted for 49% of the variance in career decision-making self-efficacy. Leadership confidence was the most important, but confidence in science, mathematics, writing, using…

Detailed comparison of the geodetic and direct glaciological mass balances on an annual time scale at Hintereisferner, Austria

NASA Astrophysics Data System (ADS)

Klug, Christoph; Bollmann, Erik; Galos, Stephan; Kaser, Georg; Prinz, Rainer; Rieg, Lorenzo; Sailer, Rudolf

2016-04-01

eventually built up before the ALS acquisition, is corrected. As snow cover biases are particular uncertain, a statistical approach has been applied to assess combined DTM errors by using the population of DTM differences over stable terrain. This method incorporates all known and unknown error sources from the surface difference in stable areas and uses its median thickness for correction in all altitudinal belts. In addition, intensity data of the ALS surveys are used to classify the optical surface properties into ice and firn zones. The resulting grids with according conversion factors (900 and 700 kg/m³ for ice and firn, respectively) are combined to calculate mass changes. In a last step, the survey dates are adjusted, using numerous field observations. On an annual time scale, the geodetic mass balances of HEF corrected using this approach, correlate well with the results from the homogenized direct glaciological method. Significant deviations occur in years with few measurements in the uppermost areas applying the direct glaciological method, due to strong melt in areas not equipped with ablation stakes (cf. Figure 2 for 2002/03) or inaccessibility due to weather conditions. On the basis of these results, the conventional error risk (e.g. confidence levels), was adopted in order to test the null hypothesis and to check if unexplained discrepancies suggest reanalyses of glaciological mass balances. Regarding the cumulative mass balance, the deviations between the two methods tend to become smaller the longer the period of comparison extends. Averaged between 2001 and 2011 the largest sources of differences are snow cover and density assumptions having high uncertainties in their estimates and/or leading to higher error ranges in the geodetic mass balances. Some errors were found to have a minor impact and are not treated explicitly, such as uncertainties in different glacier outlines used in both methods or the influence of snow covered and snow free crevasses in

Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults.

PubMed

Lip, Ryan W T; Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Guo, X

2015-03-01

[Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation.

Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults

PubMed Central

Lip, Ryan W.T.; Fong, Shirley S.M.; Ng, Shamay S.M.; Liu, Karen P.Y.; Guo, X.

2015-01-01

[Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation. PMID:25931704

Effects of dual-task balance training on postural performance in patients with Multiple Sclerosis: a double-blind, randomized controlled pilot trial.

PubMed

Monjezi, Saeideh; Negahban, Hossein; Tajali, Shirin; Yadollahpour, Nava; Majdinasab, Nastaran

2017-02-01

To investigate the effects of dual-task balance training on postural performance in patients with multiple sclerosis as compared with single-task balance training. Double-blind, pretest-posttest, randomized controlled pilot trial. Local Multiple Sclerosis Society. A total of 47 patients were randomly assigned to two equal groups labeled as single-task training and dual-task training groups. All patients received supervised balance training sessions, 3 times per week for 4 weeks. The patients in the single-task group performed balance activities, alone. However, patients in dual-task group practiced balance activities while simultaneously performing cognitive tasks. The 10-Meter Walk Test and Timed Up-and-Go under single-task and dual-task conditions, in addition to Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment were assessed pre-, and post intervention and also 6-weeks after the end of intervention. Only 38 patients completed the treatment plan. There was no difference in the amount of improvement seen between the two study groups. In both groups there was a significant effect of time for dual-10 Meter Walk Test (F 1, 36 =11.33, p=0.002) and dual-Timed Up-and-Go (F 1, 36 =14.27, p=0.001) but not for their single-tasks. Moreover, there was a significant effect of time for Activities-specific Balance Confidence, Berg Balance Scale, and Functional Gait Assessment ( P<0.01). This pilot study did not show more benefits from undertaking dual-task training than single-task training. A power analysis showed 71 patients per group would be needed to determine whether there was a clinically relevant difference for dual-task gait speed between the groups.

Clinical measures of balance in people with type two diabetes: A systematic literature review.

PubMed

Dixon, C J; Knight, T; Binns, E; Ihaka, B; O'Brien, D

2017-10-01

Approximately 422 million people have diabetes mellitus worldwide, with the majority diagnosed with type 2 diabetes mellitus (T2DM). The complications of diabetes mellitus include diabetic peripheral neuropathy (DPN) and retinopathy, both of which can lead to balance impairments. Balance assessment is therefore an integral component of the clinical assessment of a person with T2DM. Although there are a variety of balance measures available, it is uncertain which measures are the most appropriate for this population. Therefore, the aim of this study was to conduct a systematic review on clinical balance measures used with people with T2DM and DPN. Databases searched included: CINAHL plus, MEDLINE, SPORTDiscus, Dentistry and Oral Sciences source, and SCOPUS. Key terms, inclusion and exclusion criteria were used to identify appropriate studies. Identified studies were critiqued using the Downs and Black appraisal tool. Eight studies were included, these studies incorporated a total of ten different clinical balance measures. The balance measures identified included the Dynamic Balance Test, balance walk, tandem and unipedal stance, Functional Reach Test, Clinical Test of Sensory Interaction and Balance, Berg Balance Scale, Tinetti Performance-Oriented Mobility Assessment, Activity-Specific Balance Confidence Scale, Timed Up and Go test, and the Dynamic Gait Index. Numerous clinical balance measures were used for people with T2DM. However, the identified balance measures did not assess all of the systems of balance, and most had not been validated in a T2DM population. Therefore, future research is needed to identify the validity of a balance measure that assesses these systems in people with T2DM. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Evaluation of scale invariance in physiological signals by means of balanced estimation of diffusion entropy.

PubMed

Zhang, Wenqing; Qiu, Lu; Xiao, Qin; Yang, Huijie; Zhang, Qingjun; Wang, Jianyong

2012-11-01

By means of the concept of the balanced estimation of diffusion entropy, we evaluate the reliable scale invariance embedded in different sleep stages and stride records. Segments corresponding to waking, light sleep, rapid eye movement (REM) sleep, and deep sleep stages are extracted from long-term electroencephalogram signals. For each stage the scaling exponent value is distributed over a considerably wide range, which tell us that the scaling behavior is subject and sleep cycle dependent. The average of the scaling exponent values for waking segments is almost the same as that for REM segments (∼0.8). The waking and REM stages have a significantly higher value of the average scaling exponent than that for light sleep stages (∼0.7). For the stride series, the original diffusion entropy (DE) and the balanced estimation of diffusion entropy (BEDE) give almost the same results for detrended series. The evolutions of local scaling invariance show that the physiological states change abruptly, although in the experiments great efforts have been made to keep conditions unchanged. The global behavior of a single physiological signal may lose rich information on physiological states. Methodologically, the BEDE can evaluate with considerable precision the scale invariance in very short time series (∼10^{2}), while the original DE method sometimes may underestimate scale-invariance exponents or even fail in detecting scale-invariant behavior. The BEDE method is sensitive to trends in time series. The existence of trends may lead to an unreasonably high value of the scaling exponent and consequent mistaken conclusions.

Evaluation of scale invariance in physiological signals by means of balanced estimation of diffusion entropy

NASA Astrophysics Data System (ADS)

Zhang, Wenqing; Qiu, Lu; Xiao, Qin; Yang, Huijie; Zhang, Qingjun; Wang, Jianyong

2012-11-01

By means of the concept of the balanced estimation of diffusion entropy, we evaluate the reliable scale invariance embedded in different sleep stages and stride records. Segments corresponding to waking, light sleep, rapid eye movement (REM) sleep, and deep sleep stages are extracted from long-term electroencephalogram signals. For each stage the scaling exponent value is distributed over a considerably wide range, which tell us that the scaling behavior is subject and sleep cycle dependent. The average of the scaling exponent values for waking segments is almost the same as that for REM segments (˜0.8). The waking and REM stages have a significantly higher value of the average scaling exponent than that for light sleep stages (˜0.7). For the stride series, the original diffusion entropy (DE) and the balanced estimation of diffusion entropy (BEDE) give almost the same results for detrended series. The evolutions of local scaling invariance show that the physiological states change abruptly, although in the experiments great efforts have been made to keep conditions unchanged. The global behavior of a single physiological signal may lose rich information on physiological states. Methodologically, the BEDE can evaluate with considerable precision the scale invariance in very short time series (˜102), while the original DE method sometimes may underestimate scale-invariance exponents or even fail in detecting scale-invariant behavior. The BEDE method is sensitive to trends in time series. The existence of trends may lead to an unreasonably high value of the scaling exponent and consequent mistaken conclusions.

Probability assessment with response times and confidence in perception and knowledge.

PubMed

Petrusic, William M; Baranski, Joseph V

2009-02-01

In both a perceptual and a general knowledge comparison task, participants categorized the time they took to decide, selecting one of six categories ordered from "Slow" to Fast". Subsequently, they rated confidence on a six-category scale ranging from "50%" to "100%". Participants were able to accurately scale their response times thus enabling the treatment of the response time (RT) categories as potential confidence categories. Probability assessment analyses of RTs revealed indices of over/underconfidence, calibration, and resolution, each subject to the "hard-easy" effect, comparable to those obtained with the actual confidence ratings. However, in both the perceptual and knowledge domains, resolution (i.e., the ability to use the confidence categories to distinguish correct from incorrect decisions) was significantly better with confidence ratings than with RT categorization. Generally, comparable results were obtained with scaling of the objective RTs, although subjective categorization of RTs provided probability assessment indices superior to those obtained from objective RTs. Taken together, the findings do not support the view that confidence arises from a scaling of decision time.

Anchoring effects in the judgment of confidence: semantic or numeric priming?

PubMed

Carroll, Steven R; Petrusic, William M; Leth-Steensen, Craig

2009-02-01

Over the last decade, researchers have debated whether anchoring effects are the result of semantic or numeric priming. The present study tested both hypotheses. In four experiments involving a sensory detection task, participants first made a relative confidence judgment by deciding whether they were more or less confident than an anchor value in the correctness of their decision. Subsequently, they expressed an absolute level of confidence. In two of these experiments, the relative confidence anchor values represented the midpoints between the absolute confidence scale values, which were either explicitly numeric or semantic, nonnumeric representations of magnitude. In two other experiments, the anchor values were drawn from a scale modally different from that used to express the absolute confidence (i.e., nonnumeric and numeric, respectively, or vice versa). Regardless of the nature of the anchors, the mean confidence ratings revealed anchoring effects only when the relative and absolute confidence values were drawn from identical scales. Together, the results of these four experiments limit the conditions under which both numeric and semantic priming would be expected to lead to anchoring effects.

Reliability and validity of the Turkish version of the Berg Balance Scale.

PubMed

Sahin, Fusun; Yilmaz, Figen; Ozmaden, Asli; Kotevolu, Nurdan; Sahin, Tulay; Kuran, Banu

2008-01-01

The purpose of this study was to develop a Turkish version of the Berg Balance Scale (BBS) and assess its reliability and validity. Sixty healthy volunteers older than 65 years were included in to the study. Subjects who had lower extremity amputation, or were armchair or bedridden were excluded. After translation process, the Turkish version of the scale was administered to each participant twice with an interval of 2 weeks. The intraclass correlation coefficient (ICC) was calculated to assess intra- and inter-observer reliability. Chronbach alpha was calculated to evaluate internal consistency of the total BBS score. Interclass correlation coefficient was calcuated to examine test-retest reliability. Convergent validity was assessed by correlating the scale with Modified Barthel Index (MBI) and Timed Up and Go Test (TUG). Construct validity was assessed with factor analysis. The mean age in years of the participants were 77.00+/-5.67 (range: 67-92 yrs). The ICC for intra- and inter- observer reliability was 0.98 (p<0.0001) and 0.97 (p<0.0001), respectively. Chronbach alpha of the Turkish version of the BBS was 0.98. The test-retest reliability (ICC) of the Turkish version of the BBS was determined as 0.98 for the total score, and ranged from 0.86-0.99 for individual items. In terms of validity, the Turkish version of the BBS was correlated with the MBI (in positive direction) and TUG (in negative direction) (r=0.67 p<0.0001; r=-0.75 p<0.0001, respectively). The Turkish version of the BBS is a reliable and valid scale to be used in balance assessment of Turkish older adults.

Current Developments in Measuring Academic Behavioural Confidence

ERIC Educational Resources Information Center

Sander, Paul

2009-01-01

Using published findings and by further analyses of existing data, the structure, validity and utility of the Academic Behavioural Confidence scale (ABC) is critically considered. Validity is primarily assessed through the scale's relationship with other existing scales as well as by looking for predicted differences. The utility of the ABC scale…

Feasibility and outcomes of the Berg Balance Scale in older adults with intellectual disabilities.

PubMed

Oppewal, Alyt; Hilgenkamp, Thessa I M; van Wijck, Ruud; Evenhuis, Heleen M

2013-09-01

High incidence of falls and increased risk of fall-related injuries are seen in individuals with intellectual disabilities (ID). The Berg Balance Scale (BBS) is a reliable instrument for balance assessment in the population of (older) adults with ID. The aims of this study were to assess the balance capacities of a large group of older adults with ID with the BBS and look for gender and age effects, as well as reasons for drop-out on separate items, and to identify feasible subtests for subgroups in which the complete BBS is not feasible. The balance capacities of 1050 older clients with borderline to profound ID of three Dutch care-provider services (mean age 61.6 [sd=8.0]) were assessed with the BBS. The participants who completed all items of the BBS (n=508) were the functionally more able part of the study sample. Results showed that even this functionally more able part had poor balance capacities, with a mean BBS score of 47.2, 95% CI [46.3, 48.0], similar to adults in the general population aged around 20 years older. Balance capacities decreased with increasing age and females had poorer balance capacities than males. Difficulties understanding the task and physical limitations were most often the reasons for drop-out. Feasible subtests were identified for the subgroups with very low cognitive levels and wheelchair users. Low balance capacities of older adults with ID show the need for regular screening and the urge for fall prevention programs for individuals with ID. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparison of the Mini-Balance Evaluations Systems Test with the Berg Balance Scale in relationship to walking speed and motor recovery post stroke.

PubMed

Madhavan, Sangeetha; Bishnoi, Alka

2017-12-01

The Mini-BESTest is a recently developed balance assessment tool that incorporates challenging dynamic balance tasks. Few studies have compared the psychometric properties of the Mini-BESTest to the commonly used Berg Balance Scale (BBS). However, the utility of these scales in relationship to post stroke walking speeds has not been explored. The purpose of this study was to compare the sensitivity and specificity of the Mini-BESTest and BBS to evaluate walking speeds in individuals with stroke. A retrospective exploratory design. Forty-one individuals with chronic stroke were evaluated with the Mini-BESTest, BBS, and 10-meter self-selected walk test (10MWT). Based on their self-selected gait speeds (below or above 0.8 m/s), participants were classified as slow and fast walkers. Significant linear correlations were observed between the Mini-BESTest vs. BBS (r = 0.72, p ≤ 0.001), Mini-BESTest vs. 10MWT (r = 0.58, p ≤ 0.001), and BBS vs. 10MWT (r = 0.30, p = 0.05). Independent t-tests comparing the balance scores for the slow and fast walkers revealed significant group differences for the Mini-BESTest (p = 0.003), but not for the BBS (p = 0.09). The Mini-BESTest demonstrated higher sensitivity (93%) and specificity (64%) compared to the BBS (sensitivity 81%, specificity 56%) for discriminating participants into slow and fast walkers. The Mini-BESTest has a greater discriminative ability than the BBS to categorize individuals with stroke into slow and fast walkers.

Landscape-Scale water balance of cotton fields

USDA-ARS?s Scientific Manuscript database

Information on the temporal and spatial distribution of the components of the water balance of a production field is necessary to manage agronomic inputs. Furthermore, factors that determine crop yield require knowledge of the energy, water, nutrient and carbon balance and their interaction. The in...

Balance Training With a Dynamometric Platform Following Total Knee Replacement: A Randomized Controlled Trial.

PubMed

Roig-Casasús, Sergio; María Blasco, José; López-Bueno, Laura; Blasco-Igual, María Clara

2017-03-01

Sensorimotor training has proven to be an efficient approach for recovering balance control following total knee replacement (TKR). The purpose of this trial was to evaluate the influence of specific balance-targeted training using a dynamometric platform on the overall state of balance in older adults undergoing TKR. This was a randomized controlled clinical trial conducted at a university hospital rehabilitation unit. Patients meeting the inclusion criteria were randomly assigned to a control group or an experimental group. Both groups participated in the same 4-week postoperative rehabilitation training protocol. Participants in the experimental group performed additional balance training with a dynamometric platform consisting of tests related to stability challenges, weight-shifting, and moving to the limits of stability. The primary outcome measure was the overall state of balance rated according to the Berg Balance Scale. Secondary outcomes in terms of balance were the Timed Up and Go Test, Functional Reach Test, and Romberg open and closed-eyes tests. Data processing included between-group analysis of covariance, minimal detectable change assessment for the primary outcome measure, and effect size estimation. Confidence intervals (CIs) were set at 95%. Forty-three participants meeting the inclusion criteria and having signed the informed consent were randomly assigned to 2 groups. Thirty-seven completed the training (86.1%). Significant between-group differences in balance performance were found as measured with the Berg Balance Scale (P = .03) and Functional Reach Test (P = .04) with a CI = 95%. Significant differences were not recorded for the Timed Up and Go Test or Romberg open and closed-eyes tests (P > .05). Furthermore, Cohen's effect size resulted in a value of d = 0.97, suggesting a high practical significance of the trial. According to the Berg Balance Scale and Functional Reach Test, participants with TKR who have followed a 4-week training

A Connectionist Model of a Continuous Developmental Transition in the Balance Scale Task

ERIC Educational Resources Information Center

Schapiro, Anna C.; McClelland, James L.

2009-01-01

A connectionist model of the balance scale task is presented which exhibits developmental transitions between "Rule I" and "Rule II" behavior [Siegler, R. S. (1976). Three aspects of cognitive development. "Cognitive Psychology," 8, 481-520.] as well as the "catastrophe flags" seen in data from Jansen and van der Maas [Jansen, B. R. J., & van der…

The Diagnostic Accuracy of the Berg Balance Scale in Predicting Falls.

PubMed

Park, Seong-Hi; Lee, Young-Shin

2017-11-01

This study aimed to evaluate the predictive validity of the Berg Balance Scale (BBS) as a screening tool for fall risks among those with varied levels of balance. A total of 21 studies reporting predictive validity of the BBS of fall risk were meta-analyzed. With regard to the overall predictive validity of the BBS, the pooled sensitivity and specificity were 0.72 and 0.73, respectively; the accuracy curve area was 0.84. The findings showed statistical heterogeneity among studies. Among the sub-groups, the age group of those younger than 65 years, those with neuromuscular disease, those with 2+ falls, and those with a cutoff point of 45 to 49 showed better sensitivity with statistically less heterogeneity. The empirical evidence indicates that the BBS is a suitable tool to screen for the risk of falls and shows good predictability when used with the appropriate criteria and applied to those with neuromuscular disease.

Factor Structure and Psychometric Properties of the Work-Family Balance Scale in an Urban Chinese Sample

ERIC Educational Resources Information Center

Zhang, Huiping; Yip, Paul S. F.; Chi, Peilian; Chan, Kinsun; Cheung, Yee Tak; Zhang, Xiulan

2012-01-01

The purpose of this study was to explore the factor structure of the Work-Family Balance Scale (WFBS) and examine its reliability and validity in use in the urban Chinese population. The scale was validated using a sample of 605 urban Chinese residents from 7 cities. Exploratory factor analysis identified two factors: work-family conflict and…

Validation of Scores on the Marlowe-Crowne Social Desirability Scale and the Balanced Inventory of Desirable Responding

ERIC Educational Resources Information Center

Leite, Walter L.; Beretvas, S. Natasha

2005-01-01

The Marlowe-Crowne Social Desirability Scale (MCSDS), the most commonly used social desirability bias (SDB) assessment, conceptualizes SDB as an individual's need for approval. The Balanced Inventory of Desirable Responding (BIDR) measures SDB as two separate constructs: impression management and self-deception. Scores on SDB scales are commonly…

A standardized review of smartphone applications to promote balance for older adults.

PubMed

Reyes, Angelica; Qin, Pei; Brown, Cary A

2018-03-01

Balance is one of the risk factors for falls in older adults. The use of smartphone applications (apps) related to health (mHealth) is increasing and, while there is potential for apps to be used as a self-managed balance intervention, many healthcare providers are concerned about the content and credibility of mHealth apps overall. This study evaluates the quality of balance promoting apps and identifies strengths and areas of concern to assist healthcare providers in recommending these resources. Balance apps for the general public, offered on the iPhone Operating System (iOS) and Android platforms, were evaluated using the Mobile Application Rating Scale (MARS). Five iOS apps met the inclusion criteria. The mean scores for each of the domains in MARS were: Engagement (3.32), Information (3.7), Functionality (3.8), and Esthetics (3.8). Overall, one app (UStabilize) received a rating of 4.43 in MARS five-point scale, which was considered "good". Other apps in the review demonstrated acceptable quality. The reviewed balance apps targeted to improve or maintain physical balance were of acceptable quality. Apps address many current issues older adults have to accessing rehabilitation services and, as such, may be particularly useful for this group. Future research should focus on assessing and comparing app efficacy. Development of balance apps for the Android platform is also necessary. Implications for Rehabilitation Given the availability and accessibility of various mHealth apps and the increasing mobile device usage among older adults, mobile apps are a promising avenue for delivering rehabilitation interventions, such as balance training, to older adults. Smartphone apps exist for balance training but overall confidence in health apps within the healthcare community is low and rigorous evaluation is required. A range of apps exist that demonstrate acceptable to good quality and stakeholders should work towards having these apps listed in credible m

Comparison of the Mini-Balance Evaluations Systems Test with the Berg Balance Scale in relationship to walking speed and motor recovery post stroke

PubMed Central

Madhavan, Sangeetha; Bishnoi, Alka

2017-01-01

Background The Mini-BESTest is a recently developed balance assessment tool that incorporates challenging dynamic balance tasks. Few studies have compared the psychometric properties of the Mini-BESTest to the commonly used Berg Balance Scale (BBS). However, the utility of these scales in relationship to post stroke walking speeds has not been explored. Objectives The purpose of this study was to compare the sensitivity and specificity of the Mini-BESTest and BBS to evaluate walking speeds in individuals with stroke. Design A retrospective exploratory design. Methods Forty-one individuals with chronic stroke were evaluated with the Mini-BESTest, BBS, and 10-meter self-selected walk test (10MWT). Based on their self-selected gait speeds (below or above 0.8 m/s), participants were classified as slow and fast walkers. Results Significant linear correlations were observed between the Mini-BESTest vs. BBS (r = 0.72, p ≤ 0.001), Mini-BESTest vs. 10MWT (r = 0.58, p ≤ 0.001), and BBS vs. 10MWT (r = 0.30, p = 0.05). Independent t-tests comparing the balance scores for the slow and fast walkers revealed significant group differences for the Mini-BESTest (p =0.003), but not for the BBS (p = 0.09). The Mini-BESTest demonstrated higher sensitivity (93%) and specificity (64%) compared to the BBS (sensitivity 81%, specificity 56%) for discriminating participants into slow and fast walkers. No significant results were observed with the FMLE-M scores. Conclusions The Mini-BESTest has a greater discriminative ability than the BBS to categorize individuals with stroke into slow and fast walkers. PMID:28826325

On-field study of anaerobic digestion full-scale plants (part I): an on-field methodology to determine mass, carbon and nutrients balance.

PubMed

Schievano, Andrea; D'Imporzano, Giuliana; Salati, Silvia; Adani, Fabrizio

2011-09-01

The mass balance (input/output mass flows) of full-scale anaerobic digestion (AD) processes should be known for a series of purposes, e.g. to understand carbon and nutrients balances, to evaluate the contribution of AD processes to elemental cycles, especially when digestates are applied to agricultural land and to measure the biodegradation yields and the process efficiency. In this paper, three alternative methods were studied, to determine the mass balance in full-scale processes, discussing their reliability and applicability. Through a 1-year survey on three full-scale AD plants and through 38 laboratory-scale batch digesters, the congruency of the considered methods was demonstrated and a linear equation was provided that allows calculating the wet weight losses (WL) from the methane produced (MP) by the plant (WL=41.949*MP+20.853, R(2)=0.950, p<0.01). Additionally, this new tool was used to calculate carbon, nitrogen, phosphorous and potassium balances of the three observed AD plants. Copyright © 2011 Elsevier Ltd. All rights reserved.

Psychometric testing on the NLN Student Satisfaction and Self-Confidence in Learning, Simulation Design Scale, and Educational Practices Questionnaire using a sample of pre-licensure novice nurses.

PubMed

Franklin, Ashley E; Burns, Paulette; Lee, Christopher S

2014-10-01

In 2006, the National League for Nursing published three measures related to novice nurses' beliefs about self-confidence, scenario design, and educational practices associated with simulation. Despite the extensive use of these measures, little is known about their reliability and validity. The psychometric properties of the Student Satisfaction and Self-Confidence in Learning Scale, Simulation Design Scale, and Educational Practices Questionnaire were studied among a sample of 2200 surveys completed by novice nurses from a liberal arts university in the southern United States. Psychometric tests included item analysis, confirmatory and exploratory factor analyses in randomly-split subsamples, concordant and discordant validity, and internal consistency. All three measures have sufficient reliability and validity to be used in education research. There is room for improvement in content validity with the Student Satisfaction and Self-Confidence in Learning and Simulation Design Scale. This work provides robust evidence to ensure that judgments made about self-confidence after simulation, simulation design and educational practices are valid and reliable. Copyright © 2014 Elsevier Ltd. All rights reserved.

Modifying a dynamic global vegetation model for simulating large spatial scale land surface water balance

NASA Astrophysics Data System (ADS)

Tang, G.; Bartlein, P. J.

2012-01-01

Water balance models of simple structure are easier to grasp and more clearly connect cause and effect than models of complex structure. Such models are essential for studying large spatial scale land surface water balance in the context of climate and land cover change, both natural and anthropogenic. This study aims to (i) develop a large spatial scale water balance model by modifying a dynamic global vegetation model (DGVM), and (ii) test the model's performance in simulating actual evapotranspiration (ET), soil moisture and surface runoff for the coterminous United States (US). Toward these ends, we first introduced development of the "LPJ-Hydrology" (LH) model by incorporating satellite-based land covers into the Lund-Potsdam-Jena (LPJ) DGVM instead of dynamically simulating them. We then ran LH using historical (1982-2006) climate data and satellite-based land covers at 2.5 arc-min grid cells. The simulated ET, soil moisture and surface runoff were compared to existing sets of observed or simulated data for the US. The results indicated that LH captures well the variation of monthly actual ET (R2 = 0.61, p < 0.01) in the Everglades of Florida over the years 1996-2001. The modeled monthly soil moisture for Illinois of the US agrees well (R2 = 0.79, p < 0.01) with the observed over the years 1984-2001. The modeled monthly stream flow for most 12 major rivers in the US is consistent R2 > 0.46, p < 0.01; Nash-Sutcliffe Coefficients >0.52) with observed values over the years 1982-2006, respectively. The modeled spatial patterns of annual ET and surface runoff are in accordance with previously published data. Compared to its predecessor, LH simulates better monthly stream flow in winter and early spring by incorporating effects of solar radiation on snowmelt. Overall, this study proves the feasibility of incorporating satellite-based land-covers into a DGVM for simulating large spatial scale land surface water balance. LH developed in this study should be a useful

Helicity, geostrophic balance and mixing in rotating stratified turbulence: a multi-scale problem

NASA Astrophysics Data System (ADS)

Pouquet, A.; Marino, R.; Mininni, P.; Rorai, C.; Rosenberg, D. L.

2012-12-01

Helicity, geostrophic balance and mixing in rotating stratified turbulence: a multi-scale problem A. Pouquet, R. Marino, P. D. Mininni, C. Rorai & D. Rosenberg, NCAR Interactions between winds and waves have important roles in planetary and oceanic boundary layers, affecting momentum, heat and CO2 transport. Within the Abyssal Southern Ocean at Mid latitude, this may result in a mixed layer which is too shallow in climate models thereby affecting the overall evolution because of poor handling of wave breaking as in Kelvin-Helmoltz instabilities: gravity waves couple nonlinearly on slow time scales and undergo steepening through resonant interactions, or due to the presence of shear. In the oceans, sub-mesoscale frontogenesis and significant departure from quasi-geostrophy can be seen as turbulence intensifies. The ensuing anomalous vertical dispersion may not be simply modeled by a random walk, due to intermittent structures, wave propagation and to their interactions. Conversely, the energy and seeds required for such intermittent events to occur, say in the stable planetary boundary layer, may come from the wave field that is perturbed, or from winds and the effect of topography. Under the assumption of stationarity, weak nonlinearities, dissipation and forcing, one obtains large-scale geostrophic balance linking pressure gradient, gravity and Coriolis force. The role of helicity (velocity-vorticity correlations) has not received as much attention, outside the realm of astrophysics when considering the growth of large-scale magnetic fields. However, it is measured routinely in the atmosphere in order to gauge the likelihood of supercell convective storms to strengthen, and it may be a factor to consider in the formation of hurricanes. In this context, we examine the transition from a wave-dominated regime to an isotropic small-scale turbulent one in rotating flows with helical forcing. Using a direct numerical simulation (DNS) on a 3072^3 grid with Rossby and

The Relationship Between Balance Measured With a Modified Bathroom Scale and Falls and Disability in Older Adults: A 6-Month Follow-Up Study

PubMed Central

2015-01-01

Background There are indications that older adults who suffer from poor balance have an increased risk for adverse health outcomes, such as falls and disability. Monitoring the development of balance over time enables early detection of balance decline, which can identify older adults who could benefit from interventions aimed at prevention of these adverse outcomes. An innovative and easy-to-use device that can be used by older adults for home-based monitoring of balance is a modified bathroom scale. Objective The objective of this paper is to study the relationship between balance scores obtained with a modified bathroom scale and falls and disability in a sample of older adults. Methods For this 6-month follow-up study, participants were recruited via physiotherapists working in a nursing home, geriatricians, exercise classes, and at an event about health for older adults. Inclusion criteria were being aged 65 years or older, being able to stand on a bathroom scale independently, and able to provide informed consent. A total of 41 nursing home patients and 139 community-dwelling older adults stepped onto the modified bathroom scale three consecutive times at baseline to measure their balance. Their mean balance scores on a scale from 0 to 16 were calculated—higher scores indicated better balance. Questionnaires were used to study falls and disability at baseline and after 6 months of follow-up. The cross-sectional relationship between balance and falls and disability at baseline was studied using t tests and Spearman rank correlations. Univariate and multivariate logistic regression analyses were conducted to study the relationship between balance measured at baseline and falls and disability development after 6 months of follow-up. Results A total of 128 participants with complete datasets—25.8% (33/128) male—and a mean age of 75.33 years (SD 6.26) were included in the analyses of this study. Balance scores of participants who reported at baseline that

Effectiveness of balance exercises in the acute post-operative phase following total hip and knee arthroplasty: A randomized clinical trial

PubMed Central

Overend, Tom J; Spaulding, Sandi J; Zecevic, Aleksandra; Kramer, John F

2015-01-01

Objectives: To determine the effectiveness of balance exercises in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty. Methods: Patients who had total hip arthroplasty (n = 30) or total knee arthroplasty (n = 33) were seen in their residence 1–2 times per week for 5 weeks. At the first post-operative home visit, patients were randomly assigned to either typical (TE, n = 33) or typical plus balance (TE + B, n = 30) exercise groups. The TE group completed seven typical surgery-specific joint range-of-motion and muscle strengthening exercises, while the TE + B group completed the typical exercises plus three balance exercises. Patients were assessed before and 5 weeks after administering the rehabilitation program using four outcome measures: (1) the Berg Balance Scale, (2) the Timed Up and Go test, (3) the Western Ontario McMaster Universities Osteoarthritis Index, and (4) the Activities-specific Balance Confidence Scale. Results: Post-intervention scores for all four outcome measures were significantly improved (p < 0.01) over baseline scores. Patients who participated in the TE + B group demonstrated significantly greater improvement on the Berg Balance Scale and the Timed Up and Go tests (p < 0.01). Conclusion: Balance exercises added to a typical rehabilitation program resulted in significantly greater improvements in balance and functional mobility compared to typical exercises alone. PMID:26770765

Multiple balance tests improve the assessment of postural stability in subjects with Parkinson's disease

PubMed Central

Jacobs, J V; Horak, F B; Tran, V K; Nutt, J G

2006-01-01

Objectives Clinicians often base the implementation of therapies on the presence of postural instability in subjects with Parkinson's disease (PD). These decisions are frequently based on the pull test from the Unified Parkinson's Disease Rating Scale (UPDRS). We sought to determine whether combining the pull test, the one‐leg stance test, the functional reach test, and UPDRS items 27–29 (arise from chair, posture, and gait) predicts balance confidence and falling better than any test alone. Methods The study included 67 subjects with PD. Subjects performed the one‐leg stance test, the functional reach test, and the UPDRS motor exam. Subjects also responded to the Activities‐specific Balance Confidence (ABC) scale and reported how many times they fell during the previous year. Regression models determined the combination of tests that optimally predicted mean ABC scores or categorised fall frequency. Results When all tests were included in a stepwise linear regression, only gait (UPDRS item 29), the pull test (UPDRS item 30), and the one‐leg stance test, in combination, represented significant predictor variables for mean ABC scores (r2 = 0.51). A multinomial logistic regression model including the one‐leg stance test and gait represented the model with the fewest significant predictor variables that correctly identified the most subjects as fallers or non‐fallers (85% of subjects were correctly identified). Conclusions Multiple balance tests (including the one‐leg stance test, and the gait and pull test items of the UPDRS) that assess different types of postural stress provide an optimal assessment of postural stability in subjects with PD. PMID:16484639

A balanced water layer concept for subglacial hydrology in large scale ice sheet models

NASA Astrophysics Data System (ADS)

Goeller, S.; Thoma, M.; Grosfeld, K.; Miller, H.

2012-12-01

There is currently no doubt about the existence of a wide-spread hydrological network under the Antarctic ice sheet, which lubricates the ice base and thus leads to increased ice velocities. Consequently, ice models should incorporate basal hydrology to obtain meaningful results for future ice dynamics and their contribution to global sea level rise. Here, we introduce the balanced water layer concept, covering two prominent subglacial hydrological features for ice sheet modeling on a continental scale: the evolution of subglacial lakes and balance water fluxes. We couple it to the thermomechanical ice-flow model RIMBAY and apply it to a synthetic model domain inspired by the Gamburtsev Mountains, Antarctica. In our experiments we demonstrate the dynamic generation of subglacial lakes and their impact on the velocity field of the overlaying ice sheet, resulting in a negative ice mass balance. Furthermore, we introduce an elementary parametrization of the water flux-basal sliding coupling and reveal the predominance of the ice loss through the resulting ice streams against the stabilizing influence of less hydrologically active areas. We point out, that established balance flux schemes quantify these effects only partially as their ability to store subglacial water is lacking.

The Aachen Mobility and Balance Index to measure physiological falls risk: a comparison with the Tinetti POMA Scale.

PubMed

Knobe, M; Giesen, M; Plate, S; Gradl-Dietsch, G; Buecking, B; Eschbach, D; van Laack, W; Pape, H-C

2016-10-01

The most commonly used mobility assessments for screening risk of falls among older adults are rating scales such as the Tinetti performance oriented mobility assessment (POMA). However, its correlation with falls is not always predictable and disadvantages of the scale include difficulty to assess many of the items on a 3-point scale and poor specificity. The purpose of this study was to describe the ability of the new Aachen Mobility and Balance Index (AMBI) to discriminate between subjects with a fall history and subjects without such events in comparison to the Tinetti POMA Scale. For this prospective cohort study, 24 participants in the study group and 10 in the control group were selected from a population of patients in our hospital who had met the stringent inclusion criteria. Both groups completed the Tinetti POMA Scale (gait and balance component) and the AMBI (tandem stance, tandem walk, ten-meter-walk-test, sit-to-stand with five repetitions, 360° turns, timed-up-and-go-test and measurement of the dominant hand grip strength). A history of falls and hospitalization in the past year were evaluated retrospectively. The relationships among the mobility tests were examined with Bland-Altmananalysis. Receiver-operated characteristics curves, sensitivity and specificity were calculated. The study showed a strong negative correlation between the AMBI (17 points max., highest fall risk) and Tinetti POMA Scale (28 points max., lowest fall risk; r = -0.78, p < 0.001) with an excellent discrimination between community-dwelling older people and a younger control group. However, there were no differences in any of the mobility and balance measurements between participants with and without a fall history with equal characteristics in test comparison (AMBI vs. Tinetti POMA Scale: AUC 0.570 vs. 0.598; p = 0.762). The Tinetti POMA Scale (cut-off <20 points) showed a sensitivity of 0.45 and a specificity of 0.69, the AMBI a sensitivity of 0.64 and a specificity of

Contrasting Academic Behavioural Confidence in Mexican and European Psychology Students

ERIC Educational Resources Information Center

Ochoa, Alma Rosa Aguila; Sander, Paul

2012-01-01

Introduction: Research with the Academic Behavioural Confidence scale using European students has shown that students have high levels of confidence in their academic abilities. It is generally accepted that people in more collectivist cultures have more realistic confidence levels in contrast to the overconfidence seen in individualistic European…

Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines.

PubMed

Gilkey, Melissa B; McRee, Annie-Laurie; Magnus, Brooke E; Reiter, Paul L; Dempsey, Amanda F; Brewer, Noel T

2016-01-01

To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents. We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children's vaccination status for vaccines including measles, mumps, and rubella (MMR), varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents' mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. A substantial minority of parents reported a history of vaccine refusal (15%) or delay (27%). Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54-0.63) as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76-0.86). Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40-1.68), varicella (OR = 1.54, 95% CI, 1.42-1.66), and flu vaccines (OR = 1.32, 95% CI, 1.23-1.42). Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children.

Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: a randomized controlled trial

PubMed Central

Gandolfi, Marialuisa; Geroin, Christian; Picelli, Alessandro; Munari, Daniele; Waldner, Andreas; Tamburin, Stefano; Marchioretto, Fabio; Smania, Nicola

2014-01-01

Background: Extensive research on both healthy subjects and patients with central nervous damage has elucidated a crucial role of postural adjustment reactions and central sensory integration processes in generating and “shaping” locomotor function, respectively. Whether robotic-assisted gait devices might improve these functions in Multiple sclerosis (MS) patients is not fully investigated in literature. Purpose: The aim of this study was to compare the effectiveness of end-effector robot-assisted gait training (RAGT) and sensory integration balance training (SIBT) in improving walking and balance performance in patients with MS. Methods: Twenty-two patients with MS (EDSS: 1.5–6.5) were randomly assigned to two groups. The RAGT group (n = 12) underwent end-effector system training. The SIBT group (n = 10) underwent specific balance exercises. Each patient received twelve 50-min treatment sessions (2 days/week). A blinded rater evaluated patients before and after treatment as well as 1 month post treatment. Primary outcomes were walking speed and Berg Balance Scale. Secondary outcomes were the Activities-specific Balance Confidence Scale, Sensory Organization Balance Test, Stabilometric Assessment, Fatigue Severity Scale, cadence, step length, single and double support time, Multiple Sclerosis Quality of Life-54. Results: Between groups comparisons showed no significant differences on primary and secondary outcome measures over time. Within group comparisons showed significant improvements in both groups on the Berg Balance Scale (P = 0.001). Changes approaching significance were found on gait speed (P = 0.07) only in the RAGT group. Significant changes in balance task-related domains during standing and walking conditions were found in the SIBT group. Conclusion: Balance disorders in patients with MS may be ameliorated by RAGT and by SIBT. PMID:24904361

Postural control and balance self-efficacy in women with fibromyalgia: are there differences?

PubMed

Muto, L H A; Sauer, J F; Yuan, S L K; Sousa, A; Mango, P C; Marques, A P

2015-04-01

Fibromyalgia (FM) is a rheumatic disease characterized by chronic widespread pain and symptoms such as fatigue, sleep disturbances, cognitive difficulties, and depression. Postural instability is a debilitating disorder increasingly recognized as part of FM. To assess and compare postural control and balance self-efficacy in women with and without FM and verify the association of these variables with pain, symptom severity, and strength. Case-control study Physiotherapeutic Clinical Research and Electromyography Laboratory Department of Physical Therapy, Speech Therapy, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil. Case-control study of 117 women ranging from age 35 to 60 years. Of these, 67 had FM. Posture control was assessed with the modified clinical test of sensory interaction on balance with patients in forceplates, balance self-efficacy with the Activities-specific Balance Confidence Scale, pain severity with the Visual Analog Scale, tender point pain threshold with digital algometry, symptom severity with the fibromyalgia impact questionnaire, and lower limb strength with a dynamometer. Individuals with FM had impaired postural control showing increased speed of oscillation of the center of gravity (P=0.004) and decreased balance self-efficacy (P<0.001). They had moderate to excellent correlations of balance self-efficacy with pain (r=0.7, P<0.01), muscle strength (r=0.52, P<0.01), and symptom severity (r=0.78, P<0.10) compared with the control group. Correlation of postural control with the same variables was weak. Patients with FM have impaired postural control and low balance self-efficacy that are associated with pain, muscle strength, and symptom severity. Postural control and balance self-efficacy needs to be assessed in patients with FM and the treatment goals should be the improvement of postural control and balance self-efficacy.

The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson's Patients: A Report of Four Cases.

PubMed

Balci, Nilay Çömük; Tonga, Eda; Gülşen, Mustafa

2013-09-01

This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson's disease. Four patients with Parkinson's disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson's Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson's patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson's disease patients.

Investigating the psychological resilience, self-confidence and problem-solving skills of midwife candidates.

PubMed

Ertekin Pinar, Sukran; Yildirim, Gulay; Sayin, Neslihan

2018-05-01

The high level of psychological resilience, self-confidence and problem solving skills of midwife candidates play an important role in increasing the quality of health care and in fulfilling their responsibilities towards patients. This study was conducted to investigate the psychological resilience, self-confidence and problem-solving skills of midwife candidates. It is a convenience descriptive quantitative study. Students who study at Health Sciences Faculty in Turkey's Central Anatolia Region. Midwife candidates (N = 270). In collection of data, the Personal Information Form, Psychological Resilience Scale for Adults (PRSA), Self-Confidence Scale (SCS), and Problem Solving Inventory (PSI) were used. There was a negatively moderate-level significant relationship between the Problem Solving Inventory scores and the Psychological Resilience Scale for Adults scores (r = -0.619; p = 0.000), and between Self-Confidence Scale scores (r = -0.524; p = 0.000). There was a positively moderate-level significant relationship between the Psychological Resilience Scale for Adults scores and the Self-Confidence Scale scores (r = 0.583; p = 0.000). There was a statistically significant difference (p < 0.05) between the Problem Solving Inventory and the Psychological Resilience Scale for Adults scores according to getting support in a difficult situation. As psychological resilience and self-confidence levels increase, problem-solving skills increase; additionally, as self-confidence increases, psychological resilience increases too. Psychological resilience, self-confidence, and problem-solving skills of midwife candidates in their first-year of studies are higher than those who are in their fourth year. Self-confidence and psychological resilience of midwife candidates aged between 17 and 21, self-confidence and problem solving skills of residents of city centers, psychological resilience of those who perceive their monthly income as sufficient

Modified bathroom scale and balance assessment: a comparison with clinical tests.

PubMed

Duchêne, Jacques; Hewson, David; Rumeau, Pierre

2016-01-01

Frailty and detection of fall risk are major issues in preventive gerontology. A simple tool frequently used in daily life, a bathroom scale (balance quality tester: BQT), was modified to obtain information on the balance of 84 outpatients consulting at a geriatric clinic. The results computed from the BQT were compared to the values of three geriatric tests that are widely used either to detect a fall risk or frailty (timed get up and go: TUG; 10 m walking speed: WS; walking time: WT; one-leg stand: OS). The BQT calculates four parameters that are then scored and weighted, thus creating an overall indicator of balance quality. Raw data, partial scores and the global score were compared with the results of the three geriatric tests. The WT values had the highest correlation with BQT raw data (r = 0.55), while TUG (r = 0.53) and WS (r = 0.56) had the highest correlation with BQT partial scores. ROC curves for OS cut-off values (4 and 5 s) were produced, with the best results obtained for a 5 s cut-off, both with the partial scores combined using Fisher's combination (specificity 85 %: <0.11, sensitivity 85 %: >0.48), and with the empirical score (specificity 85 %: <7, sensitivity 85 %: >8). A BQT empirical score of less than seven can detect fall risk in a community dwelling population.

Concordance and discordance between measured and perceived balance and the effect on gait speed and falls following stroke

PubMed Central

Liphart, Jodi; Gallichio, Joann; Tilson, Julie K; Pei, Qinglin; Wu, Samuel S; Duncan, Pamela W

2016-01-01

Objective To ascertain the existence of discordance between perceived and measured balance in persons with stroke and to examine the impact on walking speed and falls. Design A secondary analysis of a phase three, multicentered randomized controlled trial examining walking recovery following stroke. Subjects A total of 352 participants from the Locomotor Experience Applied Post-Stroke (LEAPS) trial. Methods Participants were categorized into four groups: two concordant and two discordant groups in relation to measured and perceived balance. Number and percentage of individuals with concordance and discordance were evaluated at two and 12 months. Walking speed and fall incidence between groups were examined. Main measures Perceived balance was measured by the Activity-specific Balance Confidence scale, measured balance was determined by the Berg Balance Scale and gait speed was measured by the 10-meter walk test. Results Discordance was present for 35.8% of participants at two months post-stroke with no statistically significant change in proportion at 12 months. Discordant participants with high perceived balance and low measured balance walked 0.09 m/s faster at two months than participants with concordant low perceived and measured balance (p < 0.05). Discordant participants with low perceived balance and high measured balance walked 0.15 m/s slower than those that were concordant with high perceived and measured balance (p ⩽ 0.0001) at 12 months. Concordant participants with high perceived and measured balance walked fastest and had fewer falls. Conclusions Discordance existed between perceived and measured balance in one-third of individuals at two and 12 months post-stroke. Perceived balance impacted gait speed but not fall incidence. PMID:25810426

Empirical likelihood-based confidence intervals for the sensitivity of a continuous-scale diagnostic test at a fixed level of specificity.

PubMed

Gengsheng Qin; Davis, Angela E; Jing, Bing-Yi

2011-06-01

For a continuous-scale diagnostic test, it is often of interest to find the range of the sensitivity of the test at the cut-off that yields a desired specificity. In this article, we first define a profile empirical likelihood ratio for the sensitivity of a continuous-scale diagnostic test and show that its limiting distribution is a scaled chi-square distribution. We then propose two new empirical likelihood-based confidence intervals for the sensitivity of the test at a fixed level of specificity by using the scaled chi-square distribution. Simulation studies are conducted to compare the finite sample performance of the newly proposed intervals with the existing intervals for the sensitivity in terms of coverage probability. A real example is used to illustrate the application of the recommended methods.

Landscape-scale water balance monitoring with an iGrav superconducting gravimeter in a field enclosure

NASA Astrophysics Data System (ADS)

Güntner, Andreas; Reich, Marvin; Mikolaj, Michal; Creutzfeldt, Benjamin; Schroeder, Stephan; Wziontek, Hartmut

2017-06-01

In spite of the fundamental role of the landscape water balance for the Earth's water and energy cycles, monitoring the water balance and its components beyond the point scale is notoriously difficult due to the multitude of flow and storage processes and their spatial heterogeneity. Here, we present the first field deployment of an iGrav superconducting gravimeter (SG) in a minimized enclosure for long-term integrative monitoring of water storage changes. Results of the field SG on a grassland site under wet-temperate climate conditions were compared to data provided by a nearby SG located in the controlled environment of an observatory building. The field system proves to provide gravity time series that are similarly precise as those of the observatory SG. At the same time, the field SG is more sensitive to hydrological variations than the observatory SG. We demonstrate that the gravity variations observed by the field setup are almost independent of the depth below the terrain surface where water storage changes occur (contrary to SGs in buildings), and thus the field SG system directly observes the total water storage change, i.e., the water balance, in its surroundings in an integrative way. We provide a framework to single out the water balance components actual evapotranspiration and lateral subsurface discharge from the gravity time series on annual to daily timescales. With about 99 and 85 % of the gravity signal due to local water storage changes originating within a radius of 4000 and 200 m around the instrument, respectively, this setup paves the road towards gravimetry as a continuous hydrological field-monitoring technique at the landscape scale.

The Effect of Balance Training by Tetraks Interactive Balance System on Balance and Fall Risk in Parkinson’s Patients: A Report of Four Cases

PubMed Central

BALCI, Nilay Çömük; TONGA, Eda; GÜLŞEN, Mustafa

2013-01-01

This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson’s disease. Four patients with Parkinson’s disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson’s Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson’s patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson’s disease patients. PMID:28360557

Vaccination Confidence and Parental Refusal/Delay of Early Childhood Vaccines

PubMed Central

Gilkey, Melissa B.; McRee, Annie-Laurie; Magnus, Brooke E.; Reiter, Paul L.; Dempsey, Amanda F.; Brewer, Noel T.

2016-01-01

Objective To support efforts to address parental hesitancy towards early childhood vaccination, we sought to validate the Vaccination Confidence Scale using data from a large, population-based sample of U.S. parents. Methods We used weighted data from 9,354 parents who completed the 2011 National Immunization Survey. Parents reported on the immunization history of a 19- to 35-month-old child in their households. Healthcare providers then verified children’s vaccination status for vaccines including measles, mumps, and rubella (MMR), varicella, and seasonal flu. We used separate multivariable logistic regression models to assess associations between parents’ mean scores on the 8-item Vaccination Confidence Scale and vaccine refusal, vaccine delay, and vaccination status. Results A substantial minority of parents reported a history of vaccine refusal (15%) or delay (27%). Vaccination confidence was negatively associated with refusal of any vaccine (odds ratio [OR] = 0.58, 95% confidence interval [CI], 0.54–0.63) as well as refusal of MMR, varicella, and flu vaccines specifically. Negative associations between vaccination confidence and measures of vaccine delay were more moderate, including delay of any vaccine (OR = 0.81, 95% CI, 0.76–0.86). Vaccination confidence was positively associated with having received vaccines, including MMR (OR = 1.53, 95% CI, 1.40–1.68), varicella (OR = 1.54, 95% CI, 1.42–1.66), and flu vaccines (OR = 1.32, 95% CI, 1.23–1.42). Conclusions Vaccination confidence was consistently associated with early childhood vaccination behavior across multiple vaccine types. Our findings support expanding the application of the Vaccination Confidence Scale to measure vaccination beliefs among parents of young children. PMID:27391098

Factor Analysis of the Community Balance and Mobility Scale in Individuals with Knee Osteoarthritis.

PubMed

Takacs, Judit; Krowchuk, Natasha M; Goldsmith, Charles H; Hunt, Michael A

2017-10-01

The clinical assessment of balance is an important first step in characterizing the risk of falls. The Community Balance and Mobility Scale (CB&M) is a test of balance and mobility that was designed to assess performance on advanced tasks necessary for independence in the community. However, other factors that can affect balancing ability may also be present during performance of the real-world tasks on the CB&M. It is important for clinicians to understand fully what other modifiable factors the CB&M may encompass. The purpose of this study was to evaluate the underlying constructs in the CB&M in individuals with knee osteoarthritis (OA). This was an observational study, with a single testing session. Participants with knee OA aged 50 years and older completed the CB&M, a clinical test of balance and mobility. Confirmatory factor analysis was then used to examine whether the tasks on the CB&M measure distinct factors. Three a priori theory-driven models with three (strength, balance, mobility), four (range of motion added) and six (pain and fear added) constructs were evaluated using multiple fit indices. A total of 131 participants (mean [SD] age 66.3 [8.5] years, BMI 27.3 [5.2] kg m -2 ) participated. A three-factor model in which all tasks loaded on these three factors explained 65% of the variance and yielded the most optimal model, as determined using scree plots, chi-squared values and explained variance. The first factor accounted for 49% of the variance and was interpreted as lower limb muscle strength. The second and third factors were interpreted as mobility and balance, respectively. The CB&M demonstrated the measurement of three distinct factors, interpreted as lower limb strength, balance and mobility, supporting the use of the CB&M with people with knee OA for evaluation of these important factors in falls risk and functional mobility. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Characteristics of Nitrogen Balances of Large-scale Stock Farms and Reduction of Environmental Nitrogen Loads

NASA Astrophysics Data System (ADS)

Hattori, Toshihiro; Takamatsu, Rieko

We calculated nitrogen balances on farm gate and soil surface on large-scale stock farms and discussed methods for reducing environmental nitrogen loads. Four different types of public stock farms (organic beef, calf supply and daily cows) were surveyed in Aomori Prefecture. (1) Farm gate and soil surface nitrogen inflows were both larger than the respective outflows on all types of farms. Farm gate nitrogen balance for beef farms were worse than that for dairy farms. (2) Soil surface nitrogen outflows and soil nitrogen retention were in proportion to soil surface nitrogen inflows. (3) Reductions in soil surface nitrogen retention were influenced by soil surface nitrogen inflows. (4) In order to reduce farm gate nitrogen retention, inflows of formula feed and chemical fertilizer need to be reduced. (5) In order to reduce soil surface nitrogen retention, inflows of fertilizer need to be reduced and nitrogen balance needs to be controlled.

Internal and External Validity of Scores on the Balanced Inventory of Desirable Responding and the Paulhus Deception Scales

ERIC Educational Resources Information Center

Lanyon, Richard I.; Carle, Adam C.

2007-01-01

The internal and external validity of scores on the two-scale Balanced Inventory of Desirable Responding (BIDR) and its recent revision, the Paulhus Deception Scales (PDS), developed to measure two facets of social desirability, were studied with three groups of forensic clients and two groups of college undergraduates (total N = 519). The two…

Patient confidence and quality of life in idiopathic pulmonary fibrosis and sarcoidosis.

PubMed

Kotecha, Jalpa; Atkins, Christopher; Wilson, Andrew

2016-12-23

Idiopathic pulmonary fibrosis (IPF) and sarcoidosis impact significantly on health-related quality of life (HRQOL). There are few studies on the impact of patient confidence on HRQOL in these conditions. 1. To investigate whether patient confidence is associated with HRQOL, anxiety, depression, dyspnoea or fatigue. 2. To assess if patient confidence is associated with inpatient admissions, access to community healthcare and, for IPF patients, mortality and disease severity. Study participants self-completed seven questionnaires: Hospital Anxiety and Depression Scale, EuroQol 5D (EQ5D), King's Brief Interstitial Lung Disease questionnaire, St George's Respiratory Questionnaire, MRC dyspnoea scale, Fatigue Assessment Scale and a non-validated questionnaire assessing patient confidence, symptom duration and access to community healthcare. Lung function and follow-up data were collected from hospital electronic databases. Spearman's rank correlation coefficients were calculated to assess for correlation between patient confidence, questionnaire variables and inpatient admissions. Chi-square tests were performed to assess for association between patient confidence, mortality and disease severity. 75 IPF patients and 69 sarcoidosis patients were recruited to the study. Patient confidence in IPF was significantly negatively correlated with depression and fatigue, and significantly positively correlated with EQ5D scores, but not healthcare outcomes. No associations were found between confidence and any of the variables assessed in sarcoidosis. Lower levels of confidence in IPF patients are associated with higher levels of depression and fatigue and worse HRQOL. Efforts should be made to improve patient confidence to assess the impact on HRQOL.

Load Balancing Scientific Applications

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

Pearce, Olga Tkachyshyn

2014-12-01

The largest supercomputers have millions of independent processors, and concurrency levels are rapidly increasing. For ideal efficiency, developers of the simulations that run on these machines must ensure that computational work is evenly balanced among processors. Assigning work evenly is challenging because many large modern parallel codes simulate behavior of physical systems that evolve over time, and their workloads change over time. Furthermore, the cost of imbalanced load increases with scale because most large-scale scientific simulations today use a Single Program Multiple Data (SPMD) parallel programming model, and an increasing number of processors will wait for the slowest one atmore » the synchronization points. To address load imbalance, many large-scale parallel applications use dynamic load balance algorithms to redistribute work evenly. The research objective of this dissertation is to develop methods to decide when and how to load balance the application, and to balance it effectively and affordably. We measure and evaluate the computational load of the application, and develop strategies to decide when and how to correct the imbalance. Depending on the simulation, a fast, local load balance algorithm may be suitable, or a more sophisticated and expensive algorithm may be required. We developed a model for comparison of load balance algorithms for a specific state of the simulation that enables the selection of a balancing algorithm that will minimize overall runtime.« less

Water balance model for Kings Creek

NASA Technical Reports Server (NTRS)

Wood, Eric F.

1990-01-01

Particular attention is given to the spatial variability that affects the representation of water balance at the catchment scale in the context of macroscale water-balance modeling. Remotely sensed data are employed for parameterization, and the resulting model is developed so that subgrid spatial variability is preserved and therefore influences the grid-scale fluxes of the model. The model permits the quantitative evaluation of the surface-atmospheric interactions related to the large-scale hydrologic water balance.

;Agreement; in the IPCC Confidence measure

NASA Astrophysics Data System (ADS)

Rehg, William; Staley, Kent

2017-02-01

The Intergovernmental Panel on Climate Change (IPCC) has, in its most recent Assessment Report (AR5), articulated guidelines for evaluating and communicating uncertainty that include a qualitative scale of confidence. We examine one factor included in that scale: the "degree of agreement." Some discussions of the degree of agreement in AR5 suggest that the IPCC is employing a consensus-oriented social epistemology. We consider the application of the degree of agreement factor in practice in AR5. Our findings, though based on a limited examination, suggest that agreement attributions do not so much track the overall consensus among investigators as the degree to which relevant research findings substantively converge in offering support for IPCC claims. We articulate a principle guiding confidence attributions in AR5 that centers not on consensus but on the notion of support. In concluding, we tentatively suggest a pluralist approach to the notion of support.

Modelling the water balance of a precise weighable lysimeter for short time scales

NASA Astrophysics Data System (ADS)

Fank, Johann; Klammler, Gernot; Rock, Gerhard

2015-04-01

Precise knowledge of the water fluxes between the atmosphere and the soil-plant system and the percolation to the groundwater system is of great importance for understanding and modeling water, solute and energy transfer in the atmosphere-plant-soil-groundwater system. Weighable lysimeters yield the most precise and realistic measures for the change of stored water volume (ΔS), Precipitation (P) which can be rain, irrigation, snow and dewfall and evapotranspiration (ET) as the sum of soil evaporation, evaporation of intercepted water and transpiration. They avoid systematic errors of standard gauges and class-A pans. Lysimeters with controlled suction at the lower boundary allow estimation of capillary rise (C) and leachate (L) on short time scales. Precise weighable large scale (surface >= 1 m2) monolithic lysimeters avoiding oasis effects allow to solve the water balance equation (P - ET - L + C ± ΔS = 0) for a 3D-section of a natural atmosphere-plant-soil-system for a certain time period. Precision and accuracy of the lysimeter measurements depend not only on the precision of the weighing device but also on external conditions, which cannot be controlled or turned off. To separate the noise in measured data sets from signals the adaptive window and adaptive threshold (AWAT) filter (Peters et al., 2014) is used. The data set for the years 2010 and 2011 from the HYDRO-lysimeter (surface = 1 m2, depth = 1 m) in Wagna, Austria (Klammler and Fank, 2014) with a resolution of 0,01 mm for the lysimeter scale and of 0,001 mm for the leachate tank scale is used to evaluate the water balance. The mass of the lysimeter and the mass of the leachate tank is measured every two seconds. The measurements are stored as one minute arithmetic means. Based on calculations in a calibration period from January to May 2010 with different widths of moving window the wmax - Parameter for the AWAT filter was set to 41 minutes. A time series for the system mass ('upper boundary') of the

Functional Performance and Balance in the Oldest-Old.

PubMed

Kafri, Michal; Hutzler, Yeshayahu; Korsensky, Olga; Laufer, Yocheved

2017-06-01

The group of individuals 85 years and over (termed oldest-old) is the fastest-growing population in the Western world. Although daily functional abilities and balance capabilities are known to decrease as an individual grows older, little is known about the balance and functional characteristics of the oldest-old population. The aims of this study were to characterize balance control, functional abilities, and balance self-efficacy in the oldest-old, to test the correlations between these constructs, and to explore differences between fallers and nonfallers in this age group. Forty-five individuals living in an assisted living facility who ambulated independently participated in the study. The mean age was 90.3 (3.7) years. Function was tested using the Late-Life Function and Disability Instrument (LLFDI). Balance was tested with the mini-Balance Evaluation System Test (mini-BESTest) and the Timed Up and Go (TUG) test. Balance self-efficacy was tested with the Activities-Specific Balance Confidence (ABC) scale. The mean total function LLFDI score was 63.2 (11.4). The mean mini-BESTest score was 69.8% (18.6%) and the mean TUG time was 12.6 (6.9) seconds. The mean ABC score was 80.2% (14.2%). Good correlation (r > 0.7) was observed between the ABC and the function component of the LLFDI, as well as with the lower extremity domains. Correlations between the mini-BESTest scores and the LLFDI were fair to moderate (r's range: 0.38-0.62). Age and ABC scores were significant independent explanators of LLFDI score (P = .0141 and P = .0009, respectively). Fallers and nonfallers differed significantly across all outcome measures scores, except for TUG and for the "Reactive Postural Control" and "Sensory Orientation" domains of the mini-BESTest. The results of this study provide normative data regarding the balance and functional abilities of the oldest-old, and indicate a strong association between self-efficacy and function. These results emphasize the importance of

Confidence as a Common Currency between Vision and Audition

PubMed Central

de Gardelle, Vincent; Le Corre, François; Mamassian, Pascal

2016-01-01

The idea of a common currency underlying our choice behaviour has played an important role in sciences of behaviour, from neurobiology to psychology and economics. However, while it has been mainly investigated in terms of values, with a common scale on which goods would be evaluated and compared, the question of a common scale for subjective probabilities and confidence in particular has received only little empirical investigation so far. The present study extends previous work addressing this question, by showing that confidence can be compared across visual and auditory decisions, with the same precision as for the comparison of two trials within the same task. We discuss the possibility that confidence could serve as a common currency when describing our choices to ourselves and to others. PMID:26808061

Parameterizing a Large-scale Water Balance Model in Regions with Sparse Data: The Tigris-Euphrates River Basins as an Example

NASA Astrophysics Data System (ADS)

Flint, A. L.; Flint, L. E.

2010-12-01

The characterization of hydrologic response to current and future climates is of increasing importance to many countries around the world that rely heavily on changing and uncertain water supplies. Large-scale models that can calculate a spatially distributed water balance and elucidate groundwater recharge and surface water flows for large river basins provide a basis of estimates of changes due to future climate projections. Unfortunately many regions in the world have very sparse data for parameterization or calibration of hydrologic models. For this study, the Tigris and Euphrates River basins were used for the development of a regional water balance model at 180-m spatial scale, using the Basin Characterization Model, to estimate historical changes in groundwater recharge and surface water flows in the countries of Turkey, Syria, Iraq, Iran, and Saudi Arabia. Necessary input parameters include precipitation, air temperature, potential evapotranspiration (PET), soil properties and thickness, and estimates of bulk permeability from geologic units. Data necessary for calibration includes snow cover, reservoir volumes (from satellite data and historic, pre-reservoir elevation data) and streamflow measurements. Global datasets for precipitation, air temperature, and PET were available at very large spatial scales (50 km) through the world scale databases, finer scale WorldClim climate data, and required downscaling to fine scales for model input. Soils data were available through world scale soil maps but required parameterization on the basis of textural data to estimate soil hydrologic properties. Soil depth was interpreted from geomorphologic interpretation and maps of quaternary deposits, and geologic materials were categorized from generalized geologic maps of each country. Estimates of bedrock permeability were made on the basis of literature and data on driller’s logs and adjusted during calibration of the model to streamflow measurements where available

Participating in a virtual reality balance exercise program can reduce risk and fear of falls.

PubMed

Singh, Devinder K A; Rajaratnam, Bala S; Palaniswamy, Vijayakumar; Pearson, Hannah; Raman, Vimal P; Bong, Pei Sien

2012-11-01

The objective of this study was to quantify the effectiveness of virtual reality balance games (VRBG) to decrease risk and fear of falls among women. Thirty six community dwelling women aged 56 and above were randomly divided into experimental (exercises using VRBG focus on improving balance) and control (conventional balance exercises) groups. Both groups attended a twice 6 weekly exercise session for an hour. Risk and fear of falls were measured with Physiological Profile Approach (PPA) and Activity Specific Balance Scale (ABC-6). Pre and post intervention differences between the groups were examined using two way repeated measures ANOVA. Both VRBG and conventional balance exercise groups had significant decrease in PPA (p<0.001) and ABC-6 (p<0.01) after the interventions. However, no significant effects were demonstrated between the groups in PPA (p=0.18) and ABC-6 (p=0.25) post intervention. Time and group interaction effect were not significant for PPA (p=0.18) and ABC-6 (p=0.45). Practising VRBG can increase balance confidence and decrease risk of falls among community dwelling women. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Smarter Balanced Preliminary Performance Levels: Estimated MAP Scores Corresponding to the Preliminary Performance Levels of the Smarter Balanced Assessment Consortium (Smarter Balanced)

ERIC Educational Resources Information Center

Northwest Evaluation Association, 2015

2015-01-01

Recently, the Smarter Balanced Assessment Consortium (Smarter Balanced) released a document that established initial performance levels and the associated threshold scale scores for the Smarter Balanced assessment. The report included estimated percentages of students expected to perform at each of the four performance levels, reported by grade…

Botswana water and surface energy balance research program. Part 2: Large scale moisture and passive microwaves

NASA Technical Reports Server (NTRS)

Vandegriend, A. A.; Owe, M.; Chang, A. T. C.

1992-01-01

The Botswana water and surface energy balance research program was developed to study and evaluate the integrated use of multispectral satellite remote sensing for monitoring the hydrological status of the Earth's surface. The research program consisted of two major, mutually related components: a surface energy balance modeling component, built around an extensive field campaign; and a passive microwave research component which consisted of a retrospective study of large scale moisture conditions and Nimbus scanning multichannel microwave radiometer microwave signatures. The integrated approach of both components are explained in general and activities performed within the passive microwave research component are summarized. The microwave theory is discussed taking into account: soil dielectric constant, emissivity, soil roughness effects, vegetation effects, optical depth, single scattering albedo, and wavelength effects. The study site is described. The soil moisture data and its processing are considered. The relation between observed large scale soil moisture and normalized brightness temperatures is discussed. Vegetation characteristics and inverse modeling of soil emissivity is considered.

Single-Vector Calibration of Wind-Tunnel Force Balances

NASA Technical Reports Server (NTRS)

Parker, P. A.; DeLoach, R.

2003-01-01

An improved method of calibrating a wind-tunnel force balance involves the use of a unique load application system integrated with formal experimental design methodology. The Single-Vector Force Balance Calibration System (SVS) overcomes the productivity and accuracy limitations of prior calibration methods. A force balance is a complex structural spring element instrumented with strain gauges for measuring three orthogonal components of aerodynamic force (normal, axial, and side force) and three orthogonal components of aerodynamic torque (rolling, pitching, and yawing moments). Force balances remain as the state-of-the-art instrument that provide these measurements on a scale model of an aircraft during wind tunnel testing. Ideally, each electrical channel of the balance would respond only to its respective component of load, and it would have no response to other components of load. This is not entirely possible even though balance designs are optimized to minimize these undesirable interaction effects. Ultimately, a calibration experiment is performed to obtain the necessary data to generate a mathematical model and determine the force measurement accuracy. In order to set the independent variables of applied load for the calibration 24 NASA Tech Briefs, October 2003 experiment, a high-precision mechanical system is required. Manual deadweight systems have been in use at Langley Research Center (LaRC) since the 1940s. These simple methodologies produce high confidence results, but the process is mechanically complex and labor-intensive, requiring three to four weeks to complete. Over the past decade, automated balance calibration systems have been developed. In general, these systems were designed to automate the tedious manual calibration process resulting in an even more complex system which deteriorates load application quality. The current calibration approach relies on a one-factor-at-a-time (OFAT) methodology, where each independent variable is

Water balance creates a threshold in soil pH at the global scale.

PubMed

Slessarev, E W; Lin, Y; Bingham, N L; Johnson, J E; Dai, Y; Schimel, J P; Chadwick, O A

2016-11-21

Soil pH regulates the capacity of soils to store and supply nutrients, and thus contributes substantially to controlling productivity in terrestrial ecosystems. However, soil pH is not an independent regulator of soil fertility-rather, it is ultimately controlled by environmental forcing. In particular, small changes in water balance cause a steep transition from alkaline to acid soils across natural climate gradients. Although the processes governing this threshold in soil pH are well understood, the threshold has not been quantified at the global scale, where the influence of climate may be confounded by the effects of topography and mineralogy. Here we evaluate the global relationship between water balance and soil pH by extracting a spatially random sample (n = 20,000) from an extensive compilation of 60,291 soil pH measurements. We show that there is an abrupt transition from alkaline to acid soil pH that occurs at the point where mean annual precipitation begins to exceed mean annual potential evapotranspiration. We evaluate deviations from this global pattern, showing that they may result from seasonality, climate history, erosion and mineralogy. These results demonstrate that climate creates a nonlinear pattern in soil solution chemistry at the global scale; they also reveal conditions under which soils maintain pH out of equilibrium with modern climate.

Water balance creates a threshold in soil pH at the global scale

NASA Astrophysics Data System (ADS)

Slessarev, E. W.; Lin, Y.; Bingham, N. L.; Johnson, J. E.; Dai, Y.; Schimel, J. P.; Chadwick, O. A.

2016-12-01

Soil pH regulates the capacity of soils to store and supply nutrients, and thus contributes substantially to controlling productivity in terrestrial ecosystems. However, soil pH is not an independent regulator of soil fertility—rather, it is ultimately controlled by environmental forcing. In particular, small changes in water balance cause a steep transition from alkaline to acid soils across natural climate gradients. Although the processes governing this threshold in soil pH are well understood, the threshold has not been quantified at the global scale, where the influence of climate may be confounded by the effects of topography and mineralogy. Here we evaluate the global relationship between water balance and soil pH by extracting a spatially random sample (n = 20,000) from an extensive compilation of 60,291 soil pH measurements. We show that there is an abrupt transition from alkaline to acid soil pH that occurs at the point where mean annual precipitation begins to exceed mean annual potential evapotranspiration. We evaluate deviations from this global pattern, showing that they may result from seasonality, climate history, erosion and mineralogy. These results demonstrate that climate creates a nonlinear pattern in soil solution chemistry at the global scale; they also reveal conditions under which soils maintain pH out of equilibrium with modern climate.

Uplink Downlink Rate Balancing and Throughput Scaling in FDD Massive MIMO Systems

NASA Astrophysics Data System (ADS)

Bergel, Itsik; Perets, Yona; Shamai, Shlomo

2016-05-01

In this work we extend the concept of uplink-downlink rate balancing to frequency division duplex (FDD) massive MIMO systems. We consider a base station with large number antennas serving many single antenna users. We first show that any unused capacity in the uplink can be traded off for higher throughput in the downlink in a system that uses either dirty paper (DP) coding or linear zero-forcing (ZF) precoding. We then also study the scaling of the system throughput with the number of antennas in cases of linear Beamforming (BF) Precoding, ZF Precoding, and DP coding. We show that the downlink throughput is proportional to the logarithm of the number of antennas. While, this logarithmic scaling is lower than the linear scaling of the rate in the uplink, it can still bring significant throughput gains. For example, we demonstrate through analysis and simulation that increasing the number of antennas from 4 to 128 will increase the throughput by more than a factor of 5. We also show that a logarithmic scaling of downlink throughput as a function of the number of receive antennas can be achieved even when the number of transmit antennas only increases logarithmically with the number of receive antennas.

Reliability of the Berg Balance Scale as a Clinical Measure of Balance in Community-Dwelling Older Adults with Mild to Moderate Alzheimer Disease: A Pilot Study.

PubMed

Muir-Hunter, Susan W; Graham, Laura; Montero Odasso, Manuel

2015-08-01

To measure test-retest and interrater reliability of the Berg Balance Scale (BBS) in community-dwelling adults with mild to moderate Alzheimer disease (AD). Method : A sample of 15 adults (mean age 80.20 [SD 5.03] years) with AD performed three balance tests: the BBS, timed up-and-go test (TUG), and Functional Reach Test (FRT). Both relative reliability, using the intra-class correlation coefficient (ICC), and absolute reliability, using standard error of measurement (SEM) and minimal detectable change (MDC95) values, were calculated; Bland-Altman plots were constructed to evaluate inter-tester agreement. The test-retest interval was 1 week. Results : For the BBS, relative reliability values were 0.95 (95% CI, 0.85-0.98) for test-retest reliability and 0.72 (95% CI, 0.31-0.91) for interrater reliability; SEM was 6.01 points and MDC95 was 16.66 points; and interrater agreement was 16.62 points. The BBS performed better in test-retest reliability than the TUG and FRT, tests with established reliability in AD. Between 33% and 50% of participants required cueing beyond standardized instructions because they were unable to remember test instructions. Conclusions : The BBS achieved relative reliability values that support its clinical utility, but MDC95 and agreement values indicate the scale has performance limitations in AD. Further research to optimize balance assessment for people with AD is required.

ProteinInferencer: Confident protein identification and multiple experiment comparison for large scale proteomics projects.

PubMed

Zhang, Yaoyang; Xu, Tao; Shan, Bing; Hart, Jonathan; Aslanian, Aaron; Han, Xuemei; Zong, Nobel; Li, Haomin; Choi, Howard; Wang, Dong; Acharya, Lipi; Du, Lisa; Vogt, Peter K; Ping, Peipei; Yates, John R

2015-11-03

Shotgun proteomics generates valuable information from large-scale and target protein characterizations, including protein expression, protein quantification, protein post-translational modifications (PTMs), protein localization, and protein-protein interactions. Typically, peptides derived from proteolytic digestion, rather than intact proteins, are analyzed by mass spectrometers because peptides are more readily separated, ionized and fragmented. The amino acid sequences of peptides can be interpreted by matching the observed tandem mass spectra to theoretical spectra derived from a protein sequence database. Identified peptides serve as surrogates for their proteins and are often used to establish what proteins were present in the original mixture and to quantify protein abundance. Two major issues exist for assigning peptides to their originating protein. The first issue is maintaining a desired false discovery rate (FDR) when comparing or combining multiple large datasets generated by shotgun analysis and the second issue is properly assigning peptides to proteins when homologous proteins are present in the database. Herein we demonstrate a new computational tool, ProteinInferencer, which can be used for protein inference with both small- or large-scale data sets to produce a well-controlled protein FDR. In addition, ProteinInferencer introduces confidence scoring for individual proteins, which makes protein identifications evaluable. This article is part of a Special Issue entitled: Computational Proteomics. Copyright © 2015. Published by Elsevier B.V.

Screening older adults at risk of falling with the Tinetti balance scale.

PubMed

Raîche, M; Hébert, R; Prince, F; Corriveau, H

2000-09-16

In a prospective study of 225 community dwelling people 75 years and older, we tested the validity of the Tinetti balance scale to predict individuals who will fall at least once during the following year. A score of 36 or less identified 7 of 10 fallers with 70% sensitivity and 52% specificity. With this cut-off score, 53% of the individuals were screened positive and presented a two-fold risk of falling. These characteristics support the use of this test to screen older people at risk of falling in order to include them in a preventive intervention.

Analysis of vestibular-balance symptoms according to symptom duration: dimensionality of the Vertigo Symptom Scale-short form.

PubMed

Kondo, Masaki; Kiyomizu, Kensuke; Goto, Fumiyuki; Kitahara, Tadashi; Imai, Takao; Hashimoto, Makoto; Shimogori, Hiroaki; Ikezono, Tetsuo; Nakayama, Meiho; Watanabe, Norio; Akechi, Tatsuo

2015-01-22

Dizziness or vertigo is associated with both vestibular-balance and psychological factors. A common assessment tool is the Vertigo Symptom Scale (VSS) -short form, which has two subscales: vestibular-balance and autonomic-anxiety. Despite frequent use, the factor structure of the VSS-short form has yet to be confirmed. Here, we clarified the factor structure of the VSS-short form, and assessed the validity and reliability of the Japanese version of this tool. We conducted a cross-sectional, multicenter, psychometric evaluation of patients with non-central dizziness or vertigo persisting for longer than 1 month. Participants completed the VSS-short form, the Dizziness Handicap Inventory, and the Hospital Anxiety and Depression Scale. They also completed the VSS-short form a second time 1-3 days later. The questionnaire was translated into Japanese and cross-culturally adapted. We conducted a confirmatory factor analysis followed by an exploratory factor analysis. Convergent and discriminant validity, internal consistency, and test-retest reliability were evaluated. The total sample and retest sample consisted of 159 and 79 participants, respectively. Model-fitting for a two-subscale structure in a confirmatory factor analysis was poor. An exploratory factor analysis produced a three-factor structure: long-duration vestibular-balance symptoms, short-duration vestibular-balance symptoms, and autonomic-anxiety symptoms. Regarding convergent and discriminant validity, all hypotheses were clearly supported. We obtained high Cronbach's α coefficients for the total score and subscales, ranging from 0.758 to 0.866. Total score and subscale interclass correlation coefficients for test-retest reliability were acceptable, ranging from 0.867 to 0.897. The VSS-short form has a three-factor structure that was cross-culturally well-matched with previous data from the VSS-long version. Thus, it was suggested that vestibular-balance symptoms can be analyzed separately according to

Confidence Scoring of Speaking Performance: How Does Fuzziness become Exact?

ERIC Educational Resources Information Center

Jin, Tan; Mak, Barley; Zhou, Pei

2012-01-01

The fuzziness of assessing second language speaking performance raises two difficulties in scoring speaking performance: "indistinction between adjacent levels" and "overlap between scales". To address these two problems, this article proposes a new approach, "confidence scoring", to deal with such fuzziness, leading to "confidence" scores between…

Re-Thinking Stages of Cognitive Development: An Appraisal of Connectionist Models of the Balance Scale Task

ERIC Educational Resources Information Center

Quinlan, Philip T.; van der Maas, Han L. J.; Jansen, Brenda R. J.; Booij, Olaf; Rendell, Mark

2007-01-01

The present paper re-appraises connectionist attempts to explain how human cognitive development appears to progress through a series of sequential stages. Models of performance on the Piagetian balance scale task are the focus of attention. Limitations of these models are discussed and replications and extensions to the work are provided via the…

Discriminant analysis for predictor of falls in stroke patients by using the Berg Balance Scale.

PubMed

Maeda, Noriaki; Urabe, Yukio; Murakami, Masahito; Itotani, Keisuke; Kato, Junichi

2015-05-01

An observational study was carried out to estimate the strength of the relationships among balance, mobility and falls in hemiplegic stroke inpatients. The objective was to examine factors that may aid in the prediction of the likelihood of falls in stroke patients. A total of 53 stroke patients (30 male, 23 female) aged 67.0 ± 11.1 years were interviewed regarding their fall history. Physical performance was assessed using the Berg Balance Scale (BBS) and the Functional Independence Measure (FIM) scale. Variables that differed between fallers and non-fallers were identified, and a discriminant function analysis was carried out to determine the combination of variables that effectively predicted fall status. Of the 53 stroke patients, 19 were fallers. Compared with the non-fallers, the fallers scored low on the FIM, and differed with respect to age, time from stroke onset, length of hospital stay, Brunnstrom recovery stage and admission BBS score. Discriminant analysis for predicting falls in stroke patients showed that admission BBS score was significantly related to the likelihood of falls. Moreover, discriminant analysis showed that the use of a significant BBS score to classify fallers and non-fallers had an accuracy of 81.1%. The discriminating criterion between the two groups was a score of 31 points on the BBS. The results of this study suggest that BBS score is a strong predictor of falls in stroke patients. As balance is closely related to the risk of falls in hospitalised stroke patients, BBS might be useful in the prediction of falls.

Relationship Between Head-Turn Gait Speed and Lateral Balance Function in Community-Dwelling Older Adults.

PubMed

Singh, Harshvardhan; Sanders, Ozell; McCombe Waller, Sandy; Bair, Woei-Nan; Beamer, Brock; Creath, Robert A; Rogers, Mark W

2017-10-01

To determine and compare gait speed during head-forward and side-to-side head-turn walking in individuals with lower versus greater lateral balance. Cross-sectional study. University research laboratory. Older adults (N=93; 42 men, 51 women; mean age ± SD, 73 ± 6.08y) who could walk independently. (1) Balance tolerance limit (BTL), defined as the lowest perturbation intensity where a multistep balance recovery pattern was first evoked in response to randomized lateral waist-pull perturbations of standing balance to the left and right sides, at 6 different intensities (range from level 2: 4.5-cm displacement at 180cm/s 2 acceleration, to level 7: 22.5-cm displacement at 900cm/s 2 acceleration); (2) gait speed, determined using an instrumented gait mat; (3) balance, evaluated with the Activities-specific Balance Confidence Scale; and (4) mobility, determined with the Timed Up and Go (TUG). Individuals with low versus high BTL had a slower self-selected head-forward gait speed and head-turn gait speed (P=.002 and P<.001, respectively); the magnitude of difference was greater in head-turn gait speed than head-forward gait speed (Cohen's d=1.0 vs 0.6). Head-turn gait speed best predicted BTL. BTL was moderately and positively related (P=.003) to the ABC Scale and negatively related (P=.017) to TUG. Head-turn gait speed is affected to a greater extent than head-forward gait speed in older individuals with poorer lateral balance and at greater risk of falls. Moreover, head-turn gait speed can be used to assess the interactions of limitations in lateral balance function and gait speed in relation to fall risk in older adults. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Validity and Relative Ability of 4 Balance Tests to Identify Fall Status of Older Adults With Type 2 Diabetes.

PubMed

Marques, Alda; Silva, Alexandre; Oliveira, Ana; Cruz, Joana; Machado, Ana; Jácome, Cristina

The Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Mini-BESTest, and the Brief-BESTest are useful tests to assess balance; however, their clinimetric properties have not been studied well in older adults with type 2 diabetes (T2D). This study compared the validity and relative ability of the BBS, BESTest, Mini-BESTest, and Brief-BESTest to identify fall status in older adults with T2D. This study involved a cross-sectional design. Sixty-six older adults with T2D (75 ± 7.6 years) were included and asked to report the number of falls during the previous 12 months and to complete the Activities-specific Balance Confidence scale. The BBS and the BESTest were administered, and the Mini-BESTest and Brief-BESTest scores were computed based on the BESTest performance. Receiver operating characteristics were used to assess the ability of each balance test to differentiate between participants with and without a history of falls. The 4 balance tests were able to identify fall status (areas under the curve = 0.74-0.76), with similar sensitivity (60%-67%) and specificity (71%-76%). The 4 balance tests were able to differentiate between older adults with T2D with and without a history of falls. As the BBS and the BESTest require longer application time, the Brief-BESTest may be an appropriate choice to use in clinical practice to detect fall risk.

Monitoring the variations of the oxygen transfer rate in a full scale membrane bioreactor using daily mass balances.

PubMed

Racault, Y; Stricker, A-E; Husson, A; Gillot, S

2011-01-01

Oxygen transfer in biological wastewater treatment processes with high sludge concentration, such as membrane bioreactor (MBR), is an important issue. The variation of alpha-factor versus mixed liquor suspended solids (MLSS) concentration was investigated in a full scale MBR plant under process conditions, using mass balances. Exhaustive data from the Supervisory Control And Data Acquisition (SCADA) and from additional online sensors (COD, DO, MLSS) were used to calculate the daily oxygen consumption (OC) using a non-steady state mass balance for COD and total N on a 24-h basis. To close the oxygen balance, OC has to match the total oxygen transfer rate (OTRtot) of the system, which is provided by fine bubble (FB) diffusers in the aeration tank and coarse bubbles (CB) in separate membrane tanks. First assessing OTR(CB) then closing the balance OC = OTRtot allowed to calculate OTR(FB) and to fit an exponential relationship between OTR(FB) and MLSS. A comparison of the alpha-factor obtained by this balance method and by direct measurements with the off-gas method on the same plant is presented and discussed.

A scale value for the balance between stage and pit and inside an historical opera house

NASA Astrophysics Data System (ADS)

Prodi, Nicola; Velecka, Sylvia

2004-05-01

Despite its recognized importance, the balance between the singer and the orchestra inside an opera house has received minor attention in the past. In fact, after the fundamental work of Meyer [J. Meyer, ``Some problems of opera house acoustics,'' Proceedings of 12th I.C.A., Vancouver, 1986, pp. 13-18], who explained why the solo singing voice can compete with the orchestra, only partial results were reported on this perceived attribute. In this work a reference scale to assess the balance inside an historical opera house is achieved by means of listening tests inside a controlled room. Two scaling experiments were performed based on the acoustical data measured inside an historical opera house, the Teatro Comunale di Ferrara, Italy. By doing so all of the relevant acoustical characteristics of a typical Italian-style opera house could be exactly reproduced. Acceptable values do not differ much in the stalls and in the boxes and are within 2 dB(A) to +2.3 dB(A). The transfer of the findings to other types of opera houses is discussed, too.

Effects of confidence and anxiety on flow state in competition.

PubMed

Koehn, Stefan

2013-01-01

Confidence and anxiety are important variables that underlie the experience of flow in sport. Specifically, research has indicated that confidence displays a positive relationship and anxiety a negative relationship with flow. The aim of this study was to assess potential direct and indirect effects of confidence and anxiety dimensions on flow state in tennis competition. A sample of 59 junior tennis players completed measures of Competitive State Anxiety Inventory-2d and Flow State Scale-2. Following predictive analysis, results showed significant positive correlations between confidence (intensity and direction) and anxiety symptoms (only directional perceptions) with flow state. Standard multiple regression analysis indicated confidence as the only significant predictor of flow. The results confirmed a protective function of confidence against debilitating anxiety interpretations, but there were no significant interaction effects between confidence and anxiety on flow state.

History of falls, gait, balance, and fall risks in older cancer survivors living in the community.

PubMed

Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

2015-01-01

Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A "faller" was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher's exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594-29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may

Continental-scale footprint of balancing and positive selection in a small rodent (Microtus arvalis).

PubMed

Fischer, Martin C; Foll, Matthieu; Heckel, Gerald; Excoffier, Laurent

2014-01-01

Genetic adaptation to different environmental conditions is expected to lead to large differences between populations at selected loci, thus providing a signature of positive selection. Whereas balancing selection can maintain polymorphisms over long evolutionary periods and even geographic scale, thus leads to low levels of divergence between populations at selected loci. However, little is known about the relative importance of these two selective forces in shaping genomic diversity, partly due to difficulties in recognizing balancing selection in species showing low levels of differentiation. Here we address this problem by studying genomic diversity in the European common vole (Microtus arvalis) presenting high levels of differentiation between populations (average F ST = 0.31). We studied 3,839 Amplified Fragment Length Polymorphism (AFLP) markers genotyped in 444 individuals from 21 populations distributed across the European continent and hence over different environmental conditions. Our statistical approach to detect markers under selection is based on a Bayesian method specifically developed for AFLP markers, which treats AFLPs as a nearly codominant marker system, and therefore has increased power to detect selection. The high number of screened populations allowed us to detect the signature of balancing selection across a large geographic area. We detected 33 markers potentially under balancing selection, hence strong evidence of stabilizing selection in 21 populations across Europe. However, our analyses identified four-times more markers (138) being under positive selection, and geographical patterns suggest that some of these markers are probably associated with alpine regions, which seem to have environmental conditions that favour adaptation. We conclude that despite favourable conditions in this study for the detection of balancing selection, this evolutionary force seems to play a relatively minor role in shaping the genomic diversity of the

Group Balance Training Specifically Designed for Individuals With Alzheimer Disease: Impact on Berg Balance Scale, Timed Up and Go, Gait Speed, and Mini-Mental Status Examination.

PubMed

Ries, Julie D; Hutson, Janet; Maralit, Leslie A; Brown, Megan B

2015-01-01

Individuals with Alzheimer disease (IwAD) experience more frequent and more injurious falls than their cognitively intact peers. Evidence of balance and gait dysfunction is observed earlier in the course of Alzheimer disease (AD) than once believed. Balance training has been demonstrated to be effective in improving balance and decreasing falls in cognitively intact older adults but is not well studied in IwAD. This study was designed to analyze the effects of a group balance training program on balance and falls in IwAD. The program was developed specifically for IwAD, with explicit guidelines for communication/interaction and deliberate structure of training sessions catered to the motor learning needs of IwAD. This prospective, quasi-experimental, pretest-posttest design study describes the effects of a balance training program for a cohort of IwAD. Thirty IwAD were recruited from 3 adult day health centers; 22 completed at least 1 posttest session. Participants were tested with Berg Balance Scale (BBS), Timed Up and Go (TUG), Self-Selected Gait Speed (SSGS), Fast Gait Speed (FGS), and Mini-Mental Status Examination (MMSE) immediately before and after the 3-month intervention and again 3 months later. Group training was held at the adult day health centers for 45 minutes, twice per week. Sessions were characterized by massed, constant, and blocked practice of functional, relevant activities with considerable repetition. Ratio of participant to staff member never exceeded 3:1. Physical therapist staff members assured that participants were up on their feet the majority of each session and were individually challenged as much as possible. Repeated-measures analysis of variance (ANOVA) for BBS was significant (F = 15.04; df = 1.67/28.40; P = .000) with post hoc tests, revealing improvement between pretest and immediate posttest (P = .000) and decline in performance between immediate and 3-month posttest (P = .012). Repeated-measures ANOVA posttest for MMSE was

How Is Gender Self-Confidence Related to Subjective Well-Being?

ERIC Educational Resources Information Center

Hoffman, Rose Marie

2006-01-01

This study of ethnically diverse participants explored the relationship of gender self-confidence to subjective well-being. The 2 components of gender self-confidence (gender self-definition and gender self-acceptance) were assessed using the Hoffman Gender Scale (R. M. Hoffman, 1996; R. M. Hoffman, L. D. Borders, & J. A. Hattie, 2000). The…

Feasibility and Reliability of the Modified Berg Balance Scale in Persons with Severe Intellectual and Visual Disabilities

ERIC Educational Resources Information Center

Waninge, A.; van Wijck, R.; Steenbergen, B.; van der Schans, C. P.

2011-01-01

Background: The purpose of this study was to determine the feasibility and reliability of the modified Berg Balance Scale (mBBS) in persons with severe intellectual and visual disabilities (severe multiple disabilities, SMD) assigned Gross Motor Function Classification System (GMFCS) grades I and II. Method: Thirty-nine participants with SMD and…

A Retrospective Analysis of Post-Stroke Berg Balance Scale Scores: How Should Normal and At-Risk Scores Be Interpreted?

PubMed Central

Inness, Elizabeth; McIlroy, William E.; Mansfield, Avril

2017-01-01

Purpose: The Berg Balance Scale (BBS) is a performance-based measure of standing balance commonly used by clinicians working with individuals post-stroke. Performance on the BBS can be influenced by compensatory strategies, but measures derived from two force plates can isolate compensatory strategies and thus better indicate balance impairment. This study examined BBS scores that reflect “normal” and disordered balance with respect to dual force-plate measures of standing balance in individuals post-stroke. Methods: BBS and force-plate measures were extracted from 75 patient charts. Individuals were classified by BBS score with respect to (1) age-matched normative values and (2) values that suggested increased risk of falls. Multiple analysis of variance was used to examine the effect of group assignment on force-plate measures of standing balance. Results: Individuals with BBS scores within and below normative values did not differ in force-plate measures. Individuals with BBS scores below the falls risk cutoff loaded their affected leg less than individuals with BBS scores above the cutoff. There were no other differences in force-plate measures between these two groups. Conclusions: BBS scores indicating either normal or disordered balance function are not necessarily associated with normal or disordered quiet standing-balance control measured by two force plates. This finding suggests that the BBS may reflect a capacity for compensation rather than any underlying impairments. PMID:28539694

Home-based virtual reality balance training and conventional balance training in Parkinson's disease: A randomized controlled trial.

PubMed

Yang, Wen-Chieh; Wang, Hsing-Kuo; Wu, Ruey-Meei; Lo, Chien-Shun; Lin, Kwan-Hwa

2016-09-01

Virtual reality has the advantage to provide rich sensory feedbacks for training balance function. This study tested if the home-based virtual reality balance training is more effective than the conventional home balance training in improving balance, walking, and quality of life in patients with Parkinson's disease (PD). Twenty-three patients with idiopathic PD were recruited and underwent twelve 50-minute training sessions during the 6-week training period. The experimental group (n = 11) was trained with a custom-made virtual reality balance training system, and the control group (n = 12) was trained by a licensed physical therapist. Outcomes were measured at Week 0 (pretest), Week 6 (posttest), and Week 8 (follow-up). The primary outcome was the Berg Balance Scale. The secondary outcomes included the Dynamic Gait Index, timed Up-and-Go test, Parkinson's Disease Questionnaire, and the motor score of the Unified Parkinson's Disease Rating Scale. The experimental and control groups were comparable at pretest. After training, both groups performed better in the Berg Balance Scale, Dynamic Gait Index, timed Up-and-Go test, and Parkinson's Disease Questionnaire at posttest and follow-up than at pretest. However, no significant differences were found between these two groups at posttest and follow-up. This study did not find any difference between the effects of the home-based virtual reality balance training and conventional home balance training. The two training options were equally effective in improving balance, walking, and quality of life among community-dwelling patients with PD. Copyright © 2015. Published by Elsevier B.V.

Out-Patient Pulmonary Rehabilitation Improves Medial-Lateral Balance in Subjects With Chronic Respiratory Disease: Proof-of-Concept Study.

PubMed

Smith, Michelle D; Harvey, Elizabeth H; van den Hoorn, Wolbert; Shay, Barbara L; Pereira, Gisèle M; Hodges, Paul W

2016-04-01

Recent studies show balance impairment in subjects with chronic respiratory disease. The aim of this proof-of-concept study was to investigate clinical and quantitative measures of balance in people with chronic respiratory disease following participation in an out-patient pulmonary rehabilitation (PR) program to better understand features of balance improvement. A secondary aim was to probe possible mechanisms for balance improvement to provide the foundation for optimal design of future studies. Eleven individuals with chronic respiratory disease enrolled in an 8-week out-patient PR program participated. Standing balance, measured with a force plate, in the medial-lateral and anterior-posterior directions with eyes open and closed was assessed with linear (SD and sway path length) and non-linear (diffusion analysis) center-of-pressure measures. Balance was evaluated clinically with the Timed Up and Go and Four Square Step Test. Fear of falling and balance confidence were assessed with questionnaires. After participation in PR, medial-lateral sway path length decreased (P = .031), and center-of-pressure diffusion in the medial-lateral direction was slower (P = .02) and traveled over less distance (P = .03) with eyes closed. This suggests greater control of medial-lateral sway. There was no change in anterior-posterior balance (P > .067). Performance improved on the Timed Up and Go (median [interquartile range] pre-PR = 9.4 [7.9-12.8] vs. post-PR = 8.1 [7.3-12.2] s, P = .003) and Four Square Step Test (median [interquartile range] pre-PR = 9.3 [7.2-14.2] vs. post-PR = 8.7 [7.4-10.2] s, P = .050). There were no changes in balance confidence (P = .72) or fear of falling (P = .57). Participation in an 8-week out-patient PR program improved balance, as assessed by clinical and laboratory measures. Detailed analysis of force plate measures demonstrated improvements primarily with respect to medial-lateral balance control. These data provide a basis for the development

A small-group functional balance intervention for individuals with Alzheimer disease: a pilot study.

PubMed

Ries, Julie D; Drake, Jamie Michelle; Marino, Christopher

2010-03-01

Individuals with Alzheimer disease (AD) have a higher risk of falls than their cognitively intact peers. This pilot study was designed to assess the feasibility and effectiveness of a small-group balance exercise program for individuals with AD in a day center environment. Seven participants met the inclusion criteria: diagnosis of AD or probable AD, medical stability, and ability to walk (with or without assistive device). We used an exploratory pre- and post-test study design. Participants engaged in a functional balance exercise program in two 45-minute sessions each week for eight weeks. Balance activities were functional and concrete, and the intervention was organized into constant, blocked, massed practice. Outcome measures included Berg Balance Scale (BBS), Timed Up and Go (TUG), and gait speed (GS; self-selected and fast assessed by an instrumented walkway). Data were analyzed by comparing individual change scores with previously identified minimal detectable change scores at the 90% confidence level (MDC90). Pre- and post-test data were acquired for five participants (two participants withdrew). The BBS improved in all five participants, and improved > or = 6.4 points (the MDC90 for the BBS in three participants. Four participants improved their performance on the TUG, and three participants improved > or = 4.09 seconds (the MDC90 for the TUG). Self-selected GS increased > or = 9.44 cm/sec (the MDC90 for gait speed) in three participants. Two participants demonstrated post-test self-selected GS comparable with their pretest fast GS. This pilot study suggests that a small-group functional balance intervention for individuals with AD is feasible and effective. Although participants had no explicit memory of the program, four of five improved in at least two outcome measures. Larger scale functional balance intervention studies with individuals with AD are warranted.

Student Life Balance: Myth or Reality?

ERIC Educational Resources Information Center

Doble, Niharika; Supriya, M. V.

2011-01-01

Purpose: Student life stress, student family conflict and student life balance are issues that are scarcely researched. This paper aims to develop a scale for assessing the concept of student life balance. Design/methodology/approach: The study evaluated a 54-item scale for assessing the construct. The data are obtained from 612 Indian students.…

Family Presence During Resuscitation: Physicians' Perceptions of Risk, Benefit, and Self-Confidence.

PubMed

Twibell, Renee Samples; Siela, Debra; Neal, Alexis; Riwitis, Cheryl; Beane, Heather

Families often desire proximity to loved ones during life-threatening resuscitations and perceive clear benefits to being present. However, critical care nurses and physicians perceive risks and benefits. Whereas research is accumulating on nurses' perceptions of family presence, physicians' perspectives have not been clearly explicated. Psychometrically sound measures of physicians' perceptions are needed to create new knowledge and enhance collaboration among critical care nurses and physicians during resuscitation events. This study tests 2 new instruments that measure physicians' perceived risks, benefits, and self-confidence related to family presence during resuscitation. By a correlational design, a convenience sample of physicians (N = 195) from diverse clinical specialties in 1 hospital in the United States completed the Physicians' Family Presence Risk-Benefit Scale and Physicians' Family Presence Self-confidence Scale. Findings supported the internal consistency reliability and construct validity of both new scales. Mean scale scores indicated that physicians perceived more risk than benefit and were confident in managing resuscitations with families present, although more than two-thirds reported feeling anxious. Higher self-confidence was significantly related to more perceived benefit and less perceived risk (P = .001). Younger physicians, family practice physicians, and physicians who previously had invited family presence expressed more positive perceptions (P = .05-.001). These 2 new scales offer a means to assess key perceptions of physicians related to family presence. Further testing in diverse physician populations may further validate the scales and yield knowledge that can strengthen collaboration among critical care nurses and physicians and improve patient and family outcomes.

Large Scale Evapotranspiration Estimates: An Important Component in Regional Water Balances to Assess Water Availability

NASA Astrophysics Data System (ADS)

Garatuza-Payan, J.; Yepez, E. A.; Watts, C.; Rodriguez, J. C.; Valdez-Torres, L. C.; Robles-Morua, A.

2013-05-01

Water security, can be defined as the reliable supply in quantity and quality of water to help sustain future populations and maintaining ecosystem health and productivity. Water security is rapidly declining in many parts of the world due to population growth, drought, climate change, salinity, pollution, land use change, over-allocation and over-utilization, among other issues. Governmental offices (such as the Comision Nacional del Agua in Mexico, CONAGUA) require and conduct studies to estimate reliable water balances at regional or continental scales in order to provide reasonable assessments of the amount of water that can be provided (from surface or ground water sources) to supply all the human needs while maintaining natural vegetation, on an operational basis and, more important, under disturbances, such as droughts. Large scale estimates of evapotranspiration (ET), a critical component of the water cycle, are needed for a better comprehension of the hydrological cycle at large scales, which, in most water balances is left as the residual. For operational purposes, such water balance estimates can not rely on ET measurements since they do not exist, should be simple and require the least ground information possible, information that is often scarce or does not exist at all. Given this limitation, the use of remotely sensed data to estimate ET could supplement the lack of ground information, particularly in remote regions In this study, a simple method, based on the Makkink equation is used to estimate ET for large areas at high spatial resolutions (1 km). The Makkink model used here is forced using three remotely sensed datasets. First, the model uses solar radiation estimates obtained from the Geostationary Operational Environmental Satellite (GOES); Second, the model uses an Enhanced Vegetation Index (EVI) obtained from the Moderate-resolution Imaging Spectroradiometer (MODIS) normalized to get an estimate for vegetation amount and land use which was

Effect of enhanced manganese oxidation in the hyporheic zone on basin-scale geochemical mass balance

USGS Publications Warehouse

Harvey, Judson W.; Fuller, Christopher C.

1998-01-01

cumulative effect of hyporheic exchange in Pinal Creek basin was to remove approximately 20% of the dissolved manganese flowing out of the drainage basin. Our results illustrate that the cumulative significance of reactive uptake in the hyporheic zone depends on the balance between chemical reaction rates, hyporheic porewater residence time, and turnover of streamflow through hyporheic flow paths. The similarity between the hyporheic reaction timescale (1/λs ≈ 1.3 hours), and the hyporheic porewater residence timescale (ts ≈ 8 min) ensured that there was adequate time for the reaction to progress. Furthermore, it was the similarity between the turnover length for stream water flow through hyporheic flow paths (Ls = stream velocity/storage-zone exchange coefficient ≈ 1.3 km) and the length of Pinal Creek (L ≈ 7 km), which ensured that all stream water passed through hyporheic flow paths several times. As a means to generalize our findings to other sites where similar types of hydrologic and chemical information are available, we suggest a cumulative significance index for hyporheic reactions, Rs = λstsL/Ls (dimensionless); higher values indicate a greater potential for hyporheic reactions to influence geochemical mass balance. Our experience in Pinal Creek basin suggests that values of Rs > 0.2 characterize systems where hyporheic reactions are likely to influence geochemical mass balance at the drainage-basin scale.

AN INITIAL EVALUATION OF THE BTRACKS BALANCE PLATE AND SPORTS BALANCE SOFTWARE FOR CONCUSSION DIAGNOSIS

PubMed Central

Manyak, Kristin A.; Abdenour, Thomas E.; Rauh, Mitchell J.; Baweja, Harsimran S.

2016-01-01

Background As recently dictated by the American Medical Society, balance testing is an important component in the clinical evaluation of concussion. Despite this, previous research on the efficacy of balance testing for concussion diagnosis suggests low sensitivity (∼30%), based primarily on the popular Balance Error Scoring System (BESS). The Balance Tracking System (BTrackS, Balance Tracking Systems Inc., San Diego, CA, USA) consists of a force plate (BTrackS Balance Plate) and software (BTrackS Sport Balance) which can quickly (<2 min) perform concussion balance testing with gold standard accuracy. Purpose The present study aimed to determine the sensitivity of the BTrackS Balance Plate and Sports Balance Software for concussion diagnosis. Study Design Cross-Sectional Study Methods Preseason baseline balance testing of 519 healthy Division I college athletes playing sports with a relatively high risk for concussions was performed with the BTrackS Balance Test. Testing was administered by certified athletic training staff using the BTrackS Balance Plate and Sport Balance software. Of the baselined athletes, 25 later experienced a concussion during the ensuing sport season. Post-injury balance testing was performed on these concussed athletes within 48 of injury and the sensitivity of the BTrackS Balance Plate and Sport Balance software was estimated based on the number of athletes showing a balance decline according to the criteria specified in the Sport Balance software. This criteria is based on the minimal detectable change statistic with a 90% confidence level (i.e. 90% specificity). Results Of 25 athletes who experienced concussions, 16 had balance declines relative to baseline testing results according to the BTrackS Sport Balance software criteria. This corresponds to an estimated concussion sensitivity of 64%, which is twice as great as that reported previously for the BESS. Conclusions The BTrackS Balance Plate and Sport Balance software has the

Comprehensive, blinded assessment of balance in orthostatic tremor.

PubMed

Bhatti, Danish; Thompson, Rebecca; Xia, Yiwen; Hellman, Amy; Schmaderer, Lorene; Suing, Katie; McKune, Jennifer; Penke, Cynthia; Iske, Regan; Roeder, Bobbi Jo; Siu, Ka-Chun; Bertoni, John M; Torres-Russotto, Diego

2018-02-01

Orthostatic Tremor (OT) is a movement disorder characterized by a sensation of unsteadiness and tremors in the 13-18 Hz range present upon standing. The pathophysiology of OT is not well understood but there is a relationship between the sensation of instability and leg tremors. Despite the sensation of unsteadiness, OT patients do not fall often and balance in OT has not been formally assessed. We present a prospective blinded study comparing balance assessment in patients with OT versus healthy controls. We prospectively enrolled 34 surface Electromyography (EMG)-confirmed primary OT subjects and 21 healthy controls. Participants underwent evaluations of balance by blinded physical therapists (PT) with standardized, validated, commonly used balance scales and tasks. OT subjects were mostly female (30/34, 88%) and controls were majority males (13/20, 65%). The average age of OT subjects was 68.5 years (range 54-87) and for controls was 69.4 (range 32-86). The average duration of OT symptoms was 18 years. OT subjects did significantly worse on all the balance scales and on most balance tasks including Berg Balance Scale, Functional Gait Assessment, Dynamic Gait Index, Unipedal Stance Test, Functional Reach Test and pull test. Gait speed and five times sit to stand were normal in OT. Common validated balance scales are significantly abnormal in primary OT. Despite the objective finding of impaired balance, OT patients do not commonly have falls. The reported sensation of unsteadiness in this patient population seems to be out of proportion to the number of actual falls. Further studies are needed to determine which components of commonly used balance scales are affected by a sensation of unsteadiness and fear of falling. Copyright © 2017 Elsevier Ltd. All rights reserved.

Neural correlates of metacognitive ability and of feeling confident: a large-scale fMRI study.

PubMed

Molenberghs, Pascal; Trautwein, Fynn-Mathis; Böckler, Anne; Singer, Tania; Kanske, Philipp

2016-12-01

One important aspect of metacognition is the ability to accurately evaluate one's performance. People vary widely in their metacognitive ability and in general are too confident when evaluating their performance. This often leads to poor decision making with potentially disastrous consequences. To further our understanding of the neural underpinnings of these processes, this fMRI study investigated inter-individual differences in metacognitive ability and effects of trial-by-trial variation in subjective feelings of confidence when making metacognitive assessments. Participants (N = 308) evaluated their performance in a high-level social and cognitive reasoning task. The results showed that higher metacognitive accuracy was associated with a decrease in activation in the anterior medial prefrontal cortex, an area previously linked to metacognition on perception and memory. Moreover, the feeling of confidence about one's choices was associated with an increase of activation in reward, memory and motor related areas including bilateral striatum and hippocampus, while less confidence was associated with activation in areas linked with negative affect and uncertainty, including dorsomedial prefrontal and bilateral orbitofrontal cortex. This might indicate that positive affect is related to higher confidence thereby biasing metacognitive decisions towards overconfidence. In support, behavioural analyses revealed that increased confidence was associated with lower metacognitive accuracy. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Effects of unstable surface training on measures of balance in older adults.

PubMed

Schilling, Brian K; Falvo, Michael J; Karlage, Robyn E; Weiss, Lawrence W; Lohnes, Corey A; Chiu, Loren Zf

2009-07-01

The purpose of this investigation was to examine the effects of a 5-week, low-cost unstable surface balance training program in sexagenarians. Nineteen men and women (60-68 years; 83.7 +/- SD kg) were randomly assigned to a control or training group. The training group performed various balance activities on air-filled rubber disks for 5 weeks. Each thrice-weekly session was supervised, and progression was based on proficiency. While in an upright position, static balance (length of path [LOP] of the center of pressure) was assessed in both eyes-open and eyes-closed states for each leg separately as well as for both legs. Participants also performed the timed up-and-go (TUG) test and completed the Activity-specific Balance Confidence (ABC) questionnaire. A significant group x time effect for the ABC questionnaire was found (p = 0.04). Tukey post hoc analysis indicates that the balance training program increased self-perceived balance confidence (p < 0.01). No significant group x time interactions were noted for TUG or LOP. Because no objective measure of balance or function was changed, the increase in ABC may be spurious. Unstable surface training may not be effective in improving balance among persons for whom balance is not problematic. However, the large number of acute training variables in such a program leaves opportunity for further research in this paradigm.

Effects of elastic-band resistance exercise on balance, mobility and gait function, flexibility and fall efficacy in elderly people.

PubMed

Kwak, Cheol-Jin; Kim, You Lim; Lee, Suk Min

2016-11-01

[Purpose] The purpose of this study was to analyze the effects of elastic-band resistance exercise on balance, gait function, flexibility and fall efficacy in the elderly people of rural community. [Subjects and Methods] It is selected by 45 outpatients. They have come into the clinic continually to treat of physical therapy at least 1-2 times for a week. A group treated with both general physical therapy and elastic-band resistance exercise (23 patients), and the other group treated with only general physical therapy (22 patients). Elastic-band resistance exercise is composed of 8 movements of lower extremity joints. It is performed for 30 minutes during 8 weeks by 3 times for a week. It is measured and recorded at the pre and post test that sit and reach test (SRT), functional reach test (FRT), timed up and go test (TUG) for every subjects by measurement equipments. And, subjects performed for the form of performance and question as its rated scale by Berg's balance scale (BBS), dynamic gait index (DGI), activities-specific balance confidence scale (ABC). [Results] In the study, both the elastic-band exercise group and the general physical therapy group showed a significant improvement in balance, gait function, flexibility and fall efficacy. And the group with elastic-band resistance exercise showed more effectiveness than the contrast group in value of variation. [Conclusion] From this study, it was confirmed that elastic-band resistance exercise has influence on balance, gait function, flexibility and fall efficacy are working for agriculture of elderly people of rural community. Based on this result, elastic-band resistance exercise can be better instrument and easier to elderly people of rural community for the improvement in balance, gait function, flexibility and fall efficacy as it performing along with and reciprocal physical therapy.

Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention.

PubMed

Ellmers, Toby J; Paraskevopoulos, Ioannis Th; Williams, A Mark; Young, William R

2018-03-22

Published reports suggest a disparity between perceived and actual balance abilities, a trait associated with increased fall-risk in older adults. We investigate whether it is possible to 'recalibrate' these disparities using a novel gaming intervention. We recruited 26 older adults for a 4-week intervention in which they participated in 8-sessions using a novel gaming intervention designed to provide explicit, augmented feedback related to postural control. Measures of perceived balance abilities (Falls Efficacy Scale-International) and actual postural control (limits of stability) were assessed pre- and post-intervention. We used focus groups to elicit the opinions of participants about how the game may have influenced balance abilities and confidence. A stronger alignment was observed between postural control and perceived balance capabilities post-intervention (i.e., significant correlations between Falls Efficacy Scale-International scores and limits of stability which were not present pre-intervention). Also, significant improvements in measures of postural control were observed, with these improvements confined to the aspects of postural control for which the exergame provided explicit, augmented feedback. Qualitative data revealed that the intervention made participants more "aware" of their balance abilities. Our results demonstrate that it is possible to recalibrate the perceptions of older adults relating to their balance abilities through a targeted, short-term intervention. We propose that the post-intervention improvements in postural control may have been, in part, the result of this recalibration; with altered perceptions leading to changes in balance performance. Findings support the application of novel interventions aimed at addressing the psychological factors associated with elderly falls.

Balanced multiwavelets with interpolatory property.

PubMed

Li, Baobin; Peng, Lizhong

2011-05-01

Balanced multiwavelets with interpolatory property are discussed in this paper. This kind of multiwavelets can have a sampling property like Shannon's sampling theorem. It has been shown that the corresponding matrix-valued refinable mask has special structure, and an orthogonal multifilter bank {H(z),G(z)} can be reduced to a scalar valued conjugate quadrature filter (CQF) a(z) . But it does not mean that any scalar CQF can form a "good" multifilter bank which can generate a vector-valued refinable function with some degree of smoothness. In the context of balanced multiwavelets, we give the definition of transferring balance order, which a scalar CQF a(z) satisfies, to guarantee that the multiwavelet Ψ generated is balanced. On the basis of the parametrization of a scalar CQF with any length and conditions of transferring balance order, parametrization of multifilter banks which can generate interpolatory multiwavelet and interpolatory scaling function, is gotten. Moreover, some balanced interpolatory multiwavelets have been constructed. Interpolatory analysis-ready multiwavelets (armlets) are also discussed in this paper. It is known that conditions of armlets are easy to validate, compared with balanced multiwavelets. But it will be present that if the corresponding scaling function Φ is interpolatory, the multiwavelet Ψ is balanced of order n if and only if it is an armlet of order n. Finally, the application of balanced multiwavelets with interpolatory property in image processing is also discussed.

Exploring the Validity of the Affect Balance Scale With a Sample of Family Caregivers

PubMed Central

Perkinson, Margaret A.; Albert, Steven M.; Luborsky, Mark; Moss, Miriam; Glicksman, Allen

2014-01-01

Open-ended responses of caregiving daughters and daughters-in-law were generated by a modified random probe technique to investigate the construct validity of the two subscales of the Affect Balance Scale (ABS), i.e., the 5-item Positive Affect Scale (PAS) and the 5-item Negative Affect Scale (NAS). A set of criteria were developed to distinguish between responses that did and did not correspond to Bradburn’s assumptions concerning affect. While most responses met at least one of the criteria, very few met all. In exploring the nature of affect, we found that positive affect was based to a large extent on personal accomplishments and the recognition of others. The assessment of negative affect was a more interior, or self-focused process. For a significant subset of the sample, a negative response to a closed-ended PAS or NAS item implied disagreement or discontent with the wording or the implications of the item itself, rather than an absence of affect. Not all of the ABS items were equally valid measures of affect. PMID:8056955

Measuring and modeling the temporal dynamics of nitrogen balance in an experimental-scale paddy field

NASA Astrophysics Data System (ADS)

Tseng, C.; Lin, Y.

2013-12-01

Nitrogen balance involves many mechanisms and plays an important role to maintain the function of nature. Fertilizer application in agriculture activity is usually seen as a common and significant nitrogen input to environment. Improper fertilizer application on paddy field can result in great amount of various types of nitrogen losses. Hence, it is essential to understand and quantify the nitrogen dynamics in paddy field for fertilizer management and pollution control. In this study, we develop a model which considers major transformation processes of nitrogen (e.g. volatilization, nitrification, denitrification and plant uptake). In addition, we measured different types of nitrogen in plants, soil and water at plant growth stages in an experimental-scale paddy field in Taiwan. The measurement includes total nitrogen in plants and soil, and ammonium-N (NH4+-N), nitrate-N (NO3--N) and organic nitrogen in water. The measured data were used to calibrate the model parameters and validate the model for nitrogen balance simulation. The results showed that the model can accurately estimate the temporal dynamics of nitrogen balance in paddy field during the whole growth stage. This model might be helpful and useful for future fertilizer management and pollution control in paddy field.

Strain Gauge Balance Uncertainty Analysis at NASA Langley: A Technical Review

NASA Technical Reports Server (NTRS)

Tripp, John S.

1999-01-01

This paper describes a method to determine the uncertainties of measured forces and moments from multi-component force balances used in wind tunnel tests. A multivariate regression technique is first employed to estimate the uncertainties of the six balance sensitivities and 156 interaction coefficients derived from established balance calibration procedures. These uncertainties are then employed to calculate the uncertainties of force-moment values computed from observed balance output readings obtained during tests. Confidence and prediction intervals are obtained for each computed force and moment as functions of the actual measurands. Techniques are discussed for separate estimation of balance bias and precision uncertainties.

Direction of Wording Effects in Balanced Scales.

ERIC Educational Resources Information Center

Miller, Timothy R.; Cleary, T. Anne

1993-01-01

The degree to which statistical item selection reduces direction-of-wording effects in balanced affective measures developed from relatively small item pools was investigated with 171 male and 228 female undergraduate and graduate students at 2 U.S. universities. Clearest direction-of-wording effects result from selection of items with high…

The relationship between objective balance, perceived sense of balance, and fear of falling in stroke patients.

PubMed

Oguz, Semra; Demirbuken, Ilksan; Kavlak, Bahar; Acar, Gonul; Yurdalan, Saadet Ufuk; Polat, Mine Gulden

2017-10-01

The objective of our study was to investigate the relationship between objective balance, fear of falling, and perceived sense of balance (PSB) in stroke patients. Seventy patients aged 18-65 years with chronically developed hemiplegia or hemiparesis were enrolled in the study. Patients' objective balance scores, fear of falling, and PSB were obtained using the berg balance scale (BBS), the falls efficacy scale (FES), and a visual analog scale, respectively. The Standard Mini-Mental Examination was performed to exclude patients with mental disorders from the study. There was a moderate negative correlation between PSB and BBS scores (p = 0.001, ρ = -0.588); a strong negative correlation between BBS and FES scores (p = 0.001, ρ = -0.808); and a strong positive correlation between PSB and FES scores (p = 0.001, ρ = 0.714). We found that BBS scores had negative correlation with PBS scores in left hemiplegic patients while there was no any relationship between BBS and PBS scores in right hemiplegic patients. PSB assessment, besides the BBS, should be considered among the routine assessment methods that enable the rehabilitation team to be aware of patients' balance capacities.

Exploring new graduate nurse confidence in interprofessional collaboration: a mixed methods study.

PubMed

Pfaff, Kathryn A; Baxter, Pamela E; Jack, Susan M; Ploeg, Jenny

2014-08-01

Confidence is required for effective engagement in interprofessional collaboration. New graduate nurses often lack confidence in interprofessional interactions, and this may compromise the delivery of safe and effective healthcare. The overall objective of this study was to explore new graduate nurse confidence in interprofessional collaboration. An explanatory sequential mixed methods design was used. New graduate nurses from Ontario, Canada (N=514) completed a cross-sectional descriptive survey in 2012. The survey measured perceived confidence in interprofessional collaboration, and it included items that were proposed to have a relationship with new graduate nurse confidence in interprofessional collaboration. Follow-up qualitative telephone interviews were conducted with 16 new graduate nurses. The quantitative findings suggested that several factors have a positive relationship with new graduate nurse confidence in interprofessional collaboration: availability and accessibility of manager, availability and accessibility of educator, number of different disciplines worked with daily, number of team strategies, and satisfaction with team. The qualitative phase supported the quantitative findings and also provided new information about factors that facilitated and challenged new graduate nurse confidence when engaging in interprofessional collaboration. The facilitators were: experience, knowledge, respect, supportive relationships, and opportunities to collaborate. Challenges included: lack of experience, lack of knowledge, communication challenges, and balancing practice expectations. The overall findings relate to team and organizational support, and new graduate nurse development. Interventions that provide support for interprofessional collaboration at the team and organizational levels, and develop new graduate nurse knowledge and experiences regarding collaborative practice, are essential for enhancing new graduate nurse confidence in interprofessional

History of falls, gait, balance, and fall risks in older cancer survivors living in the community

PubMed Central

Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

2015-01-01

Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A “faller” was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher’s exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594–29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls

Relationship Between Cognitive Assessment and Balance Measures in Adolescents Referred for Vestibular Physical Therapy After Concussion

PubMed Central

Alsalaheen, Bara A.; Whitney, Susan L.; Marchetti, Gregory F.; Furman, Joseph M.; Kontos, Anthony P.; Collins, Michael W.; Sparto, Patrick J.

2016-01-01

Objective To examine the relationship between cognitive and balance performance in adolescents with concussion. Design Retrospective case series. Setting Tertiary. Patients Sixty patients. Interventions Correlation analyses were performed to describe the relationship between symptoms, cognitive measure, and balance measure at the time of initiation of vestibular physical therapy. Main Outcome Measures Cognitive performance was assessed using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT). The dizziness and balance function measures included dizziness severity rating, Activities-specific Balance Confidence scale (ABC), Dizziness Handicap Inventory (DHI), Functional Gait Assessment, gait speed, Timed “UP and GO,” Five Times Sit to Stand, and Sensory Organization Test (SOT). To account for multiple comparisons, the False Discovery Rate method was used. Results Performance measures of balance were significantly correlated with cognitive measures. Greater total symptom scores were related to greater impairment in the ABC and DHI (r = 0.35-0.39, P ≤ 0.008) and worse performance in condition 2 of the SOT (r = −0.48, P = 0.004). Among the ImPACT composite scores, lower memory scores were correlated with impaired balance performance measures (r = 0.37-0.59, P ≤ 0.012). Lower visual memory was also correlated with worse ABC scores. Conclusions The significant relationships reported between the cognitive performance scores and balance measures may reflect that similar levels of functioning exist across domains in individuals with protracted recovery who receive vestibular physical therapy. PMID:25706663

Large-scale subduction of continental crust implied by India-Asia mass-balance calculation

NASA Astrophysics Data System (ADS)

Ingalls, Miquela; Rowley, David B.; Currie, Brian; Colman, Albert S.

2016-11-01

Continental crust is buoyant compared with its oceanic counterpart and resists subduction into the mantle. When two continents collide, the mass balance for the continental crust is therefore assumed to be maintained. Here we use estimates of pre-collisional crustal thickness and convergence history derived from plate kinematic models to calculate the crustal mass balance in the India-Asia collisional system. Using the current best estimates for the timing of the diachronous onset of collision between India and Eurasia, we find that about 50% of the pre-collisional continental crustal mass cannot be accounted for in the crustal reservoir preserved at Earth's surface today--represented by the mass preserved in the thickened crust that makes up the Himalaya, Tibet and much of adjacent Asia, as well as southeast Asian tectonic escape and exported eroded sediments. This implies large-scale subduction of continental crust during the collision, with a mass equivalent to about 15% of the total oceanic crustal subduction flux since 56 million years ago. We suggest that similar contamination of the mantle by direct input of radiogenic continental crustal materials during past continent-continent collisions is reflected in some ocean crust and ocean island basalt geochemistry. The subduction of continental crust may therefore contribute significantly to the evolution of mantle geochemistry.

Correlations between Berg balance scale and gait speed in individuals with stroke wearing ankle-foot orthoses - a pilot study.

PubMed

Kobayashi, Toshiki; Leung, Aaron K L; Akazawa, Yasushi; Hutchins, Stephen W

2016-01-01

The Berg balance scale (BBS) is commonly used to assess balancing ability in patients with stroke. The BBS may be a good candidate for clinical assessment prior to orthotic intervention, if it correlates well with outcome measures such as gait speed. The purpose of this study was to investigate the correlation between the BBS measured prior to walking with an ankle-foot orthosis (AFO) and specific temporal-spatial parameters of gait when walking with an AFO donned. Eight individuals with chronic stroke participated in this study. Balancing ability was assessed using the BBS, while temporal-spatial parameters of gait (gait speed, bilateral step length, stride length and step width) were measured using a three-dimensional motion analysis system. The correlations between the BBS and gait parameters were investigated using a non-parametric Kendall's Tau (τ) correlation analysis. The BBS showed correlations with gait speed (τ = 0.64, p < 0.05), the step length of the affected side (τ = 0.74, p < 0.05), and the stride length (τ = 0.64, p < 0.05). Assessment of the BBS prior to AFO prescription may potentially help clinicians to estimate the gait speed achievable following orthotic intervention in patients with stroke. Implications for Rehabilitation Assessment of the BBS prior to AFO prescription may help orthotists to estimate the gait speed following an orthotic intervention in patients with stroke. Assessment of the BBS prior to AFO prescription may help orthotists to understand overall balance and postural control abilities in patients with stroke. A larger scale multifactorial analysis is warranted to confirm the results of this pilot study.

Traditional Chinese Mind and Body Exercises for Promoting Balance Ability of Old Adults: A Systematic Review and Meta-Analysis

PubMed Central

Zhang, Yanjie; Wang, Yong Tai; Liu, Xiao Lei

2016-01-01

The purpose of this study was to provide a quantitative evaluation of the effectiveness of traditional Chinese mind and body exercises in promoting balance ability for old adults. The eligible studies were extensively searched from electronic databases (Medline, CINAHL, SportDicus, and Web of Science) until 10 May 2016. Reference lists of relevant publications were screened for future hits. The trials used randomized controlled approaches to compare the effects of traditional Chinese mind and body exercise (TCMBE) on balance ability of old adults that were included. The synthesized results of Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and static balance with 95% confidence intervals were counted under a random-effects model. Ten studies were selected based on the inclusion criteria, and a total of 1,798 participants were involved in this review. The results of the meta-analysis showed that TCMBE had no significant improvement on BBS and TUG, but the BBS and TUG could be obviously improved by prolonging the intervention time. In addition, the results showed that TCMBE could significantly improve the static balance compared to control group. In conclusion, old adults who practiced TCMBE with the time not less than 150 minutes per week for more than 15 weeks could promote the balance ability. PMID:27990168

Traditional Chinese Mind and Body Exercises for Promoting Balance Ability of Old Adults: A Systematic Review and Meta-Analysis.

PubMed

Chen, Shihui; Zhang, Yanjie; Wang, Yong Tai; Liu, Xiao Lei

2016-01-01

The purpose of this study was to provide a quantitative evaluation of the effectiveness of traditional Chinese mind and body exercises in promoting balance ability for old adults. The eligible studies were extensively searched from electronic databases (Medline, CINAHL, SportDicus, and Web of Science) until 10 May 2016. Reference lists of relevant publications were screened for future hits. The trials used randomized controlled approaches to compare the effects of traditional Chinese mind and body exercise (TCMBE) on balance ability of old adults that were included. The synthesized results of Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and static balance with 95% confidence intervals were counted under a random-effects model. Ten studies were selected based on the inclusion criteria, and a total of 1,798 participants were involved in this review. The results of the meta-analysis showed that TCMBE had no significant improvement on BBS and TUG, but the BBS and TUG could be obviously improved by prolonging the intervention time. In addition, the results showed that TCMBE could significantly improve the static balance compared to control group. In conclusion, old adults who practiced TCMBE with the time not less than 150 minutes per week for more than 15 weeks could promote the balance ability.

Validity, Responsiveness, Minimal Detectable Change, and Minimal Clinically Important Change of "Pediatric Balance Scale" in Children with Cerebral Palsy

ERIC Educational Resources Information Center

Chen, Chia-ling; Shen, I-hsuan; Chen, Chung-yao; Wu, Ching-yi; Liu, Wen-Yu; Chung, Chia-ying

2013-01-01

This study examined criterion-related validity and clinimetric properties of the pediatric balance scale ("PBS") in children with cerebral palsy (CP). Forty-five children with CP (age range: 19-77 months) and their parents participated in this study. At baseline and at follow up, Pearson correlation coefficients were used to determine…

The reliability and validity of the Turkish version of Fullerton Advanced Balance (FAB-T) scale.

PubMed

Iyigun, Gozde; Kirmizigil, Berkiye; Angin, Ender; Oksuz, Sevim; Can, Filiz; Eker, Levent; Rose, Debra J

2018-06-04

The aim of this study was to evaluate the reliability and validity of the Turkish version of the FAB(FAB-T) scale in the older Turkish adults. The reliability and validity of the scale was tested on 200 community-dwelling older adults. FAB-T scale was scored by different physiotherapists on different days to evaluate inter-rater and intrarater reliability. The Berg Balance Scale (BBS) was used for the evaluation of convergent validity, and the content validity of the FAB-T scale was investigated. The FAB-T scale showed very high inter- and intra-rater reliability. For inter-rater agreement, on the individual test items and total score ICC values were 0.92 (95 %CI; 0.90-0.94) and 0.96 (95% CI; 0.95-0.97) respectively. The intra-rater agreement, on the individual test items and total score ICC values were 0.93 (95 %CI; 0.91- 0.95) and 0.96 (95% CI; 0.95- 0.97) respectively. There was a good agreement between the FAB-T and BBS scales. A high correlation was found between the BBS and FAB-T scales [rho = 0.70 (%95 CI; 0.62-0.76)] indicating good convergent validity. Considering the content validity of the FAB-T scale, no floor (floor score: 0%) or ceiling (ceiling score: 6.5%) effect was detected. The FAB-T scale was successfully translated from the original English version (FAB) and demonstrated strong psychometric features. It was found that the FAB-T scale has very high inter-rater and intra-rater reliability. Considering the convergent validity, the scale has high correlation with the BBS. The FAB-T has no floor and ceiling effect. Copyright © 2018 Elsevier B.V. All rights reserved.

Reliability and validity of the Korean version of the community balance and mobility scale in patients with hemiplegia after stroke

PubMed Central

Lee, Kyoung-bo; Lee, Paul; Yoo, Sang-won; Kim, Young-dong

2016-01-01

[Purpose] The aim of this study was to translate and adapt the Community Balance and Mobility Scale (CB&M) into Korean (K-CB&M) and to verify the reliability and validity of scores obtained with Korean patients. [Subjects and Methods] A total of 16 subjects were recruited from St. Vincent’s Hospital in South Korea. At each testing session, subjects completed the K-CB&M, Berg balance scale (BBS), timed up and go test (TUG), and functional reaching test. All tests were administered by a physical therapist, and subjects completed the tests in an identical standardized order during all testing sessions. [Results] The inter- and intra-rater reliability coefficients were high for most subscores, while moderate inter-rater reliability was observed for the items “walking and looking” and “walk, look, and carry”, and moderate intra-rater reliability was observed for “forward to backward walking”. There was a positive correlation between the K-CB&M and BBS and a negative correlation between the K-CB&M and TUG in the convergent validity assessments. [Conclusion] The reliability and validity of the K-CB&M was high, suggesting that clinical practitioners treating Korean patients with hemiplegia can use this material for assessing static and dynamic balance. PMID:27630420

Reliability of the Balance Evaluation Systems Test (BESTest) and BESTest sections for adults with hemiparesis

PubMed Central

Rodrigues, Letícia C.; Marques, Aline P.; Barros, Paula B.; Michaelsen, Stella M.

2014-01-01

BACKGROUND: The Balance Evaluation Systems Test (BESTest) was recently created to allow the development of treatments according to the specific balance system affected in each patient. The Brazilian version of the BESTest has not been specifically tested after stroke. OBJECTIVE: To evaluate the intra- and inter-rater reliability and concurrent and convergent validity of the total score of the BESTest and BESTest sections for adults with hemiparesis after stroke. METHOD: The study included 16 subjects (61.1±7.5 years) with chronic hemiparesis (54.5±43.5 months after stroke). The BESTest was administered by two raters in the same week and one of the raters repeated the test after a one-week interval. Intraclass correlation coefficient (ICC) was calculated to assess intra- and interrater reliability. Concurrent validity with the Berg Balance Scale (BBS) and convergent validity with the Activities-specific Balance Confidence scale (ABC-Brazil) were assessed using Pearson's correlation coefficient. RESULTS: Both the BESTest total score (ICC=0.98) and the BESTest sections (ICC between 0.85 and 0.96) have excellent intrarater reliability. Interrater reliability for the total score was excellent (ICC=0.93) and, for the sections, it ranged between 0.71 and 0.94. The correlation coefficient between the BESTest and the BBS and ABC-Brazil were 0.78 and 0.59, respectively. CONCLUSIONS: The Brazilian version of the BESTest demonstrated adequate reliability when measured by sections and could identify what balance system was affected in patients after stroke. Concurrent validity was excellent with the BBS total score and good to excellent with the sections. The total scores but not the sections present adequate convergent validity with the ABC-Brazil. However, other psychometric properties should be further investigated. PMID:25003281

Falls prevention and balance rehabilitation in multiple sclerosis: a bi-centre randomised controlled trial.

PubMed

Cattaneo, Davide; Rasova, Kamila; Gervasoni, Elisa; Dobrovodská, Gabriela; Montesano, Angelo; Jonsdottir, Johanna

2018-03-01

People with Multiple Sclerosis (PwMS) have a high incidence of accidental falls that have a potentially detrimental effect on their daily life participation. The effect of balance specific rehabilitation on clinical balance measures and frequency of falls in PwMS was studied. A bi-centre randomised rater-blinded controlled trial. Participants in both groups received 20 treatment sessions. Participants in the intervention group received treatment aimed at improving balance and mobility. Participants in the control group received treatments to reduce limitations at activity and body function level. Primary measures were frequency of fallers (>1 fall in two months) and responders (>3 points improvement) at the Berg Balance Scale (BBS). Data was analysed according to an intention to treat approach. One hundred and nineteen participants were randomised. Following treatment frequency of fallers was 22% in the intervention group and 23% in the control group, odds ratio (OR) and (confidence limits): 1.05 (0.41 to 2.77). Responders on the BBS were 28% in the intervention group and 33% in the control group, OR = 0.75 (0.30 to 1.91). At follow up ORs for fallers and responders at BBS were 0.98 (0.48 to 2.01) and 0.79 (0.26 to 2.42), respectively. Twenty sessions 2-3 times/week of balance specific rehabilitation did not reduce fall frequency nor improve balance suggesting the need for more frequent and challenging interventions. Implications for Rehabilitation Programs for balance rehabilitation can improve balance but their effects in fall prevention are unclear. Twenty treatments sessions 2/3 times per week did not reduced frequency of falls in MS. The comparison with similar studies suggests that higher intensity of practice of highly challenging balance activities appears to be critical to maximizing effectiveness.

Framing Affects Scale Usage for Judgments of Learning, Not Confidence in Memory

ERIC Educational Resources Information Center

England, Benjamin D.; Ortegren, Francesca R.; Serra, Michael J.

2017-01-01

Framing metacognitive judgments of learning (JOLs) in terms of the likelihood of forgetting rather than remembering consistently yields a counterintuitive outcome: The mean of participants' forget-framed JOLs is often higher (after reverse-scoring) than the mean of their remember-framed JOLs, suggesting greater confidence in memory. In the present…

Students' Confidence in Their Performance Judgements: A Comparison of Different Response Scales

ERIC Educational Resources Information Center

Händel, Marion; Fritzsche, Eva Susanne

2015-01-01

We report results of two studies on metacognitive accuracy with undergraduate education students. Participating students were asked to judge their personal performance in a multiple-choice exam as well as to state their confidence in their performance judgement (second-order judgement [SOJ]). In each study, we compared four conditions that…

Gaze stability, dynamic balance and participation deficits in people with multiple sclerosis at fall-risk.

PubMed

Garg, Hina; Dibble, Leland E; Schubert, Michael C; Sibthorp, Jim; Foreman, K Bo; Gappmaier, Eduard

2018-05-05

Despite the common complaints of dizziness and demyelination of afferent or efferent pathways to and from the vestibular nuclei which may adversely affect the angular Vestibulo-Ocular Reflex (aVOR) and vestibulo-spinal function in persons with Multiple Sclerosis (PwMS), few studies have examined gaze and dynamic balance function in PwMS. 1) Determine the differences in gaze stability, dynamic balance and participation measures between PwMS and controls, 2) Examine the relationships between gaze stability, dynamic balance and participation. Nineteen ambulatory PwMS at fall-risk and 14 age-matched controls were recruited. Outcomes included (a) gaze stability [angular Vestibulo-Ocular Reflex (aVOR) gain (ratio of eye to head velocity); number of Compensatory Saccades (CS) per head rotation; CS latency; gaze position error; Coefficient of Variation (CV) of aVOR gain], (b) dynamic balance [Functional Gait Assessment, FGA; four square step test], and (c) participation [dizziness handicap inventory; activities-specific balance confidence scale]. Separate independent t-tests and Pearson's correlations were calculated. PwMS were age = 53 ± 11.7yrs and had 4.2 ± 3.3 falls/yr. PwMS demonstrated significant (p<0.05) impairments in gaze stability, dynamic balance and participation measures compared to controls. CV of aVOR gain and CS latency were significantly correlated with FGA. Deficits and correlations across a spectrum of disability measures highlight the relevance of gaze and dynamic balance assessment in PwMS. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older

PubMed Central

Hawk, Cheryl; Hyland, John K; Rupert, Ronald; Colonvega, Makasha; Hall, Stephanie

2006-01-01

Background Falls are a major health concern for older adults and their impact is a significant public health problem. The chief modifiable risk factors for falls in community-dwellers are psychotropic drugs, polypharmacy, environmental hazards, poor vision, lower extremity impairments, and balance impairments. This study focused on balance impairments. Its purpose was to assess the feasibility of recruiting older adults with possible balance problems for research conducted at a chiropractic research center, and to explore the utility of several widely used balance instruments for future studies of the effect of chiropractic care on balance in older adults. Methods This descriptive study was conducted from September through December 2004. Participants were recruited through a variety of outreach methods, and all were provided with an educational intervention. Data were collected at each of two visits through questionnaires, interviews, and physical examinations. Balance was assessed on both visits using the Activities-specific Balance Confidence Scale (ABCS), the Berg Balance Scale (BBS), and the One Leg Standing Test (OLST). Results A total of 101 participants enrolled in the study. Advertising in the local senior newspaper was the most effective method of recruitment (46%). The majority of our participants were white (86%) females (67%). About one third (32%) of participants had a baseline BBS score below 46, the cut-off point for predicting risk of falling. A mean improvement in BBS scores of 1.7 points was observed on the second visit. For the subgroup with baseline scores below 46, the mean change was 4.5 points, but the group mean remained below 46 (42.5). Conclusion Recruitment of community-dwelling seniors for fall-related research conducted at a chiropractic research center appears feasible, and the most successful recruitment strategies for this center appeared to be a combination of targeted newspaper ads and personal contact through senior centers. The

Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older.

PubMed

Hawk, Cheryl; Hyland, John K; Rupert, Ronald; Colonvega, Makasha; Hall, Stephanie

2006-01-27

Falls are a major health concern for older adults and their impact is a significant public health problem. The chief modifiable risk factors for falls in community-dwellers are psychotropic drugs, polypharmacy, environmental hazards, poor vision, lower extremity impairments, and balance impairments. This study focused on balance impairments. Its purpose was to assess the feasibility of recruiting older adults with possible balance problems for research conducted at a chiropractic research center, and to explore the utility of several widely used balance instruments for future studies of the effect of chiropractic care on balance in older adults. This descriptive study was conducted from September through December 2004. Participants were recruited through a variety of outreach methods, and all were provided with an educational intervention. Data were collected at each of two visits through questionnaires, interviews, and physical examinations. Balance was assessed on both visits using the Activities-specific Balance Confidence Scale (ABCS), the Berg Balance Scale (BBS), and the One Leg Standing Test (OLST). A total of 101 participants enrolled in the study. Advertising in the local senior newspaper was the most effective method of recruitment (46%). The majority of our participants were white (86%) females (67%). About one third (32%) of participants had a baseline BBS score below 46, the cut-off point for predicting risk of falling. A mean improvement in BBS scores of 1.7 points was observed on the second visit. For the subgroup with baseline scores below 46, the mean change was 4.5 points, but the group mean remained below 46 (42.5). Recruitment of community-dwelling seniors for fall-related research conducted at a chiropractic research center appears feasible, and the most successful recruitment strategies for this center appeared to be a combination of targeted newspaper ads and personal contact through senior centers. The BBS and OLST appear to be promising

Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial.

PubMed

Meldrum, Dara; Herdman, Susan; Vance, Roisin; Murray, Deirdre; Malone, Kareena; Duffy, Douglas; Glennon, Aine; McConn-Walsh, Rory

2015-07-01

To compare the effectiveness of virtual reality-based balance exercises to conventional balance exercises during vestibular rehabilitation in patients with unilateral peripheral vestibular loss (UVL). Assessor-blind, randomized controlled trial. Two acute care university teaching hospitals. Patients with UVL (N=71) who had dizziness/vertigo, and gait and balance impairment. Patients with UVL were randomly assigned to receive 6 weeks of either conventional (n=36) or virtual reality-based (n=35) balance exercises during vestibular rehabilitation. The virtual reality-based group received an off-the-shelf virtual reality gaming system for home exercise, and the conventional group received a foam balance mat. Treatment comprised weekly visits to a physiotherapist and a daily home exercise program. The primary outcome was self-preferred gait speed. Secondary outcomes included other gait parameters and tasks, Sensory Organization Test (SOT), dynamic visual acuity, Hospital Anxiety and Depression Scale, Vestibular Rehabilitation Benefits Questionnaire, and Activities Balance Confidence Questionnaire. The subjective experience of vestibular rehabilitation was measured with a questionnaire. Both groups improved, but there were no significant differences in gait speed between the groups postintervention (mean difference, -.03m/s; 95% confidence interval [CI], -.09 to .02m/s). There were also no significant differences between the groups in SOT scores (mean difference, .82%; 95% CI, -5.00% to 6.63%) or on any of the other secondary outcomes (P>.05). In both groups, adherence to exercise was high (∼77%), but the virtual reality-based group reported significantly more enjoyment (P=.001), less difficulty with (P=.009) and less tiredness after (P=.03) balance exercises. At 6 months, there were no significant between-group differences in physical outcomes. Virtual reality-based balance exercises performed during vestibular rehabilitation were not superior to conventional balance

Hydrology beyond closing the water balance: energy conservative scaling of gradient flux relations

NASA Astrophysics Data System (ADS)

Zehe, Erwin; Loritz, Ralf; Jackisch, Conrad

2017-04-01

The value of physically-based models has been doubted since their idea was introduced by Freeze and Harlan. Physically-based models like typically rely on the Darcy-Richards concept for soil water dynamics, the Penman-Monteith equation for soil-vegetation-atmosphere exchange processes and hydraulic approaches for overland and stream flow. Each of these concepts is subject to limitations arising from our imperfect understanding of the related processes and is afflicted by the restricted transferability of process descriptions from idealized laboratory conditions to heterogeneous natural systems. Particularly the non-linearity of soil water characteristics in concert with the baffling heterogeneity subsurface properties is usually seen as the dead end for a meaningful application of physically based models outside of well observed research catchments and, more importantly, for an upscaling of point scale flux - gradient relation-ships. This study provides evidence that an energy conservative scaling of topographic gradients and soil water retention curves allows derivation of useful effective catchment scale topography and retention curve from distributed data, which allow successful simulations of the catchment water balance in two distinctly different landscapes. The starting point of our approach is that subsurface water fluxes are driven by differences in potential energy and chemical/capillary binding energy. The relief of a single hillslope controls the potential energy gradients driving downslope flows of free water, while catchment scale variability in hillslope relief is associated with differences in driving potential energy. It is more important to note that the soil water retention curve characterises the density of capillary binding energy of soil water (usually named soil water potential) at a given soil water content. Spatially variable soil water characteristics hence reflect fluctuations in capillary binding energy of soil water at a given soil water

Balance Sheets Versus Decision Dashboards to Support Patient Treatment Choices: A Comparative Analysis.

PubMed

Dolan, James G; Veazie, Peter J

2015-12-01

Growing recognition of the importance of involving patients in preference-driven healthcare decisions has highlighted the need to develop practical strategies to implement patient-centered shared decision-making. The use of tabular balance sheets to support clinical decision-making is well established. More recent evidence suggests that graphic, interactive decision dashboards can help people derive deeper a understanding of information within a specific decision context. We therefore conducted a non-randomized trial comparing the effects of adding an interactive dashboard to a static tabular balance sheet on patient decision-making. The study population consisted of members of the ResearchMatch registry who volunteered to participate in a study of medical decision-making. Two separate surveys were conducted: one in the control group and one in the intervention group. All participants were instructed to imagine they were newly diagnosed with a chronic illness and were asked to choose between three hypothetical drug treatments, which varied with regard to effectiveness, side effects, and out-of-pocket cost. Both groups made an initial treatment choice after reviewing a balance sheet. After a brief "washout" period, members of the control group made a second treatment choice after reviewing the balance sheet again, while intervention group members made a second treatment choice after reviewing an interactive decision dashboard containing the same information. After both choices, participants rated their degree of confidence in their choice on a 1 to 10 scale. Members of the dashboard intervention group were more likely to change their choice of preferred drug (10.2 versus 7.5%; p = 0.054) and had a larger increase in decision confidence than the control group (0.67 versus 0.075; p < 0.03). There were no statistically significant between-group differences in decisional conflict or decision aid acceptability. These findings suggest that clinical decision dashboards may

Balancing Certainty and Uncertainty in Clinical Practice

ERIC Educational Resources Information Center

Kamhi, Alan G.

2011-01-01

Purpose: In this article, I question how practitioners can balance the certainty and confidence that they can help their patients with the uncertainty that makes them continually question their beliefs and assumptions. Method: I compare the mechanisms of science and models of clinical practice that may help practitioners achieve the right balance…

Curling for Confidence: Psychophysical Benefits of Curling for Older Adults.

PubMed

Stone, Rachael C; Rakhamilova, Zina; Gage, William H; Baker, Joseph

2018-04-01

While physical activity is increasingly promoted for older adults, there is a paucity of sport promotion, which has distinct benefits from exercise and remains stereotypically associated with younger age. Curling is a moderately intense and safe sport that continues to gain popularity; however, no research has investigated psychophysical benefits of curling for older adults. The present study compares high-experience (20+ years; n = 63) and low-experience (<20 years; n = 53) curlers (aged 60+ years) with older adult noncurlers (n = 44) on measures of daily functionality, balance confidence, and perceptions of the aging process. While no significant differences were found between high- and low-experience curlers, any level of experience reported significantly better functionality, physical confidence, and aging attitudes compared to noncurlers (p ≤ .05). Although further research is necessary, the results suggest that any level of curling experience can enhance older adult psychophysical well-being, and warrants consideration for physical activity promotion and falls prevention programs.

Isometric Scaling in Developing Long Bones Is Achieved by an Optimal Epiphyseal Growth Balance

PubMed Central

Stern, Tomer; Aviram, Rona; Rot, Chagai; Galili, Tal; Sharir, Amnon; Kalish Achrai, Noga; Keller, Yosi; Shahar, Ron; Zelzer, Elazar

2015-01-01

One of the major challenges that developing organs face is scaling, that is, the adjustment of physical proportions during the massive increase in size. Although organ scaling is fundamental for development and function, little is known about the mechanisms that regulate it. Bone superstructures are projections that typically serve for tendon and ligament insertion or articulation and, therefore, their position along the bone is crucial for musculoskeletal functionality. As bones are rigid structures that elongate only from their ends, it is unclear how superstructure positions are regulated during growth to end up in the right locations. Here, we document the process of longitudinal scaling in developing mouse long bones and uncover the mechanism that regulates it. To that end, we performed a computational analysis of hundreds of three-dimensional micro-CT images, using a newly developed method for recovering the morphogenetic sequence of developing bones. Strikingly, analysis revealed that the relative position of all superstructures along the bone is highly preserved during more than a 5-fold increase in length, indicating isometric scaling. It has been suggested that during development, bone superstructures are continuously reconstructed and relocated along the shaft, a process known as drift. Surprisingly, our results showed that most superstructures did not drift at all. Instead, we identified a novel mechanism for bone scaling, whereby each bone exhibits a specific and unique balance between proximal and distal growth rates, which accurately maintains the relative position of its superstructures. Moreover, we show mathematically that this mechanism minimizes the cumulative drift of all superstructures, thereby optimizing the scaling process. Our study reveals a general mechanism for the scaling of developing bones. More broadly, these findings suggest an evolutionary mechanism that facilitates variability in bone morphology by controlling the activity of

Influence of a School-Based Cooking Course on Students' Food Preferences, Cooking Skills, and Confidence.

PubMed

Zahr, Rola; Sibeko, Lindiwe

2017-03-01

A quasi-experimental study was conducted to evaluate the influence of Project CHEF, a hands-on cooking and tasting program offered in Vancouver public schools, on students' food preferences, cooking skills, and confidence. Grade 4 and 5 students in an intervention group (n = 68) and a comparison group (n = 32) completed a survey at baseline and 2 to 3 weeks later. Students who participated in Project CHEF reported an increased familiarity and preference for the foods introduced through the program. This was statistically significant (P ≤ 0.05) for broccoli, swiss chard, carrots, and quinoa. A higher percentage of students exposed to Project CHEF reported a statistically significant increase (P ≤ 0.05) in: cutting vegetables and fruit (97% vs 81%), measuring ingredients (67% vs 44%), using a knife (94% vs 82%), and making a balanced meal on their own (69% vs 34%). They also reported a statistically significant increase (P ≤ 0.05) in confidence making the recipes introduced in the program: fruit salad (85% vs 81%), minestrone soup (25% vs 10%), and vegetable tofu stir fry (39% vs 26%). Involving students in hands-on cooking and tasting programs can increase their preferences for unpopular or unfamiliar foods and provide them with the skills and cooking confidence they need to prepare balanced meals.

Quantifying catchment water balances and their uncertainties by expert elicitation

NASA Astrophysics Data System (ADS)

Sebok, Eva; Refsgaard, Jens Christian; Warmink, Jord J.; Stisen, Simon; Høgh Jensen, Karsten

2017-04-01

The increasing demand on water resources necessitates a more responsible and sustainable water management requiring a thorough understanding of hydrological processes both on small scale and on catchment scale. On catchment scale, the characterization of hydrological processes is often carried out by calculating a water balance based on the principle of mass conservation in hydrological fluxes. Assuming a perfect water balance closure and estimating one of these fluxes as a residual of the water balance is a common practice although this estimate will contain uncertainties related to uncertainties in the other components. Water balance closure on the catchment scale is also an issue in Denmark, thus, it was one of the research objectives of the HOBE hydrological observatory, that has been collecting data in the Skjern river catchment since 2008. Water balance components in the 1050 km2 Ahlergaarde catchment and the nested 120 km2 Holtum catchment, located in the glacial outwash plan of the Skjern catchment, were estimated using a multitude of methods. As the collected data enables the complex assessment of uncertainty of both the individual water balance components and catchment-scale water balances, the expert elicitation approach was chosen to integrate the results of the hydrological observatory. This approach relies on the subjective opinion of experts whose available knowledge and experience about the subject allows to integrate complex information from multiple sources. In this study 35 experts were involved in a multi-step elicitation process with the aim of (1) eliciting average annual values of water balance components for two nested catchments and quantifying the contribution of different sources of uncertainties to the total uncertainty in these average annual estimates; (2) calculating water balances for two catchments by reaching consensus among experts interacting in form of group discussions. To address the complex problem of water balance closure

Confidence intervals for a difference between lognormal means in cluster randomization trials.

PubMed

Poirier, Julia; Zou, G Y; Koval, John

2017-04-01

Cluster randomization trials, in which intact social units are randomized to different interventions, have become popular in the last 25 years. Outcomes from these trials in many cases are positively skewed, following approximately lognormal distributions. When inference is focused on the difference between treatment arm arithmetic means, existent confidence interval procedures either make restricting assumptions or are complex to implement. We approach this problem by assuming log-transformed outcomes from each treatment arm follow a one-way random effects model. The treatment arm means are functions of multiple parameters for which separate confidence intervals are readily available, suggesting that the method of variance estimates recovery may be applied to obtain closed-form confidence intervals. A simulation study showed that this simple approach performs well in small sample sizes in terms of empirical coverage, relatively balanced tail errors, and interval widths as compared to existing methods. The methods are illustrated using data arising from a cluster randomization trial investigating a critical pathway for the treatment of community acquired pneumonia.

Tomboys, masculine characteristics, and self-ratings of confidence in career success.

PubMed

Hilgenkamp, Kathryn D; Livingston, Mary Margaret

2002-06-01

Previous research focusing on gender-roles and self-concept suggests a positive relationship between masculinity and self-concept. The present study explores self-perceptions of being a "tomboy," gender-role and ratings of self-confidence in later success. Higher self-ratings on the tomboy scale correlated with confidence in career success but not with confidence in passing a college course or jogging for 20 min. There was a positive correlation between masculinity scores but not femininity scores with tomboy ratings. Masculine characteristics such as independence, aggression competitiveness, leadership ability, ability to defend, stand by beliefs, mediated by compassion appear to be positively correlated with perceptions of success.

Conceptual design and quantification of phosphorus flows and balances at the country scale: The case of France

NASA Astrophysics Data System (ADS)

Senthilkumar, Kalimuthu; Nesme, Thomas; Mollier, Alain; Pellerin, Sylvain

2012-06-01

Global biogeochemical cycles have been deeply modified by human activities in recent decades. But detailed studies analyzing the influence of current economic and social organizations on global biogeochemical cycles within a system perspective are still required. Country level offers a relevant scale for assessing nutrient management and identifying key driving forces and possible leaks in the nutrient cycle. Conceptual modeling helps to quantify nutrient flows within the country and we developed such an approach for France. France is a typical Western European country with intensive agriculture, trade and an affluent diet, all of which may increase internal and external P flows. Phosphorus (P) was taken as a case study because phosphate rock is a non-renewable resource which future availability is becoming increasingly bleak. A conceptual model of major P flows at the country scale was designed. France was divided into agriculture, industry, domestic, import and export sectors, and each of these sectors was further divided into compartments. A total of 25 internal and eight external P flows were identified and quantified on a yearly basis for a period of 16 years (from 1990 to 2006) in order to understand long-term P flows. All the P flows were quantified using the substance flow analysis principle. The results showed that the industrial sector remained the largest contributor to P flows in France, followed by the agriculture and domestic sectors. Soil P balance was positive. However, a positive P balance of 18 kg P ha-1 in 1990 was reduced to 4 kg P ha-1 in 2006, mainly due to the reduced application of inorganic P fertilizer. The overall country scale P balance was positive, whereas half of this additional P was lost to the environment mainly through the landfilling of municipal and industrial waste, disposal of treated wastewater from which P was partially removed, and P losses from agricultural soils though erosion and leaching. Consequences for global P

Career Self-Efficacy and Personality: Linking Career Confidence and the Healthy Personality

ERIC Educational Resources Information Center

Borgen, Fred H.; Betz, Nancy E.

2008-01-01

This article extends recent work on the relationship between personality and career self-efficacy by examining relationships across two new inventories with scales for identifying human strengths. The Healthy Personality Inventory (HPI) has 17 content scales tapping an array of positive personality measures. The CAPA Confidence Inventory (CCI) has…

Family presence during resuscitation in a paediatric hospital: health professionals' confidence and perceptions.

PubMed

McLean, Julie; Gill, Fenella J; Shields, Linda

2016-04-01

To investigate medical and nursing staff's perceptions of and self-confidence in facilitating family presence during resuscitation in a paediatric hospital setting. Family presence during resuscitation is the attendance of family members in a location that affords visual or physical contact with the patient during resuscitation. Providing the opportunity for families to be present during resuscitation embraces the family-centred care philosophy which underpins paediatric care. Having families present continues to spark much debate amongst health care professionals. A descriptive cross-sectional randomised survey using the 'Family Presence Risk/Benefit Scale' and the 'Family Presence Self-Confidence Scale 'to assess health care professionals' (doctors and nurses) perceptions and self-confidence in facilitating family presence during resuscitation of a child in a paediatric hospital. Surveys were distributed to 300 randomly selected medical and nursing staff. Descriptive and inferential statistics were used to compare medical and nursing, and critical and noncritical care perceptions and self-confidence. Critical care staff had statistically significant higher risk/benefit scores and higher self-confidence scores than those working in noncritical care areas. Having experience in paediatric resuscitation, having invited families to be present previously and a greater number of years working in paediatrics significantly affected participants' perceptions and self-confidence. There was no difference between medical and nursing mean scores for either scale. Both medical and nursing staff working in the paediatric setting understood the needs of families and the philosophy of family-centred care is a model of care practised across disciplines. This has implications both for implementing guidelines to support family presence during resuscitation and for education strategies to shift the attitudes of staff who have limited or no experience. © 2016 John Wiley & Sons Ltd.

Identifying Balance Measures Most Likely to Identify Recent Falls.

PubMed

Criter, Robin E; Honaker, Julie A

2016-01-01

Falls sustained by older adults are an increasing health care issue. Early identification of those at risk for falling can lead to successful prevention of falls. Balance complaints are common among individuals who fall or are at risk for falling. The purpose of this study was to evaluate the clinical utility of a multifaceted balance protocol used for fall risk screening, with the hypothesis that this protocol would successfully identify individuals who had a recent fall (within the previous 12 months). This is a retrospective review of 30 individuals who self-referred for a free fall risk screening. Measures included case history, Activities-Specific Balance Confidence Scale, modified Clinical Test of Sensory Interaction on Balance, Timed Up and Go test, and Dynamic Visual Acuity. Statistical analyses were focused on the ability of the test protocol to identify a fall within the past 12 months and included descriptive statistics, clinical utility indices, logistic regression, receiver operating characteristic curve, area under the curve analysis, effect size (Cohen d), and Spearman correlation coefficients. All individuals who self-referred for this free screening had current imbalance complaints, and were typically women (70%), had a mean age of 77.2 years, and had a fear of falling (70%). Almost half (46.7%) reported at least 1 lifetime fall and 40.0% within the past 12 months. Regression analysis suggested that the Timed Up and Go test was the most important indicator of a recent fall. A cutoff score of 12 or more seconds was optimal (sensitivity: 83.3%; specificity: 61.1%). Older adults with current complaints of imbalance have a higher rate of falls, fall-related injury, and fear of falling than the general community-dwelling public. The Timed Up and Go test is useful for determining recent fall history in individuals with imbalance.

Resident physicians' attitudes and confidence in communicating with patients: a pilot study at a Japanese university hospital.

PubMed

Ishikawa, Hirono; Eto, Masato; Kitamura, Kiyoshi; Kiuchi, Takahiro

2014-09-01

This study aimed to explore the relationships among physicians' confidence in conducting medical interviews, their attitudes toward the patient-physician relationship, and undergraduate training in communication skills among resident physicians in Japan. Participants were 63 first-year resident physicians at a university hospital in Tokyo. The Physician Confidence in the Medical Interview scale (PCMI) was constructed based on the framework of the Calgary-Cambridge Guide. Additionally, participants' attitudes toward the patient-physician relationship (Patient-Practitioner Orientation Scale; PPOS), undergraduate experience of communication skills training, and demographic characteristics were assessed through a self-reported questionnaire. The internal consistency of the PCMI and PPOS scales were adequate. As expected from the undergraduate curriculum for medical interviews in Japan, residents had relatively higher confidence in their communication skills with respect to gathering information and building the relationship, whereas less confident about sharing information and planning treatment. The PCMI was associated with a more patient-centered attitude as measured by the PPOS. These scales could be useful tools to measure physicians' confidence and attitudes in communicating with patients and to explore their changes through medical education. Residency programs should consider including systematic training and assessment in communication skills related to sharing information and planning treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Case report: a balance training program using the Nintendo Wii Fit to reduce fall risk in an older adult with bilateral peripheral neuropathy.

PubMed

Hakim, Renée Marie; Salvo, Charles J; Balent, Anthony; Keyasko, Michael; McGlynn, Deidre

2015-02-01

A recent systematic review supported the use of strength and balance training for older adults at risk for falls, and provided preliminary evidence for those with peripheral neuropathy (PN). However, the role of gaming systems in fall risk reduction was not explored. The purpose of this case report was to describe the use of the Nintendo® Wii™ Fit gaming system to train standing balance in a community-dwelling older adult with PN and a history of recurrent near falls. A 76-year-old patient with bilateral PN participated in 1 h of Nintendo® Wii™ Fit balance training, two times a week for 6 weeks. Examination was conducted using a Computerized Dynamic Posturography system (i.e. Sensory Organization Test (SOT), Limits of Stability (LOS), Adaptation Test (ADT) and Motor Control Test (MCT) and clinical testing with the Berg Balance Scale (BBS), Timed Up and Go (TUG), Activities-specific Balance Confidence (ABC) scale and 30-s Chair Stand. Following training, sensory integration scores on the SOT were unchanged. Maximum excursion abilities improved by a range of 37-86% on the LOS test. MCT scores improved for amplitude with forward translations and ADT scores improved for downward platform rotations. Clinical scores improved on the BBS (28/56-34/56), ABC (57.5-70.6%) and TUG (14.9-10.9 s) which indicated reduced fall risk. Balance training with a gaming system showed promise as a feasible, objective and enjoyable method to improve physical performance and reduce fall risk in an individual with PN.

A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults.

PubMed

Whyatt, Caroline; Merriman, Niamh A; Young, William R; Newell, Fiona N; Craig, Cathy

2015-12-01

Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall. Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments. Balance game training had a significant effect on levels of functional balance and balance confidence (P < 0.05). This was further demonstrated in participants who were deemed at high risk of falls. The overall pattern of results suggests the training program is effective and suitable for individuals at all levels of ability and may therefore play a role in reducing the risk of falls. Commercial hardware can be modified to deliver engaging methods of effective balance assessment and training for the older population.

Well-being as a moving target: measurement equivalence of the Bradburn Affect Balance Scale.

PubMed

Maitland, S B; Dixon, R A; Hultsch, D F; Hertzog, C

2001-03-01

Although the Bradburn Affect Balance scale (ABS) is a frequently used two-factor indicator of well-being in later life, its measurement and invariance properties are not well documented. We examined these issues using confirmatory factor analyses of cross-sectional (adults ages 54-87 years) and longitudinal data from the Victoria Longitudinal Study. Stability of the positive and negative affect factors was moderate across a 3-year period. Overall, factor loadings for positive affect items were invariant over time with the exception of the pleased item. Negative affect items were time invariant. However, age-group comparisons between young-old and old-old groups revealed age differences in loadings for the upset item at Time 1. Finally, gender groups differed in loadings for the top of the world and going your way items. Thus a pattern of partial measurement equivalence characterized item response to the ABS. Our results suggest that group comparisons and longitudinal change in ABS scale scores of positive and negative affect should be interpreted with caution.

Variations in clinical nurse leaders' confidence with performing the core role functions.

PubMed

Gilmartin, Mattia J

2014-01-01

Clinical nurse leader (CNL) practice, by definition, requires individuals to make career transitions. CNLs must adjust to their new work role and responsibilities and doing so also entails individual adjustment. Prior work has not examined the role of individual-level factors in effective CNL role transition. This study contributes to CNL implementation efforts by developing understanding of personal and contextual factors that explain variation in individuals' levels of self-confidence with performing the key functions of the CNL role. Data were gathered using a cross-sectional survey from a national sample of registered nurses (RNs) certified as CNLs. Respondents' perceptions of their confidence in performing CNL role competencies were measured with the Clinical Nurse Leader Self-Efficacy Scale (CNLSES; Gilmartin MJ, Nokes, K. (in press). The Clinical Nurse Leader Self Efficacy Scale: Results of a pilot study. Nursing Economic$). The CNLSES is a 35-item state-specific self-efficacy scale with established measurement properties that assesses nurses' perceptions of their ability to function effectively as a CNL. Demographic data were also collected. Data were analyzed using a general linear regression model. One hundred forty-seven certified CNLs participated in the survey. Results indicate that respondents vary in their confidence with performing the nine role competencies associated with CNL practice. Results from regression analyses also show that respondents' confidence in their abilities to carry out the core functions associated with the CNL role varied significantly across geographic region, organizational type, and by CNL graduate program model. The results of this study show important differences in CNLs' levels of self-confidence with the core competencies of their role. As a result, it may be important to develop targeted career transition interventions to gain the full benefit of CNL practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Learning visual balance from large-scale datasets of aesthetically highly rated images

NASA Astrophysics Data System (ADS)

Jahanian, Ali; Vishwanathan, S. V. N.; Allebach, Jan P.

2015-03-01

The concept of visual balance is innate for humans, and influences how we perceive visual aesthetics and cognize harmony. Although visual balance is a vital principle of design and taught in schools of designs, it is barely quantified. On the other hand, with emergence of automantic/semi-automatic visual designs for self-publishing, learning visual balance and computationally modeling it, may escalate aesthetics of such designs. In this paper, we present how questing for understanding visual balance inspired us to revisit one of the well-known theories in visual arts, the so called theory of "visual rightness", elucidated by Arnheim. We define Arnheim's hypothesis as a design mining problem with the goal of learning visual balance from work of professionals. We collected a dataset of 120K images that are aesthetically highly rated, from a professional photography website. We then computed factors that contribute to visual balance based on the notion of visual saliency. We fitted a mixture of Gaussians to the saliency maps of the images, and obtained the hotspots of the images. Our inferred Gaussians align with Arnheim's hotspots, and confirm his theory. Moreover, the results support the viability of the center of mass, symmetry, as well as the Rule of Thirds in our dataset.

Balanced Atmospheric Data Assimilation

NASA Astrophysics Data System (ADS)

Hastermann, Gottfried; Reinhardt, Maria; Klein, Rupert; Reich, Sebastian

2017-04-01

The atmosphere's multi-scale structure poses several major challenges in numerical weather prediction. One of these arises in the context of data assimilation. The large-scale dynamics of the atmosphere are balanced in the sense that acoustic or rapid internal wave oscillations generally come with negligibly small amplitudes. If triggered artificially, however, through inappropriate initialization or by data assimilation, such oscillations can have a detrimental effect on forecast quality as they interact with the moist aerothermodynamics of the atmosphere. In the setting of sequential Bayesian data assimilation, we therefore investigate two different strategies to reduce these artificial oscillations induced by the analysis step. On the one hand, we develop a new modification for a local ensemble transform Kalman filter, which penalizes imbalances via a minimization problem. On the other hand, we modify the first steps of the subsequent forecast to push the ensemble members back to the slow evolution. We therefore propose the use of certain asymptotically consistent integrators that can blend between the balanced and the unbalanced evolution model seamlessly. In our work, we furthermore present numerical results and performance of the proposed methods for two nonlinear ordinary differential equation models, where we can identify the different scales clearly. The first one is a Lorenz 96 model coupled with a wave equation. In this case the balance relation is linear and the imbalances are caused only by the localization of the filter. The second one is the elastic double pendulum where the balance relation itself is already highly nonlinear. In both cases the methods perform very well and could significantly reduce the imbalances and therefore increase the forecast quality of the slow variables.

Effects of hearing aids in the balance, quality of life and fear to fall in elderly people with sensorineural hearing loss

PubMed Central

Lacerda, Clara Fonseca; Silva, Luciana Oliveira e; de Tavares Canto, Roberto Sérgio; Cheik, Nadia Carla

2012-01-01

Summary Introduction: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. Objective: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. Method: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI). The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36), Falls Efficacy International Scale- (FES-I) and the test of Berg Balance Scale (BBS). After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. Results: It had 50% of adaptation of the aged ones to the AASI. It was observed that the masculine sex had greater difficulty in adapting to the auditory device and that the variable age, degree of loss, presence of humming and vertigo had not intervened with the adaptation to auditory prosthesis. It had improvement of the quality of life in the dominance of the State General Health (EGS) and Functional Capacity (CF) and of the humming, as well as the increase of the auto-confidence after adaptation of auditory prosthesis. Conclusion: The use of auditory prosthesis provided the improvement of the domains of the quality of life, what it reflected consequently in one better auto-confidence and in the long run in the reduction of the fear of fall in aged with sensorineural auditory loss. PMID:25991930

Perceptions of balance and falls following a supervised training intervention - a qualitative study of people with Parkinson's disease.

PubMed

Leavy, Breiffni; Berntsson, Johan; Franzén, Erika; Skavberg Roaldsen, Kirsti

2017-12-21

To explore perceptions of balance and falls among people with mild to moderate Parkinson's disease 3 - 12 months following participation in supervised balance training. This qualitative study used in-depth individual interviews for data collection among 13 people with Parkinson's disease. Interviews were systematically analyzed using qualitative content analysis with an inductive approach. Three main themes arose: Falls - avoided and intended highlights the wide spectrum of fall perceptions, ranging from worse-case scenario to undramatized events; Balance identity incorporates how gradual deterioration in balance served as a reminder of disease progression and how identifying themselves as "aware not afraid" helped certain participants to maintain balance confidence despite everyday activity restriction; Training as treatment recounts how participants used exercise as disease self-management with the aim to maintain independence in daily life. Interpretation of the underlying patterns of these main themes resulted in the overarching theme Training as treatment when battling problems with balance and falls. Whereas certain participants expressed a fear of falling which they managed by activity restriction, others described being confident in their balance despite avoidance of balance-challenging activities. Training was used as treatment to self-manage disease-related balance impairments in order to maintain independence in daily life. Implication for Rehabilitation People with Parkinson's disease require early advice about the positive effects of physical activity as well as strategies for self-management in order to ease the psychological and physical burden of progressive balance impairment. Fear of falling should be investigated alongside activity avoidance in this group in order to provide a more accurate insight into the scope of psychological concerns regarding balance and falls in everyday life. Certain people with Parkinson's disease define their

Responsibility and confidence

PubMed Central

Austin, Zubin

2013-01-01

Background: Despite the changing role of the pharmacist in patient-centred practice, pharmacists anecdotally reported little confidence in their clinical decision-making skills and do not feel responsible for their patients. Observational findings have suggested these trends within the profession, but there is a paucity of evidence to explain why. We conducted an exploratory study with an objective to identify reasons for the lack of responsibility and/or confidence in various pharmacy practice settings. Methods: Pharmacist interviews were conducted via written response, face-to-face or telephone. Seven questions were asked on the topic of responsibility and confidence as it applies to pharmacy practice and how pharmacists think these themes differ in medicine. Interview transcripts were analyzed and divided by common theme. Quotations to support these themes are presented. Results: Twenty-nine pharmacists were asked to participate, and 18 responded (62% response rate). From these interviews, 6 themes were identified as barriers to confidence and responsibility: hierarchy of the medical system, role definitions, evolution of responsibility, ownership of decisions for confidence building, quality and consequences of mentorship and personality traits upon admission. Discussion: We identified 6 potential barriers to the development of pharmacists’ self-confidence and responsibility. These findings have practical applicability for educational research, future curriculum changes, experiential learning structure and pharmacy practice. Due to bias and the limitations of this form of exploratory research and small sample size, evidence should be interpreted cautiously. Conclusion: Pharmacists feel neither responsible nor confident for their clinical decisions due to social, educational, experiential and personal reasons. Can Pharm J 2013;146:155-161. PMID:23795200

Find_tfSBP: find thermodynamics-feasible and smallest balanced pathways with high yield from large-scale metabolic networks.

PubMed

Xu, Zixiang; Sun, Jibin; Wu, Qiaqing; Zhu, Dunming

2017-12-11

Biologically meaningful metabolic pathways are important references in the design of industrial bacterium. At present, constraint-based method is the only way to model and simulate a genome-scale metabolic network under steady-state criteria. Due to the inadequate assumption of the relationship in gene-enzyme-reaction as one-to-one unique association, computational difficulty or ignoring the yield from substrate to product, previous pathway finding approaches can't be effectively applied to find out the high yield pathways that are mass balanced in stoichiometry. In addition, the shortest pathways may not be the pathways with high yield. At the same time, a pathway, which exists in stoichiometry, may not be feasible in thermodynamics. By using mixed integer programming strategy, we put forward an algorithm to identify all the smallest balanced pathways which convert the source compound to the target compound in large-scale metabolic networks. The resulting pathways by our method can finely satisfy the stoichiometric constraints and non-decomposability condition. Especially, the functions of high yield and thermodynamics feasibility have been considered in our approach. This tool is tailored to direct the metabolic engineering practice to enlarge the metabolic potentials of industrial strains by integrating the extensive metabolic network information built from systems biology dataset.

Assessing Pre-Service Teacher Attitudes and Skills with the Technology Integration Confidence Scale

ERIC Educational Resources Information Center

Browne, Jeremy

2009-01-01

As technology integration continues to gain importance, preservice teachers must develop higher levels of confidence and proficiency in using technology in their classrooms (Kay, 2006). The acceptance of the National Educational Technology Standards for Teachers (NETS-T) by National Council for Accreditation of Teacher Education (NCATE) has…

Home-Based Exercise Program Improves Balance and Fear of Falling in Community-Dwelling Older Adults with Mild Alzheimer's Disease: A Pilot Study.

PubMed

Padala, Kalpana P; Padala, Prasad R; Lensing, Shelly Y; Dennis, Richard A; Bopp, Melinda M; Roberson, Paula K; Sullivan, Dennis H

2017-01-01

Balance problems are common in older adults with Alzheimer's disease (AD). The objective was to study the effects of a Wii-Fit interactive video-game-led physical exercise program to a walking program on measures of balance in older adults with mild AD. A prospective randomized controlled parallel-group trial (Wii-Fit versus walking) was conducted in thirty community-dwelling older adults (73±6.2 years) with mild AD. Home-based exercises were performed under caregiver supervision for 8 weeks. Primary (Berg Balance Scale, BBS) and secondary outcomes (fear of falls and quality of life) were measured at baseline, 8 weeks (end of intervention), and 16 weeks (8-weeks post-intervention). At 8 weeks, there was a significantly greater improvement (average inter-group difference [95% CI]) in the Wii-Fit group compared to the walking group in BBS (4.8 [3.3-6.2], p < 0.001), after adjusting for baseline. This improvement was sustained at 16 weeks (3.5 [2.0-5.0], p < 0.001). Analyses of the secondary outcome measures indicated that there was a significantly greater improvement in the Wii-Fit group compared to walking group in Activity-specific Balance Confidence scale (6.5 [3.6-9.4], p < 0.001) and Falls Efficacy Scale (-4.8 [-7.6 to -2.0], p = 0.002) at 8 weeks. However, this effect was not sustained at 16 weeks. Quality of life improved in both groups at 8 weeks; however, there were no inter-group differences (p = 0.445). Home-based, caregiver-supervised Wii-Fit exercises improve balance and may reduce fear of falling in community-dwelling older adults with mild AD.

Registered nurse leadership style and confidence in delegation.

PubMed

Saccomano, Scott J; Pinto-Zipp, Genevieve

2011-05-01

  Leadership and confidence in delegation are two important explanatory constructs of nursing practice. The relationship between these constructs, however, is not clearly understood. To be successful in their roles as leaders, regardless of their experience, registered nurses (RNs) need to understand how to best delegate. The present study explored and described the relationship between RN leadership styles, demographic variables and confidence in delegation in a community teaching hospital. Utilizing a cross-sectional survey design, RNs employed in one acute care hospital completed questionnaires that measured leadership style [Path-Goal Leadership Questionnaire (PGLQ)] and confidence in delegating patient care tasks [Confidence and Intent to Delegate Scale (CIDS)]. Contrary to expectations, the data did not confirm a relationship between confidence in delegating tasks to unlicensed assistive personnel (UAPs) and leadership style. Nurses who were diploma or associate degree prepared were initially less confident in delegating tasks to UAPs as compared with RNs holding a bachelor's degree or higher. Further, after 5 years of clinical nursing experience, nurses with less educational experience reported more confidence in delegating tasks as compared with RNs with more educational experience. The lack of a relationship between leadership style and confidence in delegating patient care tasks were discussed in terms of the PGLQ classification criteria and hospital unit differences. As suggested by the significant two-way interaction between educational preparation and clinical nursing experience, changes in the nurse's confidence in delegating patient care tasks to UAPs was a dynamic changing variable that resulted from the interplay between amount of educational preparation and years of clinical nursing experience in this population of nurses. Clearly, generalizability of these findings to nurses outside the US is questionable, thus nurse managers must be familiar

Factor Structure and Measurement Invariance of a 10-Item Decisional Balance Scale: Longitudinal and Subgroup Examination within an Adult Diabetic Sample

ERIC Educational Resources Information Center

Pickering, Michael A.; Plotnikoff, Ronald C.

2009-01-01

This study explores the longitudinal and subgroup measurement properties of a 10-item, physical activity decisional balance scale, previously published by Plotnikoff, Blanchard, Hotz, and Rhodes (2001), within a diabetic sample of Canadian adults. Results indicated that a three-factor measurement model consistently improved model fit compared to…

Inverse Force Determination on a Small Scale Launch Vehicle Model Using a Dynamic Balance

NASA Technical Reports Server (NTRS)

Ngo, Christina L.; Powell, Jessica M.; Ross, James C.

2017-01-01

A launch vehicle can experience large unsteady aerodynamic forces in the transonic regime that, while usually only lasting for tens of seconds during launch, could be devastating if structural components and electronic hardware are not designed to account for them. These aerodynamic loads are difficult to experimentally measure and even harder to computationally estimate. The current method for estimating buffet loads is through the use of a few hundred unsteady pressure transducers and wind tunnel test. Even with a large number of point measurements, the computed integrated load is not an accurate enough representation of the total load caused by buffeting. This paper discusses an attempt at using a dynamic balance to experimentally determine buffet loads on a generic scale hammer head launch vehicle model tested at NASA Ames Research Center's 11' x 11' transonic wind tunnel. To use a dynamic balance, the structural characteristics of the model needed to be identified so that the natural modal response could be and removed from the aerodynamic forces. A finite element model was created on a simplified version of the model to evaluate the natural modes of the balance flexures, assist in model design, and to compare to experimental data. Several modal tests were conducted on the model in two different configurations to check for non-linearity, and to estimate the dynamic characteristics of the model. The experimental results were used in an inverse force determination technique with a psuedo inverse frequency response function. Due to the non linearity, the model not being axisymmetric, and inconsistent data between the two shake tests from different mounting configuration, it was difficult to create a frequency response matrix that satisfied all input and output conditions for wind tunnel configuration to accurately predict unsteady aerodynamic loads.

Payload test philosophy. [to provide confidence in Shuttle structural math models

NASA Technical Reports Server (NTRS)

Mayhew, D.

1979-01-01

Shuttle payload test philosophy is discussed with reference to testing to provide confidence in Shuttle structural math models. Particular attention is given the Shuttle quarter-scale program and the Mated Vertical Ground Vibration Test Program.

Remote sensing of a coupled carbon-water-energy-radiation balances from the Globe to plot scales

NASA Astrophysics Data System (ADS)

Ryu, Y.; Jiang, C.; Huang, Y.; Kim, J.; Hwang, Y.; Kimm, H.; Kim, S.

2016-12-01

Advancements in near-surface and satellite remote sensing technologies have enabled us to monitor the global terrestrial ecosystems at multiple spatial and temporal scales. An emergent challenge is how to formulate a coupled water, carbon, energy, radiation, and nitrogen cycles from remote sensing. Here, we report Breathing Earth System Simulator (BESS), which coupled radiation (shortwave, longwave, PAR, diffuse PAR), carbon (gross primary productivity, ecosystem respiration, net ecosystem exchange), water (evaporation), and energy (latent and sensible heat) balances across the global land at 1 km resolution, 8 daily between 2000 and 2015 using multiple satellite remote sensing. The performance of BESS was tested against field observations (FLUXNET, BSRN) and other independent products (MPI-BGC, MODIS, GLASS). We found that the coupled model, BESS showed on par with, or better performance than the other products which computed land surface fluxes individually. Lastly, we show one plot-level study conducted in a paddy rice to demonstrate how to couple radiation, carbon, water, nitrogen balances with a series of near-surface spectral sensors.

Balancing the Scholarship Demands of Forensics and Graduate Study.

ERIC Educational Resources Information Center

Kuper, Glenn

It is difficult to strike a balance between the demands placed on graduate students and those placed on graduate forensics assistants. The combination of duties as Graduate Forensics Assistants (GFAs)--baby sitters, confidants, teachers, travel agents, administrators, clerical workers, psychologists, proofreaders, authority figures, and finally,…

Estimating and validating surface energy fluxes at field scale over a heterogeneous land surfaces based on two-source energy balance model (TSEB)

USDA-ARS?s Scientific Manuscript database

Accurate estimation of surface energy fluxes at field scale over large areas has the potential to improve agricultural water management in arid and semiarid watersheds. Remote sensing may be the only viable approach for mapping fluxes over heterogeneous landscapes. The Two-Source Energy Balance mode...

A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

PubMed Central

Merriman, Niamh A.; Young, William R.; Newell, Fiona N.; Craig, Cathy

2015-01-01

Abstract Background: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall. Study Design: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments. Results: Balance game training had a significant effect on levels of functional balance and balance confidence (P < 0.05). This was further demonstrated in participants who were deemed at high risk of falls. The overall pattern of results suggests the training program is effective and suitable for individuals at all levels of ability and may therefore play a role in reducing the risk of falls. Conclusions: Commercial hardware can be modified to deliver engaging methods of effective balance assessment and training for the older population. PMID:26469308

Balance Assessment Practices and Use of Standardized Balance Measures Among Ontario Physical Therapists

PubMed Central

Sibley, Kathryn M.; Straus, Sharon E.; Inness, Elizabeth L.; Salbach, Nancy M.

2011-01-01

Background Balance impairment is a significant problem for older adults, as it can influence daily functioning. Treating balance impairment in this population is a major focus of physical therapist practice. Objective The purpose of this study was to document current practices in clinical balance assessment and compare components of balance assessed and measures used across practice areas among physical therapists. Design This was a cross-sectional study. Methods A survey questionnaire was mailed to 1,000 practicing physical therapists in Ontario, Canada. Results Three hundred sixty-nine individuals completed the survey questionnaire. More than 80% of respondents reported that they regularly (more than 60% of the time) assessed postural alignment, static and dynamic stability, functional balance, and underlying motor systems. Underlying sensory systems, cognitive contributions to balance, and reactive control were regularly assessed by 59.6%, 55.0%, and 41.2% of the respondents, respectively. The standardized measures regularly used by the most respondents were the single-leg stance test (79.1%), the Berg Balance Scale (45.0%), and the Timed “Up & Go” Test (27.6%). There was considerable variation in the components of balance assessed and measures used by respondents treating individuals in the orthopedic, neurologic, geriatric, and general rehabilitation populations. Limitations The survey provides quantitative data about what is done to assess balance, but does not explain the factors influencing current practice. Conclusions Many important components of balance and standardized measures are regularly used by physical therapists to assess balance. Further research, however, is needed to understand the factors contributing to the relatively lower rates of assessing reactive control, the component of balance most directly responsible for avoiding a fall. PMID:21868613

Soil organic matter dynamics and CO2 fluxes in relation to landscape scale processes: linking process understanding to regional scale carbon mass-balances

NASA Astrophysics Data System (ADS)

Van Oost, Kristof; Nadeu, Elisabet; Wiaux, François; Wang, Zhengang; Stevens, François; Vanclooster, Marnik; Tran, Anh; Bogaert, Patrick; Doetterl, Sebastian; Lambot, Sébastien; Van wesemael, Bas

2014-05-01

In this paper, we synthesize the main outcomes of a collaborative project (2009-2014) initiated at the UCL (Belgium). The main objective of the project was to increase our understanding of soil organic matter dynamics in complex landscapes and use this to improve predictions of regional scale soil carbon balances. In a first phase, the project characterized the emergent spatial variability in soil organic matter storage and key soil properties at the regional scale. Based on the integration of remote sensing, geomorphological and soil analysis techniques, we quantified the temporal and spatial variability of soil carbon stock and pool distribution at the local and regional scales. This work showed a linkage between lateral fluxes of C in relation with sediment transport and the spatial variation in carbon storage at multiple spatial scales. In a second phase, the project focused on characterizing key controlling factors and process interactions at the catena scale. In-situ experiments of soil CO2 respiration showed that the soil carbon response at the catena scale was spatially heterogeneous and was mainly controlled by the catenary variation of soil physical attributes (soil moisture, temperature, C quality). The hillslope scale characterization relied on advanced hydrogeophysical techniques such as GPR (Ground Penetrating Radar), EMI (Electromagnetic induction), ERT (Electrical Resistivity Tomography), and geophysical inversion and data mining tools. Finally, we report on the integration of these insights into a coupled and spatially explicit model and its application. Simulations showed that C stocks and redistribution of mass and energy fluxes are closely coupled, they induce structured spatial and temporal patterns with non negligible attached uncertainties. We discuss the main outcomes of these activities in relation to sink-source behavior and relevance of erosion processes for larger-scale C budgets.

Nursing students' confidence in medication calculations predicts math exam performance.

PubMed

Andrew, Sharon; Salamonson, Yenna; Halcomb, Elizabeth J

2009-02-01

The aim of this study was to examine the psychometric properties, including predictive validity, of the newly-developed nursing self-efficacy for mathematics (NSE-Math). The NSE-Math is a 12 item scale that comprises items related to mathematic and arithmetic concepts underpinning medication calculations. The NSE-Math instrument was administered to second year Bachelor of Nursing students enrolled in a nursing practice subject. Students' academic results for a compulsory medication calculation examination for this subject were collected. One-hundred and twelve students (73%) completed both the NSE-Math instrument and the drug calculation assessment task. The NSE-Math demonstrated two factors 'Confidence in application of mathematic concepts to nursing practice' and 'Confidence in arithmetic concepts' with 63.5% of variance explained. Cronbach alpha for the scale was 0.90. The NSE-Math demonstrated predictive validity with the medication calculation examination results (p=0.009). Psychometric testing suggests the NSE-Math is a valid measure of mathematics self-efficacy of second year nursing students.

Raising Confident Kids

MedlinePlus

... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body ... Videos for Educators Search English Español Raising Confident Kids KidsHealth / For Parents / Raising Confident Kids What's in ...

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

PubMed

Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

2017-12-21

Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001). Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

We will be champions: Leaders' confidence in 'us' inspires team members' team confidence and performance.

PubMed

Fransen, K; Steffens, N K; Haslam, S A; Vanbeselaere, N; Vande Broek, G; Boen, F

2016-12-01

The present research examines the impact of leaders' confidence in their team on the team confidence and performance of their teammates. In an experiment involving newly assembled soccer teams, we manipulated the team confidence expressed by the team leader (high vs neutral vs low) and assessed team members' responses and performance as they unfolded during a competition (i.e., in a first baseline session and a second test session). Our findings pointed to team confidence contagion such that when the leader had expressed high (rather than neutral or low) team confidence, team members perceived their team to be more efficacious and were more confident in the team's ability to win. Moreover, leaders' team confidence affected individual and team performance such that teams led by a highly confident leader performed better than those led by a less confident leader. Finally, the results supported a hypothesized mediational model in showing that the effect of leaders' confidence on team members' team confidence and performance was mediated by the leader's perceived identity leadership and members' team identification. In conclusion, the findings of this experiment suggest that leaders' team confidence can enhance members' team confidence and performance by fostering members' identification with the team. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Graduating general surgery resident operative confidence: perspective from a national survey.

PubMed

Fonseca, Annabelle L; Reddy, Vikram; Longo, Walter E; Gusberg, Richard J

2014-08-01

General surgical training has changed significantly over the last decade with work hour restrictions, increasing subspecialization, the expanding use of minimally invasive techniques, and nonoperative management for solid organ trauma. Given these changes, this study was undertaken to assess the confidence of graduating general surgery residents in performing open surgical operations and to determine factors associated with increased confidence. A survey was developed and sent to general surgery residents nationally. We queried them regarding demographics and program characteristics, asked them to rate their confidence (rated 1-5 on a Likert scale) in performing open surgical procedures and compared those who indicated confidence with those who did not. We received 653 responses from the fifth year (postgraduate year 5) surgical residents: 69% male, 68% from university programs, and 51% from programs affiliated with a Veterans Affairs hospital; 22% from small programs, 34% from medium programs, and 44% from large programs. Anticipated postresidency operative confidence was 72%. More than 25% of residents reported a lack of confidence in performing eight of the 13 operations they were queried about. Training at a university program, a large program, dedicated research years, future fellowship plans, and training at a program that performed a large percentage of operations laparoscopically was associated with decreased confidence in performing a number of open surgical procedures. Increased surgical volume was associated with increased operative confidence. Confidence in performing open surgery also varied regionally. Graduating surgical residents indicated a significant lack of confidence in performing a variety of open surgical procedures. This decreased confidence was associated with age, operative volume as well as type, and location of training program. Analyzing and addressing this confidence deficit merits further study. Copyright © 2014 Elsevier Inc. All

NREL Offshore Balance-of-System Model

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

Maness, Michael; Maples, Benjamin; Smith, Aaron

The U.S. Department of Energy (DOE) has investigated the potential for 20% of nationwide electricity demand to be generated from wind by 2030 and, more recently, 35% by 2050. Achieving this level of wind power generation may require the development and deployment of offshore wind technologies. DOE (2008) has indicated that reaching these 2030 and 2050 scenarios could result in approximately 10% and 20%, respectively, of wind energy generation to come from offshore resources. By the end of 2013, 6.5 gigawatts of offshore wind were installed globally. The first U.S. project, the Block Island Wind Farm off the coast ofmore » Rhode Island, has recently begun operations. One of the major reasons that offshore wind development in the United States is lagging behind global trends is the high capital expenditures required. An understanding of the costs and associated drivers of building a commercial-scale offshore wind plant in the United States will inform future research and help U.S. investors feel more confident in offshore wind development. In an effort to explain these costs, the National Renewable Energy Laboratory has developed the Offshore Balance-of-System model.« less

High-fidelity nursing simulation: impact on student self-confidence and clinical competence.

PubMed

Blum, Cynthia A; Borglund, Susan; Parcells, Dax

2010-01-01

Development of safe nursing practice in entry-level nursing students requires special consideration from nurse educators. The paucity of data supporting high-fidelity patient simulation effectiveness in this population informed the development of a quasi-experimental, quantitative study of the relationship between simulation and student self-confidence and clinical competence. Moreover, the study reports a novel approach to measuring self-confidence and competence of entry-level nursing students. Fifty-three baccalaureate students, enrolled in either a traditional or simulation-enhanced laboratory, participated during their first clinical rotation. Student self-confidence and faculty perception of student clinical competence were measured using selected scale items of the Lasater Clinical Judgment Rubric. The results indicated an overall improvement in self-confidence and competence across the semester, however, simulation did not significantly enhance these caring attributes. The study highlights the need for further examination of teaching strategies developed to promote the transfer of self-confidence and competence from the laboratory to the clinical setting.

The confidence of speech-language pathology students regarding communicating with people with aphasia

PubMed Central

2013-01-01

Background Aphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements. Methods This study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA. Results SLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17–47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students‘ age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate). Conclusions SLP students who had received aphasia related

The confidence of speech-language pathology students regarding communicating with people with aphasia.

PubMed

Finch, Emma; Fleming, Jennifer; Brown, Kyla; Lethlean, Jennifer; Cameron, Ashley; McPhail, Steven M

2013-06-27

Aphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements. This study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA. SLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17-47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students' age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate). SLP students who had received aphasia related theoretical coursework, but not commenced clinical placements

Haptic-based perception-empathy biofeedback system for balance rehabilitation in patients with chronic stroke: Concepts and initial feasibility study.

PubMed

Yasuda, Kazuhiro; Saichi, Kenta; Kaibuki, Naomi; Harashima, Hiroaki; Iwata, Hiroyasu

2018-05-01

Most individuals have sensory disturbances post stroke, and these deficits contribute to post-stroke balance impairment. The haptic-based biofeedback (BF) system appears to be one of the promising tools for balance rehabilitation in patients with stroke, and the BF system can increase the objectivity of feedback and encouragement than that provided by a therapist. Studies in skill science indicated that feedback or encouragement from a coach or trainer enhances motor learning effect. Nevertheless, the optimal BF system (or its concept) which would refine the interpersonal feedback between patients and therapist has not been proposed. Thus, the purpose of this study was to propose a haptic-based perception-empathy BF system which provides information regarding the patient's center-of-foot pressure (CoP) pattern to the patient and the physical therapist to enhance the motor learning effect and validate the feasibility of this balance-training regimen in patients with chronic stroke. This study used a pre-post design without control group. Nine chronic stroke patients (mean age: 64.4 ± 9.2 years) received a balance-training regimen using this BF system twice a week for 4 weeks. Testing comprised quantitative measures (i.e., CoP) and clinical balance scale (Berg Balance Scale, BBS; Functional Reach Test, FRT; and Timed-Up and Go test, TUG). Post training, patients demonstrated marginally reduced postural spatial variability (i.e., 95% confidence elliptical area), and clinical balance performance significantly improved at post-training. Although the changes in FRT and TUG exceeded the minimal detectable change (MDC), changes in BBS did not reach clinical significance (i.e., smaller than MDC). These results may provide initial knowledge (i.e., beneficial effects, utility and its limitation) of the proposed BF system in designing effective motor learning strategies for stroke rehabilitation. More studies are required addressing limitations due to research design and

Self-reported confidence in prescribing skills correlates poorly with assessed competence in fourth-year medical students.

PubMed

Brinkman, David J; Tichelaar, Jelle; van Agtmael, Michiel A; de Vries, Theo P G M; Richir, Milan C

2015-07-01

The objective of this study was to investigate the relationship between students' self-reported confidence and their objectively assessed competence in prescribing. We assessed the competence in several prescribing skills of 403 fourth-year medical students at the VU University Medical Center, the Netherlands, in a formative simulated examination on a 10-point scale (1 = very low; 10 = very high). Afterwards, the students were asked to rate their confidence in performing each of the prescribing skills on a 5-point Likert scale (1 = very unsure; 5 = very confident). Their assessments were then compared with their self-confidence ratings. Students' overall prescribing performance was adequate (7.0 ± 0.8), but they lacked confidence in 2 essential prescribing skills. Overall, there was a weak positive correlation (r = 0.2, P < .01, 95%CI 0.1-0.3) between reported confidence and actual competence. Therefore, this study suggests that self-reported confidence is not an accurate measure of prescribing competence, and that students lack insight into their own strengths and weaknesses in prescribing. Future studies should focus on developing validated and reliable instruments so that students can assess their prescribing skills. © 2015, The American College of Clinical Pharmacology.

Effect of Wii-based balance training on corticomotor excitability post stroke.

PubMed

Omiyale, Oluwabunmi; Crowell, Charles R; Madhavan, Sangeetha

2015-01-01

The objective was to examine the effectiveness of a 3-week balance training program using the Nintendo Wii Fit gaming system (Nintendo Wii Sports, Nintendo, Redmond, WA) on lower limb corticomotor excitability and other clinical measures in chronic stroke survivors. Ten individuals diagnosed with ischemic stroke with residual hemiparesis received balance training using the Wii Fit for 60 min/day, three times/week, for three weeks. At the end of training, an increase in interhemispheric symmetry of corticomotor excitability of the tibialis anterior muscle representations was noted (n = 9). Participants also showed improvements in reaction time, time to perform the Dual Timed-Up-and-Go test, and balance confidence. The training-induced balance in corticomotor excitability suggests that this Wii-based balance training paradigm has the potential to influence neural plasticity and thereby functional recovery.

The development of the ICF vestibular environmental scale.

PubMed

Whitney, Susan L; Alghadir, Ahmad; Alghwiri, Alia; Alshebber, Kefah M; Alshehri, Mohammed; Furman, Joseph M; Mueller, Martin; Grill, Eva

2016-07-02

People with vestibular disorders report changes in symptoms based on their environment with many situations increasing their symptoms. The purpose of this paper was to utilize the International Classification of Functioning Disability and Health (ICF) from the World Health Organization (WHO) to describe common environmental triggers for dizziness in persons living with balance and vestibular disorders. A multi-centre cross-sectional study was conducted with four different centres on three different continents, including patients from the United States (Pittsburgh), Germany (Munich), Jordan (Amman) and Saudi Arabia (Riyadh). Three hundred eighty one persons with vestibular disorders participated. A 9-item questionnaire (the Vestibular Environmental Scale) was developed from existing ICF items, which were compared to Dizziness Handicap Inventory (DHI) scores. Sixty-five percent of participants reported that "quick movements in the vicinity" increased symptoms, "crowds" at 45%, and "design of buildings, e.g. narrow hallways, stairs, elevators" at 42%. The "crowds" item was a good positive predictor of psychogenic vertigo (OR 1.8, 95% Confidence Interval 1.03-3.16), while "food" (OR 0.47, 95% Confidence Interval 0.17-1.29) and "light" (OR 0.41 95% Confidence Interval 0.23-0.75) were negative predictors of psychogenic vertigo. There also was a positive correlation between the number of triggers and DHI score (Spearman correlation coefficient 0.47, p < 0.0001). Sixty-eight percent of the subjects reported an increase in symptoms with between 1 and 4 environmental triggers. In our cross cultural sample, environmental triggers affect dizziness in persons living with balance and vestibular disorders. The use of items from the ICF of the WHO may help to promote cross cultural sharing of information in persons with dizziness.

Influence of real and virtual heights on standing balance.

PubMed

Cleworth, Taylor W; Horslen, Brian C; Carpenter, Mark G

2012-06-01

Fear and anxiety induced by threatening scenarios, such as standing on elevated surfaces, have been shown to influence postural control in young adults. There is also a need to understand how postural threat influences postural control in populations with balance deficits and risk of falls. However, safety and feasibility issues limit opportunities to place such populations in physically threatening scenarios. Virtual reality (VR) has successfully been used to simulate threatening environments, although it is unclear whether the same postural changes can be elicited by changes in virtual and real threat conditions. Therefore, the purpose of this study was to compare the effects of real and virtual heights on changes to standing postural control, electrodermal activity (EDA) and psycho-social state. Seventeen subjects stood at low and high heights in both real and virtual environments matched in scale and visual detail. A repeated measures ANOVA revealed increases with height, independent of visual environment, in EDA, anxiety, fear, and center of pressure (COP) frequency, and decreases with height in perceived stability, balance confidence and COP amplitude. Interaction effects were seen for fear and COP mean position; where real elicited larger changes with height than VR. This study demonstrates the utility of VR, as simulated heights resulted in changes to postural, autonomic and psycho-social measures similar to those seen at real heights. As a result, VR may be a useful tool for studying threat related changes in postural control in populations at risk of falls, and to screen and rehabilitate balance deficits associated with fear and anxiety. Copyright © 2012 Elsevier B.V. All rights reserved.

Finite Element Analysis of a NASA National Transonic Facility Wind Tunnel Balance

NASA Technical Reports Server (NTRS)

Lindell, Michael C.

1996-01-01

This paper presents the results of finite element analyses and correlation studies performed on a NASA National Transonic Facility (NTF) Wind Tunnel balance. In the past NASA has relied primarily on classical hand analyses, coupled with relatively large safety factors, for predicting maximum stresses in wind tunnel balances. Now, with the significant advancements in computer technology and sophistication of general purpose analysis codes, it is more reasonable to pursue finite element analyses of these balances. The correlation studies of the present analyses show very good agreement between the analyses and data measured with strain gages and therefore the studies give higher confidence for using finite element analyses to analyze and optimize balance designs in the future.

Finite Element Analysis of a NASA National Transonic Facility Wide Tunnel Balance

NASA Technical Reports Server (NTRS)

Lindell, Michael C. (Editor)

1999-01-01

This paper presents the results of finite element analyses and correlation studies performed on a NASA National Transonic Facility (NTF) Wind Tunnel balance. In the past NASA has relied primarily on classical hand analyses, coupled with relatively large safety factors, for predicting maximum stresses in wind tunnel balances. Now, with the significant advancements in computer technology and sophistication of general purpose analysis codes, it is more reasonable to pursue finite element analyses of these balances. The correlation studies of the present analyses show very good agreement between the analyses and data measured with strain gages and therefore the studies give higher confidence for using finite element analyses to analyze and optimize balance designs in the future.

Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk.

PubMed

Tisher, Kristen; Mann, Kimberly; VanDyke, Sarah; Johansson, Charity; Vallabhajosula, Srikant

2018-03-05

Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention.

Extended use of Kinesiology Tape and Balance in Participants with Chronic Ankle Instability.

PubMed

Jackson, Kristen; Simon, Janet E; Docherty, Carrie L

2016-01-01

Participants with chronic ankle instability (CAI) have been shown to have balance deficits related to decreased proprioception and neuromuscular control. Kinesiology tape (KT) has been proposed to have many benefits, including increased proprioception. To determine if KT can help with balance deficits associated with CAI. Cohort study. Research laboratory. Thirty participants with CAI were recruited for this study. Balance was assessed using the Balance Error Scoring System (BESS). Participants were pretested and then randomly assigned to either the control or KT group. The participants in the KT group had 4 strips applied to the foot and lower leg and were instructed to leave the tape on until they returned for testing. All participants returned 48 hours later for another BESS assessment. The tape was then removed, and all participants returned 72 hours later to complete the final BESS assessment. Total BESS errors. Differences between the groups occurred at 48 hours post-application of the tape (mean difference = 4.7 ± 1.4 errors, P < .01; 95% confidence interval = 2.0, 7.5) and at 72 hours post-removal of the tape (mean difference = 2.3 ± 1.1 errors, P = .04; 95% confidence interval = 0.1, 4.6). The KT improved balance after it had been applied for 48 hours when compared with the pretest and with the control group. One of the most clinically important findings is that balance improvements were retained even after the tape had been removed for 72 hours.

Roles of divergent and rotational winds in the kinetic energy balance during intense convective activity

NASA Technical Reports Server (NTRS)

Fuelberg, H. E.; Browning, P. A.

1983-01-01

Contributions of divergent and rotational wind components to the synoptic-scale kinetic energy balance are described using rawinsonde data at 3 and 6 h intervals from NASA's fourth Atmospheric Variability experiment. Two intense thunderstorm complexes occurred during the period. Energy budgets are described for the entire computational region and for limited volumes that enclosed storm-induced, upper level wind maxima located poleward of convection. Although small in magnitude, the divergent wind component played an important role in the cross-contour generation and horizontal flux divergence of kinetic energy. The importance of V(D) appears directly related to the presence and intensity of convection. Although K(D) usually comprised less than 10 percent of the total kinetic energy content, generation of kinetic energy by V(D) was a major factor in the creation of upper-level wind maxima to the north of the storm complexes. Omission of the divergent wind apparently would lead to serious misrepresentations of the energy balance. A random error analysis is presented to assess confidence limits in the various energy parameters.

Confidence Intervals for Assessing Heterogeneity in Generalized Linear Mixed Models

ERIC Educational Resources Information Center

Wagler, Amy E.

2014-01-01

Generalized linear mixed models are frequently applied to data with clustered categorical outcomes. The effect of clustering on the response is often difficult to practically assess partly because it is reported on a scale on which comparisons with regression parameters are difficult to make. This article proposes confidence intervals for…

A single-stage optical load-balanced switch for data centers.

PubMed

Huang, Qirui; Yeo, Yong-Kee; Zhou, Luying

2012-10-22

Load balancing is an attractive technique to achieve maximum throughput and optimal resource utilization in large-scale switching systems. However current electronic load-balanced switches suffer from severe problems in implementation cost, power consumption and scaling. To overcome these problems, in this paper we propose a single-stage optical load-balanced switch architecture based on an arrayed waveguide grating router (AWGR) in conjunction with fast tunable lasers. By reuse of the fast tunable lasers, the switch achieves both functions of load balancing and switching through the AWGR. With this architecture, proof-of-concept experiments have been conducted to investigate the feasibility of the optical load-balanced switch and to examine its physical performance. Compared to three-stage load-balanced switches, the reported switch needs only half of optical devices such as tunable lasers and AWGRs, which can provide a cost-effective solution for future data centers.

The impact of previous knee injury on force plate and field-based measures of balance.

PubMed

Baltich, Jennifer; Whittaker, Jackie; Von Tscharner, Vinzenz; Nettel-Aguirre, Alberto; Nigg, Benno M; Emery, Carolyn

2015-10-01

Individuals with post-traumatic osteoarthritis demonstrate increased sway during quiet stance. The prospective association between balance and disease onset is unknown. Improved understanding of balance in the period between joint injury and disease onset could inform secondary prevention strategies to prevent or delay the disease. This study examines the association between youth sport-related knee injury and balance, 3-10years post-injury. Participants included 50 individuals (ages 15-26years) with a sport-related intra-articular knee injury sustained 3-10years previously and 50 uninjured age-, sex- and sport-matched controls. Force-plate measures during single-limb stance (center-of-pressure 95% ellipse-area, path length, excursion, entropic half-life) and field-based balance scores (triple single-leg hop, star-excursion, unipedal dynamic balance) were collected. Descriptive statistics (mean within-pair difference; 95% confidence intervals) were used to compare groups. Linear regression (adjusted for injury history) was used to assess the relationship between ellipse-area and field-based scores. Injured participants on average demonstrated greater medio-lateral excursion [mean within-pair difference (95% confidence interval); 2.8mm (1.0, 4.5)], more regular medio-lateral position [10ms (2, 18)], and shorter triple single-leg hop distances [-30.9% (-8.1, -53.7)] than controls, while no between group differences existed for the remaining outcomes. After taking into consideration injury history, triple single leg hop scores demonstrated a linear association with ellipse area (β=0.52, 95% confidence interval 0.01, 1.01). On average the injured participants adjusted their position less frequently and demonstrated a larger magnitude of movement during single-limb stance compared to controls. These findings support the evaluation of balance outcomes in the period between knee injury and post-traumatic osteoarthritis onset. Copyright © 2015 Elsevier Ltd. All rights

Clinical Tests of Standing Balance in the Knee Osteoarthritis Population: Systematic Review and Meta-analysis

PubMed Central

Hatfield, Gillian L.; Morrison, Adam; Wenman, Matthew; Hammond, Connor A.

2016-01-01

Background People with knee osteoarthritis (OA) have a high prevalence of falls. Poor standing balance is one risk factor, but the extent of standing balance deficits in people with knee OA is unknown. Purpose The primary purpose of this study was to summarize available data on standing balance in people with knee OA compared with people without knee OA. A secondary purpose was to establish the extent of balance impairment across disease severity. Data Sources A literature search of the MEDLINE, EMBASE, CINAHL, and Web of Science databases through November 19, 2014, was conducted. Study Selection Studies on individuals with knee OA containing clinical, quantifiable measures of standing balance were included. Methodological quality was assessed by 2 reviewers using a 16-item quality index developed for nonrandomized studies. Studies scoring >50% on the index were included. Data Extraction Participant characteristics (age, sex, body mass index, OA severity, compartment involvement, unilateral versus bilateral disease) and balance outcomes were extracted by 2 reviewers. Standardized mean differences were pooled using a random-effects model. Data Synthesis The search yielded 2,716 articles; 8 met selection and quality assessment criteria. The median score on the quality index was 13/17. People with knee OA consistently performed worse than healthy controls on the Step Test, Single-Leg Stance Test, Functional Reach Test, Tandem Stance Test, and Community Balance and Mobility Scale. The pooled standardized mean difference was −1.64 (95% confidence interval=−2.58, −0.69). No differences were observed between varying degrees of malalignment, or between unilateral versus bilateral disease. Limitations No studies compared between-knee OA severities. Thus, expected changes in balance as the disease progresses remain unknown. Conclusions Few studies compared people with knee OA and healthy controls, but those that did showed that people with knee OA performed

Relating the Content and Confidence of Recognition Judgments

PubMed Central

Selmeczy, Diana; Dobbins, Ian G.

2014-01-01

The Remember/Know procedure, developed by Tulving (1985) to capture the distinction between the conscious correlates of episodic and semantic retrieval, has spurned considerable research and debate. However, only a handful of reports have examined the recognition content beyond this dichotomous simplification. To address this, we collected participants’ written justifications in support of ordinary old/new recognition decisions accompanied by confidence ratings using a 3-point scale (high/medium/low). Unlike prior research, we did not provide the participants with any descriptions of Remembering or Knowing and thus, if the justifications mapped well onto theory, they would do so spontaneously. Word frequency analysis (unigrams, bigrams, and trigrams), independent ratings, and machine learning techniques (Support Vector Machine - SVM) converged in demonstrating that the linguistic content of high and medium confidence recognition differs in a manner consistent with dual process theories of recognition. For example, the use of ‘I remember’, particularly when combined with temporal or perceptual information (e.g., ‘when’, ‘saw’, ‘distinctly’), was heavily associated with high confidence recognition. Conversely, participants also used the absence of remembering for personally distinctive materials as support for high confidence new reports (‘would have remembered’). Thus, participants afford a special status to the presence or absence of remembering and use this actively as a basis for high confidence during recognition judgments. Additionally, the pattern of classification successes and failures of a SVM was well anticipated by the Dual Process Signal Detection model of recognition and inconsistent with a single process, strictly unidimensional approach. “One might think that memory should have something to do with remembering, and remembering is a conscious experience.”(Tulving, 1985, p. 1) PMID:23957366

Reliability, Validity, and Minimal Detectable Change of Balance Evaluation Systems Test and Its Short Versions in Older Cancer Survivors: A Pilot Study.

PubMed

Huang, Min H; Miller, Kara; Smith, Kristin; Fredrickson, Kayle; Shilling, Tracy

2016-01-01

Cancer is primarily a disease of older adults. About 77% of all cancers are diagnosed in persons aged 55 years and older. Cancer and its treatment can cause diverse sequelae impacting body systems underlying balance control. No study has examined the psychometric properties of balance assessment tools in older cancer survivors, presenting a significant challenge in the selection of outcome measures for clinicians treating this fast-growing population. This study aimed to determine the reliability, validity, and minimal detectable change (MDC) of the Balance Evaluation System Test (BESTest), Mini-Balance Evaluation Systems Test (Mini-BESTest), and Brief-Balance Evaluation Systems Test (Brief-BESTest) in community-dwelling older cancer survivors. This study was a cross-sectional design. Twenty breast and 8 prostate cancer survivors participated [age (SD) = 68.4 (8.13) years]. The BESTest and Activity-specific Balance Confidence (ABC) Scale were administered during the first session. Scores of Mini-BESTest and Brief-BESTest were extracted on the basis of the scores of BESTest. The BESTest was repeated within 1 to 2 weeks by the same rater to determine the test-retest reliability. For the analysis of the inter-rater reliability, 21 participants were randomly selected to be evaluated by 2 raters. A primary rater administered the test. The 2 raters independently and concurrently scored the performance of the participants. Each rater recorded the ratings separately on the scoring sheet. No discussion among the raters was allowed throughout the testing. Intraclass correlation coefficients (ICCs), standard error of measurement, minimal detectable change (MDC), and Bland-Altman plots were calculated. Concurrent validity of these balance tests with the ABC Scale was examined using the Spearman correlation. The BESTest, Mini-BESTest, and Brief-BESTest had high test-retest (ICC = 0.90-0.94) and interrater reliability (ICC = 0.86-0.96), small standard error of measurement (0

Effect of Tai Chi Exercise Combined with Mental Imagery Theory in Improving Balance in a Diabetic and Elderly Population

PubMed Central

Alsubiheen, Abdulrahman; Petrofsky, Jerrold; Daher, Noha; Lohman, Everett; Balbas, Edward

2015-01-01

Background One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Material/Methods Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40–80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week for 8 weeks. Each session was one hour long. Measures were taken using a balance platform test, an Activities-specific Balance Confidence (ABC) Scale, a one leg standing test (OLS), functional reach test (FRT) and hemoglobin A1C. These measures were taken twice, pre and post-study, for both groups. Results Both groups experienced significant improvements in ABC, OLS, FRT (P<0.01) after completing 8 weeks of TC exercise with no significant improvement between groups. Subjects using the balance platform test demonstrated improvement in balance in all different tasks with no significant change between groups. There was no significant change in HbA1C for the diabetic group. Conclusions All results showed an improvement in balance in the diabetic and the control groups; however, no significant difference between the groups was observed. Since the DM group had more problems with balance impairment at baseline than the control, the diabetic group showed the most benefit from the TC exercise. PMID:26454826

Effect of Tai Chi Exercise Combined with Mental Imagery Theory in Improving Balance in a Diabetic and Elderly Population.

PubMed

Alsubiheen, Abdulrahman; Petrofsky, Jerrold; Daher, Noha; Lohman, Everett; Balbas, Edward

2015-10-10

One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40-80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week for 8 weeks. Each session was one hour long. Measures were taken using a balance platform test, an Activities-specific Balance Confidence (ABC) Scale, a one leg standing test (OLS), functional reach test (FRT) and hemoglobin A1C. These measures were taken twice, pre and post-study, for both groups. Both groups experienced significant improvements in ABC, OLS, FRT (P<0.01) after completing 8 weeks of TC exercise with no significant improvement between groups. Subjects using the balance platform test demonstrated improvement in balance in all different tasks with no significant change between groups. There was no significant change in HbA1C for the diabetic group. All results showed an improvement in balance in the diabetic and the control groups; however, no significant difference between the groups was observed. Since the DM group had more problems with balance impairment at baseline than the control, the diabetic group showed the most benefit from the TC exercise.

Does 12-Week Latin Dance Training Affect the Self-Confidence of the University Students?

ERIC Educational Resources Information Center

Meric, Odemis; Ilhan, Adilogullari

2016-01-01

In this research, it is aimed to investigate the effect of 12-week Latin dance training on the self-confidence of university students. This research was conducted with a total of 60 students, including 30 students as control and 30 students as the working group. A 33-item self-confidence scale developed by Akin (2007) was applied to both control…

Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson's Disease

PubMed Central

Giardini, Marica; Nardone, Antonio; Guglielmetti, Simone; Arcolin, Ilaria; Pisano, Fabrizio

2018-01-01

We hypothesised that rehabilitation specifically addressing balance in Parkinson's disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises) were assessed by assigning patients to two groups (Platform, n = 15, and Exercises, n = 17). The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program. Both platform and exercise sessions were administered from easy to difficult. Outcome measures were (a) balancing behaviour, assessed by both Index of Stability (IS) on platform and Mini-BESTest, and (b) gait, assessed by both baropodometry and Timed Up and Go (TUG) test. Falls Efficacy Scale-International (FES-I) and Parkinson's Disease Questionnaire (PDQ-8) were administered. Both groups exhibited better balance control, as assessed both by IS and by Mini-BESTest. Gait speed at baropodometry also improved in both groups, while TUG was less sensitive to improvement. Scores of FES-I and PDQ-8 showed a marginal improvement. A four-week treatment featuring no gait training but focused on challenging balance tasks produces considerable gait enhancement in mildly to moderately affected patients. Walking problems in PD depend on postural instability and are successfully relieved by appropriate balance rehabilitation. This trial is registered with ClinicalTrials.gov NCT03314597. PMID:29706993

Effects of whole-body vibration on balance and mobility in institutionalized older adults: a randomized controlled trial.

PubMed

Lam, Freddy Mh; Chan, Philip Fl; Liao, L R; Woo, Jean; Hui, Elsie; Lai, Charles Wk; Kwok, Timothy Cy; Pang, Marco Yc

2018-04-01

To investigate whether a comprehensive exercise program was effective in improving physical function among institutionalized older adults and whether adding whole-body vibration to the program conferred additional therapeutic benefits. A single-blinded randomized controlled trial was conducted. This study was carried out in residential care units. In total, 73 older adults (40 women, mean age: 82.3 ± 7.3 years) were enrolled into this study. Participants were randomly allocated to one of the three groups: strength and balance program combined with whole-body vibration, strength and balance program without whole-body vibration, and social and recreational activities consisting of upper limb exercises only. All participants completed three training sessions per week for eight weeks. Assessment of mobility, balance, lower limb strength, walking endurance, and self-perceived balance confidence were conducted at baseline and immediately after the eight-week intervention. Incidences of falls requiring medical attention were recorded for one year after the end of the training period. A significant time × group interaction was found for lower limb strength (five-times-sit-to-stand test; P = 0.048), with the exercise-only group showing improvement (pretest: 35.8 ± 16.1 seconds; posttest: 29.0 ± 9.8 seconds), compared with a decline in strength among controls (pretest: 27.1 ± 10.4 seconds; posttest: 28.7 ± 12.3 seconds; P = 0.030). The exercise with whole-body vibration group had a significantly better outcome in balance confidence (pretest: 39.2 ± 29.0; posttest: 48.4 ± 30.6) than the exercise-only group (pretest: 35.9 ± 24.8; posttest: 38.2 ± 26.5; P = 0.033). The exercise program was effective in improving lower limb strength among institutionalized older adults but adding whole-body vibration did not enhance its effect. Whole-body vibration may improve balance confidence without enhancing actual balance performance.

History of falls, balance performance, and quality of life in older cancer survivors.

PubMed

Huang, Min H; Lytle, Tracy; Miller, Kara A; Smith, Kristin; Fredrickson, Kayle

2014-07-01

Older cancer survivors may be predisposed to falls because of the sequalae associated with cancer and its treatments. This study examined the association between the fall history, balance performance, and health-related quality of life (QoL) in older, community-dwelling cancer survivors who had completed primary cancer treatments. Forty-one cancer survivors (age = 67.9 ± 8.8 years) participated in the study. Balance performance was examined using the Activities-specific Balance Confidence Scale (ABC) and the Balance Evaluation Systems Test (BESTest). Scores from the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36v2 were obtained to assess the QoL. The demographics and health status were comparable between the fallers and non-fallers. While 54% of the participants had experienced at least one fall in the past 12 months, 30% had experienced two or more falls. Spearman's correlation analysis revealed a significant relationship between the outcomes from the ABC and the PCS (p < 0.001), and between the BESTest and the PCS (p < 0.001). Only the PCS significantly differentiated fallers from non-fallers (p < 0.01). Logistic regression analysis estimated that a one-unit increase in the PCS score significantly reduced the odds of falling by 13% (p < 0.01). The results demonstrate that in older cancer survivors, falls are a significant problem and balance control is a determinant of perceived physical function and well-being. Older cancer survivors reporting a poor QoL in the physical health domain may have higher risks of falling. Future studies are needed to examine the risk factor profiles of falls and the interventions to prevent falls in older cancer survivors. Copyright © 2014 Elsevier B.V. All rights reserved.

Biased information search in homogeneous groups: confidence as a moderator for the effect of anticipated task requirements.

PubMed

Kerschreiter, Rudolf; Schulz-Hardt, Stefan; Mojzisch, Andreas; Frey, Dieter

2008-05-01

When searching for information, groups that are homogeneous regarding their members' prediscussion decision preferences show a strong bias for information that supports rather than conflicts with the prevailing opinion (confirmation bias). The present research examined whether homogeneous groups blindly search for information confirming their beliefs irrespective of the anticipated task or whether they are sensitive to the usefulness of new information for this forthcoming task. Results of three experiments show that task sensitivity depends on the groups' confidence in the correctness of their decision: Moderately confident groups displayed a strong confirmation bias when they anticipated having to give reasons for their decision but showed a balanced information search or even a dis confirmation bias (i.e., predominately seeking conflicting information) when they anticipated having to refute counterarguments. In contrast, highly confident groups demonstrated a strong confirmation bias independent of the anticipated task requirements.

Quantification of seasonal to annual mass balances from glacier surface albedo derived from optical satellite images, application on 30 glaciers in the French Alps for the period 2000-2015.

NASA Astrophysics Data System (ADS)

Davaze, Lucas; Rabatel, Antoine; Arnaud, Yves; Sirguey, Pascal; Six, Delphine; Letreguilly, Anne; Dumont, Marie

2017-04-01

Increasing the number of glaciers monitored for surface mass balance is very challenging, especially using laborious methods based on in situ data. Complementary methods are therefore required to quantify the surface mass balance of unmonitored glaciers. The current study relies on the so-called albedo method, based on the analysis of albedo maps retrieved from optical satellite imagery acquired since 2000 by the MODIS sensor, onboard of TERRA satellite. Recent studies performed on single glaciers in the French Alps, the Himalayas or the Southern Alps of New Zealand revealed substantial relationships between summer minimum glacier-wide surface albedo and annual mass balance, because this minimum surface albedo is directly related to accumulation-area ratio and the equilibrium-line altitude. On the basis of 30 glaciers located in the French Alps where annual surface mass balance are available, our study conducted on the period 2000-2015 confirms the robustness and reliability of the relationship between the summer minimum surface albedo and the annual surface mass balance. At the seasonal scale, the integrated summer surface albedo is significantly correlated with the summer mass balance of the six glaciers seasonally surveyed. For the winter season, four of the six glaciers showed a significant correlation when linking the winter surface mass balance and the integrated winter surface albedo, using glacier-dependent thresholds to filter the albedo signal. Sensitivity study on the computed cloud detection algorithm revealed high confidence in retrieved albedo maps. These results are promising to monitor both annual and seasonal glacier-wide surface mass balances of individual glaciers at a regional scale using optical satellite images.

Prestimulus alpha-band power biases visual discrimination confidence, but not accuracy.

PubMed

Samaha, Jason; Iemi, Luca; Postle, Bradley R

2017-09-01

The magnitude of power in the alpha-band (8-13Hz) of the electroencephalogram (EEG) prior to the onset of a near threshold visual stimulus predicts performance. Together with other findings, this has been interpreted as evidence that alpha-band dynamics reflect cortical excitability. We reasoned, however, that non-specific changes in excitability would be expected to influence signal and noise in the same way, leaving actual discriminability unchanged. Indeed, using a two-choice orientation discrimination task, we found that discrimination accuracy was unaffected by fluctuations in prestimulus alpha power. Decision confidence, on the other hand, was strongly negatively correlated with prestimulus alpha power. This finding constitutes a clear dissociation between objective and subjective measures of visual perception as a function of prestimulus cortical excitability. This dissociation is predicted by a model where the balance of evidence supporting each choice drives objective performance but only the magnitude of evidence supporting the selected choice drives subjective reports, suggesting that human perceptual confidence can be suboptimal with respect to tracking objective accuracy. Copyright © 2017 Elsevier Inc. All rights reserved.

Small-scale Pressure-balanced Structures Driven by Oblique Slow Mode Waves Measured in the Solar Wind

NASA Astrophysics Data System (ADS)

Yao, Shuo; He, J.-S.; Tu, C.-Y.; Wang, L.-H.; Marsch, E.

2013-09-01

Recently, small-scale pressure-balanced structures (PBSs) were identified in the solar wind, but their formation mechanism remains unclear. This work aims to reveal the dependence of the properties of small-scale PBSs on the background magnetic field (B 0) direction and thus to corroborate the in situ mechanism that forms them. We analyze the plasma and magnetic field data obtained by WIND in the quiet solar wind at 1 AU. First, we use a developed moving-average method to obtain B 0(s, t) for every temporal scale (s) at each time moment (t). By wavelet cross-coherence analysis, we obtain the correlation coefficients between the thermal pressure P th and the magnetic pressure P B, distributing against the temporal scale and the angle θxB between B 0(s, t) and Geocentric Solar Ecliptic coordinates (GSE)-x. We note that the angle coverage of a PBS decreases with shorter temporal scale, but the occurrence of the PBSs is independent of θxB. Suspecting that the isolated small PBSs are formed by compressive waves in situ, we continue this study by testing the wave modes forming a small-scale PBS with B 0(s, t) quasi-parallel to GSE-x. As a result, we identify that the cross-helicity and the compressibility attain values for a slow mode from theoretical calculations. The wave vector is derived from minimum variance analysis. Besides, the proton temperatures obey T < T ∥ derived from the velocity distribution functions, excluding a mirror mode, which is the other candidate for the formation of PBSs in situ. Thus, a small-scale PBS is shown to be driven by oblique, slow-mode waves in the solar wind.

Genome-scale estimate of the metabolic turnover of E. Coli from the energy balance analysis

NASA Astrophysics Data System (ADS)

De Martino, D.

2016-02-01

In this article the notion of metabolic turnover is revisited in the light of recent results of out-of-equilibrium thermodynamics. By means of Monte Carlo methods we perform an exact sampling of the enzymatic fluxes in a genome scale metabolic network of E. Coli in stationary growth conditions from which we infer the metabolites turnover times. However the latter are inferred from net fluxes, and we argue that this approximation is not valid for enzymes working nearby thermodynamic equilibrium. We recalculate turnover times from total fluxes by performing an energy balance analysis of the network and recurring to the fluctuation theorem. We find in many cases values one of order of magnitude lower, implying a faster picture of intermediate metabolism.

Investigation of self-compassion, self-confidence and submissive behaviors of nursing students studying in different curriculums.

PubMed

Eraydın, Şahizer; Karagözoğlu, Şerife

2017-07-01

Today, nursing education which educates the future members of the nursing profession aims to gain them high self-esteem, selfconfidence and self-compassion, independence, assertiveness and ability to establish good human relations. This aim can only be achieved through a contemporary curriculum supporting students in the educational process and enabling those in charge to make arrangements by taking the characters and needs of each individual into account. The study aims to investigate self-compassion, self-confidence and submissive behaviours of undergraduate nursing students studying in different curriculums. This descriptive, cross-sectional, comparative study was carried out with the 1st- and 4th-year students of the three schools, each of which has a different curriculum: conventional, integrated and Problem Based Learning (PBL). The study data were collected with the Self-Compassion Scale (SCS), Self-Confidence Scale (CS) and Submissive Acts Scale (SAS): The data were analyzed through frequency distribution, means, analysis of variance and the significance test for the difference between the two means. The mean scores the participating students obtained from the Self-Compassion, Self-confidence and Submissive Acts Scales were 3.31±0.56, 131.98±20.85 and 36.48±11.43 respectively. The integrated program students' mean self-compassion and self-confidence scores were statistically significantly higher and their mean submissive behaviour scores were lower than were those of the students studying in the other two programs (p<0.05). The analysis of the correlation between the mean scores obtained from the scales revealed that there was a statistically significant relationships between the SCS and CS values (r=0.388, p<0.001), between the SCS and SAS values (r=-0307, p<0.001) and between the CS and SAS values (r=-0325, p<0.001). In line with the study results, it can be said that the participating nursing students tended to display moderate levels of

Vibrotactile neurofeedback balance training in patients with Parkinson's disease: reducing the number of falls.

PubMed

Rossi-Izquierdo, Marcos; Ernst, Arne; Soto-Varela, Andrés; Santos-Pérez, Sofía; Faraldo-García, Ana; Sesar-Ignacio, Angel; Basta, Dietmar

2013-02-01

The aim of this study was to assess effectiveness of balance training with a vibrotactile neurofeedback system in improving overall stability in patients with Parkinson's disease (PD). Ten patients diagnosed with idiopathic PD were included. Individualization of the rehabilitation program started with a body sway analysis of stance and gait tasks (Standard Balance Deficit Test, SBDT) by using the diagnostic tool of the applied device (Vertiguard(®)-RT). Those tasks with the poorest outcome as related to age- and gender-related controls were included in the training program (not more than six tasks). Improvement of postural stability was assessed by performing SBDT, Sensory Organization Test (SOT) of Computerized Dynamic Posturography (CDP), Dizziness Handicap Inventory (DHI), activity-specific balance confidence scale and recording the number of falls over the past three months. Furthermore, scores of SOT and DHI of 10 PD patients previously trained in an earlier study (by using CDP) were compared with results of those in the present study. After neurofeedback training (NFT), there was a statistically significant improvement in body sway (calculated over all training tasks), number of falls, and scores of SOT, DHI and ABC. In comparison with CDP-training, a statistically significant higher increase of SOT score was observed for patients after NFT with the Vertiguard-RT device compared to CDP training. Our results showed that a free-field vibrotactile NFT with Vertiguard(®)-RT device can improve balance in PD patients in everyday life conditions very effectively, which might led in turn to a reduction of falls. Copyright © 2012 Elsevier B.V. All rights reserved.

Does footwear affect balance?: the views and experiences of people with diabetes and neuropathy who have fallen.

PubMed

Paton, Joanne S; Roberts, Anne; Bruce, Graham K; Marsden, Jon

2013-01-01

Despite falls being a major concern for people living with somatosensory deficit, little is known about the perceived impact of footwear and footwear features on balance. Clinical relevance is increased given that therapeutic footwear is often provided to people with diabetes to reduce foot ulcer risk. This qualitative study aims to explore the experiences and views of people with diabetes and neuropathy who have recently fallen to understand whether footwear type is perceived to affect balance or contribute to falling. Sixteen individuals (13 men and three women aged 44-83 years) were purposively sampled from a larger population of potential participants. Audio-recorded, in-depth, semistructured interviews were conducted in participant homes or at a place preferable to them. Once transcribed verbatim, the data were themed, charted, and interpreted using a framework approach. Although most participants did not believe that the footwear in which they fell contributed to their fall, most revealed how footwear choice influenced their balance confidence to undertake daily tasks. Most found their therapeutic footwear "difficult" to walk in, "heavy, or "slippery bottomed." Design recommendations for enhanced balance included a close fit with tight fastening, lightweight, substantial tread, and a firm, molded sole/insole. Complying with these recommendations, the hiking sandal was believed to be the most stable and safe shoe and was frequently worn as a walking aid to reduce fear of falling and boost confidence. People with diabetic neuropathy have disease-specific needs and concerns relating to how footwear affects balance. Engaging with patients to address those needs and concerns is likely to improve the feasibility and acceptability of therapeutic footwear to reduce foot ulcer risk and boost balance confidence.

Using thermal balance model to determine optimal reactor volume and insulation material needed in a laboratory-scale composting reactor.

PubMed

Wang, Yongjiang; Pang, Li; Liu, Xinyu; Wang, Yuansheng; Zhou, Kexun; Luo, Fei

2016-04-01

A comprehensive model of thermal balance and degradation kinetics was developed to determine the optimal reactor volume and insulation material. Biological heat production and five channels of heat loss were considered in the thermal balance model for a representative reactor. Degradation kinetics was developed to make the model applicable to different types of substrates. Simulation of the model showed that the internal energy accumulation of compost was the significant heat loss channel, following by heat loss through reactor wall, and latent heat of water evaporation. Lower proportion of heat loss occurred through the reactor wall when the reactor volume was larger. Insulating materials with low densities and low conductive coefficients were more desirable for building small reactor systems. Model developed could be used to determine the optimal reactor volume and insulation material needed before the fabrication of a lab-scale composting system. Copyright © 2016 Elsevier Ltd. All rights reserved.

Compensatory mechanisms of balance to the scaling of arm-swing frequency.

PubMed

Ko, Ji Hyun; Wang, Zheng; Challis, John H; Newell, Karl M

2015-11-05

The present study investigated the contribution of the Hof (2007) mechanism 1 (M1-moving the center of pressure (COP) with respect to the vertical projection of the center of mass (COMTotal)); and mechanism 2 (M2-rotating the trunk and upper limbs around the COMTotal) to postural control and the stability of COP-COMTotal cophase as a function of lateral arm-swing frequency. Young adults were instructed to stand still on a force platform while alternating their arm swinging from above the head to the side of their thigh to create perturbations to postural control. Scaling the frequency of arm-swing (random step changes of 0.2 Hz within a bandwidth of 0.2 to 1.6 Hz) increased the SD of COP but decreased the SD of COMTotal. Increments in arm-swing frequency induced a progressive increase in M1 and decrease in M2 in terms of their relative contribution to postural stability. The cophase between COP and COMTotal became more tightly in-phase over increments of arm-swing frequency. These findings show an adaptive compensatory role of M1 and M2 within the stability of COP-COMTotal coupling in the regulation of human balance control. Copyright © 2015 Elsevier Ltd. All rights reserved.

The idiosyncratic nature of confidence

PubMed Central

Navajas, Joaquin; Hindocha, Chandni; Foda, Hebah; Keramati, Mehdi; Latham, Peter E; Bahrami, Bahador

2017-01-01

Confidence is the ‘feeling of knowing’ that accompanies decision making. Bayesian theory proposes that confidence is a function solely of the perceived probability of being correct. Empirical research has suggested, however, that different individuals may perform different computations to estimate confidence from uncertain evidence. To test this hypothesis, we collected confidence reports in a task where subjects made categorical decisions about the mean of a sequence. We found that for most individuals, confidence did indeed reflect the perceived probability of being correct. However, in approximately half of them, confidence also reflected a different probabilistic quantity: the perceived uncertainty in the estimated variable. We found that the contribution of both quantities was stable over weeks. We also observed that the influence of the perceived probability of being correct was stable across two tasks, one perceptual and one cognitive. Overall, our findings provide a computational interpretation of individual differences in human confidence. PMID:29152591

Impact of co-digestion on existing salt and nutrient mass balances for a full-scale dairy energy project.

PubMed

Camarillo, Mary Kay; Stringfellow, William T; Spier, Chelsea L; Hanlon, Jeremy S; Domen, Jeremy K

2013-10-15

Anaerobic digestion of manure and other agricultural waste streams with subsequent energy production can result in more sustainable dairy operations; however, importation of digester feedstocks onto dairy farms alters previously established carbon, nutrient, and salinity mass balances. Salt and nutrient mass balance must be maintained to avoid groundwater contamination and salination. To better understand salt and nutrient contributions of imported methane-producing substrates, a mass balance for a full-scale dairy biomass energy project was developed for solids, carbon, nitrogen, sulfur, phosphorus, chloride, and potassium. Digester feedstocks, consisting of thickened manure flush-water slurry, screened manure solids, sudan grass silage, and feed-waste, were tracked separately in the mass balance. The error in mass balance closure for most elements was less than 5%. Manure contributed 69.2% of influent dry matter while contributing 77.7% of nitrogen, 90.9% of sulfur, and 73.4% of phosphorus. Sudan grass silage contributed high quantities of chloride and potassium, 33.3% and 43.4%, respectively, relative to the dry matter contribution of 22.3%. Five potential off-site co-digestates (egg waste, grape pomace, milk waste, pasta waste, whey wastewater) were evaluated for anaerobic digestion based on salt and nutrient content in addition to bio-methane potential. Egg waste and wine grape pomace appeared the most promising co-digestates due to their high methane potentials relative to bulk volume. Increasing power production from the current rate of 369 kW to the design value of 710 kW would require co-digestion with either 26800 L d(-1) egg waste or 60900 kg d(-1) grape pomace. However, importation of egg waste would more than double nitrogen loading, resulting in an increase of 172% above the baseline while co-digestion with grape pomace would increase potassium by 279%. Careful selection of imported co-digestates and management of digester effluent is required to

The greenhouse gas balance of European grasslands.

PubMed

Chang, Jinfeng; Ciais, Philippe; Viovy, Nicolas; Vuichard, Nicolas; Sultan, Benjamin; Soussana, Jean-François

2015-10-01

The greenhouse gas (GHG) balance of European grasslands (EU-28 plus Norway and Switzerland), including CO2 , CH4 and N2 O, is estimated using the new process-based biogeochemical model ORCHIDEE-GM over the period 1961-2010. The model includes the following: (1) a mechanistic representation of the spatial distribution of management practice; (2) management intensity, going from intensively to extensively managed; (3) gridded simulation of the carbon balance at ecosystem and farm scale; and (4) gridded simulation of N2 O and CH4 emissions by fertilized grassland soils and livestock. The external drivers of the model are changing animal numbers, nitrogen fertilization and deposition, land-use change, and variable CO2 and climate. The carbon balance of European grassland (NBP) is estimated to be a net sink of 15 ± 7 g C m(-2 ) year(-1) during 1961-2010, equivalent to a 50-year continental cumulative soil carbon sequestration of 1.0 ± 0.4 Pg C. At the farm scale, which includes both ecosystem CO2 fluxes and CO2 emissions from the digestion of harvested forage, the net C balance is roughly halved, down to a small sink, or nearly neutral flux of 8 g C m(-2 ) year(-1) . Adding CH4 and N2 O emissions to net ecosystem exchange to define the ecosystem-scale GHG balance, we found that grasslands remain a net GHG sink of 19 ± 10 g C-CO2 equiv. m(-2 ) year(-1) , because the CO2 sink offsets N2 O and grazing animal CH4 emissions. However, when considering the farm scale, the GHG balance (NGB) becomes a net GHG source of -50 g C-CO2 equiv. m(-2 ) year(-1) . ORCHIDEE-GM simulated an increase in European grassland NBP during the last five decades. This enhanced NBP reflects the combination of a positive trend of net primary production due to CO2 , climate and nitrogen fertilization and the diminishing requirement for grass forage due to the Europe-wide reduction in livestock numbers. © 2015 John Wiley & Sons Ltd.

Validity of the Mexican version of the combined Foot Care Confidence / Foot-Care Behavior scale for diabetes.

PubMed

García-Inzunza, Jaime A; Valles-Medina, Ana M; Muñoz, Fátima A; Delgadillo-Ramos, Guadalupe; Compean-Ortiz, Lidia G

2015-07-01

To 1) translate / transculturally adapt the original (English-language) combined Foot Care Confidence Scale / Foot-Care Behavior instrument (FCCS-FCB) to produce a Mexican-Spanish version and 2) determine its validity and reliability in a population with diabetes in Tijuana, Mexico. The original FCCS-FCB was translated (and back-translated), the content validated (by a group of health professional experts), and the instrument applied to 304 patients 23-78 years old in diabetes support groups in Tijuana, Mexico. Internal consistency for the study constructs ("self-efficacy," and risk / preventive foot self-care behaviors) was measured using Cronbach's alpha. The constructs were validated using principal component factor analysis. The Cronbach's alpha values for internal consistency were 0.782 for self-efficacy and 0.505 for behaviors. Based on the analysis, two factors explained 49.1% of the total variance for self-efficacy, and six factors explained 57.7% of the total variance for behaviors. The results were consistent with those for the original (English) version of the FCCS-FCB. The Mexican version of the FCCS-FCB is a reliable and valid instrument recommended for use with Mexican-Spanish-speaking patients with diabetes.

Studying Basin Water Balance Variations at Inter- and Intra-annual Time Scales Based On the Budyko Hypothesis and GRACE Gravimetry Satellite Observations

NASA Astrophysics Data System (ADS)

Shen, H.

2017-12-01

Increasing intensity in global warming and anthropogenic activities has triggered significant changes over regional climates and landscapes, which, in turn, drive the basin water cycle and hydrological balance into a complex and unstable state. Budyko hypothesis is a powerful tool to characterize basin water balance and hydrological variations at long-term average scale. However, due to the absence of basin water storage change, applications of Budyko theory to the inter-annual and intra-annual time scales has been prohibited. The launch of GRACE gavimetry satellites provides a great opportunity to quantify terrestrial water storage change, which can be further introduced into the Budyko hypothesis to reveal the inter- and intra-annual response of basin water components under impacts of climate variability and/or human activities. This research targeted Hai River Basin (in China) and Murray-Darling Basin (in Australia), which have been identified with a continuous groundwater depletion trend as well as impacts by extreme climates in the past decade. This can help us to explore how annual or seasonal precipitation were redistributed to evapotranspiration and runoff via changing basin water storage. Moreover, the impacts of vegetation on annual basin water balance will be re-examined. Our results are expected to provide deep insights about the water cycle and hydrological behaviors for the targeted basins, as well as a proof for a consideration of basin water storage change into the Budyko model at inter- or intra-annual time steps.

Multiscale Metabolic Modeling: Dynamic Flux Balance Analysis on a Whole-Plant Scale1[W][OPEN

PubMed Central

Grafahrend-Belau, Eva; Junker, Astrid; Eschenröder, André; Müller, Johannes; Schreiber, Falk; Junker, Björn H.

2013-01-01

Plant metabolism is characterized by a unique complexity on the cellular, tissue, and organ levels. On a whole-plant scale, changing source and sink relations accompanying plant development add another level of complexity to metabolism. With the aim of achieving a spatiotemporal resolution of source-sink interactions in crop plant metabolism, a multiscale metabolic modeling (MMM) approach was applied that integrates static organ-specific models with a whole-plant dynamic model. Allowing for a dynamic flux balance analysis on a whole-plant scale, the MMM approach was used to decipher the metabolic behavior of source and sink organs during the generative phase of the barley (Hordeum vulgare) plant. It reveals a sink-to-source shift of the barley stem caused by the senescence-related decrease in leaf source capacity, which is not sufficient to meet the nutrient requirements of sink organs such as the growing seed. The MMM platform represents a novel approach for the in silico analysis of metabolism on a whole-plant level, allowing for a systemic, spatiotemporally resolved understanding of metabolic processes involved in carbon partitioning, thus providing a novel tool for studying yield stability and crop improvement. PMID:23926077

Confidence in delegation and leadership of registered nurses in long-term-care hospitals.

PubMed

Yoon, Jungmin; Kim, Miyoung; Shin, Juhhyun

2016-07-01

Effective delegation improves job satisfaction, responsibility, productivity and development. The ageing population demands more nurses in long-term-care hospitals. Delegation and leadership promote cooperation among nursing staff. However, little research describes nursing delegation and leadership style. We investigated the relationship between registered nurses' delegation confidence and leadership in Korean long-term-care hospitals. Our descriptive correlational design sampled 199 registered nurses from 13 long-term-care hospitals in Korea. Instruments were the Confidence and Intent to Delegate Scale and Multifactor Leadership Questionnaire. Confidence in delegation significantly aligned with current-unit clinical experience, length of total clinical-nursing experience, delegation-training experience and leadership. Transformational leadership was the most statistically significant factor influencing delegation confidence. When effective delegation integrates with efficient leadership, staff can deliver optimal care to long-term-care patients. © 2016 John Wiley & Sons Ltd.

Cognitive motor intervention for gait and balance in Parkinson's disease: systematic review and meta-analysis.

PubMed

Wang, Xue-Qiang; Pi, Yan-Ling; Chen, Bing-Lin; Wang, Ru; Li, Xin; Chen, Pei-Jie

2016-02-01

We performed a systematic review and meta-analysis to assess the effect of cognitive motor intervention (CMI) on gait and balance in Parkinson's disease. PubMed, Embase, Cochrane Library, CINAHL, Web of Science, PEDro, and China Biology Medicine disc. We included randomized controlled trials (RCTs) and non RCTs. Two reviewers independently evaluated articles for eligibility and quality and serially abstracted data. A standardized mean difference ± standard error and 95% confidence interval (CI) was calculated for each study using Hedge's g to quantify the treatment effect. Nine trials with 181 subjects, four randomized controlled trials, and five single group intervention studies were included. The pooling revealed that cognitive motor intervention can improve gait speed (Hedge's g = 0.643 ± 0.191; 95% CI: 0.269 to 1.017, P = 0.001), stride time (Hedge's g = -0.536 ± 0.167; 95% CI: -0.862 to -0.209, P = 0.001), Berg Balance Scale (Hedge's g = 0.783 ± 0.289; 95% CI: 0.218 to 1.349, P = 0.007), Unipedal Stance Test (Hedge's g = 0.440 ± 0.189; 95% CI: 0.07 to 0.81, P =0.02). The systematic review demonstrates that cognitive motor intervention is effective for gait and balance in Parkinson's disease. However, the paper is limited by the quality of the included trials. © The Author(s) 2015.

Stochastic satisficing account of confidence in uncertain value-based decisions

PubMed Central

Bahrami, Bahador; Keramati, Mehdi

2018-01-01

Every day we make choices under uncertainty; choosing what route to work or which queue in a supermarket to take, for example. It is unclear how outcome variance, e.g. uncertainty about waiting time in a queue, affects decisions and confidence when outcome is stochastic and continuous. How does one evaluate and choose between an option with unreliable but high expected reward, and an option with more certain but lower expected reward? Here we used an experimental design where two choices’ payoffs took continuous values, to examine the effect of outcome variance on decision and confidence. We found that our participants’ probability of choosing the good (high expected reward) option decreased when the good or the bad options’ payoffs were more variable. Their confidence ratings were affected by outcome variability, but only when choosing the good option. Unlike perceptual detection tasks, confidence ratings correlated only weakly with decisions’ time, but correlated with the consistency of trial-by-trial choices. Inspired by the satisficing heuristic, we propose a “stochastic satisficing” (SSAT) model for evaluating options with continuous uncertain outcomes. In this model, options are evaluated by their probability of exceeding an acceptability threshold, and confidence reports scale with the chosen option’s thus-defined satisficing probability. Participants’ decisions were best explained by an expected reward model, while the SSAT model provided the best prediction of decision confidence. We further tested and verified the predictions of this model in a second experiment. Our model and experimental results generalize the models of metacognition from perceptual detection tasks to continuous-value based decisions. Finally, we discuss how the stochastic satisficing account of decision confidence serves psychological and social purposes associated with the evaluation, communication and justification of decision-making. PMID:29621325

Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

PubMed Central

Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

2016-01-01

Suboptimal health status (SHS)—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sample of 24,475 individuals aged 15−60 years from a population in southern China. In so doing, we hoped to illuminate the associations between work-recreation balance conditions, healthy lifestyles, and SHS. Work-recreation balance conditions were categorically defined by frequency (“rarely, sometimes, or always”). Health-Promoting Lifestyle Profile (HPLP-II) was used to evaluate the level of healthy lifestyles, and the medical examination report and Sub-Health Measurement Scale V1.0 (SHMS V1.0) were both used to evaluate health status. The ratio of SHS (46.3%) is higher than health status (18.4%) or disease status (35.3%). Overall, 4.9% of respondents reported the lowest level of work-recreation balance, and they scored lower on both the HPLP-II and SHMS V1.0 compared with those who frequently maintained a work-recreation balance. Significant association was found between work-recreation balance behaviors and healthy lifestyles (p < 0.001) after demographic adjustment. In comparison with those reporting a frequent work-recreation balance, individuals whose work-recreation balance was categorically “rare” were 1.69 times as likely to develop SHS (odds ratio (OR): 1.69, 95% confidence interval (CI): 1.49–1.92), and those with infrequent work-recreation balance (“sometimes”) were 1.71 times more likely to develop SHS (OR: 1.71, 95% CI: 1.62–1.81). These findings suggest that work-recreation balance conditions are significantly associated with, and seem to be

Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study.

PubMed

Wu, Shengwei; Xuan, Zhengzheng; Li, Fei; Xiao, Wei; Fu, Xiuqiong; Jiang, Pingping; Chen, Jieyu; Xiang, Lei; Liu, Yanyan; Nie, Xiaoli; Luo, Ren; Sun, Xiaomin; Kwan, Hiuyee; Zhao, Xiaoshan

2016-03-19

Suboptimal health status (SHS)-an intermediate state between health and illness--refers to functional somatic symptoms that are medically undiagnosed. Although- SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work-life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sample of 24,475 individuals aged 15-60 years from a population in southern China. In so doing, we hoped to illuminate the associations between work-recreation balance conditions, healthy lifestyles, and SHS. Work-recreation balance conditions were categorically defined by frequency ("rarely, sometimes, or always"). Health-Promoting Lifestyle Profile (HPLP-II) was used to evaluate the level of healthy lifestyles, and the medical examination report and Sub-Health Measurement Scale V1.0 (SHMS V1.0) were both used to evaluate health status. The ratio of SHS (46.3%) is higher than health status (18.4%) or disease status (35.3%). Overall, 4.9% of respondents reported the lowest level of work-recreation balance, and they scored lower on both the HPLP-II and SHMS V1.0 compared with those who frequently maintained a work-recreation balance. Significant association was found between work-recreation balance behaviors and healthy lifestyles (p < 0.001) after demographic adjustment. In comparison with those reporting a frequent work-recreation balance, individuals whose work-recreation balance was categorically "rare" were 1.69 times as likely to develop SHS (odds ratio (OR): 1.69, 95% confidence interval (CI): 1.49-1.92), and those with infrequent work-recreation balance ("sometimes") were 1.71 times more likely to develop SHS (OR: 1.71, 95% CI: 1.62-1.81). These findings suggest that work-recreation balance conditions are significantly associated with, and seem to be accurate behavioral

Comparison of sub-scaled to full-scaled aircrafts in simulation environment for air traffic management

NASA Astrophysics Data System (ADS)

Elbakary, Mohamed I.; Iftekharuddin, Khan M.; Papelis, Yiannis; Newman, Brett

2017-05-01

Air Traffic Management (ATM) concepts are commonly tested in simulation to obtain preliminary results and validate the concepts before adoption. Recently, the researchers found that simulation is not enough because of complexity associated with ATM concepts. In other words, full-scale tests must eventually take place to provide compelling performance evidence before adopting full implementation. Testing using full-scale aircraft produces a high-cost approach that yields high-confidence results but simulation provides a low-risk/low-cost approach with reduced confidence on the results. One possible approach to increase the confidence of the results and simultaneously reduce the risk and the cost is using unmanned sub-scale aircraft in testing new concepts for ATM. This paper presents the simulation results of using unmanned sub-scale aircraft in implementing ATM concepts compared to the full scale aircraft. The results of simulation show that the performance of sub-scale is quite comparable to that of the full-scale which validates use of the sub-scale in testing new ATM concepts. Keywords: Unmanned

Monitoring glacier albedo as a proxy to derive summer and annual surface mass balances from optical remote-sensing data

NASA Astrophysics Data System (ADS)

Davaze, Lucas; Rabatel, Antoine; Arnaud, Yves; Sirguey, Pascal; Six, Delphine; Letreguilly, Anne; Dumont, Marie

2018-01-01

Less than 0.25 % of the 250 000 glaciers inventoried in the Randolph Glacier Inventory (RGI V.5) are currently monitored with in situ measurements of surface mass balance. Increasing this archive is very challenging, especially using time-consuming methods based on in situ measurements, and complementary methods are required to quantify the surface mass balance of unmonitored glaciers. The current study relies on the so-called albedo method, based on the analysis of albedo maps retrieved from optical satellite imagery acquired since 2000 by the MODIS sensor, on board the TERRA satellite. Recent studies revealed substantial relationships between summer minimum glacier-wide surface albedo and annual surface mass balance, because this minimum surface albedo is directly related to the accumulation-area ratio and the equilibrium-line altitude. On the basis of 30 glaciers located in the French Alps where annual surface mass balance data are available, our study conducted on the period 2000-2015 confirms the robustness and reliability of the relationship between the summer minimum surface albedo and the annual surface mass balance. For the ablation season, the integrated summer surface albedo is significantly correlated with the summer surface mass balance of the six glaciers seasonally monitored. These results are promising to monitor both annual and summer glacier-wide surface mass balances of individual glaciers at a regional scale using optical satellite images. A sensitivity study on the computed cloud masks revealed a high confidence in the retrieved albedo maps, restricting the number of omission errors. Albedo retrieval artifacts have been detected for topographically incised glaciers, highlighting limitations in the shadow correction algorithm, although inter-annual comparisons are not affected by systematic errors.

Laminar-specific Scaling Down of Balanced Excitation and Inhibition in Auditory Cortex by Active Behavioral States

PubMed Central

Zhou, Mu; Liang, Feixue; Xiong, Xiaorui R.; Li, Lu; Li, Haifu; Xiao, Zhongju; Tao, Huizhong W.; Zhang, Li I.

2014-01-01

Cortical sensory processing is modulated by behavioral and cognitive states. How the modulation is achieved through impacting synaptic circuits remains largely unknown. In awake mouse auditory cortex, we reported that sensory-evoked spike responses of layer 2/3 (L2/3) excitatory cells were scaled down with preserved sensory tuning when animals transitioned from quiescence to active behaviors, while L4 and thalamic responses were unchanged. Whole-cell voltage-clamp recordings further revealed that tone-evoked synaptic excitation and inhibition exhibited a robust functional balance. Changes of behavioral state caused scaling down of excitation and inhibition at an approximately equal level in L2/3 cells, but no synaptic changes in L4 cells. This laminar-specific gain control could be attributed to an enhancement of L1–mediated inhibitory tone, with L2/3 parvalbumin inhibitory neurons suppressed as well. Thus, L2/3 circuits can adjust the salience of output in accordance with momentary behavioral demands while maintaining the sensitivity and quality of sensory processing. PMID:24747575

Walking can be more effective than balance training in fall prevention among community-dwelling older adults.

PubMed

Okubo, Yoshiro; Osuka, Yosuke; Jung, Songee; Rafael, Figueroa; Tsujimoto, Takehiko; Aiba, Tatsuya; Kim, Teaho; Tanaka, Kiyoji

2016-01-01

To examine the effects of walking on falls among community-dwelling older adults while accounting for exposures. A total of 90 older adults, ranging in age from 65 to 79 years, were allocated into either the walking (brisk walking, n = 50) or the balance (balance and strength training, n = 40) group to participate in a 3-month supervised and 13-month unsupervised fall-prevention program held from 2012 to 2014 in Japan. Falls and trips that occurred during the 16-month period were monitored with a monthly fall calendar. The risk of falls and trips was evaluated by person-year, physically active person-day and person-step. The walking group showed a significant reduction in the fall risk when evaluated by the falls per physically active person-day (rate ratio 0.38, 95% confidence interval 0.19-0.77) and falls per person-step (rate ratio 0.47, 95% confidence interval 0.26-0.85) compared with the balance group. In contrast, the number of trips significantly increased with walking, even when evaluated as trips per physically active person-day (rate ratio 1.50, 95% confidence interval 1.12-2.00). The present findings suggest that walking among community-dwelling older adults can be more effective for fall prevention than balance training. However, because walking can induce more trips, walking should not be recommended for older adults who are susceptible to falling or frailty. © 2015 Japan Geriatrics Society.

The balance effect of acupuncture therapy among stroke patients.

PubMed

Huang, Shih-Wei; Wang, Wei-Te; Yang, Tsung-Hsien; Liou, Tsan-Hon; Chen, Guan-Yu; Lin, Li-Fong

2014-08-01

To analyze how acupuncture therapy affects balance in patients experiencing their first stroke and to identify the stroke group with greatest improvement in balance after acupuncture intervention. Retrospective case-control study. Ward of a medical university hospital. A total of 629 stroke patients were enrolled initially; 345 patients met the study criteria and 132 were analyzed (66 each in the study and control groups). The study group received physiotherapy combined with acupuncture and the control group received only physiotherapy. The Postural Assessment Scale for Stroke patients (PASS) was used to evaluate balance. This balance scale system can be subdivided into static balance (PASS-MP, maintain posture) and dynamic balance (PASS-CP, change posture). This study revealed no statistically significant improvement of balance in the study group (t test). When patients with high Brunnstrom stage (Br stage) and low Br stage were analyzed separately, once again no statistical difference was detected between the study and control groups of those with high Br stage. However, among low-Br stage patients, the study group showed significant improvement in static balance (mean PASS-MP score±standard deviation: 4.7±3.7) compared with the control group (PASS-MP score: 2.8±2.7) (p<0.05). In first-ever stroke patients with a low Br stage, acupuncture therapy can improve static balance during rehabilitation. However, the effect on balance was limited among high-Br stage patients. This study provides information valuable to patients with hemiplegic stroke because it suggests that acupuncture can be used to improve balance. A prospective double-blind, randomized, controlled study design is recommended for future studies in patients with hemiplegic stroke.

Dynamic power balance analysis in JET

NASA Astrophysics Data System (ADS)

Matthews, G. F.; Silburn, S. A.; Challis, C. D.; Eich, T.; Iglesias, D.; King, D.; Sieglin, B.; Contributors, JET

2017-12-01

The full scale realisation of nuclear fusion as an energy source requires a detailed understanding of power and energy balance in current experimental devices. In this we explore whether a global power balance model in which some of the calibration factors applied to the source or sink terms are fitted to the data can provide insight into possible causes of any discrepancies in power and energy balance seen in the JET tokamak. We show that the dynamics in the power balance can only be properly reproduced by including the changes in the thermal stored energy which therefore provides an additional opportunity to cross calibrate other terms in the power balance equation. Although the results are inconclusive with respect to the original goal of identifying the source of the discrepancies in the energy balance, we do find that with optimised parameters an extremely good prediction of the total power measured at the outer divertor target can be obtained over a wide range of pulses with time resolution up to ∼25 ms.

Virtual-reality balance training with a video-game system improves dynamic balance in chronic stroke patients.

PubMed

Cho, Ki Hun; Lee, Kyoung Jin; Song, Chang Ho

2012-09-01

Stroke is one of the most serious healthcare problems and a major cause of impairment of cognition and physical functions. Virtual rehabilitation approaches to postural control have been used for enhancing functional recovery that may lead to a decrease in the risk of falling. In the present study, we investigated the effects of virtual reality balance training (VRBT) with a balance board game system on balance of chronic stroke patients. Participants were randomly assigned to 2 groups: VRBT group (11 subjects including 3 women, 65.26 years old) and control group (11 subjects including 5 women, 63.13 years old). Both groups participated in a standard rehabilitation program (physical and occupational therapy) for 60 min a day, 5 times a week for 6 weeks. In addition, the VRBT group participated in VRBT for 30 min a day, 3 times a week for 6 weeks. Static balance (postural sway velocity with eyes open or closed) was evaluated with the posturography. Dynamic balance was evaluated with the Berg Balance Scale (BBS) and Timed Up and Go test (TUG) that measures balance and mobility in dynamic balance. There was greater improvement on BBS (4.00 vs. 2.81 scores) and TUG (-1.33 vs. -0.52 sec) in the VRBT group compared with the control group (P < 0.05), but not on static balance in both groups. In conclusion, we demonstrate a significant improvement in dynamic balance in chronic stroke patients with VRBT. VRBT is feasible and suitable for chronic stroke patients with balance deficit in clinical settings.

Expanding a dynamic flux balance model of yeast fermentation to genome-scale

PubMed Central

2011-01-01

Background Yeast is considered to be a workhorse of the biotechnology industry for the production of many value-added chemicals, alcoholic beverages and biofuels. Optimization of the fermentation is a challenging task that greatly benefits from dynamic models able to accurately describe and predict the fermentation profile and resulting products under different genetic and environmental conditions. In this article, we developed and validated a genome-scale dynamic flux balance model, using experimentally determined kinetic constraints. Results Appropriate equations for maintenance, biomass composition, anaerobic metabolism and nutrient uptake are key to improve model performance, especially for predicting glycerol and ethanol synthesis. Prediction profiles of synthesis and consumption of the main metabolites involved in alcoholic fermentation closely agreed with experimental data obtained from numerous lab and industrial fermentations under different environmental conditions. Finally, fermentation simulations of genetically engineered yeasts closely reproduced previously reported experimental results regarding final concentrations of the main fermentation products such as ethanol and glycerol. Conclusion A useful tool to describe, understand and predict metabolite production in batch yeast cultures was developed. The resulting model, if used wisely, could help to search for new metabolic engineering strategies to manage ethanol content in batch fermentations. PMID:21595919

The relationship between fundamental movement skill proficiency and physical self-confidence among adolescents.

PubMed

McGrane, Bronagh; Belton, Sarahjane; Powell, Danielle; Issartel, Johann

2017-09-01

This study aims to assess fundamental movement skill (FMS) proficiency, physical self-confidence levels, and the relationship between these variables and gender differences among adolescents. Three hundred and ninety five adolescents aged 13.78 years (SD = ±1.2) from 20 schools were involved in this study. The Test of Gross Motor Development-2nd Edition (TGMD), TGMD-2 and Victorian Skills Manual were used to assess 15 FMS. Participants' physical self-confidence was also assessed using a valid skill-specific scale. A significant correlation was observed between FMS proficiency and physical self-confidence for females only (r = 0.305, P < 0.001). Males rated themselves as having significantly higher physical self-confidence levels than females (P = 0.001). Males scored significantly higher than females in FMS proficiency (P < 0.05), and the lowest physical self-confidence group were significantly less proficient at FMS than the medium (P < 0.001) and high physical self-confidence groups (P < 0.05). This information not only highlights those in need of assistance to develop their FMS but will also facilitate in the development of an intervention which aims to improve physical self-confidence and FMS proficiency.

Cortical reinstatement and the confidence and accuracy of source memory.

PubMed

Thakral, Preston P; Wang, Tracy H; Rugg, Michael D

2015-04-01

Cortical reinstatement refers to the overlap between neural activity elicited during the encoding and the subsequent retrieval of an episode, and is held to reflect retrieved mnemonic content. Previous findings have demonstrated that reinstatement effects reflect the quality of retrieved episodic information as this is operationalized by the accuracy of source memory judgments. The present functional magnetic resonance imaging (fMRI) study investigated whether reinstatement-related activity also co-varies with the confidence of accurate source judgments. Participants studied pictures of objects along with their visual or spoken names. At test, they first discriminated between studied and unstudied pictures and then, for each picture judged as studied, they also judged whether it had been paired with a visual or auditory name, using a three-point confidence scale. Accuracy of source memory judgments- and hence the quality of the source-specifying information--was greater for high than for low confidence judgments. Modality-selective retrieval-related activity (reinstatement effects) also co-varied with the confidence of the corresponding source memory judgment. The findings indicate that the quality of the information supporting accurate judgments of source memory is indexed by the relative magnitude of content-selective, retrieval-related neural activity. Copyright © 2015 Elsevier Inc. All rights reserved.

Neurophysiology of perceived confidence.

PubMed

Graziano, Martin; Parra, Lucas C; Sigman, Mariano

2010-01-01

In a partial report paradigm, subjects observe during a brief presentation a cluttered field and after some time - typically ranging from 100 ms to a second - are asked to report a subset of the presented elements. A vast buffer of information is transiently available to be broadcasted which, if not retrieved in time, fades rapidly without reaching consciousness. An interesting feature of this experiment is that objective performance and subjective confidence is decoupled. This converts this paradigm in an ideal vehicle to understand the brain dynamics of the construction of confidence. Here we report a high-density EEG experiment in which we infer elements of the EEG response which are indicative of subjective confidence. We find that an early response during encoding partially correlates with perceived confidence. However, the bulk of the weight of subjective confidence is determined during a late, N400-like waveform, during the retrieval stage. This shows that we can find markers of access to internal, subjective states, that are uncoupled from objective response and stimulus properties of the task, and we propose that this can be used with decoding methods of EEG to infer subjective mental states.

Tree carbon allocation dynamics determined using a carbon mass balance approach.

PubMed

Klein, Tamir; Hoch, Günter

2015-01-01

Tree internal carbon (C) fluxes between compound and compartment pools are difficult to measure directly. Here we used a C mass balance approach to decipher these fluxes and provide a full description of tree C allocation dynamics. We collected independent measurements of tree C sinks, source and pools in Pinus halepensis in a semi-arid forest, and converted all fluxes to g C per tree d(-1) . Using this data set, a process flowchart was created to describe and quantify the tree C allocation on diurnal to annual time-scales. The annual C source of 24.5 kg C per tree yr(-1) was balanced by C sinks of 23.5 kg C per tree yr(-1) , which partitioned into 70%, 17% and 13% between respiration, growth, and litter (plus export to soil), respectively. Large imbalances (up to 57 g C per tree d(-1) ) were observed as C excess during the wet season, and as C deficit during the dry season. Concurrent changes in C reserves (starch) were sufficient to buffer these transient C imbalances. The C pool dynamics calculated using the flowchart were in general agreement with the observed pool sizes, providing confidence regarding our estimations of the timing, magnitude, and direction of the internal C fluxes. © 2014 The Authors. New Phytologist © 2014 New Phytologist Trust.

Evaluation of a distributed catchment scale water balance model

NASA Technical Reports Server (NTRS)

Troch, Peter A.; Mancini, Marco; Paniconi, Claudio; Wood, Eric F.

1993-01-01

The validity of some of the simplifying assumptions in a conceptual water balance model is investigated by comparing simulation results from the conceptual model with simulation results from a three-dimensional physically based numerical model and with field observations. We examine, in particular, assumptions and simplifications related to water table dynamics, vertical soil moisture and pressure head distributions, and subsurface flow contributions to stream discharge. The conceptual model relies on a topographic index to predict saturation excess runoff and on Philip's infiltration equation to predict infiltration excess runoff. The numerical model solves the three-dimensional Richards equation describing flow in variably saturated porous media, and handles seepage face boundaries, infiltration excess and saturation excess runoff production, and soil driven and atmosphere driven surface fluxes. The study catchments (a 7.2 sq km catchment and a 0.64 sq km subcatchment) are located in the North Appalachian ridge and valley region of eastern Pennsylvania. Hydrologic data collected during the MACHYDRO 90 field experiment are used to calibrate the models and to evaluate simulation results. It is found that water table dynamics as predicted by the conceptual model are close to the observations in a shallow water well and therefore, that a linear relationship between a topographic index and the local water table depth is found to be a reasonable assumption for catchment scale modeling. However, the hydraulic equilibrium assumption is not valid for the upper 100 cm layer of the unsaturated zone and a conceptual model that incorporates a root zone is suggested. Furthermore, theoretical subsurface flow characteristics from the conceptual model are found to be different from field observations, numerical simulation results, and theoretical baseflow recession characteristics based on Boussinesq's groundwater equation.

Sources of sport confidence, imagery type and performance among competitive athletes: the mediating role of sports confidence.

PubMed

Levy, A R; Perry, J; Nicholls, A R; Larkin, D; Davies, J

2015-01-01

This study explored the mediating role of sport confidence upon (1) sources of sport confidence-performance relationship and (2) imagery-performance relationship. Participants were 157 competitive athletes who completed state measures of confidence level/sources, imagery type and performance within one hour after competition. Among the current sample, confirmatory factor analysis revealed appropriate support for the nine-factor SSCQ and the five-factor SIQ. Mediational analysis revealed that sport confidence had a mediating influence upon the achievement source of confidence-performance relationship. In addition, both cognitive and motivational imagery types were found to be important sources of confidence, as sport confidence mediated imagery type- performance relationship. Findings indicated that athletes who construed confidence from their own achievements and report multiple images on a more frequent basis are likely to benefit from enhanced levels of state sport confidence and subsequent performance.

Parental self-confidence, parenting styles, and corporal punishment in families of ADHD children in Iran.

PubMed

Alizadeh, Hamid; Applequist, Kimberly F; Coolidge, Frederick L

2007-05-01

This study examines the relationship between parental self-confidence, warmth, and involvement, and corporal punishment in families of children with attention deficit/hyperactivity disorder (ADHD). The diagnosis of ADHD was established through clinical interviews with the parents, children, and teachers, according the criteria in DSM-IV-TR. This diagnosis was also established by having the parents complete the Conners' Parent Rating Scale, and the teachers complete the Conners' Teacher Rating Scale. Two groups of Iranian parents, one group with children who have ADHD (N=130) and a control group (N=120), completed questionnaires measuring parental self-confidence and parenting styles. Parents of children with ADHD were found to have lower self-confidence and less warmth and involvement with their children, and used corporal punishment significantly more than the parents of control children. The study provides strong evidence that children with ADHD are at considerable risk of abuse by their parents. Rather than focusing only on the child's ADHD, treatment may also need to address the parents' functioning.

Development of a superconductor magnetic suspension and balance prototype facility for studying the feasibility of applying this technique to large scale aerodynamic testing

NASA Technical Reports Server (NTRS)

Zapata, R. N.; Humphris, R. R.; Henderson, K. C.

1975-01-01

The basic research and development work towards proving the feasibility of operating an all-superconductor magnetic suspension and balance device for aerodynamic testing is presented. The feasibility of applying a quasi-six-degree-of freedom free support technique to dynamic stability research was studied along with the design concepts and parameters for applying magnetic suspension techniques to large-scale aerodynamic facilities. A prototype aerodynamic test facility was implemented. Relevant aspects of the development of the prototype facility are described in three sections: (1) design characteristics; (2) operational characteristics; and (3) scaling to larger facilities.

Management of orthodontic emergencies in primary care - self-reported confidence of general dental practitioners.

PubMed

Popat, H; Thomas, K; Farnell, D J J

2016-07-08

Objective To determine general dental practitioners' (GDPs) confidence in managing orthodontic emergencies.Design Cross-sectional study.Setting Primary dental care.Subjects and methods An online survey was distributed to dentists practicing in Wales. The survey collected basic demographic information and included descriptions of ten common orthodontic emergency scenarios.Main outcome measure Respondents' self-reported confidence in managing the orthodontic emergency scenarios on a 5-point Likert scale. Differences between the Likert responses and the demographic variables were investigated using chi-squared tests.Results The median number of orthodontic emergencies encountered by respondents over the previous six months was 1. Overall, the self-reported confidence of respondents was high with 7 of the 10 scenarios presented scoring a median of 4 indicating that GDPs were 'confident' in their management. Statistical analysis revealed that GDPs who saw more orthodontic emergencies in the previous six months were more confident when managing the presented scenarios. Other variables such as age, gender, geographic location of practice and number of years practising dentistry were not associated with self-reported confidence.Conclusions Despite GDPs encountering very few orthodontic emergencies in primary care, they appear to be confident in dealing with commonly arising orthodontic emergency situations.

Exploring separable components of institutional confidence.

PubMed

Hamm, Joseph A; PytlikZillig, Lisa M; Tomkins, Alan J; Herian, Mitchel N; Bornstein, Brian H; Neeley, Elizabeth M

2011-01-01

Despite its contemporary and theoretical importance in numerous social scientific disciplines, institutional confidence research is limited by a lack of consensus regarding the distinctions and relationships among related constructs (e.g., trust, confidence, legitimacy, distrust, etc.). This study examined four confidence-related constructs that have been used in studies of trust/confidence in the courts: dispositional trust, trust in institutions, obligation to obey the law, and cynicism. First, the separability of the four constructs was examined by exploratory factor analyses. Relationships among the constructs were also assessed. Next, multiple regression analyses were used to explore each construct's independent contribution to confidence in the courts. Finally, a second study replicated the first study and also examined the stability of the institutional confidence constructs over time. Results supported the hypothesized separability of, and correlations among, the four confidence-related constructs. The extent to which the constructs independently explained the observed variance in confidence in the courts differed as a function of the specific operationalization of confidence in the courts and the individual predictor measures. Implications for measuring institutional confidence and future research directions are discussed. Copyright © 2011 John Wiley & Sons, Ltd.

Drought impacts on vegetation activity in the Mediterranean region: An assessment using remote sensing data and multi-scale drought indicators

NASA Astrophysics Data System (ADS)

Gouveia, C. M.; Trigo, R. M.; Beguería, S.; Vicente-Serrano, S. M.

2017-04-01

The present work analyzes the drought impacts on vegetation over the entire Mediterranean basin, with the purpose of determining the vegetation communities, regions and seasons at which vegetation is driven by drought. Our approach is based on the use of remote sensing data and a multi-scalar drought index. Correlation maps between fields of monthly Normalized Difference Vegetation Index (NDVI) and the Standardized Precipitation-Evapotranspiration Index (SPEI) at different time scales (1-24 months) were computed for representative months of winter (Feb), spring (May), summer (Aug) and fall (Nov). Results for the period from 1982 to 2006 show large areas highly controlled by drought, although presenting high spatial and seasonal differences, with a maximum influence in August and a minimum in February. The highest correlation values are observed in February for 3 months' time scale and in May for 6 and 12 months. The higher control of drought on vegetation in February and May is obtained mainly over the drier vegetation communities (Mediterranean Dry and Desertic) at shorter time scales (3 to 9 months). Additionally, in February the impact of drought on vegetation is lower for Temperate Oceanic and Continental vegetation types and takes place at longer time scales (18-24). The dependence of drought time-scale response with water balance, as obtained through a simple difference between precipitation and reference evapotranspiration, varies with vegetation communities. During February and November low water balance values correspond to shorter time scales over dry vegetation communities, whereas high water balance values implies longer time scales over Temperate Oceanic and Continental areas. The strong control of drought on vegetation observed for Mediterranean Dry and Desertic vegetation types located over areas with high negative values of water balance emphasizes the need for an early warning drought system covering the entire Mediterranean basin. We are confident

'Losing my touch': decline in self-reported confidence in performing practical procedures in consultant oncologists.

PubMed

Thomson, A H; Foy, C J W; Benstead, K

2006-08-01

This study aimed to compare the confidence of oncology consultants and specialist registrars (SpRs) in the performance of practical procedures, to contrast this with confidence in other areas of practice and to determine at what grade they felt most confident. Questionnaires were sent to all 57 oncology consultants and SpRs in the South-West region. Respondents scored confidence on a five-point Likert scale. The response rate was 70%. SpRs were significantly more confident in cardiopulmonary resuscitation (p = 0.003) and central line insertion (p = 0.006). Consultants were significantly more confident in developing management plans (p = 0.001) and performing committee work (p = 0.002). Only 6% of consultants felt most confident performing practical procedures as a consultant, and were less confident about these than other tasks (p = 0.001). Some 86% of SpRs considered they were more confident performing practical procedures as senior house officers (SHOs). In conclusion, self-reported confidence in performing practical procedures declines during career progression in oncology. This raises questions about the teaching and supervision of these procedures. If there is a greater emphasis on a consultant-provided service, their educational needs will need to be recognized and retraining or outsourcing of these procedures to other specialties may be necessary.

Optimizing Balanced Incomplete Block Designs for Educational Assessments

ERIC Educational Resources Information Center

van der Linden, Wim J.; Veldkamp, Bernard P.; Carlson, James E.

2004-01-01

A popular design in large-scale educational assessments as well as any other type of survey is the balanced incomplete block design. The design is based on an item pool split into a set of blocks of items that are assigned to sets of "assessment booklets." This article shows how the problem of calculating an optimal balanced incomplete block…

Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation.

PubMed

Hedberg, Berith; Malm, Dan; Karlsson, Jan-Erik; Årestedt, Kristofer; Broström, Anders

2018-06-01

Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making. The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms. A cross-sectional design was used and 322 patients (34% women), mean age 66.1 years (SD 10.5 years) with atrial fibrillation were included in the south of Sweden. Clinical examinations were done post an atrial fibrillation episode. Self-rating scales for communication (Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness), uncertainty in illness (Mishel Uncertainty in Illness Scale-Community), mastery of daily life (Mastery Scale), depressive symptoms (Hospital Anxiety and Depression Scale) and vitality, physical health and mental health (36-item Short Form Health Survey) were used to collect data. Decreased vitality and mastery of daily life, as well as increased uncertainty in illness, were independently associated with lower confidence in decision making. Absence of hypertension and increased uncertainty in illness were independently associated with lower satisfaction with risk communication. Clinical atrial fibrillation variables or depressive symptoms were not associated with satisfaction with confidence in decision making or satisfaction with risk communication. The final models explained 29.1% and 29.5% of the variance in confidence in decision making and satisfaction with risk communication. Confidence in decision making is associated with decreased vitality and mastery of daily life, as well as increased uncertainty in illness, while absence of hypertension and increased uncertainty in illness are associated with risk communication satisfaction.

Distinguishing highly confident accurate and inaccurate memory: insights about relevant and irrelevant influences on memory confidence

PubMed Central

Chua, Elizabeth F.; Hannula, Deborah E.; Ranganath, Charan

2012-01-01

It is generally believed that accuracy and confidence in one’s memory are related, but there are many instances when they diverge. Accordingly, it is important to disentangle the factors which contribute to memory accuracy and confidence, especially those factors that contribute to confidence, but not accuracy. We used eye movements to separately measure fluent cue processing, the target recognition experience, and relative evidence assessment on recognition confidence and accuracy. Eye movements were monitored during a face-scene associative recognition task, in which participants first saw a scene cue, followed by a forced-choice recognition test for the associated face, with confidence ratings. Eye movement indices of the target recognition experience were largely indicative of accuracy, and showed a relationship to confidence for accurate decisions. In contrast, eye movements during the scene cue raised the possibility that more fluent cue processing was related to higher confidence for both accurate and inaccurate recognition decisions. In a second experiment, we manipulated cue familiarity, and therefore cue fluency. Participants showed higher confidence for cue-target associations for when the cue was more familiar, especially for incorrect responses. These results suggest that over-reliance on cue familiarity and under-reliance on the target recognition experience may lead to erroneous confidence. PMID:22171810

Distinguishing highly confident accurate and inaccurate memory: insights about relevant and irrelevant influences on memory confidence.

PubMed

Chua, Elizabeth F; Hannula, Deborah E; Ranganath, Charan

2012-01-01

It is generally believed that accuracy and confidence in one's memory are related, but there are many instances when they diverge. Accordingly it is important to disentangle the factors that contribute to memory accuracy and confidence, especially those factors that contribute to confidence, but not accuracy. We used eye movements to separately measure fluent cue processing, the target recognition experience, and relative evidence assessment on recognition confidence and accuracy. Eye movements were monitored during a face-scene associative recognition task, in which participants first saw a scene cue, followed by a forced-choice recognition test for the associated face, with confidence ratings. Eye movement indices of the target recognition experience were largely indicative of accuracy, and showed a relationship to confidence for accurate decisions. In contrast, eye movements during the scene cue raised the possibility that more fluent cue processing was related to higher confidence for both accurate and inaccurate recognition decisions. In a second experiment we manipulated cue familiarity, and therefore cue fluency. Participants showed higher confidence for cue-target associations for when the cue was more familiar, especially for incorrect responses. These results suggest that over-reliance on cue familiarity and under-reliance on the target recognition experience may lead to erroneous confidence.

Explorations in Statistics: Confidence Intervals

ERIC Educational Resources Information Center

Curran-Everett, Douglas

2009-01-01

Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This third installment of "Explorations in Statistics" investigates confidence intervals. A confidence interval is a range that we expect, with some level of confidence, to include the true value of a population parameter…

DistributedFBA.jl: High-level, high-performance flux balance analysis in Julia

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

Heirendt, Laurent; Thiele, Ines; Fleming, Ronan M. T.

Flux balance analysis and its variants are widely used methods for predicting steady-state reaction rates in biochemical reaction networks. The exploration of high dimensional networks with such methods is currently hampered by software performance limitations. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on a subset or all the reactions of large and huge-scale networks, on any number of threads or nodes. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on amore » subset or all the reactions of large and huge-scale networks, on any number of threads or nodes.« less

DistributedFBA.jl: High-level, high-performance flux balance analysis in Julia

DOE PAGES

Heirendt, Laurent; Thiele, Ines; Fleming, Ronan M. T.

2017-01-16

Flux balance analysis and its variants are widely used methods for predicting steady-state reaction rates in biochemical reaction networks. The exploration of high dimensional networks with such methods is currently hampered by software performance limitations. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on a subset or all the reactions of large and huge-scale networks, on any number of threads or nodes. DistributedFBA.jl is a high-level, high-performance, open-source implementation of flux balance analysis in Julia. It is tailored to solve multiple flux balance analyses on amore » subset or all the reactions of large and huge-scale networks, on any number of threads or nodes.« less

Sampling Theory and Confidence Intervals for Effect Sizes: Using ESCI To Illustrate "Bouncing"; Confidence Intervals.

ERIC Educational Resources Information Center

Du, Yunfei

This paper discusses the impact of sampling error on the construction of confidence intervals around effect sizes. Sampling error affects the location and precision of confidence intervals. Meta-analytic resampling demonstrates that confidence intervals can haphazardly bounce around the true population parameter. Special software with graphical…

The Individual and Relational Role Balance Scale (IRRBS): A Preliminary Scale Development and Validation Study

ERIC Educational Resources Information Center

Bishop, Jennifer L.; Welsh, Deborah P.; Lounsbury, John W.; Norona, Jerika C.

2016-01-01

During emerging adulthood, young people begin the process of balancing individual and relational role commitments. Whereas development within specific domains, primarily career and relationship (work and love), have been explored separately, it is important to understand how emerging adults divide their attention across multiple individual (i.e.,…

Is Gaydar Affected by Attitudes Toward Homosexuality? Confidence, Labeling Bias, and Accuracy.

PubMed

Brewer, Gayle; Lyons, Minna

2017-01-01

Previous research has largely ignored the relationship between sexual orientation judgement accuracy, confidence, and attitudes toward homosexuality. In an online study, participants (N = 269) judged the sexual orientation of homosexual and heterosexual targets presented via a series of facial photographs. Participants also indicated their confidence in each judgment and completed the Modern Homonegativity Scale (Morrison & Morrison, 2002). We found that (1) homosexual men and heterosexual women were more accurate when judging photographs of women as opposed to photographs of men, and (2) in heterosexual men, negative attitudes toward homosexual men predicted confidence and bias when rating men's photographs. Findings indicate that homosexual men and heterosexual women are similar in terms of accuracy in judging women's sexuality. Further, especially in men, homophobia is associated with cognitive biases in labeling other men but does not have a relationship with increased accuracy.

Parent's confidence as a caregiver.

PubMed

Raines, Deborah A; Brustad, Judith

2012-06-01

The purpose of this study was to describe the parent's self-reported confidence as a caregiver. The specific research questions were as follows: • What is the parent's perceived level of confidence when performing infant caregiving activities in the neonatal intensive care unit (NICU)? • What is the parent's projected level of confidence about performing infant caregiving activities on the first day at home? Participants were parents of infants with an anticipated discharge date within 5 days. Inclusion criteria were as follows: parent at least 18 years of age, infant's discharge destination is home with the parent, parent will have primary responsibility for the infant after discharge, and the infant's length of stay in the NICU was a minimum of 10 days. Descriptive, survey research. Participants perceived themselves to be confident in all but 2 caregiving activities when caring for their infants in the NICU, but parents projected a change in their level of confidence in their ability to independently complete infant care activities at home. When comparing the self-reported level of confidence in the NICU and the projected level of confidence at home, the levels of confidence decreased for 5 items, increased for 8 items, and remained unchanged for 2 items. All of the items with a decrease in score were the items with the lowest score when performed in the NICU. All of these low-scoring items are caregiving activities that are unique to the post-NICU status of the infant. Interestingly, the parent's projected level of confidence increased for the 8 items focused on handling and interacting with the infant. The findings of this research provide evidence that nurses may need to rethink when parents become active participants in their infant's medical-based caregiving activities.

Amount of balance necessary for the independence of transfer and stair-climbing in stroke inpatients.

PubMed

Fujita, Takaaki; Sato, Atsushi; Ohashi, Yuji; Nishiyama, Kazutaka; Ohashi, Takuro; Yamane, Kazuhiro; Yamamoto, Yuichi; Tsuchiya, Kenji; Otsuki, Koji; Tozato, Fusae

2018-05-01

The purpose of this study was to clarify the amount of balance necessary for the independence of transfer and stair-climbing in stroke patients. This study included 111 stroke inpatients. Simple and multiple regression analyses were conducted to establish the association between the FIM ® instrument scores for transfer or stair-climbing and Berg Balance Scale. Furthermore, receiver operating characteristic curves were used to elucidate the amount of balance necessary for the independence of transfer and stair-climbing. Simple and multiple regression analyses showed that the FIM ® instrument scores for transfer and stair-climbing were strongly associated with Berg Balance Scale. On comparison of the independent and supervision-dependent groups, Berg Balance Scale cut-off values for transfer and stair-climbing were 41/40 and 54/53 points, respectively. On comparison of the independent-supervision and dependent groups, the cut-off values for transfer and stair-climbing were 30/29 and 41/40 points, respectively. The calculated cut-off values indicated the amount of balance necessary for the independence of transfer and stair-climbing, with and without supervision, in stroke patients. Berg Balance Scale has a good discriminatory ability and cut-off values are clinically useful to determine the appropriate independence levels of transfer and stair-climbing in hospital wards. Implications for rehabilitation The Berg Balance Scale's (BBS) strong association with transfer and stair-climbing independence and performance indicates that establishing cut-off values is vitally important for the established use of the BBS clinically. The cut-off values calculated herein accurately demonstrate the level of balance necessary for transfer and stair-climbing independence, with and without supervision, in stroke patients. These criteria should be employed clinically for determining the level of independence for transfer and stair-climbing as well as for setting balance training

Specificity of Balance Training in Healthy Individuals: A Systematic Review and Meta-Analysis.

PubMed

Kümmel, Jakob; Kramer, Andreas; Giboin, Louis-Solal; Gruber, Markus

2016-09-01

It has become common practice to incorporate balance tasks into the training program for athletes who want to improve performance and prevent injuries, in rehabilitation programs, and in fall prevention programs for the elderly. However, it is still unclear whether incorporating balance tasks into a training program increases performance only in these specific tasks or if it affects balance in a more general way. The objective of this systematic literature review and meta-analysis was to determine to what extent the training of balance tasks can improve performance in non-trained balance tasks. A systematic literature search was performed in the online databases EMBASE, PubMed, SPORTDiscus and Web of Science. Articles related to balance training and testing in healthy populations published between January 1985 and March 2015 were considered. A total of 3093 articles were systematically evaluated. Randomized controlled trials were included that (i) used only balance tasks during the training, (ii) used at least two balance tests before and after training, and (iii) tested performance in the trained balance tasks and at least one non-trained balance task. Six studies with a total of 102 subjects met these criteria and were included into the meta-analysis. The quality of the studies was evaluated by means of the Physiotherapy Evidence Database (PEDro) scale. A random effect model was used to calculate the between-subject standardized mean differences (SMDbs) in order to quantify the effect of balance training on various kinds of balance measures relative to controls. The tested balance tasks in each study were classified into tasks that had been trained and tasks that had not been trained. For further analyses, the non-trained balance tasks were subdivided into tasks with similar or non-similar body position and similar or non-similar balance perturbation direction compared to the trained task. The effect of balance training on the performance of the trained balance

Reliability of the Community Balance and Mobility Scale (CB&M) in high-functioning school-aged children and adolescents who have an acquired brain injury.

PubMed

Wright, F Virginia; Ryan, Jennifer; Brewer, Kelly

2010-01-01

To examine inter-rater, intra-rater and test-re-test reliability of the Community Balance and Mobility Scale (CB&M) and compare reliability in live vs videotape rating contexts for children with acquired brain injury (ABI). Repeated measures design. Seven physiotherapists (PTs) were trained as assessors. The primary assessor administered and scored baseline CB&M while the second assessor observed and scored independently (inter-rater reliability). Re-assessment occurred 3-10 days later by primary assessor (test-re-test reliability). Assessments were videotaped. There were 32 participants with ABI (mean age = 14 years 1 month (SD = 2 years 1 month)). Baseline mean scores were 67.4% (18.2) and 66.7% (18.3) for primary and second assessor, respectively. Primary assessors' re-test mean score was 69.3%. Inter-rater reliability ICC was 0.93 (95% confidence interval (CI) = 0.87-0.97). Test-re-test ICC was 0.90 (95%CI = 0.81-0.95) and Bland-Altman plot indicated greatest test-re-test differences for mid-range CB&M scores. Minimum detectable change (MDC₉₀) was 13.5% points. The CB&M showed excellent reliability in youth. Reliability was comparable for live and videotape rating approaches, meaning that the easier and less expensive live-rating can be recommended. Future work should focus on evaluation of responsiveness to change in rehabilitation centre and community intervention contexts.

Small-scale Pressure-balanced Structures Driven by Mirror-mode Waves in the Solar Wind

NASA Astrophysics Data System (ADS)

Yao, Shuo; He, J.-S.; Tu, C.-Y.; Wang, L.-H.; Marsch, E.

2013-10-01

Recently, small-scale pressure-balanced structures (PBSs) have been studied with regard to their dependence on the direction of the local mean magnetic field B0 . The present work continues these studies by investigating the compressive wave mode forming small PBSs, here for B0 quasi-perpendicular to the x-axis of Geocentric Solar Ecliptic coordinates (GSE-x). All the data used were measured by WIND in the quiet solar wind. From the distribution of PBSs on the plane determined by the temporal scale and angle θxB between the GSE-x and B0 , we notice that at θxB = 115° the PBSs appear at temporal scales ranging from 700 s to 60 s. In the corresponding temporal segment, the correlations between the plasma thermal pressure P th and the magnetic pressure P B, as well as that between the proton density N p and the magnetic field strength B, are investigated. In addition, we use the proton velocity distribution functions to calculate the proton temperatures T and T ∥. Minimum Variance Analysis is applied to find the magnetic field minimum variance vector BN . We also study the time variation of the cross-helicity σc and the compressibility C p and compare these with values from numerical predictions for the mirror mode. In this way, we finally identify a short segment that has T > T ∥, proton β ~= 1, both pairs of P th-P B and N p-B showing anti-correlation, and σc ≈ 0 with C p > 0. Although the examination of σc and C p is not conclusive, it provides helpful additional information for the wave mode identification. Additionally, BN is found to be highly oblique to B0 . Thus, this work suggests that a candidate mechanism for forming small-scale PBSs in the quiet solar wind is due to mirror-mode waves.

The evaluation of a strength and balance exercise program for falls prevention in community primary care.

PubMed

Hawley-Hague, Helen; Roden, Amy; Abbott, Jo

2017-08-01

We aimed to evaluate a strength and balance program delivered in the community. There is little evidence of implementation of evidence-based exercise in practice. The program was a step-down model, designed to encourage long-term exercise in community classes. The program consisted of a fully funded referral only evidence-based 12-week strength and balance (Community Otago) class, followed by an evidence-based continuous open-access community strength and balance class (Active Always). The program was offered to patients: 1) after formal falls rehabilitation (falls and fracture service); 2) after falls rehabilitation in intermediate care; and 3) referred by a GP who were not eligible for rehabilitation (preventative measure). Outcome evaluation used descriptive statistics to report changes in function, confidence in balance, hospital attendance/admission for falls/fractures and transition to community classes. Focus groups established participant experience/satisfaction. Seventy-nine participants were included, aged 56-96, and 53 (67%) were women. About 63.3% of patients transitioned to Active Always classes, demonstrating improvement in maintenance. Follow-up scores from baseline attendance at falls and fracture service to 12-weeks follow-up (24 weeks) in Community Otago showed the majority of patients improved their function (Timed up and Go), confidence (ConfBal) and lowered their falls risk (Tinetti). Follow-up of participants from Community Otago baseline to the end of 12-weeks showed improvement in function and confidence, but only a third of participants lowered their falls risk. Focus groups data suggest that continuity of delivery, the role of the instructor, health professional, and social and physical outcomes were essential for maintenance. A supportive environment can be created which encourages older adults' continued participation in group-based strength and balance, helping the delivery of evidence-based practice.