Objective Biomarkers of Balance and Gait for Parkinson’s Disease using Body-worn Sensors
Horak, Fay B; Mancini, Martina
2014-01-01
Balance and gait impairments characterize progression of Parkinson’s disease (PD), predict fall risk, and are important contributors to reduced quality of life. Advances in technology of small, body-worn inertial sensors have made it possible to develop quick, objective measures of balance and gait impairments in the clinic for research trials and clinical practice. Objective balance and gait metrics may eventually provide useful biomarkers for PD. In fact, objective balance and gait measures are already being used as surrogate end-points for demonstrating clinical efficacy of new treatments, in place of counting falls from diaries, using stop-watch measures of gait speed, or clinical balance rating scales. This review summarizes the types of objective measures available from body-worn sensors. We organize the metrics based on the neural control system for mobility affected by PD: postural stability in stance, postural responses, gait initiation, gait (temporal-spatial lower and upper body coordination and dynamic equilibrium), postural transitions, and freezing of gait. However, the explosion of metrics derived by wearable sensors during prescribed balance and gait tasks that are abnormal in people with PD do not yet qualify as behavioral biomarkers because many balance and gait impairments observed in PD are not specific to the disease, nor shown to be related to specific pathophysiologic biomarkers. In the future, the most useful balance and gait biomarkers for PD will be those that are sensitive and specific for early PD and related to the underlying disease process. PMID:24132842
Darbin, Olivier; Gubler, Coral; Naritoku, Dean; Dees, Daniel; Martino, Anthony; Adams, Elizabeth
2016-01-01
This study describes a cost-effective screening protocol for parkinsonism based on combined objective and subjective monitoring of balance function. Objective evaluation of balance function was performed using a game industry balance board and an automated analyses of the dynamic of the center of pressure in time, frequency, and non-linear domains collected during short series of stand up tests with different modalities and severity of sensorial deprivation. The subjective measurement of balance function was performed using the Dizziness Handicap Inventory questionnaire. Principal component analyses on both objective and subjective measurements of balance function allowed to obtained a specificity and selectivity for parkinsonian patients (vs. healthy subjects) of 0.67 and 0.71 respectively. The findings are discussed regarding the relevance of cost-effective balance-based screening system as strategy to meet the needs of broader and earlier screening for parkinsonism in communities with limited access to healthcare.
Teel, Elizabeth F; Gay, Michael R; Arnett, Peter A; Slobounov, Semyon M
2015-01-01
Objective Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care. Design Retrospective, case-control study Setting Institutional research laboratory Participants Normal controls (n=94) and concussed participants (n=27) Interventions All participants completed a VR balance assessment paradigm. Concussed participants were diagnosed by a Certified Athletic Trainer or physician (with 48 hours post-injury) and tested in the lab between 7-10 days post-injury. ROC curves were performed in order to establish the VR module’s sensitivity and specificity for detecting lingering balance deficits. Main Outcome Measures Final balance score Results For the VR balance module, a cutoff score of 8.25 was established to maximize sensitivity at 85.7% and specificity at 87.8%. Conclusions The VR balance module has high sensitivity and specificity for detecting sub-acute balance deficits after concussive injury. PMID:26505696
Lefaivre, Shannon C; Almeida, Quincy J
2015-02-01
Impaired sensory processing in Parkinson's disease (PD) has been argued to contribute to balance deficits. Exercises aimed at improving sensory feedback and body awareness have the potential to ameliorate balance deficits in PD. Recently, PD SAFEx™, a sensory and attention focused rehabilitation program, has been shown to improve motor deficits in PD, although balance control has never been evaluated. The objective of this study was to measure the effects of PD SAFEx™ on balance control in PD. Twenty-one participants with mild to moderate idiopathic PD completed 12 weeks of PD SAFEx™ training (three times/week) in a group setting. Prior to training, participants completed a pre-assessment evaluating balance in accordance with an objective, computerized test of balance (modified clinical test of sensory integration and balance (m-CTSIB) and postural stability testing (PST)) protocols. The m-CTSIB was our primary outcome measure, which allowed assessment of balance in both eyes open and closed conditions, thus enabling evaluation of specific sensory contributions to balance improvement. At post-test, a significant interaction between time of assessment and vision condition (p=.014) demonstrated that all participants significantly improved balance control, specifically when eyes were closed. Balance control did not change from pre to post with eyes open. These results provide evidence that PD SAFEx™ is effective at improving the ability to utilize proprioceptive information, resulting in improved balance control in the absence of vision. Enhancing the ability to utilize proprioception for individuals with PD is an important intermediary to improving balance deficits. Copyright © 2015. Published by Elsevier B.V.
Tally, Zachary; Boetefuer, Laura; Kauk, Courtney; Perez, Gabriela; Schrand, Lorraine; Hoder, Jeffrey
2017-10-01
Physical activity and exercise interventions are useful in facilitating the functional recovery of those with chronic stroke and, routinely, are gait-specific. While treadmill training has proven useful in gait performance recovery post-stroke, its efficacy on balance dysfunction has not been systematically reviewed. The purpose of this systematic review was to determine the effect of treadmill training (TT) interventions on balance dysfunction in individuals with chronic stroke. A systematic literature search of PubMed, EMBASE, and CINAHL was performed. Eligible randomized controlled trials were published between 2007 and 2016. Selected trials investigated TT interventions in persons with chronic stroke and implemented at least one objective balance measure. Methodological quality was assessed using PEDro criteria. Eight studies met eligibility criteria and were included in the qualitative analysis. Studies differed in TT implementation and use of adjunctive treatments; however, all trials demonstrated improvements in balance measures that were as effective, if not more so, than conventional physical therapy treatments, including targeted balance training. This review recognized moderate evidence in favor of TT interventions in balance and stroke rehabilitation programs. With TT, intensity may be a more critical factor than specificity and may offer additional carryover to recovery parameters of postural control and balance, beyond gait performance. It is recommended that clinicians utilizing TT incorporate objective measures of balance to assess the potential for skill transference and improvements in balance. Higher quality studies and additional research are needed to denote critical parameters by which improvements in balance may be optimized.
Building a balanced scorecard for a burn center.
Wachtel, T L; Hartford, C E; Hughes, J A
1999-08-01
The Balanced Scorecard provides a model that can be adapted to the management of any burn center, burn service or burn program. This model enables an organization to translate its mission and vision into specific strategic objectives across the four perspective: (1) the financial perspective; (2) the customer service perspective; (3) the internal business perspective; and (4) the growth and learning perspective. Once the appropriate objectives are identified, the Balanced Scorecard guides the organization to develop reasonable performance measures and establishes targets, initiatives and alternatives to meet programmatic goals and pursue longer-term visionary improvements. We used the burn center at the University of Colorado Health Sciences Center to test whether the Balanced Scorecard methodology was appropriate for the core business plan of a healthcare strategic business unit (i.e. a burn center).
Zemková, Erika
2014-05-01
This review includes the latest findings based on experimental studies addressing sport-specific balance, an area of research that has grown dramatically in recent years. The main objectives of this work were to investigate the postural sway response to different forms of exercise under laboratory and sport-specific conditions, to examine how this effect can vary with expertise, and to provide examples of the association of impaired balance with sport performance and/or increasing risk of injury. In doing so, sports where body balance is one of the limiting factors of performance were analyzed. While there are no significant differences in postural stability between athletes of different specializations and physically active individuals during standing in a standard upright position (e.g., bipedal stance), they have a better ability to maintain balance in specific conditions (e.g., while standing on a narrow area of support). Differences in magnitude of balance impairment after specific exercises (rebound jumps, repeated rotations, etc.) and mainly in speed of its readjustment to baseline are also observed. Besides some evidence on an association of greater postural sway with the increasing risk of injuries, there are many myths related to the negative influence of impaired balance on sport performance. Though this may be true for shooting or archery, findings have shown that in many other sports, highly skilled athletes are able to perform successfully in spite of increased postural sway. These findings may contribute to better understanding of the postural control system under various performance requirements. It may provide useful knowledge for designing training programs for specific sports.
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.
Baracks, Joshua; Casa, Douglas J; Covassin, Tracey; Sacko, Ryan; Scarneo, Samantha E; Schnyer, David; Yeargin, Susan W; Neville, Christopher
2018-06-13
Without a true criterion standard assessment, the sport-related concussion (SRC) diagnosis remains subjective. Inertial balance sensors have been proposed to improve acute SRC assessment, but few researchers have studied their clinical utility. To determine if group differences exist when using objective measures of balance in a sample of collegiate athletes with recent SRCs and participants serving as the control group and to calculate sensitivity and specificity to determine the diagnostic utility of the inertial balance sensor for acute SRC injuries. Cohort study. Multicenter clinical trial. We enrolled 48 participants with SRC (age = 20.62 ± 1.52 years, height = 179.76 ± 10.00 cm, mass = 83.92 ± 23.22 kg) and 45 control participants (age = 20.85 ± 1.42 years, height = 177.02 ± 9.59 cm, mass = 74.61 ± 14.92 kg) at 7 clinical sites in the United States. All were varsity or club collegiate athletes, and all participants with SRC were tested within 72 hours of SRC. Balance performance was assessed using an inertial balance sensor. Two measures (root mean square [RMS] sway and 95% ellipse sway area) were analyzed to represent a range of general balance measures. Balance assessments were conducted in double-legged, single-legged, and tandem stances. A main effect for group was associated with the root mean square sway measure ( F 1,91 = 11.75, P = .001), with the SRC group demonstrating balance deficits compared with the control group. We observed group differences in the 95% ellipse sway area measure for the double-legged ( F 1,91 = 11.59, P = .001), single-legged ( F 1,91 = 6.91, P = .01), and tandem ( F 1,91 = 7.54, P = .007) stances. Sensitivity was greatest using a cutoff value of 0.5 standard deviations (54% [specificity = 71%]), whereas specificity was greatest using a cutoff value of 2 standard deviations (98% [sensitivity = 33%]). Inertial balance sensors may be useful tools for objectively measuring balance during acute SRC evaluation. However, low sensitivity suggests that they may be best used in conjunction with other assessments to form a comprehensive screening that may improve sensitivity.
An improved NSGA - II algorithm for mixed model assembly line balancing
NASA Astrophysics Data System (ADS)
Wu, Yongming; Xu, Yanxia; Luo, Lifei; Zhang, Han; Zhao, Xudong
2018-05-01
Aiming at the problems of assembly line balancing and path optimization for material vehicles in mixed model manufacturing system, a multi-objective mixed model assembly line (MMAL), which is based on optimization objectives, influencing factors and constraints, is established. According to the specific situation, an improved NSGA-II algorithm based on ecological evolution strategy is designed. An environment self-detecting operator, which is used to detect whether the environment changes, is adopted in the algorithm. Finally, the effectiveness of proposed model and algorithm is verified by examples in a concrete mixing system.
Application of dynamic flux balance analysis to an industrial Escherichia coli fermentation.
Meadows, Adam L; Karnik, Rahi; Lam, Harry; Forestell, Sean; Snedecor, Brad
2010-03-01
We have developed a reactor-scale model of Escherichia coli metabolism and growth in a 1000 L process for the production of a recombinant therapeutic protein. The model consists of two distinct parts: (1) a dynamic, process specific portion that describes the time evolution of 37 process variables of relevance and (2) a flux balance based, 123-reaction metabolic model of E. coli metabolism. This model combines several previously reported modeling approaches including a growth rate-dependent biomass composition, maximum growth rate objective function, and dynamic flux balancing. In addition, we introduce concentration-dependent boundary conditions of transport fluxes, dynamic maintenance demands, and a state-dependent cellular objective. This formulation was able to describe specific runs with high-fidelity over process conditions including rich media, simultaneous acetate and glucose consumption, glucose minimal media, and phosphate depleted media. Furthermore, the model accurately describes the effect of process perturbations--such as glucose overbatching and insufficient aeration--on growth, metabolism, and titer. (c) 2009 Elsevier Inc. All rights reserved.
Mobility Lab to Assess Balance and Gait with Synchronized Body-worn Sensors
Mancini, Martina; King, Laurie; Salarian, Arash; Holmstrom, Lars; McNames, James; Horak, Fay B
2014-01-01
This paper is a commentary to introduce how rehabilitation professionals can use a new, body-worn sensor system to obtain objective measures of balance and gait. Current assessments of balance and gait in clinical rehabilitation are largely limited to subjective scales, simple stop-watch measures, or complex, expensive machines not practical or largely available. Although accelerometers and gyroscopes have been shown to accurately quantify many aspects of gait and balance kinematics, only recently a comprehensive, portable system has become available for clinicians. By measuring body motion during tests that clinicians are already performing, such as the Timed Up and Go test (TUG) and the Clinical Test of Sensory Integration for Balance (CITSIB), the additional time for assessment is minimal. By providing instant analysis of balance and gait and comparing a patient’s performance to age-matched control values, therapists receive an objective, sensitive screening profile of balance and gait strategies. This motion screening profile can be used to identify mild abnormalities not obvious with traditional clinical testing, measure small changes due to rehabilitation, and design customized rehabilitation programs for each individual’s specific balance and gait deficits. PMID:24955286
1980-02-01
maneuver conditions, and transmit the net axial thrust force between the turbine and fan sections due to pressure and aero dynamic gas loads . 49 Lm...stiffness composite material shaft. Both~~ balancing demonstration and the composite shaft design ad as their objective the management of small turbofan ...CONFIGURATIONS 99 LIST OF ILLUSTRATIONS Figure Title Page 1 High Speed Balancing Program Schedule 4 2 Teledyne CAE Model 471-11DX Turbofan Engine
Fibromyalgia is Associated with Impaired Balance and Falls
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
Khurana, Meetika; Walia, Shefali
2017-01-01
Objective: To determine whether there is any difference between virtual reality game–based balance training and real-world task-specific balance training in improving sitting balance and functional performance in individuals with paraplegia. Methods: The study was a pre test–post test experimental design. There were 30 participants (28 males, 2 females) with traumatic spinal cord injury randomly assigned to 2 groups (group A and B). The levels of spinal injury of the participants were between T6 and T12. The virtual reality game–based balance training and real-world task-specific balance training were used as interventions in groups A and B, respectively. The total duration of the intervention was 4 weeks, with a frequency of 5 times a week; each training session lasted 45 minutes. The outcome measures were modified Functional Reach Test (mFRT), t-shirt test, and the self-care component of the Spinal Cord Independence Measure–III (SCIM-III). Results: There was a significant difference for time (p = .001) and Time × Group effect (p = .001) in mFRT scores, group effect (p = .05) in t-shirt test scores, and time effect (p = .001) in the self-care component of SCIM-III. Conclusions: Virtual reality game–based training is better in improving balance and functional performance in individuals with paraplegia than real-world task-specific balance training. PMID:29339902
Khurana, Meetika; Walia, Shefali; Noohu, Majumi M
2017-01-01
Objective: To determine whether there is any difference between virtual reality game-based balance training and real-world task-specific balance training in improving sitting balance and functional performance in individuals with paraplegia. Methods: The study was a pre test-post test experimental design. There were 30 participants (28 males, 2 females) with traumatic spinal cord injury randomly assigned to 2 groups (group A and B). The levels of spinal injury of the participants were between T6 and T12. The virtual reality game-based balance training and real-world task-specific balance training were used as interventions in groups A and B, respectively. The total duration of the intervention was 4 weeks, with a frequency of 5 times a week; each training session lasted 45 minutes. The outcome measures were modified Functional Reach Test (mFRT), t-shirt test, and the self-care component of the Spinal Cord Independence Measure-III (SCIM-III). Results: There was a significant difference for time ( p = .001) and Time × Group effect ( p = .001) in mFRT scores, group effect ( p = .05) in t-shirt test scores, and time effect ( p = .001) in the self-care component of SCIM-III. Conclusions: Virtual reality game-based training is better in improving balance and functional performance in individuals with paraplegia than real-world task-specific balance training.
Specific Stimuli Induce Specific Adaptations: Sensorimotor Training vs. Reactive Balance Training
Freyler, Kathrin; Krause, Anne; Gollhofer, Albert; Ritzmann, Ramona
2016-01-01
Typically, balance training has been used as an intervention paradigm either as static or as reactive balance training. Possible differences in functional outcomes between the two modalities have not been profoundly studied. The objective of the study was to investigate the specificity of neuromuscular adaptations in response to two balance intervention modalities within test and intervention paradigms containing characteristics of both profiles: classical sensorimotor training (SMT) referring to a static ledger pivoting around the ankle joint vs. reactive balance training (RBT) using externally applied perturbations to deteriorate body equilibrium. Thirty-eight subjects were assigned to either SMT or RBT. Before and after four weeks of intervention training, postural sway and electromyographic activities of shank and thigh muscles were recorded and co-contraction indices (CCI) were calculated. We argue that specificity of training interventions could be transferred into corresponding test settings containing properties of SMT and RBT, respectively. The results revealed that i) postural sway was reduced in both intervention groups in all test paradigms; magnitude of changes and effect sizes differed dependent on the paradigm: when training and paradigm coincided most, effects were augmented (P<0.05). ii) These specificities were accompanied by segmental modulations in the amount of CCI, with a greater reduction within the CCI of thigh muscles after RBT compared to the shank muscles after SMT (P<0.05). The results clearly indicate the relationship between test and intervention specificity in balance performance. Hence, specific training modalities of postural control cause multi-segmental and context-specific adaptations, depending upon the characteristics of the trained postural strategy. In relation to fall prevention, perturbation training could serve as an extension to SMT to include the proximal segment, and thus the control of structures near to the body’s centre of mass, into training. PMID:27911944
How Building Systems Affect Worker Wellness
1994-03-01
spatial configuration must strike a balance between the objective needs of the organization and the more subjective human ingredient. Good building...sense, building design for thermal comfort involves a balance between the building’s orientation, its windowing scheme, the use of thermal mass, and the...stated above. An improved quality of worklife and a humanized work environment are psychological incentives that can increase productivity. Worker specific
[Application of the balanced scorecard in nursing practice].
Huang, Tsai-Yu; Chwo, Miao-Ju
2004-02-01
Kaplan and Norton's balanced scorecard (BSC) was developed in 1992. It was designed to be both a performance framework and a management methodology. The BSC enables an organization to convert its mission and vision into specific strategic objectives across four perspectives: (1) the financial perspective, (2) the customer perspective, (3) the internal business process perspective, and (4) the learning and growth perspective. Emphasis is focused on the balance of internal and external, outcome and future, and subjective and objective measures. Currently, some health care organizations have implemented the concept of the BSC as a performance measurement tool and are convinced that the BSC can be of great value to an organization. This paper provides development of the BSC and its application in the health care system and nursing practice.
[The Balanced Scorecard as a management tool in a public health organization].
Villalbí, Joan R; Villalbí, Joan; Guix, Joan; Casas, Conrad; Borrell, Carme; Duran, Júlia; Artazcoz, Lucía; Camprubí, Esteve; Cusí, Meritxell; Rodríguez-Montuquín, Pau; Armengol, Josep M; Jiménez, Guy
2007-01-01
The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.
ERIC Educational Resources Information Center
Waldron, Laurie
This guide offers a nutrition education program for students in Kindergarten through Grade 6. Activities span all grades as well as activities for the specific level. Nutrition education objectives are stated for each grade level: (1) grade four--students will explore how to balance food intake and energy output for overall health and physical…
The balanced scorecard: an incremental approach model to health care management.
Pineno, Charles J
2002-01-01
The balanced scorecard represents a technique used in strategic management to translate an organization's mission and strategy into a comprehensive set of performance measures that provide the framework for implementation of strategic management. This article develops an incremental approach for decision making by formulating a specific balanced scorecard model with an index of nonfinancial as well as financial measures. The incremental approach to costs, including profit contribution analysis and probabilities, allows decisionmakers to assess, for example, how their desire to meet different health care needs will cause changes in service design. This incremental approach to the balanced scorecard may prove to be useful in evaluating the existence of causality relationships between different objective and subjective measures to be included within the balanced scorecard.
Asphalt pavement performance-based specifications : research brief.
DOT National Transportation Integrated Search
2017-03-01
The fundamental objective of asphalt mix design is to select an aggregate skeleton and asphalt binder content that balances constructability and performance. High performance mixtures that protect against rutting, cracking and moisture damage are dif...
Sremakaew, Munlika; Jull, Gwendolen; Treleaven, Julia; Barbero, Marco; Falla, Deborah; Uthaikhup, Sureeporn
2018-02-13
Impaired cervical joint position sense and balance are associated with neck pain. Specific therapeutic exercise and manual therapy are effective for improving neck pain and functional ability but their effects on joint position sense and balance impairments remain uncertain. Changes in the joint position sense and balance may need to be addressed specifically. The primary objective is to investigate the most effective interventions to improve impaired cervical joint position sense and balance in individuals with neck pain. The secondary objective is to assess the effectiveness of the interventions on pain intensity and disability, pain location, dizziness symptoms, cervical range of motion, gait speed, functional ability, treatment satisfaction and quality of life. A 2 × 2 factorial, single blind RCT with immediate, short- and long-term follow-ups. One hundred and sixty eight participants with neck pain with impaired joint position sense and balance will be recruited into the trial. Participants will be randomly allocated to one of four intervention groups: i) local neck treatment, ii) local treatment plus tailored sensorimotor exercises, iii) local treatment plus balance exercises, and iv) local treatment plus sensorimotor and balance exercises. Participants receive two treatments for 6 weeks. Primary outcomes are postural sway and cervical joint position error. Secondary outcomes include gait speed, dizziness intensity, neck pain intensity, neck disability, pain extent and location, cervical range of motion, functional ability, perceived benefit, and quality of life. Assessment will be measured at baseline, immediately after treatment and at 3, 6, 12 month-follow ups. Neck pain is one of the major causes of disability. Effective treatment must address not only the symptoms but the dysfunctions associated with neck pain. This trial will evaluate the effectiveness of interventions for individuals with neck pain with impaired cervical joint position sense and balance. This trial will impact on clinical practice by providing evidence towards optimal and efficient management. ClinicalTrials.gov ( NCT03149302 ). May 10, 2017.
Groene, Oliver; Brandt, Elimer; Schmidt, Werner; Moeller, Johannes
2009-08-01
Strategy development and implementation in acute care settings is often restricted by competing challenges, the pace of policy reform and the existence of parallel hierarchies. To describe a generic approach to strategy development, illustrate the use of the Balanced Scorecard as a tool to facilitate strategy implementation and demonstrate how to break down strategic goals into measurable elements. Multi-method approach using three different conceptual models: Health Promoting Hospitals Standards and Strategies, the European Foundation for Quality Management (EFQM) Model and the Balanced Scorecard. A bundle of qualitative and quantitative methods were used including in-depth interviews, standardized organization-wide surveys on organizational values, staff satisfaction and patient experience. Three acute care hospitals in four different locations belonging to a German holding group. Chief executive officer, senior medical officers, working group leaders and hospital staff. Development and implementation of the Balanced Scorecard. Twenty strategic objectives with corresponding Balanced Scorecard measures. A stepped approach from strategy development to implementation is presented to identify key themes for strategy development, drafting a strategy map and developing strategic objectives and measures. The Balanced Scorecard, in combination with the EFQM model, is a useful tool to guide strategy development and implementation in health care organizations. As for other quality improvement and management tools not specifically developed for health care organizations, some adaptations are required to improve acceptability among professionals. The step-wise approach of strategy development and implementation presented here may support similar processes in comparable organizations.
William J. Zielinski; Jeffrey R. Dunk; Andrew N. Gray
2012-01-01
Managing forests for multiple objectives requires balancing timber and vegetation management objectives with needs of sensitive species. Especially challenging is how to retain the habitat elements for species that are typically associated with late-seral forests. We develop a regionally specific, multivariate model describing habitat selection that can be used â when...
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 influence perceptions of ambulation disability and fatigue as well as perceived quality of life in people with MS.
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.
Evaluation of Predictive Factors Influencing Community Reintegration in Adult Patients with Stroke
Olawale, Olajide Ayinla; Usman, Jibrin Sammani; Oke, Kayode Israel; Osundiya, Oladunni Caroline
2018-01-01
Objectives: Patients with stroke are faced with gait, balance, and fall difficulties which could impact on their community reintegration. In Nigeria, community reintegration after stroke has been understudied. The objective of this study was to evaluate the predictors of community reintegration in adult patients with stroke. Materials and Methods: Participants were 91 adult patients with stroke. Gait variables, balance self-efficacy, community balance/mobility, and fall self-efficacy were assessed using Rivermead Mobility Index, Activities-specific Balance Confidence Scale, Community Balance and Mobility Scale, and Falls Efficacy Scale-International respectively. Reintegration to Normal Living Index was used to assess satisfaction with community reintegration. Pearson Product-Moment Correlation Coefficient was used to determine the relationship between community reintegration and gait spatiotemporal variables, balance performance, and risk of fall. Multiple regression analysis was used to determine predictors of community reintegration (P ≤ 0.05). Results: There was significant positive relationship between community reintegration and cadence (r = 0.250, P = 0.017), functional mobility (r = 0.503, P = 0.001), balance self-efficacy (r = 0.608, P = 0.001), community balance/mobility (r = 0.586, P = 0.001), and duration of stroke (r = 0.220, P = 0.036). Stride time (r = −0.282, P = 0.073) and fall self-efficacy (r = 0.566, P = 0.001) were negatively correlated with community reintegration. Duration of stroke, balance self-efficacy, community balance/mobility, and fall self-efficacy (52.7% of the variance) were the significant predictors of community reintegration. Conclusion: Community reintegration is influenced by cadence, functional mobility, balance self-efficacy, community balance/mobility, and duration of stroke. Hence, improving balance and mobility during rehabilitation is important in enhancing community reintegration in patients with stroke. PMID:29456337
The relationship between balance confidence and control in individuals with Parkinson's disease
Lee, Hyo Keun; Altman, Lori J.P.; McFarland, Nikolaus; Hass, Chris J.
2016-01-01
Introduction A broad range of subjective and objective assessments have been used to assess balance confidence and balance control in persons with Parkinson's disease (PD). However, little is known about the relationship between self-perceived balance confidence and actual balance control in PD. The purpose of this investigation was to determine the relationship between self-perceived balance confidence and objectively measured static/dynamic balance control abilities. Methods Forty-four individuals with PD participated in the study. Patients were stratified into 2 groups based on the modified Hoehn and Yahr (H&Y) disability score: early stage, H&Y≤2.0 and moderate stage, H&Y ≥2.5. All participants completed the activities-specific balance confidence (ABC) scale and performed standing balance and gait initiation tasks to assess static and dynamic balance control. The center of pressure (COP) sway (CE95%Sway) during static balance and the peak distance between the projections of the COP and the center of mass (COM) in the transverse plane (COPCOM) during gait initiation were calculated. Pearson correlation analyses were conducted relating the ABC score and CE95%Sway and COPCOM. Results For early stage PD, there was a moderate correlation between ABC score and CE95 %Sway (r=-0.56, R2=0.32, p=0.002), while no significant correlation was found between ABC score and COPCOM (r=-0.24, R2=0.06, p=0.227). For moderate stage PD, there was a moderate correlation between ABC score and COPCOM (r=0.49, R2=0.24, p=0.044), while no correlation was found between ABC score and CE95%Sway (r=-0.19, R2=0.04, p=0.478). Conclusion Individuals with different disease severities showed different relationships between balance confidence and actual static/dynamic balance control. PMID:26949065
14 CFR Section 6 - Objective Classification of Balance Sheet Elements
Code of Federal Regulations, 2010 CFR
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Objective Classification of Balance Sheet... AIR CARRIERS Balance Sheet Classifications Section 6 Objective Classification of Balance Sheet...) Record here all general and working funds available on demand as of the date of the balance sheet which...
14 CFR Section 6 - Objective Classification of Balance Sheet Elements
Code of Federal Regulations, 2011 CFR
2011-01-01
... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Objective Classification of Balance Sheet... AIR CARRIERS Balance Sheet Classifications Section 6 Objective Classification of Balance Sheet...) Record here all general and working funds available on demand as of the date of the balance sheet which...
Dubouloz, C J; Chevrier, J; Savoie-Zajc, L
2001-06-01
Transformative learning is a process of adaptation that allows for profound personal change in occupational therapy clients. This process is provoked by a triggering factor, such as illness, which results in a critical reflection on values, beliefs, feelings and personal knowledge associated with the object of change (Mezirow, 1991). As part of an objective aimed at modifying the balance of occupation, nine participants were interviewed over a 6 month period to explore their processes of change. Eight concepts related to the objective of change of the balance of occupation emerged from an inductive data analysis process (Glaser and Strauss, 1967). The perception of work was interpreted by the authors as having undergone the most significant sense of transformation amongst the participants. Two other perceptions, 1) the definition of self and 2) the concept of health emerged as new elements essential to the modification of the balance of occupation. The transformation process linked to these eight concepts revealed a specific structure and sequence. The results highlight the primary role of critical reflection amongst occupational therapy clients and underline the importance of deconstructing common values and beliefs which could slow down the process of change. Moreover, the development of new values and beliefs is a vehicle for change in occupational therapy.
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
ERIC Educational Resources Information Center
Stanford Univ., CA.
Recognizing the need to balance generality and economy in system costs, the Project INFO team at Stanford University developing OASIS has sought to provide generalized and powerful computer support within the normal range of operating and analytical requirements associated with university administration. The specific design objectives of the OASIS…
Posturography and locomotor tests of dynamic balance after long-duration spaceflight.
Cohen, Helen S; Kimball, Kay T; Mulavara, Ajitkumar P; Bloomberg, Jacob J; Paloski, William H
2012-01-01
The currently approved objective clinical measure of standing balance in astronauts after space flight is the Sensory Organization Test battery of computerized dynamic posturography. No tests of walking balance are currently approved for standard clinical testing of astronauts. This study determined the sensitivity and specificity of standing and walking balance tests for astronauts before and after long-duration space flight. Astronauts were tested on an obstacle avoidance test known as the Functional Mobility Test (FMT) and on the Sensory Organization Test using sway-referenced support surface motion with eyes closed (SOT 5) before and six months after (n=15) space flight on the International Space Station. They were tested two to seven days after landing. Scores on SOT tests decreased and scores on FMT increased significantly from pre- to post-flight. In other words, post-flight scores were worse than pre-flight scores. SOT and FMT scores were not significantly related. ROC analyses indicated supra-clinical cut-points for SOT 5 and for FMT. The standard clinical cut-point for SOT 5 had low sensitivity to post-flight astronauts. Higher cut-points increased sensitivity to post-flight astronauts but decreased specificity to pre-flight astronauts. Using an FMT cut-point that was moderately highly sensitive and highly specific plus SOT 5 at the standard clinical cut-point was no more sensitive than SOT 5, alone. FMT plus SOT 5 at higher cut-points was more specific and more sensitive. The total correctly classified was highest for FMT, alone, and for FMT plus SOT 5 at the highest cut-point. These findings indicate that standard clinical comparisons are not useful for identifying problems. Testing both standing and walking balance will be more likely to identify balance deficits.
The relationship between balance confidence and control in individuals with Parkinson's disease.
Lee, Hyo Keun; Altmann, Lori J P; McFarland, Nikolaus; Hass, Chris J
2016-05-01
A broad range of subjective and objective assessments have been used to assess balance confidence and balance control in persons with Parkinson's disease (PD). However, little is known about the relationship between self-perceived balance confidence and actual balance control in PD. The purpose of this investigation was to determine the relationship between self-perceived balance confidence and objectively measured static/dynamic balance control abilities. Forty-four individuals with PD participated in the study. Patients were stratified into 2 groups based on the modified Hoehn and Yahr (H&Y) disability score: early stage, H&Y ≤ 2.0 and moderate stage, H&Y ≥ 2.5. All participants completed the activities-specific balance confidence (ABC) scale and performed standing balance and gait initiation tasks to assess static and dynamic balance control. The center of pressure (COP) sway (CE95%Sway) during static balance and the peak distance between the projections of the COP and the center of mass (COM) in the transverse plane (COPCOM) during gait initiation were calculated. Pearson correlation analyses were conducted relating the ABC score and CE95%Sway and COPCOM. For early stage PD, there was a moderate correlation between ABC score and CE95%Sway (r = -0.56, R(2) = 0.32, p = 0.002), while no significant correlation was found between ABC score and COPCOM (r = -0.24, R(2) = 0.06, p = 0.227). For moderate stage PD, there was a moderate correlation between ABC score and COPCOM (r = 0.49, R(2) = 0.24, p = 0.044), while no correlation was found between ABC score and CE95%Sway (r = -0.19, R(2) = 0.04, p = 0.478). Individuals with different disease severities showed different relationships between balance confidence and actual static/dynamic balance control. Copyright © 2016 Elsevier Ltd. All rights reserved.
Prediction of Balance Compensation After Vestibular Schwannoma Surgery.
Parietti-Winkler, Cécile; Lion, Alexis; Frère, Julien; Perrin, Philippe P; Beurton, Renaud; Gauchard, Gérome C
2016-06-01
Background Balance compensation after vestibular schwannoma (VS) surgery is under the influence of specific preoperative patient and tumor characteristics. Objective To prospectively identify potential prognostic factors for balance recovery, we compared the respective influence of these preoperative characteristics on balance compensation after VS surgery. Methods In 50 patients scheduled for VS surgical ablation, we measured postural control before surgery (BS), 8 (AS8) days after, and 90 (AS90) days after surgery. Based on factors found previously in the literature, we evaluated age, body mass index and preoperative physical activity (PA), tumor grade, vestibular status, and preference for visual cues to control balance as potential prognostic factors using stepwise multiple regression models. Results An asymmetric vestibular function was the sole significant explanatory factor for impaired balance performance BS, whereas the preoperative PA alone significantly contributed to higher performance at AS8. An evaluation of patients' balance recovery over time showed that PA and vestibular status were the 2 significant predictive factors for short-term postural compensation (BS to AS8), whereas none of these preoperative factors was significantly predictive for medium-term postoperative postural recovery (AS8 to AS90). Conclusions We identified specific preoperative patient and vestibular function characteristics that may predict postoperative balance recovery after VS surgery. Better preoperative characterization of these factors in each patient could inform more personalized presurgical and postsurgical management, leading to a better, more rapid balance recovery, earlier return to normal daily activities and work, improved quality of life, and reduced medical and societal costs. © The Author(s) 2015.
Abnormal computerized dynamic posturography findings in dizzy patients with normal ENG results.
Sataloff, Robert T; Hawkshaw, Mary J; Mandel, Heidi; Zwislewski, Amy B; Armour, Jonathan; Mandel, Steven
2005-04-01
The complexities of the balance system create difficulties for professionals interested in testing equilibrium function objectively. Traditionally, electronystagmography (ENG) has been used for this purpose, but it provides information on only a limited portion of the equilibrium system. Computerized dynamic posturography (CDP) is less specific than ENG, but it provides more global insight into a patient's ability to maintain equilibrium under more challenging environmental circumstances. CD Palso appears to be valuable in obtaining objective confirmation of an abnormality in some dizzy patients whose ENG findings are normal. Our review of 33 patients with normal ENG results and abnormal CDP findings suggests that posturography is useful for confirming or quantifying a balance abnormality in some patients whose complaints cannot be confirmed by other tests frequently used by otologists.
Community Delivery of a Comprehensive Fall-Prevention Program in People with Multiple Sclerosis
Frankel, Debra; Tompkins, Sara A.; Cameron, Michelle
2016-01-01
Background: People with multiple sclerosis (MS) fall frequently. In 2011, the National Multiple Sclerosis Society launched a multifactorial fall-prevention group exercise and education program, Free From Falls (FFF), to prevent falls in MS. The objective of this study was to assess the impact of participation in the FFF program on balance, mobility, and falls in people with MS. Methods: This was a retrospective evaluation of assessments from community delivery of FFF. Changes in Activities-specific Balance Confidence scale scores, Berg Balance Scale scores, 8-foot Timed Up and Go performance, and falls were assessed. Results: A total of 134 participants completed the measures at the first and last FFF sessions, and 109 completed a 6-month follow-up assessment. Group mean scores on the Activities-specific Balance Confidence scale (F1,66 = 17.14, P < .05, η2 = 0.21), Berg Balance Scale (F1,68 = 23.39, P < .05, η2 = 0.26), and 8-foot Timed Up and Go (F1,79 = 4.83, P < .05, η2 = 0.06) all improved significantly from the first to the last session. At the 6-month follow-up, fewer falls were reported (χ2 [4, N = 239] = 10.56, P < .05, Phi = 0.21). Conclusions: These observational data suggest that the FFF group education and exercise program improves balance confidence, balance performance, and functional mobility and reduces falls in people with MS. PMID:26917997
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.
Epidemiology of balance symptoms and disorders in the community: a systematic review.
Murdin, Louisa; Schilder, Anne G M
2015-03-01
Balance disorders presenting with symptoms of dizziness or vertigo may have significant impact on quality of life and are a recognized risk factor for falls. The objective of this review was to systematically synthesize the published literature on the epidemiology of balance symptoms and disorders in the adult community population. A search was carried out across PubMed, Medline, and Cochrane databases to identify suitable studies. Studies were eligible for inclusion if they contained data on the epidemiology of symptoms of balance disorders (dizziness and vertigo) or balance disorders sampled from community-based adult populations. Data were collected on prevalence and incidence of balance symptoms and on specific balance disorders. A validated risk-of-bias assessment was carried out. Twenty eligible studies were identified. The lifetime prevalence estimates of significant dizziness ranged between 17 and 30%, and for vertigo between 3 and 10%. Published point prevalence data exist for Ménière's disease (0.12-0.5%) and for vestibular migraine (0.98%). For benign paroxysmal positional vertigo, 1-year incidence estimates range from 0.06 to 0.6%. There are no community-based studies on the prevalence or incidence of chronic uncompensated peripheral vestibular disorders or vestibular neuritis. Symptoms of dizziness and vertigo are common in the adult population, and data give a coherent picture of community epidemiology. These data can inform rational service planning and much-needed clinical trials in this field. There are insufficient data on specific balance disorders, especially peripheral vestibular disorders such as vestibular neuritis and its long-term sequelae.
Senay, Gabriel B.
2008-01-01
The main objective of this study is to present an improved modeling technique called Vegetation ET (VegET) that integrates commonly used water balance algorithms with remotely sensed Land Surface Phenology (LSP) parameter to conduct operational vegetation water balance modeling of rainfed systems at the LSP’s spatial scale using readily available global data sets. Evaluation of the VegET model was conducted using Flux Tower data and two-year simulation for the conterminous US. The VegET model is capable of estimating actual evapotranspiration (ETa) of rainfed crops and other vegetation types at the spatial resolution of the LSP on a daily basis, replacing the need to estimate crop- and region-specific crop coefficients.
PID Controller Design for FES Applied to Ankle Muscles in Neuroprosthesis for Standing Balance
Rouhani, Hossein; Same, Michael; Masani, Kei; Li, Ya Qi; Popovic, Milos R.
2017-01-01
Closed-loop controlled functional electrical stimulation (FES) applied to the lower limb muscles can be used as a neuroprosthesis for standing balance in neurologically impaired individuals. The objective of this study was to propose a methodology for designing a proportional-integral-derivative (PID) controller for FES applied to the ankle muscles toward maintaining standing balance for several minutes and in the presence of perturbations. First, a model of the physiological control strategy for standing balance was developed. Second, the parameters of a PID controller that mimicked the physiological balance control strategy were determined to stabilize the human body when modeled as an inverted pendulum. Third, this PID controller was implemented using a custom-made Inverted Pendulum Standing Apparatus that eliminated the effect of visual and vestibular sensory information on voluntary balance control. Using this setup, the individual-specific FES controllers were tested in able-bodied individuals and compared with disrupted voluntary control conditions in four experimental paradigms: (i) quiet-standing; (ii) sudden change of targeted pendulum angle (step response); (iii) balance perturbations that simulate arm movements; and (iv) sudden change of targeted angle of a pendulum with individual-specific body-weight (step response). In paradigms (i) to (iii), a standard 39.5-kg pendulum was used, and 12 subjects were involved. In paradigm (iv) 9 subjects were involved. Across the different experimental paradigms and subjects, the FES-controlled and disrupted voluntarily-controlled pendulum angle showed root mean square errors of <1.2 and 2.3 deg, respectively. The root mean square error (all paradigms), rise time, settle time, and overshoot [paradigms (ii) and (iv)] in FES-controlled balance were significantly smaller or tended to be smaller than those observed with voluntarily-controlled balance, implying improved steady-state and transient responses of FES-controlled balance. At the same time, the FES-controlled balance required similar torque levels (no significant difference) as voluntarily-controlled balance. The implemented PID parameters were to some extent consistent among subjects for standard weight conditions and did not require prolonged individual-specific tuning. The proposed methodology can be used to design FES controllers for closed-loop controlled neuroprostheses for standing balance. Further investigation of the clinical implementation of this approach for neurologically impaired individuals is needed. PMID:28676739
ERIC Educational Resources Information Center
Appalachian Regional Commission, Washington, DC.
Recommendations by task forces at the Appalachian Balanced Growth and Economic Development Conference in 1977 to the Appalachian Regional Commission (ARC) resulted in ARC's adoption of six resolutions which are listed in this supplement. Specific recommendations were made under the following resolution headings: (1) legislation for a national…
ERIC Educational Resources Information Center
Jeeroburkhan, M. Fazal
This study evaluated the Agricultural Curriculum Project which is being implemented in 16 secondary schools in Mauritius. Specific areas examined included: (1) the relevance, appropriateness, and practicability of the project's general objectives; (2) the relevance, balance, and organization of the course content; (3) the effectiveness and…
Wii Fit Balance Board Playing Improves Balance and Gait in Parkinson Disease
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 balance and gait in adults with PD. However, no significant changes were seen in mood or confidence regarding balance. PMID:23770422
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
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
Schinkel-Ivy, Alison; Singer, Jonathan C.; Inness, Elizabeth L.; Mansfield, Avril
2016-01-01
Objective To determine whether quiet standing measures at specific frequency levels (representative of reactive control) differed between individuals with stroke based on their ability to recover balance (failed or successful responses to external perturbations). Methods Individuals with stroke completed a clinical assessment, including 30 s of quiet standing and lean-and-release postural perturbations, at admission to in-patient rehabilitation. Quiet standing centre of pressure (COP) signals were calculated and discrete wavelet decomposition was performed. Net COP amplitude, between-limb synchronization, and ratios of individual-limb COP were determined for each frequency level of interest, and for the non-decomposed signal (all frequency levels). Outcome measures were compared between individuals who exhibited failed and successful responses during a) unconstrained and b) encouraged-use lean-and-release trials. Results Individuals with failed responses during the unconstrained lean-and-release trials displayed greater net COP amplitude than those with successful responses, specifically within a frequency range of 0.40–3.20 Hz. Conclusions Reduced ability to recover balance among individuals with stroke may be reflected in impaired reactive control of quiet standing. Significance These results provide insight into the mechanism by which reactive control of quiet standing is impaired in individuals with stroke, and may inform assessment and rehabilitation strategies for post-stroke reactive balance control. PMID:27178866
Participating in a virtual reality balance exercise program can reduce risk and fear of falls.
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.
Effects of unstable surface training on measures of balance in older adults.
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.
Hammami, Raouf; Chaouachi, Anis; Makhlouf, Issam; Granacher, Urs; Behm, David G
2016-11-01
Balance, strength and power relationships may contain important information at various maturational stages to determine training priorities. The objective was to examine maturity-specific relationships of static/dynamic balance with strength and power measures in young male athletes. Soccer players (N = 130) aged 10-16 were assessed with the Stork and Y balance (YBT) tests. Strength/power measures included back extensor muscle strength, standing long jump (SLJ), countermovement jump (CMJ), and 3-hop jump tests. Associations between balance with strength/power variables were calculated according to peak-height-velocity (PHV). There were significant medium-large sized correlations between all balance measures with back extensor strength (r = .486-.791) and large associations with power (r = .511-.827). These correlation coefficients were significantly different between pre-PHV and circa PHV as well as pre-PHV and post-PHV with larger associations in the more mature groups. Irrespective of maturity-status, SLJ was the best strength/power predictor with the highest proportion of variance (12-47%) for balance (i.e., Stork eyes opened) and the YBT was the best balance predictor with the highest proportion of variance (43-78%) for all strength/power variables. The associations between balance and muscle strength/power measures in youth athletes that increase with maturity may imply transfer effects from balance to strength/power training and vice versa in youth athletes.
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.
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
Castilla-Earls, Anny P.; Restrepo, María Adelaida; Perez-Leroux, Ana Teresa; Gray, Shelley; Holmes, Paul; Gail, Daniel; Chen, Ziqiang
2015-01-01
This study examines the interaction between language impairment and different levels of bilingual proficiency. Specifically, we explore the potential of articles and direct object pronouns as clinical markers of primary language impairment (PLI) in bilingual Spanish-speaking children. The study compared children with PLI and typically developing children (TD) matched on age, English language proficiency, and mother’s education level. Two types of bilinguals were targeted: Spanish-dominant children with intermediate English proficiency (asymmetrical bilinguals, AsyB), and near-balanced bilinguals (BIL). We measured children’s accuracy in the use of direct object pronouns and articles with an elicited language task. Results from this preliminary study suggest language proficiency affects the patterns of use of direct object pronouns and articles. Across language proficiency groups, we find marked differences between TD and PLI, in the use of both direct object pronouns and articles. However, the magnitude of the difference diminishes in balanced bilinguals. Articles appear more stable in these bilinguals and therefore, seem to have a greater potential to discriminate between TD bilinguals from those with PLI. Future studies using discriminant analyses are needed to assess the clinical impact of these findings. PMID:27570320
Clinical history and biologic age predicted falls better than objective functional tests.
Gerdhem, Paul; Ringsberg, Karin A M; Akesson, Kristina; Obrant, Karl J
2005-03-01
Fall risk assessment is important because the consequences, such as a fracture, may be devastating. The objective of this study was to find the test or tests that best predicted falls in a population-based sample of elderly women. The fall-predictive ability of a questionnaire, a subjective estimate of biologic age and objective functional tests (gait, balance [Romberg and sway test], thigh muscle strength, and visual acuity) were compared in 984 randomly selected women, all 75 years of age. A recalled fall was the most important predictor for future falls. Only recalled falls and intake of psycho-active drugs independently predicted future falls. Women with at least five of the most important fall predictors (previous falls, conditions affecting the balance, tendency to fall, intake of psychoactive medication, inability to stand on one leg, high biologic age) had an odds ratio of 11.27 (95% confidence interval 4.61-27.60) for a fall (sensitivity 70%, specificity 79%). The more time-consuming objective functional tests were of limited importance for fall prediction. A simple clinical history, the inability to stand on one leg, and a subjective estimate of biologic age were more important as part of the fall risk assessment.
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
Role of body-worn movement monitor technology for balance and gait rehabilitation.
Horak, Fay; King, Laurie; Mancini, Martina
2015-03-01
This perspective article will discuss the potential role of body-worn movement monitors for balance and gait assessment and treatment in rehabilitation. Recent advances in inexpensive, wireless sensor technology and smart devices are resulting in an explosion of miniature, portable sensors that can quickly and accurately quantify body motion. Practical and useful movement monitoring systems are now becoming available. It is critical that therapists understand the potential advantages and limitations of such emerging technology. One important advantage of obtaining objective measures of balance and gait from body-worn sensors is impairment-level metrics characterizing how and why functional performance of balance and gait activities are impaired. Therapy can then be focused on the specific physiological reasons for difficulty in walking or balancing during specific tasks. A second advantage of using technology to measure balance and gait behavior is the increased sensitivity of the balance and gait measures to document mild disability and change with rehabilitation. A third advantage of measuring movement, such as postural sway and gait characteristics, with body-worn sensors is the opportunity for immediate biofeedback provided to patients that can focus attention and enhance performance. In the future, body-worn sensors may allow therapists to perform telerehabilitation to monitor compliance with home exercise programs and the quality of their natural mobility in the community. Therapists need technological systems that are quick to use and provide actionable information and useful reports for their patients and referring physicians. Therapists should look for systems that provide measures that have been validated with respect to gold standard accuracy and to clinically relevant outcomes such as fall risk and severity of disability. © 2015 American Physical Therapy Association.
Role of Body-Worn Movement Monitor Technology for Balance and Gait Rehabilitation
King, Laurie; Mancini, Martina
2015-01-01
This perspective article will discuss the potential role of body-worn movement monitors for balance and gait assessment and treatment in rehabilitation. Recent advances in inexpensive, wireless sensor technology and smart devices are resulting in an explosion of miniature, portable sensors that can quickly and accurately quantify body motion. Practical and useful movement monitoring systems are now becoming available. It is critical that therapists understand the potential advantages and limitations of such emerging technology. One important advantage of obtaining objective measures of balance and gait from body-worn sensors is impairment-level metrics characterizing how and why functional performance of balance and gait activities are impaired. Therapy can then be focused on the specific physiological reasons for difficulty in walking or balancing during specific tasks. A second advantage of using technology to measure balance and gait behavior is the increased sensitivity of the balance and gait measures to document mild disability and change with rehabilitation. A third advantage of measuring movement, such as postural sway and gait characteristics, with body-worn sensors is the opportunity for immediate biofeedback provided to patients that can focus attention and enhance performance. In the future, body-worn sensors may allow therapists to perform telerehabilitation to monitor compliance with home exercise programs and the quality of their natural mobility in the community. Therapists need technological systems that are quick to use and provide actionable information and useful reports for their patients and referring physicians. Therapists should look for systems that provide measures that have been validated with respect to gold standard accuracy and to clinically relevant outcomes such as fall risk and severity of disability. PMID:25504484
Emerging therapies for gait disability and balance impairment: promises and pitfalls.
Maetzler, Walter; Nieuwhof, Freek; Hasmann, Sandra E; Bloem, Bastiaan R
2013-09-15
Therapeutic management of gait and balance impairment during aging and neurodegeneration has long been a neglected topic. This has changed considerably during recent years, for several reasons: (1) an increasing recognition that gait and balance deficits are among the most relevant determinants of an impaired quality of life and increased mortality for affected individuals; (2) the arrival of new technology, which has allowed for new insights into the anatomy and functional (dis)integrity of gait and balance circuits; and (3) based in part on these improved insights, the development of new, more specific treatment strategies in the field of pharmacotherapy, deep brain surgery, and physiotherapy. The initial experience with these emerging treatments is encouraging, although much work remains to be done. The objective of this narrative review is to discuss several promising developments in the field of gait and balance treatment. We also address several pitfalls that can potentially hinder a fast and efficient continuation of this vital progress. Important issues that should be considered in future research include a clear differentiation between gait and balance as two distinctive targets for treatment and recognition of compensatory mechanisms as a separate target for therapeutic intervention. © 2013 Movement Disorder Society.
Syrek, Christine J; Apostel, Ella; Antoni, Conny H
2013-07-01
The objective of this article is to investigate transformational leadership as a potential moderator of the negative relationship of time pressure to work-life balance and of the positive relationship between time pressure and exhaustion. Recent research regards time pressure as a challenge stressor; while being positively related to motivation and performance, time pressure also increases employee strain and decreases well-being. Building on the Job Demand-Resources model, we hypothesize that transformational leadership moderates the relationships between time pressure and both employees' exhaustion and work-life balance such that both relationships will be weaker when transformational leadership is higher. Of seven information technology organizations in Germany, 262 employees participated in the study. Established scales for time pressure, transformational leadership, work-life balance, and exhaustion were used, all showing good internal consistencies. The results support our assumptions. Specifically, we find that under high transformational leadership the impact of time pressure on exhaustion and work-life balance was less strong. The results of this study suggest that, particularly under high time pressure, transformational leadership is an important factor for both employees' work-life balance and exhaustion. PsycINFO Database Record (c) 2013 APA, all rights reserved.
A novel strategy for load balancing of distributed medical applications.
Logeswaran, Rajasvaran; Chen, Li-Choo
2012-04-01
Current trends in medicine, specifically in the electronic handling of medical applications, ranging from digital imaging, paperless hospital administration and electronic medical records, telemedicine, to computer-aided diagnosis, creates a burden on the network. Distributed Service Architectures, such as Intelligent Network (IN), Telecommunication Information Networking Architecture (TINA) and Open Service Access (OSA), are able to meet this new challenge. Distribution enables computational tasks to be spread among multiple processors; hence, performance is an important issue. This paper proposes a novel approach in load balancing, the Random Sender Initiated Algorithm, for distribution of tasks among several nodes sharing the same computational object (CO) instances in Distributed Service Architectures. Simulations illustrate that the proposed algorithm produces better network performance than the benchmark load balancing algorithms-the Random Node Selection Algorithm and the Shortest Queue Algorithm, especially under medium and heavily loaded conditions.
Sakakibara, Brodie M.; Miller, William C.; Backman, Catherine L.
2012-01-01
Objective To explore shortened response formats for use with the Activities-specific Balance Confidence scale and then: 1) evaluate the unidimensionality of the scale; 2) evaluate the item difficulty; 3) evaluate the scale for redundancy and content gaps; and 4) evaluate the item standard error of measurement (SEM) and internal consistency reliability among aging individuals (≥50 years) with a lower-limb amputation living in the community. Design Secondary analysis of cross-sectional survey and chart review data. Setting Out-patient amputee clinics, Ontario, Canada. Participants Four hundred forty eight community living adults, at least 50 years old (mean = 68 years), who have used a prosthesis for at least 6 months for a major unilateral lower limb amputation. Three hundred twenty five (72.5%) were men. Intervention N/a Main Outcome Measure(s) Activities-specific Balance Confidence Scale. Results A 5-option response format outperformed 4- and 6-option formats. Factor analyses confirmed a unidimensional scale. The distance between response options is not the same for all items on the scale, evident by the Partial Credit Model (PCM) having a better fit to the data than the Rating Scale Model. Two items, however, did not fit the PCM within statistical reason. Revising the wording of the two items may resolve the misfit, and improve the construct validity and lower the SEM. Overall, the difficulty of the scale’s items is appropriate for use with aging individuals with lower-limb amputation, and is most reliable (Cronbach ∝ = 0.94) for use with individuals with moderately low balance confidence levels. Conclusions The ABC-scale with a simplified 5-option response format is a valid and reliable measure of balance confidence for use with individuals aging with a lower limb amputation. PMID:21704978
Teel, Elizabeth F; Gay, Michael R; Arnett, Peter A; Slobounov, Semyon M
2016-03-01
Balance assessments are part of the recommended clinical concussion evaluation, along with computerized neuropsychological testing and self-reported symptoms checklists. New technology has allowed for the creation of virtual reality (VR) balance assessments to be used in concussion care, but there is little information on the sensitivity and specificity of these evaluations. The purpose of this study is to establish the sensitivity and specificity of a VR balance module for detecting lingering balance deficits clinical concussion care. Retrospective case-control study. Institutional research laboratory. Normal controls (n = 94) and concussed participants (n = 27). All participants completed a VR balance assessment paradigm. Concussed participants were diagnosed by a Certified Athletic Trainer or physician (with 48 hours postinjury) and tested in the laboratory between 7 and 10 days postinjury. Receiver operating characteristic curves were performed to establish the VR module's sensitivity and specificity for detecting lingering balance deficits. Final balance score. For the VR balance module, a cutoff score of 8.25 was established to maximize sensitivity at 85.7% and specificity at 87.8%. The VR balance module has high sensitivity and specificity for detecting subacute balance deficits after concussive injury. The VR balance has a high subacute sensitivity and specificity as a stand-alone balance assessment tool and may detect ongoing balance deficits not readily detectable by the Balance Error Scoring System or Sensory Organization Test. Virtual reality balance modules may be a beneficial addition to the current clinical concussion diagnostic battery.
Montagna, Jéssica Cristine; Santos, Bárbara C; Battistuzzo, Camila R; Loureiro, Ana Paula C
2014-01-01
Introduction: One of the main problems associate with hemiparesis after stroke is the decrease in balance during static and dynamic postures which can highly affect daily life activities. Objective: To assess the effects of aquatic physiotherapy on the balance and quality of life (SS-QoL) of people with pos stroke. Methods: Chronic stroke participants received at total 18 individual sessions of aquatic physiotherapy using the principle of Halliwick (2x of 40 minutes per week). The outcomes measured were: Berg Balance scale, Timed up & go test (TUG), Stroke Specific Quality of Life Scale (SS-QoL) and baropodometric analysis. These assessment were performed before and one week after intervention. Results: Fifteen participants were included in this study. The mean age was 58.5 and 54% was male. After intervention, participants had a significant improvement on their static balance measured by Berg Balance scale and TUG. Dynamic balance had a significant trend of improvement in mediolateral domain with eyes closed and during sit-to-stand. The mobility domain of the SS-QoL questionnaire was significant higher after intervention. Conclusions: Our results suggest that aquatic physiotherapy using the method of Halliwick can be a useful tool during stroke rehabilitation to improve balance. However, this improvement may not have significant impact of their quality of life. PMID:24955206
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
Cammisuli, Sharon; Cavazzi, Enrico; Baldissarro, Eleonora; Leandri, Massimo
2016-08-01
Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have sensory and motor deficits leading to inappropriate proprioceptive feedback, impaired postural control, and fall risk. Balance training with computerized force platforms has been successfully used in rehabilitation of balance disturbances, but programs specifically developed for CIPN patients are lacking. This pilot study evaluated a rehabilitation protocol exclusively based on visual computer-feedback balance training (VCFBT) to improve balance in patients with CIPN. Open-label, non-randomized pilot study, 4-week intervention with pre- vs. post-treatment evaluation. Outpatients of the Rehabilitation Institute of the Salvatore Maugeri Foundation, in Genoa, Italy. Seven out-patients with clinical-instrumental diagnosis of CIPN. At admission, patients were administered the Berg Balance Scale (BBS) and underwent static-dynamic posturography using a computerized force platform to objectively quantify their balance impairment. Their performance was compared to values of a normal age-matched population. Patients then underwent 4 weeks of VCFBT (three 60-minute sessions/week). At discharge, BBS and posturography were repeated and the results compared with those at admission. A significant pre- vs. post-treatment improvement was found in balance as measured by static-dynamic posturography (P=0.004) and BBS (P<0.002). Despite caution needed for the low sample size, this pilot study has shown preliminary evidence that intensive rehabilitation, based on VCFBT can produce a significant improvement in balance outcomes. To our knowledge, this is the first report in CIPN patients of a rehabilitation program based exclusively on VCFBT.
Cost-effective (gaming) motion and balance devices for functional assessment: Need or hype?
Bonnechère, B; Jansen, B; Van Sint Jan, S
2016-09-06
In the last decade, technological advances in the gaming industry have allowed the marketing of hardware for motion and balance control that is based on technological concepts similar to scientific and clinical equipment. Such hardware is attractive to researchers and clinicians for specific applications. However, some questions concerning their scientific value and the range of future potential applications have yet to be answered. This article attempts to present an objective analysis about the pros and cons of using such hardware for scientific and clinical purposes and calls for a constructive discussion based on scientific facts and practical clinical requests that are emerging from application fields. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ecosystem oceanography for global change in fisheries.
Cury, Philippe Maurice; Shin, Yunne-Jai; Planque, Benjamin; Durant, Joël Marcel; Fromentin, Jean-Marc; Kramer-Schadt, Stephanie; Stenseth, Nils Christian; Travers, Morgane; Grimm, Volker
2008-06-01
Overexploitation and climate change are increasingly causing unanticipated changes in marine ecosystems, such as higher variability in fish recruitment and shifts in species dominance. An ecosystem-based approach to fisheries attempts to address these effects by integrating populations, food webs and fish habitats at different scales. Ecosystem models represent indispensable tools to achieve this objective. However, a balanced research strategy is needed to avoid overly complex models. Ecosystem oceanography represents such a balanced strategy that relates ecosystem components and their interactions to climate change and exploitation. It aims at developing realistic and robust models at different levels of organisation and addressing specific questions in a global change context while systematically exploring the ever-increasing amount of biological and environmental data.
Specificity of Balance Training in Healthy Individuals: A Systematic Review and Meta-Analysis.
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 tasks reached an SMDbs of 0.79 [95 % confidence interval (CI) 0.48-1.10], indicating a high effect in favor for the trained task, with no notable heterogeneity (I (2) = 0 %). The SMDbs in non-trained categories reached values between -0.07 (95 % CI -0.53 to 0.38) and 0.18 (95 % CI -0.27 to 0.64), with non-notable to moderate heterogeneity (I (2) = 0-32 %), indicating no effect of the balance training on the respective non-trained balance tasks. With six studies, the number of studies included in this meta-analysis is rather low. It remains unclear how the limited number of studies with considerable methodological diversity affects the outcome of the SMD calculations and thus the general outcome of the meta-analysis. In healthy populations, balance training can improve the performance in trained tasks, but may have only minor or no effects on non-trained tasks. Consequently, therapists and coaches should identify exactly those tasks that need improvement, and use these tasks in the training program and as a part of the test battery that evaluates the efficacy of the training program. Generic balance tasks-such as one-leg stance-may have little value as overall balance measures or when assessing the efficacy of specific training interventions.
78 FR 32165 - Broadband Over Power Lines
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-29
... balance between the dual objectives of providing for Access BPL technology--which has potential... decisions in this proceeding strike an appropriate balance between the dual objectives of providing for...
Is This Object Balanced or Unbalanced? Judgments Are on the Safe Side
ERIC Educational Resources Information Center
Samuel, Francoise; Kerzel, Dirk
2011-01-01
Do we perceive correctly whether a 2-D object is balanced or unbalanced? What would be the cause of biased equilibrium judgments? In two psychometric studies, we varied independently the characteristics of the objects and the equilibrium states. First, we observed that observers were excessively sensitive to the eccentricity of the object top.…
Verma, Anurag; Bansal, Ashok K; Ghosh, Amitava; Pandit, Jayanta K
2012-06-01
Chitosan has become a focus of major interest in recent years due to its excellent biocompatibility, biodegradability and non-toxicity. Although this material has already been extensively investigated in the design of different types of drug delivery systems, it is still little explored for stomach specific drug delivery systems. The objective of the present investigation was to explore the potential of low molecular mass chitosan (LMCH) as carrier for a hydrodynamically balanced system (HBS) for sustained delivery of water soluble drug ciprofloxacin hydrochloride (CP). Various formulations were prepared by physical blending of drug and polymer(s) in varying ratios followed by encapsulation into hard gelatin capsules. All the formulations remained buoyant in 0.1 mol L⁻¹ HCl (pH 1.2) throughout the experiment. Effect of addition of xanthan gum (XG) or ethyl cellulose (EC) on drug release was also investigated. Zero order drug release was obtained from the formulations containing LMCH alone or in combination with XG, and in one instance also with EC. Our results suggest that LMCH alone or in combination with XG is an excellent material for stomach specific sustained delivery of CP from hydrodynamically balanced single unit capsules.
Prangley, Alyssa; Aggerholm, Mathew; Cinelli, Michael
2017-10-01
Concussed individuals have been found to experience balance deficits in the anterior-posterior (AP) direction as indicated by greater Center of Pressure (COP) displacement and velocity. One possible reason for this change in balance control could be due to damage to the lateral vestibulospinal tract which sends signals to control posterior muscles, specifically ankle extensors leading to compensatory torques about the ankle. The purpose of the study was to quantify balance assessments in individuals experiencing persistent post-concussion symptoms (PCS) to determine balance control changes following a vestibular training intervention. Participants (N=6,>26days symptomatic), were tested during their first appointment with a registered physiotherapist (PT) and during each follow up appointment. Participants were prescribed balance, visual, and neck strengthening exercises by the PT that were to be completed daily between bi-weekly appointments. Balance assessments were quantified using a Nintendo Wii board to record ground reaction forces. Participants completed 4 balance assessments: 1) Romberg stance eyes open (REO); 2) Romberg stance eyes closed (REC); 3) single leg stance eyes open (SEO); and 4) single leg stance eyes closed (SEC). The balance assessments were conducted on both a firm and compliant surfaces. Significant improvements in balance control were noted in ML/AP displacement and velocity of COP for both SEC and Foam REC conditions, with additional improvements in AP velocity of COP for Foam REC and in ML displacement of COP during Foam SEC. Overall, findings indicate that objectively quantifying balance changes for individuals experiencing persistent PCS allows for a more sensitive measure of balance and detects changes unrecognizable to the naked eye. Copyright © 2017 Elsevier B.V. All rights reserved.
van den Heuvel, Maarten R C; van Wegen, Erwin E H; de Goede, Cees J T; Burgers-Bots, Ingrid A L; Beek, Peter J; Daffertshofer, Andreas; Kwakkel, Gert
2013-10-04
Patients with Parkinson's disease often suffer from reduced mobility due to impaired postural control. Balance exercises form an integral part of rehabilitative therapy but the effectiveness of existing interventions is limited. Recent technological advances allow for providing enhanced visual feedback in the context of computer games, which provide an attractive alternative to conventional therapy. The objective of this randomized clinical trial is to investigate whether a training program capitalizing on virtual-reality-based visual feedback is more effective than an equally-dosed conventional training in improving standing balance performance in patients with Parkinson's disease. Patients with idiopathic Parkinson's disease will participate in a five-week balance training program comprising ten treatment sessions of 60 minutes each. Participants will be randomly allocated to (1) an experimental group that will receive balance training using augmented visual feedback, or (2) a control group that will receive balance training in accordance with current physical therapy guidelines for Parkinson's disease patients. Training sessions consist of task-specific exercises that are organized as a series of workstations. Assessments will take place before training, at six weeks, and at twelve weeks follow-up. The functional reach test will serve as the primary outcome measure supplemented by comprehensive assessments of functional balance, posturography, and electroencephalography. We hypothesize that balance training based on visual feedback will show greater improvements on standing balance performance than conventional balance training. In addition, we expect that learning new control strategies will be visible in the co-registered posturographic recordings but also through changes in functional connectivity.
Chaouachi, Mehdi; Granacher, Urs; Makhlouf, Issam; Hammami, Raouf; Behm, David G; Chaouachi, Anis
2017-03-01
The integration of balance and plyometric training has been shown to provide significant improvements in sprint, jump, agility, and other performance measures in young athletes. It is not known if a specific within session balance and plyometric exercise sequence provides more effective training adaptations. The objective of the present study was to investigate the effects of using a sequence of alternating pairs of exercises versus a block (series) of all balance exercises followed by a block of plyometric exercises on components of physical fitness such as muscle strength, power, speed, agility, and balance. Twenty-six male adolescent soccer players (13.9 ± 0.3 years) participated in an 8-week training program that either alternated individual balance (e.g., exercises on unstable surfaces) and plyometric (e.g., jumps, hops, rebounds) exercises or performed a block of balance exercises prior to a block of plyometric exercises within each training session. Pre- and post-training measures included proxies of strength, power, agility, sprint, and balance such as countermovement jumps, isometric back and knee extension strength, standing long jump, 10 and 30-m sprints, agility, standing stork, and Y-balance tests. Both groups exhibited significant, generally large magnitude (effect sizes) training improvements for all measures with mean performance increases of approximately >30%. There were no significant differences between the training groups over time. The results demonstrate the effectiveness of combining balance and plyometric exercises within a training session on components of physical fitness with young adolescents. The improved performance outcomes were not significantly influenced by the within session exercise sequence.
Propensity score method: a non-parametric technique to reduce model dependence
2017-01-01
Propensity score analysis (PSA) is a powerful technique that it balances pretreatment covariates, making the causal effect inference from observational data as reliable as possible. The use of PSA in medical literature has increased exponentially in recent years, and the trend continue to rise. The article introduces rationales behind PSA, followed by illustrating how to perform PSA in R with MatchIt package. There are a variety of methods available for PS matching such as nearest neighbors, full matching, exact matching and genetic matching. The task can be easily done by simply assigning a string value to the method argument in the matchit() function. The generic summary() and plot() functions can be applied to an object of class matchit to check covariate balance after matching. Furthermore, there is a useful package PSAgraphics that contains several graphical functions to check covariate balance between treatment groups across strata. If covariate balance is not achieved, one can modify model specifications or use other techniques such as random forest and recursive partitioning to better represent the underlying structure between pretreatment covariates and treatment assignment. The process can be repeated until the desirable covariate balance is achieved. PMID:28164092
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.
Applying graph partitioning methods in measurement-based dynamic load balancing
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bhatele, Abhinav; Fourestier, Sebastien; Menon, Harshitha
Load imbalance leads to an increasing waste of resources as an application is scaled to more and more processors. Achieving the best parallel efficiency for a program requires optimal load balancing which is a NP-hard problem. However, finding near-optimal solutions to this problem for complex computational science and engineering applications is becoming increasingly important. Charm++, a migratable objects based programming model, provides a measurement-based dynamic load balancing framework. This framework instruments and then migrates over-decomposed objects to balance computational load and communication at runtime. This paper explores the use of graph partitioning algorithms, traditionally used for partitioning physical domains/meshes, formore » measurement-based dynamic load balancing of parallel applications. In particular, we present repartitioning methods developed in a graph partitioning toolbox called SCOTCH that consider the previous mapping to minimize migration costs. We also discuss a new imbalance reduction algorithm for graphs with irregular load distributions. We compare several load balancing algorithms using microbenchmarks on Intrepid and Ranger and evaluate the effect of communication, number of cores and number of objects on the benefit achieved from load balancing. New algorithms developed in SCOTCH lead to better performance compared to the METIS partitioners for several cases, both in terms of the application execution time and fewer number of objects migrated.« less
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.
A computer vision based candidate for functional balance test.
Nalci, Alican; Khodamoradi, Alireza; Balkan, Ozgur; Nahab, Fatta; Garudadri, Harinath
2015-08-01
Balance in humans is a motor skill based on complex multimodal sensing, processing and control. Ability to maintain balance in activities of daily living (ADL) is compromised due to aging, diseases, injuries and environmental factors. Center for Disease Control and Prevention (CDC) estimate of the costs of falls among older adults was $34 billion in 2013 and is expected to reach $54.9 billion in 2020. In this paper, we present a brief review of balance impairments followed by subjective and objective tools currently used in clinical settings for human balance assessment. We propose a novel computer vision (CV) based approach as a candidate for functional balance test. The test will take less than a minute to administer and expected to be objective, repeatable and highly discriminative in quantifying ability to maintain posture and balance. We present an informal study with preliminary data from 10 healthy volunteers, and compare performance with a balance assessment system called BTrackS Balance Assessment Board. Our results show high degree of correlation with BTrackS. The proposed system promises to be a good candidate for objective functional balance tests and warrants further investigations to assess validity in clinical settings, including acute care, long term care and assisted living care facilities. Our long term goals include non-intrusive approaches to assess balance competence during ADL in independent living environments.
Petró, Bálint; Papachatzopoulou, Alexandra; Kiss, Rita M
2017-01-01
Static balancing assessment is often complemented with dynamic balancing tasks. Numerous dynamic balancing assessment methods have been developed in recent decades with their corresponding balancing devices and tasks. The aim of this systematic literature review is to identify and categorize existing objective methods of standing dynamic balancing ability assessment with an emphasis on the balancing devices and tasks being used. Three major scientific literature databases (Science Direct, Web of Science, PLoS ONE) and additional sources were used. Studies had to use a dynamic balancing device and a task described in detail. Evaluation had to be based on objectively measureable parameters. Functional tests without instrumentation evaluated exclusively by a clinician were excluded. A total of 63 articles were included. The data extracted during full-text assessment were: author and date; the balancing device with the balancing task and the measured parameters; the health conditions, size, age and sex of participant groups; and follow-up measurements. A variety of dynamic balancing assessment devices were identified and categorized as 1) Solid ground, 2) Balance board, 3) Rotating platform, 4) Horizontal translational platform, 5) Treadmill, 6) Computerized Dynamic Posturography, and 7) Other devices. The group discrimination ability of the methods was explored and the conclusions of the studies were briefly summarized. Due to the wide scope of this search, it provides an overview of balancing devices and do not represent the state-of-the-art of any single method. The identified dynamic balancing assessment methods are offered as a catalogue of candidate methods to complement static assessments used in studies involving postural control.
Dynamic balance control in elders: gait initiation assessment as a screening tool
NASA Technical Reports Server (NTRS)
Chang, H.; Krebs, D. E.; Wall, C. C. (Principal Investigator)
1999-01-01
OBJECTIVE: To determine whether measurements of center of gravity-center of pressure separation (CG-CP moment arm) during gait initiation can differentiate healthy from disabled subjects with sufficient specificity and sensitivity to be useful as a screening test for dynamic balance in elderly patients. SUBJECTS: Three groups of elderly subjects (age, 74.97+/-6.56 yrs): healthy elders (HE, n = 21), disabled elders (DE, n = 20), and elders with vestibular hypofunction (VH, n = 18). DESIGN: Cross-sectional, intact-groups research design. Peak CG-CP moment arm measures how far the subject will tolerate the whole-body CG to deviate from the ground reaction force's CP; it represents dynamic balance control. Screening test cutoff points at 16 to 18 cm peak CG-CP moment arm predicted group membership. RESULTS: The magnitude of peak CG-CP moment arm was significantly greater in HE than in DE and VH subjects (p<.01) and was not different between the DE and VH groups. The peak CG-CP moment arm occurred at the end of single stance phase in all groups. As a screening test, the peak moment arm has greater than 50% sensitivity and specificity to discriminate the HE group from the DE and VH groups with peak CG-CP moment arm cutoff points between 16 and 18 cm. CONCLUSIONS: Examining dynamic balance through the use of the CG-CP moment arm during single stance in gait initiation discriminates between nondisabled and disabled older persons and warrants further investigation as a potential tool to identify people with balance dysfunction.
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
Prenatal alcohol exposure and childhood balance ability: findings from a UK birth cohort study
Humphriss, Rachel; Hall, Amanda; May, Margaret; Zuccolo, Luisa; Macleod, John
2013-01-01
Objective To investigate the association of prenatal alcohol exposure with balance in10-year-old children. Design Population-based prospective longitudinal study. Setting Former Avon region of UK (Southwest England). Participants 6915 children from the Avon Longitudinal Study of Parents and Children who had a balance assessment at age 10 and had data on maternal alcohol consumption. Outcome measures 3 composite balance scores: dynamic balance (beam-walking), static balance eyes open, static balance eyes closed (heel-to-toe balance on a beam and standing on one leg, eyes open or closed). Results Most mothers (95.5%) consumed no-to-moderate amounts (3–7 glasses/week) of alcohol during pregnancy. Higher total-alcohol consumption was associated with maternal-social advantage, whereas binge drinking (≥4 units/day) and abstinence were associated with maternal social disadvantage. No evidence was found of an adverse effect of maternal-alcohol consumption on childhood balance. Higher maternal-alcohol use during pregnancy was generally associated with better offspring outcomes, with some specific effects appearing strong (static balance eyes open and moderate total alcohol exposure at 18 weeks, adjusted OR 1.23 (95% CI 1.01 to 1.49); static balance eyes closed and moderate total alcohol exposure at 18 weeks, adjusted OR 1.25 (95% CI 1.06 to 1.48). Similar results were found for both paternal and postnatal maternal alcohol exposure. A Mendelian-randomization approach was used to estimate the association between maternal genotype and offspring balance using the non-synonymous variant rs1229984*A (ADH1B) to proxy for lower maternal alcohol consumption; no strong associations were found between this genotype/proxy and offspring balance. Conclusions No evidence was found to indicate that moderate maternal alcohol consumption in this population sample had an adverse effect on offspring balance at age 10. An apparent beneficial effect of higher total maternal alcohol consumption on offspring balance appeared likely to reflect residual confounding. PMID:23794556
Validation of measures from the smartphone sway balance application: a pilot study.
Patterson, Jeremy A; Amick, Ryan Z; Thummar, Tarunkumar; Rogers, Michael E
2014-04-01
A number of different balance assessment techniques are currently available and widely used. These include both subjective and objective assessments. The ability to provide quantitative measures of balance and posture is the benefit of objective tools, however these instruments are not generally utilized outside of research laboratory settings due to cost, complexity of operation, size, duration of assessment, and general practicality. The purpose of this pilot study was to assess the value and validity of using software developed to access the iPod and iPhone accelerometers output and translate that to the measurement of human balance. Thirty healthy college-aged individuals (13 male, 17 female; age = 26.1 ± 8.5 years) volunteered. Participants performed a static Athlete's Single Leg Test protocol for 10 sec, on a Biodex Balance System SD while concurrently utilizing a mobile device with balance software. Anterior/posterior stability was recorded using both devices, described as the displacement in degrees from level, and was termed the "balance score." There were no significant differences between the two reported balance scores (p = 0.818. Mean balance score on the balance platform was 1.41 ± 0.90, as compared to 1.38 ± 0.72 using the mobile device. There is a need for a valid, convenient, and cost-effective tool to objectively measure balance. Results of this study are promising, as balance score derived from the Smartphone accelerometers were consistent with balance scores obtained from a previously validated balance system. However, further investigation is necessary as this version of the mobile software only assessed balance in the anterior/posterior direction. Additionally, further testing is necessary on a healthy populations and as well as those with impairment of the motor control system. Level 2b (Observational study of validity)(1.)
Preschool physics: Using the invisible property of weight in causal reasoning tasks
Williamson, Rebecca A.; Meltzoff, Andrew N.
2018-01-01
Causal reasoning is an important aspect of scientific thinking. Even young human children can use causal reasoning to explain observations, make predictions, and design actions to bring about specific outcomes in the physical world. Weight is an interesting type of cause because it is an invisible property. Here, we tested preschool children with causal problem-solving tasks that assessed their understanding of weight. In an experimental setting, 2- to 5-year-old children completed three different tasks in which they had to use weight to produce physical effects—an object displacement task, a balance-scale task, and a tower-building task. The results showed that the children’s understanding of how to use object weight to produce specific object-to-object causal outcomes improved as a function of age, with 4- and 5-year-olds showing above-chance performance on all three tasks. The younger children’s performance was more variable. The pattern of results provides theoretical insights into which aspects of weight processing are particularly difficult for preschool children and why they find it difficult. PMID:29561840
Preschool physics: Using the invisible property of weight in causal reasoning tasks.
Wang, Zhidan; Williamson, Rebecca A; Meltzoff, Andrew N
2018-01-01
Causal reasoning is an important aspect of scientific thinking. Even young human children can use causal reasoning to explain observations, make predictions, and design actions to bring about specific outcomes in the physical world. Weight is an interesting type of cause because it is an invisible property. Here, we tested preschool children with causal problem-solving tasks that assessed their understanding of weight. In an experimental setting, 2- to 5-year-old children completed three different tasks in which they had to use weight to produce physical effects-an object displacement task, a balance-scale task, and a tower-building task. The results showed that the children's understanding of how to use object weight to produce specific object-to-object causal outcomes improved as a function of age, with 4- and 5-year-olds showing above-chance performance on all three tasks. The younger children's performance was more variable. The pattern of results provides theoretical insights into which aspects of weight processing are particularly difficult for preschool children and why they find it difficult.
Pellerin, D; Charbonneau, E; Fadul-Pacheco, L; Soucy, O; Wattiaux, M A
2017-10-01
Our objective was to explore the trade-offs between economic performance (farm net income, FNI) and environmental outcomes (whole-farm P and N balances) of dairy farms in Wisconsin (WI; United States) and Québec (QC; Canada). An Excel-based linear program model (N-CyCLES; nutrient cycling: crops, livestock, environment, and soil) was developed to optimize feeding, cropping, and manure management as a single unit of management. In addition to FNI, P and N balances model outputs included (1) the mix of up to 9 home-grown and 17 purchased feeds for up to 5 animal groups, (2) the mix of up to 5 crop rotations in up to 5 land units and c) the mix of up to 7 fertilizers (solid and liquid manure and 5 commercial fertilizers) to allocate in each land unit. The model was parameterized with NRC nutritional guidelines and regional nutrient management planning rules. Simulations were conducted on a typical WI farm of 107 cows and 151 ha of cropland and, a Southern QC farm of 87 cows and 142 ha of cropland and all results were expressed per kg of fat- and protein-corrected milk (FPCM). In absence of constraints on P and N balances, maximum FNI was 0.12 and 0.11 $/kg of FPCM for WI and QC, respectively, with P and N balances of 1.05 and 14.29 g/kg of FPCM in WI but 0.60 and 15.70 g/kg of FPCM in QC. The achievable reduction (balance at maximum FNI minus balance when the simulation objective was to minimize P or N balance) was 0.31 and 0.54 g of P/kg of FPCM (29 and 89% reduction), but 2.37 and 3.31 g of N/kg of FPCM (17 and 24% reduction) in WI and QC, respectively. Among other factors, differences in animal unit per hectare and reliance on biological N fixation may have contributed to lower achievable reductions of whole-farm balances in WI compared with QC. Subsequent simulations to maximize FNI under increasing constraints on nutrient balances revealed that it was possible to reduce P balance, N balance, and both together by up to 33% without a substantial effect on FNI. Partial reduction in P balance reduced N balance (synergetic effect) in WI, but increased N balance (antagonistic effect) in QC. In contrast, reducing N balance increased P balance in both regions, albeit in different magnitudes. The regional comparison highlighted the importance of site-specific conditions on modeling outcomes. This study demonstrated that even when recommended guidelines are followed for herd nutrition and crop fertilization, the optimization of herd feeding, cropping, and manure spreading as a single unit of management may help identify management options that preserve FNI, while substantially reducing whole-farm nutrient balance. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Standridge, J. S.; Bhattacharya, Amit; Succop, Paul; Cox, Cyndy; Haynes, Erin
2009-01-01
OBJECTIVE The objective of this study was to determine the effect of non-occupational exposure to manganese on postural balance. METHODS Residents living near a ferromanganese refinery provided hair and blood samples after postural balance testing. The relationship between hair manganese and postural balance was analyzed with logistic regression. Following covariate adjustment, postural balance was compared with control data by analysis of covariance. RESULTS Mean hair manganese was 4.4 µg/g. A significantly positive association was found between hair manganese and sway area (EO, p=0.05; EC, p=0.04) and sway length (EO, p=0.05; EC, p=0.04). Postural balance of residents was significantly larger than controls in 5 out of 8 postural balance outcomes. CONCLUSION Preliminary findings suggest subclinical impairment in postural balance among residents chronically exposed to ambient Mn. A prospective study with a larger sample size is warranted. PMID:19092498
Reliability and Validity Evidence of Multiple Balance Assessments in Athletes With a Concussion
Murray, Nicholas; Salvatore, Anthony; Powell, Douglas; Reed-Jones, Rebecca
2014-01-01
Context: An estimated 300 000 sport-related concussion injuries occur in the United States annually. Approximately 30% of individuals with concussions experience balance disturbances. Common methods of balance assessment include the Clinical Test of Sensory Organization and Balance (CTSIB), the Sensory Organization Test (SOT), the Balance Error Scoring System (BESS), and the Romberg test; however, the National Collegiate Athletic Association recommended the Wii Fit as an alternative measure of balance in athletes with a concussion. A central concern regarding the implementation of the Wii Fit is whether it is reliable and valid for measuring balance disturbance in athletes with concussion. Objective: To examine the reliability and validity evidence for the CTSIB, SOT, BESS, Romberg test, and Wii Fit for detecting balance disturbance in athletes with a concussion. Data Sources: Literature considered for review included publications with reliability and validity data for the assessments of balance (CTSIB, SOT, BESS, Romberg test, and Wii Fit) from PubMed, PsycINFO, and CINAHL. Data Extraction: We identified 63 relevant articles for consideration in the review. Of the 63 articles, 28 were considered appropriate for inclusion and 35 were excluded. Data Synthesis: No current reliability or validity information supports the use of the CTSIB, SOT, Romberg test, or Wii Fit for balance assessment in athletes with a concussion. The BESS demonstrated moderate to high reliability (interclass correlation coefficient = 0.87) and low to moderate validity (sensitivity = 34%, specificity = 87%). However, the Romberg test and Wii Fit have been shown to be reliable tools in the assessment of balance in Parkinson patients. Conclusions: The BESS can evaluate balance problems after a concussion. However, it lacks the ability to detect balance problems after the third day of recovery. Further investigation is needed to establish the use of the CTSIB, SOT, Romberg test, and Wii Fit for assessing balance in athletes with concussions. PMID:24933431
2013-01-01
Kinect-based exergames allow players to undertake physical exercise in an interactive manner with visual stimulation. Previous studies focused on investigating physical fitness based on calories or heart rate to ascertain the effectiveness of exergames. However, designing an exergame for specific training purposes, with intensity levels suited to the needs and skills of the players, requires the investigation of motion performance to study player experience. This study investigates how parameters of a Kinect-based exergame, combined with balance training exercises, influence the balance control ability and intensity level the player can tolerate, by analyzing both objective and gameplay-based player experience, and taking enjoyment and difficulty levels into account. The exergame tested required participants to maintain their balance standing on one leg within a posture frame (PF) while a force plate evaluated the player's balance control ability in both static and dynamic gaming modes. The number of collisions with the PF depended on the frame's travel time for static PFs, and the leg-raising rate and angle for dynamic PFs. In terms of center of pressure (COP) metrics, significant impacts were caused by the frame's travel time on MDIST-AP for static PFs, and the leg-raising rate on MDIST-ML and TOTEX for dynamic PFs. The best static PF balance control performance was observed with a larger frame offset by a travel time of 2 seconds, and the worst performance with a smaller frame and a travel time of 1 second. The best dynamic PF performance was with a leg-raising rate of 1 second at a 45-degree angle, while the worst performance was with a rate of 2 seconds at a 90-degree angle. The results demonstrated that different evaluation methods for player experience could result in different findings, making it harder to study the design of those exergames with training purposes based on player experience. PMID:23922716
Balance Training Enhances Motor Coordination During a Perturbed Sidestep Cutting Task.
Oliveira, Anderson Souza; Silva, Priscila Brito; Lund, Morten Enemark; Farina, Dario; Kersting, Uwe Gustav
2017-11-01
Study Design Controlled laboratory study. Background Balance training may improve motor coordination. However, little is known about the changes in motor coordination during unexpected perturbations to postural control following balance training. Objectives To study the effects of balance training on motor coordination and knee mechanics during perturbed sidestep cutting maneuvers in healthy adults. Methods Twenty-six healthy men were randomly assigned to a training group or a control group. Before balance training, subjects performed unperturbed, 90° sidestep cutting maneuvers and 1 unexpected perturbed cut (10-cm translation of a movable platform). Participants in the training group participated in a 6-week balance training program, while those in the control group followed their regular activity schedule. Both groups were retested after a 6-week period. Surface electromyography was recorded from 16 muscles of the supporting limb and trunk, as well as kinematics and ground reaction forces. Motor modules were extracted from electromyography by nonnegative matrix factorization. External knee abduction moments were calculated using inverse dynamics equations. Results Balance training reduced the external knee abduction moment (33% ± 25%, P<.03, η p 2 = 0.725) and increased the activation of trunk and proximal hip muscles in specific motor modules during perturbed cutting. Balance training also increased burst duration for the motor module related to landing early in the perturbation phase (23% ± 11%, P<.01, η p 2 = 0.532). Conclusion Balance training resulted in altered motor coordination and a reduction in knee abduction moment during an unexpected perturbation. The previously reported reduction in injury incidence following balance training may be linked to changes in dynamic postural stability and modular neuromuscular control. J Orthop Sports Phys Ther 2017;47(11):853-862. Epub 23 Sep 2017. doi:10.2519/jospt.2017.6980.
Multiobjective optimization techniques for structural design
NASA Technical Reports Server (NTRS)
Rao, S. S.
1984-01-01
The multiobjective programming techniques are important in the design of complex structural systems whose quality depends generally on a number of different and often conflicting objective functions which cannot be combined into a single design objective. The applicability of multiobjective optimization techniques is studied with reference to simple design problems. Specifically, the parameter optimization of a cantilever beam with a tip mass and a three-degree-of-freedom vabration isolation system and the trajectory optimization of a cantilever beam are considered. The solutions of these multicriteria design problems are attempted by using global criterion, utility function, game theory, goal programming, goal attainment, bounded objective function, and lexicographic methods. It has been observed that the game theory approach required the maximum computational effort, but it yielded better optimum solutions with proper balance of the various objective functions in all the cases.
Kiers, Henri; van Dieën, Jaap; Dekkers, Henk; Wittink, Harriët; Vanhees, Luc
2013-11-01
In many sports, maintaining balance is necessary to compete at a high level. Also, in many health problems, balance is impaired. Postural sway (PS) is often used as an indicator of upright balance control, and physical activity (PA) might enhance balance control. However, the relationship between PS and PA has never been systematically reviewed. Our objective was to summarize the evidence regarding the relationship between PS in upright bipedal and unipedal standing and PA. We conducted a literature search in MEDLINE, EmBase, CINAHL, the Cochrane Database, and PEDro, up to March 2012, with no limit on the starting date. Characteristics and methodological aspects of each article were extracted by two reviewers. We used centre of pressure (CoP) velocity, and variables related to the CoP area, to compare studies. A total of 39 articles were reviewed from an initial yield of 2,058. Of these 39 studies, 37 used a comparative design, one was a cohort study, and one was a randomized controlled trial. The main conclusion was that in general, sport practitioners sway less than controls, and high-level athletes sway less than low-level athletes. Additionally, we identified specific effects dependent on the use of vision, sport-specific postures, and frequency and duration of the (sports) activity. PS in unperturbed bipedal stance appears to have limited sensitivity to detect subtle differences between groups of healthy people.
Tailored balance exercises on people with multiple sclerosis: A pilot randomized, controlled study.
Brichetto, Giampaolo; Piccardo, Elisa; Pedullà, Ludovico; Battaglia, Mario Alberto; Tacchino, Andrea
2015-07-01
Altered integration of signals from visual (VIS), somatosensory (PROP) and vestibular system (VEST) lead to balance control impairments affecting the daily living activities of patients with multiple sclerosis (PwMS). As a consequence, tailored interventions could be crucial in improving efficacy of balance rehabilitation treatments. The objective of this paper is to assess the efficacy of tailored rehabilitation treatments for balance disorders based on visual, somatosensory and vestibular deficits versus traditional rehabilitation exercises. Thirty-two PwMS were assessed with the Berg Balance Scale (BBS), the composite score (CS) obtained by computerized dynamic posturography (CDP) test and the Modified Fatigue Impact Scale (MFIS). Based on CDP analysis, prevalent VIS, PROP or VEST deficits were identified and patients randomly allocated to a personalized (PRG) or traditional (TRG) rehabilitation group. BBS score showed a significant difference between pre- and post-treatment scores of 6.3 and 2.0 points respectively for PRG and TRG. CS showed a significant difference between pre- and post-treatment scores of 16.6 and 7.6 points respectively for PRG and TRG. No interaction effect was found for MFIS score. BBS and CS showed changes in the PRG group that met clinical relevant difference, underlining that tailored rehabilitation interventions based on patient-specific sensory system impairment could improve balance and postural control in PwMS. © The Author(s), 2015.
Chaouachi, Mehdi; Granacher, Urs; Makhlouf, Issam; Hammami, Raouf; Behm, David G; Chaouachi, Anis
2017-01-01
The integration of balance and plyometric training has been shown to provide significant improvements in sprint, jump, agility, and other performance measures in young athletes. It is not known if a specific within session balance and plyometric exercise sequence provides more effective training adaptations. The objective of the present study was to investigate the effects of using a sequence of alternating pairs of exercises versus a block (series) of all balance exercises followed by a block of plyometric exercises on components of physical fitness such as muscle strength, power, speed, agility, and balance. Twenty-six male adolescent soccer players (13.9 ± 0.3 years) participated in an 8-week training program that either alternated individual balance (e.g., exercises on unstable surfaces) and plyometric (e.g., jumps, hops, rebounds) exercises or performed a block of balance exercises prior to a block of plyometric exercises within each training session. Pre- and post-training measures included proxies of strength, power, agility, sprint, and balance such as countermovement jumps, isometric back and knee extension strength, standing long jump, 10 and 30-m sprints, agility, standing stork, and Y-balance tests. Both groups exhibited significant, generally large magnitude (effect sizes) training improvements for all measures with mean performance increases of approximately >30%. There were no significant differences between the training groups over time. The results demonstrate the effectiveness of combining balance and plyometric exercises within a training session on components of physical fitness with young adolescents. The improved performance outcomes were not significantly influenced by the within session exercise sequence. Key points The combination of balance and plyometric exercises can induce significant and substantial training improvements in muscle strength, power, speed, agility, and balance with adolescent youth athletes The within training session sequence of balance and plyometric exercises does not substantially affect these training improvements. PMID:28344461
Task oriented training improves the balance outcome & reducing fall risk in diabetic population
Ghazal, Javeria; Malik, Arshad Nawaz; Amjad, Imran
2016-01-01
Objectives: The objective was to determine the balance impairments and to compare task oriented versus traditional balance training in fall reduction among diabetic patients. Methods: The randomized control trial with descriptive survey and 196 diabetic patients were recruited to assess balance impairments through purposive sampling technique. Eighteen patients were randomly allocated into two groups; task oriented balance training group TOB (n=8) and traditional balance training group TBT (n=10). The inclusion criteria were 30-50 years age bracket and diagnosed cases of Diabetes Mellitus with neuropathy. The demographics were taken through standardized & valid assessment tools include Berg Balance Scale and Functional Reach Test. The measurements were obtained at baseline, after 04 and 08 weeks of training. Results: The mean age of the participants was 49 ±6.79. The result shows that 165(84%) were at moderate risk of fall and 31(15%) were at mild risk of fall among total 196 diabetic patients. There was significant improvement (p <0.05) in task oriented balance training group for dynamic balance, anticipatory balance and reactive balance after 8 weeks of training as compare to traditional balance training. Conclusion: Task oriented balance training is effective in improving the dynamic, anticipator and reactive balance. The task oriented training reduces the risk of falling through enhancing balance outcome. PMID:27648053
Larivière, Nadine; Denis, Catherine; Payeur, Amélie; Ferron, Amélie; Levesque, Stéphanie; Rivard, Guillaume
2016-12-01
Life balance is associated to health, well-being and quality of life and is a target of psychiatric rehabilitation interventions. However, little is known about this life dimension in women living with personality disorders. The purpose of this descriptive-correlational study was to compare and explore relationships between subjective life balance, objective time use, quality of life and perceived stress in women without a mental health disorder (n = 43) and women with a personality disorder (clusters B and C) (n = 30), aged between 18 and 50 years old. The variables were measured with the Life Balance Inventory (subjective life balance), the Occupational Questionnaire (objective time use), the Depression Anxiety Stress Scale (perceived stress) and the Quality of Life Index (satisfaction and importance with life domains). The analyses showed that women with a personality disorder spend significantly less time in work but more time in daily tasks and leisure. Subjective life balance, quality of life and perceived stress were significantly lower in women with a personality disorder (p < 0.05). In women with a personality disorder, subjective life balance was explained by quality of life (R 2 = 27.5 %). In women without a mental illness, subjective life balance was explained by quality of life and motherhood (R 2 = 36.1 %). To support the recovery of women with personality disorders and their quality of life, it is important to address objective and subjective time use to enable accomplishment of a variety of meaningful activities.
Characterization of static balance abilities in elite soccer players by playing position and age.
Pau, Massimiliano; Ibba, Gianfranco; Leban, Bruno; Scorcu, Marco
2014-01-01
In this study, we investigated the static balance of adult and adolescent elite soccer players to understand how expertise and playing position influence postural control. Seventy-one national level players were tested using a force platform to acquire Center-of-Pressure (COP) data in uni- and bipedal stance and calculate sway area (SA), COP path length, velocity and displacements. The results show significant differences in postural sway related to age and playing position only for single-limb stance. In particular, midfielders exhibited significantly lower values of SA with respect to defenders (-48%, p = 0.001) and the under-15 players exhibited SA 42-64% higher than all the others (p = 0.001). In the light of planning training or rehabilitation programs specific for each player's role and age, sway measurements may supply useful, objective and reliable information only for the unipedal test as the bipedal standing appears not challenging enough to let differences in balance abilities emerge.
Development and implementation of a balanced scorecard in an academic hospitalist group.
Hwa, Michael; Sharpe, Bradley A; Wachter, Robert M
2013-03-01
Academic hospitalist groups (AHGs) are often expected to excel in multiple domains: quality improvement, patient safety, education, research, administration, and clinical care. To be successful, AHGs must develop strategies to balance their energies, resources, and performance. The balanced scorecard (BSC) is a strategic management system that enables organizations to translate their mission and vision into specific objectives and metrics across multiple domains. To date, no hospitalist group has reported on BSC implementation. We set out to develop a BSC as part of a strategic planning initiative. Based on a needs assessment of the University of California, San Francisco, Division of Hospital Medicine, mission and vision statements were developed. We engaged representative faculty to develop strategic objectives and determine performance metrics across 4 BSC perspectives. There were 41 metrics identified, and 16 were chosen for the initial BSC. It allowed us to achieve several goals: 1) present a broad view of performance, 2) create transparency and accountability, 3) communicate goals and engage faculty, and 4) ensure we use data to guide strategic decisions. Several lessons were learned, including the need to build faculty consensus, establish metrics with reliable measureable data, and the power of the BSC to drive goals across the division. We successfully developed and implemented a BSC in an AHG as part of a strategic planning initiative. The BSC has been instrumental in allowing us to achieve balanced success in multiple domains. Academic groups should consider employing the BSC as it allows for a data-driven strategic planning and assessment process. Copyright © 2013 Society of Hospital Medicine.
Shen, Xia; Mak, Margaret K Y
2014-07-01
Background Fear of falling has been identified as an important and independent fall-risk predictor in patients with Parkinson's disease (PD). However, there are inconsistent findings on the effects of balance and gait training on balance confidence. Objective To explore whether balance and gait training with augmented feedback can enhance balance confidence in PD patients immediately after treatment and at 3- and 12-month follow-ups. Methods A total of 51 PD patients were randomly assigned to a balance and gait training (BAL) group or to an active control (CON) group. The BAL group received balance and gait training with augmented feedback, whereas CON participants received lower-limb strength training for 12 weeks. Outcome measures included Activities-Specific Balance Confidence (ABC) Scale, limits-of-stability test, single-leg-stance test, and spatiotemporal gait characteristics. All tests were administered before intervention (Pre), immediately after training (Post), and at 3 months (Post3m) and 12 months (Post12m) after treatment completion. Results The ABC score improved marginally at Post and significantly at Post3m and Post12m only in the BAL group (P < .017). Both participant groups increased their end point excursion at Post, but only the BAL group maintained the improvement at Post3m. The BAL group maintained significantly longer time-to-loss-of-balance during the single-leg stance test than the CON group at Post3m and Post12m (P < .05). For gait characteristics, both participant groups increased gait velocity, but only the BAL group increased stride length at Post, Post3m, and Post12m (P < .017). Conclusions Positive findings from this study provide evidence that BAL with augmented feedback could enhance balance confidence and balance and gait performance in patients with PD. © The Author(s) 2014.
76 FR 13353 - Department of Commerce FY 2011-2016 Strategic Plan
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-11
... scorecard. A balanced scorecard ``balances'' or equally emphasizes programmatic and management objectives... senior leadership to develop a balanced scorecard to deploy and execute this Strategic Plan. The Secretary directed a balanced scorecard approach to establish and maintain focus on the Department's top...
Wendland, Edson; Gomes, Luis H; Troeger, Uwe
2015-01-01
The contribution of recharge to regional groundwater flow systems is essential information required to establish sustainable water resources management. The objective of this work was to determine the groundwater outflow in the Ribeirão da Onça Basin using a water balance model of the saturated soil zone. The basin is located in the outcrop region of the Guarani Aquifer System (GAS). The water balance method involved the determination of direct recharge values, groundwater storage variation and base flow. The direct recharge was determined by the water table fluctuation method (WTF). The base flow was calculated by the hydrograph separation method, which was generated by a rain-flow model supported by biweekly streamflow measurements in the control section. Undisturbed soil samples were collected at depths corresponding to the variation zone of the groundwater level to determine the specific yield of the soil (drainable porosity). Water balances were performed in the saturated zone for the hydrological years from February 2004 to January 2007. The direct recharge ranged from 14.0% to 38.0%, and groundwater outflow from 0.4% to 2.4% of the respective rainfall during the same period.
Viguier, Marion; Dupui, Philippe; Montoya, Richard
2009-02-01
Twenty-four women divided into three groups: control, exercise and nutrition, have been involved in a -6 degrees head down bed rest (HDBR) experiment for 60 days. The objective was to analyse the effects of microgravity on balance function regulation. Group comparisons assessed the efficiency of countermeasures (specific exercises and in particular diet) on the deleterious effects of simulated microgravity. Measurements of orthostatic and dynamic balance were taken 9 and 2 days prior to the experiment, on the first day of getting up, the following day and 4 and 10 days after, under two visual conditions: eyes open and eyes closed. The results confirmed that, as in any other test performed with ordinary subjects, the postural balance performances are better with eyes open than with eyes closed. The static and dynamic postural performances were impaired on the first day of recovery (R0) following HDBR. This impairment lasted up to 4 days after getting up and, afterwards the volunteers recovered their initial performances. The exercise group recovered static postural performances more quickly than the other groups whereas there were no differences in the recovery of the dynamic balance performances.
Fundamental movement skills and balance of children with Down syndrome.
Capio, C M; Mak, T C T; Tse, M A; Masters, R S W
2018-03-01
Conclusive evidence supports the importance of fundamental movement skills (FMS) proficiency in promoting physical activity and countering obesity. In children with Down Syndrome (DS), FMS development is delayed, which has been suggested to be associated with balance deficits. This study therefore examined the relationship between FMS proficiency and balance ability in children with DS, with the aim of contributing evidence to programmes that address FMS delay. Participants consisted of 20 children with DS (7.1 ± 2.9 years old) and an age-matched control group of children with typical development (7.25 ± 2.5 years). In the first part of the study, FMS (i.e. locomotor and object control) proficiency of the children was tested using the Test of Gross Motor Development-2. Balance ability was assessed using a force platform to measure centre of pressure average velocity (AV; mm/sec), path length (mm), medio-lateral standard deviation (mm) and antero-posterior standard deviation (mm). In the second part of the study, children with DS participated in 5 weeks of FMS training. FMS proficiency and balance ability were tested post-training and compared to pre-training scores. Verbal and visuo-spatial short-term memory capacities were measured at pre-training to verify the role of working memory in skill learning. FMS proficiency was associated with centre of pressure parameters in children with DS but not in children with typical development. After controlling for age, AV was found to predict significant variance in locomotor (R 2 = 0.61, P < 0.001) and object control (R 2 = 0.69, P < 0.001) scores. FMS proficiency and mastery improved after FMS training, as did AV, path length and antero-posterior standard deviation (all P < 0.05). Verbal and visuo-spatial short-term memory did not interact with the effects of training. Children with DS who have better balance ability tend to have more proficient FMS. Skill-specific training improved not only FMS sub-skills but static balance stability as well. Working memory did not play a role in the changes caused by skills training. Future research should examine the causal relationship between balance and FMS. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Toosizadeh, Nima; Lei, Hong; Schwenk, Michael; Sherman, Scott J.; Esternberg, Esther; Mohler, Jane; Najafi, Bijan
2014-01-01
Background Postural balance and potentially fall risk increases among older adults living with neurological diseases, especially Parkinson's disease (PD). Since conventional therapies, such as levodopa or deep brain stimulation may fail to alleviate or may even worsen balance, interest is growing in evaluating alternative PD therapies. Objective The purpose of the current study was to assess improvement in postural balance in PD patients following electro-acupuncture (EA), as an alternative therapy. Methods Fifteen aging adults (70.2 ± 7.3 years) with idiopathic PD and 44 healthy age- matched participants (74.6 ± 6.5 years) were recruited. PD participants were randomly assigned (with a ratio of 2 to 1) to an intervention (n=10) or to a control group (n=5). The intervention group received a 30-minute EA treatment on a weekly basis for three weeks, while the control group received a sham treatment. Outcomes were assessed at baseline and after the final therapy. Measurements included balance assessment, specifically ratio of medial-lateral (ML) center of gravity (COG) sway to anterior-posterior (AP) sway (COGML/AP) and ankle-to-hip sway during eyes-open, eyes-closed, and eyes-open dual-tasks trials, Unified Parkinson's Disease Rating Scale (UPDRS), and quality of life, concerns for fall, and pain questionnaires. Results No difference was observed for assessed parameters between intervention and control groups in baseline. After treatment, improvement in balance performance was observed in the intervention group. Compared with a healthy population, PD patients prior to treatment had larger COGML/AP sway with more dependency on upper-body movements for maintaining balance. Following EA therapy, COGML/AP sway reduced by 31% and Ankle/Hip sway increased by 46% among different conditions (p = 0.02 for dual-task condition). The clinical rating revealed an overall improvement (p < 0.01) in the activity of daily living (UPDRS part II, 46%) and motor examination (UPDRS part III, 40%). There was significant reduction (p < 0.02) in the specific items regarding UPDRS fall status (67%), and rigidity (48%). Changes were small and non-significant in the controls (p > 0.29). Conclusions This pilot study demonstrated improvement in rigidity and balance following EA. These preliminary results suggest EA could be a promising alternative treatment for balance disturbance in PD. PMID:25341431
Mansfield, Avril; Aqui, Anthony; Centen, Andrew; Danells, Cynthia J; DePaul, Vincent G; Knorr, Svetlana; Schinkel-Ivy, Alison; Brooks, Dina; Inness, Elizabeth L; McIlroy, William E; Mochizuki, George
2015-06-06
Falls are one of the most common medical complications post-stroke. Physical exercise, particularly exercise that challenges balance, reduces the risk of falls among healthy and frail older adults. However, exercise has not proven effective for preventing falls post-stroke. Falls ultimately occur when an individual fails to recover from a loss of balance. Thus, training to specifically improve reactive balance control could prevent falls. Perturbation training aims to improve reactive balance control by repeatedly exposing participants to postural perturbations. There is emerging evidence that perturbation training reduces fall rates among individuals with neurological conditions, such as Parkinson disease. The primary aim of this work is to determine if perturbation-based balance training can reduce occurrence of falls in daily life among individuals with chronic stroke. Secondary objectives are to determine the effect of perturbation training on balance confidence and activity restriction, and functional balance and mobility. Individuals with chronic stroke will be recruited. Participants will be randomly assigned to one of two groups: 1) perturbation training, or 2) 'traditional' balance training. Perturbation training will involve both manual perturbations (e.g., a push or pull from a physiotherapist), and rapid voluntary movements to cause a loss of balance. Training will occur twice per week for 6 weeks. Participants will record falls and activity for 12 months following completion of the training program. Standardized clinical tools will be used to assess functional balance and mobility, and balance confidence before and after training. Falls are a significant problem for those with stroke. Despite the large body of work demonstrating effective interventions, such as exercise, for preventing falls in other populations, there is little evidence for interventions that prevent falls post-stroke. The proposed study will investigate a novel and promising intervention: perturbation training. If effective, this training has the potential to not only prevent falls, but to also improve safe independent mobility and engagement in daily activities for those with stroke. Current Controlled Trials: ISRCTN05434601 .
NASA Astrophysics Data System (ADS)
Landhäusser, Simon
2017-04-01
Forest loss and degradation is occurring worldwide, but at the same time efforts in forest restoration are ever increasing. While approaches to restoration often follow specific stakeholder objectives, regional climates and the degree of site degradation also play an important role in the prioritization of restoration efforts. Often the restoration of degraded lands can satisfy only few measurable objectives; however, to design and restore resistant and resilient ecosystems that can adapt to changing conditions, there is a need for new and adaptive management approaches. Mining and other resource extraction industries are affecting more and more forested areas worldwide. A priority in the reclamation and certification of forest lands disturbed by industrial activity is their expeditious redevelopment to functioning forests. To rehabilitate these heavily disturbed areas back to forest ecosystems, planting of trees remains one of the most effective strategies for the redevelopment of a continuous tree canopy on a site. It is well understood that access to good quality seedling stock is essential to achieve establishment success and early growth of seedlings. However, most reclamation areas have challenging initial site conditions and these conditions are often not a single factor but a combination of factors that can be additive or synergistic. Therefore successful forest restoration on degraded lands needs to consider multiple objectives and approaches to minimize trade-offs in achieving these objectives. To meet these demands, new methods for the production and evaluation of seedling stock types are needed to ensure that that seedlings are fit to grow on a wide range of site conditions or are particularly designed to grow in very specific conditions. Generally, defining seedling quality is difficult as it is species specific and results have been mixed; likely influenced by site conditions, further reiterating the need to carefully evaluate sites allowing appropriate seedling qualities to be identified. In this presentation, I will show results from a range of studies that explored the role of seedling characteristics in response to challenging site conditions and explore the need for a balance between the recognition and improvement of limiting site conditions and the availability of quality seedling stock in forest restoration.
Collado-Mateo, D.; Gallego-Diaz, J. M.; Adsuar, J. C.; Domínguez-Muñoz, F. J.; Olivares, P. R.; Gusi, N.
2015-01-01
Objective. To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. Methods. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. Results. Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. Conclusion. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance. PMID:26618173
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.
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.
NASA Astrophysics Data System (ADS)
Rabbani, Masoud; Montazeri, Mona; Farrokhi-Asl, Hamed; Rafiei, Hamed
2016-12-01
Mixed-model assembly lines are increasingly accepted in many industrial environments to meet the growing trend of greater product variability, diversification of customer demands, and shorter life cycles. In this research, a new mathematical model is presented considering balancing a mixed-model U-line and human-related issues, simultaneously. The objective function consists of two separate components. The first part of the objective function is related to balance problem. In this part, objective functions are minimizing the cycle time, minimizing the number of workstations, and maximizing the line efficiencies. The second part is related to human issues and consists of hiring cost, firing cost, training cost, and salary. To solve the presented model, two well-known multi-objective evolutionary algorithms, namely non-dominated sorting genetic algorithm and multi-objective particle swarm optimization, have been used. A simple solution representation is provided in this paper to encode the solutions. Finally, the computational results are compared and analyzed.
Objectively measured physical activity and balance among U.S. adults.
Loprinzi, Paul D; Brosky, Joseph A
2014-08-01
The purpose of this study was to examine the association between objectively measured physical activity (PA) and balance in a nationally representative sample of U.S. adults 40 years of age and older. Data from the 2003-2004 National Health and Nutrition Examination Survey were used. Physical activity was measured over a 7-day period using accelerometry, and balance was assessed using the Romberg test. Participants completed a questionnaire regarding their subjective views on difficulty with falling in the past 12 months. For every 60-minute increase in light-intensity PA, participants were 10% (p = 0.04) more likely to have functional balance. Similarly, for every 1-minute increase in log-transformed moderate-to-vigorous physical activity, participants were 23% (p = 0.04) more likely to have functional balance. Regular PA, regardless of intensity, may have health benefits for older adults and is associated with functional balance.
The balanced scorecard: an integrative approach to performance evaluation.
Oliveira, J
2001-05-01
In addition to strict financial outcomes, healthcare financial managers should assess intangible assets that affect the organization's bottom line, such as clinical processes, staff skills, and patient satisfaction and loyalty. The balanced scorecard, coupled with data-warehousing capabilities, offers a way to measure an organization's performance against its strategic objectives while focusing on building capabilities to achieve these objectives. The balanced scorecard examines performance related to finance, human resources, internal processes, and customers. Because the balanced scorecard requires substantial amounts of data, it is a necessity to establish an organizational data warehouse of clinical, operational, and financial data that can be used in decision support. Because it presents indicators that managers and staff can influence directly by their actions, the balanced-scorecard approach to performance measurement encourages behavioral changes aimed at achieving corporate strategies.
Hopcraft, J Grant C; Bigurube, Gerald; Lembeli, James Daudi; Borner, Markus
2015-01-01
Developing countries often have rich natural resources but poor infrastructure to capitalize on them, which leads to significant challenges in terms of balancing poverty alleviation with conservation. The underlying premise in development strategies is to increase the socio-economic welfare of the people while simultaneously ensuring environmental sustainability, however these objectives are often in direct conflict. National progress is dependent on developing infrastructure such as effective transportation networks, however roads can be ecologically catastrophic in terms of disrupting habitat connectivity and facilitating illegal activity. How can national development and conservation be balanced? The proposed Serengeti road epitomizes the conflict between poverty alleviation on one hand, and the conservation of a critical ecosystem on the other. We use the Serengeti as an exemplar case-study in which the relative economic and social benefits of a road can be assessed against the ecological impacts. Specifically, we compare three possible transportation routes and ask which route maximizes the socio-economic returns for the people while minimizing the ecological costs. The findings suggest that one route in particular that circumnavigates the Serengeti links the greatest number of small and medium sized entrepreneurial businesses to the largest labour force in the region. Furthermore, this route connects the most children to schools, provisions the greatest access to hospitals, and opens the most fertile crop and livestock production areas, and does not compromise the ecology and tourism revenue of the Serengeti. This route would improve Tanzania's food security and self-reliance and would facilitate future infrastructure development which would not be possible if the road were to pass through the Serengeti. This case study provides a compelling example of how a detailed spatial analysis can balance the national objectives of poverty alleviation while maintaining ecological integrity.
Hopcraft, J. Grant C.; Bigurube, Gerald; Lembeli, James Daudi; Borner, Markus
2015-01-01
Developing countries often have rich natural resources but poor infrastructure to capitalize on them, which leads to significant challenges in terms of balancing poverty alleviation with conservation. The underlying premise in development strategies is to increase the socio-economic welfare of the people while simultaneously ensuring environmental sustainability, however these objectives are often in direct conflict. National progress is dependent on developing infrastructure such as effective transportation networks, however roads can be ecologically catastrophic in terms of disrupting habitat connectivity and facilitating illegal activity. How can national development and conservation be balanced? The proposed Serengeti road epitomizes the conflict between poverty alleviation on one hand, and the conservation of a critical ecosystem on the other. We use the Serengeti as an exemplar case-study in which the relative economic and social benefits of a road can be assessed against the ecological impacts. Specifically, we compare three possible transportation routes and ask which route maximizes the socio-economic returns for the people while minimizing the ecological costs. The findings suggest that one route in particular that circumnavigates the Serengeti links the greatest number of small and medium sized entrepreneurial businesses to the largest labour force in the region. Furthermore, this route connects the most children to schools, provisions the greatest access to hospitals, and opens the most fertile crop and livestock production areas, and does not compromise the ecology and tourism revenue of the Serengeti. This route would improve Tanzania’s food security and self-reliance and would facilitate future infrastructure development which would not be possible if the road were to pass through the Serengeti. This case study provides a compelling example of how a detailed spatial analysis can balance the national objectives of poverty alleviation while maintaining ecological integrity. PMID:26200107
Is Kyphosis Related to Mobility, Balance and Disability?
Eum, Regina; Leveille, Suzanne G.; Kiely, Dan K.; Kiel, Douglas P.; Samelson, Elizabeth J.; Bean, Jonathan F.
2013-01-01
Objective To determine the association of increased kyphosis with declines in mobility, balance and disability among community-living older adults. Design 18-month follow-up visit data from 2006–2009 for 620 participants from the population-based MOBILIZE Boston Study of older adults was used. Cross-sectional multivariable regression analyses were performed to assess the relationship between kyphosis (measured using the kyphosis index (KI)) and measures of mobility performance (Short Physical Performance Battery (SPPB)), balance (Berg Balance Score (BBS)) and disability (self-reported difficulty walking a quarter-mile or climbing a flight of stairs). We then evaluated men and women separately. Adjustment variables included demographic factors (age, gender, race, education), body-mass index, self-rated health, comorbidities (heart disease, diabetes, stroke, depressive symptoms), back pain, knee pain and falls self-efficacy. Results After full adjustment, greater KI was associated with lower SPPB scores (adj. β = −0.08, p = 0.01), but not BBS (adj. β = −0.09, p = 0.23) or self-reported disability (adj. β = 1.00, 95% CI, 0.93 –1.06). In gender-specific analyses, KI was only associated with SPPB in women. Conclusions Greater kyphosis is associated with poorer mobility performance, but not balance or self-reported disability. This association with SPPB was only observed among women. Mechanisms by which increased kyphosis influence physical performance should be explored prospectively. PMID:23636086
The Decisional Balance Sheet to Promote Healthy Behavior Among Ethnically Diverse Older Adults
Geller, Karly S.; Mendoza, Ilora D.; Timbobolan, Jasah; Montjoy, Holly L.; Nigg, Claudio R.
2012-01-01
Objective The rising health care costs and increasing older adult population in the United States make preventive medicine for this age group especially crucial. Regular physical activity and fruit and vegetable consumption may prevent or delay the onset of many chronic conditions that are common among older adults. The decisional balance sheet is a promotional tool targeting the perceived pros and cons of behavior adoption. The current study tested the efficiency and effectiveness of a single-day decisional balance sheet program, targeting increased physical activity and fruit and vegetable intake among older adults. Design and Sample Participating adults (N = 21, age = 72.2) who represented a diverse population in Hawaii (Japanese = 5, Filipino = 4, Caucasian = 4, Native American = 1, Native Hawaiian = 1, Hispanic = 1, and Others = 5) were recruited from housing communities and randomized to a decisional balance sheet program adapted for physical activity or fruit and vegetable consumption. Measures Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form, and daily fruit and vegetable intake with the National Health and Nutrition Examination Survey single item instrument. Baseline and follow-up data were collected. Results Both programs were implemented efficiently, and participants in both groups improved their daily physical activity. The decisional balance sheet for fruit and vegetable consumption appeared less effective. Conclusions Specific suggestions for similar programs are reported. PMID:22512425
Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients
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
Department of Defense Civilian Human Resources Strategic Plan
2005-04-01
the strategic plan. A balanced scorecard approach was used to build the strategic plan. The balanced scorecard is a strategic management tool that...in the balanced scorecard format. Details of how the balanced scorecard addresses the DoD Human Capital Initiative are outlined in the Office of...mission- ready civilian workforce 8 GOALS AND OBJECTIVES The balanced scorecard approach reflects the changes the Department is undergoing and
Toward accommodating physicians' conscientious objections: an argument for public disclosure.
Harter, Thomas D
2015-03-01
This paper aims to demonstrate how public disclosure can be used to balance physicians' conscientious objections with their professional obligations to patients--specifically respect for patient autonomy and informed consent. It is argued here that physicians should be permitted to exercise conscientious objections, but that they have a professional obligation to provide advance notification to patients about those objections. It is further argued here that public disclosure is an appropriate and ethically justifiable limit to the principle of advance notification. The argument for publicly disclosing physicians' conscientious objections is made in this paper by discussing three practical benefits of public disclosure in medicine, and then addressing how publicly disclosing physicians' conscientious objections is not an undue invasion of privacy. Three additional concerns with public disclosure of physicians' conscientious objections are briefly addressed--potential harassment of physicians, workplace discrimination, and mischaracterising physicians' professional aptitude--concluding that each of these concerns requires further deliberation in the realm of business ethics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
The Revised Neurobehavioral Severity Scale (NSS-R) for Rodents.
Yarnell, Angela M; Barry, Erin S; Mountney, Andrea; Shear, Deborah; Tortella, Frank; Grunberg, Neil E
2016-04-08
Motor and sensory deficits are common following traumatic brain injury (TBI). Although rodent models provide valuable insight into the biological and functional outcomes of TBI, the success of translational research is critically dependent upon proper selection of sensitive, reliable, and reproducible assessments. Published literature includes various observational scales designed to evaluate post-injury functionality; however, the heterogeneity in TBI location, severity, and symptomology can complicate behavioral assessments. The importance of choosing behavioral outcomes that can be reliably and objectively quantified in an efficient manner is becoming increasingly important. The Revised Neurobehavioral Severity Scale (NSS-R) is a continuous series of specific, sensitive, and standardized observational tests that evaluate balance, motor coordination, and sensorimotor reflexes in rodents. The tasks follow a specific order designed to minimize interference: balance, landing, tail raise, dragging, righting reflex, ear reflex, eye reflex, sound reflex, tail pinch, and hindpaw pinch. The NSS-R has proven to be a reliable method differentiating brain-injured rodents from non-brain-injured rodents across many brain injury models. Copyright © 2016 John Wiley & Sons, Inc.
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 in the dual-task balance training group (p < 0.05). A 4-week single- and dual-task balance exercise programs are effective in improving static balance, dynamic balance, and balance confidence during daily activities in older adults with osteoporosis. However, single- and dual-task gait speeds showed greater improvement following the application of a specific type of dual-task exercise programs. 24102014-2.
Hutzler, Yeshayahu; Korsensky, Olga; Laufer, Yocheved
2017-01-01
Rapid voluntary stepping has been recognized as an important measure of balance control. The purpose of this study was to assess the feasibility and convergent validity of a Rapid Stepping Test protocol utilizing a virtual reality SeeMeTM system (VR-RST) in elderly ambulatory and independent individuals living in a community residential home. Associations between step execution times determined by the system and the Activities-specific Balance Confidence (ABC) Questionnaire, and clinical measures of balance performance in the MiniBESTest and Timed Up and Go (TUG) test, were established in 60 participants (mean age 88.2 ± 5.0 years). All participants completed the study. The correlations of the ABC questionnaire and the clinical tests with VR-RST forward and backward stepping were moderate (ρ rage 0.42-0.52), and weak to moderate with sideward stepping (ρ rage 0.32-0.52). Moderate to strong correlations were found across stepping directions (ρ rage 0.45-0.87). Findings support the test's feasibility and validity and confirm the utility of the VR-RST as an assessment tool in an elderly population.
NASA Astrophysics Data System (ADS)
Lönngren, Johanna; Ingerman, Åke; Svanström, Magdalena
2017-08-01
Wicked sustainability problems (WSPs) are an important and particularly challenging type of problem. Science and engineering education can play an important role in preparing students to deal with such problems, but current educational practice may not adequately prepare students to do so. We address this gap by providing insights related to students' abilities to address WSPs. Specifically, we aim to (I) describe key constituents of engineering students' approaches to a WSP, (II) evaluate these approaches in relation to the normative context of education for sustainable development (ESD), and (III) identify relevant aspects of learning related to WSPs. Aim I is addressed through a phenomenographic study, while aims II and III are addressed by relating the results to research literature about human problem solving, sustainable development, and ESD. We describe four qualitatively different ways of approaching a specific WSP, as the outcome of the phenomenographic study: A. Simplify and avoid, B. Divide and control, C. Isolate and succumb, and D. Integrate and balance. We identify approach D as the most appropriate approach in the context of ESD, while A and C are not. On this basis, we identify three learning objectives related to students' abilities to address WSPs: learn to use a fully integrative approach, distinguish WSPs from tame and well-structured problems, and understand and consider the normative context of SD. Finally, we provide recommendations for how these learning objectives can be used to guide the design of science and engineering educational activities.
[Functional assessment of patients with vertigo and dizziness in occupational medicine].
Zamysłowska-Szmytke, Ewa; Szostek-Rogula, Sylwia; Śliwińska-Kowalska, Mariola
2018-03-09
Balance assessment relies on symptoms, clinical examination and functional assessment and their verification in objective tests. Our study was aimed at calculating the assessment compatibility between questionnaires, functional scales and objective vestibular and balance examinations. A group of 131 patients (including 101 women; mean age: 59±14 years) of the audiology outpatient clinic was examined. Benign paroxysmal positional vertigo, phobic vertigo and central dizziness were the most common diseases observed in the study group. Patients' symptoms were tested using the questionnaire on Cawthworne-Cooksey exercises (CC), Dizziness Handicap Inventory (DHI) and Duke Anxiety-Depression Scale. Berg Balance Scale (BBS), Dynamic Gait Index (DGI), the Tinetti test, Timed Up and Go test (TUG), and Dynamic Visual Acuity (DVA) were used for the functional balance assessment. Objective evaluation included: videonystagmography caloric test and static posturography. The study results revealed statistically significant but moderate compatibility between functional tests BBS, DGI, TUG, DVA and caloric results (Kendall's W = 0.29) and higher for posturography (W = 0.33). The agreement between questionnaires and objective tests were very low (W = 0.08-0.11).The positive predictive values of BBS were 42% for caloric and 62% for posturography tests, of DGI - 46% and 57%, respectively. The results of functional tests (BBS, DGI, TUG, DVA) revealed statistically significant correlations with objective balance tests but low predictive values did not allow to use these tests in vestibular damage screening. Only half of the patients with functional disturbances revealed abnormal caloric or posturography tests. The qualification to work based on objective tests ignore functional state of the worker, which may influence the ability to work. Med Pr 2018;69(2):179-189. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Plat, M J; Frings-Dresen, M H W; Sluiter, J K
2011-12-01
Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers' health surveillance (WHS) activities and (2) the effectiveness of job-specific WHS interventions with respect to work functioning, for selected jobs. The search strategy systematically searched the PubMed, PsycINFO and OSH-update databases. The search strategy consisted of several synonyms of the job titles of interest, combined with synonyms for workers' health surveillance. The methodological quality was checked. At least one study was found for each of the following occupations fire fighters, ambulance personnel, police personnel and military personnel. For the first objective, 24 studies described several job-specific WHS activities aimed at aspects of psychological, 'physical' (energetic, biomechanical and balance), sense-related, environmental exposure or cardiovascular requirements. The seven studies found for the second objective measured different outcomes related to work functioning. The methodological quality of the interventions varied, but with the exception of one study, all scored over 55% of the maximum score. Six studies showed effectiveness on at least some of the defined outcomes. The studies described several job-specific interventions: a trauma resilience training, healthy lifestyle promotion, physical readiness training, respiratory muscle training, endurance and resistance training, a physical exercise programme and comparing vaccines. Several examples of job-specific WHS activities were found for the four occupations. Compared to studies focusing on physical tasks, a few studies were found that focus on psychological tasks. Effectiveness studies for job-specific WHS interventions were scarce, although their results were promising. We recommend studying job-specific WHS in effectiveness studies.
Balancing the popularity bias of object similarities for personalised recommendation
NASA Astrophysics Data System (ADS)
Hou, Lei; Pan, Xue; Liu, Kecheng
2018-03-01
Network-based similarity measures have found wide applications in recommendation algorithms and made significant contributions for uncovering users' potential interests. However, existing measures are generally biased in terms of popularity, that the popular objects tend to have more common neighbours with others and thus are considered more similar to others. Such popularity bias of similarity quantification will result in the biased recommendations, with either poor accuracy or poor diversity. Based on the bipartite network modelling of the user-object interactions, this paper firstly calculates the expected number of common neighbours of two objects with given popularities in random networks. A Balanced Common Neighbour similarity index is accordingly developed by removing the random-driven common neighbours, estimated as the expected number, from the total number. Recommendation experiments in three data sets show that balancing the popularity bias in a certain degree can significantly improve the recommendations' accuracy and diversity simultaneously.
Fast grasping of unknown objects using cylinder searching on a single point cloud
NASA Astrophysics Data System (ADS)
Lei, Qujiang; Wisse, Martijn
2017-03-01
Grasping of unknown objects with neither appearance data nor object models given in advance is very important for robots that work in an unfamiliar environment. The goal of this paper is to quickly synthesize an executable grasp for one unknown object by using cylinder searching on a single point cloud. Specifically, a 3D camera is first used to obtain a partial point cloud of the target unknown object. An original method is then employed to do post treatment on the partial point cloud to minimize the uncertainty which may lead to grasp failure. In order to accelerate the grasp searching, surface normal of the target object is then used to constrain the synthetization of the cylinder grasp candidates. Operability analysis is then used to select out all executable grasp candidates followed by force balance optimization to choose the most reliable grasp as the final grasp execution. In order to verify the effectiveness of our algorithm, Simulations on a Universal Robot arm UR5 and an under-actuated Lacquey Fetch gripper are used to examine the performance of this algorithm, and successful results are obtained.
High Temperature Transparent Furnace Development
NASA Technical Reports Server (NTRS)
Bates, Stephen C.
1997-01-01
This report describes the use of novel techniques for heat containment that could be used to build a high temperature transparent furnace. The primary objective of the work was to experimentally demonstrate transparent furnace operation at 1200 C. Secondary objectives were to understand furnace operation and furnace component specification to enable the design and construction of a low power prototype furnace for delivery to NASA in a follow-up project. The basic approach of the research was to couple high temperature component design with simple concept demonstration experiments that modify a commercially available transparent furnace rated at lower temperature. A detailed energy balance of the operating transparent furnace was performed, calculating heat losses through the furnace components as a result of conduction, radiation, and convection. The transparent furnace shells and furnace components were redesigned to permit furnace operation at at least 1200 C. Techniques were developed that are expected to lead to significantly improved heat containment compared with current transparent furnaces. The design of a thermal profile in a multizone high temperature transparent furnace design was also addressed. Experiments were performed to verify the energy balance analysis, to demonstrate some of the major furnace improvement techniques developed, and to demonstrate the overall feasibility of a high temperature transparent furnace. The important objective of the research was achieved: to demonstrate the feasibility of operating a transparent furnace at 1200 C.
Zech, Astrid; Klahn, Philipp; Hoeft, Jon; zu Eulenburg, Christine; Steib, Simon
2014-02-01
Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures. Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing. No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86%. All balance measures except the medial-lateral TTS improved significantly over time (p < 0.05) in both groups. Significant group by time interactions were found for the BESS score (p < 0.001). The intervention group showed greater improvements (69.3 ± 10.3%) after 10 weeks in comparison to controls (31.8 ± 22.1%). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity. Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.
Balance control during gait initiation: State-of-the-art and research perspectives.
Yiou, Eric; Caderby, Teddy; Delafontaine, Arnaud; Fourcade, Paul; Honeine, Jean-Louis
2017-11-18
It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices.
[Nutrition, acid-base metabolism, cation-anion difference and total base balance in humans].
Mioni, R; Sala, P; Mioni, G
2008-01-01
The relationship between dietary intake and acid-base metabolism has been investigated in the past by means of the inorganic cation-anion difference (C(+)(nm)-A(-)(nm)) method based on dietary ash-acidity titration after the oxidative combustion of food samples. Besides the inorganic components of TA (A(-)(nm)-C(+)(nm)), which are under renal control, there are also metabolizable components (A(-)(nm)-C(+)(nm)) of TA, which are under the control of the intermediate metabolism. The whole body base balance, NBb(W), is obtained only by the application of C(+)(nm)-A(-)(nm) to food, feces and urine, while the metabolizable component (A(-)(nm)-C(+)(nm)) is disregarded. A novel method has been subsequently suggested to calculate the net balance of fixed acid, made up by the difference between the input of net endogenous acid production: NEAP = SO(4)(2-)+A(-)(m)-(C(+)(nm)-A(-)(nm)), and the output of net acid excretion: NAE = TA + NH(4)(+) - HCO(3)(-). This approach has been criticized because 1) it includes metabolizable acids, whose production cannot be measured independently; 2) the specific control of metabolizable acid and base has been incorrectly attributed to the kidney; 3) the inclusion of A-m in the balance input generates an acid overload; 4) the object of measurement in making up a balance has to be the same, a condition not fulfilled as NEAP is different from NAE. Lastly, by rearranging the net balance of the acid equation, the balance of nonmetabolizable acid equation is obtained. Therefore, any discrepancy between these two equations is due to the inaccuracy in the urine measurement of metabolizable cations and/or anions.
Balance control during gait initiation: State-of-the-art and research perspectives
Yiou, Eric; Caderby, Teddy; Delafontaine, Arnaud; Fourcade, Paul; Honeine, Jean-Louis
2017-01-01
It is well known that balance control is affected by aging, neurological and orthopedic conditions. Poor balance control during gait and postural maintenance are associated with disability, falls and increased mortality. Gait initiation - the transient period between the quiet standing posture and steady state walking - is a functional task that is classically used in the literature to investigate how the central nervous system (CNS) controls balance during a whole-body movement involving change in the base of support dimensions and center of mass progression. Understanding how the CNS in able-bodied subjects exerts this control during such a challenging task is a pre-requisite to identifying motor disorders in populations with specific impairments of the postural system. It may also provide clinicians with objective measures to assess the efficiency of rehabilitation programs and better target interventions according to individual impairments. The present review thus proposes a state-of-the-art analysis on: (1) the balance control mechanisms in play during gait initiation in able bodied subjects and in the case of some frail populations; and (2) the biomechanical parameters used in the literature to quantify dynamic stability during gait initiation. Balance control mechanisms reviewed in this article included anticipatory postural adjustments, stance leg stiffness, foot placement, lateral ankle strategy, swing foot strike pattern and vertical center of mass braking. Based on this review, the following viewpoints were put forward: (1) dynamic stability during gait initiation may share a principle of homeostatic regulation similar to most physiological variables, where separate mechanisms need to be coordinated to ensure stabilization of vital variables, and consequently; and (2) rehabilitation interventions which focus on separate or isolated components of posture, balance, or gait may limit the effectiveness of current clinical practices. PMID:29184756
Pérez-de-Heredia-Torres, Marta; Huertas-Hoyas, Elisabet; Martínez-Piédrola, Rosa; Palacios-Ceña, Domingo; Alegre-Ayala, Jorge; Santamaría-Vázquez, Montserrat; Fernández-de-las-Peñas, César
2017-01-01
Objectives Our aims were (1) to compare the sensory organisation of balance control and balance strategies between women with fibromyalgia (FM) and healthy women; (2) to investigate which sensory component, that is, vestibular, visual or somato-sensory, is the most affected in FM and (3) to determine the associations between the functional independence measure (FIM) and balance responses in FM. Design Cross-sectional observational study. Setting Urban regional hospital and university (Universidad Rey Juan Carlos, Madrid, Spain). Participants Twenty women with FM and 20 matched healthy women. Primary/secondary outcome measures The sensory organisation test (SOT) was used to determine postural sway and balance during six different conditions with subjects in a standing position. The FIM was used to determine the level of functional independence in daily life activities (ADL). Between-group differences were analysed with analysis of covariance, and the Spearman's test was used for correlations. Results Significant differences between-groups and between-conditions were found for all SOT conditions (all, p<0.001): women with FM showed lower scores being the vestibular score the most affected. Different correlations between SOT conditions and some specific ADL were observed in the FM group: bathing activity and balance condition 6 (rs=0.541; p<0.001), bed transfers activity and conditions 2 (rs=0.491; p<0.001) and 3 (rs=0.510; p<0.001), positioning strategy six and dressing the upper (rs=0.530; p<0.001) or lower (rs=0.562; p<0.001) body, and toileting (rs=0.521; p<0.001): the greater the loss of balance, the greater the interference on some daily life activities. Conclusions Women with FM exhibited balance deficiencies and used different strategies for maintaining their balance in standing, which was associated with a negative impact on functional independence. PMID:28765133
A Review of Balance and Gait Capacities in Relation to Falls in Persons with Intellectual Disability
ERIC Educational Resources Information Center
Enkelaar, Lotte; Smulders, Ellen; van Schrojenstein Lantman-de Valk, Henny; Geurts, Alexander C. H.; Weerdesteyn, Vivian
2012-01-01
Limitations in mobility are common in persons with intellectual disabilities (ID). As balance and gait capacities are key aspects of mobility, the prevalence of balance and gait problems is also expected to be high in this population. The objective of this study was to critically review the available literature on balance and gait characteristics…
Cheung, C Y Maurice; Ratcliffe, R George; Sweetlove, Lee J
2015-11-01
Flux balance analysis of plant metabolism is an established method for predicting metabolic flux phenotypes and for exploring the way in which the plant metabolic network delivers specific outcomes in different cell types, tissues, and temporal phases. A recurring theme is the need to explore the flexibility of the network in meeting its objectives and, in particular, to establish the extent to which alternative pathways can contribute to achieving specific outcomes. Unfortunately, predictions from conventional flux balance analysis minimize the simultaneous operation of alternative pathways, but by introducing flux-weighting factors to allow for the variable intrinsic cost of supporting each flux, it is possible to activate different pathways in individual simulations and, thus, to explore alternative pathways by averaging thousands of simulations. This new method has been applied to a diel genome-scale model of Arabidopsis (Arabidopsis thaliana) leaf metabolism to explore the flexibility of the network in meeting the metabolic requirements of the leaf in the light. This identified alternative flux modes in the Calvin-Benson cycle revealed the potential for alternative transitory carbon stores in leaves and led to predictions about the light-dependent contribution of alternative electron flow pathways and futile cycles in energy rebalancing. Notable features of the analysis include the light-dependent tradeoff between the use of carbohydrates and four-carbon organic acids as transitory storage forms and the way in which multiple pathways for the consumption of ATP and NADPH can contribute to the balancing of the requirements of photosynthetic metabolism with the energy available from photon capture. © 2015 American Society of Plant Biologists. All Rights Reserved.
Sway Area and Velocity Correlated With MobileMat Balance Error Scoring System (BESS) Scores.
Caccese, Jaclyn B; Buckley, Thomas A; Kaminski, Thomas W
2016-08-01
The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass-center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.
Hebert, Jeffrey R; Forster, Jeri E; Stearns-Yoder, Kelly A; Penzenik, Molly E; Brenner, Lisa A
2018-01-30
To investigate linear relationships between dizziness, fatigue, and depression and posttraumatic stress disorder (PTSD) and objectively measured balance performance in Veterans with remote mild traumatic brain injury (mTBI). Academic laboratory; Veterans Affairs Medical Center. Thirty Veterans (28 men) who served in Iraq/Afghanistan and whose most recent mTBI was sustained more than 6 months prior to enrollment. Cross-sectional, observational trial. The Computerized Dynamic Posturography-Sensory Organization Test (CDP-SOT) and the Community Balance and Mobility (CB&M) scale measured balance. Dizziness (Dizziness Handicap Inventory), fatigue (Modified Fatigue Impact Scale), depression-related symptoms (Beck Depression Inventory-II), and PTSD-related symptoms (PTSD Checklist 5) were also measured. Objectively measured balance, CDP-SOT composite, was impaired (mean score of 67.9). CDP-SOT scores correlated with dizziness (r = -0.53; P = .002), fatigue (r = -0.38; P = .03), depression (r = -0.55; P = .001), and PTSD symptoms (r = -0.53; P = .002). Dizziness, time since most recent mTBI, and PTSD symptoms and depression combined explained significant variability in CDP-SOT scores (R = 0.46; P = .003), as did fatigue depression and PTSD symptoms (R = 0.33; P = .01). Impaired balance was identified among the cohort. Findings suggest that dizziness, fatigue, depression and PTSD, and time since most recent mTBI may influence balance performance. Additional research is needed to identify the potentially interrelated natural histories of these co-occurring symptoms.
Bonarius, H P; Timmerarends, B; de Gooijer, C D; Tramper, J
The estimation of intracellular fluxes of mammalian cells using only mass balances of the relevant metabolites is not possible because the set of linear equations defined by these mass balances is underdetermined. In order to quantify fluxes in cyclic pathways the mass balance equations can be complemented with several constraints: (1) the mass balances of co-metabolites, such as ATP or NAD(P)H, (2) linear objective functions, (3) flux data obtained by isotopic-tracer experiments. Here, these three methods are compared for the analysis of fluxes in the primary metabolism of continuously cultured hybridoma cells. The significance of different theoretical constraints and different objective functions is discussed after comparing their resulting flux distributions to the fluxes determined using 13CO2 and 13C-lactate measurements of 1 - 13C-glucose-fed hybridoma cells. Metabolic fluxes estimated using the objective functions "maximize ATP" and "maximize NADH" are relatively similar to the experimentally determined fluxes. This is consistent with the observation that cancer cells, such as hybridomas, are metabolically hyperactive, and produce ATP and NADH regardless of the need for these cofactors. Copyright 1998 John Wiley & Sons, Inc.
Schwenk, Michael; Grewal, Gurtej S; Holloway, Dustin; Muchna, Amy; Garland, Linda; Najafi, Bijan
2016-01-01
Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) have deficits in sensory and motor skills leading to inappropriate proprioceptive feedback, impaired postural control, and fall risk. Balance training programs specifically developed for CIPN patients are lacking. This pilot study investigated the effect of an interactive motor adaptation balance training program based on wearable sensors for improving balance in older cancer patients with CIPN. Twenty-two patients (age: 70.3 ± 8.7 years) with objectively confirmed CIPN [vibration perception threshold (VPT) >25 V] were randomized to either an intervention (IG) or a control (CG) group. The IG received interactive game-based balance training including repetitive weight shifting and virtual obstacle crossing tasks. Wearable sensors provided real-time visual/auditory feedback from the lower limb trajectory and allowed the perception of motor errors during each motor action. The CG received no exercise intervention and continued their normal activity. Outcome measures were changes in sway of ankle, hip, and center of mass (CoM) in both mediolateral and anteroposterior (AP) directions during 30-second balance tests with increasing task difficulty [i.e. standing in feet-closed position with eyes open (EO) and eyes closed (EC), and in semi-tandem position with EO] at baseline and after the intervention. Additionally, gait performance (speed, variability) and fear of falling [Falls Efficacy Scale-International (FES-I)] were measured. Training was safe despite the participants' impaired health status, great severity of CIPN (VPT 49.6 ± 26.7 V), and great fear of falling (FES-I score 31.37 ± 11.20). After the intervention, sway of hip, ankle, and CoM was significantly reduced in the IG compared to the CG while standing in feet-closed position with EO (p = 0.010-0.022, except AP CoM sway) and in semi-tandem position (p = 0.008-0.035, except ankle sway). No significant effects were found for balance with EC, gait speed, and FES-I score (p > 0.05). This proof-of-concept study demonstrates that older cancer patients with CIPN can significantly improve their postural balance with specifically tailored, sensor-based exercise training. The training approach has potential as a therapy for improving CIPN-related postural control deficits. However, future studies comparing the proposed technology-based training with traditional balance training are required to evaluate the benefit of the interactive joint movement feedback. © 2015 S. Karger AG, Basel.
Interchangeability of the Wii Balance Board for Bipedal Balance Assessment
Jansen, Bart; Omelina, Lubos; Rooze, Marcel; Van Sint Jan, Serge
2015-01-01
Background Since 2010, an increasing interest in more portable and flexible hardware for balance and posture assessment led to previously published studies determining whether or not the Wii Balance Board could be used to assess balance and posture, both scientifically and clinically. However, no previous studies aimed at comparing results from different Wii Balance Boards for clinical balance evaluation exist. Objective The objective of this crossover study is to assess the interchangeability of the Wii Balance Board. Methods A total of 6 subjects participated in the study and their balance was assessed using 4 different Wii Balance Boards. Trials were recorded simultaneously with Wii Balance Boards and with a laboratory force plate. Nine relevant clinical parameters were derived from center of pressure displacement data obtained from Wii Balance Board and force plate systems. Intraclass correlation coefficients (ICC), F tests, and Friedman tests were computed to assess the agreement between trials and to compare the Wii Balance Board and force plate results. Results Excellent correlations were found between the Wii Balance Board and force plate (mean ρ =.83). With the exception of 2 parameters, strong to excellent agreements were found for the 7 remaining parameters (ICC=.96). No significant differences were found between trials recorded with different Wii Balance Boards. Conclusions Our results indicate that for most of the parameters analyzed, balance and posture assessed with one Wii Balance Board were statistically similar to results obtained from another. Furthermore, the good correlation between the Wii Balance Board and force plate results shows that Wii Balance Boards can be reliably used for scientific assessment using most of the parameters analyzed in this study. These results also suggest that the Wii Balance Board could be used in multicenter studies and therefore, would allow for the creation of larger populations for clinical studies. Trial Registration Ethical Committee of the Erasme Hospital (CCB B406201215142). PMID:28582237
Management of the water balance and quality in mining areas
NASA Astrophysics Data System (ADS)
Pasanen, Antti; Krogerus, Kirsti; Mroueh, Ulla-Maija; Turunen, Kaisa; Backnäs, Soile; Vento, Tiia; Veijalainen, Noora; Hentinen, Kimmo; Korkealaakso, Juhani
2015-04-01
Although mining companies have long been conscious of water related risks they still face environmental management problems. These problems mainly emerge because mine sites' water balances have not been adequately assessed in the stage of the planning of mines. More consistent approach is required to help mining companies identify risks and opportunities related to the management of water resources in all stages of mining. This approach requires that the water cycle of a mine site is interconnected with the general hydrologic water cycle. In addition to knowledge on hydrological conditions, the control of the water balance in the mining processes require knowledge of mining processes, the ability to adjust process parameters to variable hydrological conditions, adaptation of suitable water management tools and systems, systematic monitoring of amounts and quality of water, adequate capacity in water management infrastructure to handle the variable water flows, best practices to assess the dispersion, mixing and dilution of mine water and pollutant loading to receiving water bodies, and dewatering and separation of water from tailing and precipitates. WaterSmart project aims to improve the awareness of actual quantities of water, and water balances in mine areas to improve the forecasting and the management of the water volumes. The study is executed through hydrogeological and hydrological surveys and online monitoring procedures. One of the aims is to exploit on-line water quantity and quality monitoring for the better management of the water balances. The target is to develop a practical and end-user-specific on-line input and output procedures. The second objective is to develop mathematical models to calculate combined water balances including the surface, ground and process waters. WSFS, the Hydrological Modeling and Forecasting System of SYKE is being modified for mining areas. New modelling tools are developed on spreadsheet and system dynamics platforms to systematically integrate all water balance components (groundwater, surface water, infiltration, precipitation, mine water facilities and operations etc.) into overall dynamic mine site considerations. After coupling the surface and ground water models (e.g. Feflow and WSFS) with each other, they are compared with Goldsim. The third objective is to integrate the monitoring and modelling tools into the mine management system and process control. The modelling and predictive process control can prevent flood situations, ensure water adequacy, and enable the controlled mine water treatment. The project will develop a constantly updated management system for water balance including both natural waters and process waters.
Psychological contracts: a new strategy for retaining reduced-hour physicians.
Hartwell, Jennifer K
2010-01-01
As a retention strategy, healthcare organizations offer reduced-hour schedules to physicians seeking better work-family balance. However, this quantitative study of 94 full-time and reduced-hour female physicians in the Boston area found that working fewer hours helps physicians achieve better balance but does not improve their burnout or career satisfaction, or impact their intention to quit or leave the field of medicine. Instead, the findings demonstrate that psychological contract fulfillment, which reflects the subjective nature of the employment relationship, is more important than work hours, an objective job condition, in predicting intention to quit and these other outcomes. A fine-grained analysis is initiated uncovering the multidimensionality of the psychological contract construct. To integrate successful reduced-hour arrangements for physicians, medical managers are directed to the importance of understanding the composition of reduced-hour physicians' psychological contracts, specifically, their need to do challenging work, receive high levels of supervisor support, and promotion opportunities.
D'Orso, M I; Garaguso, M; Ferrari, G; Riva, M A; Gallamini, M; Cesana, G
2012-01-01
A relevant part of deadly work accidents and of severe work accidents reported in national specific statistics coming from INAIL is until today caused by workers' falls during their at height work activities. Medical evaluation of eventual workers' hyper susceptibility to fall caused by balance alterations, if included in medical surveillance, is frequently carried out by medical doctors using different subjective tests included in different clinical protocols. Use of a computerized stabylometric footboard on the contrary allows to obtain objective and reproducible data concerning vestibular function which, associated with traditional clinical medical evaluation, seem to better detect eventual presence of balance disturbances, especially those non clinically perceivable by workers and therefore more dangerous. We report results evidenced in a research carried out in a group of 185 workers engaged in building firms and having work tasks including phases of at height work.
[Optimal solution and analysis of muscular force during standing balance].
Wang, Hongrui; Zheng, Hui; Liu, Kun
2015-02-01
The present study was aimed at the optimal solution of the main muscular force distribution in the lower extremity during standing balance of human. The movement musculoskeletal system of lower extremity was simplified to a physical model with 3 joints and 9 muscles. Then on the basis of this model, an optimum mathematical model was built up to solve the problem of redundant muscle forces. Particle swarm optimization (PSO) algorithm is used to calculate the single objective and multi-objective problem respectively. The numerical results indicated that the multi-objective optimization could be more reasonable to obtain the distribution and variation of the 9 muscular forces. Finally, the coordination of each muscle group during maintaining standing balance under the passive movement was qualitatively analyzed using the simulation results obtained.
Balance Confidence and Falls in Non-Demented Essential Tremor Patients: The Role of Cognition
Rao, Ashwini K.; Gilman, Arthur; Louis, Elan D.
2014-01-01
Objective To examine 1) the effect of cognitive ability on balance confidence and falls, 2) the relationship of balance confidence and falls with quantitative measures of gait, and 3) measures that predict falls, in people with Essential Tremor (ET). Design Cross-sectional study. Setting: General community. Participants One-hundred-eighty participants (132 people with ET and 48 controls). People with ET were divided into two groups based on the median score on the modified Mini Mental State Exam: ET-LCS vs. ET-HCS. Interventions Not applicable. Main Outcome Measures Activities of Balance Confidence-6 (ABC) scale and falls in the previous year. Results ET-LCS had lower ABC-6 scores and a greater number of falls than ET-HCS (p<0.05 for all measures) or controls (p<0.01 for all measures). Quantitative gait measures were significantly correlated with ABC-6 score and falls. Gait speed (p<0.007) and ABC-6 score (p<0.02) were significant predictors of falls. Receiver Operating Characteristic curve analysis revealed that gait speed < 0.9 m/s and ABC-6 score < 51% were associated with moderate sensitivity and specificity in identifying fallers. Conclusions People with ET with low cognitive scores have impaired gait, and report lower balance confidence, and higher number of falls than their counterparts with higher cognitive scores, and controls. We have identified assessments that are easily administered (gait speed and ABC-6 scale), and are associated with falls in ET. PMID:24769121
Granacher, Urs; Muehlbauer, Thomas; Zahner, Lukas; Gollhofer, Albert; Kressig, Reto W
2011-05-01
Demographic change in industrialized countries produced an increase in the proportion of elderly people in our society, resulting in specific healthcare challenges. One such challenge is how to effectively deal with the increased risk of sustaining a fall and fall-related injuries in old age. Deficits in postural control and muscle strength represent important intrinsic fall risk factors. Thus, adequate training regimens need to be designed and applied that have the potential to reduce the rate of falling in older adults by countering these factors. Therefore, the purpose of this review is to compare traditional and recent approaches in the promotion of balance and strength in older adults. Traditionally, balance and resistance training programmes proved to be effective in improving balance and strength, and in reducing the number of falls. Yet, it was argued that these training protocols are not specific enough to induce adaptations in neuromuscular capacities that are specifically needed in actual balance-threatening situations (e.g. abilities to recover balance and to produce force explosively). Recent studies indicated that perturbation-based or multitask balance training and power/high-velocity resistance training have the potential to improve these specific capacities because they comply with the principle of training specificity. In fact, there is evidence that these specifically tailored training programmes are more effective in improving balance recovery mechanisms and muscle power than traditional training protocols. A few pilot studies have even shown that these recently designed training protocols have an impact on the reduction of fall incidence rate in older adults. Further research is needed to confirm these results and to elucidate the underlying mechanisms responsible for the adaptive processes.
ERIC Educational Resources Information Center
Barrera-Garrido, Azael
2017-01-01
In order to measure the mass of an object in the absence of gravity, one useful tool for many decades has been the inertial balance. One of the simplest forms of inertial balance is made by two mass holders or pans joined together with two stiff metal plates, which act as springs.
Sequence Based Prediction of Antioxidant Proteins Using a Classifier Selection Strategy
Zhang, Lina; Zhang, Chengjin; Gao, Rui; Yang, Runtao; Song, Qing
2016-01-01
Antioxidant proteins perform significant functions in maintaining oxidation/antioxidation balance and have potential therapies for some diseases. Accurate identification of antioxidant proteins could contribute to revealing physiological processes of oxidation/antioxidation balance and developing novel antioxidation-based drugs. In this study, an ensemble method is presented to predict antioxidant proteins with hybrid features, incorporating SSI (Secondary Structure Information), PSSM (Position Specific Scoring Matrix), RSA (Relative Solvent Accessibility), and CTD (Composition, Transition, Distribution). The prediction results of the ensemble predictor are determined by an average of prediction results of multiple base classifiers. Based on a classifier selection strategy, we obtain an optimal ensemble classifier composed of RF (Random Forest), SMO (Sequential Minimal Optimization), NNA (Nearest Neighbor Algorithm), and J48 with an accuracy of 0.925. A Relief combined with IFS (Incremental Feature Selection) method is adopted to obtain optimal features from hybrid features. With the optimal features, the ensemble method achieves improved performance with a sensitivity of 0.95, a specificity of 0.93, an accuracy of 0.94, and an MCC (Matthew’s Correlation Coefficient) of 0.880, far better than the existing method. To evaluate the prediction performance objectively, the proposed method is compared with existing methods on the same independent testing dataset. Encouragingly, our method performs better than previous studies. In addition, our method achieves more balanced performance with a sensitivity of 0.878 and a specificity of 0.860. These results suggest that the proposed ensemble method can be a potential candidate for antioxidant protein prediction. For public access, we develop a user-friendly web server for antioxidant protein identification that is freely accessible at http://antioxidant.weka.cc. PMID:27662651
A clinical test of stepping and change of direction to identify multiple falling older adults.
Dite, Wayne; Temple, Viviene A
2002-11-01
To establish the reliability and validity of a new clinical test of dynamic standing balance, the Four Square Step Test (FSST), to evaluate its sensitivity, specificity, and predictive value in identifying subjects who fall, and to compare it with 3 established balance and mobility tests. A 3-group comparison performed by using 3 validated tests and 1 new test. A rehabilitation center and university medical school in Australia. Eighty-one community-dwelling adults over the age of 65 years. Subjects were age- and gender-matched to form 3 groups: multiple fallers, nonmultiple fallers, and healthy comparisons. Not applicable. Time to complete the FSST and Timed Up and Go test and the number of steps to complete the Step Test and Functional Reach Test distance. High reliability was found for interrater (n=30, intraclass correlation coefficient [ICC]=.99) and retest reliability (n=20, ICC=.98). Evidence for validity was found through correlation with other existing balance tests. Validity was supported, with the FSST showing significantly better performance scores (P<.01) for each of the healthier and less impaired groups. The FSST also revealed a sensitivity of 85%, a specificity of 88% to 100%, and a positive predictive value of 86%. As a clinical test, the FSST is reliable, valid, easy to score, quick to administer, requires little space, and needs no special equipment. It is unique in that it involves stepping over low objects (2.5cm) and movement in 4 directions. The FSST had higher combined sensitivity and specificity for identifying differences between groups in the selected sample population of older adults than the 3 tests with which it was compared. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
NASA Astrophysics Data System (ADS)
Hadzigeorgiou, Yannis; Anastasiou, Leonidas; Konsolas, Manos; Prevezanou, Barbara
2009-01-01
The purpose of this study was to investigate whether participation in sensorimotor activities by preschool children involving their own bodily balance while walking on a beam over the floor has an effect on their understanding of the mechanical equilibrium of a balance beam. The balance beam consisted of a horizontal stick balancing around its center of mass (middle point), while carrying equal-weight objects on either side of it. The study utilized a two-group design, and was conducted in three phases (pre-test, treatment and post-test). The results of the study provide evidence that there was such an effect, since the children (who participated in the sensorimotor activities) could select out of a number of objects those two with the same weight regardless of their shape, size or colour, in order to balance the stick. This effect also can be seen when a comparison is made with a second group of children, which had previously participated in a hands-on activity regarding the equilibrium of a similar balance beam, and which (children), therefore, had a definite advantage over the other children who had participated in the sensorimotor activity. A Chi Square Test showed no significant differences between the two groups on both an immediate and a delayed post-test, while the McNemar Test for the Significance of Change showed a statistically significant difference (that is, a negative change in performance between the first and the second post-test) only within the hands-on group. This difference represents evidence that the children from the sensorimotor group remembered better the rule they were applying (i.e., selecting equal-weight objects) in order to balance the beam.
Dordevic, Milos; Hökelmann, Anita; Müller, Patrick; Rehfeld, Kathrin; Müller, Notger G
2017-01-01
Background: Slackline-training has been shown to improve mainly task-specific balancing skills. Non-task specific effects were assessed for tandem stance and preferred one-leg stance on stable and perturbed force platforms with open eyes. It is unclear whether transfer effects exist for other balancing conditions and which component of the balancing ability is affected. Also, it is not known whether slackline-training can improve non-visual-dependent spatial orientation abilities, a function mainly supported by the hippocampus. Objective: To assess the effect of one-month of slackline-training on different components of balancing ability and its transfer effects on non-visual-dependent spatial orientation abilities. Materials and Methods: Fifty subjects aged 18-30 were randomly assigned to the training group (T) ( n = 25, 23.2 ± 2.5 years; 12 females) and the control group (C) ( n = 25, 24.4 ± 2.8 years; 11 females). Professional instructors taught the intervention group to slackline over four consecutive weeks with three 60-min-trainings in each week. Data acquisition was performed (within 2 days) by blinded investigators at the baseline and after the training. Main outcomes Improvement in the score of a 30-item clinical balance test (CBT) developed at our institute (max. score = 90 points) and in the average error distance (in centimeters) in an orientation test (OT), a triangle completion task with walking and wheelchair conditions for 60°, 90°, and 120°. Results: Training group performed significantly better on the closed-eyes conditions of the CBT (1.6 points, 95% CI: 0.6 to 2.6 points vs. 0.1 points, 95% CI: -1 to 1.1 points; p = 0.011, [Formula: see text] = 0.128) and in the wheelchair (vestibular) condition of the OT (21 cm, 95% CI: 8-34 cm vs. 1 cm, 95% CI: -14-16 cm; p = 0.049, [Formula: see text] = 0.013). Conclusion: Our results indicate that one month of intensive slackline training is a novel approach for enhancing clinically relevant balancing abilities in conditions with closed eyes as well as for improving the vestibular-dependent spatial orientation capability; both of the benefits are likely caused by positive influence of slackline-training on the vestibular system function.
Dordevic, Milos; Hökelmann, Anita; Müller, Patrick; Rehfeld, Kathrin; Müller, Notger G.
2017-01-01
Background: Slackline-training has been shown to improve mainly task-specific balancing skills. Non-task specific effects were assessed for tandem stance and preferred one-leg stance on stable and perturbed force platforms with open eyes. It is unclear whether transfer effects exist for other balancing conditions and which component of the balancing ability is affected. Also, it is not known whether slackline-training can improve non-visual-dependent spatial orientation abilities, a function mainly supported by the hippocampus. Objective: To assess the effect of one-month of slackline-training on different components of balancing ability and its transfer effects on non-visual-dependent spatial orientation abilities. Materials and Methods: Fifty subjects aged 18–30 were randomly assigned to the training group (T) (n = 25, 23.2 ± 2.5 years; 12 females) and the control group (C) (n = 25, 24.4 ± 2.8 years; 11 females). Professional instructors taught the intervention group to slackline over four consecutive weeks with three 60-min-trainings in each week. Data acquisition was performed (within 2 days) by blinded investigators at the baseline and after the training. Main outcomes Improvement in the score of a 30-item clinical balance test (CBT) developed at our institute (max. score = 90 points) and in the average error distance (in centimeters) in an orientation test (OT), a triangle completion task with walking and wheelchair conditions for 60°, 90°, and 120°. Results: Training group performed significantly better on the closed-eyes conditions of the CBT (1.6 points, 95% CI: 0.6 to 2.6 points vs. 0.1 points, 95% CI: –1 to 1.1 points; p = 0.011, ηp2 = 0.128) and in the wheelchair (vestibular) condition of the OT (21 cm, 95% CI: 8–34 cm vs. 1 cm, 95% CI: –14–16 cm; p = 0.049, ηp2 = 0.013). Conclusion: Our results indicate that one month of intensive slackline training is a novel approach for enhancing clinically relevant balancing abilities in conditions with closed eyes as well as for improving the vestibular-dependent spatial orientation capability; both of the benefits are likely caused by positive influence of slackline-training on the vestibular system function. PMID:28239345
DOE Office of Scientific and Technical Information (OSTI.GOV)
Engberg, L; KTH Royal Institute of Technology, Stockholm; Eriksson, K
Purpose: To formulate objective functions of a multicriteria fluence map optimization model that correlate well with plan quality metrics, and to solve this multicriteria model by convex approximation. Methods: In this study, objectives of a multicriteria model are formulated to explicitly either minimize or maximize a dose-at-volume measure. Given the widespread agreement that dose-at-volume levels play important roles in plan quality assessment, these objectives correlate well with plan quality metrics. This is in contrast to the conventional objectives, which are to maximize clinical goal achievement by relating to deviations from given dose-at-volume thresholds: while balancing the new objectives means explicitlymore » balancing dose-at-volume levels, balancing the conventional objectives effectively means balancing deviations. Constituted by the inherently non-convex dose-at-volume measure, the new objectives are approximated by the convex mean-tail-dose measure (CVaR measure), yielding a convex approximation of the multicriteria model. Results: Advantages of using the convex approximation are investigated through juxtaposition with the conventional objectives in a computational study of two patient cases. Clinical goals of each case respectively point out three ROI dose-at-volume measures to be considered for plan quality assessment. This is translated in the convex approximation into minimizing three mean-tail-dose measures. Evaluations of the three ROI dose-at-volume measures on Pareto optimal plans are used to represent plan quality of the Pareto sets. Besides providing increased accuracy in terms of feasibility of solutions, the convex approximation generates Pareto sets with overall improved plan quality. In one case, the Pareto set generated by the convex approximation entirely dominates that generated with the conventional objectives. Conclusion: The initial computational study indicates that the convex approximation outperforms the conventional objectives in aspects of accuracy and plan quality.« less
Performance analysis of parallel branch and bound search with the hypercube architecture
NASA Technical Reports Server (NTRS)
Mraz, Richard T.
1987-01-01
With the availability of commercial parallel computers, researchers are examining new classes of problems which might benefit from parallel computing. This paper presents results of an investigation of the class of search intensive problems. The specific problem discussed is the Least-Cost Branch and Bound search method of deadline job scheduling. The object-oriented design methodology was used to map the problem into a parallel solution. While the initial design was good for a prototype, the best performance resulted from fine-tuning the algorithm for a specific computer. The experiments analyze the computation time, the speed up over a VAX 11/785, and the load balance of the problem when using loosely coupled multiprocessor system based on the hypercube architecture.
Comparison of Objective Measures for Predicting Perceptual Balance and Visual Aesthetic Preference
Hübner, Ronald; Fillinger, Martin G.
2016-01-01
The aesthetic appreciation of a picture largely depends on the perceptual balance of its elements. The underlying mental mechanisms of this relation, however, are still poorly understood. For investigating these mechanisms, objective measures of balance have been constructed, such as the Assessment of Preference for Balance (APB) score of Wilson and Chatterjee (2005). In the present study we examined the APB measure and compared it to an alternative measure (DCM; Deviation of the Center of “Mass”) that represents the center of perceptual “mass” in a picture and its deviation from the geometric center. Additionally, we applied measures of homogeneity and of mirror symmetry. In a first experiment participants had to rate the balance and symmetry of simple pictures, whereas in a second experiment different participants rated their preference (liking) for these pictures. In a third experiment participants rated the balance as well as the preference of new pictures. Altogether, the results show that DCM scores accounted better for balance ratings than APB scores, whereas the opposite held with respect to preference. Detailed analyses revealed that these results were due to the fact that aesthetic preference does not only depend on balance but also on homogeneity, and that the APB measure takes this feature into account. PMID:27014143
Imbalance: Objective measures versus subjective self-report in clinical practice.
Chiarovano, Elodie; Wang, Wei; Reynolds, Pam; MacDougall, Hamish G
2018-01-01
Dizziness and imbalance are very common complaints in clinical practice. One of the challenges is to evaluate the 'real' risk of falls. Two tools are available: the patient's self-report and the measure of the patient's balance. We evaluated the relationship between these methods using the Dizziness Handicap Inventory (DHI) and measures of balance while visual inputs are perturbed with Virtual Reality (VR). 90 consecutive patients underwent the DHI questionnaire and the balance test. The DHI questionnaire was used to measure the subject's perception of handicap associated with dizziness. The balance test measured the postural sway in several visual conditions: eyes open, eyes closed, and with an unpredictable visual perturbation using VR at several amplitudes of movement. No correlation was found between the DHI score and the balance measurement. The visual perturbations allow us to characterize patients into three groups: one group with a high DHI score who did not fall on the balance test (5.5%), one group with a low DHI score who failed eyes closed on a compliant surface (9.0%), and one group of the remaining patients (85.5%). The correlation between the DHI score and the balance performance became significant on the remaining group of patients. Both subjective self-report and objective measure are important to characterize a patient. The use of VR visual perturbations allowed us to define three important groups of patients. VR visual perturbations provided additional information that helps explain the lack of correlation between DHI and objective test results. Copyright © 2017 Elsevier B.V. All rights reserved.
Zissimopoulos, Angelika; Fatone, Stefania; Gard, Steven
2014-04-01
One intervention often used to address physical impairments post stroke is an ankle-foot orthosis. Ankle-foot orthoses may improve walking speed, stride length, and gait pattern. However, effects on balance, crucial for safe ambulation, are thus far inconclusive. One aspect of balance shown to contribute to functional ability is self-efficacy. Self-efficacy, defined as the belief in one's ability to succeed in particular situations, has been shown to be more strongly associated with activity and participation (as defined by the International Classification of Functioning, Disability, and Health) than physical performance measures of gait or balance. We investigated whether self-efficacy, or balance confidence when referred to in the context of balance capabilities, is improved with ankle-foot orthosis use. Repeated measures study design. Balance confidence was measured using the Activities-specific Balance Confidence Scale in 15 persons with chronic poststroke hemiplegia, with and without their regular ankle-foot orthosis. Activities-specific Balance Confidence Scale scores were significantly higher (p ≤ 0.01) for the ankle-foot orthosis condition compared to no ankle-foot orthosis. One mechanism by which ankle-foot orthosis use may influence balance is improved balance confidence. Future work should explore the specific mechanisms underlying this improvement in self-efficacy. Clinical relevance Self-efficacy may be an important factor to consider when evaluating functioning post stroke. Rehabilitative interventions that improve balance confidence may help restore participation and overall functioning in pathological populations, particularly in the fall-prone poststroke population. Study results provide evidence for improvements in balance confidence with ankle-foot orthosis use.
Between pharmaceutical patents and European patients: is a compromise still possible?
Garattini, Livio; Padula, Anna
2017-10-01
Pharmaceutical regulation has always attempted to balance the public health objective to make safe and effective drugs available for patients while providing commercial incentives through patents. Here we discuss whether it is still possible to find a balance between the incentives on the supply side and the regulatory framework on the demand side. Areas covered: The current regulatory framework on pharmaceutical exclusivity has been harshly criticized by many experts, arguing about whether it is still fit for public purposes and needs. Here we envisage a different scenario without 'revolutionizing' the whole present system. The main radical change should concern the present management of pharmaceutical patents by introducing a specific agency dedicated to them. Secondly, specific pharmaceutical patents could be restricted to compounds for one (or more) declared indication(s). Thirdly, pharmaceutical patents should be kept only for compounds that start a first clinical trial within five years from the granting date. Expert opinion: We think it is time to reconsider the regulation of pharmaceutical patents in the light of their relevance in terms of public health. New models of enhancing research investments are required for long-term sustainability of public pharmaceutical expenditure and the EU can still play a leading role.
Nitrogen balance in response to dryland crop rotations and cultural practices
USDA-ARS?s Scientific Manuscript database
Nitrogen balance provides a measure of agroecosystem performance and environmental sustainability by taking into accounts of N inputs and outputs and N retention in the soil. The objective of this study was to evaluate N balance based on N inputs and outputs and soil N sequestration after 7 yr in re...
Federal Register 2010, 2011, 2012, 2013, 2014
2012-08-23
... program has two objectives. The first is to reduce emissions of nitrogen oxides (NO X ) and volatile.... Maryland's regulations established initial NMOG credit balances for manufacturer credit account balances to... established ZEV credit account balances to provide parity between California and Maryland with respect to the...
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…
MultiMiTar: a novel multi objective optimization based miRNA-target prediction method.
Mitra, Ramkrishna; Bandyopadhyay, Sanghamitra
2011-01-01
Machine learning based miRNA-target prediction algorithms often fail to obtain a balanced prediction accuracy in terms of both sensitivity and specificity due to lack of the gold standard of negative examples, miRNA-targeting site context specific relevant features and efficient feature selection process. Moreover, all the sequence, structure and machine learning based algorithms are unable to distribute the true positive predictions preferentially at the top of the ranked list; hence the algorithms become unreliable to the biologists. In addition, these algorithms fail to obtain considerable combination of precision and recall for the target transcripts that are translationally repressed at protein level. In the proposed article, we introduce an efficient miRNA-target prediction system MultiMiTar, a Support Vector Machine (SVM) based classifier integrated with a multiobjective metaheuristic based feature selection technique. The robust performance of the proposed method is mainly the result of using high quality negative examples and selection of biologically relevant miRNA-targeting site context specific features. The features are selected by using a novel feature selection technique AMOSA-SVM, that integrates the multi objective optimization technique Archived Multi-Objective Simulated Annealing (AMOSA) and SVM. MultiMiTar is found to achieve much higher Matthew's correlation coefficient (MCC) of 0.583 and average class-wise accuracy (ACA) of 0.8 compared to the others target prediction methods for a completely independent test data set. The obtained MCC and ACA values of these algorithms range from -0.269 to 0.155 and 0.321 to 0.582, respectively. Moreover, it shows a more balanced result in terms of precision and sensitivity (recall) for the translationally repressed data set as compared to all the other existing methods. An important aspect is that the true positive predictions are distributed preferentially at the top of the ranked list that makes MultiMiTar reliable for the biologists. MultiMiTar is now available as an online tool at www.isical.ac.in/~bioinfo_miu/multimitar.htm. MultiMiTar software can be downloaded from www.isical.ac.in/~bioinfo_miu/multimitar-download.htm.
Deyer, T W; Ashton-Miller, J A
1999-09-01
To test the (null) hypotheses that the reliability of unipedal balance is unaffected by the attenuation of visual velocity feedback and that, relative to baseline performance, deterioration of balance success rates from attenuated visual velocity feedback will not differ between groups of young men and older women, and the presence (or absence) of a vertical foreground object will not affect balance success rates. Single blind, single case study. University research laboratory. Two volunteer samples: 26 healthy young men (mean age, 20.0yrs; SD, 1.6); 23 healthy older women (mean age, 64.9 yrs; SD, 7.8). Normalized success rates in unipedal balance task. Subjects were asked to transfer to and maintain unipedal stance for 5 seconds in a task near the limit of their balance capabilities. Subjects completed 64 trials: 54 trials of three experimental visual scenes in blocked randomized sequences of 18 trials and 10 trials in a normal visual environment. The experimental scenes included two that provided strong velocity/weak position feedback, one of which had a vertical foreground object (SVWP+) and one without (SVWP-), and one scene providing weak velocity/strong position (WVSP) feedback. Subjects' success rates in the experimental environments were normalized by the success rate in the normal environment in order to allow comparisons between subjects using a mixed model repeated measures analysis of variance. The normalized success rate was significantly greater in SVWP+ than in WVSP (p = .0001) and SVWP- (p = .013). Visual feedback significantly affected the normalized unipedal balance success rates (p = .001); neither the group effect nor the group X visual environment interaction was significant (p = .9362 and p = .5634, respectively). Normalized success rates did not differ significantly between the young men and older women in any visual environment. Near the limit of the young men's or older women's balance capability, the reliability of transfer to unipedal balance was adversely affected by visual environments offering attenuated visual velocity feedback cues and those devoid of vertical foreground objects.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Khadjavi, Amina; Magnetto, Chiara; Panariti, Alice
Background: : In chronic wounds, efficient epithelial tissue repair is hampered by hypoxia, and balances between the molecules involved in matrix turn-over such as matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) are seriously impaired. Intriguingly, new oxygenating nanocarriers such as 2H,3H-decafluoropentane-based oxygen-loaded nanodroplets (OLNs) might effectively target chronic wounds. Objective: : To investigate hypoxia and chitosan-shelled OLN effects on MMP/TIMP production by human keratinocytes. Methods: : HaCaT cells were treated for 24 h with 10% v/v OLNs both in normoxia or hypoxia. Cytotoxicity and cell viability were measured through biochemical assays; cellular uptake by confocal microscopy; and MMPmore » and TIMP production by enzyme-linked immunosorbent assay or gelatin zymography. Results: : Normoxic HaCaT cells constitutively released MMP-2, MMP-9, TIMP-1 and TIMP-2. Hypoxia strongly impaired MMP/TIMP balances by reducing MMP-2, MMP-9, and TIMP-2, without affecting TIMP-1 release. After cellular uptake by keratinocytes, nontoxic OLNs abrogated all hypoxia effects on MMP/TIMP secretion, restoring physiological balances. OLN abilities were specifically dependent on time-sustained oxygen diffusion from OLN core. Conclusion: : Chitosan-shelled OLNs effectively counteract hypoxia-dependent dysregulation of MMP/TIMP balances in human keratinocytes. Therefore, topical administration of exogenous oxygen, properly encapsulated in nanodroplet formulations, might be a promising adjuvant approach to promote healing processes in hypoxic wounds. - Highlights: • Hypoxia impairs MMP9/TIMP1 and MMP2/TIMP2 balances in HaCaT human keratinocytes. • Chitosan-shelled oxygen-loaded nanodroplets (OLNs) are internalised by HaCaT cells. • OLNs are not toxic to HaCaT cells. • OLNs effectively counteract hypoxia effects on MMP/TIMP balances in HaCaT cells. • OLNs appear as promising and cost-effective therapeutic tools for hypoxic wounds.« less
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.
40 CFR 1065.295 - PM inertial balance for field-testing analysis.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 32 2010-07-01 2010-07-01 false PM inertial balance for field-testing... inertial balance for field-testing analysis. (a) Application. You may use an inertial balance to quantify... balance that meets the specifications in Table 1 of § 1065.205. Note that your balance-based system must...
40 CFR 1065.295 - PM inertial balance for field-testing analysis.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 33 2011-07-01 2011-07-01 false PM inertial balance for field-testing... inertial balance for field-testing analysis. (a) Application. You may use an inertial balance to quantify... balance that meets the specifications in Table 1 of § 1065.205. Note that your balance-based system must...
Korzynska, Anna; Roszkowiak, Lukasz; Pijanowska, Dorota; Kozlowski, Wojciech; Markiewicz, Tomasz
2014-01-01
The aim of this study is to compare the digital images of the tissue biopsy captured with optical microscope using bright field technique under various light conditions. The range of colour's variation in immunohistochemically stained with 3,3'-Diaminobenzidine and Haematoxylin tissue samples is immense and coming from various sources. One of them is inadequate setting of camera's white balance to microscope's light colour temperature. Although this type of error can be easily handled during the stage of image acquisition, it can be eliminated with use of colour adjustment algorithms. The examination of the dependence of colour variation from microscope's light temperature and settings of the camera is done as an introductory research to the process of automatic colour standardization. Six fields of view with empty space among the tissue samples have been selected for analysis. Each field of view has been acquired 225 times with various microscope light temperature and camera white balance settings. The fourteen randomly chosen images have been corrected and compared, with the reference image, by the following methods: Mean Square Error, Structural SIMilarity and visual assessment of viewer. For two types of backgrounds and two types of objects, the statistical image descriptors: range, median, mean and its standard deviation of chromaticity on a and b channels from CIELab colour space, and luminance L, and local colour variability for objects' specific area have been calculated. The results have been averaged for 6 images acquired in the same light conditions and camera settings for each sample. The analysis of the results leads to the following conclusions: (1) the images collected with white balance setting adjusted to light colour temperature clusters in certain area of chromatic space, (2) the process of white balance correction for images collected with white balance camera settings not matched to the light temperature moves image descriptors into proper chromatic space but simultaneously the value of luminance changes. So the process of the image unification in a sense of colour fidelity can be solved in separate introductory stage before the automatic image analysis.
Griffin, Paul M; Lee, Hyunji; Scherrer, Christina; Swann, Julie L
2014-12-01
Two common health disparities in the US include a lack of access to care and a lack of insurance coverage. To help address these disparities, healthcare reform will provide $11B to expand Federally Qualified Health Centers (FQHCs) over the next 5 years. In 2014, Medicaid rules will be modified so that more people will become eligible. There are, however, important tradeoffs in the investment in these two programs. We find a balanced investment between FQHC expansion and relaxing Medicaid eligibility to improve both access (by increasing the number of FQHCs) and coverage (by FQHC and Medicaid expansion) for the state of Pennsylvania. The comparison is achieved by integrating multi-objective mathematical models with several public data sets that allow for specific estimations of healthcare need. Demand is estimated based on current access and coverage status in order to target groups to be considered preferentially. Results show that for Pennsylvania, FQHCs are more cost effective than Medicaid if we invest all of the resources in just one policy. However, we find a better investment point balancing those two policies. This point is approximately where the additional expenses incurred from relaxing Medicaid eligibility equals the investment in FQHC expansion.
Manufacturability: from design to SPC limits through "corner-lot" characterization
NASA Astrophysics Data System (ADS)
Hogan, Timothy J.; Baker, James C.; Wesneski, Lisa; Black, Robert S.; Rothenbury, Dave
2004-12-01
Texas Instruments" Digital Micro-mirror Device, is used in a wide variety of optical display applications ranging from fixed and portable projectors to high-definition television (HDTV) to digital cinema projection systems. A new DMD pixel architecture, called "FTP", was designed and qualified by Texas Instruments DLPTMTM Group in 2003 to meet increased performance objectives for brightness and contrast ratio. Coordination between design, test and fabrication groups was required to balance pixel performance requirements and manufacturing capability. "Corner Lot" designed experiments (DOE) were used to verify "fabrication space" available for the pixel design. The corner lot technique allows confirmation of manufacturability projections early in the design/qualification cycle. Through careful design and analysis of the corner-lot DOE, a balance of critical dimension (cd) "budgets" is possible so that specification and process control limits can be established that meet both customer and factory requirements. The application of corner-lot DOE is illustrated in a case history of the DMD "FTP" pixel. The process for balancing test parameter requirements with multiple critical dimension budgets is shown. MEMS/MOEMS device design and fabrication can use similar techniques to achieve agressive design-to-qualification goals.
Manufacturability: from design to SPC limits through "corner-lot" characterization
NASA Astrophysics Data System (ADS)
Hogan, Timothy J.; Baker, James C.; Wesneski, Lisa; Black, Robert S.; Rothenbury, Dave
2005-01-01
Texas Instruments" Digital Micro-mirror Device, is used in a wide variety of optical display applications ranging from fixed and portable projectors to high-definition television (HDTV) to digital cinema projection systems. A new DMD pixel architecture, called "FTP", was designed and qualified by Texas Instruments DLPTMTM Group in 2003 to meet increased performance objectives for brightness and contrast ratio. Coordination between design, test and fabrication groups was required to balance pixel performance requirements and manufacturing capability. "Corner Lot" designed experiments (DOE) were used to verify "fabrication space" available for the pixel design. The corner lot technique allows confirmation of manufacturability projections early in the design/qualification cycle. Through careful design and analysis of the corner-lot DOE, a balance of critical dimension (cd) "budgets" is possible so that specification and process control limits can be established that meet both customer and factory requirements. The application of corner-lot DOE is illustrated in a case history of the DMD "FTP" pixel. The process for balancing test parameter requirements with multiple critical dimension budgets is shown. MEMS/MOEMS device design and fabrication can use similar techniques to achieve agressive design-to-qualification goals.
Seeing the tipping point: Balance perception and visual shape.
Firestone, Chaz; Keil, Frank C
2016-07-01
In a brief glance at an object or shape, we can appreciate a rich suite of its functional properties, including the organization of the object's parts, its optimal contact points for grasping, and its center of mass, or balancing point. However, in the real world and the laboratory, balance perception shows systematic biases whereby observers may misjudge a shape's center of mass by a severe margin. Are such biases simply quirks of physical reasoning? Or might they instead reflect more fundamental principles of object representation? Here we demonstrate systematically biased center-of-mass estimation for two-dimensional (2D) shapes (Study 1) and advance a surprising explanation of such biases. We suggest that the mind implicitly represents ordinary 2D shapes as rich, volumetric, three-dimensional (3D) objects, and that these "inflated" shape representations intrude on and bias perception of the 2D shape's geometric properties. Such "inflation" is a computer-graphics technique for segmenting shapes into parts, and we show that a model derived from this technique best accounts for the biases in center-of-mass estimation in Study 1. Further supporting this account, we show that reducing the need for inflated shape representations diminishes such biases: Center-of-mass estimation improved when cues to shapehood were attenuated (Study 2) and when shapes' depths were explicitly depicted using real-life objects laser-cut from wood (Study 3). We suggest that the technique of shape inflation is actually implemented in the mind; thus, biases in our impressions of balance reflect a more general functional characteristic of object perception. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
40 CFR 1065.290 - PM gravimetric balance.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 40 Protection of Environment 33 2011-07-01 2011-07-01 false PM gravimetric balance. 1065.290... balance. (a) Application. Use a balance to weigh net PM on a sample medium for laboratory testing. (b) Component requirements. We recommend that you use a balance that meets the specifications in Table 1 of...
40 CFR 1065.290 - PM gravimetric balance.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 40 Protection of Environment 32 2010-07-01 2010-07-01 false PM gravimetric balance. 1065.290... balance. (a) Application. Use a balance to weigh net PM on a sample medium for laboratory testing. (b) Component requirements. We recommend that you use a balance that meets the specifications in Table 1 of...
Energy balance measurement: when something is not better than nothing.
Dhurandhar, N V; Schoeller, D; Brown, A W; Heymsfield, S B; Thomas, D; Sørensen, T I A; Speakman, J R; Jeansonne, M; Allison, D B
2015-07-01
Energy intake (EI) and physical activity energy expenditure (PAEE) are key modifiable determinants of energy balance, traditionally assessed by self-report despite its repeated demonstration of considerable inaccuracies. We argue here that it is time to move from the common view that self-reports of EI and PAEE are imperfect, but nevertheless deserving of use, to a view commensurate with the evidence that self-reports of EI and PAEE are so poor that they are wholly unacceptable for scientific research on EI and PAEE. While new strategies for objectively determining energy balance are in their infancy, it is unacceptable to use decidedly inaccurate instruments, which may misguide health-care policies, future research and clinical judgment. The scientific and medical communities should discontinue reliance on self-reported EI and PAEE. Researchers and sponsors should develop objective measures of energy balance.
NASA Astrophysics Data System (ADS)
McCreery, Glenn Ernest
An experimental and analytical investigation of dispersed and dispersed-annular (rivulet or thin film) flow phase separation in tees has been successfully completed. The research was directed at, but is not specific to, determining flow conditions, following a loss of coolant accident, in the large rectangular passageways leading to vacuum buildings in the containment envelope of some CANDU nuclear reactors. The primary objectives of the research were to: (1) obtain experimental data to help formulate and test mechanistic analytical models of phase separation, and (2) develop the analytical models in computer programs which predict phase separation from upstream flow and pressure conditions and downstream and side branch pressure boundary conditions. To meet these objectives an air-water experimental apparatus was constructed, and consists of large air blowers attached to a long rectangular duct leading to a tee in the horizontal plane. A variety of phenomena was investigated including, for comparison with computer predictions, air streamlines and eddy boundary geometry, drop size spectra, macroscopic mass balances, liquid rivulet pathlines, and trajectories of drops of known size and velocity. Four separate computer programs were developed to analyze phase separation. Three of the programs are used sequentially to calculate dispersed mist phase separation in a tee. The fourth is used to calculate rivulet or thin film pathlines. Macroscopic mass balances are calculated from a summation of mass balances for drops with representative sizes (and masses) spaced across the drop size spectrum. The programs are tested against experimental data, and accurately predict gas flow fields, drop trajectories, rivulet pathlines and macroscopic mass balances. In addition to development of the computer programs, analysis was performed to specify the scaling of dispersed mist and rivulet or thin film flow, to investigate pressure losses in tees, and the inter-relationship of loss coefficients, contraction coefficients, and eddy geometry. The important transient effects of liquid storage in eddies were also analyzed.
Fernández-Alvira, Juan M; te Velde, Saskia J; De Bourdeaudhuij, Ilse; Bere, Elling; Manios, Yannis; Kovacs, Eva; Jan, Natasa; Brug, Johannes; Moreno, Luis A
2013-06-21
It is well known that the prevalence of overweight and obesity is considerably higher among youth from lower socio-economic families, but there is little information about the role of some energy balance-related behaviors in the association between socio-economic status and childhood overweight and obesity. The objective of this paper was to assess the possible mediation role of energy balance-related behaviors in the association between parental education and children's body composition. Data were obtained from the cross sectional study of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY) project. 2121 boys and 2516 girls aged 10 to 12 from Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia and Spain were included in the analyses. Data were obtained via questionnaires assessing obesity related dietary, physical activity and sedentary behaviors and basic anthropometric objectively measured indicators (weight, height, waist circumference). The possible mediating effect of sugared drinks intake, breakfast consumption, active transportation to school, sports participation, TV viewing, computer use and sleep duration in the association between parental education and children's body composition was explored via MacKinnon's product-of-coefficients test in single and multiple mediation models. Two different body composition indicators were included in the models, namely Body Mass Index and waist circumference. The association between parental education and children's body composition was partially mediated by breakfast consumption, sports participation, TV viewing and computer use. Additionally, a suppression effect was found for sugared drinks intake. No mediation effect was found for active transportation and sleep duration. The significant mediators explained a higher proportion of the association between parental education and waist circumference compared to the association between parental education and BMI. Tailored overweight and obesity prevention strategies in low SES preadolescent populations should incorporate specific messages focusing on the importance of encouraging daily breakfast consumption, increasing sports participation and decreasing TV viewing and computer use. However, longitudinal research to support these findings is needed.
Modelling Tradeoffs Evolution in Multipurpose Water Systems Operation in Response to Extreme Events
NASA Astrophysics Data System (ADS)
Mason, E.; Gazzotti, P.; Amigoni, F.; Giuliani, M.; Castelletti, A.
2015-12-01
Multipurpose water resource systems are usually operated on a tradeoff of the operating objectives, which - under steady state climatic and socio-economic boundary conditions - is supposed to ensure a fair and/or efficient balance among the conflicting interests. Extreme variability in the system's drivers might affect operators' risk aversion and force a change in the tradeoff. Properly accounting for these shifts is key to any rigorous retrospective assessment of operators' behavior and the associated system's performance. In this study, we explore how the selection of different optimal tradeoffs among the operating objectives is linked to the variations of the boundary conditions, such as, for example, drifting rainfall season or remarkable changes in crop and energy prices. We argue that tradeoff selection is driven by recent, extreme variations in system performance: underperforming on one of the operating objective target value should push the tradeoff toward the disadvantaged objective. To test this assumption, we developed a rational procedure to simulate the operators' tradeoff selection process. We map the selection onto a multi lateral negotiation process, where different multiple, virtual agents optimize different operating objectives. The agents periodically negotiate a compromise on the operating policy. The agent's rigidity in each negotiation round is determined by the recent system performances according to the specific objective it represents. The negotiation follows a set-based egocentric monotonic concession protocol: at each negotiation step an agent incrementally adds some options to the set of its acceptable compromises and (possibly) accepts lower and lower satisfying policies until an agreement is achieved. We apply this reiterated negotiation framework on the regulated Lake Como, Italy, simulating the lake dam operation and its recurrent updates over the last 50 years. The operation aims to balance shoreline flood prevention and irrigation deficit control in the downstream irrigated areas. The results of our simulated negotiations are able to accurately capture the operator's risk aversion changes as driven by extreme wet and dry situations, and to well reproduce the observational release data.
2002-06-01
Achievement of Internal Customer Objectives A Graduate Management Project Submitted to The Residency Committee In Candidacy for the Degree of Masters in...internal customer relations, the GPRMC has incorporated use of a Balanced Scorecard within its management scheme. The scorecard serves as a strategy map...headquarters. The goal, "Provide Policy Management , Advocacy and Problem Solving", addresses the relationship between the headquarters and its internal
NASA Technical Reports Server (NTRS)
Zimmerman, W. F.; Matijevic, J. R.
1987-01-01
Novel system engineering techniques have been developed and applied to establishing structured design and performance objectives for the Telerobotics Testbed that reduce technical risk while still allowing the testbed to demonstrate an advancement in state-of-the-art robotic technologies. To estblish the appropriate tradeoff structure and balance of technology performance against technical risk, an analytical data base was developed which drew on: (1) automation/robot-technology availability projections, (2) typical or potential application mission task sets, (3) performance simulations, (4) project schedule constraints, and (5) project funding constraints. Design tradeoffs and configuration/performance iterations were conducted by comparing feasible technology/task set configurations against schedule/budget constraints as well as original program target technology objectives. The final system configuration, task set, and technology set reflected a balanced advancement in state-of-the-art robotic technologies, while meeting programmatic objectives and schedule/cost constraints.
Deshpande, Nandini; Simonsick, Eleanor; Metter, E Jeffrey; Ko, Seunguk; Ferrucci, Luigi; Studenski, Stephanie
2016-06-01
Ankle proprioceptive information is integrated by the central nervous system to generate and modulate muscle contractions for maintaining standing balance. This study evaluated the association of ankle joint proprioception with objective and self-report measures of balance, mobility, and physical function across the adult life span. Seven hundred and ninety participants (age range 24-97 years, 362 women) who completed ankle proprioception assessment between 2010 and 2014 were included in the present study from the population-based cohort of the Baltimore Longitudinal Study of Aging (BLSA), USA. Outcome measures included ankle joint proprioception measured as threshold for perception of passive movement (TPPM); single leg stance time; perceived difficulty for standing balance; usual, fastest, and narrow-path gait speed; walking index; short physical performance battery score; and self-reported activity restriction due to fear of falling. Descriptive variables included age, sex, body mass index, education, strength, and cognition. Analyses of covariance (ANCOVA) in general linear model (GLM) or multinomial logistic regression analyses were performed, as appropriate, to test the hypothesis that balance, mobility, and physical function were significantly different according to TPPM quintiles even after adjusting for relevant covariates. Those with TPPM >2.2° consistently demonstrated poor balance, mobility, and physical function. However, with increase in challenge (single leg stance, fastest walking speed, and SPPB), TPPM >1.4° was associated with significantly worse performance. In conclusion, ankle proprioceptive acuity has an overall graded relationship with objective and self-report measures of balance, mobility, and physical function. However, the cutoff proprioceptive acuity associated with substantial decline or inability to perform could depend on the challenge induced.
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, the water balance was separated into five components: precipitation, evapotranspiration, surface runoff, recharge and subsurface outflow. During the study, experts first participated in individual interviews where they gave their opinion on the probability distribution of their water balance component of interest. The average annual values and uncertainty of water balance components and catchment-scale water balances were obtained at a later stage by reaching consensus during group discussions. The obtained water balance errors for the Ahlergaarde catchment and the Holtum catchment were -5 and -62 mm/yr, respectively, with an uncertainty of 66 and 86 mm/yr, respectively. As an advantage of the expert elicitation, drawing on the intuitive experience and capabilities of experts to assess complex, site-specific problems, not only the uncertainty of the water balance error was quantified, but the uncertainty of individual water balance components as well.
Lee, Seung-Mi; Cynn, Heon-Seock; Yoon, Tae-Lim; Lee, Ji-Hyun
2017-09-01
The objective of this study was to investigate the effects of Heel-Raise-Lower Exercise (HRLE) interventions on the strength of plantarflexion, balance, and gait parameters in people with stroke. Specifically, this study compared the two different HRLEs to identify whether heels raise-lower with forefoot on a block (HRB) is more effective or ineffective to enhance strength and functional capacities than heels raise-lower on a level floor (HRL) exercise in people with stroke. Repetitive heel raise-lower is a common exercise for improving the strength and power of ankle plantarflexors. It is a simple movement, requires no equipment, and can be performed at home. Each group of 10 people with stroke was given either HRB training or HRL training. The subjects performed the exercise 100 times per day, 5 days per week for 6 weeks. The strength of plantarflexors, static/dynamic balance, and gait parameters were measured using the manual muscle test (MMT), a Biodex Balance System (BBS) SD, and the GAITRite system. After 6 weeks of treatment, there were significant increases in the plantarflexors strength in both groups: by 34% in the HRB group and by 21% in the HRL group. Static and dynamic balance and gait speed also increased significantly in both groups. However, cadence, the paretic side single limb support period (SLSP), paretic side step length, and paretic side stride length significantly increased only in the HRB group. The HRB improved significantly the plantar flexor strength of the paretic side, gait speed, and cadence compared to the HRL.
Development of a mass balance model for estimating PCB export from the lower Fox River to Green Bay
DOE Office of Scientific and Technical Information (OSTI.GOV)
Velleux, M.; Endicott, D.
A mass balance approach was used to model contaminant cycling in the lower Fox River from the DePere Dam to Green Bay. The objectives of this research were (1) to estimate present contaminant export from the Fox River to Green Bay, and (2) to quantify contaminant transport and fate pathways in the lower river for the study period. Specifically, a model describing the transport, fate, and export of chlorides, total suspended solids, total PCBs, and six PCB congeners for the lower Fox River was developed. Field data collected as part of the U.S. Environmental Protection Agency's Green Bay Mass Balancemore » Study were used to calibrate the model. Model results suggest that the transport of inplace pollutants significantly contributed to the cumulative export of total PCBs over this period. Estimated total PCB transport in the Fox River during 1989 increased 60% between the dam and river mouth due to the resuspension of lower river sediments. Total suspended solids and PCB predictions are most sensitive to particle transport parameters, particularly the settling and resuspension velocities. The significant components of the total PCB mass balance are import (loading over the DePere Dam), settling, resuspension, and export to Green Bay. Volatilization, porewater transport, and point source input were not significant to the mass balance. Present point source discharges to the river are not significant total PCB sources, collectively contributing less than 6 kg of PCB to the river during the mass balance period.« less
Hakim, Renée M; Davies, Lauren; Jaworski, Kate; Tufano, Nina; Unterstein, Allison
2012-04-01
A systematic review by Barclay-Goddard et al (2004) reported that force platform feedback improved stance symmetry but not sway, clinical balance outcomes, or measures of independence in adults with stroke. However, the role of computerized dynamic posturography (CDP) systems was not explored. The purpose of this case report was to describe a CDP training program to improve balance and reduce fall risk in a patient with a diagnosis of chronic stroke. A 61-year-old patient 8 years poststroke participated in 1 hour of CDP training, three times a week over a period of 6 weeks. Examination was conducted before and after intervention using the Sensory Organization Test (SOT), Limits of Stability (LOS) test, and Weight Bearing/Squat Symmetry test on a CDP system, and clinical testing with the Berg Balance Scale (BBS), Timed Up and Go (TUG), Activities-specific Balance Confidence (ABC) scale, 30-second Chair Stand (CS), and range of motion of the ankle joints. The patient improved in sensory integration abilities on the SOT for conditions 4, 5, and 6, and maximum excursion abilities improved by a range of 23-103% on the LOS test. Scores on the BBS increased from 37/56 to 47/56, which indicated reduced fall risk and her ABC score improved from 50% to 70%. Ankle ROM improved bilaterally by 6 to 8 degrees. This CDP training program showed promise as a systematic, objective method to reduce fall risk with improved overground performance of balance tasks in an individual with chronic stroke.
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.
Meneghini, Robert M; Ziemba-Davis, Mary M; Lovro, Luke R; Ireland, Phillip H; Damer, Brent M
2016-10-01
The optimal "target" ligament balance for each patient undergoing total knee arthroplasty (TKA) remains unknown. The study purpose was to determine if patient outcomes are affected by intraoperative ligament balance measured with force-sensing implant trials and if an optimal "target" balance exists. A multicenter, retrospective study reviewed consecutive TKAs performed by 3 surgeons. TKA's were performed with standard surgical techniques and ligament releases. After final implants were made, sensor-embedded smart tibial trials were inserted, and compartment forces recorded throughout the range of motion. Clinical outcome measures were obtained preoperatively and at 4 months. Statistical analysis correlated ligament balance with clinical outcomes. One hundred eighty-nine consecutive TKAs were analyzed. Patients were grouped by average medial and lateral compartment force differences. Twenty-nine TKAs (15%) were balanced within 15 lbs and 53 (28%) were "balanced" greater than 75 lbs. Greater improvement in University of California Los Angeles activity level was associated with a mediolateral force difference <60 lbs. (P = .006). Knee Society objective, function, and satisfaction scores, and self-reported health state were unrelated to mediolateral balance in the knee. Intraoperative force-sensing has potential in providing real-time objective data to optimize TKA outcomes. These data support some early outcomes may improve by balancing TKAs within 60 lbs difference. Close follow-up is warranted to determine if gait pattern adaptations affect longer term outcomes with greater or less ligament "imbalance." Copyright © 2016 Elsevier Inc. All rights reserved.
Culyer, A. J.
1989-01-01
Health care cost containment is not in itself a sensible policy objective, because any assessment of the appropriateness of health care expenditure in aggregate, as of that on specific programs, requires a balancing of costs and benefits at the margin. International data on expenditures can, however, provide indications of the likely impact on costs and expenditures of structural features of health care systems. Data from the Organization for Economic Cooperation and Development for both European countries and a wider set are reviewed, and some current policies in Europe that are directed at controlling health care costs are outlined. PMID:10313433
Advanced space engine powerhead breadboard assembly system study
NASA Technical Reports Server (NTRS)
Campbell, R. G.
1978-01-01
The objective of this study was to establish a preliminary design of a Powerhead Breadboard Assembly (PBA) for an 88 964-Newton (20,000-pound) thrust oxygen/hydrogen staged combustion cycle engine for use in orbital transfer vehicle propulsion. Existing turbopump, preburner, and thrust chamber components were integrated with interconnecting ducting, a heat exchanger, and a control system to complete the PBA design. Cycle studies were conducted to define starting transients and steady-state balances for the completed design. Specifications were developed for all valve applications and the conditions required for the control system integration with the facility for system test were defined.
Ceria-Ulep, Clementina D.; Grove, John; Chen, Randi; Masaki, Kamal H.; Rodriguez, Beatriz L.; Donlon, Tim A.; Guralnik, Jack; Willcox, Bradley J.; Willcox, D. Craig; Nigg, Claudio; Curb, J. David
2010-01-01
Objectives. To investigate the reliability and correlations with age of the balance components of the EPESE, NHANES, and the Good Balance Platform System (GBPS) in a normal population of adults. Design. Cross-sectional. Setting. Urban Medical Center in the Pacific. Participants. A random sample of 203 healthy offspring of Honolulu Heart Program participants, ages 38–71. Measurements. Subjects were examined twice at visits one week apart using the balance components of the EPESE, NHANES, and the good balance system tests. Results. The EPESE and NHANES batteries of tests were not sufficiently challenging to allow successful discrimination among subjects in good health, even older subjects. The GBPS allowed objective quantitative measurements, but the test-retest correlations generally were not high. The GBPS variables correlated with age only when subjects stood on a foam pad; they also were correlated with anthropometric variables. Conclusion. Both EPESE and NHANES balance tests were too easy for healthy subjects. The GBPS had generally low reliability coefficients except for the most difficult testing condition (foam pad, eyes closed). Both height and body fat were associated with GBPS scores, necessitating adjusting for these variables if using balance as a predictor of future health. PMID:21437003
NASA Astrophysics Data System (ADS)
Niemand, C.; Kuhn, K.; Schwarze, R.
2010-12-01
SHARP is a European INTERREG IVc Program. It focuses on the exchange of innovative technologies to protect groundwater resources for future generations by considering the climate change and the different geological and geographical conditions. Regions involved are Austria, United Kingdom, Poland, Italy, Macedonia, Malta, Greece and Germany. They will exchange practical know-how and also determine know-how demands concerning SHARP’s key contents: general groundwater management tools, artificial groundwater recharge technologies, groundwater monitoring systems, strategic use of groundwater resources for drinking water, irrigation and industry, techniques to save water quality and quantity, drinking water safety plans, risk management tools and water balance models. SHARP Outputs & results will influence the regional policy in the frame of sustainable groundwater management to save and improve the quality and quantity of groundwater reservoirs for future generations. The main focus of the Saxon State Office for Environment, Agriculture and Landscape in this project is the enhancement and purposive use of water balance models. Already since 1992 scientists compare different existing water balance models on different scales and coupled with groundwater models. For example in the KLIWEP (Assessment of Impacts of Climate Change Projections on Water and Matter Balance for the Catchment of River Parthe in Saxony) project the coupled model WaSiM-ETH - PCGEOFIM® has been used to study the impact of climate change on water balance and water supplies. The project KliWES (Assessment of the Impacts of Climate Change Projections on Water and Matter Balance for Catchment Areas in Saxony) still running, comprises studies of fundamental effects of climate change on catchments in Saxony. Project objective is to assess Saxon catchments according to the vulnerability of their water resources towards climate change projections in order to derive region-specific recommendations for management actions. The model comparisons within reference areas showed significant differences in outcome. The values of water balance components calculated with different models partially fluctuate by a multiple of their value. The SHARP project was prepared in several previous projects that were testing suitable water balance models and is now able to assist the knowledge transfer.
NASA Astrophysics Data System (ADS)
Lehoczky, Annamária; Kern, Zoltán; Pongrácz, Rita
2014-05-01
Glacio-climatological studies recognise glacier mass balance changes as high-confident climate indicators. The climatic sensitivity of a glacier does not simply depend on regional climate variability but also influenced via large- and mesoscale atmospheric circulation patterns. This study focuses on recent changes in the mass balance using records from three border regions of Europe, and investigates the relationships between the seasonal mass balance components, regional climatic conditions, and distant atmospheric forcing. Since glaciers in different macro-climatological conditions (i.e., mid-latitudes or high-latitudes, dry-continental or maritime regions) may present strongly diverse mass balance characteristics, the three analysed regions were selected from different glacierised macroregions (using the database of the World Glacier Monitoring Service). These regions belong to the Caucasus Mountains (Central Europe macroregion), the Polar Ural (Northern Asia macroregion), and Svalbard (Arctic Islands macroregion). The analysis focuses on winter, summer, and annual mass balance series of eight glaciers. The climatic variables (atmospheric pressure, air temperature, precipitation) and indices of teleconnection patterns (e.g., North Atlantic Oscillation, Pacific Decadal Oscillation) are used from the gridded databases of the University of East Anglia, Climatic Research Unit and the National Oceanic and Atmospheric Administration, National Center for Environmental Prediction. However, the period and length of available mass balance data in the selected regions vary greatly (the first full record is in 1958, Polar Ural; the last is in 2010, Caucasus Mountains), a comparative analysis can be carried out for the period of 1968-1981. Since glaciers from different regions respond to large- and mesoscale climatic forcings differently, and because the mass balance of glaciers within a region often co-vary, our specific objectives are (i) to examine the variability and the integrative climatic signal in the averaged mass balance records of the selected regions; (ii) to analyse the possible coupling between the mass balance and climatic variables, including the dominant patterns of Northern Hemisphere climate variability; and (iii) to compare the main characteristics of the three regions. Furthermore, (iv) a short discussion is given considering the significant decreasing trend of the cumulative annual mass balances in every region under the detected climatic changes in the second half of the 20th century. Preliminary results suggest that the strongest teleconnection links could be between winter mass balance and winter NAO for the Polar Ural (r=0.46, p<0.05), and between annual mass balance and PDO for Svalbard (r=-0.43, p<0.05). Neither seasonal, nor annual mass balance records showed significant correlation with any of the examined circulation indices for the Caucasus.
Estimation of mean response via effective balancing score
Hu, Zonghui; Follmann, Dean A.; Wang, Naisyin
2015-01-01
Summary We introduce effective balancing scores for estimation of the mean response under a missing at random mechanism. Unlike conventional balancing scores, the effective balancing scores are constructed via dimension reduction free of model specification. Three types of effective balancing scores are introduced: those that carry the covariate information about the missingness, the response, or both. They lead to consistent estimation with little or no loss in efficiency. Compared to existing estimators, the effective balancing score based estimator relieves the burden of model specification and is the most robust. It is a near-automatic procedure which is most appealing when high dimensional covariates are involved. We investigate both the asymptotic and the numerical properties, and demonstrate the proposed method in a study on Human Immunodeficiency Virus disease. PMID:25797955
Differential force balances during levitation
NASA Astrophysics Data System (ADS)
Todd, Paul
The simplest arithmetic of inertial, buoyant, magnetic and electrokinetic levitation is explored in the context of a model living system with “acceleration-sensitive structures” in which motion, if allowed, produces a biological effect. The simple model is a finite-sized object enclosed within another finite-sized object suspended in an outer fluid (liquid or vapor) medium. The inner object has density and electrical and magnetic properties quantitatively different from those of the outer object and the medium. In inertial levitation (“weightlessness”) inertial accelerations are balanced, and the forces due to them are canceled in accordance with Newton’s third law. In the presence of inertial acceleration (gravity, centrifugal) motionlessness depends on a balance between the levitating force and the inertial force. If the inner and outer objects differ in density one or the other will be subjected to an unbalanced force when one object is levitated by any other force (buoyant, magnetic, electrokinetic). The requirements for motionlessness of the internal object in the presence of a levitating force are equality of density in the case of buoyant levitation, equality of magnetic susceptibility in the case of magnetic levitation, and equality of zeta potential and dielectric constant in the case of electrokinetic levitation. Examples of internal “acceleration-sensitive structures” are cellular organelles and the organs of advanced plants and animals. For these structures fundamental physical data are important in the interpretation of the effects of forces used for levitation.
USDA-ARS?s Scientific Manuscript database
The objective of the research was to quantify the changes of nitrogen (N) and phosphorus (P) balances in Poland and Mississippi (MS). Nutrient balances were calculated as difference between input and output in the agricultural system according to Organisation for Economic Cooperation and Development...
Can We Really "Feel" a Balanced Total Knee Arthroplasty?
Elmallah, Randa K; Mistry, Jaydev B; Cherian, Jeffrey J; Chughtai, Morad; Bhave, Anil; Roche, Martin W; Mont, Michael A
2016-09-01
Balancing techniques in total knee arthroplasty are often based on surgeons' subjective judgment. However, newer technologies have allowed for objective measurements of soft tissue balancing. This study compared the use of sensor technology to the 30-year surgeon experience regarding (1) compartment loads, (2) soft tissue releases, and (3) component rotational alignments. Patients received either sensor-guided soft tissue balancing (n = 10) or manual gap balancing (n = 12). Wireless, intraoperative sensor tibial inserts were used to measure intracompartmental loads. The surgeon was blinded to values in the manual gap-balancing cohort. In the sensor cohort, the surgeon was unblinded, and implant trials were placed after normal releases were performed to guide further ligament releases after femoral and tibial resections, as needed. Load measurements were taken at 10°, 45°, and 90°. The sensor cohort had lower medial and lateral compartment loading at 10°, 45°, and 90°. The sensor group had lower mean differences in intercompartment loading at 10° (-5.6 vs -51.7 lbs), 45° (-9.8 vs -45.9 lbs), and 90° (-4.3 vs -27 lbs) compared to manually balanced patients. There were 10 additional soft tissue releases in the sensor cohort (2 initial ones before sensor use), compared to 2 releases in the gap-balanced cohort. In the gap-balanced cohort, tibial trays were positioned at a mean 9° external rotation, compared to a mean 1° internal rotation in the sensor-guided cohort. Sensor-balanced total knee arthroplasties provide objective feedback to perform releases and potentially improve knee balancing and rotational alignment. Future work may clarify whether these changes are beneficial for our patients. Copyright © 2016 Elsevier Inc. All rights reserved.
Bone Balance within a Cortical BMU: Local Controls of Bone Resorption and Formation
Smith, David W.; Gardiner, Bruce S.; Dunstan, Colin
2012-01-01
Maintaining bone volume during bone turnover by a BMU is known as bone balance. Balance is required to maintain structural integrity of the bone and is often dysregulated in disease. Consequently, understanding how a BMU controls bone balance is of considerable interest. This paper develops a methodology for identifying potential balance controls within a single cortical BMU. The theoretical framework developed offers the possibility of a directed search for biological processes compatible with the constraints of balance control. We first derive general control constraint equations and then introduce constitutive equations to identify potential control processes that link key variables that describe the state of the BMU. The paper describes specific local bone volume balance controls that may be associated with bone resorption and bone formation. Because bone resorption and formation both involve averaging over time, short-term fluctuations in the environment are removed, leaving the control systems to manage deviations in longer-term trends back towards their desired values. The length of time for averaging is much greater for bone formation than for bone resorption, which enables more filtering of variability in the bone formation environment. Remarkably, the duration for averaging of bone formation may also grow to control deviations in long-term trends of bone formation. Providing there is sufficient bone formation capacity by osteoblasts, this leads to an extraordinarily robust control mechanism that is independent of either osteoblast number or the cellular osteoid formation rate. A complex picture begins to emerge for the control of bone volume. Different control relationships may achieve the same objective, and the ‘integration of information’ occurring within a BMU may be interpreted as different sets of BMU control systems coming to the fore as different information is supplied to the BMU, which in turn leads to different observable BMU behaviors. PMID:22844401
Bateni, Hamid; Zecevic, Aleksandra; McIlroy, William E; Maki, Brian E
2004-07-01
The ability to reach and "grasp" (grip or touch) structures for support in reaction to instability is an important element of the postural repertoire. It is unclear, however, how the central nervous system (CNS) resolves the potential conflict between holding an object and the need to release the held object and grasp alternative support, particularly if the held object is perceived to be relevant to the task of stabilizing the body, e.g. an assistive device. This study examined whether compensatory grasping is inhibited when holding an object, and whether the influence differs when holding an assistive device (cane) versus a task-irrelevant object (top handle portion of a cane). We also investigated the influence of preloading the assistive device, to determine whether conflicting demands for arm-muscle activation (requiring disengagement of ongoing agonist or antagonist activity) would influence the inhibition of compensatory grasping. Unpredictable forward and backward platform translations were used to evoke the balancing reactions in 16 healthy young adults. A handrail was mounted to the right and foot motion was constrained by barriers, with the intent that successful balance recovery would (in large-perturbation trials) require subjects to release the held object and contact the rail with the right hand. Results showed that grasping reactions were commonly used to recover equilibrium when the hand was free (rail contact in 71% of large-perturbation trials). However, holding either the cane or canetop had a potent modulating effect: although early biceps activation was almost never inhibited completely (significant activity within 200 ms in 98% of trials), the average activation amplitude was attenuated by 30-64% and the average frequency of handrail contact was reduced by a factor of two or more. This reduced use of the rail occurred even though the consequence often involved falling against a safety harness or barriers. Handrail contact occurred least frequently when holding the cane during forward loss of balance: subjects persisted in pushing on the cane (failing to use the rail) in 93% of trials, even when the perturbations were too large to allow this strategy to be successful. Prior contraction (preloading the cane) did not influence any of these findings. Complex strategies (e.g. partial release of object) were often adopted to allow balance to be recovered without dropping the held object. Remarkably, it appears that the CNS may give priority to the ongoing task of holding an object, even when it has no stabilizing value (cane during backward falls) or any intrinsic value whatsoever (canetop).
NASA Astrophysics Data System (ADS)
Lin, Chien-Liang; Su, Yu-Zheng; Hung, Min-Wei; Huang, Kuo-Cheng
2010-08-01
In recent years, Augmented Reality (AR)[1][2][3] is very popular in universities and research organizations. The AR technology has been widely used in Virtual Reality (VR) fields, such as sophisticated weapons, flight vehicle development, data model visualization, virtual training, entertainment and arts. AR has characteristics to enhance the display output as a real environment with specific user interactive functions or specific object recognitions. It can be use in medical treatment, anatomy training, precision instrument casting, warplane guidance, engineering and distance robot control. AR has a lot of vantages than VR. This system developed combines sensors, software and imaging algorithms to make users feel real, actual and existing. Imaging algorithms include gray level method, image binarization method, and white balance method in order to make accurate image recognition and overcome the effects of light.
14 CFR Section 23 - Certification and Balance Sheet Elements
Code of Federal Regulations, 2011 CFR
2011-01-01
... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Certification and Balance Sheet Elements... AIR CARRIERS Financial Reporting Requirements Section 23 Certification and Balance Sheet Elements... report except as specifically noted in the financial and statistical statements. Schedule B-1 Balance...
78 FR 28540 - Airworthiness Directives; Hawker Beechcraft Corporation
Federal Register 2010, 2011, 2012, 2013, 2014
2013-05-15
... airplanes. That NPRM proposed requiring inspections of elevator balance weights and replacement of defective elevator balance weights. That NPRM was prompted by reports of elevator balance weights becoming loose or failing because the balance weight material was under strength and did not meet material specifications...
14 CFR Section 23 - Certification and Balance Sheet Elements
Code of Federal Regulations, 2010 CFR
2010-01-01
... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Certification and Balance Sheet Elements... AIR CARRIERS Financial Reporting Requirements Section 23 Certification and Balance Sheet Elements... report except as specifically noted in the financial and statistical statements. Schedule B-1 Balance...
Toward a whole-landscape approach for sustainable land use in the tropics.
DeFries, R; Rosenzweig, C
2010-11-16
Increasing food production and mitigating climate change are two primary but seemingly contradictory objectives for tropical landscapes. This special feature examines synergies and trade-offs among these objectives. Four themes emerge from the papers: the important roles of both forest and agriculture sectors for climate mitigation in tropical countries; the minor contribution from deforestation-related agricultural expansion to overall food production at global and continental scales; the opportunities for synergies between improved food production and reductions in greenhouse gas emissions through diversion of agricultural expansion to already-cleared lands, improved soil, crop, and livestock management, and agroforestry; and the need for targeted policy and management interventions to make these synergistic opportunities a reality. We conclude that agricultural intensification is a key factor to meet dual objectives of food production and climate mitigation, but there is no single panacea for balancing these objectives in all tropical landscapes. Place-specific strategies for sustainable land use emerge from assessments of current land use, demographics, and other biophysical and socioeconomic characteristics, using a whole-landscape, multisector perspective.
Nero, Håkan; Benka Wallén, Martin; Franzén, Erika; Conradsson, David; Ståhle, Agneta; Hagströmer, Maria
2016-10-19
The desirable effects of physical activity in individuals with Parkinson's disease are well-known, although according to results from previous studies factors associated with objectively assessed physical activity are not fully investigated. To investigate demographic, disease-related and mobility-related factors that associate with objectively measured physical activity, in a sample of older adults with mild to moderate Parkinson's disease. Demographic, disease-related and mobility-related factors were gathered by interview from a total of 91 older adults with Parkinson's disease, followed by an evaluation of balance control using the Mini-BESTest. After initial testing, participants wore a tri-axial accelerometer during a week of free-living. Correlation analysis and multiple linear regression was used to investigate factors associated with total PA, represented by total activity counts, and time in brisk walking. Motor impairment, physical function, body mass index and dyskinesia contributed to the variance of total physical activity, explaining 34 % of the variance, while physical function and balance control were significant factors associated with brisk walking, explaining 22 %. This study identified factors that have not been shown to associate with objectively measured physical activity previously, such as dyskinesia, balance control and self-rated physical function. The findings also demonstrated that associated factors differ, depending on the activity behavior being investigated. However, other factors than those included in this study may also be of importance.
Verzola, Adriano; Bentivegna, Roberto; Carandina, Gianni; Trevisani, Lucio; Gregorio, Pasquale; Mandini, Alberto
2009-09-08
One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change.In our research the employees were pleased to be evaluated, not only for the financial outcomes, but also for the satisfaction of improving internal procedure, relationships with the community and their own growth/learning. BSC is an ideal point of contact between the financial and clinical dimensions of management. However, difficulties in its application were faced, among these, at least in the initial phase, the lack of information systems able to drive it, and the complexity of the research for specific indicators needed to be overcome. The time factor (on average, at least two years are required) and the availability of technological resources were also limiting factors.The rapid diffusion of BSC among the principal international profit and non-profit organisations is testament to its great potential. This project could be seen as a preparatory phase in the strategical analysis of a subsequent business plan.
D'Angelo, Fabio; Puricelli, Marco; Binda, Tommaso; Surace, Michele Francesco; Floridi, Chiara; Cherubino, Paolo
2015-05-01
The eLibra® Dynamic Knee Balancing System (Synvasive Technology, Zimmer, Warsaw, IN) is an instrument designed to address the flexion stability during a TKA. It provides an objective measurement of the soft-tissue forces in the two compartments before the final cuts are made, allowing to obtain patient-specific rotational orientation of the femoral component. Between March 2010 and March 2012, the eLibra® system was used during the implantation of 75 TKAs in 75 patients at the author's institution. Preoperative and postoperative clinical assessment were evaluated using the Knee Society Score (KSS) and the Visual Analogical Scale (VAS). Radiographic evaluation was performed with weight-bearing radiographs in antero-posterior and lateral views in order to study the presence of radiolucencies. In a sample of 20 patients, representative of the population studied, the rotation of the femoral component was measured by two independent observers using the C-arm Cone Beam CT scan (XperCT/Allura FD20 angiography system; Philips, Best, Netherlands). At a mean follow-up of 42.3 months (29-54 months), three patients died from causes not related to the surgery. We had one case of aseptic loosening three years after surgery. None of the patients reported complications peri- or postoperatively. Clinical evaluation showed an improvement in KSS scoring, from preoperative means of 48.35 and 47.53 points for clinical and functional aspects, respectively, to postoperative means of 88.03 and 91.2 points, respectively (p<0.001 for both aspects). The current study demonstrates that the use of the eLibra® device is simple and reproducible. It could help surgeons objectively quantify ligament balance and perform soft tissue-guided resection in a reproducible way, resulting in better post-operative stability and reduced complications. The use of the postoperative cone beam computed tomography (CBCT), in a representative sample of patients, revealed a specific and optimal orientation of the femoral component with a mean of 2.18° of external rotation.
Telerehabilitation using virtual reality task can improve balance in patients with stroke.
Cikajlo, Imre; Rudolf, Marko; Goljar, Nika; Burger, Helena; Matjačić, Zlatko
2012-01-01
The objective of the telerehabilitation is a continuation of the rehabilitation process on patients' home. The study also compares the balance training in clinical environment with the telerehabilitation approach when the physiotherapists and physicians can follow the progress remotely. In this paper, the preliminary study of the pilot project with virtual reality (VR)-based tasks for dynamic standing frame supported balance training is presented. Six patients with stroke participated in the study. The patients performed the balance training 3 weeks, 2 weeks in the clinical settings and 1 week in the home environment, five times a week, and each time for up to 20 minutes. Objective effectiveness was demonstrated by parameters as track time, number of collisions and the clinical instruments Berg Balance Scale (BBS), Timed Up & Go (TUG), 10-m walk test and standing on the unaffected and affected extremity. The outcomes were compared to the balance training group without VR and telerehabilitation support. A 2-way ANOVA was used to explore the differences between the both stroke groups. In patients who were subject to VR supported balance training, the BBS demonstrated improvement for 15%, the TUG for 29%, the 10-m walk for 26%, stance time on the affected and unaffected extremity for 200 and 67%, respectively. The follow-up demonstrated that the patients preserved the gained functional improvement. The VR task performance time and number of collisions decreased to 45 and 68%, respectively. Besides, no statistical differences were found between the telerehabilitation approach with VR supported balance training and conventional balance training in clinical settings either regarding the overall mean level or regarding the mean improvement. The telerehabilitation approach in VR supported balance training improved balance in stroke patients and had similar effect on patients' postural functional improvement as conventional balance training in clinical settings. However, when balance training is continued on patient's home instead of the hospital, it would eventually decrease the number of outpatients' visits, reduce related costs and enable treatment of larger number of patients.
NASA Technical Reports Server (NTRS)
Hailperin, M.
1993-01-01
This thesis provides design and analysis of techniques for global load balancing on ensemble architectures running soft-real-time object-oriented applications with statistically periodic loads. It focuses on estimating the instantaneous average load over all the processing elements. The major contribution is the use of explicit stochastic process models for both the loading and the averaging itself. These models are exploited via statistical time-series analysis and Bayesian inference to provide improved average load estimates, and thus to facilitate global load balancing. This thesis explains the distributed algorithms used and provides some optimality results. It also describes the algorithms' implementation and gives performance results from simulation. These results show that the authors' techniques allow more accurate estimation of the global system loading, resulting in fewer object migrations than local methods. The authors' method is shown to provide superior performance, relative not only to static load-balancing schemes but also to many adaptive load-balancing methods. Results from a preliminary analysis of another system and from simulation with a synthetic load provide some evidence of more general applicability.
Layer-specific excitation/inhibition balances during neuronal synchronization in the visual cortex.
Adesnik, Hillel
2018-05-01
Understanding the balance between synaptic excitation and inhibition in cortical circuits in the brain, and how this contributes to cortical rhythms, is fundamental to explaining information processing in the cortex. This study used cortical layer-specific optogenetic activation in mouse cortex to show that excitatory neurons in any cortical layer can drive powerful gamma rhythms, while inhibition balances excitation. The net impact of this is to keep activity within each layer in check, but simultaneously to promote the propagation of activity to downstream layers. The data show that rhythm-generating circuits exist in all principle layers of the cortex, and provide layer-specific balances of excitation and inhibition that affect the flow of information across the layers. Rhythmic activity can synchronize neural ensembles within and across cortical layers. While gamma band rhythmicity has been observed in all layers, the laminar sources and functional impacts of neuronal synchronization in the cortex remain incompletely understood. Here, layer-specific optogenetic stimulation demonstrates that populations of excitatory neurons in any cortical layer of the mouse's primary visual cortex are sufficient to powerfully entrain neuronal oscillations in the gamma band. Within each layer, inhibition balances excitation and keeps activity in check. Across layers, translaminar output overcomes inhibition and drives downstream firing. These data establish that rhythm-generating circuits exist in all principle layers of the cortex, but provide layer-specific balances of excitation and inhibition that may dynamically shape the flow of information through cortical circuits. These data might help explain how excitation/inhibition (E/I) balances across cortical layers shape information processing, and shed light on the diverse nature and functional impacts of cortical gamma rhythms. © 2018 The Authors. The Journal of Physiology © 2018 The Physiological Society.
Mapping the landscape of metabolic goals of a cell
Zhao, Qi; Stettner, Arion I.; Reznik, Ed; ...
2016-05-23
Here, genome-scale flux balance models of metabolism provide testable predictions of all metabolic rates in an organism, by assuming that the cell is optimizing a metabolic goal known as the objective function. We introduce an efficient inverse flux balance analysis (invFBA) approach, based on linear programming duality, to characterize the space of possible objective functions compatible with measured fluxes. After testing our algorithm on simulated E. coli data and time-dependent S. oneidensis fluxes inferred from gene expression, we apply our inverse approach to flux measurements in long-term evolved E. coli strains, revealing objective functions that provide insight into metabolic adaptationmore » trajectories.« less
78 FR 51053 - Airworthiness Directives; Beechcraft Corporation and Hawker Beechcraft Corporation
Federal Register 2010, 2011, 2012, 2013, 2014
2013-08-20
... of elevator balance weights becoming loose or failing because the balance weight material was under strength and did not meet material specifications. This AD requires inspections of elevator balance weights and replacement of defective elevator balance weights. We are issuing this AD to correct the unsafe...
van Asseldonk, Edwin H F; Buurke, Jaap H; Bloem, Bastiaan R; Renzenbrink, Gerbert J; Nene, Anand V; van der Helm, Frans C T; van der Kooij, Herman
2006-10-01
During stroke recovery, restoration of the paretic ankle and compensation in the non-paretic ankle may contribute to improved balance maintenance. We examine a new approach to disentangle these recovery mechanisms by objectively quantifying the contribution of each ankle to balance maintenance. Eight chronic hemiparetic patients were included. Balance responses were elicited by continuous random platform movements. We measured body sway and ground reaction forces below each foot to calculate corrective ankle torques in each leg. These measurements yielded the Frequency Response Function (FRF) of the stabilizing mechanisms, which expresses the amount and timing of the generated corrective torque in response to sway at the specified frequencies. The FRFs were used to calculate the relative contribution of the paretic and non-paretic ankle to the total amount of generated corrective torque to correct sway. All patients showed a clear asymmetry in the balance contribution in favor of the non-paretic ankle. Paretic balance contribution was significantly smaller than the contribution of the paretic leg to weight bearing, and did not show a clear relation with the contribution to weight bearing. In contrast, a group of healthy subjects instructed to distribute their weight asymmetrically showed a one-on-one relation between the contribution to weight bearing and to balance. We conclude that the presented approach objectively quantifies the contribution of each ankle to balance maintenance. Application of this method in longitudinal surveys of balance rehabilitation makes it possible to disentangle the different recovery mechanisms. Such insights will be critical for the development and evaluation of rehabilitation strategies.
An Appraisal of Some Energy Films.
ERIC Educational Resources Information Center
Dowling, John
1979-01-01
Discusses problems of achieving balance and objectivity in dealing with the energy crisis, and describes ten instructional films that might be useful in achieving objective, unbiased instruction. (CMV)
Mobility, balance and falls in persons with multiple sclerosis.
Sosnoff, Jacob J; Socie, Michael J; Boes, Morgan K; Sandroff, Brian M; Pula, John H; Suh, Yoojin; Weikert, Madeline; Balantrapu, Swathi; Morrison, Steven; Motl, Robert W
2011-01-01
There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established.
Mobility, Balance and Falls in Persons with Multiple Sclerosis
Sosnoff, Jacob J.; Socie, Michael J.; Boes, Morgan K.; Sandroff, Brian M.; Pula, John H.; Suh, Yoojin; Weikert, Madeline; Balantrapu, Swathi; Morrison, Steven; Motl, Robert W.
2011-01-01
Background There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS). Methods 52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery. Results Over 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS. Conclusions The current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established. PMID:22132196
Baird, Harriet M; Webb, Thomas L; Martin, Jilly; Sirois, Fuschia M
2018-05-10
Self-monitoring of blood glucose helps people with type 1 diabetes to maintain glycemic control and reduce the risk of complications. However, adherence to blood glucose monitoring is often suboptimal. Like many health behaviors, self-monitoring of blood glucose involves exerting effort in the present to achieve future benefits. As such, the present research explored whether individual differences in time perspective-specifically, the extent to which people have a balanced time perspective-are associated with the frequency with which people with type 1 diabetes monitor their blood glucose and, thus, maintain glycemic control. Adults with type 1 diabetes completed measures of time perspective, feelings associated with monitoring, attitudes toward monitoring, and trait self-control. Objective data regarding the frequency with which participants monitored their blood glucose levels and their long-term glycemic control were extracted from their medical records. Hierarchical regression analyses and tests of indirect effects (N = 129) indicated that having a more balanced time perspective was associated with more frequent monitoring of blood glucose and, as a result, better glycemic control. Further analyses (N = 158) also indicated that there was an indirect relationship between balanced time perspective and monitoring of blood glucose via the feelings that participants associated with monitoring and their subsequent attitudes toward monitoring. These findings point to the importance and relevance of time perspective for understanding health-related behavior and may help to inform interventions designed to promote self-monitoring of blood glucose in people with type 1 diabetes.
Büyükvural Şen, Sıdıka; Özbudak Demir, Sibel; Ekiz, Timur; Özgirgin, Neşe
2015-01-01
Objective: To evaluate the effects of the bilateral isokinetic strengthening training applied to knee and ankle muscles on balance, functional parameters, gait, and the quality of in stroke patients. Methods: Fifty patients (33 M, 17 F) with subacute-chronic stroke and 30 healthy subjects were included. Stroke patients were allocated into isokinetic and control groups. Conventional rehabilitation program was applied to all cases; additionally maximal concentric isokinetic strengthening training was applied to the knee-ankle muscles bilaterally to the isokinetic group 5 days a week for 3 weeks. Biodex System 3 Pro Multijoint System isokinetic dynamometer was used for isokinetic evaluation. The groups were assessed by Functional Independence Measure, Stroke Specific Quality of Life Scale, Timed 10-Meter Walk Test, Six-Minute Walk Test, Stair-Climbing Test, Timed up&go Test, Berg Balance Scale, and Rivermead Mobility Index. Results: Compared with baseline, the isokinetic PT values of the knee and ankle on both sides significantly increased in all cases. PT change values were significantly higher in the isokinetic group than the control group (P<0.025). Furthermore, the quality of life, gait, balance and mobility index values improved significantly in both groups, besides the increase levels were found significantly higher in the isokinetic group (P<0.025, P<0.05). Conclusion: Bilateral isokinetic strengthening training in addition to conventional rehabilitation program after stroke seems to be effective on strengthening muscles on both sides, improving functional parameters, gait, balance and life quality. PMID:26629238
Laska, Melissa N.
2012-01-01
Objective To characterize associations between perceived time constraints for healthy eating and work, school, and family responsibilities among young adults. Design Cross-sectional survey. Setting A large, Midwestern metropolitan region. Participants A diverse sample of community college (n=598) and public university (n=603) students. Main Outcome Measures Time constraints in general, as well as those specific to meal preparation/structure, and perceptions of a healthy life balance. Analysis Chi-square tests and multivariate logistic regression (α=0.005). Results Women, four-year students, and students with lower socio-economic status perceived more time constraints (P<0.001–0.002); students with lower socio-economic status were less likely to have a healthy balance (P<0.001–0.003). Having a heavy course load and working longer hours were important predictors of time constraints among men (P<0.001–0.004), whereas living situation and being in a relationship were more important among women (P=0.002–0.003). Conclusions and Implications Most young adults perceive time constraints on healthy dietary behaviors, yet some young adults appear able to maintain a healthy life balance despite multiple time demands. Interventions focused on improved time management strategies and nutrition-related messaging to achieve healthy diets on a low time budget may be more successful if tailored to the factors that contribute to time constraints among men and women separately. PMID:23017891
Single- and Dual-Task Balance Training Are Equally Effective in Youth
Lüder, Benjamin; Kiss, Rainer; Granacher, Urs
2018-01-01
Due to maturation of the postural control system and secular declines in motor performance, adolescents experience deficits in postural control during standing and walking while concurrently performing cognitive interference tasks. Thus, adequately designed balance training programs may help to counteract these deficits. While the general effectiveness of youth balance training is well-documented, there is hardly any information available on the specific effects of single-task (ST) versus dual-task (DT) balance training. Therefore, the objectives of this study were (i) to examine static/dynamic balance performance under ST and DT conditions in adolescents and (ii) to study the effects of ST versus DT balance training on static/dynamic balance under ST and DT conditions in adolescents. Twenty-eight healthy girls and boys aged 12–13 years were randomly assigned to either 8 weeks of ST or DT balance training. Before and after training, postural sway and spatio-temporal gait parameters were registered under ST (standing/walking only) and DT conditions (standing/walking while concurrently performing an arithmetic task). At baseline, significantly slower gait speed (p < 0.001, d = 5.1), shorter stride length (p < 0.001, d = 4.8), and longer stride time (p < 0.001, d = 3.8) were found for DT compared to ST walking but not standing. Training resulted in significant pre–post decreases in DT costs for gait velocity (p < 0.001, d = 3.1), stride length (-45%, p < 0.001, d = 2.4), and stride time (-44%, p < 0.01, d = 1.9). Training did not induce any significant changes (p > 0.05, d = 0–0.1) in DT costs for all parameters of secondary task performance during standing and walking. Training produced significant pre–post increases (p = 0.001; d = 1.47) in secondary task performance while sitting. The observed increase was significantly greater for the ST training group (p = 0.04; d = 0.81). For standing, no significant changes were found over time irrespective of the experimental group. We conclude that adolescents showed impaired DT compared to ST walking but not standing. ST and DT balance training resulted in significant and similar changes in DT costs during walking. Thus, there appears to be no preference for either ST or DT balance training in adolescents. PMID:29928248
Single- and Dual-Task Balance Training Are Equally Effective in Youth.
Lüder, Benjamin; Kiss, Rainer; Granacher, Urs
2018-01-01
Due to maturation of the postural control system and secular declines in motor performance, adolescents experience deficits in postural control during standing and walking while concurrently performing cognitive interference tasks. Thus, adequately designed balance training programs may help to counteract these deficits. While the general effectiveness of youth balance training is well-documented, there is hardly any information available on the specific effects of single-task (ST) versus dual-task (DT) balance training. Therefore, the objectives of this study were (i) to examine static/dynamic balance performance under ST and DT conditions in adolescents and (ii) to study the effects of ST versus DT balance training on static/dynamic balance under ST and DT conditions in adolescents. Twenty-eight healthy girls and boys aged 12-13 years were randomly assigned to either 8 weeks of ST or DT balance training. Before and after training, postural sway and spatio-temporal gait parameters were registered under ST (standing/walking only) and DT conditions (standing/walking while concurrently performing an arithmetic task). At baseline, significantly slower gait speed ( p < 0.001, d = 5.1), shorter stride length ( p < 0.001, d = 4.8), and longer stride time ( p < 0.001, d = 3.8) were found for DT compared to ST walking but not standing. Training resulted in significant pre-post decreases in DT costs for gait velocity ( p < 0.001, d = 3.1), stride length (-45%, p < 0.001, d = 2.4), and stride time (-44%, p < 0.01, d = 1.9). Training did not induce any significant changes ( p > 0.05, d = 0-0.1) in DT costs for all parameters of secondary task performance during standing and walking. Training produced significant pre-post increases ( p = 0.001; d = 1.47) in secondary task performance while sitting. The observed increase was significantly greater for the ST training group ( p = 0.04; d = 0.81). For standing, no significant changes were found over time irrespective of the experimental group. We conclude that adolescents showed impaired DT compared to ST walking but not standing. ST and DT balance training resulted in significant and similar changes in DT costs during walking. Thus, there appears to be no preference for either ST or DT balance training in adolescents.
Balanced RAP/RAS mix design and performance evaluation for project - specific service conditions.
DOT National Transportation Integrated Search
2013-01-01
This presentation summarizes Projects 0-6092/0-6614. It includes accomplishments, best practices, field performance data of RAP/RAS test sections, balanced RAP/RAS mix design for project-specific conditions, and approaches for improving RAP/RAS mix p...
Motor skills, haptic perception and social abilities in children with mild speech disorders.
Müürsepp, Iti; Aibast, Herje; Gapeyeva, Helena; Pääsuke, Mati
2012-02-01
The aim of the study was to evaluate motor skills, haptic object recognition and social interaction in 5-year-old children with mild specific expressive language impairment (expressive-SLI) and articulation disorder (AD) in comparison of age- and gender matched healthy children. Twenty nine children (23 boys and 6 girls) with expressive-SLI, 27 children (20 boys and 7 girls) with AD and 30 children (23 boys and 7 girls) with typically developing language as controls participated in our study. The children were examined for manual dexterity, ball skills, static and dynamic balance by M-ABC test, haptic object recognition and for social interaction by questionnaire completed by teachers. Children with mild expressive-SLI demonstrated significantly poorer results in all subtests of motor skills (p<0.05), in haptic object recognition and social interaction (p<0.01) compared to controls. There were no statistically significant differences (p>0.05) in measured parameters between children with AD and controls. Children with expressive-SLI performed considerably poorer compared to AD group in balance subtest (p<0.05), and in overall M-ABC test (p<0.01). In children with mild expressive-SLI the functional motor performance, haptic perception and social interaction are considerably more affected than in children with AD. Although motor difficulties in speech production are prevalent in AD, it is localised and does not involve children's general motor skills, haptic perception or social interaction. Copyright © 2011 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
Kilgore, Meredith L; Grabowski, David C; Morrisey, Michael A; Ritchie, Christine S; Yun, Huifeng; Locher, Julie L
2009-03-01
Home health and hospice services can constitute important elements in the continuum of care for older adults diagnosed with cancer. The Balanced Budget Act (BBA) of 1997 included provisions affecting those services. The first objective of this study is to assess the effect of the BBA of 1997 on home health and hospice service utilization in older cancer patients. The second objective is to estimate the effect of the BBA of 1997 on costs associated specifically with home health and hospice services and on total costs of care. The final objective is to evaluate the effect of the BBA of 1997 on mortality in these patients. Longitudinal analysis using the Surveillance, Epidemiology, and End Results-Medicare Database, covering a service area that includes 26% of the US population. Community-dwelling Medicare beneficiaries 65 years of age and older. Utilization rates of home health and hospice services; costs associated with those services, and total costs of care; and mortality. Home health utilization rates dropped substantially and hospice utilization rates increased after the BBA. Medicare costs for home health services declined as did total Medicare costs but hospice costs increased. There was no discernable effect on mortality rates. The BBA was successful in containing the costs of home health services and resulted in savings in overall costs of care for older cancer patients. Reduction in utilization of home health services did not seem to negatively affect outcomes. The BBA may have contributed to the trend of increasing use of hospice care.
NASA Astrophysics Data System (ADS)
Pincus, R.; Mlawer, E. J.
2017-12-01
Radiation is key process in numerical models of the atmosphere. The problem is well-understood and the parameterization of radiation has seen relatively few conceptual advances in the past 15 years. It is nonthelss often the single most expensive component of all physical parameterizations despite being computed less frequently than other terms. This combination of cost and maturity suggests value in a single radiation parameterization that could be shared across models; devoting effort to a single parameterization might allow for fine tuning for efficiency. The challenge lies in the coupling of this parameterization to many disparate representations of clouds and aerosols. This talk will describe RRTMGP, a new radiation parameterization that seeks to balance efficiency and flexibility. This balance is struck by isolating computational tasks in "kernels" that expose as much fine-grained parallelism as possible. These have simple interfaces and are interoperable across programming languages so that they might be repalced by alternative implementations in domain-specific langauges. Coupling to the host model makes use of object-oriented features of Fortran 2003, minimizing branching within the kernels and the amount of data that must be transferred. We will show accuracy and efficiency results for a globally-representative set of atmospheric profiles using a relatively high-resolution spectral discretization.
USEQ: A Short Questionnaire for Satisfaction Evaluation of Virtual Rehabilitation Systems.
Gil-Gómez, José-Antonio; Manzano-Hernández, Pilar; Albiol-Pérez, Sergio; Aula-Valero, Carmen; Gil-Gómez, Hermenegildo; Lozano-Quilis, José-Antonio
2017-07-07
New emerging technologies have proven their efficacy in aiding people in their rehabilitation. The tests that are usually used to evaluate usability (in general) or user satisfaction (in particular) of this technology are not specifically focused on virtual rehabilitation and patients. The objective of this contribution is to present and evaluate the USEQ (User Satisfaction Evaluation Questionnaire). The USEQ is a questionnaire that is designed to properly evaluate the satisfaction of the user (which constitutes part of usability) in virtual rehabilitation systems. Forty patients with balance disorders completed the USEQ after their first session with ABAR (Active Balance Rehabilitation), which is a virtual rehabilitation system that is designed for the rehabilitation of balance disorders. Internal consistency analysis and exploratory factor analysis were carried out to identify the factor structure of the USEQ. The six items of USEQ were significantly associated with each other, and the Cronbach alpha coefficient for the questionnaire was 0.716. In an analysis of the principal components, a one-factor solution was considered to be appropriate. The findings of the study suggest that the USEQ is a reliable questionnaire with adequate internal consistency. With regard to patient perception, the patients found the USEQ to be an easy-to-understand questionnaire with a convenient number of questions.
Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.
Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert
2016-05-01
Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P < .003 for all). The findings indicate that an interdisciplinary rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Middleton, Addie; Merlo-Rains, Angela; Peters, Denise M.; Greene, Jennifaye V.; Blanck, Erika L.; Moran, Robert; Fritz, Stacy L.
2014-01-01
Background Body weight–supported treadmill training (BWSTT) has produced mixed results compared with other therapeutic techniques. Objective The purpose of this study was to determine whether an intensive intervention (intensive mobility training) including BWSTT provides superior gait, balance, and mobility outcomes compared with a similar intervention with overground gait training in place of BWSTT. Methods Forty-three individuals with chronic stroke (mean [SD] age, 61.5 [13.5] years; mean [SD] time since stroke, 3.3 [3.8] years), were randomized to a treatment (BWSTT, n = 23) or control (overground gait training, n = 20) group. Treatment consisted of 1 hour of gait training; 1 hour of balance activities; and 1 hour of strength, range of motion, and coordination for 10 consecutive weekdays (30 hours). Assessments (step length differential, self-selected and fast walking speed, 6-minute walk test, Berg Balance Scale [BBS], Dynamic Gait Index [DGI], Activities-specific Balance Confidence [ABC] scale, single limb stance, Timed Up and Go [TUG], Fugl-Meyer [FM], and perceived recovery [PR]) were conducted before, immediately after, and 3 months after intervention. Results No significant differences (α = 0.05) were found between groups after training or at follow-up; therefore, groups were combined for remaining analyses. Significant differences (α = 0.05) were found pretest to posttest for fast walking speed, BBS, DGI, ABC, TUG, FM, and PR. DGI, ABC, TUG, and PR results remained significant at follow-up. Effect sizes were small to moderate in the direction of improvement. Conclusions Future studies should investigate the effectiveness of intensive interventions of durations greater than 10 days for improving gait, balance, and mobility in individuals with chronic stroke. PMID:25467394
Biomechanical assessment of dynamic balance: Specificity of different balance tests.
Ringhof, Steffen; Stein, Thorsten
2018-04-01
Dynamic balance is vitally important for most sports and activities of daily living, so the assessment of dynamic stability has become an important issue. In consequence, a large number of balance tests have been developed. However, it is not yet known whether these tests (i) measure the same construct and (ii) can differentiate between athletes with different balance expertise. We therefore studied three common dynamic balance tests: one-leg jump landings, Posturomed perturbations and simulated forward falls. Participants were 24 healthy young females in regular training in either gymnastics (n = 12) or swimming (n = 12). In each of the tests, the participants were instructed to recover balance as quickly as possible. Dynamic stability was computed by time to stabilization and margin of stability, deduced from force plates and motion capture respectively. Pearson's correlations between the dynamic balance tests found no significant associations between the respective dynamic stability measures. Furthermore, independent t-tests indicated that only jump landings could properly distinguish between both groups of athletes. In essence, the different dynamic balance tests applied did not measure the same construct but rather task-specific skills, each of which depends on multifactorial internal and external constraints. Our study therefore contradicts the traditional view of considering balance as a general ability, and reinforces that dynamic balance measures are not interchangeable. This highlights the importance of selecting appropriate balance tests. Copyright © 2018 Elsevier B.V. All rights reserved.
Zhou, Guangwei; Brodsky, Jacob R
2015-06-01
To conduct objective assessment of children with balance and vestibular complaints following sports-related concussions and identify the underlying deficits by analyzing laboratory test outcomes. Case series with chart review. Pediatric tertiary care facility. Medical records were reviewed of 42 pediatric patients with balance and/or vestibular complaints following sports-related concussions who underwent comprehensive laboratory testing on their balance and vestibular function. Patients' characteristics were summarized and results analyzed. More than 90% of the children with protracted dizziness or imbalance following sports-related concussion had at least 1 abnormal finding from the comprehensive balance and vestibular evaluation. The most frequent deficit was found in dynamic visual acuity test, followed by Sensory Organization Test and rotational test. Patient's balance problem associated with concussion seemed to be primarily instigated by vestibular dysfunction. Furthermore, semicircular canal dysfunction was involved more often than dysfunction of otolith organs. Yet, <10% of the children experienced a hearing loss following sports-related concussion. Vestibular impairment is common among children with protracted dizziness or imbalance following sports-related concussion. Our study demonstrated that proper and thorough evaluation is imperative to identify these underlying deficits and laboratory tests were helpful in the diagnosis and recommendation of following rehabilitations. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
Shadli, S M; Glue, P; McIntosh, J; McNaughton, N
2015-01-01
Anxiety disorders are among the most common mental illness in the western world with a major impact on disability. But their diagnosis has lacked objective biomarkers. We previously demonstrated a human anxiety process biomarker, goal-conflict-specific electroencephalography (EEG) rhythmicity (GCSR) in the stop-signal task (SST). Here we have developed and characterized an improved test appropriate for clinical group testing. We modified the SST to produce balanced numbers of trials in clearly separated stop-signal delay groups. As previously, right frontal (F8) GCSR was extracted as the difference in EEG log Fourier power between matching stop and go trials (that is, stop-signal-specific power) of a quadratic contrast of the three delay values (that is, power when stopping and going are in balanced conflict compared with the average of when stopping or going is greater). Separate experiments assessed drug sensitivity (n=34) and personality relations (n=59). GCSR in this new SST was reduced by three chemically distinct anxiolytic drugs (administered double-blind): buspirone (10 mg), triazolam (0.25 mg) and pregabalin (75 mg); had a frequency range (4–12 Hz) consistent with rodent model data; and positively correlated significantly with neuroticism and nonsignificantly with trait anxiety scores. GCSR, measured in our new form of the SST, should be suitable as a biomarker for one specific anxiety process in the testing of clinical groups and novel drugs and in the development of measures suitable for individual diagnosis. PMID:26670284
Ursino, Mauro; Magosso, Elisa; Cuppini, Cristiano
2009-02-01
Synchronization of neural activity in the gamma band is assumed to play a significant role not only in perceptual processing, but also in higher cognitive functions. Here, we propose a neural network of Wilson-Cowan oscillators to simulate recognition of abstract objects, each represented as a collection of four features. Features are ordered in topological maps of oscillators connected via excitatory lateral synapses, to implement a similarity principle. Experience on previous objects is stored in long-range synapses connecting the different topological maps, and trained via timing dependent Hebbian learning (previous knowledge principle). Finally, a downstream decision network detects the presence of a reliable object representation, when all features are oscillating in synchrony. Simulations performed giving various simultaneous objects to the network (from 1 to 4), with some missing and/or modified properties suggest that the network can reconstruct objects, and segment them from the other simultaneously present objects, even in case of deteriorated information, noise, and moderate correlation among the inputs (one common feature). The balance between sensitivity and specificity depends on the strength of the Hebbian learning. Achieving a correct reconstruction in all cases, however, requires ad hoc selection of the oscillation frequency. The model represents an attempt to investigate the interactions among topological maps, autoassociative memory, and gamma-band synchronization, for recognition of abstract objects.
Alexeeva, Natalia; Sames, Carol; Jacobs, Patrick L.; Hobday, Lori; DiStasio, Marcello M.; Mitchell, Sarah A.; Calancie, Blair
2011-01-01
Objective To compare two forms of device-specific training – body-weight-supported (BWS) ambulation on a fixed track (TRK) and BWS ambulation on a treadmill (TM) – to comprehensive physical therapy (PT) for improving walking speed in persons with chronic, motor-incomplete spinal cord injury (SCI). Methods Thirty-five adult subjects with a history of chronic SCI (>1 year; AIS ‘C’ or ‘D’) participated in a 13-week (1 hour/day; 3 days per week) training program. Subjects were randomized into one of the three training groups. Subjects in the two BWS groups trained without the benefit of additional input from a physical therapist or gait expert. For each training session, performance values and heart rate were monitored. Pre- and post-training maximal 10-m walking speed, balance, muscle strength, fitness, and quality of life were assessed in each subject. Results All three training groups showed significant improvement in maximal walking speed, muscle strength, and psychological well-being. A significant improvement in balance was seen for PT and TRK groups but not for subjects in the TM group. In all groups, post-training measures of fitness, functional independence, and perceived health and vitality were unchanged. Conclusions Our results demonstrate that persons with chronic, motor-incomplete SCI can improve walking ability and psychological well-being following a concentrated period of ambulation therapy, regardless of training method. Improvement in walking speed was associated with improved balance and muscle strength. In spite of the fact that we withheld any formal input of a physical therapist or gait expert from subjects in the device-specific training groups, these subjects did just as well as subjects receiving comprehensive PT for improving walking speed and strength. It is likely that further modest benefits would accrue to those subjects receiving a combination of device-specific training with input from a physical therapist or gait expert to guide that training. PMID:21903010
Development of an interactive game-based rehabilitation tool for dynamic balance training.
Lange, BeLinda; Flynn, Sheryl; Proffitt, Rachel; Chang, Chien-Yen; Rizzo, Albert Skip
2010-01-01
Conventional physical therapy techniques have been shown to improve balance, mobility, and gait following neurological injury. Treatment involves training patients to transfer weight onto the impaired limb to improve weight shift while standing and walking. Visual biofeedback and force plate systems are often used for treatment of balance and mobility disorders. Researchers have also been exploring the use of video game consoles such as the Nintendo Wii Fit as rehabilitation tools. Case studies have demonstrated that the use of video games may have promise for balance rehabilitation. However, initial usability studies and anecdotal evidence suggest that the current commercial games are not compatible with controlled, specific exercise required to meet therapy goals. Based on focus group data and observations with patients, a game has been developed to specifically target weight shift training using an open source game engine and the Nintendo Wii Fit Balance Board. The prototype underwent initial usability testing with a sample of clinicians and with persons with neurological injury. Overall, feedback was positive, and areas for improvement were identified. This preliminary research provides support for the development of a game that caters specifically to the key requirements of balance rehabilitation.
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 Society.
The sympathetic/parasympathetic imbalance in heart failure with reduced ejection fraction
Floras, John S.; Ponikowski, Piotr
2015-01-01
Cardiovascular autonomic imbalance, a cardinal phenotype of human heart failure, has adverse implications for symptoms during wakefulness and sleep; for cardiac, renal, and immune function; for exercise capacity; and for lifespan and mode of death. The objectives of this Clinical Review are to summarize current knowledge concerning mechanisms for disturbed parasympathetic and sympathetic circulatory control in heart failure with reduced ejection fraction and its clinical and prognostic implications; to demonstrate the patient-specific nature of abnormalities underlying this common phenotype; and to illustrate how such variation provides opportunities to improve or restore normal sympathetic/parasympathetic balance through personalized drug or device therapy. PMID:25975657
Development of a Conceptual Chum Salmon Emergence Model for Ives Island
DOE Office of Scientific and Technical Information (OSTI.GOV)
Murray, Christopher J.; Geist, David R.; Arntzen, Evan V.
2011-02-09
The objective of the study described herein was to develop a conceptual model of chum salmon emergence that was based on empirical water temperature of the riverbed and river in specific locations where chum salmon spawn in the Ives Island area. The conceptual model was developed using water temperature data that have been collected in the past and are currently being collected in the Ives Island area. The model will be useful to system operators who need to estimate the complete distribution of chum salmon emergence (first emergence through final emergence) in order to balance chum salmon redd protection andmore » power system operation.« less
Nonlinear normal modes modal interactions and isolated resonance curves
Kuether, Robert J.; Renson, L.; Detroux, T.; ...
2015-05-21
The objective of the present study is to explore the connection between the nonlinear normal modes of an undamped and unforced nonlinear system and the isolated resonance curves that may appear in the damped response of the forced system. To this end, an energy balance technique is used to predict the amplitude of the harmonic forcing that is necessary to excite a specific nonlinear normal mode. A cantilever beam with a nonlinear spring at its tip serves to illustrate the developments. Furthermore, the practical implications of isolated resonance curves are also discussed by computing the beam response to sine sweepmore » excitations of increasing amplitudes.« less
White-nose Syndrome management: Report on structured decision making initiative
Szymanski, Jennifer A.; Runge, Michael C.; Parkin, Mary J.; Armstrong, Mike
2009-01-01
This report describes an analysis undertaken to assist state and federal natural resources managers in addressing the following question: What management measures should be taken this year within a given area to control the spread and minimize the effects of white-nose syndrome (WNS) on hibernating bats at the individual and population levels? The answer depends upon specific characteristics of the bat species, the hibernacula, and the syndrome itself, all of which could vary across the geographic extent of WNS and change over time. It also depends on a large number of agency and societal judgments concerning how to balance disease management against other objectives.
Application of Bayesian Networks to hindcast barrier island morphodynamics
Wilson, Kathleen E.; Adams, Peter N.; Hapke, Cheryl J.; Lentz, Erika E.; Brenner, Owen T.
2015-01-01
We refine a preliminary Bayesian Network by 1) increasing model experience through additional observations, 2) including anthropogenic modification history, and 3) replacing parameterized wave impact values with maximum run-up elevation. Further, we develop and train a pair of generalized models with an additional dataset encompassing a different storm event, which expands the observations beyond our hindcast objective. We compare the skill of the generalized models against the Nor'Ida specific model formulation, balancing the reduced skill with an expectation of increased transferability. Results of Nor'Ida hindcasts ranged in skill from 0.37 to 0.51 and accuracy of 65.0 to 81.9%.
Balance Calibration – A Method for Assigning a Direct-Reading Uncertainty to an Electronic Balance.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mike Stears
2010-07-01
Paper Title: Balance Calibration – A method for assigning a direct-reading uncertainty to an electronic balance. Intended Audience: Those who calibrate or use electronic balances. Abstract: As a calibration facility, we provide on-site (at the customer’s location) calibrations of electronic balances for customers within our company. In our experience, most of our customers are not using their balance as a comparator, but simply putting an unknown quantity on the balance and reading the displayed mass value. Manufacturer’s specifications for balances typically include specifications such as readability, repeatability, linearity, and sensitivity temperature drift, but what does this all mean when themore » balance user simply reads the displayed mass value and accepts the reading as the true value? This paper discusses a method for assigning a direct-reading uncertainty to a balance based upon the observed calibration data and the environment where the balance is being used. The method requires input from the customer regarding the environment where the balance is used and encourages discussion with the customer regarding sources of uncertainty and possible means for improvement; the calibration process becomes an educational opportunity for the balance user as well as calibration personnel. This paper will cover the uncertainty analysis applied to the calibration weights used for the field calibration of balances; the uncertainty is calculated over the range of environmental conditions typically encountered in the field and the resulting range of air density. The temperature stability in the area of the balance is discussed with the customer and the temperature range over which the balance calibration is valid is decided upon; the decision is based upon the uncertainty needs of the customer and the desired rigor in monitoring by the customer. Once the environmental limitations are decided, the calibration is performed and the measurement data is entered into a custom spreadsheet. The spreadsheet uses measurement results, along with the manufacturer’s specifications, to assign a direct-read measurement uncertainty to the balance. The fact that the assigned uncertainty is a best-case uncertainty is discussed with the customer; the assigned uncertainty contains no allowance for contributions associated with the unknown weighing sample, such as density, static charges, magnetism, etc. The attendee will learn uncertainty considerations associated with balance calibrations along with one method for assigning an uncertainty to a balance used for non-comparison measurements.« less
Civilian Fitness: A Readiness Enabler
2008-03-24
bonus to make working out convenient and facilitate work / life balance . This was secondary to the hope that a fitness program would produce healthier...workforce; and 3) become an employer of choice and promote work life balance .88 34 Strategic plans and supporting objectives of the Army Installation
NASA Technical Reports Server (NTRS)
Hailperin, Max
1993-01-01
This thesis provides design and analysis of techniques for global load balancing on ensemble architectures running soft-real-time object-oriented applications with statistically periodic loads. It focuses on estimating the instantaneous average load over all the processing elements. The major contribution is the use of explicit stochastic process models for both the loading and the averaging itself. These models are exploited via statistical time-series analysis and Bayesian inference to provide improved average load estimates, and thus to facilitate global load balancing. This thesis explains the distributed algorithms used and provides some optimality results. It also describes the algorithms' implementation and gives performance results from simulation. These results show that our techniques allow more accurate estimation of the global system load ing, resulting in fewer object migration than local methods. Our method is shown to provide superior performance, relative not only to static load-balancing schemes but also to many adaptive methods.
The Systems Biology Markup Language (SBML) Level 3 Package: Flux Balance Constraints.
Olivier, Brett G; Bergmann, Frank T
2015-09-04
Constraint-based modeling is a well established modelling methodology used to analyze and study biological networks on both a medium and genome scale. Due to their large size, genome scale models are typically analysed using constraint-based optimization techniques. One widely used method is Flux Balance Analysis (FBA) which, for example, requires a modelling description to include: the definition of a stoichiometric matrix, an objective function and bounds on the values that fluxes can obtain at steady state. The Flux Balance Constraints (FBC) Package extends SBML Level 3 and provides a standardized format for the encoding, exchange and annotation of constraint-based models. It includes support for modelling concepts such as objective functions, flux bounds and model component annotation that facilitates reaction balancing. The FBC package establishes a base level for the unambiguous exchange of genome-scale, constraint-based models, that can be built upon by the community to meet future needs (e. g. by extending it to cover dynamic FBC models).
The Systems Biology Markup Language (SBML) Level 3 Package: Flux Balance Constraints.
Olivier, Brett G; Bergmann, Frank T
2015-06-01
Constraint-based modeling is a well established modelling methodology used to analyze and study biological networks on both a medium and genome scale. Due to their large size, genome scale models are typically analysed using constraint-based optimization techniques. One widely used method is Flux Balance Analysis (FBA) which, for example, requires a modelling description to include: the definition of a stoichiometric matrix, an objective function and bounds on the values that fluxes can obtain at steady state. The Flux Balance Constraints (FBC) Package extends SBML Level 3 and provides a standardized format for the encoding, exchange and annotation of constraint-based models. It includes support for modelling concepts such as objective functions, flux bounds and model component annotation that facilitates reaction balancing. The FBC package establishes a base level for the unambiguous exchange of genome-scale, constraint-based models, that can be built upon by the community to meet future needs (e. g. by extending it to cover dynamic FBC models).
Improving the performance of surgery-based clinical pathways: a simulation-optimization approach.
Ozcan, Yasar A; Tànfani, Elena; Testi, Angela
2017-03-01
This paper aims to improve the performance of clinical processes using clinical pathways (CPs). The specific goal of this research is to develop a decision support tool, based on a simulation-optimization approach, which identify the proper adjustment and alignment of resources to achieve better performance for both the patients and the health-care facility. When multiple perspectives are present in a decision problem, critical issues arise and often require the balancing of goals. In our approach, meeting patients' clinical needs in a timely manner, and to avoid worsening of clinical conditions, we assess the level of appropriate resources. The simulation-optimization model seeks and evaluates alternative resource configurations aimed at balancing the two main objectives-meeting patient needs and optimal utilization of beds and operating rooms.Using primary data collected at a Department of Surgery of a public hospital located in Genoa, Italy. The simulation-optimization modelling approach in this study has been applied to evaluate the thyroid surgical treatment together with the other surgery-based CPs. The low rate of bed utilization and the long elective waiting lists of the specialty under study indicates that the wards were oversized while the operating room capacity was the bottleneck of the system. The model enables hospital managers determine which objective has to be given priority, as well as the corresponding opportunity costs.
Developing a Social, Cultural and Economic Report Card for a Regional Industrial Harbour.
Pascoe, Sean; Tobin, Renae; Windle, Jill; Cannard, Toni; Marshall, Nadine; Kabir, Zobaidul; Flint, Nicole
2016-01-01
Report cards are increasingly used to provide ongoing snap-shots of progress towards specific ecosystem health goals, particularly in coastal regions where planners need to balance competing demands for coastal resources from a range of industries. While most previous report cards focus on the biophysical components of the system, there is a growing interest in including the social and economic implications of ecosystem management to provide a greater social-ecological system understanding. Such a report card was requested on the Gladstone Harbour area in central Queensland, Australia. Gladstone Harbour adjoins the southern Great Barrier Reef, and is also a major industrial and shipping port. Balancing social, economic and environmental interests is therefore of great concern to the regional managers. While environmental benchmarking procedures are well established within Australia (and elsewhere), a method for assessing social and economic performance of coastal management is generally lacking. The key aim of this study was to develop and pilot a system for the development of a report card relating to appropriate cultural, social and economic objectives. The approach developed uses a range of multicriteria decision analysis methods to assess and combine different qualitative and quantitative measures, including the use of Bayesian Belief Networks to combine the different measures and provide an overall quantitative score for each of the key management objectives. The approach developed is readily transferable for purposes of similar assessments in other regions.
Developing a Social, Cultural and Economic Report Card for a Regional Industrial Harbour
Pascoe, Sean; Tobin, Renae; Windle, Jill; Cannard, Toni; Marshall, Nadine; Kabir, Zobaidul; Flint, Nicole
2016-01-01
Report cards are increasingly used to provide ongoing snap-shots of progress towards specific ecosystem health goals, particularly in coastal regions where planners need to balance competing demands for coastal resources from a range of industries. While most previous report cards focus on the biophysical components of the system, there is a growing interest in including the social and economic implications of ecosystem management to provide a greater social-ecological system understanding. Such a report card was requested on the Gladstone Harbour area in central Queensland, Australia. Gladstone Harbour adjoins the southern Great Barrier Reef, and is also a major industrial and shipping port. Balancing social, economic and environmental interests is therefore of great concern to the regional managers. While environmental benchmarking procedures are well established within Australia (and elsewhere), a method for assessing social and economic performance of coastal management is generally lacking. The key aim of this study was to develop and pilot a system for the development of a report card relating to appropriate cultural, social and economic objectives. The approach developed uses a range of multicriteria decision analysis methods to assess and combine different qualitative and quantitative measures, including the use of Bayesian Belief Networks to combine the different measures and provide an overall quantitative score for each of the key management objectives. The approach developed is readily transferable for purposes of similar assessments in other regions. PMID:26839949
A method to quantify the "cone of economy".
Haddas, Ram; Lieberman, Isador H
2018-05-01
A non-randomized, prospective, concurrent control cohort study. The purpose of this study is to develop and evaluate a method to quantify the dimensions of the cone of economy (COE) and the energy expenditure associated with maintaining a balanced posture within the COE, scoliosis patients and compare them to matched non-scoliotic controls in a group of adult degenerative. Balance is defined as the ability of the human body to maintain its center of mass (COM) within the base of support with minimal postural sway. The cone of economy refers to the stable region of upright standing posture. The underlying assumption is that deviating outside one's individual cone challenges the balance mechanisms. Adult degenerative scoliosis (ADS) patients exhibit a variety of postural changes within their COE, involving the spine, pelvis and lower extremities, in their effort to compensate for the altered posture. Ten ADS patients and ten non-scoliotic volunteers performed a series of functional balance tests. The dimensions of the COE and the energy expenditure related to maintaining balance within the COE were measured using a human motion video capture system and dynamic surface electromyography. ADS patients presented more COM sway in the sagittal (ADS: 1.59 cm vs. H: 0.61 cm; p = 0.049) and coronal (ADS: 2.84 cm vs. H: 1.72 cm; p = 0.046) directions in comparison to the non-scoliotic control. ADS patients presented with more COM (ADS: 33.30 cm vs. H: 19.13 cm; p = 0.039) and head (ADS: 31.06 cm vs. H: 19.13 cm; p = 0.013) displacements in comparison to the non-scoliotic controls. Scoliosis patients expended more muscle activity to maintain static standing, as manifest by increased muscle activity in their erector spinae (ADS: 37.16 mV vs. H: 20.31 mV; p = 0.050), and gluteus maximus (ADS: 33.12 mV vs. H: 12.09 mV; p = 0.001) muscles. We were able to develop and evaluate a method that quantifies the COE boundaries, COM displacement, and amount of sway within the COE along with the energy expenditure for a specific patient. This method of COE measurement will enable spine care practitioners to objectively evaluate their patients in an effort to determine the most appropriate treatment options, and in objectively documenting the effectiveness of their intervention.
Compression-based integral curve data reuse framework for flow visualization
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hong, Fan; Bi, Chongke; Guo, Hanqi
Currently, by default, integral curves are repeatedly re-computed in different flow visualization applications, such as FTLE field computation, source-destination queries, etc., leading to unnecessary resource cost. We present a compression-based data reuse framework for integral curves, to greatly reduce their retrieval cost, especially in a resource-limited environment. In our design, a hierarchical and hybrid compression scheme is proposed to balance three objectives, including high compression ratio, controllable error, and low decompression cost. Specifically, we use and combine digitized curve sparse representation, floating-point data compression, and octree space partitioning to adaptively achieve the objectives. Results have shown that our data reusemore » framework could acquire tens of times acceleration in the resource-limited environment compared to on-the-fly particle tracing, and keep controllable information loss. Moreover, our method could provide fast integral curve retrieval for more complex data, such as unstructured mesh data.« less
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 balance confidence was significantly correlated with change in general physical function. Because of the observation of discordance between balance confidence change and changes in fall risk and physical abilities, those who design group-based exercise programs for community-dwelling older adults may wish to consider including an education component on factors that influence fear of falling. Objective changes in fall risk factors cannot be assumed to mirror change of fear of falling and physical abilities in older adults in the short-term. PMID:15477698
Faerber, Adrienne E; Kreling, David H
2012-01-01
The objective of this study was to measure differences in fair balance (benefit and risk statements) and adequate provision (toll-free numbers, Internet URLs, print ad references, and medical professional references) in advertising content for drugs that have switched from prescription to over-the-counter (OTC). The Vanderbilt TV News Archive was used to select products to study, to measure the frequency and placement of ads for those products, and to view advertising content for those products. Unique advertisements (n = 108) for loratadine (Claritin), citirizine (Zyrtec), and omeprazole (Prilosec) were analyzed for the presence of adequate provision statements and for the frequency of benefit, risk, and other statements. OTC ads were shorter than prescription ads by 10.6 seconds but contained the same total number of statements. Most prescription ads (n (RX) = 31) contained toll-free numbers (97%), Internet URLs (94%), medical professional references (100%) and print ad references (68%). Few OTC ads (n (OTC) = 77) contained adequate provision statements: 4% contained toll-free numbers and 10% contained Internet URLs. Prescription ads had similar numbers of benefits (1.5) and risks (1.8) per 30 seconds of ad time, and OTC ads had more benefits (6.6) than risks (1.2) per 30 seconds of ad time. Prescription drug ads contained risk statements that listed specific side effects and explicit harms from taking the product, but OTC ads contained nonspecific risk information and statements that implied risk rather than directly identifying risk. Differences in the Food and Drug Administration (FDA) and Federal Trade Commission (FTC) regulation of advertising affected the balance of risk and benefit information that appeared and the specificity of risk information available.
Children's Behaviour and Cognitions across Different Balance Tasks
ERIC Educational Resources Information Center
Messer, David J.; Pine, Karen J.; Butler, Cathal
2008-01-01
Children's understanding of the way objects balance has provided important insights about cognitive development [e.g., Karmiloff-Smith, A. (1992). "Beyond modularity: A developmental perspective on cognitive science." Cambridge, MA: MIT Press; Siegler, R. S. (1976). Three aspects of cognitive development. "Cognitive Psychology," 8, 481-520]. We…
Application of an energy balance method for estimating evapotranspiration in cropping systems
USDA-ARS?s Scientific Manuscript database
Accurate quantification of evapotranspiration (ET, consumptive water use) from planting through harvest is critical for managing the limited water resources for crop irrigation. Our objective was to develop and apply an improved land-crop surface residual energy balance (EB) method for quantifying E...
Mendes, Paula; Nunes, Luis Miguel; Teixeira, Margarida Ribau
2014-09-01
This article demonstrates how decision-makers can be guided in the process of defining performance target values in the balanced scorecard system. We apply a method based on sensitivity analysis with Monte Carlo simulation to the municipal solid waste management system in Loulé Municipality (Portugal). The method includes two steps: sensitivity analysis of performance indicators to identify those performance indicators with the highest impact on the balanced scorecard model outcomes; and sensitivity analysis of the target values for the previously identified performance indicators. Sensitivity analysis shows that four strategic objectives (IPP1: Comply with the national waste strategy; IPP4: Reduce nonrenewable resources and greenhouse gases; IPP5: Optimize the life-cycle of waste; and FP1: Meet and optimize the budget) alone contribute 99.7% of the variability in overall balanced scorecard value. Thus, these strategic objectives had a much stronger impact on the estimated balanced scorecard outcome than did others, with the IPP1 and the IPP4 accounting for over 55% and 22% of the variance in overall balanced scorecard value, respectively. The remaining performance indicators contribute only marginally. In addition, a change in the value of a single indicator's target value made the overall balanced scorecard value change by as much as 18%. This may lead to involuntarily biased decisions by organizations regarding performance target-setting, if not prevented with the help of methods such as that proposed and applied in this study. © The Author(s) 2014.
Fluid Balance, Diuretic Use, and Mortality in Acute Kidney Injury
Estrella, Michelle M.; Coresh, Josef; Brower, Roy G.; Liu, Kathleen D.
2011-01-01
Summary Background and objectives Management of volume status in patients with acute kidney injury (AKI) is complex, and the role of diuretics is controversial. The primary objective was to elucidate the association between fluid balance, diuretic use, and short-term mortality after AKI in critically ill patients. Design, setting, participants, & measurements Using data from the Fluid and Catheter Treatment Trial (FACTT), a multicenter, randomized controlled trial evaluating a conservative versus liberal fluid-management strategy in 1000 patients with acute lung injury (ALI), we evaluated the association of post-renal injury fluid balance and diuretic use with 60-day mortality in patients who developed AKI, as defined by the AKI Network criteria. Results 306 patients developed AKI in the first 2 study days and were included in our analysis. There were 137 in the fluid-liberal arm and 169 in the fluid-conservative arm (P = 0.04). Baseline characteristics were similar between groups. Post-AKI fluid balance was significantly associated with mortality in both crude and adjusted analysis. Higher post-AKI furosemide doses had a protective effect on mortality but no significant effect after adjustment for post-AKI fluid balance. There was no threshold dose of furosemide above which mortality increased. Conclusions A positive fluid balance after AKI was strongly associated with mortality. Post-AKI diuretic therapy was associated with 60-day patient survival in FACTT patients with ALI; this effect may be mediated by fluid balance. PMID:21393482
Face verification with balanced thresholds.
Yan, Shuicheng; Xu, Dong; Tang, Xiaoou
2007-01-01
The process of face verification is guided by a pre-learned global threshold, which, however, is often inconsistent with class-specific optimal thresholds. It is, hence, beneficial to pursue a balance of the class-specific thresholds in the model-learning stage. In this paper, we present a new dimensionality reduction algorithm tailored to the verification task that ensures threshold balance. This is achieved by the following aspects. First, feasibility is guaranteed by employing an affine transformation matrix, instead of the conventional projection matrix, for dimensionality reduction, and, hence, we call the proposed algorithm threshold balanced transformation (TBT). Then, the affine transformation matrix, constrained as the product of an orthogonal matrix and a diagonal matrix, is optimized to improve the threshold balance and classification capability in an iterative manner. Unlike most algorithms for face verification which are directly transplanted from face identification literature, TBT is specifically designed for face verification and clarifies the intrinsic distinction between these two tasks. Experiments on three benchmark face databases demonstrate that TBT significantly outperforms the state-of-the-art subspace techniques for face verification.
Life balance and well-being: testing a novel conceptual and measurement approach.
Sheldon, Kennon M; Cummins, Robert; Kamble, Shanmukh
2010-08-01
Although a balanced life has always been viewed as desirable, there are problems with extant conceptualizations and measures of this construct. Here we introduce 2 new life-balance measures, based on time-use profiles, that address these problems. One defines life balance as objectively equitable time use across multiple life domains, and the other defines life balance as low subjective discrepancy between actual and ideal time-use profiles. Study 1 finds that both measures predict concurrent well-being, in both U.S. and Indian samples. Study 2 shows that fluctuations in balance predict fluctuations in well-being over a 3-week period. Study 3 replicates the Study 1 findings using a different time assessment technique, based on the Day Reconstruction Method. Study 4 assigns participants the month-long goal of enhancing their life balance, finding that those who achieve this goal enhance their well-being. In all 4 studies, the balance effects on well-being were mediated by psychological need satisfaction associated with balance.
Should Torsion Balance Technique Continue to be Taught to Pharmacy Students?
Bilger, Rhonda; Chereson, Rasma; Salama, Noha Nabil
2017-06-01
Objective. To determine the types of balances used in compounding pharmacies: torsion or digital. Methods. A survey was mailed to the pharmacist-in-charge at 698 pharmacies, representing 47% of the pharmacies in Missouri as of July 2013. The pharmacies were randomly selected and stratified by region into eight regions to ensure a representative sample. Information was gathered regarding the type and use of balances and pharmacists' perspectives on the need to teach torsion balance technique to pharmacy students. Results. The response rate for the survey was 53.3%. Out of the total responses received, those pharmacies having a torsion balance, digital balance or both were 46.8%, 27.4% and 11.8%, respectively. About 68.3% of respondents compound prescriptions. The study showed that 52% of compounding pharmacies use torsion balances in their practice. Of those with a balance in their pharmacy, 65.6% favored continuation of torsion balance instruction. Conclusions. Digital balances have become increasingly popular and have replaced torsion balances in some pharmacies, especially those that compound a significant number of prescriptions. The results of this study indicate that torsion balances remain integral to compounding practice. Therefore, students should continue being taught torsion balance technique at the college.
Should Torsion Balance Technique Continue to be Taught to Pharmacy Students?
Bilger, Rhonda; Chereson, Rasma
2017-01-01
Objective. To determine the types of balances used in compounding pharmacies: torsion or digital. Methods. A survey was mailed to the pharmacist-in-charge at 698 pharmacies, representing 47% of the pharmacies in Missouri as of July 2013. The pharmacies were randomly selected and stratified by region into eight regions to ensure a representative sample. Information was gathered regarding the type and use of balances and pharmacists’ perspectives on the need to teach torsion balance technique to pharmacy students. Results. The response rate for the survey was 53.3%. Out of the total responses received, those pharmacies having a torsion balance, digital balance or both were 46.8%, 27.4% and 11.8%, respectively. About 68.3% of respondents compound prescriptions. The study showed that 52% of compounding pharmacies use torsion balances in their practice. Of those with a balance in their pharmacy, 65.6% favored continuation of torsion balance instruction. Conclusions. Digital balances have become increasingly popular and have replaced torsion balances in some pharmacies, especially those that compound a significant number of prescriptions. The results of this study indicate that torsion balances remain integral to compounding practice. Therefore, students should continue being taught torsion balance technique at the college. PMID:28720913
Treleaven, Julia; Peterson, Gunnel; Ludvigsson, Maria Landén; Kammerlind, Ann-Sofi; Peolsson, Anneli
2016-04-01
Dizziness and unsteadiness are common symptoms following a whiplash injury. To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizziness. A sub-analysis of a randomized study. One hundred and forty subjects were randomized to either a physiotherapist-guided neck-specific exercise (NSE), physiotherapist-guided neck-specific exercise, with a behavioural approach (NSEB) or prescription of general physical activity (PPA) group. Pre intervention, 3, 6 and 12 months post baseline they completed the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Visual Analogue Scales (VAS) for, dizziness at rest and during activity and physical measures (static and dynamic clinical balance tests and head repositioning accuracy (HRA)). There were significant time by group differences with respect to dizziness during activity and UCLA-Q favouring the physiotherapy led neck specific exercise group with a behavioural approach. Within group analysis of changes over time also revealed significant changes in most variables apart from static balance. Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.
Dynamics and control of robot for capturing objects in space
NASA Astrophysics Data System (ADS)
Huang, Panfeng
Space robots are expected to perform intricate tasks in future space services, such as satellite maintenance, refueling, and replacing the orbital replacement unit (ORU). To realize these missions, the capturing operation may not be avoided. Such operations will encounter some challenges because space robots have some unique characteristics unfound on ground-based robots, such as, dynamic singularities, dynamic coupling between manipulator and space base, limited energy supply and working without a fixed base, and so on. In addition, since contacts and impacts may not be avoided during capturing operation. Therefore, dynamics and control problems of space robot for capturing objects are significant research topics if the robots are to be deployed for the space services. A typical servicing operation mainly includes three phases: capturing the object, berthing and docking the object, then repairing the target. Therefore, this thesis will focus on resolving some challenging problems during capturing the object, berthing and docking, and so on. In this thesis, I study and analyze the dynamics and control problems of space robot for capturing objects. This work has potential impact in space robotic applications. I first study the contact and impact dynamics of space robot and objects. I specifically focus on analyzing the impact dynamics and mapping the relationship of influence and speed. Then, I develop the fundamental theory for planning the minimum-collision based trajectory of space robot and designing the configuration of space robot at the moment of capture. To compensate for the attitude of the space base during the capturing approach operation, a new balance control concept which can effectively balance the attitude of the space base using the dynamic couplings is developed. The developed balance control concept helps to understand of the nature of space dynamic coupling, and can be readily applied to compensate or minimize the disturbance to the space base. After capturing the object, the space robot must complete the following two tasks: one is to berth the object, and the other is to re-orientate the attitude of the whole robot system for communication and power supply. Therefore, I propose a method to accomplish these two tasks simultaneously using manipulator motion only. The ultimate goal of space services is to realize the capture and manipulation autonomously. Therefore, I propose an affective approach based on learning human skill to track and capture the objects automatically in space. With human-teaching demonstration, the space robot is able to learn and abstract human tracking and capturing skill using an efficient neural-network learning architecture that combines flexible Cascade Neural Networks with Node Decoupled Extended Kalman Filtering (CNN-NDEKF). The simulation results attest that this approach is useful and feasible in tracking trajectory planning and capturing of space robot. Finally I propose a novel approach based on Genetic Algorithms (GAs) to optimize the approach trajectory of space robots in order to realize effective and stable operations. I complete the minimum-torque path planning in order to save the limited energy in space, and design the minimum jerk trajectory for the stabilization of the space manipulator and its space base. These optimal algorithms are very important and useful for the application of space robot.
A Balanced Comparison of Object Invariances in Monkey IT Neurons.
Ratan Murty, N Apurva; Arun, Sripati P
2017-01-01
Our ability to recognize objects across variations in size, position, or rotation is based on invariant object representations in higher visual cortex. However, we know little about how these invariances are related. Are some invariances harder than others? Do some invariances arise faster than others? These comparisons can be made only upon equating image changes across transformations. Here, we targeted invariant neural representations in the monkey inferotemporal (IT) cortex using object images with balanced changes in size, position, and rotation. Across the recorded population, IT neurons generalized across size and position both stronger and faster than to rotations in the image plane as well as in depth. We obtained a similar ordering of invariances in deep neural networks but not in low-level visual representations. Thus, invariant neural representations dynamically evolve in a temporal order reflective of their underlying computational complexity.
Salisbury, Joseph P; Keshav, Neha U; Sossong, Anthony D
2018-01-01
Background Lightweight and portable devices that objectively measure concussion-related impairments could improve injury detection and critical decision-making in contact sports and the military, where brain injuries commonly occur but remain underreported. Current standard assessments often rely heavily on subjective methods such as symptom self-reporting. Head-mounted wearables, such as smartglasses, provide an emerging platform for consideration that could deliver the range of assessments necessary to develop a rapid and objective screen for brain injury. Standing balance assessment, one parameter that may inform a concussion diagnosis, could theoretically be performed quantitatively using current off-the-shelf smartglasses with an internal accelerometer. However, the validity of balance measurement using smartglasses has not been investigated. Objective This study aimed to perform preliminary validation of a smartglasses-based balance accelerometer measure (BAM) compared with the well-described and characterized waist-based BAM. Methods Forty-two healthy individuals (26 male, 16 female; mean age 23.8 [SD 5.2] years) participated in the study. Following the BAM protocol, each subject performed 2 trials of 6 balance stances while accelerometer and gyroscope data were recorded from smartglasses (Glass Explorer Edition). Test-retest reliability and correlation were determined relative to waist-based BAM as used in the National Institutes of Health’s Standing Balance Toolbox. Results Balance measurements obtained using a head-mounted wearable were highly correlated with those obtained through a waist-mounted accelerometer (Spearman rho, ρ=.85). Test-retest reliability was high (intraclass correlation coefficient, ICC2,1=0.85, 95% CI 0.81-0.88) and in good agreement with waist balance measurements (ICC2,1=0.84, 95% CI 0.80-0.88). Considering the normalized path length magnitude across all 3 axes improved interdevice correlation (ρ=.90) while maintaining test-retest reliability (ICC2,1=0.87, 95% CI 0.83-0.90). All subjects successfully completed the study, demonstrating the feasibility of using a head-mounted wearable to assess balance in a healthy population. Conclusions Balance measurements derived from the smartglasses-based accelerometer were consistent with those obtained using a waist-mounted accelerometer. Additional research is necessary to determine to what extent smartglasses-based accelerometry measures can detect balance dysfunction associated with concussion. However, given the potential for smartglasses to perform additional concussion-related assessments in an integrated, wearable platform, continued development and validation of a smartglasses-based balance assessment is warranted. This approach could lead to a wearable platform for real-time assessment of concussion-related impairments that could be further augmented with telemedicine capabilities to integrate professional clinical guidance. Smartglasses may be superior to fully immersive virtual reality headsets for this application, given their lighter weight and reduced likelihood of potential safety concerns. PMID:29362210
Observing Black History in Elementary Schools.
ERIC Educational Resources Information Center
Wilson, Herbert A.
Five lesson plans that were prepared for Black History Month can be used to teach purposeful, interesting, and reasonably balanced black history to students in grades 3-6. Objectives for preparing black studies units are to: (1) make reasonably balanced presentations through social studies, language arts, music, and other appropriate subject…
Cumulative soil water evaporation as a function of depth and time
USDA-ARS?s Scientific Manuscript database
Soil water evaporation is an important component of the surface water balance and the surface energy balance. Accurate and dynamic measurements of soil water evaporation enhance the understanding of water and energy partitioning at the land-atmosphere interface. The objective of this study is to mea...
THE WATER BALANCE OF THE SUSQUEHANNA RIVER BASIN AND ITS RESPONSE TO CLIMATE CHANGE. (R824995)
Historical precipitation, temperature and streamflow data for the Susquehanna River Basin (SRB) are analyzed with the objective of developing simple statistical and water balance models of streamflow at the watershed's outlet. Annual streamflow is highly corre...
The Effects of Exercise Advertising on Self-efficacy and Decisional Balance
ERIC Educational Resources Information Center
Berry, Tanya R.; Howe, Bruce L.
2005-01-01
Objectives: To investigate the effects of exercise advertising on self-efficacy and decisional balance for changing exercise behavior. Methods: One hundred seventy-four university students (females = 108; males = 66) watched a video that contained health, appearance, or control advertising and completed stage of change, exercise self-efficacy, and…
Task oriented training improves the balance outcome & reducing fall risk in diabetic population.
Ghazal, Javeria; Malik, Arshad Nawaz; Amjad, Imran
2016-01-01
The objective was to determine the balance impairments and to compare task oriented versus traditional balance training in fall reduction among diabetic patients. The randomized control trial with descriptive survey and 196 diabetic patients were recruited to assess balance impairments through purposive sampling technique. Eighteen patients were randomly allocated into two groups; task oriented balance training group TOB (n=8) and traditional balance training group TBT (n=10). The inclusion criteria were 30-50 years age bracket and diagnosed cases of Diabetes Mellitus with neuropathy. The demographics were taken through standardized & valid assessment tools include Berg Balance Scale and Functional Reach Test. The measurements were obtained at baseline, after 04 and 08 weeks of training. The mean age of the participants was 49 ±6.79. The result shows that 165(84%) were at moderate risk of fall and 31(15%) were at mild risk of fall among total 196 diabetic patients. There was significant improvement (p <0.05) in task oriented balance training group for dynamic balance, anticipatory balance and reactive balance after 8 weeks of training as compare to traditional balance training. Task oriented balance training is effective in improving the dynamic, anticipator and reactive balance. The task oriented training reduces the risk of falling through enhancing balance outcome.
Conscientious objection: personal and professional ethics in the public square.
Montgomery, Jonathan
2015-01-01
English law expects health professionals to have, and act upon, consciences, but formal conscience clauses are not the main legal recognition of this expectation. Rather, they should be regarded as an anomaly with roots in very specific political settlements between society and health professions, whose legitimacy is historically contingent, and as an aspect of the 'price' to be paid for securing services. There are sound reasons for the protection of conscientious discretion as an aspect of professional identify, but specific rights of personal conscientious objection are difficult to reconcile with legitimate public expectations of comprehensive and non-discriminatory services. Professional identities include moral commitments, such as the privileging of patient safety over administrative convenience. These should not be permitted to be overridden by personal moralities during the course of service delivery (as opposed to debating in the abstract what the proper courses of action should be). Consequently, formal conscientious objection clauses should be reduced to a minimum and regularly revisited. It is generally more satisfactory to address clashes between the personal moralities of professionals and public expectations through more flexible means, enabling accommodation of a plurality of views where possible but acknowledging that this is a matter of striking an appropriate balance. Employment law rather than healthcare law provides the best mechanism for regulating this process. © The Author [2015]. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.
Miller, Carol A; Williams, Jennifer E; Durham, Katey L; Hom, Selena C; Smith, Julie L
2017-10-01
Many individuals with lower limb loss report concern with walking ability after completing structured traditional rehabilitation. The purpose of this study was to explore the impact of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation. Repeated measures. The supervised exercise program was offered biweekly for 6 weeks. The GAITRite System by CIR Systems, Inc., the Figure-of-8 Walk Test, and Activity-specific Balance Confidence Scale were used to measure clinical outcomes pre- and post-intervention. In total, 16 participants with lower limb amputation (mean age: 50.8 years) completed the study. A multivariate, repeated measures analysis of variance indicated a statistically significant effect of training across six clinical outcome measures ( F(6, 10) = 4.514, p = .018). Moderate effect sizes were found for the Figure-of-8 Walk Test ( η 2 = .586), Activity-specific Balance Confidence Scale ( η 2 = .504), and gait velocity at comfortable walking speed ( η 2 = .574). The average increase in gait speed was clinically meaningful at .14 m/s. The supervised community-based exercise program implemented in this study was designed to address specific functional needs for individuals with lower limb loss. Each participant experienced clinically meaningful improvements in balance, balance confidence, and walking ability. Clinical relevance The provision of a supervised community-based exercise program, after traditional rehabilitation, provides opportunity to offer a continuum of care that may enhance prosthetic functional ability and active participation in the community for individuals with lower limb amputation.
Chronic Ankle Instability: Evolution of the Model
Hiller, Claire E.; Kilbreath, Sharon L.; Refshauge, Kathryn M.
2011-01-01
Abstract Context: The Hertel model of chronic ankle instability (CAI) is commonly used in research but may not be sufficiently comprehensive. Mechanical instability and functional instability are considered part of a continuum, and recurrent sprain occurs when both conditions are present. A modification of the Hertel model is proposed whereby these 3 components can exist independently or in combination. Objective: To examine the fit of data from people with CAI to 2 CAI models and to explore whether the different subgroups display impairments when compared with a control group. Design: Cross-sectional study. Patients or Other Participants: Community-dwelling adults and adolescent dancers were recruited: 137 ankles with ankle sprain for objective 1 and 81 with CAI and 43 controls for objective 2. Intervention(s): Two balance tasks and time to recover from an inversion perturbation were assessed to determine if the subgroups demonstrated impairments when compared with a control group (objective 2). Main Outcome Measure(s): For objective 1 (fit to the 2 models), outcomes were Cumberland Ankle Instability Tool score, anterior drawer test results, and number of sprains. For objective 2, outcomes were 2 balance tasks (number of foot lifts in 30 seconds, ability to balance on the ball of the foot) and time to recover from an inversion perturbation. The Cohen d was calculated to compare each subgroup with the control group. Results: A total of 56.5% of ankles (n = 61) fit the Hertel model, whereas all ankles (n = 108) fit the proposed model. In the proposed model, 42.6% of ankles were classified as perceived instability, 30.5% as recurrent sprain and perceived instability, and 26.9% as among the remaining groups. All CAI subgroups performed more poorly on the balance and inversion-perturbation tasks than the control group. Subgroups with perceived instability had greater impairment in single-leg stance, whereas participants with recurrent sprain performed more poorly than the other subgroups when balancing on the ball of the foot. Only individuals with hypomobility appeared unimpaired when recovering from an inversion perturbation. Conclusions: The new model of CAI is supported by the available data. Perceived instability alone and in combination characterized the majority of participants. Several impairments distinguished the sprain groups from the control group. PMID:21391798
Verzola, Adriano; Bentivegna, Roberto; Carandina, Gianni; Trevisani, Lucio; Gregorio, Pasquale; Mandini, Alberto
2009-01-01
Background and Aims One of the best-known performance planning and evaluation techniques utilising both monetary and non-monetary data is the Balanced Scorecard (BSC). This is a means of rationalising the global activity of a business in the attempt to create value, and to translate the company vision into a set of tactical objectives and measurable strategies. The aim of this study was to implement and evaluate the use of BSC in two departments of the St. Anna University Hospital, Ferrara: the Analysis Laboratory and Digestive Endoscopy operating units (OU). Materials and methods With the collaboration of the health workers involved, a precise methodological programme was pursued: Definition of the strategic map from 4 perspectives, according to Kaplan and Norton, Definition of the Key Performance Areas (KPA), or macro-objectives, Identification of the cause-effect relationships between KPAs, Identification of the sub-objectives of each KPA, Definition of the Key Performance Indicators (KPI), Definition of the weight/importance of each objective in the global evaluation. Results The information gathered permitted the definition of macro- and sub-objectives for each perspective, as well as determining the relevant indicators, standards, weights, frequency of detection and means of acquisition. Strategic maps showing the cause/effect relationships in each OU were created, as were 'evaluation panels', which describe the global performance of each department. For each perspective, the fundamental data were summarised in one table. Evaluation of each perspective yielded a positive result for the majority of the objectives, and the global result (including all 4 perspectives) was found to be satisfactory. Discussion-Conclusion The Balanced Scorecard was implemented in the abovementioned OUs of St. Anna University Hospital, Ferrara, after the health workers themselves realised the need for change. In our research the employees were pleased to be evaluated, not only for the financial outcomes, but also for the satisfaction of improving internal procedure, relationships with the community and their own growth/learning. BSC is an ideal point of contact between the financial and clinical dimensions of management. However, difficulties in its application were faced, among these, at least in the initial phase, the lack of information systems able to drive it, and the complexity of the research for specific indicators needed to be overcome. The time factor (on average, at least two years are required) and the availability of technological resources were also limiting factors. The rapid diffusion of BSC among the principal international profit and non-profit organisations is testament to its great potential. This project could be seen as a preparatory phase in the strategical analysis of a subsequent business plan. PMID:19737409
Rodríguez López, Santiago; Nilsson, Charlotte; Lund, Rikke; Montero, Pilar; Fernández-Ballesteros, Rocío; Avlund, Kirsten
2012-01-01
This study investigates the association between socioeconomic status (SES) and dynamic balance performance and whether lifestyle factors explained any possible associations. A total of 448 nondisabled individuals, age-range 54-75 years and enrolled in the Active Aging Longitudinal Study of Spain in 2006, constituted the study population. Baseline data of this cross-sectional study were obtained by personal interviews and objective measures of balance performance. The present study shows an educational gradient in poor dynamic balance, where individuals with no formal education had higher risk of poor balance, also after adjustment for age, gender, obesity and physical activity. In addition, obesity and sedentary physical activity were related to poor dynamic balance. The findings suggest an independent effect of both SES and behavioral factors on poor balance performance in the older Spanish population. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Risco, Ester; Zabalegui, Adelaida; Miguel, Susana; Farré, Marta; Alvira, Carme; Cabrera, Esther
To describe the implementation of the Balance of Care model in decision-making regarding the best care for patients with dementia in Spain. The Balance of Care model was used, which consists of (1) describing the profile of the typical cases of people with dementia and their caregivers, (2) identifying the most suitable care setting for each of the cases (home-care or long-term care institution), (3) designing specific care plans for each case, and (4) evaluating the cost of the proposed care plans. A total of 1,641 people with dementia and their caregivers from eight European countries were used in the case design. The evaluation of cases was conducted by 20 experts in different medical fields of dementia. In Spain, the results indicated that initially the most suitable placement to take care of people with dementia was the home, however in cases with higher dependency in activities of daily living, the long-term care setting was the best option. For the best care plan, the following resources were chosen: professional help to perform basic activities; day center; multidisciplinary home care team; financial support; community nurse; and social worker. The Balance of Care method allows us to assess the most appropriate place of care for people with dementia systematically, objectively and with a multidisciplinary team. Other cost-effective interventions should be integrated in patients with dementia care in order to improve home care. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
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 balance of bottom-up and top-down in linking climate policies
NASA Astrophysics Data System (ADS)
Green, Jessica F.; Sterner, Thomas; Wagner, Gernot
2014-12-01
Top-down climate negotiations embodied by the Kyoto Protocol have all but stalled, chiefly because of disagreements over targets and objections to financial transfers. To avoid those problems, many have shifted their focus to linkage of bottom-up climate policies such as regional carbon markets. This approach is appealing, but we identify four obstacles to successful linkage: different levels of ambition; competing domestic policy objectives; objections to financial transfers; and the difficulty of close regulatory coordination. Even with a more decentralized approach, overcoming the 'global warming gridlock' of the intergovernmental negotiations will require close international coordination. We demonstrate how a balance of bottom-up and top-down elements can create a path toward an effective global climate architecture.
Bohannon, Richard W
2012-01-01
Measures of balance are an important component of the physical therapist examination. This study investigated the usefulness of timed static stance durations for identifying balance impairments among patients receiving home-based physical therapy. This study involved the retrospective retrieval of data from the records of 48 patients at least 60 years of age. Their balance was measured under 3 foot configurations; that is, feet apart, feet together, and on each foot. Every patient demonstrated impaired standing balance. Most, but not all could balance 30 seconds with the feet apart or together. Only 19 could maintain balance on each of both feet. Of those who could so balance, none was able to achieve the average time of normal individuals of comparable age. Although not able to identify all aspects of balance, timed durations of stance under different configurations demonstrate a high prevalence of balance impairments among patients receiving home-based physical therapy. As the tests are objective, fast, and require little space, they can be advocated in such a setting.
Collado-Mateo, D; Gallego-Diaz, J M; Adsuar, J C; Domínguez-Muñoz, F J; Olivares, P R; Gusi, N
2015-01-01
To evaluate fear of falling, number of falls, and balance performance in women with FM and to examine the relationship between these variables and others, such as balance performance, quality of life, age, pain, and impact of fibromyalgia. A total of 240 women participated in this cross-sectional study. Of these, 125 had fibromyalgia. Several variables were assessed: age, fear of falling from 0 to 100, number of falls, body composition, balance performance, lower limb strength, health-related quality of life, and impact of fibromyalgia. Women with fibromyalgia reported more falls and more fear of falling. Fear of falling was associated with number of falls in the last year, stiffness, perceived balance problems, impact of FM, and HRQoL whereas the number of falls was related to fear of falling, balance performance with eyes closed, pain, tenderness to touch level, anxiety, self-reported balance problems, impact of FM, and HRQoL. FM has an impact on fear of falling, balance performance, and number of falls. Perceived balance problems seem to be more closely associated with fear of falling than objective balance performance.
Joseph E. de Steiguer; Leslie Liberti; Albert Schuler; Bruce Hansen
2003-01-01
Foresters and natural resource managers must balance conflicting objectives when developing land-management plans. Conflicts may encompass economic, environmental, social, cultural, technical, and aesthetic objectives. Selecting the best combination of management uses from numerous objectives is difficult and challenging. Multi-Criteria Decision Models (MCDM) provide a...
Prestimulus alpha-band power biases visual discrimination confidence, but not accuracy.
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.
Analyzing Variability in Ebola-Related Controls Applied to Returned Travelers in the United States
Siedner, Mark J.; Stoto, Michael A.
2015-01-01
Public health authorities have adopted entry screening and subsequent restrictions on travelers from Ebola-affected West African countries as a strategy to prevent importation of Ebola virus disease (EVD) cases. We analyzed international, federal, and state policies—principally based on the policy documents themselves and media reports—to evaluate policy variability. We employed means-ends fit analysis to elucidate policy objectives. We found substantial variation in the specific approaches favored by WHO, CDC, and various American states. Several US states impose compulsory quarantine on a broader range of travelers or require more extensive monitoring than recommended by CDC or WHO. Observed differences likely partially resulted from different actors having different policy goals—particularly the federal government having to balance foreign policy objectives less salient to states. Further, some state-level variation appears to be motivated by short-term political goals. We propose recommendations to improve future policies, which include the following: (1) actors should explicitly clarify their objectives, (2) legal authority should be modernized and clarified, and (3) the federal government should consider preempting state approaches that imperil its goals. PMID:26348222
Heuristics for Multiobjective Optimization of Two-Sided Assembly Line Systems
Jawahar, N.; Ponnambalam, S. G.; Sivakumar, K.; Thangadurai, V.
2014-01-01
Products such as cars, trucks, and heavy machinery are assembled by two-sided assembly line. Assembly line balancing has significant impacts on the performance and productivity of flow line manufacturing systems and is an active research area for several decades. This paper addresses the line balancing problem of a two-sided assembly line in which the tasks are to be assigned at L side or R side or any one side (addressed as E). Two objectives, minimum number of workstations and minimum unbalance time among workstations, have been considered for balancing the assembly line. There are two approaches to solve multiobjective optimization problem: first approach combines all the objectives into a single composite function or moves all but one objective to the constraint set; second approach determines the Pareto optimal solution set. This paper proposes two heuristics to evolve optimal Pareto front for the TALBP under consideration: Enumerative Heuristic Algorithm (EHA) to handle problems of small and medium size and Simulated Annealing Algorithm (SAA) for large-sized problems. The proposed approaches are illustrated with example problems and their performances are compared with a set of test problems. PMID:24790568
Clark, David J; Chatterjee, Sudeshna A; McGuirk, Theresa E; Porges, Eric C; Fox, Emily J; Balasubramanian, Chitralakshmi K
2018-02-01
Walking adaptability tasks are challenging for people with motor impairments. The construct of perceived challenge is typically measured by self-report assessments, which are susceptible to subjective measurement error. The development of an objective physiologically-based measure of challenge may help to improve the ability to assess this important aspect of mobility function. The objective of this study to investigate the use of sympathetic nervous system (SNS) activity measured by skin conductance to gauge the physiological stress response to challenging walking adaptability tasks in people post-stroke. Thirty adults with chronic post-stroke hemiparesis performed a battery of seventeen walking adaptability tasks. SNS activity was measured by skin conductance from the palmar surface of each hand. The primary outcome variable was the percent change in skin conductance level (ΔSCL) between the baseline resting and walking phases of each task. Task difficulty was measured by performance speed and by physical therapist scoring of performance. Walking function and balance confidence were measured by preferred walking speed and the Activities-specific Balance Confidence Scale, respectively. There was a statistically significant negative association between ΔSCL and task performance speed and between ΔSCL and clinical score, indicating that tasks with greater SNS activity had slower performance speed and poorer clinical scores. ΔSCL was significantly greater for low functioning participants versus high functioning participants, particularly during the most challenging walking adaptability tasks. This study supports the use of SNS activity measured by skin conductance as a valuable approach for objectively quantifying the perceived challenge of walking adaptability tasks in people post-stroke. Published by Elsevier B.V.
Clark, David J.; Chatterjee, Sudeshna A.; McGuirk, Theresa E.; Porges, Eric C.; Fox, Emily J.; Balasubramanian, Chitralakshmi K.
2018-01-01
Background Walking adaptability tasks are challenging for people with motor impairments. The construct of perceived challenge is typically measured by self-report assessments, which are susceptible to subjective measurement error. The development of an objective physiologically-based measure of challenge may help to improve the ability to assess this important aspect of mobility function. The objective of this study to investigate the use of sympathetic nervous system (SNS) activity measured by skin conductance to gauge the physiological stress response to challenging walking adaptability tasks in people post-stroke. Methods Thirty adults with chronic post-stroke hemiparesis performed a battery of seventeen walking adaptability tasks. SNS activity was measured by skin conductance from the palmar surface of each hand. The primary outcome variable was the percent change in skin conductance level (ΔSCL) between the baseline resting and walking phases of each task. Task difficulty was measured by performance speed and by physical therapist grading of performance. Walking function and balance confidence were measured by preferred walking speed and the Activities Specific Balance Confidence Scale, respectively. Results There was a statistically significant negative association between ΔSCL and task performance speed and between ΔSCL and clinical score, indicating that tasks with greater SNS activity had slower performance speed and poorer clinical scores. ΔSCL was significantly greater for low functioning participants versus high functioning participants, particularly during the most challenging walking adaptability tasks. Conclusion This study supports the use of SNS activity measured by skin conductance as a valuable approach for objectively quantifying the perceived challenge of walking adaptability tasks in people post-stroke. PMID:29216598
Validity and Reliability of Nintendo Wii Fit Balance Scores
Wikstrom, Erik A.
2012-01-01
Context: Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. Objective: To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Design: Descriptive laboratory study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty-five recreationally active participants (age = 27.0 ± 9.8 years, height = 170.9 ± 9.2 cm, mass = 72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Intervention(s): Participants completed a single-limb–stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Main Outcome Measure(s): Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. Results: All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r < 0.50). Intrasession reliability for Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC] = 0.80) to poor (ICC = 0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with scores ranging from fair (ICC = 0.74) to poor (ICC = 0.29). Conclusions: Wii Fit balance activity scores had poor concurrent validity relative to COP outcomes and SEBT reach distances. In addition, the included Wii Fit balance activity scores generally had poor intrasession and intersession reliability. PMID:22892412
Goble, Daniel J; Cone, Brian L; Fling, Brett W
2014-02-08
The Nintendo Wii Fit was released just over five years ago as a means of improving basic fitness and overall well-being. Despite this broad mission, the Wii Fit has generated specific interest in the domain of neurorehabilitation as a biobehavioral measurement and training device for balance ability. Growing interest in Wii Fit technology is likely due to the ubiquitous nature of poor balance and catastrophic falls, which are commonly seen in older adults and various disability conditions. The present review provides the first comprehensive summary of Wii Fit balance research, giving specific insight into the system's use for the assessment and training of balance. Overall, at the time of the fifth anniversary, work in the field showed that custom applications using the Wii Balance Board as a proxy for a force platform have great promise as a low cost and portable way to assess balance. On the other hand, use of Wii Fit software-based balance metrics has been far less effective in determining balance status. As an intervention tool, positive balance outcomes have typically been obtained using Wii Fit balance games, advocating their use for neurorehabilitative training. Despite this, limited sample sizes and few randomized control designs indicate that research regarding use of the Wii Fit system for balance intervention remains subject to improvement. Future work aimed at conducting studies with larger scale randomized control designs and a greater mechanistic focus is recommended to further advance the efficacy of this impactful neurorehabilitation tool.
2014-01-01
The Nintendo Wii Fit was released just over five years ago as a means of improving basic fitness and overall well-being. Despite this broad mission, the Wii Fit has generated specific interest in the domain of neurorehabilitation as a biobehavioral measurement and training device for balance ability. Growing interest in Wii Fit technology is likely due to the ubiquitous nature of poor balance and catastrophic falls, which are commonly seen in older adults and various disability conditions. The present review provides the first comprehensive summary of Wii Fit balance research, giving specific insight into the system’s use for the assessment and training of balance. Overall, at the time of the fifth anniversary, work in the field showed that custom applications using the Wii Balance Board as a proxy for a force platform have great promise as a low cost and portable way to assess balance. On the other hand, use of Wii Fit software-based balance metrics has been far less effective in determining balance status. As an intervention tool, positive balance outcomes have typically been obtained using Wii Fit balance games, advocating their use for neurorehabilitative training. Despite this, limited sample sizes and few randomized control designs indicate that research regarding use of the Wii Fit system for balance intervention remains subject to improvement. Future work aimed at conducting studies with larger scale randomized control designs and a greater mechanistic focus is recommended to further advance the efficacy of this impactful neurorehabilitation tool. PMID:24507245
2012-01-01
Background There is increasing scientific knowledge about the interaction between physiological (musculoskeletal, neuromuscular, cognitive and sensory) systems and their influence on balance and walking impairments in Parkinson’s disease. We have developed a new conceptual framework for balance training, emphasising specific components of balance control related to Parkinson’s disease symptoms by using highly challenging, progressive and varying training conditions. The primary aim of this proposed randomised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson’s disease. Methods/Design Eighty participants with mild to moderate idiopathic Parkinson’s disease will be recruited and randomly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care. The intervention will consist of a 10-week group training regime (1-hour training, three times per week), which will be led by two physiotherapists to ensure training progression and safety. The conceptual framework will be applied by addressing specific balance components (sensory integration, anticipatory postural adjustments, motor agility, stability limits) through varying training conditions and structured progression. Assessment will be conducted through a multi-dimensional battery of outcomes, prior to and immediately after the 10-week intervention, and at 9 and 15 months’ follow-up after entering the study. Primary outcome measures will be balance performance (assessed using the Mini Balance Evaluation Systems Test), change in gait velocity (m/s) between single and dual task walking, and fear of falling (evaluated using the Fall Efficacy Scale International). Discussion This study has the potential to provide new insight and knowledge of the effects of specific, varied and challenging balance training on a wide health spectrum in elderly with PD. If found to be effective, this pragmatic approach with translation of theory into practice, can be implemented in existing outpatient care. Trial registration NCT01417598 PMID:23017069
Low-cost modular array-field designs for flat-panel and concentrator photovoltaic systems
NASA Astrophysics Data System (ADS)
Post, H. N.; Carmichael, D. C.; Alexander, G.; Castle, J. A.
1982-09-01
Described are the design and development of low-cost, modular array fields for flat-panel and concentrator photovoltaic (PV) systems. The objective of the work was to reduce substantially the cost of the array-field Balance-of-System (BOS) subsystems and site-specific design costs as compared to previous PV installations. These subsystems include site preparation, foundations, support structures, electrical writing, grounding, lightning protection, electromagnetic interference considerations, and controls. To reduce these BOS and design costs, standardized modular (building-block) designs for flat-panel and concentrator array fields have been developed that are fully integrated and optimized for lowest life-cycle costs. Using drawings and specifications now available, these building-block designs can be used in multiples to install various size array fields. The developed designs are immediately applicable (1982) and reduce the array-field BOS costs to a fraction of previous costs.
Development of a two wheeled self balancing robot with speech recognition and navigation algorithm
NASA Astrophysics Data System (ADS)
Rahman, Md. Muhaimin; Ashik-E-Rasul, Haq, Nowab. Md. Aminul; Hassan, Mehedi; Hasib, Irfan Mohammad Al; Hassan, K. M. Rafidh
2016-07-01
This paper is aimed to discuss modeling, construction and development of navigation algorithm of a two wheeled self balancing mobile robot in an enclosure. In this paper, we have discussed the design of two of the main controller algorithms, namely PID algorithms, on the robot model. Simulation is performed in the SIMULINK environment. The controller is developed primarily for self-balancing of the robot and also it's positioning. As for the navigation in an enclosure, template matching algorithm is proposed for precise measurement of the robot position. The navigation system needs to be calibrated before navigation process starts. Almost all of the earlier template matching algorithms that can be found in the open literature can only trace the robot. But the proposed algorithm here can also locate the position of other objects in an enclosure, like furniture, tables etc. This will enable the robot to know the exact location of every stationary object in the enclosure. Moreover, some additional features, such as Speech Recognition and Object Detection, are added. For Object Detection, the single board Computer Raspberry Pi is used. The system is programmed to analyze images captured via the camera, which are then processed through background subtraction, followed by active noise reduction.
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.
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
Crawford, Jarret T; Mallinas, Stephanie R; Furman, Bryan J
2015-12-01
We introduce the balanced ideological antipathy (BIA) model, which challenges assumptions that right-wing authoritarianism (RWA) and social dominance orientation (SDO) predict inter-group antipathy per se. Rather, the effects of RWA and SDO on antipathy should depend on the target's political orientation and political objectives, the specific components of RWA, and the type of antipathy expressed. Consistent with the model, two studies (N = 585) showed that the Traditionalism component of RWA positively and negatively predicted both political intolerance and prejudice toward tradition-threatening and -reaffirming groups, respectively, whereas SDO positively and negatively predicted prejudice (and to some extent political intolerance) toward hierarchy-attenuating and -enhancing groups, respectively. Critically, the Conservatism component of RWA positively predicted political intolerance (but not prejudice) toward each type of target group, suggesting it captures the anti-democratic impulse at the heart of authoritarianism. Recommendations for future research on the relationship between ideological attitudes and inter-group antipathy are discussed. © 2015 by the Society for Personality and Social Psychology, Inc.
Embedded piezoelectrics for sensing and energy harvesting in total knee replacement units
NASA Astrophysics Data System (ADS)
Wilson, Brooke E.; Meneghini, Michael; Anton, Steven R.
2015-04-01
The knee replacement is the second most common orthopedic surgical intervention in the United States, but currently only 1 in 5 knee replacement patients are satisfied with their level of pain reduction one year after surgery. It is imperative to make the process of knee replacement surgery more objective by developing a data driven approach to ligamentous balance, which increases implant life. In this work, piezoelectric materials are considered for both sensing and energy harvesting applications in total knee replacement implants. This work aims to embed piezoelectric material in the polyethylene bearing of a knee replacement unit to act as self-powered sensors that will aid in the alignment and balance of the knee replacement by providing intraoperative feedback to the surgeon. Postoperatively, the piezoelectric sensors can monitor the structural health of the implant in order to perceive potential problems before they become bothersome to the patient. Specifically, this work will present on the use of finite element modeling coupled with uniaxial compression testing to prove that piezoelectric stacks can be utilized to harvest sufficient energy to power sensors needed for this application.
NASA Technical Reports Server (NTRS)
Wood, Eric F.
1993-01-01
The objectives of the research were as follows: (1) Extend the Representative Elementary Area (RE) concept, first proposed and developed in Wood et al, (1988), to the water balance fluxes of the interstorm period (redistribution, evapotranspiration and baseflow) necessary for the analysis of long-term water balance processes. (2) Derive spatially averaged water balance model equations for spatially variable soil, topography and vegetation, over A RANGE OF CLIMATES. This is a necessary step in our goal to derive consistent hydrologic results up to GCM grid scales necessary for global climate modeling. (3) Apply the above macroscale water balance equations with remotely sensed data and begin to explore the feasibility of parameterizing the water balance constitutive equations at GCM grid scale.
Expert Systems on Multiprocessor Architectures. Volume 3. Technical Reports
1991-06-01
choice of load balancing vs. load sharing 1141. While load balancing strives to keep all sites equally loaded, load sharing merely tries to prevent ...unnecessary idleness. Loo. balancing is appropriate to object- oriented real- time systems because * real-time systems ne ,l to prevent long waits for...oetavir ConClass siy51cr Iz a n ubjeU rephitation ’-enare ir order wo prevent a partic=Lar abiec:;ram heing (ntrlu ~lel Ar iic]en:f etautaan ire chanw
Effect of Wii-based balance training on corticomotor excitability post stroke.
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.
Multi-objective game-theory models for conflict analysis in reservoir watershed management.
Lee, Chih-Sheng
2012-05-01
This study focuses on the development of a multi-objective game-theory model (MOGM) for balancing economic and environmental concerns in reservoir watershed management and for assistance in decision. Game theory is used as an alternative tool for analyzing strategic interaction between economic development (land use and development) and environmental protection (water-quality protection and eutrophication control). Geographic information system is used to concisely illustrate and calculate the areas of various land use types. The MOGM methodology is illustrated in a case study of multi-objective watershed management in the Tseng-Wen reservoir, Taiwan. The innovation and advantages of MOGM can be seen in the results, which balance economic and environmental concerns in watershed management and which can be interpreted easily by decision makers. For comparison, the decision-making process using conventional multi-objective method to produce many alternatives was found to be more difficult. Copyright © 2012 Elsevier Ltd. All rights reserved.
Nikdel, Ali; Braatz, Richard D; Budman, Hector M
2018-05-01
Dynamic flux balance analysis (DFBA) has become an instrumental modeling tool for describing the dynamic behavior of bioprocesses. DFBA involves the maximization of a biologically meaningful objective subject to kinetic constraints on the rate of consumption/production of metabolites. In this paper, we propose a systematic data-based approach for finding both the biological objective function and a minimum set of active constraints necessary for matching the model predictions to the experimental data. The proposed algorithm accounts for the errors in the experiments and eliminates the need for ad hoc choices of objective function and constraints as done in previous studies. The method is illustrated for two cases: (1) for in silico (simulated) data generated by a mathematical model for Escherichia coli and (2) for actual experimental data collected from the batch fermentation of Bordetella Pertussis (whooping cough).
A Balanced Comparison of Object Invariances in Monkey IT Neurons
2017-01-01
Abstract Our ability to recognize objects across variations in size, position, or rotation is based on invariant object representations in higher visual cortex. However, we know little about how these invariances are related. Are some invariances harder than others? Do some invariances arise faster than others? These comparisons can be made only upon equating image changes across transformations. Here, we targeted invariant neural representations in the monkey inferotemporal (IT) cortex using object images with balanced changes in size, position, and rotation. Across the recorded population, IT neurons generalized across size and position both stronger and faster than to rotations in the image plane as well as in depth. We obtained a similar ordering of invariances in deep neural networks but not in low-level visual representations. Thus, invariant neural representations dynamically evolve in a temporal order reflective of their underlying computational complexity. PMID:28413827
Ratify, Reject or Revise: Balanced Scorecard and Universities
ERIC Educational Resources Information Center
Sayed, Naqi
2013-01-01
Purpose: The purpose of this paper is to examine the use of the Balanced Scorecard (BSC) in universities. Initially directed toward profit-oriented businesses, the BSC has since been adopted by many non-profit organisations with seemingly diverse objectives. A number of primarily publicly-funded universities and institutions, which are part of…
Strategic Control in the Real World: A Multidisciplinary Function
ERIC Educational Resources Information Center
McGinty, Robert L.; Regel, Roy
2004-01-01
This research paper was developed after completing and publishing articles using the Balanced Scorecard as a means of achieving strategic objectives of over twenty destination ski resorts. We believe the balanced scorecard idea is essentially a new model of the way the world works and should be conceptualized. Our research has helped answer a…
USDA-ARS?s Scientific Manuscript database
Recent findings indicate that double- or relay-cropping winter camelina (Camelina sativa L. Crantz.) with feed or food crops can increase yield per area, improve energy balance, and provide several ecosystem services. Double-cropping can help balance food and energy production. The objective of this...
Work-Family Balance and Academic Advancement in Medical Schools
ERIC Educational Resources Information Center
Fox, Geri; Schwartz, Alan; Hart, Katherine M.
2006-01-01
Objective: This study examines various options that a faculty member might exercise to achieve work-family balance in academic medicine and their consequences for academic advancement. Method: Three data sets were analyzed: an anonymous web-administered survey of part-time tenure track-eligible University of Illinois College of Medicine (UI-COM)…
BALANCER: A Computer Program for Balancing Chemical Equations.
ERIC Educational Resources Information Center
Jones, R. David; Schwab, A. Paul
1989-01-01
Describes the theory and operation of a computer program which was written to balance chemical equations. Software consists of a compiled file of 46K for use under MS-DOS 2.0 or later on IBM PC or compatible computers. Additional specifications of courseware and availability information are included. (Author/RT)
An Analysis of the Algebraic Method for Balancing Chemical Reactions.
ERIC Educational Resources Information Center
Olson, John A.
1997-01-01
Analyzes the algebraic method for balancing chemical reactions. Introduces a third general condition that involves a balance between the total amount of oxidation and reduction. Requires the specification of oxidation states for all elements throughout the reaction. Describes the general conditions, the mathematical treatment, redox reactions, and…
Regaining motor control in musician's dystonia by restoring sensorimotor organization.
Rosenkranz, Karin; Butler, Katherine; Williamon, Aaron; Rothwell, John C
2009-11-18
Professional musicians are an excellent model of long-term motor learning effects on structure and function of the sensorimotor system. However, intensive motor skill training has been associated with task-specific deficiency in hand motor control, which has a higher prevalence among musicians (musician's dystonia) than in the general population. Using a transcranial magnetic stimulation paradigm, we previously found an expanded spatial integration of proprioceptive input into the hand motor cortex [sensorimotor organization (SMO)] in healthy musicians. In musician's dystonia, however, this expansion was even larger. Whereas motor skills of musicians are likely to be supported by a spatially expanded SMO, we hypothesized that in musician's dystonia this might have developed too far and now disrupts rather than assists task-specific motor control. If so, motor control should be regained by reversing the excessive reorganization in musician's dystonia. Here, we test this hypothesis and show that a 15 min intervention with proprioceptive input (proprioceptive training) restored SMO in pianists with musician's dystonia to the pattern seen in healthy pianists. Crucially, task-specific motor control improved significantly and objectively as measured with a MIDI (musical instrument digital interface) piano, and the amount of behavioral improvement was significantly correlated to the degree of sensorimotor reorganization. In healthy pianists and nonmusicians, the SMO and motor performance remained essentially unchanged. These findings suggest that the differentiation of SMO in the hand motor cortex and the degree of motor control of intensively practiced tasks are significantly linked and finely balanced. Proprioceptive training restored this balance in musician's dystonia to the behaviorally beneficial level of healthy musicians.
Arnold, C M; Faulkner, R A; Gyurcsik, N C
2011-01-01
Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. EE participants with low baseline falls efficacy demonstrated significantly (p<0.05) greater improvement in balance and falls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (p<0.05) correlated with positive balance and falls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes.
Faulkner, R.A.; Gyurcsik, N.C.
2011-01-01
ABSTRACT Purpose: Older adults with decreased confidence in their ability to prevent a fall may benefit from an exercise programme that includes self-efficacy-enhancing education. The objectives of this study were to explore differences in fall-risk outcomes in older adults with higher vs. lower levels of falls efficacy and to evaluate the relationship between baseline falls-efficacy status and changes in fall risk factors following two interventions. Method: Fifty-four older adults with hip osteoarthritis and at least one risk factor for falls received aquatic exercise twice weekly plus education once weekly (EE) or aquatic exercise only, twice weekly (EO), for 11 weeks. Results: EE participants with low baseline falls efficacy demonstrated significantly (p<0.05) greater improvement in balance and falls efficacy compared to EE participants with high baseline falls efficacy. In the EE group only, baseline falls-efficacy status (low vs. high median split on the Activities-specific Balance Confidence Scale) was significantly (p<0.05) correlated with positive balance and falls-efficacy change scores (Spearman rank r=0.45 and 0.63 respectively). Conclusions: Individuals with one or more fall-risk factors and low falls efficacy may benefit from receiving an intervention that combines exercise with self-efficacy-enhancing education. Falls-efficacy screening may be important for decisions regarding referral to fall-prevention programmes. PMID:22942514
Boldt, Joachim; Suttner, Stephan; Brosch, Christian; Lehmann, Andreas; Röhm, Kerstin; Mengistu, Andinet
2009-03-01
A balanced fluid replacement strategy appears to be promising for correcting hypovolemia. The benefits of a balanced fluid replacement regimen were studied in elderly cardiac surgery patients. In a randomized clinical trial, 50 patients aged >75 years undergoing cardiac surgery received a balanced 6% HES 130/0.42 plus a balanced crystalloid solution (n = 25) or a non-balanced HES in saline plus saline solution (n = 25) to keep pulmonary capillary wedge pressure/central venous pressure between 12-14 mmHg. Acid-base status, inflammation, endothelial activation (soluble intercellular adhesion molecule-1, kidney integrity (kidney-specific proteins glutathione transferase-alpha; neutrophil gelatinase-associated lipocalin) were studied after induction of anesthesia, 5 h after surgery, 1 and 2 days thereafter. Serum creatinine (sCr) was measured approximately 60 days after discharge. A total of 2,750 +/- 640 mL of balanced and 2,820 +/- 550 mL of unbalanced HES were given until the second POD. Base excess (BE) was significantly reduced in the unbalanced (from +1.21 +/- 0.3 to -4.39 +/- 1.0 mmol L(-1) 5 h after surgery; P < 0.001) and remained unchanged in the balanced group (from 1.04 +/- 0.3 to -0.81 +/- 0.3 mmol L(-1) 5 h after surgery). Evolution of the BE was significantly different. Inflammatory response and endothelial activation were significantly less pronounced in the balanced than the unbalanced group. Concentrations of kidney-specific proteins after surgery indicated less alterations of kidney integrity in the balanced than in the unbalanced group. A total balanced volume replacement strategy including a balanced HES and a balanced crystalloid solution resulted in moderate beneficial effects on acid-base status, inflammation, endothelial activation, and kidney integrity compared to a conventional unbalanced volume replacement regimen.
Guzman, Jill; Aktan, Nadine
2016-02-01
Concussions are a major health concern for athletes given the potential for these injuries in a wide range of sport activities. The leading concern for clinicians is that athletes are at risk for devastating consequences if they are not evaluated properly and cleared too early to return to play or competition. The evaluation of postural stability has been identified as an important aspect to the comprehensive management of such injuries. Clinicians are in need of a portable tool they can use in various settings to aid in decision making and health care delivery for concussed athletes. The Nintendo Wii Balance Board (Nintendo of America Inc., Redmond, Washington) is a portable, cost-effective tool that has the potential to aid in the evaluation of postural stability in concussed individuals. The purpose of this study was to evaluate the Wii Balance Board as an objective, user-friendly, cost effective, valid alternative tool for the measurement of postural stability in college athletes. This study questioned whether the Wii Balance Board, when compared to the Balance Error Scoring System (BESS), is an objective tool that can be used as an acceptable measurement of postural stability in college athletes. Copyright © 2015 Elsevier Inc. All rights reserved.
NASA Technical Reports Server (NTRS)
Santi, L. Michael; Helmicki, Arthur J.
1993-01-01
The objective of Phase I of this research effort was to develop an advanced mathematical-empirical model of SSME steady-state performance. Task 6 of Phase I is to develop component specific modification strategy for baseline case influence coefficient matrices. This report describes the background of SSME performance characteristics and provides a description of the control variable basis of three different gains models. The procedure used to establish influence coefficients for each of these three models is also described. Gains model analysis results are compared to Rocketdyne's power balance model (PBM).
The precision problem in conservation and restoration
Hiers, J. Kevin; Jackson, Stephen T.; Hobbs, Richard J.; Bernhardt, Emily S.; Valentine, Leonie E.
2016-01-01
Within the varied contexts of environmental policy, conservation of imperilled species populations, and restoration of damaged habitats, an emphasis on idealized optimal conditions has led to increasingly specific targets for management. Overly-precise conservation targets can reduce habitat variability at multiple scales, with unintended consequences for future ecological resilience. We describe this dilemma in the context of endangered species management, stream restoration, and climate-change adaptation. Inappropriate application of conservation targets can be expensive, with marginal conservation benefit. Reduced habitat variability can limit options for managers trying to balance competing objectives with limited resources. Conservation policies should embrace habitat variability, expand decision-space appropriately, and support adaptation to local circumstances to increase ecological resilience in a rapidly changing world.
Recovery Act: Advanced Direct Methanol Fuel Cell for Mobile Computing
DOE Office of Scientific and Technical Information (OSTI.GOV)
Fletcher, James H.; Cox, Philip; Harrington, William J
2013-09-03
ABSTRACT Project Title: Recovery Act: Advanced Direct Methanol Fuel Cell for Mobile Computing PROJECT OBJECTIVE The objective of the project was to advance portable fuel cell system technology towards the commercial targets of power density, energy density and lifetime. These targets were laid out in the DOE’s R&D roadmap to develop an advanced direct methanol fuel cell power supply that meets commercial entry requirements. Such a power supply will enable mobile computers to operate non-stop, unplugged from the wall power outlet, by using the high energy density of methanol fuel contained in a replaceable fuel cartridge. Specifically this project focusedmore » on balance-of-plant component integration and miniaturization, as well as extensive component, subassembly and integrated system durability and validation testing. This design has resulted in a pre-production power supply design and a prototype that meet the rigorous demands of consumer electronic applications. PROJECT TASKS The proposed work plan was designed to meet the project objectives, which corresponded directly with the objectives outlined in the Funding Opportunity Announcement: To engineer the fuel cell balance-of-plant and packaging to meet the needs of consumer electronic systems, specifically at power levels required for mobile computing. UNF used existing balance-of-plant component technologies developed under its current US Army CERDEC project, as well as a previous DOE project completed by PolyFuel, to further refine them to both miniaturize and integrate their functionality to increase the system power density and energy density. Benefits of UNF’s novel passive water recycling MEA (membrane electrode assembly) and the simplified system architecture it enabled formed the foundation of the design approach. The package design was hardened to address orientation independence, shock, vibration, and environmental requirements. Fuel cartridge and fuel subsystems were improved to ensure effective fuel containment. PROJECT OVERVIEW The University of North Florida (UNF), with project partner the University of Florida, recently completed the Department of Energy (DOE) project entitled “Advanced Direct Methanol Fuel Cell for Mobile Computing”. The primary objective of the project was to advance portable fuel cell system technology towards the commercial targets as laid out in the DOE R&D roadmap by developing a 20-watt, direct methanol fuel cell (DMFC), portable power supply based on the UNF innovative “passive water recovery” MEA. Extensive component, sub-system, and system development and testing was undertaken to meet the rigorous demands of the consumer electronic application. Numerous brassboard (nonpackaged) systems were developed to optimize the integration process and facilitating control algorithm development. The culmination of the development effort was a fully-integrated, DMFC, power supply (referred to as DP4). The project goals were 40 W/kg for specific power, 55 W/l for power density, and 575 Whr/l for energy density. It should be noted that the specific power and power density were for the power section only, and did not include the hybrid battery. The energy density is based on three, 200 ml, fuel cartridges, and also did not include the hybrid battery. The results show that the DP4 system configured without the methanol concentration sensor exceeded all performance goals, achieving 41.5 W/kg for specific power, 55.3 W/l for power density, and 623 Whr/l for energy density. During the project, the DOE revised its technical targets, and the definition of many of these targets, for the portable power application. With this revision, specific power, power density, specific energy (Whr/kg), and energy density are based on the total system, including fuel tank, fuel, and hybridization battery. Fuel capacity is not defined, but the same value is required for all calculations. Test data showed that the DP4 exceeded all 2011 Technical Status values; for example, the DP4 energy density was 373 Whr/l versus the DOE 2011 status of 200 Whr/l. For the DOE 2013 Technical Goals, the operation time was increased from 10 hours to 14.3 hours. Under these conditions, the DP4 closely approached or surpassed the technical targets; for example, the DP4 achieved 468 Whr/l versus the goal of 500 Whr/l. Thus, UNF has successfully met the project goals. A fully-operational, 20-watt DMFC power supply was developed based on the UNF passive water recovery MEA. The power supply meets the project performance goals and advances portable power technology towards the commercialization targets set by the DOE.« less
Okonkwo, Uchenna Prosper; Ibeneme, Sam Chidi; Ihegihu, Ebere Yvonne; Egwuonwu, Afamefuna Victor; Ezema, Charles Ikechukwu; Maruf, Fatai Adesina
2018-05-02
Stroke results in varying levels of physical disabilities that may adversely impact balance with increased tendency to falls. This may intensify with cognitive impairments (CI), and impede functional recovery. Therefore, task-specific balance training (TSBT), which presents versatile task-specific training options that matches varied individual needs, was explored as a beneficial rehabilitation regime for stroke survivors with and without CI. It was hypothesized that there will be no significant difference in the balance control measures in stroke survivors with and without CI after a 12-month TSBT. To determine if TSBT will have comparable beneficial effects on the balance control status of sub-acute ischemic stroke survivors with CI and without CI. One hundred of 143 available sub-acute first ever ischemic stroke survivors were recruited using convenience sampling technique in a quasi-experimental study. They were later assigned into the cognitive impaired group (CIG) and non-cognitive impaired group (NCIG), respectively, based on the baseline presence or absence of CI, after screening with the mini-mental examination (MMSE) tool. With the help of four trained research assistants, TSBT was applied to each group, thrice times a week, 60 mins per session, for 12 months. Their balance was measured as Bergs Balance scores (BBS) at baseline, 4th, 8th, and 12th month intervals. Data were analyzed statistically using Kruskal Wallis test, and repeated measure ANOVA, at p < 0.05. There was significant improvement across time points in the balance control of CIG with large effect size of 0.69 after 12 months of TSBT. There was also significant improvement across time points in the balance control of NCIG with large effect size of 0.544 after 12 months of TSBT. There was no significant difference between the improvement in CIG and NCIG after 8th and 12th months of TSBT. Within the groups, a 12-month TSBT intervention significantly improved balance control, respectively, but with broader effects in the CIG than NCIG. Importantly, though between-group comparison at baseline revealed significantly impaired balance control in the CIG than NCIG, these differences were not significant at the 8th month and non-existent at the 12th month of TSBT intervention. These results underscore the robustness of TSBT to evenly address specific balance deficits of stroke survivors with and without CI within a long-term rehabilitation plan as was hypothesized.
MultiMetEval: Comparative and Multi-Objective Analysis of Genome-Scale Metabolic Models
Gevorgyan, Albert; Kierzek, Andrzej M.; Breitling, Rainer; Takano, Eriko
2012-01-01
Comparative metabolic modelling is emerging as a novel field, supported by the development of reliable and standardized approaches for constructing genome-scale metabolic models in high throughput. New software solutions are needed to allow efficient comparative analysis of multiple models in the context of multiple cellular objectives. Here, we present the user-friendly software framework Multi-Metabolic Evaluator (MultiMetEval), built upon SurreyFBA, which allows the user to compose collections of metabolic models that together can be subjected to flux balance analysis. Additionally, MultiMetEval implements functionalities for multi-objective analysis by calculating the Pareto front between two cellular objectives. Using a previously generated dataset of 38 actinobacterial genome-scale metabolic models, we show how these approaches can lead to exciting novel insights. Firstly, after incorporating several pathways for the biosynthesis of natural products into each of these models, comparative flux balance analysis predicted that species like Streptomyces that harbour the highest diversity of secondary metabolite biosynthetic gene clusters in their genomes do not necessarily have the metabolic network topology most suitable for compound overproduction. Secondly, multi-objective analysis of biomass production and natural product biosynthesis in these actinobacteria shows that the well-studied occurrence of discrete metabolic switches during the change of cellular objectives is inherent to their metabolic network architecture. Comparative and multi-objective modelling can lead to insights that could not be obtained by normal flux balance analyses. MultiMetEval provides a powerful platform that makes these analyses straightforward for biologists. Sources and binaries of MultiMetEval are freely available from https://github.com/PiotrZakrzewski/MetEval/downloads. PMID:23272111
Do kinematic metrics of walking balance adapt to perturbed optical flow?
Thompson, Jessica D; Franz, Jason R
2017-08-01
Visual (i.e., optical flow) perturbations can be used to study balance control and balance deficits. However, it remains unclear whether walking balance control adapts to such perturbations over time. Our purpose was to investigate the propensity for visuomotor adaptation in walking balance control using prolonged exposure to optical flow perturbations. Ten subjects (age: 25.4±3.8years) walked on a treadmill while watching a speed-matched virtual hallway with and without continuous mediolateral optical flow perturbations of three different amplitudes. Each of three perturbation trials consisted of 8min of prolonged exposure followed by 1min of unperturbed walking. Using 3D motion capture, we analyzed changes in foot placement kinematics and mediolateral sacrum motion. At their onset, perturbations elicited wider and shorter steps, alluding to a more cautious, general anticipatory balance control strategy. As perturbations continued, foot placement tended toward values seen during unperturbed walking while step width variability and mediolateral sacrum motion concurrently increased. Our findings suggest that subjects progressively shifted from a general anticipatory balance control strategy to a reactive, task-specific strategy using step-to-step adjustments. Prolonged exposure to optical flow perturbations may have clinical utility to reinforce reactive, task-specific balance control through training. Copyright © 2017 Elsevier B.V. All rights reserved.
Variable-Position Acoustic Levitation
NASA Technical Reports Server (NTRS)
Barmatz, M. B.; Stoneburner, J. D.; Jacobi, N.; Wang, T. G.
1983-01-01
Method of acoustic levitation supports objects at positions other than acoustic nodes. Acoustic force is varied so it balances gravitational (or other) force, thereby maintaining object at any position within equilibrium range. Levitation method applicable to containerless processing. Such objects as table-tennis balls, hollow plastic spheres, and balsa-wood spheres levitated in laboratory by new method.
Sex Differences in Balance Among Alpine Ski Racers: Cross-Sectional Age Comparisons.
Raschner, Christian; Hildebrandt, Carolin; Mohr, Johanna; Müller, Lisa
2017-12-01
Although balance is a key ability in the strength demands of alpine ski racing, affecting both performance and injury prevention, few studies have examined balance or related sex differences among still-maturing athletes. In this 10-year study, we investigated cross-sectional balance performances at different age periods of a representative sample of over 500 11-18-year-old elite skiers of both genders. Participants performed balance tests using the MFT S3-Check. Left-right and forward-backward movements were used to calculate sensory and symmetry balance scores, which were both incorporated into a stability score. Mann-Whitney U tests assessed gender-specific differences by age-group with a significance level set at p < .05. Results showed gender differences only on forward-backward measurements for 14-16-year-olds, with females showing better stability and sensory (but not symmetry) scores than males. Thus, gender interacted with age and maturation to influence balance ability in these participants. Additionally, these rare 10-year data support coaches in their training and talent development of maturing athletes by providing important sport-, age-, and gender-specific normative comparison data for individual trainees.
Kung-fu versus swimming training and the effects on balance abilities in young adolescents.
Baccouch, Rym; Rebai, Haithem; Sahli, Sonia
2015-11-01
Our purpose is to investigate the static balance control of young adolescents practicing kung-fu and swimming in order to find out which of these physical activities is the most effective in developing specific balance abilities in young adolescents. Comparative experimental study. University laboratory research. Three groups of 11-13-year-old boys (12 practicing Kung-Fu, 12 practicing swimming and 12 controls). Center of pressure (CoP) excursions were registered in upright bipedal and unipedal stances on a stabilometric force platform in eyes open (EO) and eyes closed (EC) conditions. Kung-fu practitioners control their balance (P < .05) better than controls and swimmers in the unipedal posture when visual inputs are available. Kung-fu training improved (P < .05) the bipedal balance control in the EO condition. However, swimming training developed (P < .05) bipedal balance control in both EO and EC conditions. The swimmers showed a lower reliance on vision (P < .05) compared to kung-fu practitioners. Both of these physical activities could be recommended for young adolescents as recreational or rehabilitation programs as they develop specific balance abilities that could be important for improving and maintaining optimal health. Copyright © 2015 Elsevier Ltd. All rights reserved.
Gschwind, Yves J; Kressig, Reto W; Lacroix, Andre; Muehlbauer, Thomas; Pfenninger, Barbara; Granacher, Urs
2013-10-09
With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested. Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale - International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version ('3 times 3') that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period. It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose-response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention.
NASA Astrophysics Data System (ADS)
Azmi, N. I. L. Mohd; Ahmad, R.; Zainuddin, Z. M.
2017-09-01
This research explores the Mixed-Model Two-Sided Assembly Line (MMTSAL). There are two interrelated problems in MMTSAL which are line balancing and model sequencing. In previous studies, many researchers considered these problems separately and only few studied them simultaneously for one-sided line. However in this study, these two problems are solved simultaneously to obtain more efficient solution. The Mixed Integer Linear Programming (MILP) model with objectives of minimizing total utility work and idle time is generated by considering variable launching interval and assignment restriction constraint. The problem is analysed using small-size test cases to validate the integrated model. Throughout this paper, numerical experiment was conducted by using General Algebraic Modelling System (GAMS) with the solver CPLEX. Experimental results indicate that integrating the problems of model sequencing and line balancing help to minimise the proposed objectives function.
Tanaka, Erika H.; Santos, Paulo F.; Reis, Júlia G.; Rodrigues, Natalia C.; Moraes, Renato; Abreu, Daniela C. C.
2015-01-01
Background: Risk of falls increases as age advances. Complaints of impaired balance are very common in the elderly age group. Objectives: The objective of this study was to investigate whether the subjective perception of impaired balance was associated with deficits in postural control (objective analysis) in elderly community-dwelling women. Method: Static posturography was used in two groups: elderly women with (WC group) and without (NC group) complaints of impaired balance. The area, mean sway amplitude and mean speed of the center of pressure (COP) in the anterior-posterior (AP) and medial-lateral (ML) directions were analyzed in three stances: single-leg stance, double-leg stance and tandem stance, with eyes open or closed on two different surfaces: stable (firm) and unstable (foam). A digital chronometer was activated to measure the time limit (Tlimit) in the single-leg stance. Kruskal-Wallis tests followed by Mann-Whitney tests, Friedman analyses followed by post hoc Wilcoxon tests and Bonferroni corrections, and Spearman statistical tests were used in the data analysis. Differences of p<0.05 were considered statistically significant. Results: The results of posturography variables revealed no differences between groups. The timed single-leg stance test revealed a shorter Tlimit in the left single-leg stance (p=0.01) in WC group compared to NC group. A negative correlation between posturography variables and Tlimit was detected. Conclusions: Posturography did not show any differences between the groups; however, the timed single-leg stance allowed the authors to observe differences in postural control performance between elderly women with and those without complaints of impaired balance. PMID:26083602
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 slightly higher interrater reliability and ability to differentiate participants' fall status. © 2016 American Physical Therapy Association.
Application of model predictive control for optimal operation of wind turbines
NASA Astrophysics Data System (ADS)
Yuan, Yuan; Cao, Pei; Tang, J.
2017-04-01
For large-scale wind turbines, reducing maintenance cost is a major challenge. Model predictive control (MPC) is a promising approach to deal with multiple conflicting objectives using the weighed sum approach. In this research, model predictive control method is applied to wind turbine to find an optimal balance between multiple objectives, such as the energy capture, loads on turbine components, and the pitch actuator usage. The actuator constraints are integrated into the objective function at the control design stage. The analysis is carried out in both the partial load region and full load region, and the performances are compared with those of a baseline gain scheduling PID controller. The application of this strategy achieves enhanced balance of component loads, the average power and actuator usages in partial load region.
NASA Technical Reports Server (NTRS)
Postma, Barry Dirk
2005-01-01
This thesis discusses application of a robust constrained optimization approach to control design to develop an Auto Balancing Controller (ABC) for a centrifuge rotor to be implemented on the International Space Station. The design goal is to minimize a performance objective of the system, while guaranteeing stability and proper performance for a range of uncertain plants. The Performance objective is to minimize the translational response of the centrifuge rotor due to a fixed worst-case rotor imbalance. The robustness constraints are posed with respect to parametric uncertainty in the plant. The proposed approach to control design allows for both of these objectives to be handled within the framework of constrained optimization. The resulting controller achieves acceptable performance and robustness characteristics.
Measuring pictorial balance perception at first glance using Japanese calligraphy
Gershoni, Sharon; Hochstein, Shaul
2011-01-01
According to art theory, pictorial balance acts to unify picture elements into a cohesive composition. For asymmetrical compositions, balancing elements is thought to be similar to balancing mechanical weights in a framework of symmetry axes. Assessment of preference for balance (APB), based on the symmetry-axes framework suggested in Arnheim R, 1974 Art and Visual Perception: A Psychology of the Creative Eye (Berkeley, CA: University of California Press), successfully matched subject balance ratings of images of geometrical shapes over unlimited viewing time. We now examine pictorial balance perception of Japanese calligraphy during first fixation, isolated from later cognitive processes, comparing APB measures with results from balance-rating and comparison tasks. Results show high between-task correlation, but low correlation with APB. We repeated the rating task, expanding the image set to include five rotations of each image, comparing balance perception of artist and novice participant groups. Rotation has no effect on APB balance computation but dramatically affects balance rating, especially for art experts. We analyze the variety of rotation effects and suggest that, rather than depending on element size and position relative to symmetry axes, first fixation balance processing derives from global processes such as grouping of lines and shapes, object recognition, preference for horizontal and vertical elements, closure, and completion, enhanced by vertical symmetry. PMID:23145242
Work/Life Balance Issues for Female Physicians and Implications for Medical Education
ERIC Educational Resources Information Center
Corder, Paige Frances
2016-01-01
Work/life balance issues exist for all people who navigate both professional and personal responsibilities, regardless of profession, gender, marital status, or number of children. This research sought to better understand the specific work/life balance challenges faced by female physicians and how medical education can better prepare future…
Sensory-Challenge Balance Exercises Improve Multisensory Reweighting in Fall-Prone Older Adults.
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.
ERIC Educational Resources Information Center
Karapolat, Hale; Eyigor, Sibel; Kirazli, Yesim; Celebisoy, Nese; Bilgen, Cem; Kirazli, Tayfun
2010-01-01
The aim of this study is to evaluate the internal consistency, test-retest reliability, construct validity, and sensitivity to change of the Activities-specific Balance Confidence Scale (ABC) in people with peripheral vestibular disorder. Thirty-three patients with unilateral peripheral vestibular disease were included in the study. Patients were…
The balanced scorecard: sustainable performance assessment for forensic laboratories.
Houck, Max; Speaker, Paul J; Fleming, Arron Scott; Riley, Richard A
2012-12-01
The purpose of this article is to introduce the concept of the balanced scorecard into the laboratory management environment. The balanced scorecard is a performance measurement matrix designed to capture financial and non-financial metrics that provide insight into the critical success factors for an organization, effectively aligning organization strategy to key performance objectives. The scorecard helps organizational leaders by providing balance from two perspectives. First, it ensures an appropriate mix of performance metrics from across the organization to achieve operational excellence; thereby the balanced scorecard ensures that no single or limited group of metrics dominates the assessment process, possibly leading to long-term inferior performance. Second, the balanced scorecard helps leaders offset short term performance pressures by giving recognition and weight to long-term laboratory needs that, if not properly addressed, might jeopardize future laboratory performance. Copyright © 2012 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.
Ortiz-Rubio, Araceli; Cabrera-Martos, Irene; Torres-Sánchez, Irene; Casilda-López, Jesús; López-López, Laura; Valenza, Marie Carmen
2017-11-22
Fatigue and balance impairment leads to a loss of independence and are important to adequately manage. The objective of this study was to examine the effects of a resistance training program on dynamic balance and fatigue in patients with Parkinson's disease (PD). Randomized controlled trial. Forty-six patients with PD were randomly allocated to an intervention group receiving a 8-week resistance training program focused on lower limbs or to a control group. Balance was assessed using the Mini-BESTest and fatigue was assessed by the Piper Fatigue Scale. Patients in the intervention group improved significantly (p<0.05) on dynamic balance (reactive postural control and total values) and perceived fatigue. An 8-week resistance training program was found to be effective at improving dynamic balance and fatigue in patients with PD. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Balancing feasibility and precision of wildlife habitat analysis in planning for natural resources
Anita T. Morzillo; Joshua S. Halofsky; Jennifer DiMiceli; Blair Csuti; Pamela Comeleo; Miles Hemstrom
2012-01-01
Wildlife conservation often is a central focus in planning for natural resource management. Evaluation of wildlife habitat involves balancing the desire for information about detailed habitat characteristics and the feasibility of completing analyses across large areas. Our objective is to describe tradeoffs made in assessments of wildlife habitat within a multiple-...
USDA-ARS?s Scientific Manuscript database
Background: The effect of whole grains on the regulation of energy balance remains controversial. Objective: To determine the effects of substituting whole grains for refined grains, independent of body weight change, on energy metabolism parameters and glycemic control. Design: A randomized, con...
ERIC Educational Resources Information Center
Raynor, Hollie A.; Jelalian, Elissa; Vivier, Patrick M.; Hart, Chantelle N.; Wing, Rena R.
2009-01-01
Objective: Compare parent-reported preschool- and school-aged children's eating and leisure-time activity patterns that are proposed to influence energy balance. Design: Cross-sectional investigation of children, 2 to 12 years, attending a well visit. Setting: Pediatric private practice/ambulatory pediatric clinic. Participants: One hundred…
Brian R. Sturtevant; Andrew Fall; Daniel D. Kneeshaw; Neal P. P. Simon; Michael J. Papaik; Kati Berninger; Frederik Doyon; Don G. Morgan; Christian Messier
2007-01-01
To assist forest managers in balancing an increasing diversity of resource objectives, we developed a toolkit modeling approach for sustainable forest management (SFM). The approach inserts a meta-modeling strategy into a collaborative modeling framework grounded in adaptive management philosophy that facilitates participation among stakeholders, decision makers, and...
Effects of feeding monensin to bred heifers fed in a drylot on nutrient and energy balance
USDA-ARS?s Scientific Manuscript database
The objective of this study was to determine if feeding monensin would improve diet digestion, energy and nitrogen balance in bred heifers receiving a limit-fed corn stalk-based diet. Sixteen pregnant Meat Animal Research Center (MARC) III composite heifers were used in a 161 d completely randomized...
Beutel, Bryan G; Cardone, Dennis A
2014-10-01
Due to limited regulation of websites, the quality and content of online health-related information has been questioned as prior studies have shown that websites often misrepresent orthopaedic conditions and treatments. Kinesio tape has gained popularity among athletes and the general public despite limited evidence supporting its efficacy. The primary objective of this study was to assess the quality and content of Internet-based information on Kinesio taping. An Internet search using the terms "Kinesio tape" and "kinesiology tape" was performed using the Google search engine. Websites returned within the first two pages of results, as well as hyperlinks embedded within these sites, were included in the study. These sites were subsequently classified by type. The quality of the website was determined by the Health On the Net (HON) score, an objective metric based upon recommendations from the United Nations for the ethical representation of health information. A content analysis was performed by noting specific misleading versus balanced features in each website. A total of 31 unique websites were identified. The majority of the websites (71%) were commercial. Out of a total possible 16 points, the mean HON score among the websites was 8.9 points (SD 2.2 points). The number of misleading features was significantly higher than the balanced features (p < 0.001). Fifty-eight percent of sites used anecdotal testimonials to promote the product. Only small percentages of websites discussed complications, alternatives, or provided accurate medical outcomes. Overall, commercial sites had a greater number of misleading features compared to non-commercial sites (p = 0.01). Websites discussing Kinesio tape are predominantly of poor quality and present misleading, imbalanced information. It is of ever-increasing importance that healthcare providers work to ensure that reliable, balanced, and accurate information be available to Internet users. IV.
Lopes, Susana; Correia, Christophe; Félix, Gonçalo; Lopes, Mário; Cruz, Ana; Ribeiro, Fernando
2017-10-01
Low back pain affects the person's ability to keep balance, especially in challenging conditions. The purpose of this study was to determine the immediate effects of Pilates exercises on postural sway and dynamic balance of young individuals with non-specific low back pain. Controlled laboratory design. Forty-six participants with non-specific low back pain were randomized to a Pilates (n=23, 10 males; age: 21.8±3.2years) and a control group (n=23, 9 males; age: 22.8±3.6years). Postural sway was assessed with a force platform and dynamic balance with the Star Excursion Balance Test, before and after the intervention or rest period. To assess postural sway, participants stood still on an unstable surface set on the force plate for 90s, with eyes closed. The intervention lasted 20min and consisted on four Pilates exercises: single leg stretch (level 1), pelvic press (level 1), swimming (level 1) and kneeling opposite arm and leg reach. At baseline, no differences were found between groups. The Pilates group improved in all the postural sway values (area of CoP: 11.5±3.4 to 9.7±2.7cm 2 , p=0.002 and CoP velocity: 2.8±0.6 to 2.3±0.5cm/s, p<0.001) and in the Star Excursion Balance Test. Control group only improved in CoP velocity, however, this improvement was significantly inferior compared to the Pilates group. Pilates exercises immediately improved postural sway and dynamic balance in young adults with non-specific low back pain. Copyright © 2017 Elsevier Ltd. All rights reserved.
Monticone, Marco; Ambrosini, Emilia; Brunati, Roberto; Capone, Antonio; Pagliari, Giulia; Secci, Claudio; Zatti, Giovanni; Ferrante, Simona
2018-03-01
To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture. Randomized controlled trial. A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26). The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months. Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group). An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.
The antidepressant debate and the balanced placebo trial design: an ethical analysis.
Waring, Duff R
2008-12-01
There is ongoing debate about whether randomized, placebo-controlled trials under a double-blind have reliably established the pharmacological efficacy of antidepressants. Numerous meta-analyses of antidepressant efficacy trials, e.g., Kirsch et al. [Kirsch, I., Moore, T. J., Scoboria, A., & Nicholls, S. (2002). The emperor's new drugs: An analysis of antidepressant medication data submitted to the U.S. food and drug administration. Prevention and Treatment, 5, Article 23. (Retrieved July 19, 2007 from http://journals.apa.org/prevention/volume5)], have shown a modest drug-placebo difference but methodological problems with standard trial design preclude a definitive conclusion that this difference results from specific biological effects of antidepressants or the nonspecific factors that have not been adequately excluded. Standard trial design assumes the additivity thesis of pharmacological efficacy, being the assumption that the specific or "true" magnitude of the pharmacological effect is limited to the difference between the drug and placebo responses in a standard trial. If the drug effects are as small as these meta-analyses suggest, then their clinical effectiveness is questionable. If the drug effects are actually larger but masked by placebo effects, then the additivity thesis is not valid and we risk false negative results with standard trial design. Kirsch et al. propose an alternative, four arm balanced placebo trial design (BPTD) that can accurately test the additivity thesis. The BPTD uses antidepressants, active placebos and the intentional deception of research subjects. My focal question is whether the BPTD is ethically defensible. I will explore two objections that can be raised against it: 1) lying to BPTD research subjects violates their autonomy and exploits their illness and 2) the BPTD may not enable us to test the additivity thesis with accuracy, i.e., it may contribute to the masking of drug effects that it aims to avoid. I argue that these objections support the conclusion that the BPTD is ethically indefensible.
ERIC Educational Resources Information Center
City Coll. of San Francisco, CA.
This document consists of two reports about trends in the expressed educational objectives of students applying for admission to the City College of San Francisco. The first report reveals that between 1968 and 1973: (1) the balance between students choosing transfer or semi-professional programs has shifted toward the latter; (2) student interest…
Hetherington, Sharon; Henwood, Tim; Swinton, Paul; Keogh, Justin; Gardiner, Paul; Tuckett, Anthony; Rouse, Kevin
2018-04-05
To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change. Intervention study. Community-based older adult-specific exercise clinic. Older adults (N=245) with complex care needs who were receiving government-funded aged care support. Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level. At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r=-.55; P<.01). Change in balance confidence after the exercise intervention was accompanied by improved physical performance (+12%) and reduced frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention. This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Yeşilyaprak, Sevgi Sevi; Yıldırım, Meriç Şenduran; Tomruk, Murat; Ertekin, Özge; Algun, Z Candan
2016-01-01
There is limited information on effective balance training techniques including virtual reality (VR)-based balance exercises in residential settings and no studies have been designed to compare the effects of VR-based balance exercises with conventional balance exercises in older adults living in nursing homes in Turkey. The objective of our study was to investigate the effects of VR-based balance exercises on balance and fall risk in comparison to conventional balance exercises in older adults living in nursing homes. A total sample of 18 subjects (65-82 years of age) with fall history who were randomly assigned to either the VR group (Group 1, n = 7) or the conventional exercise group (Group 2, n = 11) completed the exercise training. In both groups, Berg balance score (BBS), timed up & go duration, and left leg stance and tandem stance duration with eyes closed significantly improved with time (p < 0.05), but changes were similar in both groups (p > 0.05) after training, indicating that neither the exercise method was superior. Similar improvements were found in balance and fall risk with VR-based balance training and conventional balance training in older adults living in the nursing home. Both exercise trainings can be preferable by health care professionals considering fall prevention. Appropriate patient selection is essential.
Altered Functional Performance in Patients with Fibromyalgia.
Costa, Isis da Silva; Gamundí, Antoni; Miranda, José G Vivas; França, Lucas G Souza; De Santana, Charles Novaes; Montoya, Pedro
2017-01-01
Fibromyalgia is a common chronic pain condition that exerts a considerable impact on patients' daily activities and quality of life. Objectives: The main objective of the present study was to evaluate kinematic parameters of gait, functional performance, and balance in women with fibromyalgia syndrome. Methods: The study included 26 female patients with fibromyalgia (49.2 ± 8.0 years) according to the criteria of the American College of Rheumatology, as well as 16 pain-free women (43.5 ± 8.5 years). Gait and balance parameters were extracted from video recordings of participants performing several motor tasks. Non-linear dynamic of body sway time series was also analyzed by computing the Hurst exponent. In addition, functional performance and clinical pain were obtained by using standardized motor tests (Berg's balance scale, 6-min walking test, timed up and go task, Romberg's balance test) and self-report questionnaires (Fibromyalgia Impact Questionnaire). Results: Walking speed was significantly diminished ( p < 0.001) in FM patients as compared to pain-free controls, probably due to significant reductions in stride length ( p < 0.001) and cycle frequency ( p < 0.001). Analyses of balance also revealed significant differences between fibromyalgia and pain-free controls on body sway in the medial-lateral and anterior-posterior axes (all ps < 0.01). Several parameters of gait and balance were significantly associated with high levels of pain, depression, stiffness, anxiety, and fatigue in fibromyalgia. Conclusion: Our data revealed that both gait and balance were severely impaired in FM, and that subjective complaints associated with FM could contribute to functional disability in these patients. These findings suggest that optimal rehabilitation and fall prevention in fibromyalgia require a comprehensive assessment of both psychological responses to pain and physical impairments during postural control and gait.
Altered Functional Performance in Patients with Fibromyalgia
Costa, Isis da Silva; Gamundí, Antoni; Miranda, José G. Vivas; França, Lucas G. Souza; De Santana, Charles Novaes; Montoya, Pedro
2017-01-01
Fibromyalgia is a common chronic pain condition that exerts a considerable impact on patients' daily activities and quality of life. Objectives: The main objective of the present study was to evaluate kinematic parameters of gait, functional performance, and balance in women with fibromyalgia syndrome. Methods: The study included 26 female patients with fibromyalgia (49.2 ± 8.0 years) according to the criteria of the American College of Rheumatology, as well as 16 pain-free women (43.5 ± 8.5 years). Gait and balance parameters were extracted from video recordings of participants performing several motor tasks. Non-linear dynamic of body sway time series was also analyzed by computing the Hurst exponent. In addition, functional performance and clinical pain were obtained by using standardized motor tests (Berg's balance scale, 6-min walking test, timed up and go task, Romberg's balance test) and self-report questionnaires (Fibromyalgia Impact Questionnaire). Results: Walking speed was significantly diminished (p < 0.001) in FM patients as compared to pain-free controls, probably due to significant reductions in stride length (p < 0.001) and cycle frequency (p < 0.001). Analyses of balance also revealed significant differences between fibromyalgia and pain-free controls on body sway in the medial-lateral and anterior-posterior axes (all ps < 0.01). Several parameters of gait and balance were significantly associated with high levels of pain, depression, stiffness, anxiety, and fatigue in fibromyalgia. Conclusion: Our data revealed that both gait and balance were severely impaired in FM, and that subjective complaints associated with FM could contribute to functional disability in these patients. These findings suggest that optimal rehabilitation and fall prevention in fibromyalgia require a comprehensive assessment of both psychological responses to pain and physical impairments during postural control and gait. PMID:28184193
Does Marriage Make Us Healthier? Inter-Country Comparative Evidence from China, Japan, and Korea
Fu, Rong; Noguchi, Haruko
2016-01-01
Objectives This study focuses on East Asian countries and investigates the difference in the marriage premium on the health-marriage protection effect (MPE) between younger and older generations and the intra-couple education concordance effect (ECE) on the health of married individuals. This study used inter-country comparative data from China, Japan, and Korea. Methods This study focused on individuals (n = 7,938) in China, Japan, and Korea who were sampled from the 2010 East Asian Social Survey. To investigate MPE and ECE, four health indicators were utilized: a physical and mental components summary (PCS and MCS), self-rated health status (Dself), and happiness level (Dhappy). Ordinary least squares regression was conducted by country- and gender-specific subsamples. Results We found that the MPE on PCS, MCS, and Dself was more significant for the older generation than for the younger generation in both China and Japan, whereas the results were inconclusive in Korea. With regard to the ECE on happiness (Dhappy), for both men and women, couples tend to be happier when both the husband and the wife are well educated (“higher balanced marriage”) compared to couples with a lower level of educational achievement (“lower balanced marriage”). Significant benefits from a “higher balanced marriage” on MCS and Dself were observed for women only. In contrast, no statistically significant differences in health status were observed between “higher balanced marriage” couples and couples with different levels of educational achievements (“upward marriage” or “downward marriage”). Conclusions This study found that (1) the MPE was more significant for the older generation, and (2) the health gap, particularly the happiness gap, between higher- and lower-balanced married couples was significant. The inter-country comparative findings are useful to explain how the role of marriage (and therefore of family) on health has been diluted due to the progress of industrialization and modernization. PMID:26862896
The Nutrient Balance Concept: A New Quality Metric for Composite Meals and Diets
Fern, Edward B; Watzke, Heribert; Barclay, Denis V.; Roulin, Anne; Drewnowski, Adam
2015-01-01
Background Combinations of foods that provide suitable levels of nutrients and energy are required for optimum health. Currently, however, it is difficult to define numerically what are ‘suitable levels’. Objective To develop new metrics based on energy considerations—the Nutrient Balance Concept (NBC)—for assessing overall nutrition quality when combining foods and meals. Method The NBC was developed using the USDA Food Composition Database (Release 27) and illustrated with their MyPlate 7-day sample menus for a 2000 calorie food pattern. The NBC concept is centered on three specific metrics for a given food, meal or diet—a Qualifying Index (QI), a Disqualifying Index (DI) and a Nutrient Balance (NB). The QI and DI were determined, respectively, from the content of 27 essential nutrients and 6 nutrients associated with negative health outcomes. The third metric, the Nutrient Balance (NB), was derived from the Qualifying Index (QI) and provided key information on the relative content of qualifying nutrients in the food. Because the Qualifying and Disqualifying Indices (QI and DI) were standardized to energy content, both become constants for a given food/meal/diet and a particular consumer age group, making it possible to develop algorithms for predicting nutrition quality when combining different foods. Results Combining different foods into composite meals and daily diets led to improved nutrition quality as seen by QI values closer to unity (indicating nutrient density was better equilibrated with energy density), DI values below 1.0 (denoting an acceptable level of consumption of disqualifying nutrients) and increased NB values (signifying complementarity of foods and better provision of qualifying nutrients). Conclusion The Nutrient Balance Concept (NBC) represents a new approach to nutrient profiling and the first step in the progression from the nutrient evaluation of individual foods to that of multiple foods in the context of meals and total diets. PMID:26176770
Hafström, Anna; Malmström, Eva-Maj; Terdèn, Josefine; Fransson, Per-Anders; Magnusson, Måns
2016-01-01
Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP) designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO), 206% with eyes closed (EC) on solid surface, and 54% EO on compliant surface (p < .001). Posturography confirmed balance improvements when perturbed on solid and compliant surfaces with EO and EC (p ≤ .033). Walking, step stool, and Timed Up and Go speeds increased (p ≤ .001), as did scores in Berg Balance and balance confidence scales (p ≤ .018). Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly. PMID:28138495
Russek, Leslie; Gardner, Sarah; Maguire, Kelly; Stevens, Caitlin; Brown, Erica Z; Jayawardana, Veroni; Mondal, Sumona
2015-06-01
Fear of movement may contribute to functional limitations and loss of well-being among individuals with fibromyalgia (FM). The objectives of this study were to assess factors contributing to movement-related fear and to explore relationships among these factors, function and wellness, in a widespread population of people with FM. This was an internet survey of individuals with FM. Respondents completed a battery of surveys including the Fibromyalgia Impact Questionnaire--Revised (FIQR), Tampa Scale of Kinesiophobia (TSK), Activities-Specific Balance Confidence Scale (ABC), Primary Care Posttraumatic Stress Disorder screen (PC-PTSD), Vertigo Symptom Scale (VSS-SF), a joint hypermobility syndrome screen (JHS), and screening questions related to obsessive-compulsive personality disorder (OCPD), physical activity, work status, and demographics. Analysis included descriptive statistics, Pearson product-moment correlations, and linear regression. Over a 2-year period, 1,125 people (97.6 % female) completed the survey battery. Kinesiophobia was present in 72.9 % of the respondents, balance confidence was compromised in 74.8 %, PTSD likely in 60.4 %, joint hypermobility syndrome likely in 46.6 %, and OCPD tendencies in 26.8 %. The total FIQR and FIQR perceived function subscores were highly correlated (p < 0.0005, r > 0.4) with pain, kinesiophobia, balance confidence, and vertigo. Reported activity level had poor correlation (r < 0.25) with all measured variables. Pain, ABC, VSS, and TSK predicted FIQR and FIQR-pf, explaining 65 and 48 % of the variance, respectively. Kinesiophobia, balance complaints, vertigo, PTSD, and joint hypermobility were common in this population of people with FM. Sources of movement-related fear correlated to overall wellness and perceived function as measured by the FIQR and FIQR-pf.
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.).
Behennah, Jessica; Conway, Rebecca; Fisher, James; Osborne, Neil; Steele, James
2018-03-01
Chronic low back pain is associated with lumbar extensor deconditioning. This may contribute to decreased neuromuscular control and balance. However, balance is also influenced by the hip musculature. Thus, the purpose of this study was to examine balance in both asymptomatic participants and those with chronic low back pain, and to examine the relationships among balance, lumbar extension strength, trunk extension endurance, and pain. Forty three asymptomatic participants and 21 participants with non-specific chronic low back pain underwent balance testing using the Star Excursion Balance Test, lumbar extension strength, trunk extension endurance, and pain using a visual analogue scale. Significant correlations were found between lumbar extension strength and Star Excursion Balance Test scores in the chronic low back pain group (r = 0.439-0.615) and in the asymptomatic group (r = 0.309-0.411). Correlations in the chronic low back pain group were consistently found in posterior directions. Lumbar extension strength explained ~19.3% to ~37.8% of the variance in Star Excursion Balance Test scores for the chronic low back pain group and ~9.5% to ~16.9% for the asymptomatic group. These results suggest that the lumbar extensors may be an important factor in determining the motor control dysfunctions, such as limited balance, that arise in chronic low back pain. As such, specific strengthening of this musculature may be an approach to aid in reversing these dysfunctions. Copyright © 2018 Elsevier Ltd. All rights reserved.
Accessing wound-care information on the Internet: the implications for patients.
Bovill, E S; Hormbrey, E; Gillespie, P H; Banwell, P E
2001-02-01
The Internet and the World Wide Web have revolutionised communication and provide a unique forum for the exchange of information. It has been proposed that the Internet has given the public more access to medical information resources and improved patient education. This study assessed the impact of the Internet on the availability of information on wound care management. The search phrases 'wound care', 'wound healing' and 'wounds' were analysed using a powerful Metacrawler search engine (www.go2net.com). Web site access was classified according to the target audience (wound-care specialists, other health professionals, patients) and the author (societies, institutions or commercial companies). The largest proportion of web sites were commercially based (32%). Of the total number, 23% specifically targeted patients, mostly by advertising. Only 20% were aimed at wound specialists. Extensive surfing was required to obtain wound-care information, and objective information sites were under-represented. Regulated, easily accessible, objective information sites on wound-healing topics are needed for improved patient education and to balance the existing commercial bias.
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 (sensitivity = 93%, specificity = 60%) to discriminate persons with 2 or more falls from those with fewer than 2 falls in the past year. CB&M scale is reliable and valid to evaluate gait, balance, and mobility in community-dwelling older adults. Unlike some currently used balance and mobility assessments for the community-dwelling older adults, the CB&M scale did not show a ceiling in detection of balance and mobility deficits. In addition, cutoff scores have been proposed that might serve as criteria to discriminate older adults with balance and mobility deficits. The CB&M scale might enable assessment of balance and mobility limitations masked by other assessments and help design interventions to improve community mobility and sustain independence in the higher-functioning community-dwelling older adult.
Calvet, S; Estellés, F; Cambra-López, M; Torres, A G; Van den Weghe, H F A
2011-11-01
Carbon dioxide balances are useful in determining ventilation rates in livestock buildings. These balances need an accurate estimation of the CO(2) produced by animals and their litter to determine the ventilation flows. To estimate the daily variation in ventilation flow, it is necessary to precisely know the daily variation pattern of CO(2) production, which mainly depends on animal activity. The objective of this study was to explore the applicability of CO(2) balances for determining ventilation flows in broiler buildings. More specifically, this work aimed to quantify the amount of CO(2) produced by the litter, as well as the amount of CO(2) produced by the broilers, as a function of productive parameters, and to analyze the influence of broiler activity on CO(2) emissions. Gas concentrations and ventilation flows were simultaneously measured in 3 trials, with 1 under experimental conditions and the other 2 in a commercial broiler farm. In the experimental assay, broiler activity was also determined. At the end of the experimental trial, on the day after the removal of the broilers, the litter accounted for 20% of the total CO(2) produced, and the broilers produced 3.71 L/h of CO(2) per kg of metabolic weight. On the commercial farm, CO(2) production was the same for the 2 cycles (2.60 L/h per kg of metabolic weight, P > 0.05). However, substantial differences were found between CO(2) and broiler activity patterns after changes in light status. A regression model was used to explain these differences (R(2) = 0.52). Carbon dioxide increased with bird activity, being on average 3.02 L/h per kg of metabolic weight for inactive birds and 4.73 L/h per kg of metabolic weight when bird activity was highest. Overall, CO(2) balances are robust tools for determining the daily average ventilation flows in broiler farms. These balances could also be applied at more frequent intervals, but in this case, particular care is necessary after light status changes because of discrepancy between animal activity and CO(2) production.
Jacobson, Gary P; McCaslin, Devin L; Piker, Erin G; Gruenwald, Jill; Grantham, Sarah; Tegel, Lauren
2011-01-01
The objective of this study was to assess the sensitivity, specificity, and positive and negative predictive value of the Romberg Test of Standing Balance on Firm and Compliant Support Surfaces (RTSBFCSS) for the identification of patients with vestibular system impairments affecting the horizontal semicircular canal, saccule, and/or inferior and superior vestibular nerves. The RTSBFCSS was developed for the National Health and Nutrition Examination Survey (NHANES) and was used recently to estimate the numbers of individuals aged 40 yr or older with vestibular system impairments among the general population of the United States. A retrospective analysis of the medical records of 103 consecutive patients aged 40 yr or older (mean age 59 ± 12 yr, 71 females) who had undergone vestibular assessment at the Balance Disorders Clinic at the Vanderbilt University School of Medicine. Patients with complete electro- or videonystagmography testing, cervical vestibular evoked myogenic potential (cVEMP) testing, and the RTSBFCSS screening test were included in the analysis. A series of 2 × 2 tables were created that represented the number of "true positives," "true negatives," "false positives," and "false negatives" of the RTSBFCSS under conditions where the caloric test was abnormal and then separately where the cVEMP test was abnormal. The data were analyzed in a manner such that sensitivity, specificity, and both positive and negative predictive value of the RTSBFCSS could be calculated. When the caloric test was used as the criterion standard and the subject selection criteria in the NHANES study were used (i.e., subjects who were able to maintain postural stability for trials 1-3 of the RTSBFCSS; N = 45), the sensitivity and specificity of the RTSBFCSS to impairment of the horizontal semicircular canal or superior vestibular nerve were 55% and 64%, respectively, yielding positive and negative predictive values of 55% and 64%, respectively. When all patients aged 40 yr or older were evaluated (N = 103), the sensitivity and specificity were 61% and 58%, respectively, yielding positive and negative predictive values of 39% and 78%, respectively. Using the cVEMP test as the criterion standard for the detection of impairment affecting the saccule and/or inferior vestibular nerve did not improve the performance criteria of the NHANES screening measure. The RTSBFCSS should not be used as a screening measure for vestibular impairment.
NASA Astrophysics Data System (ADS)
Zatarain-Salazar, J.; Reed, P. M.; Quinn, J.; Giuliani, M.; Castelletti, A.
2016-12-01
As we confront the challenges of managing river basin systems with a large number of reservoirs and increasingly uncertain tradeoffs impacting their operations (due to, e.g. climate change, changing energy markets, population pressures, ecosystem services, etc.), evolutionary many-objective direct policy search (EMODPS) solution strategies will need to address the computational demands associated with simulating more uncertainties and therefore optimizing over increasingly noisy objective evaluations. Diagnostic assessments of state-of-the-art many-objective evolutionary algorithms (MOEAs) to support EMODPS have highlighted that search time (or number of function evaluations) and auto-adaptive search are key features for successful optimization. Furthermore, auto-adaptive MOEA search operators are themselves sensitive to having a sufficient number of function evaluations to learn successful strategies for exploring complex spaces and for escaping from local optima when stagnation is detected. Fortunately, recent parallel developments allow coordinated runs that enhance auto-adaptive algorithmic learning and can handle scalable and reliable search with limited wall-clock time, but at the expense of the total number of function evaluations. In this study, we analyze this tradeoff between parallel coordination and depth of search using different parallelization schemes of the Multi-Master Borg on a many-objective stochastic control problem. We also consider the tradeoff between better representing uncertainty in the stochastic optimization, and simplifying this representation to shorten the function evaluation time and allow for greater search. Our analysis focuses on the Lower Susquehanna River Basin (LSRB) system where multiple competing objectives for hydropower production, urban water supply, recreation and environmental flows need to be balanced. Our results provide guidance for balancing exploration, uncertainty, and computational demands when using the EMODPS framework to discover key tradeoffs within the LSRB system.
Urban pavement surface temperature. Comparison of numerical and statistical approach
NASA Astrophysics Data System (ADS)
Marchetti, Mario; Khalifa, Abderrahmen; Bues, Michel; Bouilloud, Ludovic; Martin, Eric; Chancibaut, Katia
2015-04-01
The forecast of pavement surface temperature is very specific in the context of urban winter maintenance. to manage snow plowing and salting of roads. Such forecast mainly relies on numerical models based on a description of the energy balance between the atmosphere, the buildings and the pavement, with a canyon configuration. Nevertheless, there is a specific need in the physical description and the numerical implementation of the traffic in the energy flux balance. This traffic was originally considered as a constant. Many changes were performed in a numerical model to describe as accurately as possible the traffic effects on this urban energy balance, such as tires friction, pavement-air exchange coefficient, and infrared flux neat balance. Some experiments based on infrared thermography and radiometry were then conducted to quantify the effect fo traffic on urban pavement surface. Based on meteorological data, corresponding pavement temperature forecast were calculated and were compared with fiels measurements. Results indicated a good agreement between the forecast from the numerical model based on this energy balance approach. A complementary forecast approach based on principal component analysis (PCA) and partial least-square regression (PLS) was also developed, with data from thermal mapping usng infrared radiometry. The forecast of pavement surface temperature with air temperature was obtained in the specific case of urban configurtation, and considering traffic into measurements used for the statistical analysis. A comparison between results from the numerical model based on energy balance, and PCA/PLS was then conducted, indicating the advantages and limits of each approach.
ERIC Educational Resources Information Center
Granacher, Urs; Gollhofer, Albert; Kriemler, Susi
2010-01-01
Deficits in strength of the lower extremities and postural control have been associated with a high risk of sustaining sport-related injuries. Such injuries often occur during physical education (PE) classes and mostly affect the lower extremities. Thus, the objectives of this study were to investigate the effects of balance training on postural…
Mass, Energy, Entropy and Exergy Rate Balance in a Ranque-Hilsh Vortex Tube
ERIC Educational Resources Information Center
Carrascal Lecumberri, Edorta; Sala Lizarraga, José María
2013-01-01
The objective of this paper is to present a laboratory program designed for the Thermodynamics course offered in the Department of Thermal Engineering at the University of the Basque Country. With reference to one of the examples given in the textbook by Moran, Shapiro, Boettner and Bailey (2012), the balances of mass, energy, entropy and exergy…
ERIC Educational Resources Information Center
Liberatore, Matthew W.
2011-01-01
Personalized, online homework was used to supplement textbook homework, quizzes, and exams for one section of a course in material and energy balances. The objective of this study was to test the hypothesis that students using personalized, online homework earned better grades in the course. The online homework system asks the same questions of…
ERIC Educational Resources Information Center
Shih, Ching-Hsiang; Chang, Man-Ling
2012-01-01
The latest researches have adopted software technology, turning the Nintendo Wii Balance Board into a high performance standing location detector with a newly developed standing location detection program (SLDP). This study extended SLDP functionality to assess whether two people with developmental disabilities would be able to actively perform…
Wii Fit balance board playing improves balance and gait in Parkinson disease.
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 confidence regarding balance. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Bressel, Eadric; Yonker, Joshua C; Kras, John; Heath, Edward M
2007-01-01
Context: How athletes from different sports perform on balance tests is not well understood. When prescribing balance exercises to athletes in different sports, it may be important to recognize performance variations. Objective: To compare static and dynamic balance among collegiate athletes competing or training in soccer, basketball, and gymnastics. Design: A quasi-experimental, between-groups design. Independent variables included limb (dominant and nondominant) and sport played. Setting: A university athletic training facility. Patients or Other Participants: Thirty-four female volunteers who competed in National Collegiate Athletic Association Division I soccer (n = 11), basketball (n = 11), or gymnastics (n = 12). Intervention(s): To assess static balance, participants performed 3 stance variations (double leg, single leg, and tandem leg) on 2 surfaces (stiff and compliant). For assessment of dynamic balance, participants performed multidirectional maximal single-leg reaches from a unilateral base of support. Main Outcome Measure(s): Errors from the Balance Error Scoring System and normalized leg reach distances from the Star Excursion Balance Test were used to assess static and dynamic balance, respectively. Results: Balance Error Scoring System error scores for the gymnastics group were 55% lower than for the basketball group (P = .01), and Star Excursion Balance Test scores were 7% higher in the soccer group than the basketball group (P = .04). Conclusions: Gymnasts and soccer players did not differ in terms of static and dynamic balance. In contrast, basketball players displayed inferior static balance compared with gymnasts and inferior dynamic balance compared with soccer players. PMID:17597942
Postural perturbations: new insights for treatment of balance disorders
NASA Technical Reports Server (NTRS)
Horak, F. B.; Henry, S. M.; Shumway-Cook, A.; Peterson, B. W. (Principal Investigator)
1997-01-01
This article reviews the neural control of posture as understood through studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new view of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implications for rehabilitation of balance disorders and demonstrate how an understanding of the specific systems underlying postural control can help to focus and enrich our therapeutic approaches. By understanding the basic systems underlying control of balance, such as strategy selection, rapid latencies, coordinated temporal spatial patterns, force control, and context-specific adaptations, therapists can focus their treatment on each patient's specific impairments. Research on postural responses to surface translations has shown that balance is not based on a fixed set of equilibrium reflexes but on a flexible, functional motor skill that can adapt with training and experience. More research is needed to determine the extent to which quantification of automatic postural responses has practical implications for predicting falls in patients with constraints in their postural control system.
Mass-balance modelling of Ak-Shyirak massif Glaciers, Inner Tian Shan
NASA Astrophysics Data System (ADS)
Rets, Ekaterina; Barandun, Martina; Belozerov, Egor; Petrakov, Dmitry; Shpuntova, Alena
2017-04-01
Tian Shan is a water tower of Central Asia. Rapid and accelerating glacier downwasting is typical for this region. Study sites - Sary-Tor glacier and Glacier No.354 are located in Ak-Shyirak massif, Naryn headwaters. Sary-Tor was chosen as representative for Ak-Shyirak (Ushnurtsev, 1991; Oledeneniye TianShanya, 1995) for direct mass-balance measurements in 1985-1991. Glacier No.354 was an object of direct mass-balance measurements for 2011-2016. An energy-balance distributed A-Melt model (Rets et al, 2010) was used to reconstruct mass-balance for the glaciers for 2003-2015. Verification of modelingresults showed a good reproduction of direct melting measurements data on ablation stakes and mass loss according to geodetic method. Modeling results for Glacier No. 354 were compared to different modeling approach: distributed accumulation and temperature-index melt (Kronenberg et al, 2016)
Work-life balance and welfare.
Evans, Lois; Young, Greg
2017-04-01
An online survey and focus groups were conducted, providing qualitative information on the work-life balance of psychiatrists and trainees in Australasia. An invitation to participate in an anonymous online welfare survey was emailed to all the Royal Australian and New Zealand College of Psychiatrists trainees, Fellows, and Affiliates. Following this, nine focus groups were held across Australia and New Zealand. Responses received were thematically analysed. The emergent patterns are presented in this report. Our research suggests that work-life balance can be subjectively and objectively measured. There are phases of good and bad work-life balance, depending on stage of career and other commitments. Work-life balance may be an indicator of the health of individuals and organisations. Due to its complexity, with intrinsic and extrinsic factors involved, solutions are unlikely to be simple. Further studies are needed to substantiate our findings.
Bae, Young-Hyeon; Lee, Suk Min; Ko, Mansoo
2017-05-01
Robot-assisted gait training (RAGT) is effective for improving dynamic balance and aerobic capacity, but previous RAGT method does not set suitable training intensity. Recently, high-intensity treadmill gait training at 70% of heart rate reserve (HRR) was used for improving aerobic capacity and dynamic balance. This study was designed to compare the effectiveness between objective and subjective methods of high-intensity RAGT for improving dynamic balance and aerobic capacity in chronic stroke. Subjects were randomly allocated into experimental (n = 17) and control (n = 17) groups. The experimental group underwent high-intensity RAGT at 70% of HRR, whereas the control group underwent high-intensity RAGT at an RPE of 15. Both groups received their assigned training for 30 min per session, 3 days per week for 6 weeks. All subjects also received an additional 30 min of conventional physical therapy. Before and after each of the 18 sessions, the dynamic balance and aerobic capacity of all subjects were evaluated by a blinded examiner. After training, Berg Balance Scale (BBS) and Timed Up and Go Test scores, VO 2 max, and VO 2 max/kg were significantly increased in both groups (p < 0.05). These variables in experimental group were significantly greater than control group. However, the BBS score was not significantly different between both groups. All subjects completed high-intensity RAGT. No adverse effect of training was observed in both groups. High-intensity RAGT at 70% of HRR significantly improved dynamic balance and aerobic capacity more than RAGT at RPE of 15. These results suggest that high-intensity RAGT at 70% of HRR is safe and effective for improving dynamic balance and aerobic capacity in chronic stroke.
Cryogenic balances for the US NTF
NASA Technical Reports Server (NTRS)
Ferris, Alice T.
1989-01-01
Force balances were used to obtain aerodynamic data in the National Transonic Facility (NTF) wind tunnel since it became operational in 1983. These balances were designed, fabricated, gaged, and calibrated to Langley Research Center's specifications to operate over the temperature range of -320 F to +140 F without thermal control. Some of the materials and procedures developed to obtain a balance that would perform in this environment are reviewed. The degree of success in using these balances thus far is reported. Some of the problem areas that need additional work are specified and some of the progress addressing these problems is described.
Visual feedback training using WII Fit improves balance in Parkinson's disease.
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.
Art to science: Tools for greater objectivity in resource monitoring
USDA-ARS?s Scientific Manuscript database
The earliest inventories of western US rangelands were “ocular” estimates. Now, objective data consistent with formal scientific inquiry is needed to support management decisions that sustain the resource while balancing numerous competing land uses and sometimes-vociferous stakeholders. Yet, the co...
Physical Education Objectives. DOD Dependents Schools.
ERIC Educational Resources Information Center
Dependents Schools (DOD), Washington, DC.
These program objectives were developed to support the Department of Defense Dependent Schools Five Year Curriculum Development Plan and are designed to provide a basis for elementary, middle, and secondary school physical education curricula. A balance of psychomotor, cognitive, and affective aspects is emphasized. General, program, and…
Butler, Robert J; Lehr, Michael E; Fink, Michael L; Kiesel, Kyle B; Plisky, Phillip J
2013-09-01
Field expedient screening tools that can identify individuals at an elevated risk for injury are needed to minimize time loss in American football players. Previous research has suggested that poor dynamic balance may be associated with an elevated risk for injury in athletes; however, this has yet to be examined in college football players. To determine if dynamic balance deficits are associated with an elevated risk of injury in collegiate football players. It was hypothesized that football players with lower performance and increased asymmetry in dynamic balance would be at an elevated risk for sustaining a noncontact lower extremity injury. Prospective cohort study. Fifty-nine collegiate American football players volunteered for this study. Demographic information, injury history, and dynamic balance testing performance were collected, and noncontact lower extremity injuries were recorded over the course of the season. Receiver operator characteristic curves were calculated based on performance on the Star Excursion Balance Test (SEBT), including composite score and asymmetry, to determine the population-specific risk cut-off point. Relative risk was then calculated based on these variables, as well as previous injury. A cut-off point of 89.6% composite score on the SEBT optimized the sensitivity (100%) and specificity (71.7%). A college football player who scored below 89.6% was 3.5 times more likely to get injured. Poor performance on the SEBT may be related to an increased risk for sustaining a noncontact lower extremity injury over the course of a competitive American football season. College football players should be screened preseason using the SEBT to identify those at an elevated risk for injury based upon dynamic balance performance to implement injury mitigation strategies to this specific subgroup of athletes.
Energy availabilities for state and local development: projected energy patterns for 1980 and 1985
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vogt, D. P.; Rice, P. L.; Pai, V. P.
1978-06-01
This report presents projections of the supply, demand, and net imports of seven fuel types and four final consuming sectors for BEAs, states, census regions, and the nation for 1980 and 1985. The data are formatted to present regional energy availability from primary extraction, as well as from regional transformation processes. As constructed, the tables depict energy balances between availability and use for each of the specific fuels. The objective of the program is to provide a consistent base of historic and projected energy information within a standard format. Such a framework should aid regional policymakers in their consideration ofmore » regional growth issues that may be influenced by the regional energy system. This basic data must be supplemented by region-specific information which only the local policy analyst can bring to bear in his assessment of the energy conditions which characterize each region. The energy data, coupled with specific knowledge of projected economic growth and employment patterns, can assist EDA in developing its grant-in-aid investment strategy.« less
Sensorimotor System Measurement Techniques
Riemann, Bryan L.; Myers, Joseph B.; Lephart, Scott M.
2002-01-01
Objective: To provide an overview of currently available sensorimotor assessment techniques. Data Sources: We drew information from an extensive review of the scientific literature conducted in the areas of proprioception, neuromuscular control, and motor control measurement. Literature searches were conducted using MEDLINE for the years 1965 to 1999 with the key words proprioception, somatosensory evoked potentials, nerve conduction testing, electromyography, muscle dynamometry, isometric, isokinetic, kinetic, kinematic, posture, equilibrium, balance, stiffness, neuromuscular, sensorimotor, and measurement. Additional sources were collected using the reference lists of identified articles. Data Synthesis: Sensorimotor measurement techniques are discussed with reference to the underlying physiologic mechanisms, influential factors and locations of the variable within the system, clinical research questions, limitations of the measurement technique, and directions for future research. Conclusions/Recommendations: The complex interactions and relationships among the individual components of the sensorimotor system make measuring and analyzing specific characteristics and functions difficult. Additionally, the specific assessment techniques used to measure a variable can influence attained results. Optimizing the application of sensorimotor research to clinical settings can, therefore, be best accomplished through the use of common nomenclature to describe underlying physiologic mechanisms and specific measurement techniques. PMID:16558672
Badaracco, Carlo; Labini, Francesca Sylos; Meli, Annalisa; De Angelis, Ezio; Tufarelli, Davide
2007-09-01
To evaluate the efficiency of the rehabilitative protocols in patients with labyrinthine hypofunction, focusing on computerized dynamic visual acuity test (DVAt) and Gaze stabilization test (GST) specifically evaluating the vestibulo-oculomotor reflex (VOR) changes due to vestibular rehabilitation. Consecutive sample study. Day hospital in Ears, Nose, and Throat Rehabilitation Unit. Thirty-two patients with chronic dizziness with a mean age of 60.74 years. Patients performed one cycle of 12 daily rehabilitation sessions (2 h each) consisting of exercises aimed at improving VOR gain. The rehabilitation program included substitutional and/or habitudinal exercises, exercises on a stability platform, and exercises on a moving footpath with rehabilitative software. Dizziness Handicap Inventory and Activities-specific Balance Confidence Scale. Computerized dynamic posturography, computerized DVAt, and GST. The patients significantly improved in all the tests. Vestibular rehabilitation improved the quality of life by reducing the handicap index and improving the ability in everyday tasks. The recovery of the vestibular-ocular reflex and vestibular-spinal reflex efficiency was objectively proven by instrumental testing. The DVAt and the GST allow to objectively quantify the fixation ability at higher frequencies and speeds (main VOR function). Moreover, these new parameters permit to completely evaluate vestibular rehabilitation outcomes, adding new information to the generally used tests that only assess vestibulospinal reflex.
Radiation balances and the solar constant
NASA Technical Reports Server (NTRS)
Crommelynck, D.
1981-01-01
The radiometric concepts are defined in order to consider various types of radiation balances and relate them to the diabetic form of the energy balance. Variability in space and time of the components of the radiation field are presented. A specific concept for sweeping which is tailored to the requirements is proposed. Finally, after establishing the truncated character of the present knowledge of the radiation balance. The results of the last observations of the solar constant are given. Ground and satellite measurement techniques are discussed.
Svetlana A. (Kushch) Schroder; Sandor F. Toth; Robert L. Deal; Gregory J. Ettl
2016-01-01
Forest owners worldwide are increasingly interested in managing forests to provide a broad suite of Ecosystem services, balancing multiple objectives and evaluating management activities in terms of Potential tradeoffs. We describe a multi-objective mathematical programming model to quantify tradeoffs in expected sediment delivery and the preservation of Northern...
Michelle F. Tacconelli; Edward F. Loewenstein
2012-01-01
Natural resource managers must often balance multiple objectives on a single property. When these objectives are seemingly conflicting, the managerâs job can be extremely difficult and complex. This paper presents a decision support tool, designed to aid land managers in optimizing wildlife habitat needs while accomplishing additional objectives such as ecosystem...
Finding the Density of Objects without Measuring Mass and Volume
ERIC Educational Resources Information Center
Mumba, Frackson; Tsige, Mesfin
2007-01-01
A simple method based on the moment of forces and Archimedes' principle is described for finding density without measuring the mass and volume of an object. The method involves balancing two unknown objects of masses M[subscript 1] and M[subscript 2] on each side of a pivot on a metre rule and measuring their corresponding moment arms. The object…
26 CFR 1.482-2 - Determination of taxable income in specific situations.
Code of Federal Regulations, 2013 CFR
2013-04-01
... applied first to the opening June balance, and then to the additional amounts incurred during the month of June. With respect to X's June opening balance of $100, no interest is required to be accrued on $60 of... the opening balance not paid until August 31. No interest is required to be accrued on the $200 of...
26 CFR 1.482-2 - Determination of taxable income in specific situations.
Code of Federal Regulations, 2014 CFR
2014-04-01
... applied first to the opening June balance, and then to the additional amounts incurred during the month of June. With respect to X's June opening balance of $100, no interest is required to be accrued on $60 of... the opening balance not paid until August 31. No interest is required to be accrued on the $200 of...
26 CFR 1.482-2 - Determination of taxable income in specific situations.
Code of Federal Regulations, 2011 CFR
2011-04-01
... applied first to the opening June balance, and then to the additional amounts incurred during the month of June. With respect to X's June opening balance of $100, no interest is required to be accrued on $60 of... the opening balance not paid until August 31. No interest is required to be accrued on the $200 of...
26 CFR 1.482-2 - Determination of taxable income in specific situations.
Code of Federal Regulations, 2012 CFR
2012-04-01
... applied first to the opening June balance, and then to the additional amounts incurred during the month of June. With respect to X's June opening balance of $100, no interest is required to be accrued on $60 of... the opening balance not paid until August 31. No interest is required to be accrued on the $200 of...
Mobile, Virtual Enhancements for Rehabilitation (MOVER)
2015-02-28
patient uses COTS input devices, such as the Microsoft Kinect and the Wii Balance Board , to perform therapeutic exercises that are mapped to...by hardcoding specific, commonly used balance exercises into the system and enabling the therapists to select and customize pre-identified... balance disorder patients. We made these games highly customizable to enable therapists to tune each game to the capabilities of individual patients
Carbon Isotope Biogeochemistry of Methane from Anoxic Sediments
NASA Technical Reports Server (NTRS)
Blair, Neal E.
1993-01-01
The isotopic composition of naturally occurring methane was used to constrain the tropospheric budget of that radiatively active gas. Numerous studies have shown that the isotopic composition is not constant, even for a specific source, and may vary temporally and spatially. The objective was to develop a process-level model that reproduced the seasonal variations in the C-13/C-12 composition of methane observed at the coastal site, Cape Lookout Bight, NC. Details of the mass balance are provided. Experiments and models designed to determine what factors incluence C-13/C-12 ratio of dissolved CO2 are reported. All the factors described were combined in a model that faithfully reproduces the seasonal C-13/C-12 variations observed at Cape Lookout. The model is described.
Hydrologic modeling strategy for the Islamic Republic of Mauritania, Africa
Friedel, Michael J.
2008-01-01
The government of Mauritania is interested in how to maintain hydrologic balance to ensure a long-term stable water supply for minerals-related, domestic, and other purposes. Because of the many complicating and competing natural and anthropogenic factors, hydrologists will perform quantitative analysis with specific objectives and relevant computer models in mind. Whereas various computer models are available for studying water-resource priorities, the success of these models to provide reliable predictions largely depends on adequacy of the model-calibration process. Predictive analysis helps us evaluate the accuracy and uncertainty associated with simulated dependent variables of our calibrated model. In this report, the hydrologic modeling process is reviewed and a strategy summarized for future Mauritanian hydrologic modeling studies.
The Precision Problem in Conservation and Restoration.
Hiers, J Kevin; Jackson, Stephen T; Hobbs, Richard J; Bernhardt, Emily S; Valentine, Leonie E
2016-11-01
Within the varied contexts of environmental policy, conservation of imperilled species populations, and restoration of damaged habitats, an emphasis on idealized optimal conditions has led to increasingly specific targets for management. Overly-precise conservation targets can reduce habitat variability at multiple scales, with unintended consequences for future ecological resilience. We describe this dilemma in the context of endangered species management, stream restoration, and climate-change adaptation. Inappropriate application of conservation targets can be expensive, with marginal conservation benefit. Reduced habitat variability can limit options for managers trying to balance competing objectives with limited resources. Conservation policies should embrace habitat variability, expand decision-space appropriately, and support adaptation to local circumstances to increase ecological resilience in a rapidly changing world. Copyright © 2016 Elsevier Ltd. All rights reserved.
An experimental and theoretical study of radiative extinction of diffusion flames
NASA Technical Reports Server (NTRS)
Wichman, Indrek S.; Atreya, A.
1994-01-01
Our work was primarily theoretical and numerical. We investigated the simplified modeling of heat losses in diffusion flames, then we 'ramped up' the level of complexity in each successive study until the final chapter discussed the general problem of soot/flame interaction. With regard to the specific objective of studying radiative extinction, we conclude that in the steady case a self-extinguishing zero-g flame is unlikely to occur. The soot volume fractions are too small. On the other hand, our work does provide rational means for assessing the mixture of chemical energy release and radiative heat release. It also provides clues for suitable 'tailoring' this balance. Thus heat fluxes to surrounding surfaces can be substantially increased by exploiting and modifying its sooting capability.
A Module on Death and Dying to Develop Empathy in Student Pharmacists
Olin, Jacqueline L.; Thornton, Phillip L.; Dolder, Christian R.; Hanrahan, Conor
2011-01-01
Objective To implement an integrated module on death and dying into a 15-week bioethics course and determine whether it increased student pharmacists’ empathy. Design Students participated in a 5-week death and dying module that included presentation of the film Wit, an interactive lecture on hospice, and a lecture on the ethics of pain management. Assessment Fifty-six students completed the 30-item Balanced Emotional Empathy Scale (BEES) before and after completing the module and wrote a reflective essay. Students demonstrated an appreciation of patient-specific values in their essay. Quantitative data collected via BEES scores demonstrated significant improvement in measured empathy. Conclusion A 5-week instructional model on death and dying significantly increased student empathy. PMID:21769147
Athletic Trainer Perceptions of Life-Work Balance and Parenting Concerns
Eberman, Lindsey E.; Kahanov, Leamor
2013-01-01
Context: Life-work balance may be one reason for retention concerns among athletic trainers (ATs), yet evidence does not exist to support the supposition. Objective: To assess the perceptions of ATs regarding life-work balance, specifically on parenting issues. Design: Survey. Setting: Online survey at www.surveymonkey.com. Patients or Other Participants: A random sample of National Athletic Trainers' Association members (N = 9516) received the survey; 20.6% (n = 1962; male = 954, female = 816; age = 37 ± 10 years, experience = 13 ± 9 years) completed any portion of the survey. Most respondents worked in the college/university (34.5%, n = 657 of 1908) and secondary school settings (25.9%, n = 476 of 1908). A majority of participants (50.7%, n = 898 of 1770) were parents. Intervention(s): We calculated frequencies and percentages and used Mann-Whitney U tests and Kruskal-Wallis tests to identify the differences between sexes and among job settings on life-work balance measures among parents. Main Outcome Measures: The questionnaire included 8 life-work balance items, 7 parenting challenge items, and 3 nonparent items. Results: The results indicate that sex and setting significantly affected perceptions about parenting. Males articulated a stronger sense of difficulty in finding balance as a working parent (P < .001; 1.95 ± 1.98). Females felt more strongly than males that managing work and family was stressful (P = .04; 3.86 ± 1.13) and caused burnout (P = .004; 3.50 ± 1.24), and that their energy tended to fall short of their needs (P < .001; 3.74 ± 1.15). The decision not to have children was strongly affected by the work setting (P = .014; 3.37 ± 1.42). Both college/university (4.14 ± 0.85) and secondary school (4.03 ± 0.90) ATs would prefer to spend more time at home, as compared with ATs in other settings (P < .001). College/university ATs (P = .025; 3.17 ± 1.23) felt most strongly that their families were neglected because of work. In none of the settings did ATs feel that their employment settings were particularly tolerant of their parenting responsibilities (P = .027; 1.72 ± 1.97). Conclusions: Male and female employees had similar perceptions of life-work balance, but occupational setting may affect these perceptions. PMID:23675801
Littlejohn, Nicole K.
2015-01-01
Metabolic disease, specifically obesity, has now become the greatest challenge to improving cardiovascular health. The renin-angiotensin system (RAS) exists as both a circulating hormone system and as a local paracrine signaling mechanism within various tissues including the brain, kidney, and adipose, and this system is strongly implicated in cardiovascular health and disease. Growing evidence also implicates the RAS in the control of energy balance, supporting the concept that the RAS may be mechanistically involved in the pathogenesis of obesity and obesity hypertension. Here, we review the involvement of the RAS in the entire spectrum of whole organism energy balance mechanisms, including behaviors (food ingestion and spontaneous physical activity) and biological processes (digestive efficiency and both aerobic and nonaerobic resting metabolic rates). We hypothesize that opposing, tissue-specific effects of the RAS to modulate these various components of energy balance can explain the apparently paradoxical results reported by energy-balance studies that involve stimulating, versus disrupting, the RAS. We propose a model in which such opposing and tissue-specific effects of the RAS can explain the failure of simple, global RAS blockade to result in weight loss in humans, and hypothesize that obesity-mediated uncoupling of endogenous metabolic rate control mechanisms can explain the phenomenon of obesity-related hypertension. PMID:26491099
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.
New technologies lead to a new frontier: cognitive multiple data representation
NASA Astrophysics Data System (ADS)
Buffat, S.; Liege, F.; Plantier, J.; Roumes, C.
2005-05-01
The increasing number and complexity of operational sensors (radar, infrared, hyperspectral...) and availability of huge amount of data, lead to more and more sophisticated information presentations. But one key element of the IMINT line cannot be improved beyond initial system specification: the operator.... In order to overcome this issue, we have to better understand human visual object representation. Object recognition theories in human vision balance between matching 2D templates representation with viewpoint-dependant information, and a viewpoint-invariant system based on structural description. Spatial frequency content is relevant due to early vision filtering. Orientation in depth is an important variable to challenge object constancy. Three objects, seen from three different points of view in a natural environment made the original images in this study. Test images were a combination of spatial frequency filtered original images and an additive contrast level of white noise. In the first experiment, the observer's task was a same versus different forced choice with spatial alternative. Test images had the same noise level in a presentation row. Discrimination threshold was determined by modifying the white noise contrast level by means of an adaptative method. In the second experiment, a repetition blindness paradigm was used to further investigate the viewpoint effect on object recognition. The results shed some light on the human visual system processing of objects displayed under different physical descriptions. This is an important achievement because targets which not always match physical properties of usual visual stimuli can increase operational workload.
Burel, Christine; Tanguy, Mael; Guerre, Philippe; Boilletot, Eric; Cariolet, Roland; Queguiner, Marilyne; Postollec, Gilbert; Pinton, Philippe; Salvat, Gilles; Oswald, Isabelle P.; Fravalo, Philippe
2013-01-01
The objective of this study was to measure the effects of chronic exposure to fumonisins via the ingestion of feed containing naturally contaminated corn in growing pigs infected or not with Salmonella spp. This exposure to a moderate dietary concentration of fumonisins (11.8 ppm) was sufficient to induce a biological effect in pigs (Sa/So ratio), but no mortality or pathology was observed over 63 days of exposure. No mortality or related clinical signs, even in cases of inoculation with Salmonella (5 × 104 CFU), were observed either. Fumonisins, at these concentrations, did not affect the ability of lymphocytes to proliferate in the presence of mitogens, but after seven days post-inoculation they led to inhibition of the ability of specific Salmonella lymphocytes to proliferate following exposure to a specific Salmonella antigen. However, the ingestion of fumonisins had no impact on Salmonella translocation or seroconversion in inoculated pigs. The inoculation of Salmonella did not affect faecal microbiota profiles, but exposure to moderate concentrations of fumonisins transiently affected the digestive microbiota balance. In cases of co-infection with fumonisins and Salmonella, the microbiota profiles were rapidly and clearly modified as early as 48 h post-Salmonella inoculation. Therefore under these experimental conditions, exposure to an average concentration of fumonisins in naturally contaminated feed had no effect on pig health but did affect the digestive microbiota balance, with Salmonella exposure amplifying this phenomenon. PMID:23612754
Interoceptive influences on peripersonal space boundary.
Ardizzi, Martina; Ferri, Francesca
2018-08-01
Integration of body-related signals within the peripersonal space (PPS) contributes to bodily self-awareness. Whereas several studies have shown how individual PPS extension is shaped by external factors, e.g. during interactions with people and objects, no studies have looked at interoceptive influences on PPS extension. We exposed participants to an audio-tactile interaction task, to measure their PPS boundary (Session 1), and to a heartbeat counting task and a time estimation task, to specifically assess their interoceptive accuracy (Session 2). Participants' traits of private self-consciousness and social anxiety were also evaluated, to account for their possible effect on the relation between interoception and PPS representation. We found that higher interoceptive accuracy specifically predicts narrower PPS boundary. Moreover, this relation is moderated by individual traits of private self-consciousness, but not social anxiety. Extending the concept of interoceptive influences on exteroceptive body representations to PPS, our results, first, support the idea that a dynamic balance between intero-exteroceptive processing might represent a general principle underlying bodily self-awareness; second, they shed light on how interoception may affect also the way we interface with the external world. Finally, showing that, in order for interoceptive accuracy to be effective on the intero-exteroceptive balance, it is important that individuals tend to focus on inner sensations and feelings, our results suggest that a comprehensive intero-exteroceptive model of bodily self-awareness should be (at least) a three-dimensional model that includes individual self-consciousness traits. Copyright © 2018 Elsevier B.V. All rights reserved.
Song, Kyeongtak; Rhodes, Evan; Wikstrom, Erik A
2018-04-01
Visual, vestibular, and somatosensory systems contribute to postural control. Chronic ankle instability (CAI) patients have been observed to have a reduced ability to dynamically shift their reliance among sources of sensory information and rely more heavily on visual information during a single-limb stance relative to uninjured controls. Balance training is proven to improve postural control but there is a lack of evidence regarding the ability of balance training programs to alter the reliance on visual information in CAI patients. Our objective was to determine if balance training alters the reliance on visual information during static stance in CAI patients. The PubMed, CINAHL, and SPORTDiscus databases were searched from their earliest available date to October 2017 using a combination of keywords. Study inclusion criteria consisted of (1) using participants with CAI; (2) use of a balance training intervention; and (3) calculation of an objective measure of static postural control during single-limb stance with eyes open and eyes closed. Sample sizes, means, and standard deviations of single-leg balance measures for eyes-open and eyes-closed testing conditions before and after balance training were extracted from the included studies. Eyes-open to eyes-closed effect sizes [Hedges' g and 95% confidence intervals (CI)] before and after balance training were calculated, and between-study variability for heterogeneity and potential risks of publication bias were examined. Six studies were identified. The overall eyes-open to eyes-closed effect size difference between pre- and post-intervention assessments was not significant (Hedges' g effect size = 0.151, 95% CI = - 0.151 to 0.453, p = 0.26). This result indicates that the utilization of visual information in individuals with CAI during the single-leg balance is not altered after balance training. Low heterogeneity (Q(5) = 2.96, p = 0.71, I 2 = 0%) of the included studies and no publication bias were found. On the basis of our systematic review with meta-analysis, it appears that traditional balance training protocols do not alter the reliance on visual information used by CAI patients during a single-leg stance.
Engberg, Lovisa; Forsgren, Anders; Eriksson, Kjell; Hårdemark, Björn
2017-06-01
To formulate convex planning objectives of treatment plan multicriteria optimization with explicit relationships to the dose-volume histogram (DVH) statistics used in plan quality evaluation. Conventional planning objectives are designed to minimize the violation of DVH statistics thresholds using penalty functions. Although successful in guiding the DVH curve towards these thresholds, conventional planning objectives offer limited control of the individual points on the DVH curve (doses-at-volume) used to evaluate plan quality. In this study, we abandon the usual penalty-function framework and propose planning objectives that more closely relate to DVH statistics. The proposed planning objectives are based on mean-tail-dose, resulting in convex optimization. We also demonstrate how to adapt a standard optimization method to the proposed formulation in order to obtain a substantial reduction in computational cost. We investigated the potential of the proposed planning objectives as tools for optimizing DVH statistics through juxtaposition with the conventional planning objectives on two patient cases. Sets of treatment plans with differently balanced planning objectives were generated using either the proposed or the conventional approach. Dominance in the sense of better distributed doses-at-volume was observed in plans optimized within the proposed framework. The initial computational study indicates that the DVH statistics are better optimized and more efficiently balanced using the proposed planning objectives than using the conventional approach. © 2017 American Association of Physicists in Medicine.
Bernstein, Stéphanie
2011-01-01
This paper looks at the role of legislated norms of general application in shaping "family-friendly" workplaces and their interaction with collectively-bargained standards in the retail service sector and more specifically, in a single unionized retail sector in Quebec, Canada. The methodology used is traditional legal research methodology: analysis of laws, collective agreements and case law. The principal norms examined concern parental and family leave, working time and disparities between different employment statuses. A series of legislative provisions have been adopted in Quebec over the last 30 years whose objectives are the improvement of family-related leave and the reduction of working time. Unions have also negotiated provisions in collective agreements with these same goals. In the low-wage retail sector studied, the working time standards negotiated between the unions and the employers reflect the characteristics of the sector, most notably extended opening hours, seven days a week. Predictability of hours also varies according to employment status. Such issues as family-unfriendly working time arrangements (last-minute scheduling, asocial hours, etc.) and the need for flexibility in family-related leave are insufficiently taken into account by the legislated and bargained provisions. A fine analysis and comprehension of existing formal regulation, be it legislated or collectively-bargained, is required to fully understand workers' experiences with work-family balance and to identify the gaps between formal norms and the needs expressed by workers with respect to work-family balance.
Vestibular function assessment using the NIH Toolbox
Schubert, Michael C.; Whitney, Susan L.; Roberts, Dale; Redfern, Mark S.; Musolino, Mark C.; Roche, Jennica L.; Steed, Daniel P.; Corbin, Bree; Lin, Chia-Cheng; Marchetti, Greg F.; Beaumont, Jennifer; Carey, John P.; Shepard, Neil P.; Jacobson, Gary P.; Wrisley, Diane M.; Hoffman, Howard J.; Furman, Gabriel; Slotkin, Jerry
2013-01-01
Objective: Development of an easy to administer, low-cost test of vestibular function. Methods: Members of the NIH Toolbox Sensory Domain Vestibular, Vision, and Motor subdomain teams collaborated to identify 2 tests: 1) Dynamic Visual Acuity (DVA), and 2) the Balance Accelerometry Measure (BAM). Extensive work was completed to identify and develop appropriate software and hardware. More than 300 subjects between the ages of 3 and 85 years, with and without vestibular dysfunction, were recruited and tested. Currently accepted gold standard measures of static visual acuity, vestibular function, dynamic visual acuity, and balance were performed to determine validity. Repeat testing was performed to examine reliability. Results: The DVA and BAM tests are affordable and appropriate for use for individuals 3 through 85 years of age. The DVA had fair to good reliability (0.41–0.94) and sensitivity and specificity (50%–73%), depending on age and optotype chosen. The BAM test was moderately correlated with center of pressure (r = 0.42–0.48) and dynamic posturography (r = −0.48), depending on age and test condition. Both tests differentiated those with and without vestibular impairment and the young from the old. Each test was reliable. Conclusion: The newly created DVA test provides a valid measure of visual acuity with the head still and moving quickly. The novel BAM is a valid measure of balance. Both tests are sensitive to age-related changes and are able to screen for impairment of the vestibular system. PMID:23479540
[Postural control disorders in initial phases of whiplash].
Pleguezuelos Cobo, Eulogio; García-Alsina, Joan; García Almazán, Concepción; Ortiz Fandiño, Javier; Pérez Mesquida, M Engracia; Guirao Cano, Lluis; Samitier Pastor, Beatriz; Perucho Pont, Cristina; Coll Serra, Estel; Matarrubias, Carlos; Reveron, Genoveva
2009-05-02
Dizziness of variable intensity is a frequent complaint in patients who suffered whiplash and largely documented balance disturbances. The objective of the study was to identify balance disorders in early stage of whiplash after road traffic accidents. Ninety nine women were included in the study. Fifty four women had suffered whiplash within two weeks and 45 were included in a healthy control group. Static posturography on a force platform was carried out in all study participants, by means of the Romberg test in four sequential phases, using the postural sway area (SA) as a dependent variable. Visual Analogic Scale (VAS) and Northwick Park Neck Pain Questionnaire (NPH) were used to evaluate pain and function. Postural sway area increased significantly in each of the consecutive phases in both groups. The differences of the means of the postural sway area were statistically significant in all Romberg phases (p=.009 to P=.000). No correlation was found between SA and VAS or NPH scores. There was a positive correlation between the postural sway area standing on a thick foam cushion placed over the plate with closed eyes and the number of days of transitory incapacity (r=0.414; P=.009). Patients with recent whiplash show a postural control disturbance revealed trough a sequential static posturography analysis. This suggests that the balance disorder is not only a consequence of late whiplash syndrome evolution. Therefore, we should promote early instauration of a specific therapeutic approach if and when the patient refers dizziness and related symptoms.
Influence of spasticity on mobility and balance in persons with multiple sclerosis.
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.
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.
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
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.
2013-01-01
Background With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested. Methods/Design Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale – International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with each training session lasting 30 min. (actual training time). One intervention group will complete an extensive supervised training program, while the other intervention group will complete a short version ('3 times 3’) that is home-based and controlled by weekly phone calls. Post-tests will be conducted right after the intervention period. Additionally, detraining effects will be measured 12 weeks after program cessation. The control group / waiting group will not participate in any specific intervention during the experimental period, but will receive the extensive supervised program after the experimental period. Discussion It is expected that particularly the supervised combination of balance and strength / power training will improve performance in variables of balance, strength / power, body composition, cognitive function, psychosocial well-being, and falls self-efficacy of older adults. In addition, information regarding fall risk assessment, dose–response-relations, detraining effects, and supervision of training will be provided. Further, training-induced health-relevant changes, such as improved performance in activities of daily living, cognitive function, and quality of life, as well as a reduced risk for falls may help to lower costs in the health care system. Finally, practitioners, therapists, and instructors will be provided with a scientifically evaluated feasible, safe, and easy-to-administer exercise program for fall prevention. Trial registration ClinicalTrials.gov Identifier: NCT01906034 PMID:24106864
Cortical processes associated with continuous balance control as revealed by EEG spectral power.
Hülsdünker, T; Mierau, A; Neeb, C; Kleinöder, H; Strüder, H K
2015-04-10
Balance is a crucial component in numerous every day activities such as locomotion. Previous research has reported distinct changes in cortical theta activity during transient balance instability. However, there remains little understanding of the neural mechanisms underlying continuous balance control. This study aimed to investigate cortical theta activity during varying difficulties of continuous balance tasks, as well as examining the relationship between theta activity and balance performance. 37 subjects completed nine balance tasks with different levels of surface stability and base of support. Throughout the balancing task, electroencephalogram (EEG) was recorded from 32 scalp locations. ICA-based artifact rejection was applied and spectral power was analyzed in the theta frequency band. Theta power increased in the frontal, central, and parietal regions of the cortex when balance tasks became more challenging. In addition, fronto-central and centro-parietal theta power correlated with balance performance. This study demonstrates the involvement of the cerebral cortex in maintaining upright posture during continuous balance tasks. Specifically, the results emphasize the important role of frontal and parietal theta oscillations in balance control. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Park, Shin-Kyu; Kim, Sung-Jin; Yoon, Tak Yong; Lee, Suk-Min
2018-05-01
[Purpose] This study aimed to investigate the effects of circular gait training on balance and balance confidence in patients with stroke. [Subjects and Methods] Fifteen patients with stroke were randomly divided into either the circular gait training (CGT) group (n=8) or the straight gait training (SGT) group (n=7). Both groups had conventional therapy that adhered to the neurodevelopmental treatment (NDT) approach, for 30 min. In addition, the CGT group performed circular gait training, and the SGT group practiced straight gait training for 30 min. Each intervention was applied for 1 h, 5 days a week, for 2 weeks. Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Activities-specific Balance Confidence (ABC) scale were used to test balance and balance confidence. [Results] After the intervention, both groups showed significant increases in balance and balance confidence. Significant improvements in the balance of the CGT group compared with the SGT group were observed at post-assessment. [Conclusion] This study showed that circular gait training significantly improves balance in patients with stroke.
Chang, Jasper O; Levy, Susan S; Seay, Seth W; Goble, Daniel J
2014-05-01
Recent guidelines advocate sports medicine professionals to use balance tests to assess sensorimotor status in the management of concussions. The present study sought to determine whether a low-cost balance board could provide a valid, reliable, and objective means of performing this balance testing. Criterion validity testing relative to a gold standard and 7 day test-retest reliability. University biomechanics laboratory. Thirty healthy young adults. Balance ability was assessed on 2 days separated by 1 week using (1) a gold standard measure (ie, scientific grade force plate), (2) a low-cost Nintendo Wii Balance Board (WBB), and (3) the Balance Error Scoring System (BESS). Validity of the WBB center of pressure path length and BESS scores were determined relative to the force plate data. Test-retest reliability was established based on intraclass correlation coefficients. Composite scores for the WBB had excellent validity (r = 0.99) and test-retest reliability (R = 0.88). Both the validity (r = 0.10-0.52) and test-retest reliability (r = 0.61-0.78) were lower for the BESS. These findings demonstrate that a low-cost balance board can provide improved balance testing accuracy/reliability compared with the BESS. This approach provides a potentially more valid/reliable, yet affordable, means of assessing sports-related concussion compared with current methods.
USDA-ARS?s Scientific Manuscript database
The objective of this study was to determine the effects of supplemental organic cobalt on nutrient digestion and nitrogen balance in lambs fed forage-based diets. Sixteen wether lambs (avg initial BW = 28.6 ± 1.3 kg) were used in a 2 × 2 Latin square and randomly allotted to one of two treatments b...
Army Vocational Guidance in Two-Year Colleges
1987-11-01
worklife . Second, counselors were quite receptive to the idea of having high quality Army information available that could aid student career planning...the CVG/JOIN information presentations to be informative and rather objective (i.e., balanced pros and cons about Army life/options). Nonetheless...presentation; variety, color is excellant. - Very honest and balanced presentations. "* 130 0 - - - - - - - - - - 15) quality of "Army Jobs" info
ERIC Educational Resources Information Center
Vanderloo, Leigh M.; Tucker, Patricia
2017-01-01
Objective: To compare physical activity and sedentary time among young children whose schools adhere to traditional (i.e. three outdoor playtimes = 70 minutes) versus balanced day (i.e. two outdoor playtimes = ~55 minutes) schedules in Ontario full-day kindergarten classrooms. Design: The project was part of a larger, 2-year cross-sectional study.…
Implement balanced scorecard to translate strategic plan into actionable objectives.
2004-09-01
Faced with challenges ranging from declining reimbursement to staff shortages, health care organizations--integrated delivery systems, physician group practices, disease management providers, and others--increasingly are turning to general business models to map out step-by-step action plans for performance measurement and process improvement. Creating a "balanced scorecard" is an obvious starting point for assessing and improving clinical and financial performance.
Binns, Michael; de Atauri, Pedro; Vlysidis, Anestis; Cascante, Marta; Theodoropoulos, Constantinos
2015-02-18
Flux balance analysis is traditionally implemented to identify the maximum theoretical flux for some specified reaction and a single distribution of flux values for all the reactions present which achieve this maximum value. However it is well known that the uncertainty in reaction networks due to branches, cycles and experimental errors results in a large number of combinations of internal reaction fluxes which can achieve the same optimal flux value. In this work, we have modified the applied linear objective of flux balance analysis to include a poling penalty function, which pushes each new set of reaction fluxes away from previous solutions generated. Repeated poling-based flux balance analysis generates a sample of different solutions (a characteristic set), which represents all the possible functionality of the reaction network. Compared to existing sampling methods, for the purpose of generating a relatively "small" characteristic set, our new method is shown to obtain a higher coverage than competing methods under most conditions. The influence of the linear objective function on the sampling (the linear bias) constrains optimisation results to a subspace of optimal solutions all producing the same maximal fluxes. Visualisation of reaction fluxes plotted against each other in 2 dimensions with and without the linear bias indicates the existence of correlations between fluxes. This method of sampling is applied to the organism Actinobacillus succinogenes for the production of succinic acid from glycerol. A new method of sampling for the generation of different flux distributions (sets of individual fluxes satisfying constraints on the steady-state mass balances of intermediates) has been developed using a relatively simple modification of flux balance analysis to include a poling penalty function inside the resulting optimisation objective function. This new methodology can achieve a high coverage of the possible flux space and can be used with and without linear bias to show optimal versus sub-optimal solution spaces. Basic analysis of the Actinobacillus succinogenes system using sampling shows that in order to achieve the maximal succinic acid production CO₂ must be taken into the system. Solutions involving release of CO₂ all give sub-optimal succinic acid production.
Van Ooteghem, Karen; Frank, James S.; Allard, Fran; Horak, Fay B
2011-01-01
Postural motor learning for dynamic balance tasks has been demonstrated in healthy older adults (Van Ooteghem et al. 2009). The purpose of this study was to investigate the type of knowledge (general or specific) obtained with balance training in this age group and to examine whether embedding perturbation regularities within a balance task masks specific learning. Two groups of older adults maintained balance on a constant frequency-variable amplitude oscillating platform. One group was trained using an embedded sequence (ES) protocol which contained the same 15-s sequence of variable amplitude oscillations in the middle of each trial. A second group was trained using a looped sequence (LS) protocol which contained a 15-s sequence repeated three times to form each trial. All trials were 45-s. Participants were not informed of any repetition. To examine learning, participants performed a retention test following a 24-h delay. LS participants also completed a transfer task. Specificity of learning was examined by comparing performance for repeated versus random sequences (ES) and training versus transfer sequences (LS). Performance was measured by deriving spatial and temporal measures of whole body centre of mass (COM), and trunk orientation. Both groups improved performance with practice as characterized by reduced COM displacement, improved COM-platform phase relationships, and decreased angular trunk motion. Improvements were also characterized by general rather than specific postural motor learning. These findings are similar to young adults (Van Ooteghem et al. 2008) and indicate that age does not influence the type of learning which occurs for balance control. PMID:20544184
NASA Technical Reports Server (NTRS)
Karns, James
1993-01-01
The objective of this study was to establish the initial quantitative reliability bounds for nuclear electric propulsion systems in a manned Mars mission required to ensure crew safety and mission success. Finding the reliability bounds involves balancing top-down (mission driven) requirements and bottom-up (technology driven) capabilities. In seeking this balance we hope to accomplish the following: (1) provide design insights into the achievability of the baseline design in terms of reliability requirements, given the existing technology base; (2) suggest alternative design approaches which might enhance reliability and crew safety; and (3) indicate what technology areas require significant research and development to achieve the reliability objectives.
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.
NASA Technical Reports Server (NTRS)
Wilson, R. Gale
1994-01-01
The potential capabilities and limitations of single ball lenses for coupling laser diode radiation to single-mode optical fibers have been analyzed; parameters important to optical communications were specifically considered. These parameters included coupling efficiency, effective numerical apertures, lens radius, lens refractive index, wavelength, magnification in imaging the laser diode on the fiber, and defocus to counterbalance spherical aberration of the lens. Limiting numerical apertures in object and image space were determined under the constraint that the lens perform to the Rayleigh criterion of 0.25-wavelength (Strehl ratio = 0.80). The spherical aberration-defocus balance to provide an optical path difference of 0.25 wavelength units was shown to define a constant coupling efficiency (i.e., 0.56). The relative numerical aperture capabilities of the ball lens were determined for a set of wavelengths and associated fiber-core diameters of particular interest for single-mode fiber-optic communication. The results support general continuing efforts in the optical fiber communications industry to improve coupling links within such systems with emphasis on manufacturing simplicity, system packaging flexibility, relaxation of assembly alignment tolerances, cost reduction of opto-electronic components and long term reliability and stability.
Schmidt, Stefan; Bateman, Ian; Breinlinger-O'Reilly, Jochen; Smith, Peter
2006-01-01
Achieving excellence is a current preoccupation in U.K. public health organisations. This article aims to use a case study to explain how a mental health trust delivers excellent performance using a balanced scorecard (BSC) management approach. Reports a project to implement a BSC approach in the South West Yorkshire Mental Health NHS Trust to achieve its "excellence" objectives. The authors were participants in the project. The design of the pilot project was informed theoretically by the work of Kaplan and Norton and practically by in-house discussions on a strategy to achieve excellence. Explains the process of building a BSC strategy step-by-step. Discusses how the vision and strategies of a mental health trust can be translated into tangible measures, which are the basis for actions that are driven strategically. There are many possibilities for a BSC management approach and this case study is specific to mental health trusts in the UK, although it is believed that the case has a universally applicable modus operandi. This article will help healthcare managers to evaluate the benefits of a BSC management approach. This article explains how actions can be structured in connection with a BSC management approach.
Pedroso, João A.B.; Zampieri, Thais T.; Donato, Jose
2015-01-01
Leucine is a well-known activator of the mammalian target of rapamycin (mTOR). Because mTOR signaling regulates several aspects of metabolism, the potential of leucine as a dietary supplement for treating obesity and diabetes mellitus has been investigated. The objective of the present review was to summarize and discuss the available evidence regarding the mechanisms and the effects of leucine supplementation on the regulation of food intake, energy balance, and glucose homeostasis. Based on the available evidence, we conclude that although central leucine injection decreases food intake, this effect is not well reproduced when leucine is provided as a dietary supplement. Consequently, no robust evidence indicates that oral leucine supplementation significantly affects food intake, although several studies have shown that leucine supplementation may help to decrease body adiposity in specific conditions. However, more studies are necessary to assess the effects of leucine supplementation in already-obese subjects. Finally, although several studies have found that leucine supplementation improves glucose homeostasis, the underlying mechanisms involved in these potential beneficial effects remain unknown and may be partially dependent on weight loss. PMID:26007339
Gender-specific heart rate dynamics in severe intrauterine growth-restricted fetuses.
Gonçalves, Hernâni; Bernardes, João; Ayres-de-Campos, Diogo
2013-06-01
Management of intrauterine growth restriction (IUGR) remains a major issue in perinatology. The objective of this paper was the assessment of gender-specific fetal heart rate (FHR) dynamics as a diagnostic tool in severe IUGR. FHR was analyzed in the antepartum period in 15 severe IUGR fetuses and 18 controls, matched for gestational age, in relation to fetal gender. Linear and entropy methods, such as mean FHR (mFHR), low (LF), high (HF) and movement frequency (MF), approximate, sample and multiscale entropy. Sensitivities and specificities were estimated using Fisher linear discriminant analysis and the leave-one-out method. Overall, IUGR fetuses presented significantly lower mFHR and entropy compared with controls. However, gender-specific analysis showed that significantly lower mFHR was only evident in IUGR males and lower entropy in IUGR females. In addition, lower LF/(MF+HF) was patent in IUGR females compared with controls, but not in males. Rather high sensitivities and specificities were achieved in the detection of the FHR recordings related with IUGR male fetuses, when gender-specific analysis was performed at gestational ages less than 34 weeks. Severe IUGR fetuses present gender-specific linear and entropy FHR changes, compared with controls, characterized by a significantly lower entropy and sympathetic-vagal balance in females than in males. These findings need to be considered in order to achieve better diagnostic results. Copyright © 2013 Elsevier Ltd. All rights reserved.
Caparros-Midwood, Daniel; Barr, Stuart; Dawson, Richard
2017-11-01
Future development in cities needs to manage increasing populations, climate-related risks, and sustainable development objectives such as reducing greenhouse gas emissions. Planners therefore face a challenge of multidimensional, spatial optimization in order to balance potential tradeoffs and maximize synergies between risks and other objectives. To address this, a spatial optimization framework has been developed. This uses a spatially implemented genetic algorithm to generate a set of Pareto-optimal results that provide planners with the best set of trade-off spatial plans for six risk and sustainability objectives: (i) minimize heat risks, (ii) minimize flooding risks, (iii) minimize transport travel costs to minimize associated emissions, (iv) maximize brownfield development, (v) minimize urban sprawl, and (vi) prevent development of greenspace. The framework is applied to Greater London (U.K.) and shown to generate spatial development strategies that are optimal for specific objectives and differ significantly from the existing development strategies. In addition, the analysis reveals tradeoffs between different risks as well as between risk and sustainability objectives. While increases in heat or flood risk can be avoided, there are no strategies that do not increase at least one of these. Tradeoffs between risk and other sustainability objectives can be more severe, for example, minimizing heat risk is only possible if future development is allowed to sprawl significantly. The results highlight the importance of spatial structure in modulating risks and other sustainability objectives. However, not all planning objectives are suited to quantified optimization and so the results should form part of an evidence base to improve the delivery of risk and sustainability management in future urban development. © 2017 The Authors Risk Analysis published by Wiley Periodicals, Inc. on behalf of Society for Risk Analysis.
NASA Astrophysics Data System (ADS)
Chaudhuri, Anirban
Global optimization based on expensive and time consuming simulations or experiments usually cannot be carried out to convergence, but must be stopped because of time constraints, or because the cost of the additional function evaluations exceeds the benefits of improving the objective(s). This dissertation sets to explore the implications of such budget and time constraints on the balance between exploration and exploitation and the decision of when to stop. Three different aspects are considered in terms of their effects on the balance between exploration and exploitation: 1) history of optimization, 2) fixed evaluation budget, and 3) cost as a part of objective function. To this end, this research develops modifications to the surrogate-based optimization technique, Efficient Global Optimization algorithm, that controls better the balance between exploration and exploitation, and stopping criteria facilitated by these modifications. Then the focus shifts to examining experimental optimization, which shares the issues of cost and time constraints. Through a study on optimization of thrust and power for a small flapping wing for micro air vehicles, important differences and similarities between experimental and simulation-based optimization are identified. The most important difference is that reduction of noise in experiments becomes a major time and cost issue, and a second difference is that parallelism as a way to cut cost is more challenging. The experimental optimization reveals the tendency of the surrogate to display optimistic bias near the surrogate optimum, and this tendency is then verified to also occur in simulation based optimization.
Tuning rules for robust FOPID controllers based on multi-objective optimization with FOPDT models.
Sánchez, Helem Sabina; Padula, Fabrizio; Visioli, Antonio; Vilanova, Ramon
2017-01-01
In this paper a set of optimally balanced tuning rules for fractional-order proportional-integral-derivative controllers is proposed. The control problem of minimizing at once the integrated absolute error for both the set-point and the load disturbance responses is addressed. The control problem is stated as a multi-objective optimization problem where a first-order-plus-dead-time process model subject to a robustness, maximum sensitivity based, constraint has been considered. A set of Pareto optimal solutions is obtained for different normalized dead times and then the optimal balance between the competing objectives is obtained by choosing the Nash solution among the Pareto-optimal ones. A curve fitting procedure has then been applied in order to generate suitable tuning rules. Several simulation results show the effectiveness of the proposed approach. Copyright © 2016. Published by Elsevier Ltd.
Balance quality assessment as an early indicator of physical frailty in older people.
Chkeir, Aly; Safieddine, Doha; Bera, D; Collart, M; Novella, J L; Drame, M; Hewson, David J; Duchene, Jacques
2016-08-01
Frailty is an increasingly common geriatric condition that results in an increased risk of adverse health outcomes such as falls. The most widely-used means of detecting frailty is the Fried phenotype, which includes several objective measures such as grip strength and gait velocity. One method of screening for falls is to measure balance, which can be done by a range of techniques including the assessment of the Centre of Pressure (CoP) during a balance assessment. The Balance Quality Tester (BQT) is a device based on a commercial bathroom scale that can evaluate balance quality. The BQT provides instantaneously the position of the CoP (stabilogram) in both anteroposterior (AP) and mediolateral (ML) directions and can estimate the vertical ground reaction force. The purpose of this study was to examine the relationship between balance quality assessment and physical frailty. Balance quality was compared to physical frailty in 186 older subjects. Rising rate (RR) was slower and trajectory velocity (TV) was higher in subjects classified as frail for both grip strength and gait velocity (p<;0.05). Balance assessment could be used in conjunction with functional tests of grip strength and gait velocity as a means of screening for frailty.
Mobile, Virtual Enhancements for Rehabilitation (MOVER)
2015-08-28
bottom of the figure. The patient uses COTS input devices, such as the Microsoft Kinect and the Wii Balance Board , to perform therapeutic exercises...specific, commonly used balance exercises into the system and enabling the therapists to select and customize pre-identified parameters for these exercises... balance disorder patients. We made these games highly customizable to enable therapists to tune each game to the capabilities of individual
Chisholm, Amanda E; Malik, Raza Naseem; Blouin, Jean-Sébastien; Borisoff, Jaimie; Forwell, Susan; Lam, Tania
2014-06-06
Previous evidence suggests the effects of task-specific therapy can be further enhanced when sensory stimulation is combined with motor practice. Sensory tongue stimulation is thought to facilitate activation of regions in the brain that are important for balance and gait. Improvements in balance and gait have significant implications for functional mobility for people with incomplete spinal cord injury (iSCI). The aim of this case study was to evaluate the feasibility of a lab- and home-based program combining sensory tongue stimulation with balance and gait training on functional outcomes in people with iSCI. Two male participants (S1 and S2) with chronic motor iSCI completed 12 weeks of balance and gait training (3 lab and 2 home based sessions per week) combined with sensory tongue stimulation using the Portable Neuromodulation Stimulator (PoNS). Laboratory based training involved 20 minutes of standing balance with eyes closed and 30 minutes of body-weight support treadmill walking. Home based sessions consisted of balancing with eyes open and walking with parallel bars or a walker for up to 20 minutes each. Subjects continued daily at-home training for an additional 12 weeks as follow-up. Both subjects were able to complete a minimum of 83% of the training sessions. Standing balance with eyes closed increased from 0.2 to 4.0 minutes and 0.0 to 0.2 minutes for S1 and S2, respectively. Balance confidence also improved at follow-up after the home-based program. Over ground walking speed improved by 0.14 m/s for S1 and 0.07 m/s for S2, and skilled walking function improved by 60% and 21% for S1 and S2, respectively. Sensory tongue stimulation combined with task-specific training may be a feasible method for improving balance and gait in people with iSCI. Our findings warrant further controlled studies to determine the added benefits of sensory tongue stimulation to rehabilitation training.
Hong, Do-Kwan; Joo, Dae-Suk; Woo, Byung-Chul; Koo, Dae-Hyun; Ahn, Chan-Woo
2014-01-01
The objective of the present study was to deal with the rotordynamics of the rotor of an ultra-high speed PM type synchronous motor-generator for a 500 W rated micro gas turbine generator. This paper introduces dynamic analysis, and experiments on the motor-generator. The focus is placed on an analytical approach considering the mechanical dynamic problems. It is essential to deal with dynamic stability at ultra-high speeds. Unbalance response analysis is performed by calculating the unbalance with and without balancing using a balancing machine. Critical speed analysis is performed to determine the operating speed with sufficient separation margin. The unbalance response analysis is compared with the experimental results considering the balancing grade (ISO 1940-1) and predicted vibration displacement with and without balancing. Based on these results, a high-speed motor-generator was successfully developed. PMID:25177804
An energy-aware routing protocol for query-based applications in wireless sensor networks.
Ahvar, Ehsan; Ahvar, Shohreh; Lee, Gyu Myoung; Crespi, Noel
2014-01-01
Wireless sensor network (WSN) typically has energy consumption restriction. Designing energy-aware routing protocol can significantly reduce energy consumption in WSNs. Energy-aware routing protocols can be classified into two categories, energy savers and energy balancers. Energy saving protocols are used to minimize the overall energy consumed by a WSN, while energy balancing protocols attempt to efficiently distribute the consumption of energy throughout the network. In general terms, energy saving protocols are not necessarily good at balancing energy consumption and energy balancing protocols are not always good at reducing energy consumption. In this paper, we propose an energy-aware routing protocol (ERP) for query-based applications in WSNs, which offers a good trade-off between traditional energy balancing and energy saving objectives and supports a soft real time packet delivery. This is achieved by means of fuzzy sets and learning automata techniques along with zonal broadcasting to decrease total energy consumption.
An Energy-Aware Routing Protocol for Query-Based Applications in Wireless Sensor Networks
Crespi, Noel
2014-01-01
Wireless sensor network (WSN) typically has energy consumption restriction. Designing energy-aware routing protocol can significantly reduce energy consumption in WSNs. Energy-aware routing protocols can be classified into two categories, energy savers and energy balancers. Energy saving protocols are used to minimize the overall energy consumed by a WSN, while energy balancing protocols attempt to efficiently distribute the consumption of energy throughout the network. In general terms, energy saving protocols are not necessarily good at balancing energy consumption and energy balancing protocols are not always good at reducing energy consumption. In this paper, we propose an energy-aware routing protocol (ERP) for query-based applications in WSNs, which offers a good trade-off between traditional energy balancing and energy saving objectives and supports a soft real time packet delivery. This is achieved by means of fuzzy sets and learning automata techniques along with zonal broadcasting to decrease total energy consumption. PMID:24696640
Valiant load-balanced robust routing under hose model for WDM mesh networks
NASA Astrophysics Data System (ADS)
Zhang, Xiaoning; Li, Lemin; Wang, Sheng
2006-09-01
In this paper, we propose Valiant Load-Balanced robust routing scheme for WDM mesh networks under the model of polyhedral uncertainty (i.e., hose model), and the proposed routing scheme is implemented with traffic grooming approach. Our Objective is to maximize the hose model throughput. A mathematic formulation of Valiant Load-Balanced robust routing is presented and three fast heuristic algorithms are also proposed. When implementing Valiant Load-Balanced robust routing scheme to WDM mesh networks, a novel traffic-grooming algorithm called MHF (minimizing hop first) is proposed. We compare the three heuristic algorithms with the VPN tree under the hose model. Finally we demonstrate in the simulation results that MHF with Valiant Load-Balanced robust routing scheme outperforms the traditional traffic-grooming algorithm in terms of the throughput for the uniform/non-uniform traffic matrix under the hose model.
Cluff, Tyler; Boulet, Jason; Balasubramaniam, Ramesh
2011-08-01
Theories of motor learning argue that the acquisition of novel motor skills requires a task-specific organization of sensory and motor subsystems. We examined task-specific coupling between motor subsystems as subjects learned a novel stick-balancing task. We focused on learning-induced changes in finger movements and body sway and investigated the effect of practice on their coupling. Eight subjects practiced balancing a cylindrical wooden stick for 30 min a day during a 20 day learning period. Finger movements and center of pressure trajectories were recorded in every fifth practice session (4 in total) using a ten camera VICON motion capture system interfaced with two force platforms. Motor learning was quantified using average balancing trial lengths, which increased with practice and confirmed that subjects learned the task. Nonlinear time series and phase space reconstruction methods were subsequently used to investigate changes in the spatiotemporal properties of finger movements, body sway and their progressive coupling. Systematic increases in subsystem coupling were observed despite reduced autocorrelation and differences in the temporal properties of center of pressure and finger trajectories. The average duration of these coupled trajectories increased systematically across the learning period. In short, the abrupt transition between coupled and decoupled subsystem dynamics suggested that stick balancing is regulated by a hierarchical control mechanism that switches from collective to independent control of the finger and center of pressure. In addition to traditional measures of motor performance, dynamical analyses revealed changes in motor subsystem organization that occurred when subjects learned a novel stick-balancing task.
Sibley, Kathryn M; Straus, Sharon E; Inness, Elizabeth L; Salbach, Nancy M; Jaglal, Susan B
2013-03-20
Balance impairment is common in multiple clinical populations, and comprehensive assessment is important for identifying impairments, planning individualized treatment programs, and evaluating change over time. However, little information is available regarding whether clinicians who treat balance are satisfied with existing assessment tools. In 2010 we conducted a cross-sectional survey of balance assessment practices among physiotherapists in Ontario, Canada, and reported on the use of standardized balance measures (Sibley et al. 2011 Physical Therapy; 91: 1583-91). The purpose of this study was to analyse additional survey data and i) evaluate satisfaction with current balance assessment practices and standardized measures among physiotherapists who treat adult or geriatric populations with balance impairment, and ii) identify factors associated with satisfaction. The questionnaire was distributed to 1000 practicing physiotherapists. This analysis focuses on questions in which respondents were asked to rate their general perceptions about balance assessment, the perceived utility of individual standardized balance measures, whether they wanted to improve balance assessment practices, and why. Data were summarized with descriptive statistics and utility of individual measures was compared across clinical practice areas (orthopaedic, neurological, geriatric or general rehabilitation). The questionnaire was completed by 369 respondents, of which 43.4% of respondents agreed that existing standardized measures of balance meet their needs. In ratings of individual measures, the Single Leg Stance test and Berg Balance Scale were perceived as useful for clinical decision-making and evaluating change over time by over 70% of respondents, and the Timed Up-and-Go test was perceived as useful for decision-making by 56.9% of respondents and useful for evaluating change over time by 62.9% of respondents, but there were significant differences across practice groups. Seventy-nine percent of respondents wanted to improve their assessments, identifying individual, environmental and measure-specific barriers. The most common barriers were lack of time and knowledge. This study offers new information on issues affecting the evaluation of balance in clinical settings from a broad sample of physiotherapists. Continued work to address barriers by specific practice area will be critical for the success of any intervention attempting to implement optimal balance assessment practices in the clinical setting.
Behrouzi, Farshad; Shaharoun, Awaluddin Mohamed; Ma'aram, Azanizawati
2014-05-01
In order to attain a useful balanced scorecard (BSC), appropriate performance perspectives and indicators are crucial to reflect all strategies of the organisation. The objectives of this survey were to give an insight regarding the situation of the BSC in the health sector over the past decade, and to afford a generic approach of the BSC development for health settings with specific focus on performance perspectives, performance indicators and BSC generation. After an extensive search based on publication date and research content, 29 articles published since 2002 were identified, categorised and analysed. Four critical attributes of each article were analysed, including BSC generation, performance perspectives, performance indicators and auxiliary tools. The results showed that 'internal business process' was the most notable BSC perspective as it was included in all reviewed articles. After investigating the literature, it was concluded that its comprehensiveness is the reason for the importance and high usage of this perspective. The findings showed that 12 cases out of 29 reviewed articles (41%) exceeded the maximum number of key performance indicators (KPI) suggested in a previous study. It was found that all 12 cases were large organisations with numerous departments (e.g. national health organisations). Such organisations require numerous KPI to cover all of their strategic objectives. It was recommended to utilise the cascaded BSC within such organisations to avoid complexity and difficulty in gathering, analysing and interpreting performance data. Meanwhile it requires more medical staff to contribute in BSC development, which will result in greater reliability of the BSC.
An, Minjeong; Shaughnessy, Marianne
2011-12-01
This review evaluated the effects of balance and/or gait exercise interventions for stroke survivors and summarized the available evidence on these exercise interventions. A search for studies published between January 2001 and January 2010 was performed using the keywords stroke, walking or balance, and physical activity or exercise. Seventeen randomized clinical trials were identified. The findings suggest that initiating early rehabilitation during acute to subacute stroke recovery can improve balance and walking capacity. The findings also demonstrate that at least 1 hour, three to five times per week, of balance training and 30 minutes, three to five times per week, of gait-oriented exercise are effective to improve balance and walking. This review confirms that balance and walking capacity are improved with specific exercise modalities. A combination of balance, gait, and aerobic exercises would be ideal.
Obesity during pregnancy alters maternal oxidant balance and micronutrient status
USDA-ARS?s Scientific Manuscript database
Objective: Little is known about the effect of obesity on inflammatory status in pregnant women. The objective of this study was to determine the effect of obesity on markers of inflammation, oxidative stress and micronutrient status in obese pregnant women compared to their lean counterparts. St...
The Equilibrium Rule--A Personal Discovery
ERIC Educational Resources Information Center
Hewitt, Paul G.
2016-01-01
Examples of equilibrium are evident everywhere and the equilibrium rule provides a reasoned way to view all things, whether in static (balancing rocks, steel beams in building construction) or dynamic (airplanes, bowling balls) equilibrium. Interestingly, the equilibrium rule applies not just to objects at rest but whenever any object or system of…
[BALANCED SCORECARD AS A MANAGEMENT TOOL IN CLINICAL NUTRITION].
Gutiérrez López, Cristina; Mauriz, Jose L; Culebras, Jesús M
2015-07-01
Nowadays, balanced scorecards have updated traditional management systems in the business sector. In this way, Kaplan and Norton propose performance measurement through several perspectives with a logical sequence: internal processes and learning impact client services, so that financial performance is affected. The aim of the present paper is to analyze the main characteristics of balanced scorecard when it is applied to non-for-profit companies and, specifically to the health sector in the clinical nutrition field. This model improves the economic vision of management with clinical indicators that represent healthcare professional's perspective. The balanced scorecard would allow a proper monitoring and tracking system for the main healthcare indicators. This contributes to a better control in comparison with standards that are associated with adequate quality assistance. Owing to the role of management accounting and cost calculations, the definition of healthcare professionals as clients or users, and clinical results relevance, it is necessary to adapt the balanced scorecard to the specific characteristics of the clinical field, redefining both perspectives and indicators. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Granacher, Urs; Gollhofer, Albert; Hortobágyi, Tibor; Kressig, Reto W; Muehlbauer, Thomas
2013-07-01
The aging process results in a number of functional (e.g., deficits in balance and strength/power performance), neural (e.g., loss of sensory/motor neurons), muscular (e.g., atrophy of type-II muscle fibers in particular), and bone-related (e.g., osteoporosis) deteriorations. Traditionally, balance and/or lower extremity resistance training were used to mitigate these age-related deficits. However, the effects of resistance training are limited and poorly translate into improvements in balance, functional tasks, activities of daily living, and fall rates. Thus, it is necessary to develop and design new intervention programs that are specifically tailored to counteract age-related weaknesses. Recent studies indicate that measures of trunk muscle strength (TMS) are associated with variables of static/dynamic balance, functional performance, and falls (i.e., occurrence, fear, rate, and/or risk of falls). Further, there is preliminary evidence in the literature that core strength training (CST) and Pilates exercise training (PET) have a positive influence on measures of strength, balance, functional performance, and falls in older adults. The objectives of this systematic literature review are: (a) to report potential associations between TMS/trunk muscle composition and balance, functional performance, and falls in old adults, and (b) to describe and discuss the effects of CST/PET on measures of TMS, balance, functional performance, and falls in seniors. A systematic approach was employed to capture all articles related to TMS/trunk muscle composition, balance, functional performance, and falls in seniors that were identified using the electronic databases PubMed and Web of Science (1972 to February 2013). A systematic approach was used to evaluate the 582 articles identified for initial review. Cross-sectional (i.e., relationship) or longitudinal (i.e., intervention) studies were included if they investigated TMS and an outcome-related measure of balance, functional performance, and/or falls. In total, 20 studies met the inclusionary criteria for review. Longitudinal studies were evaluated using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes (ES) were calculated whenever possible. For ease of discussion, the 20 articles were separated into three groups [i.e., cross-sectional (n = 6), CST (n = 9), PET (n = 5)]. The cross-sectional studies reported small-to-medium correlations between TMS/trunk muscle composition and balance, functional performance, and falls in older adults. Further, CST and/or PET proved to be feasible exercise programs for seniors with high-adherence rates. Age-related deficits in measures of TMS, balance, functional performance, and falls can be mitigated by CST (mean strength gain = 30 %, mean effect size = 0.99; mean balance/functional performance gain = 23 %, mean ES = 0.88) and by PET (mean strength gain = 12 %, mean ES = 0.52; mean balance/functional performance gain = 18 %, mean ES = 0.71). Given that the mean PEDro quality score did not reach the predetermined cut-off of ≥6 for the intervention studies, there is a need for more high-quality studies to explicitly identify the relevance of CST and PET to the elderly population. Core strength training and/or PET can be used as an adjunct or even alternative to traditional balance and/or resistance training programs for old adults. Further, CST and PET are easy to administer in a group setting or in individual fall preventive or rehabilitative intervention programs because little equipment and space is needed to perform such exercises.
Gap-balancing technique combined with patient-specific instrumentation in TKA.
Hommel, Hagen; Perka, Carsten
2015-11-01
Combining patient-specific instrumentation (PSI) with a balancer device in total knee arthroplasty (TKA) to achieve functional femoral rotational alignment is a novel technique. The primary goal of this study was to introduce a new method to combine PSI with a gap-balancing technique and to determine the impact of the technique on rotation of the femoral component. Twenty-five primary TKAs (15 women, 10 men) were prospectively studied. All TKAs involved PSI with an associated gap-balancing device. Front plane alignment was performed intraoperatively with the PSI, followed by rectangular, symmetrical extension and creation of a flexion gap using the balancer device to set the femoral rotation. Femoral component rotation was between 3° internal and 6° external rotation versus the transepicondylar axis. There were no postoperative signs of patellofemoral dysfunction. In no cases was the resulting joint line displacement >3 mm. The mean elevation was 1.2 ± 0.9 mm (range 0-3). The leg axis was straight in all cases (±3°), at a mean of 1.6° ± 1.0° varus (range 0°-3° varus). PSI was with the gap-balancing technique was successfully used without affecting anatomical alignment. With the balancer device, PSI can be used more widely than techniques based solely on landmarks, as the soft-tissue tension can be taken into account, thus virtually eliminating flexion instabilities.
Structural Optimization of a Force Balance Using a Computational Experiment Design
NASA Technical Reports Server (NTRS)
Parker, P. A.; DeLoach, R.
2002-01-01
This paper proposes a new approach to force balance structural optimization featuring a computational experiment design. Currently, this multi-dimensional design process requires the designer to perform a simplification by executing parameter studies on a small subset of design variables. This one-factor-at-a-time approach varies a single variable while holding all others at a constant level. Consequently, subtle interactions among the design variables, which can be exploited to achieve the design objectives, are undetected. The proposed method combines Modern Design of Experiments techniques to direct the exploration of the multi-dimensional design space, and a finite element analysis code to generate the experimental data. To efficiently search for an optimum combination of design variables and minimize the computational resources, a sequential design strategy was employed. Experimental results from the optimization of a non-traditional force balance measurement section are presented. An approach to overcome the unique problems associated with the simultaneous optimization of multiple response criteria is described. A quantitative single-point design procedure that reflects the designer's subjective impression of the relative importance of various design objectives, and a graphical multi-response optimization procedure that provides further insights into available tradeoffs among competing design objectives are illustrated. The proposed method enhances the intuition and experience of the designer by providing new perspectives on the relationships between the design variables and the competing design objectives providing a systematic foundation for advancements in structural design.
Jump Rope Training: Balance and Motor Coordination in Preadolescent Soccer Players
Trecroci, Athos; Cavaggioni, Luca; Caccia, Riccardo; Alberti, Giampietro
2015-01-01
General physical practice and multidimensional exercises are essential elements that allow young athletes to enhance their coordinative traits, balance, and strength and power levels, which are linked to the learning soccer-specific skills. Jumping rope is a widely-used and non-specific practical method for the development of athletic conditioning, balance and coordination in several disciplines. Thus, the aim of this study was to investigate the effects of a short-term training protocol including jumping rope (JR) exercises on motor abilities and body balance in young soccer players. Twenty-four preadolescent soccer players were recruited and placed in two different groups. In the Experimental group (EG), children performed JR training at the beginning of the training session. The control group (CG), executed soccer specific drills. Harre circuit test (HCT) and Lower Quarter Y balance test (YBT-LQ) were selected to evaluate participant’s motor ability (e.g. ability to perform rapidly a course with different physical tasks such as somersault and passages above/below obstacles ) and to assess unilateral dynamic lower limb balance after 8 weeks of training. Statistical analysis consisted of paired t-test and mixed analysis of variance scores to determine any significant interactions. Children who performed jumping rope exercises showed a significant decrease of 9% (p < 0.01, ES = 0.50-0.80) in the performance time of HCT. With regard to the CG, no differences were highlighted (p > 0.05, ES = 0.05-0.2) from pre- to post-training. A training-by-group interaction was found for the composite score in both legs (p < 0.05, Part η2 > 0.14). Our findings demonstrated that JR practice within regular soccer training enhanced general motor coordination and balance in preadolescent soccer players. Therefore, the inclusion of JR practice within regular soccer training session should encouraged to improve children’s motor skills. Key points Performing jumping rope exercises within a regular soccer program can be an additional method to improve balance and motor coordination. The performance improvement in the Harre Circuit Test associated with jump rope training can potentially be attributed to an enhancement of the inter-limb coordination and SSC ability. Results from the present study indicate that young soccer players should be encouraged to practice general physical activities together with sport-specific exercise during their training sessions. PMID:26664276
Jump Rope Training: Balance and Motor Coordination in Preadolescent Soccer Players.
Trecroci, Athos; Cavaggioni, Luca; Caccia, Riccardo; Alberti, Giampietro
2015-12-01
General physical practice and multidimensional exercises are essential elements that allow young athletes to enhance their coordinative traits, balance, and strength and power levels, which are linked to the learning soccer-specific skills. Jumping rope is a widely-used and non-specific practical method for the development of athletic conditioning, balance and coordination in several disciplines. Thus, the aim of this study was to investigate the effects of a short-term training protocol including jumping rope (JR) exercises on motor abilities and body balance in young soccer players. Twenty-four preadolescent soccer players were recruited and placed in two different groups. In the Experimental group (EG), children performed JR training at the beginning of the training session. The control group (CG), executed soccer specific drills. Harre circuit test (HCT) and Lower Quarter Y balance test (YBT-LQ) were selected to evaluate participant's motor ability (e.g. ability to perform rapidly a course with different physical tasks such as somersault and passages above/below obstacles ) and to assess unilateral dynamic lower limb balance after 8 weeks of training. Statistical analysis consisted of paired t-test and mixed analysis of variance scores to determine any significant interactions. Children who performed jumping rope exercises showed a significant decrease of 9% (p < 0.01, ES = 0.50-0.80) in the performance time of HCT. With regard to the CG, no differences were highlighted (p > 0.05, ES = 0.05-0.2) from pre- to post-training. A training-by-group interaction was found for the composite score in both legs (p < 0.05, Part η(2) > 0.14). Our findings demonstrated that JR practice within regular soccer training enhanced general motor coordination and balance in preadolescent soccer players. Therefore, the inclusion of JR practice within regular soccer training session should encouraged to improve children's motor skills. Key pointsPerforming jumping rope exercises within a regular soccer program can be an additional method to improve balance and motor coordination.The performance improvement in the Harre Circuit Test associated with jump rope training can potentially be attributed to an enhancement of the inter-limb coordination and SSC ability.Results from the present study indicate that young soccer players should be encouraged to practice general physical activities together with sport-specific exercise during their training sessions.
How many stakes are required to measure the mass balance of a glacier?
Fountain, A.G.; Vecchia, A.
1999-01-01
Glacier mass balance is estimated for South Cascade Glacier and Maclure Glacier using a one-dimensional regression of mass balance with altitude as an alternative to the traditional approach of contouring mass balance values. One attractive feature of regression is that it can be applied to sparse data sets where contouring is not possible and can provide an objective error of the resulting estimate. Regression methods yielded mass balance values equivalent to contouring methods. The effect of the number of mass balance measurements on the final value for the glacier showed that sample sizes as small as five stakes provided reasonable estimates, although the error estimates were greater than for larger sample sizes. Different spatial patterns of measurement locations showed no appreciable influence on the final value as long as different surface altitudes were intermittently sampled over the altitude range of the glacier. Two different regression equations were examined, a quadratic, and a piecewise linear spline, and comparison of results showed little sensitivity to the type of equation. These results point to the dominant effect of the gradient of mass balance with altitude of alpine glaciers compared to transverse variations. The number of mass balance measurements required to determine the glacier balance appears to be scale invariant for small glaciers and five to ten stakes are sufficient.
NASA Astrophysics Data System (ADS)
Li, Ziru; Zhang, Xusheng
2009-08-01
To explore the assessing technique which could objectively reflect the characteristics of Chinese medicine in the prevention of cardiovascular and cerebrovascular diseases, four balance features of infrared thermal images (ITI) corresponding to the up and down, left and right, proximal and distal balance of blood circulation of human body were studied. First, the ITI features of the middle-aged and elderly people with lipid abnormality history were compared with those of the healthy youth. It was found that the balance state of the youth was significantly better than that of the middle-aged and elderly, P<=0.01 for all the balance features. For the youth, the balance state of females was better than that of the males. But this sexual difference disappeared for the middle-aged and elderly group. Second, a double-blind randomized trial was carried out to study the influences of Shengyi capsule, a Chinese medicine health food with the function of helping to decrease serum lipid, on the balance features. The subjects were middle-aged and elderly people with lipid abnormality history. Shengyi capsule was taken by the trial group while Xuezhikang capsule (with lovastatin as the main effective component) by the control group for 108 days. The balance features of ITI showed that Shengyi was significantly better than Xuezhikang in improving the whole body balance of blood circulation (including the up and down, left and right, proximal and distal balance). The relative efficacy rate was 81.0% for the trial group and 33.3% for the control group, there was significant difference between the two groups (P=0.002). Shengyi could effectively decrease the low density lipoprotein cholesterol (LDL-C) but the effect of Xuezhikang in decreasing total cholesterol (TC) and LDL-C was better than Shengyi. Though the lipid-lowering effect of Shengyi was not as good as Xuezhikang, ITI reflected the obvious advantage of Shengyi in improving the whole body balance of blood circulation which indicated that helping to decrease serum lipid is only part of the health function of Shengyi. The physiology and pathology basis of the influences of Shengyi on the four balance features and its relationship with the clinical outcome deserves further study. So the prospect of infrared thermal imaging is indicated as the suitable evaluation technique which could objectively reflect the whole balance regulation advantage of Chinese medicinal compounds.
[The development and validation of two scales on retribution practices: PRG-13 and PRE-21].
Boada-Grau, Joan; Costa-Solé, Jordi; Gil-Ripoll, Carme; Vigil-Colet, Andreu
2012-01-01
The present study outlines the development process of two scales that measure general and specific retribution practices in organisations. Historically, retribution has been the subject of research of other social sciences such as Sociology and Business Administration. In Psychology, and more specifically in Work and Organisational Psychology, there are hardly any studies or inventories designed to evaluate retribution practices. In order to accomplish the objectives, a sample of 237 employees was selected, 42.6% of whom were women and 57.4% were men. We performed and exploratory factorial analysis using principal axis factoring as extraction method and an oblique rotation (oblimin) to analyse the two scales. The former is made up of four factors and the latter is a two-factor scale. The reliability coefficients of the six subscales we obtained ranged between .72 and .89. External validity was analysed using the correlations obtained between the two inventories and the Balanced Scorecard. The two tools were found to be two potentially useful scales to evaluate retribution practices.
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
Interchangeability of the Wii Balance Board for Bipedal Balance Assessment.
Bonnechère, Bruno; Jansen, Bart; Omelina, Lubos; Rooze, Marcel; Van Sint Jan, Serge
2015-08-27
Since 2010, an increasing interest in more portable and flexible hardware for balance and posture assessment led to previously published studies determining whether or not the Wii Balance Board could be used to assess balance and posture, both scientifically and clinically. However, no previous studies aimed at comparing results from different Wii Balance Boards for clinical balance evaluation exist. The objective of this crossover study is to assess the interchangeability of the Wii Balance Board. A total of 6 subjects participated in the study and their balance was assessed using 4 different Wii Balance Boards. Trials were recorded simultaneously with Wii Balance Boards and with a laboratory force plate. Nine relevant clinical parameters were derived from center of pressure displacement data obtained from Wii Balance Board and force plate systems. Intraclass correlation coefficients (ICC), F tests, and Friedman tests were computed to assess the agreement between trials and to compare the Wii Balance Board and force plate results. Excellent correlations were found between the Wii Balance Board and force plate (mean ρ =.83). With the exception of 2 parameters, strong to excellent agreements were found for the 7 remaining parameters (ICC=.96). No significant differences were found between trials recorded with different Wii Balance Boards. Our results indicate that for most of the parameters analyzed, balance and posture assessed with one Wii Balance Board were statistically similar to results obtained from another. Furthermore, the good correlation between the Wii Balance Board and force plate results shows that Wii Balance Boards can be reliably used for scientific assessment using most of the parameters analyzed in this study. These results also suggest that the Wii Balance Board could be used in multicenter studies and therefore, would allow for the creation of larger populations for clinical studies. Ethical Committee of the Erasme Hospital (CCB B406201215142). ©Bruno Bonnechère, Bart Jansen, Lubos Omelina, Marcel Rooze, Serge Van Sint Jan. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 27.08.2015.
2003-09-01
A structured balance and mobility-training programme specifically designed to reduce physical frailty and the rising incidence of falls among older people. This practical manual blends theory into practical applications and covers an introduction to the body systems, balance assessments and a discussion of contemporary motor learning principles. Tel: Customer Services 0113 255 5665. Email: hk@hkeurope.com.
False Balance in Climate Change Reporting Among TV Meteorologists
NASA Astrophysics Data System (ADS)
Timm, K.; Maibach, E.; Boykoff, M.; Broeckelman-Post, M.; Myers, T.; Perkins, D. R., IV
2017-12-01
False balance is the journalistic practice of giving equal weight to both sides of a story, regardless of an established truth and validity on one side. Despite widespread scientific agreement about the anthropogenic causes of climate change, false balance on the subject of climate change remains common in television despite a documented decline in other media. In this exploratory study, 452 American TV meteorologists were surveyed about their climate change beliefs and asked how often and why they present an opposing viewpoint when they present about human contributions to climate change. The results indicate that this practice is fairly common, with nearly 30% of TV meteorologists presenting an opposing viewpoint at least half the time or more frequently when they present about climate change. Weathercasters described including an opposing viewpoint in their stories for many different reasons, including that it is essential to objective and balanced reporting, that it is used to acknowledge different audience viewpoints, and because the science is perceived to be uncertain. The results also suggest that being more certain that climate change is happening, that it is primarily caused by humans, and perceiving the full extent of the scientific consensus about human-caused climate change, are associated with decreased frequency of presenting an opposing viewpoint. This is the first time the issue of false balance has been studied in the context of TV weathercasters, and while more research is needed, these results provide some preliminary evidence to suggest that increasing weathercasters' understanding of the scientific consensus of human caused climate change may help reduce false balance reporting. Furthermore, as meteorologists and weathercasters become more prominent reporters of local climate news, it will be important for them to have techniques to accurately report the science, while maintaining their sense of objectivity.
Sibley, Kathryn M; Beauchamp, Marla K; Van Ooteghem, Karen; Straus, Sharon E; Jaglal, Susan B
2015-01-01
To identify components of postural control included in standardized balance measures for adult populations. Electronic searches of MEDLINE, EMBASE, and CINAHL databases using keyword combinations of postural balance/equilibrium, psychometrics/reproducibility of results/predictive value of tests/validation studies, instrument construction/instrument validation, geriatric assessment/disability evaluation, gray literature, and hand searches. Inclusion criteria were measures with a stated objective to assess balance, adult populations (18y and older), at least 1 psychometric evaluation, 1 standing task, a standardized protocol and evaluation criteria, and published in English. Two reviewers independently identified studies for inclusion. Sixty-six measures were included. A research assistant extracted descriptive characteristics and 2 reviewers independently coded components of balance in each measure using the Systems Framework for Postural Control, a widely recognized model of balance. Components of balance evaluated in these measures were underlying motor systems (100% of measures), anticipatory postural control (71%), dynamic stability (67%), static stability (64%), sensory integration (48%), functional stability limits (27%), reactive postural control (23%), cognitive influences (17%), and verticality (8%). Thirty-four measures evaluated 3 or fewer components of balance, and 1 measure-the Balance Evaluation Systems Test-evaluated all components of balance. Several standardized balance measures provide only partial information on postural control and omit important components of balance related to avoiding falls. As such, the choice of measure(s) may limit the overall interpretation of an individual's balance ability. Continued work is necessary to increase the implementation of comprehensive balance assessment in research and practice. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
The effectiveness of Pilates on balance and falls in community dwelling older adults.
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.
The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke
Sohn, Min Kyun; Jee, Sung Ju; Hwang, Pyoungsik; Jeon, Yumi
2015-01-01
Objective To investigate the effects of a shoulder sling on balance in patients with hemiplegia. Methods Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. Results The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. Conclusion The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position. PMID:26798614
ERIC Educational Resources Information Center
Wang, Li Hui; Yang, Hsin Ling; Chen, Yin Chang; Davis, Rebecca; Schwartz, Miriam E.; Tam, Chick F.
2008-01-01
The objective was to examine differences of dietary pattern, physical activity and energy balance in 240 college students with 137 of them enrolled in California State University, Los Angeles (LA) and the other 93 enrolled in China Medical University in Taichung, Taiwan (TW). A three-day dietary record and a 24-hour physical activity journal were…
Experimental design for evaluating WWTP data by linear mass balances.
Le, Quan H; Verheijen, Peter J T; van Loosdrecht, Mark C M; Volcke, Eveline I P
2018-05-15
A stepwise experimental design procedure to obtain reliable data from wastewater treatment plants (WWTPs) was developed. The proposed procedure aims at determining sets of additional measurements (besides available ones) that guarantee the identifiability of key process variables, which means that their value can be calculated from other, measured variables, based on available constraints in the form of linear mass balances. Among all solutions, i.e. all possible sets of additional measurements allowing the identifiability of all key process variables, the optimal solutions were found taking into account two objectives, namely the accuracy of the identified key variables and the cost of additional measurements. The results of this multi-objective optimization problem were represented in a Pareto-optimal front. The presented procedure was applied to a full-scale WWTP. Detailed analysis of the relation between measurements allowed the determination of groups of overlapping mass balances. Adding measured variables could only serve in identifying key variables that appear in the same group of mass balances. Besides, the application of the experimental design procedure to these individual groups significantly reduced the computational effort in evaluating available measurements and planning additional monitoring campaigns. The proposed procedure is straightforward and can be applied to other WWTPs with or without prior data collection. Copyright © 2018 Elsevier Ltd. All rights reserved.
The clinical utility of posturography.
Visser, Jasper E; Carpenter, Mark G; van der Kooij, Herman; Bloem, Bastiaan R
2008-11-01
Postural instability and falls are common and devastating features of ageing and many neurological, visual, vestibular or orthopedic disorders. Current management of these problems is hampered by the subjective and variable nature of the available clinical balance measures. In this narrative review, we discuss the clinical utility of posturography as a more objective and quantitative measure of balance and postural instability, focusing on several areas where clinicians presently experience the greatest difficulties in managing their patients: (a) to make an appropriate differential diagnosis in patients presenting with falls or balance impairment; (b) to reliably identify those subjects who are at risk of falling; (c) to objectively and quantitatively document the outcome of therapeutic interventions; and (d) to gain a better pathophysiological understanding of postural instability and falls, as a basis for the development of improved treatment strategies to prevent falling. In each of these fields, posturography offers several theoretical advantages and, when applied correctly, provides a useful tool to gain a better understanding of pathophysiological mechanisms in patients with balance disorders, at the group level. However, based on the available evidence, none of the existing techniques is currently able to significantly influence the clinical decision making in individual patients. We critically review the shortcomings of posturography as it is presently used, and conclude with several recommendations for future research.
NASA Astrophysics Data System (ADS)
Zatarain Salazar, Jazmin; Reed, Patrick M.; Quinn, Julianne D.; Giuliani, Matteo; Castelletti, Andrea
2017-11-01
Reservoir operations are central to our ability to manage river basin systems serving conflicting multi-sectoral demands under increasingly uncertain futures. These challenges motivate the need for new solution strategies capable of effectively and efficiently discovering the multi-sectoral tradeoffs that are inherent to alternative reservoir operation policies. Evolutionary many-objective direct policy search (EMODPS) is gaining importance in this context due to its capability of addressing multiple objectives and its flexibility in incorporating multiple sources of uncertainties. This simulation-optimization framework has high potential for addressing the complexities of water resources management, and it can benefit from current advances in parallel computing and meta-heuristics. This study contributes a diagnostic assessment of state-of-the-art parallel strategies for the auto-adaptive Borg Multi Objective Evolutionary Algorithm (MOEA) to support EMODPS. Our analysis focuses on the Lower Susquehanna River Basin (LSRB) system where multiple sectoral demands from hydropower production, urban water supply, recreation and environmental flows need to be balanced. Using EMODPS with different parallel configurations of the Borg MOEA, we optimize operating policies over different size ensembles of synthetic streamflows and evaporation rates. As we increase the ensemble size, we increase the statistical fidelity of our objective function evaluations at the cost of higher computational demands. This study demonstrates how to overcome the mathematical and computational barriers associated with capturing uncertainties in stochastic multiobjective reservoir control optimization, where parallel algorithmic search serves to reduce the wall-clock time in discovering high quality representations of key operational tradeoffs. Our results show that emerging self-adaptive parallelization schemes exploiting cooperative search populations are crucial. Such strategies provide a promising new set of tools for effectively balancing exploration, uncertainty, and computational demands when using EMODPS.
NASA Astrophysics Data System (ADS)
Zhang, Q. P.; Xu, X. N.; Liu, Y. T.; Xu, M.; Deng, S. H.; Chen, Y.; Yuan, H.; Yu, F.; Huang, Y.; Zhao, K.; Xu, S.; Xiong, G.
2017-04-01
Practical, efficient synthesis of metal oxide nanocrystals with good crystallinity and high specific surface area by a modified polymer-network gel method is demonstrated, taking ZnO nanocrystals as an example. A novel stepwise heat treatment yields significant improvement in crystal quality. Such nanophase materials can effectively degrade common organic dyes under solar radiation and can perform very well in photo-assisted detection of NO2 gas. Other typical metal oxide nanocrystals with good crystallinity and high specific surface area were also synthesized successfully under similar conditions. This work provides a general strategy for the synthesis of metal oxide nanocrystals, balancing the crystallinity and specific surface area.
The Azimuthally Averaged Boundary Layer Structure of a Numerically Simulated Major Hurricane
2015-08-14
layer in which the effects of sur- face friction are associated with significant departures from gradient wind balance. The boundary layer in the... effects of surface friction are associated with significant departures from gradient wind balance. More specifically, we follow Key Points: The...comprises a balance between three horizontal forces: Coriolis , pressure gradient, and friction. The boundary layer flow is characterized by a large Reynolds
Work Environment Questionnaires and Army Unit Effectiveness and Satisfaction Measures
1977-09-01
satisfaction indices (retention rates and disciplinary actions) and place more emphasis on these outcomes. In balance , the work environment and...last me a year"), and that "effective" supervisors and organizations planned carefully to stay within these constraints and balance expenditures over...scale was out of balance with its higher end. Most instruments reviewed used Likert scales with numerical anchors; very few provided specific descriptive
Mental imagery. Effects on static balance and attentional demands of the elderly.
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.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gillin, Charmel; Lipscomb, Brian
This project aimed at supporting one key component of a major multi-step undertaking on the part of the CSKT: the acquisition of the Kerr Hydroelectric project and its subsequent operation as a wholesale power generation facility. This project provided support to kick-start the development of the organizational structure to acquire and operate the facility by acquiring critical expertise necessary for the acquisition by funding in part two key personnel for the first two years of the four-year organizational development process. These individuals provided the Tribes with expert knowledge in the highly specialized areas of resource balancing, power marketing, and hydro-engineering;more » essential prerequisites to the Tribes' ability to build an organization for the operation of the Kerr Project and to securing financial backing for the acquisition. Goals achieved: • Establishing an efficient and economic conveyance process, and transition plans • Establishing an efficient and effective Tribal wholesale power generation corporation to manage the plant, balance the resources, and market the power from the Kerr Project. The success of this project, which is essential to the Tribes' acquisition of the Kerr Hydroelectric facility, helps to address poverty and unemployment among Tribal members by generating a number of highly skilled and specialized, high-paying Tribal member jobs and providing a stream of income from power sales that will be used for Tribal economic development. Objectives achieved: The project supported the position of Power Plant Operations and Maintenance engineer and power marketing coordinator positions. These are key, in part, to the Tribes' successful acquisition and operation of the facility because they will enable to the Tribes to gain the very specialized expertise required to operate a large wholesale power generation facility. Specific objectives include: Objective 1: Hire a power marketing coordinator to develop and coordinate the appropriate power marketing strategy for the sale of power generated by the operation of Kerr Dam. Objective 2: Hire a staff engineer.« less
The gait and balance of patients with diabetes can be improved: a randomised controlled trial.
Allet, L; Armand, S; de Bie, R A; Golay, A; Monnin, D; Aminian, K; Staal, J B; de Bruin, E D
2010-03-01
Gait characteristics and balance are altered in diabetic patients. Little is known about possible treatment strategies. This study evaluates the effect of a specific training programme on gait and balance of diabetic patients. This was a randomised controlled trial (n=71) with an intervention (n=35) and control group (n=36). The intervention consisted of physiotherapeutic group training including gait and balance exercises with function-orientated strengthening (twice weekly over 12 weeks). Controls received no treatment. Individuals were allocated to the groups in a central office. Gait, balance, fear of falls, muscle strength and joint mobility were measured at baseline, after intervention and at 6-month follow-up. The trial is closed to recruitment and follow-up. After training, the intervention group increased habitual walking speed by 0.149 m/s (p<0.001) compared with the control group. Patients in the intervention group also significantly improved their balance (time to walk over a beam, balance index recorded on Biodex balance system), their performance-oriented mobility, their degree of concern about falling, their hip and ankle plantar flexor strength, and their hip flexion mobility compared with the control group. After 6 months, all these variables remained significant except for the Biodex sway index and ankle plantar flexor strength. Two patients developed pain in their Achilles tendon: the progression for two related exercises was slowed down. Specific training can improve gait speed, balance, muscle strength and joint mobility in diabetic patients. Further studies are needed to explore the influence of these improvements on the number of reported falls, patients' physical activity levels and quality of life. ClinicalTrials.gov NCT00637546 This work was supported by the Swiss National Foundation (SNF): PBSKP-123446/1/
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.
Basins of attraction in human balance
NASA Astrophysics Data System (ADS)
Smith, Victoria A.; Lockhart, Thurmon E.; Spano, Mark L.
2017-12-01
Falls are a recognized risk factor for unintentional injuries among older adults, accounting for a large proportion of fractures, emergency department visits, and urgent hospitalizations. Human balance and gait research traditionally uses linear or qualitative tests to assess and describe human motion; however, human motion is neither a simple nor a linear process. The objective of this research is to identify and to learn more about what factors affect balance using nonlinear dynamical techniques, such as basin boundaries. Human balance data was collected using dual force plates for leans using only ankle movements as well as for unrestricted leans. Algorithms to describe the basin boundary were created and compared based on how well each method encloses the experimental data points as well as captures the differences between the two leaning conditions.
Yasuda, Kazuhiro; Saichi, Kenta; Iwata, Hiroyasu
2018-01-01
Falls and fall-induced injuries are major global public health problems, and sensory input impairment in older adults results in significant limitations in feedback-type postural control. A haptic-based biofeedback (BF) system can be used for augmenting somatosensory input in older adults, and the application of this BF system can increase the objectivity of the feedback and encourage comparison with that provided by a trainer. Nevertheless, an optimal BF system that focuses on interpersonal feedback for balance training in older adults has not been proposed. Thus, we proposed a haptic-based perception-empathy BF system that provides information regarding the older adult's center-of-foot pressure pattern to the trainee and trainer for refining the motor learning effect. The first objective of this study was to examine the effect of this balance training regimen in healthy older adults performing a postural learning task. Second, this study aimed to determine whether BF training required high cognitive load to clarify its practicability in real-life settings. Twenty older adults were assigned to two groups: BF and control groups. Participants in both groups tried balance training in the single-leg stance while performing a cognitive task (i.e., serial subtraction task). Retention was tested 24 h later. Testing comprised balance performance measures (i.e., 95% confidence ellipse area and mean velocity of sway) and dual-task performance (number of responses and correct answers). Measurements of postural control using a force plate revealed that the stability of the single-leg stance was significantly lower in the BF group than in the control group during the balance task. The BF group retained the improvement in the 95% confidence ellipse area 24 h after the retention test. Results of dual-task performance during the balance task were not different between the two groups. These results confirmed the potential benefit of the proposed balance training regimen in designing successful motor learning programs for preventing falls in older adults. PMID:29868597
Yasuda, Kazuhiro; Saichi, Kenta; Iwata, Hiroyasu
2018-01-01
Falls and fall-induced injuries are major global public health problems, and sensory input impairment in older adults results in significant limitations in feedback-type postural control. A haptic-based biofeedback (BF) system can be used for augmenting somatosensory input in older adults, and the application of this BF system can increase the objectivity of the feedback and encourage comparison with that provided by a trainer. Nevertheless, an optimal BF system that focuses on interpersonal feedback for balance training in older adults has not been proposed. Thus, we proposed a haptic-based perception-empathy BF system that provides information regarding the older adult's center-of-foot pressure pattern to the trainee and trainer for refining the motor learning effect. The first objective of this study was to examine the effect of this balance training regimen in healthy older adults performing a postural learning task. Second, this study aimed to determine whether BF training required high cognitive load to clarify its practicability in real-life settings. Twenty older adults were assigned to two groups: BF and control groups. Participants in both groups tried balance training in the single-leg stance while performing a cognitive task (i.e., serial subtraction task). Retention was tested 24 h later. Testing comprised balance performance measures (i.e., 95% confidence ellipse area and mean velocity of sway) and dual-task performance (number of responses and correct answers). Measurements of postural control using a force plate revealed that the stability of the single-leg stance was significantly lower in the BF group than in the control group during the balance task. The BF group retained the improvement in the 95% confidence ellipse area 24 h after the retention test. Results of dual-task performance during the balance task were not different between the two groups. These results confirmed the potential benefit of the proposed balance training regimen in designing successful motor learning programs for preventing falls in older adults.
NASA Astrophysics Data System (ADS)
Kovacs, Kent; West, Grant; Xu, Ying
2017-04-01
Efficiency frontiers are a useful tool for governmental agencies that balance the protection of ecosystem services with the economic returns from an agricultural landscape because the tool illustrates that a compromise of objectives generates greater value to society than optimizing a sole objective. Policy makers facing the problem of groundwater overdraft on an agricultural landscape want to know if regulations or irrigation technology adoption will enhance both economic and ecosystem service benefits. Conjunctive water management with on-farm reservoirs and tail water recovery system is frequently suggested to alleviate groundwater and surface water quality problems in the Lower Mississippi River Basin of the United States, and this study evaluates the consequence of the adoption of this technology for the balance of ecosystem service and economic objectives. A compromise of objectives that maximizes the value to society provides 76% more value to society without reservoirs and 66% more value to society with reservoirs than the sole objective of economic returns. The reservoirs help an agricultural landscape maximizing economic returns to align more closely with a landscape maximizing the value to society, although there are still significant gains possible from finding a landscape that directly compromises on the objectives.
The dual task-cost of standing balance affects quality of life in mildly disabled MS people.
Castelli, Letizia; De Luca, Francesca; Marchetti, Maria Rita; Sellitto, Giovanni; Fanelli, Fulvia; Prosperini, Luca
2016-05-01
The aim of this study was to explore the correlations between the dual-task cost (DTC) of standing balance and quality of life (QoL) in mildly disabled patients with multiple sclerosis (MS). In this cross-sectional study, patients affected by MS with an expanded disability status scale (EDSS) score of 3.0 or less and without an overt balance impairment were tested by means of static posturography under eyes-opened (single-task condition) and while performing the Stroop word-color test (dual-task condition), to estimate the DTC of standing balance. The self-reported 54-item MS quality of life questionnaire (MSQoL-54) was also administered to obtain a MS-specific assessment of health-related QoL. Among the 120 screened patients, 75 (53 women, 22 men) were tested. Although there was no impact of the DTC of standing balance on the physical and mental composite scores of MSQoL-54, patients who had a greater DTC of standing balance scored worse on role limitations due to physical problems (p = 0.007) and social function (p < 0.001), irrespective of demographic and other clinical characteristics including walking performance and cognitive status. However, the EDSS step and fatigue also contributed to reduced scores in these two QoL domains (p-values < 0.01). In conclusion, the phenomenon of cognitive-motor interference, investigated as DTC of standing balance, may affect specific QoL domains even in mildly disabled patients with MS and in the absence of an overt balance dysfunction.
Van Ooteghem, Karen; Frank, James S; Allard, Fran; Horak, Fay B
2010-08-01
Postural motor learning for dynamic balance tasks has been demonstrated in healthy older adults (Van Ooteghem et al. in Exp Brain Res 199(2):185-193, 2009). The purpose of this study was to investigate the type of knowledge (general or specific) obtained with balance training in this age group and to examine whether embedding perturbation regularities within a balance task masks specific learning. Two groups of older adults maintained balance on a translating platform that oscillated with variable amplitude and constant frequency. One group was trained using an embedded-sequence (ES) protocol which contained the same 15-s sequence of variable amplitude oscillations in the middle of each trial. A second group was trained using a looped-sequence (LS) protocol which contained a 15-s sequence repeated three times to form each trial. All trials were 45 s. Participants were not informed of any repetition. To examine learning, participants performed a retention test following a 24-h delay. LS participants also completed a transfer task. Specificity of learning was examined by comparing performance for repeated versus random sequences (ES) and training versus transfer sequences (LS). Performance was measured by deriving spatial and temporal measures of whole body center of mass (COM) and trunk orientation. Both groups improved performance with practice as characterized by reduced COM displacement, improved COM-platform phase relationships, and decreased angular trunk motion. Furthermore, improvements reflected general rather than specific postural motor learning regardless of training protocol (ES or LS). This finding is similar to young adults (Van Ooteghem et al. in Exp Brain Res 187(4):603-611, 2008) and indicates that age does not influence the type of learning which occurs for balance control.
Booth, Vicky; Masud, Tahir; Bath-Hextall, Fiona
Balance impairment can result in falls and reduced activities of daily living and function. Virtual reality and interactive gaming systems provide a novel and potentially environmentally flexible treatment option to improve postural stability and reduce falls in balance impaired populations. There are no existing systematic reviews in this topic area. To search, critically appraise and synthesise the best available evidence on whether virtual reality interventions, including interactive gaming systems, are effective at improving balance in adults with impaired balance. Adults with impaired, altered or reduced balance identified either through reduced balance outcome measure score or increased risk or incidence of falls.Types of interventions:Any virtual reality or interactive gaming systems used within a rehabilitative setting.The primary outcome was an objective measure of balance (i.e. balance outcome measure such as Berg Balance Score) or number and/or incidence of falls. Secondary outcome measures of interest included any adverse effects experienced, an outcome measure indicating functional balance (i.e. walking speed), quality of life (through use of an objective measure i.e. EuroQOL), and number of days in hospital due to falls.Types of studies:Randomised controlled trials (RCT). A three-stage strategy searched the following electronic databases: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PsycBITE, OTseeker, Ei Compendex, Inspec, Current Controlled Trials, and the National Institute of Health Clinical Trials Database. The methodological quality of each included study was independently assessed using the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) to systematically comment on influence of bias. Data was individually extracted from the included studies using the standardised JBI data extraction tool from JBI-MAStARI. Data was analysed using Review Manager 5 software. Results were expressed as mean difference (MD) with 95% confidence intervals for continuous outcomes. Meta-analysis was not possible due to the variation of the interventions given and small number of included trials; hence, a description of the results was given. Four studies were included in the systematic review. All the included studies used different types of virtual reality or interactive gaming interventions. Two of the included studies used the same balance outcome measure. There was a notable inconsistency of balance outcome measurement between all the included studies. No data was given regarding falls in any of the studies. A secondary outcome, the 10m walk test, was recorded in two of the studies. The four included studies had small sample sizes and poor methodological quality. Despite the presentation of statistically significant results, the clinical significance is questionable. The review can not recommend the inclusion of virtual reality or interactive gaming systems into the rehabilitation of balance impairment based on the results of the four included studies. Further investigation in this topic area is required.
Maki, Brian E; Sibley, Katherine M; Jaglal, Susan B; Bayley, Mark; Brooks, Dina; Fernie, Geoff R; Flint, Alastair J; Gage, William; Liu, Barbara A; McIlroy, William E; Mihailidis, Alex; Perry, Stephen D; Popovic, Milos R; Pratt, Jay; Zettel, John L
2011-12-01
Falling is a leading cause of serious injury, loss of independence, and nursing-home admission in older adults. Impaired balance control is a major contributing factor. Results from our balance-control studies have been applied in the development of new and improved interventions and assessment tools. Initiatives to facilitate knowledge-translation of this work include setting up a new network of balance clinics, a research-user network and a research-user advisory board. Our findings support the efficacy of the developed balance-training methods, balance-enhancing footwear, neuro-prosthesis, walker design, handrail-cueing system, and handrail-design recommendations in improving specific aspects of balance control. IMPACT ON KNOWLEDGE USERS: A new balance-assessment tool has been implemented in the first new balance clinic, a new balance-enhancing insole is available through pharmacies and other commercial outlets, and handrail design recommendations have been incorporated into 10 Canadian and American building codes. Work in progress is expected to have further impact. Copyright © 2011 National Safety Council and Elsevier Ltd. All rights reserved.
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
A Program of Physical Education for Vocational Technical Schools of Connecticut.
ERIC Educational Resources Information Center
Connecticut State Dept. of Education, Hartford. Bureau of Vocational-Technical Schools.
These recommendations and suggestions are intended as a guide for the development of a well-balanced program of physical education in vocational schools. Introductory materials outline the purpose, aims, and objectives of a physical education program as well as the general philosophy and goals, program goals and their objectives, general policies,…
Step wise, multiple objective calibration of a hydrologic model for a snowmelt dominated basin
Hay, L.E.; Leavesley, G.H.; Clark, M.P.; Markstrom, S.L.; Viger, R.J.; Umemoto, M.
2006-01-01
The ability to apply a hydrologic model to large numbers of basins for forecasting purposes requires a quick and effective calibration strategy. This paper presents a step wise, multiple objective, automated procedure for hydrologic model calibration. This procedure includes the sequential calibration of a model's simulation of solar radiation (SR), potential evapotranspiration (PET), water balance, and daily runoff. The procedure uses the Shuffled Complex Evolution global search algorithm to calibrate the U.S. Geological Survey's Precipitation Runoff Modeling System in the Yampa River basin of Colorado. This process assures that intermediate states of the model (SR and PET on a monthly mean basis), as well as the water balance and components of the daily hydrograph are simulated, consistently with measured values.
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 they had fallen at least once in the past 6 months were lower compared to nonfallers—8.9 and 11.2, respectively (P<.001). The correlation between mean balance score and disability sum-score at baseline was -.51 (P<.001). No significant associations were found between balance at baseline and falls after 6 months of follow-up. Baseline balance scores were significantly associated with the development of disability after 6 months of follow-up in the univariate analysis—odds ratio (OR) 0.86 (95% CI 0.76-0.98)—but not in the multivariate analysis when correcting for age, gender, baseline disability, and falls at follow-up—OR 0.94 (95% CI 0.79-1.11). Conclusions There is a cross-sectional relationship between balance measured by a modified bathroom scale and falls and disability in older adults. Despite this cross-sectional relationship, longitudinal data showed that balance scores have no predictive value for falls and might only have limited predictive value for disability development after 6 months of follow-up. PMID:26018423
Magnetic suspension and balance system advanced study, 1989 design
NASA Technical Reports Server (NTRS)
Boom, Roger W.; Eyssa, Y. M.; Abdelsalam, Moustafa K.; Mcintosh, Glen E.
1991-01-01
The objectives are to experimentally confirm several advanced design concepts on the Magnetic Suspension and Balance Systems (MSBS). The advanced design concepts were identified as potential improvements by Madison Magnetics, Inc. (MMI) during 1984 and 1985 studies of an MSBS utilizing 14 external superconductive coils and a superconductive solenoid in an airplane test model suspended in a wind tunnel. This study confirmed several advanced design concepts on magnetic suspension and balance systems. The 1989 MSBS redesign is based on the results of these experiments. Savings of up to 30 percent in supporting magnet ampere meters and 50 percent in energy stored over the 1985 design were achieved.
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.
Leddy, Abigail L; Crowner, Beth E; Earhart, Gammon M
2011-01-01
Gait impairments, balance impairments, and falls are prevalent in individuals with Parkinson disease (PD). Although the Berg Balance Scale (BBS) can be considered the reference standard for the determination of fall risk, it has a noted ceiling effect. Development of ceiling-free measures that can assess balance and are good at discriminating "fallers" from "nonfallers" is needed. The purpose of this study was to compare the Functional Gait Assessment (FGA) and the Balance Evaluation Systems Test (BESTest) with the BBS among individuals with PD and evaluate the tests' reliability, validity, and discriminatory sensitivity and specificity for fallers versus nonfallers. This was an observational study of community-dwelling individuals with idiopathic PD. The BBS, FGA, and BESTest were administered to 80 individuals with PD. Interrater reliability (n=15) was assessed by 3 raters. Test-retest reliability was based on 2 tests of participants (n=24), 2 weeks apart. Intraclass correlation coefficients (2,1) were used to calculate reliability, and Spearman correlation coefficients were used to assess validity. Cutoff points, sensitivity, and specificity were based on receiver operating characteristic plots. Test-retest reliability was .80 for the BBS, .91 for the FGA, and .88 for the BESTest. Interrater reliability was greater than .93 for all 3 tests. The FGA and BESTest were correlated with the BBS (r=.78 and r=.87, respectively). Cutoff scores to identify fallers were 47/56 for the BBS, 15/30 for the FGA, and 69% for the BESTest. The overall accuracy (area under the curve) for the BBS, FGA, and BESTest was .79, .80, and .85, respectively. Fall reports were retrospective. Both the FGA and the BESTest have reliability and validity for assessing balance in individuals with PD. The BESTest is most sensitive for identifying fallers.
Optical read/write memory system components
NASA Technical Reports Server (NTRS)
Kozma, A.
1972-01-01
The optical components of a breadboard holographic read/write memory system have been fabricated and the parameters specified of the major system components: (1) a laser system; (2) an x-y beam deflector; (3) a block data composer; (4) the read/write memory material; (5) an output detector array; and (6) the electronics to drive, synchronize, and control all system components. The objectives of the investigation were divided into three concurrent phases: (1) to supply and fabricate the major components according to the previously established specifications; (2) to prepare computer programs to simulate the entire holographic memory system so that a designer can balance the requirements on the various components; and (3) to conduct a development program to optimize the combined recording and reconstruction process of the high density holographic memory system.
Systems Engineering Model for ART Energy Conversion
DOE Office of Scientific and Technical Information (OSTI.GOV)
Mendez Cruz, Carmen Margarita; Rochau, Gary E.; Wilson, Mollye C.
The near-term objective of the EC team is to establish an operating, commercially scalable Recompression Closed Brayton Cycle (RCBC) to be constructed for the NE - STEP demonstration system (demo) with the lowest risk possible. A systems engineering approach is recommended to ensure adequate requirements gathering, documentation, and mode ling that supports technology development relevant to advanced reactors while supporting crosscut interests in potential applications. A holistic systems engineering model was designed for the ART Energy Conversion program by leveraging Concurrent Engineering, Balance Model, Simplified V Model, and Project Management principles. The resulting model supports the identification and validation ofmore » lifecycle Brayton systems requirements, and allows designers to detail system-specific components relevant to the current stage in the lifecycle, while maintaining a holistic view of all system elements.« less
Non-Vitamin K Oral Anticoagulants (NOACs) A Review of Clinical Management and Laboratory Issues.
Blann, Andrew
2016-01-01
The non-vitamin K oral anticoagulants (NOACs) are set to replace vitamin K antagonists (principally warfarin), unfractionated heparin and low molecular weight heparin as the leading antithrombotic prophylaxis in several medical and surgical settings. As a group, NOACs have a better safety profile and at least an equivalent (and sometimes superior) efficacy profile than their comparator. The objective of this review is to provide the practitioner with a comprehensive, balanced and contemporary view of these drugs and their applications. More specifically, it focuses on the evidence base for their licences, use in clinical practice (such as in renal dysfunction, orthopaedic surgery, atrial fibrillation, and venous thromboembolism, and the effects of co-medications), responses to actual or perceived haemorrhage, and the role of the laboratory.
The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury.
Han, Jia; Anson, Judith; Waddington, Gordon; Adams, Roger; Liu, Yu
2015-01-01
Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport.
The effect of virtual reality gaming on dynamic balance in older adults.
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 Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury
Han, Jia; Waddington, Gordon; Adams, Roger; Liu, Yu
2015-01-01
Balance control improvement is one of the most important goals in sports and exercise. Better balance is strongly positively associated with enhanced athletic performance and negatively associated with lower limb sports injuries. Proprioception plays an essential role in balance control, and ankle proprioception is arguably the most important. This paper reviews ankle proprioception and explores synergies with balance control, specifically in a sporting context. Central processing of ankle proprioceptive information, along with other sensory information, enables integration for balance control. When assessing ankle proprioception, the most generalizable findings arise from methods that are ecologically valid, allow proprioceptive signals to be integrated with general vision in the central nervous system, and reflect the signal-in-noise nature of central processing. Ankle proprioceptive intervention concepts driven by such a central processing theory are further proposed and discussed for the improvement of balance control in sport. PMID:26583139
History of falls, gait, balance, and fall risks in older cancer survivors living in the community.
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 help detect individuals at risk of falling.
History of falls, gait, balance, and fall risks in older cancer survivors living in the community
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 help detect individuals at risk of falling. PMID:26425079
Centre of pressure correlates with pyramid performance in acrobatic gymnastics.
Floría, Pablo; Gómez-Landero, Luis Arturo; Harrison, Andrew J
2015-01-01
Acrobatic gymnasts need excellent balance control to execute pyramids where one gymnast is supported by another. The objectives of this study were: (1) to describe balance performance by assessing the centre of pressure displacement in a group of acrobatic gymnasts executing pyramids; (2) to determine the relationship between the parameters describing the centre of pressure oscillations and pyramid score; and (3) to examine the role of each foot in providing a solid base of support to maintain the balance of the pyramid. Sixteen acrobatic gymnasts grouped in pairs performed a Half pyramid and a Straddle pyramid held for 7 s on two force platforms. Path length, variance, range trajectory, and surface area of the centre of pressure of each foot were examined to analyse the balance of the pyramid. The path length was correlated with the pyramid score (Straddle: p = 0.692 [large]; Half: p = 0.407 [moderate]). There were differences in the functions of each leg to maintain balance, with the non-preferred leg supporting a higher weight of the pyramid while the preferred leg performed control movements to maintain balance. The results suggested that quantitative analysis of balance can provide important information on pyramid performance.
2017-01-01
Objective To investigate the clinical feasibility of a newly developed, portable, gait assistive robot (WA-H, ‘walking assist for hemiplegia’) for improving the balance function of patients with stroke-induced hemiplegia. Methods Thirteen patients underwent 12 weeks of gait training on the treadmill while wearing WA-H for 30 minutes per day, 4 days a week. Patients' balance function was evaluated by the Berg Balance Scale (BBS), Fugl-Meyer Assessment Scale (FMAS), Timed Up and Go Test (TUGT), and Short Physical Performance Battery (SPPB) before and after 6 and 12 weeks of training. Results There were no serious complications or clinical difficulties during gait training with WA-H. In three categories of BBS, TUGT, and the balance scale of SPPB, there was a statistically significant improvement at the 6th week and 12th week of gait training with WA-H. In the subscale of balance function of FMAS, there was statistically significant improvement only at the 12th week. Conclusion Gait training using WA-H demonstrated a beneficial effect on balance function in patients with hemiplegia without a safety issue. PMID:28503449
National Airspace System Plan: Facilities, Equipment, Associated Development and Other Capital Needs
1989-09-01
yes include: 0 Air carrier routes and services will reflect a * Having an operating National Airspace System better balance between trip frequency and... balanced workload. " A major improvement and integration of the FAA communications system will be imple- 0 Reliable equipment, which minimizes the stress...them in this will lead to the development of production level balancing sector staffing levels, specifications in FY 97. * Trial flight plan function
Validating a dance-specific screening test for balance: preliminary results from multisite testing.
Batson, Glenna
2010-09-01
Few dance-specific screening tools adequately capture balance. The aim of this study was to administer and modify the Star Excursion Balance Test (oSEBT) to examine its utility as a balance screen for dancers. The oSEBT involves standing on one leg while lightly targeting with the opposite foot to the farthest distance along eight spokes of a star-shaped grid. This task simulates dance in the spatial pattern and movement quality of the gesturing limb. The oSEBT was validated for distance on athletes with history of ankle sprain. Thirty-three dancers (age 20.1 +/- 1.4 yrs) participated from two contemporary dance conservatories (UK and US), with or without a history of lower extremity injury. Dancers were verbally instructed (without physical demonstration) to execute the oSEBT and four modifications (mSEBT): timed (speed), timed with cognitive interference (answering questions aloud), and sensory disadvantaging (foam mat). Stepping strategies were tracked and performance strategies video-recorded. Unlike the oSEBT results, distances reached were not significant statistically (p = 0.05) or descriptively (i.e., shorter) for either group. Performance styles varied widely, despite sample homogeneity and instructions to control for strategy. Descriptive analysis of mSEBT showed an increased number of near-falls and decreased timing on the injured limb. Dancers appeared to employ variable strategies to keep balance during this test. Quantitative analysis is warranted to define balance strategies for further validation of SEBT modifications to determine its utility as a balance screening tool.
Code of Federal Regulations, 2010 CFR
2010-07-01
... recovery of productivity levels compatible with approved land uses; (g) Minimum disturbance to the... area; and (j) Striking a balance between protection of the environment and agricultural productivity...
Stuart, Elizabeth A.; Lee, Brian K.; Leacy, Finbarr P.
2013-01-01
Objective Examining covariate balance is the prescribed method for determining when propensity score methods are successful at reducing bias. This study assessed the performance of various balance measures, including a proposed balance measure based on the prognostic score (also known as the disease-risk score), to determine which balance measures best correlate with bias in the treatment effect estimate. Study Design and Setting The correlations of multiple common balance measures with bias in the treatment effect estimate produced by weighting by the odds, subclassification on the propensity score, and full matching on the propensity score were calculated. Simulated data were used, based on realistic data settings. Settings included both continuous and binary covariates and continuous covariates only. Results The standardized mean difference in prognostic scores, the mean standardized mean difference, and the mean t-statistic all had high correlations with bias in the effect estimate. Overall, prognostic scores displayed the highest correlations of all the balance measures considered. Prognostic score measure performance was generally not affected by model misspecification and performed well under a variety of scenarios. Conclusion Researchers should consider using prognostic score–based balance measures for assessing the performance of propensity score methods for reducing bias in non-experimental studies. PMID:23849158
ERIC Educational Resources Information Center
Liang, Ying; Lee, Judy; Tam, Chick F.; Bridges, Elizabeth; Keating, Xiaofen D.
2007-01-01
The purpose was to compare the differences in body mass index (BMI), energy balance (EB) and specific physical activity (SPA) between 30 CSULA college students (Y) and their respective parents (O) living in the same household at Los Angeles, California, U.S.A. Each student completed a 24-hour dietary record with SPA journal, and the same for…
Balance confidence is related to features of balance and gait in individuals with chronic stroke
Schinkel-Ivy, Alison; Wong, Jennifer S.; Mansfield, Avril
2016-01-01
Reduced balance confidence is associated with impairments in features of balance and gait in individuals with sub-acute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke. Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months post-discharge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable and quiet standing, walking, and reactive stepping outcome measures as the dependent variables. Walking velocity was positively correlated with balance confidence, while medio-lateral centre of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence. This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs. PMID:27955809
Evaluating the balanced scorecard at the University Health Network: an impact assessment.
Young, Justin; Bell, Robert; Khalfan, Adil; Lindquist, Evert
2008-01-01
The balanced scorecard (BSC) has become increasing popular in healthcare organizations. A recent study conducted at the University Health Network in Toronto explored the extent to which the BSC has focused and aligned various organizational units and departments around shared goals and objectives. The evaluation also assessed the BSC's impact on front-line staff and how the development and rollout of the BSC should be modified in the next planning iteration.