Kaleri sets up Russian MBI-12 Payload in the SM

NASA Image and Video Library

2010-12-09

ISS026-E-008718 (8 Dec. 2010) --- Russian cosmonaut Alexander Kaleri, Expedition 26 flight engineer, sets up the Russian MBI-12 payload for a Sonokard experiment session in the Zvezda Service Module of the International Space Station. Kaleri used a sports shirt from the Sonokard kit with a special device in the pocket for testing a new method for acquiring physiological data without using direct contact on the skin. Measurements are recorded on a data card for return to Earth.

Functional Recovery Measures for Spinal Cord Injury: An Evidence-Based Review for Clinical Practice and Research

PubMed Central

Anderson, Kim; Aito, Sergio; Atkins, Michal; Biering-Sørensen, Fin; Charlifue, Susan; Curt, Armin; Ditunno, John; Glass, Clive; Marino, Ralph; Marshall, Ruth; Mulcahey, Mary Jane; Post, Marcel; Savic, Gordana; Scivoletto, Giorgio; Catz, Amiram

2008-01-01

Background/Objective: The end goal of clinical care and clinical research involving spinal cord injury (SCI) is to improve the overall ability of persons living with SCI to function on a daily basis. Neurologic recovery does not always translate into functional recovery. Thus, sensitive outcome measures designed to assess functional status relevant to SCI are important to develop. Method: Evaluation of currently available SCI functional outcome measures by a multinational work group. Results: The 4 measures that fit the prespecified inclusion criteria were the Modified Barthel Index (MBI), the Functional Independence Measure (FIM), the Quadriplegia Index of Function (QIF), and the Spinal Cord Independence Measure (SCIM). The MBI and the QIF were found to have minimal evidence for validity, whereas the FIM and the SCIM were found to be reliable and valid. The MBI has little clinical utility for use in the SCI population. Likewise, the FIM applies mainly when measuring burden of care, which is not necessarily a reflection of functional recovery. The QIF is useful for measuring functional recovery but only in a subpopulation of people with SCI, and substantial validity data are still required. The SCIM is the only functional recovery outcome measure designed specifically for SCI. Conclusions: The multinational work group recommends that the latest version of the SCIM (SCIM III) continue to be refined and validated and subsequently implemented worldwide as the primary functional recovery outcome measure for SCI. The QIF may continue to be developed and validated for use as a supplemental tool for the nonambulatory tetraplegic population. PMID:18581660

Impact of mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI) on central line-associated bloodstream infections (CLABSIs) in department of hematology at single university hospital in Japan.

PubMed

Kato, Yukiko; Hagihara, Mao; Kurumiya, Ai; Takahashi, Tomoko; Sakata, Miki; Shibata, Yuichi; Kato, Hideo; Shiota, Arufumi; Watanabe, Hiroki; Asai, Nobuhiro; Koizumi, Yusuke; Yamagishi, Yuka; Mikamo, Hiroshige

2018-01-01

Central line-associated bloodstream infections (CLABSIs) are among the most serious complications especially in blood cancer patients. In January 2013, Centers for Disease and Prevention (CDC) introduced a new surveillance definition of mucosal barrier injury-associated laboratory-confirmed bloodstream infection (MBI-LCBI). This study was to determine the impact of MBI-LCBI on CLABSIs and compare the clinical characteristics of MBI versus non-MBI-LCBI cases. We retrospectively reviewed the records of 250 consecutive patients. They were admitted in department of hematology at Aichi Medical University Hospital. We applied the revised 2013 CLABSI surveillance protocol to all CLABSI cases identified during the 47-months period from May 2012 through June 2016. A total of 44 CLABSIs were identified. The median patient age was 65 years (range, 12 to 89). Among 44 patients, 31 patients were diagnosed as leukemia (70.5%) and 12 patients as lymphoma (27.3%). Six patients underwent bone transplantation for leukemia or myelodysplastic syndrome (13.6%). A total of 20 patients (45.5%) were classified as MBI-LCBI and 24 (54.5%) were classified as non-MBI-LCBI. The primary disease type (P = 0.018), neutropenic within 3 days before CLABSI (MBI-LCBI vs. non-MBI-LCBI: 95.0% vs. 26.3%, P = <0.0001), line(s) removed owing to CLABSI (15.0% vs. 54.2%, P = 0.011) and Gram-negative organisms cultured (70.0% vs. 37.5%, P = 0.004) showed significantly difference between the groups. Our data showed that MBI-LCBI cases account for 45.5% of the CLABSI cases identified in blood cancer patients, and constituted a significant burden to this high-risk patient population. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Effects of modified constraint-induced movement therapy with trunk restraint in early stroke patients: A single-blinded, randomized, controlled, pilot trial.

PubMed

Bang, Dae-Hyouk; Shin, Won-Seob; Choi, Ho-Suk

2018-01-01

Reducing compensatory strategies during repetitive upper-limb training may be helpful in relearning motor skills. To explore the effects of modified constraint-induced movement therapy (mCIMT), additionally modified by adding trunk restraint (TR), on upper-limb function and activities of daily living (ADLs) in early post-stroke patients. Twenty-four participants with early stroke were randomly assigned to mCIMT combined with TR (mCIMT + TR) or mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk for 4 weeks). Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer Assessment-Upper extremity (FMA-UE), the Modified Barthel index (MBI), the Maximal elbow extension angle during reaching (MEEAR), and Motor Activity Logs (MAL-AOU and MAL-QOM). The mCIMT + TR group exhibited greater improvement in the ARAT, FMA-UE, MBI, MEEAR, and MAL-AOU, and MAL-QOM than the mCIMT group. Statistical analyses showed significant differences in ARAT (P = 0.003), FMA-UE (P = 0.042), MBI (P = 0.001), MEEAR (P = 0.002), and MAL-AOU (P = 0.005) between the groups. Modified CIMT combined with TR may be more effective than mCIMT alone in improving upper-limb function and ADLs in patients with early stroke.

Effects of modified constraint-induced movement therapy combined with trunk restraint in chronic stroke: A double-blinded randomized controlled pilot trial.

PubMed

Bang, Dae-Hyouk; Shin, Won-Seob; Choi, Ho-Suk

2015-01-01

Reducing the compensatory mechanism by restraining the unnecessary movement may be helpful in relearning the upper-limb movement. To investigate the effects of a modified constraint-induced movement therapy (mCIMT) with trunk restraint (TR) in chronic stroke patients with moderate impairment. Eighteen participants with hemiparesis were randomly assigned to mCIMT + TR or mCIMT. Each group underwent 20 (1 h/d) intervention session (5 d/wk for 4 weeks). Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment upper extremity (FMA-UE), the modified Barthel index (MBI), and the motor activity log (MAL-AOU and MAL-QOM). The mCIMT combined with trunk restraint group exhibited greater changes in the ARAT, FMA, MBI, and MAL (MAL-AOU and MAL-QOM) compared with the mCIMT group. Statistical analyses showed significantly different in ARAT (Z = -2.17, P = 0.03), FMA-UE (Z = -2.49, P = 0.01), MBI (Z = -2.44, P = 0.02), MAL-AOU (Z = -2.17, P = 0.03), and MAL-QOM (Z = -2.17, P = 0.03) between groups. These finding suggest that mCIMT combined with trunk restraint is more helpful to improve upper-extremity function than mCIMT only in patient with chronic stroke.

Effect of Virtual Reality on Cognition in Stroke Patients

PubMed Central

Kim, Bo Ryun; Kim, Lee Suk; Park, Ji Young

2011-01-01

Objective To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Method Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the control group received only computer-based cognitive rehabilitation. To measure, activity of daily living cognitive and motor functions, the following assessment tools were used: computerized neuropsychological test and the Tower of London (TOL) test for cognitive function assessment, Korean-Modified Barthel index (K-MBI) for functional status evaluation, and the motricity index (MI) for motor function assessment. All recruited patients underwent these evaluations before rehabilitation and four weeks after rehabilitation. Results The VR group showed significant improvement in the K-MMSE, visual and auditory continuous performance tests (CPT), forward digit span test (DST), forward and backward visual span tests (VST), visual and verbal learning tests, TOL, K-MBI, and MI scores, while the control group showed significant improvement in the K-MMSE, forward DST, visual and verbal learning tests, trail-making test-type A, TOL, K-MBI, and MI scores after rehabilitation. The changes in the visual CPT and backward VST in the VR group after rehabilitation were significantly higher than those in the control group. Conclusion Our findings suggest that virtual reality training combined with computer-based cognitive rehabilitation may be of additional benefit for treating cognitive impairment in stroke patients. PMID:22506159

Effect of virtual reality on cognition in stroke patients.

PubMed

Kim, Bo Ryun; Chun, Min Ho; Kim, Lee Suk; Park, Ji Young

2011-08-01

To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the control group received only computer-based cognitive rehabilitation. To measure, activity of daily living cognitive and motor functions, the following assessment tools were used: computerized neuropsychological test and the Tower of London (TOL) test for cognitive function assessment, Korean-Modified Barthel index (K-MBI) for functional status evaluation, and the motricity index (MI) for motor function assessment. All recruited patients underwent these evaluations before rehabilitation and four weeks after rehabilitation. The VR group showed significant improvement in the K-MMSE, visual and auditory continuous performance tests (CPT), forward digit span test (DST), forward and backward visual span tests (VST), visual and verbal learning tests, TOL, K-MBI, and MI scores, while the control group showed significant improvement in the K-MMSE, forward DST, visual and verbal learning tests, trail-making test-type A, TOL, K-MBI, and MI scores after rehabilitation. The changes in the visual CPT and backward VST in the VR group after rehabilitation were significantly higher than those in the control group. Our findings suggest that virtual reality training combined with computer-based cognitive rehabilitation may be of additional benefit for treating cognitive impairment in stroke patients.

Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients.

PubMed

Lim, Kil-Byung; Lee, Hong-Jae; Yoo, Jeehyun; Yun, Hyun-Ju; Hwang, Hye-Jung

2016-08-01

To investigate the effect of mirror therapy containing functional tasks on upper extremity function and activities of daily living in patients with subacute stroke. The subjects were randomly divided into two groups: the mirror therapy group (30 patients) and the sham therapy group (30 patients). The mirror therapy group underwent a mirror therapy program together with conventional therapy for 20 minutes per day on 5 days per week for 4 weeks. The control group received a sham conventional therapy program under the same schedule as the mirror therapy group. The Fugl-Meyer Motor Function Assessment (FMA), Brunnstrom motor recovery stage, and Modified Barthel Index (MBI) were evaluated 4 weeks after the treatment. The upper extremity function on the affected side and ability to perform daily life activities after the intervention were significantly improved in both groups. After 4 weeks of intervention, improvements in the FMA (p=0.027) and MBI (p=0.041) were significantly greater in the mirror therapy group than the sham therapy group. In this study, we found that the mirror therapy containing functional task was effective in terms of improving the upper extremity functions and activities of daily living in patients with subacute stroke.

Effects of action observation therapy on upper extremity function, daily activities and motion evoked potential in cerebral infarction patients.

PubMed

Fu, Jianming; Zeng, Ming; Shen, Fang; Cui, Yao; Zhu, Meihong; Gu, Xudong; Sun, Ya

2017-10-01

The aim of this study was to explore the effects of action observation therapy on motor function of upper extremity, activities of daily living, and motion evoked potential in cerebral infarction patients. Cerebral infarction survivors were randomly assigned to an experimental group (28 patients) or a control group (25 patients). The conventional rehabilitation treatments were applied in both groups, but the experimental group received an additional action observation therapy for 8 weeks (6 times per week, 20 minutes per time). Fugl-Meyer assessment (FMA), Wolf Motor Function Test (WMFT), Modified Barthel Index (MBI), and motor evoked potential (MEP) were used to evaluate the upper limb movement function and daily life activity. There were no significant differences between experiment and control group in the indexes, including FMA, WMFT, and MBI scores, before the intervention. However, after 8 weeks treatments, these indexes were improved significantly. MEP latency and center-motion conduction time (CMCT) decreased from 23.82 ± 2.16 and 11.15 ± 1.68 to 22.69 ± 2.11 and 10.12 ± 1.46 ms. MEP amplitude increased from 0.61 ± 0.22 to 1.25 ± 0.38 mV. A remarkable relationship between the evaluations indexes of MEP and FMA was found. Combination of motion observation and traditional upper limb rehabilitation treatment technology can significantly elevate the movement function of cerebral infarction patients in subacute seizure phase with upper limb dysfunction, which expanded the application range of motion observation therapy and provided an effective therapy strategy for upper extremities hemiplegia in stroke patients.

Music as an Experience Integral to the Ethnicity of the "Mbyá"-Guarani of South America

ERIC Educational Resources Information Center

Pittau Sevilla, Zulma M.

2016-01-01

The "Mbyá" culture forms a part of the Guaraní ethnic group that mainly inhabits the territories of south-eastern Brazil, in the Province of Misiones--Argentina, and the Republic of Paraguay. This article will focus mainly on field observations I have made in different communities in these countries, and which will try to synthetically…

Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients

PubMed Central

2016-01-01

Objective To investigate the effect of mirror therapy containing functional tasks on upper extremity function and activities of daily living in patients with subacute stroke. Methods The subjects were randomly divided into two groups: the mirror therapy group (30 patients) and the sham therapy group (30 patients). The mirror therapy group underwent a mirror therapy program together with conventional therapy for 20 minutes per day on 5 days per week for 4 weeks. The control group received a sham conventional therapy program under the same schedule as the mirror therapy group. The Fugl-Meyer Motor Function Assessment (FMA), Brunnstrom motor recovery stage, and Modified Barthel Index (MBI) were evaluated 4 weeks after the treatment. Results The upper extremity function on the affected side and ability to perform daily life activities after the intervention were significantly improved in both groups. After 4 weeks of intervention, improvements in the FMA (p=0.027) and MBI (p=0.041) were significantly greater in the mirror therapy group than the sham therapy group. Conclusion In this study, we found that the mirror therapy containing functional task was effective in terms of improving the upper extremity functions and activities of daily living in patients with subacute stroke. PMID:27606269

The effect of virtual reality training on unilateral spatial neglect in stroke patients.

PubMed

Kim, Yong Mi; Chun, Min Ho; Yun, Gi Jeong; Song, Young Jin; Young, Han Eun

2011-06-01

To investigate the effect of virtual reality training on unilateral spatial neglect in stroke patients. Twenty-four stroke patients (14 males and 10 females, mean age=64.7) who had unilateral spatial neglect as a result of right hemisphere stroke were recruited. All patients were randomly assigned to either the virtual reality (VR) group (n=12) or the control group (n=12). The VR group received VR training, which stimulated the left side of their bodies. The control group received conventional neglect therapy such as visual scanning training. Both groups received therapy for 30 minutes a day, five days per week for three weeks. Outcome measurements included star cancellation test, line bisection test, Catherine Bergego scale (CBS), and the Korean version of modified Barthel index (K-MBI). These measurements were taken before and after treatment. There were no significant differences in the baseline characteristics and initial values between the two groups. The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment. The changes in line bisection test score and the K-MBI in the VR group were not statistically significant. This study suggests that virtual reality training may be a beneficial therapeutic technique on unilateral spatial neglect in stroke patients.

Comparison of Diffusion Tensor Tractography and Motor Evoked Potentials for the Estimation of Clinical Status in Subacute Stroke

PubMed Central

Chun, Kwang-Soo; Lee, Yong-Taek; Park, Jong-Wan; Lee, Joon-Youn; Park, Chul-Hyun

2016-01-01

Objective To compare diffusion tensor tractography (DTT) and motor evoked potentials (MEPs) for estimation of clinical status in patients in the subacute stage of stroke. Methods Patients with hemiplegia due to stroke who were evaluated using both DTT and MEPs between May 2012 and April 2015 were recruited. Clinical assessments investigated upper extremity motor and functional status. Motor status was evaluated using Medical Research Council grading and the Fugl-Meyer Assessment of upper limb and hand (FMA-U and FMA-H). Functional status was measured using the Modified Barthel Index (MBI). Patients were classified into subgroups according to DTT findings, MEP presence, fractional anisotropy (FA) value, FA ratio (rFA), and central motor conduction time (CMCT). Correlations of clinical assessments with DTT parameters and MEPs were estimated. Results Fifty-five patients with hemiplegia were recruited. In motor assessments (FMA-U), MEPs had the highest sensitivity and negative predictive value (NPV) as well as the second highest specificity and positive predictive value (PPV). CMCT showed the highest specificity and PPV. Regarding functional status (MBI), FA showed the highest sensitivity and NPV, whereas CMCT had the highest specificity and PPV. Correlation analysis showed that the resting motor threshold (RMT) ratio was strongly associated with motor status of the upper limb, and MEP parameters were not associated with MBI. Conclusion DTT and MEPs could be suitable complementary modalities for analyzing the motor and functional status of patients in the subacute stage of stroke. The RMT ratio was strongly correlated with motor status. PMID:26949679

Drug burden index to define the burden of medicines in older adults with intellectual disabilities: An observational cross-sectional study.

PubMed

O'Connell, Juliette; Burke, Éilish; Mulryan, Niamh; O'Dwyer, Claire; Donegan, Clare; McCallion, Philip; McCarron, Mary; Henman, Martin C; O'Dwyer, Máire

2018-03-01

The drug burden index (DBI) is a dose-related measure of anticholinergic and sedative drug exposure. This cross-sectional study described DBI in older adults with intellectual disabilities (ID) and the most frequently reported therapeutic classes contributing to DBI and examined associations between higher DBI scores and potential adverse effects as well as physical function. This study analysed data from Wave 2 (2013/2014) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA), a representative study on the ageing of people with ID in Ireland. Self- and objectively-reported data were collected on medication use and physical health, including health conditions. The Barthel index was the physical function measure. The study examined 677 individuals with ID, of whom 644 (95.1%) reported taking medication and 78.6% (n = 532) were exposed to medication with anticholinergic and/or sedative activity. 54.2% (n = 367) were exposed to high DBI score (≥1). Adjusted multivariate regression analysis revealed no significant association between DBI score and daytime dozing, constipation or falls. After adjusting for confounders (sex, age, level of ID, comorbidities, behaviours that challenge, history of falls), DBI was associated with significantly higher dependence in the Barthel index (P = 0.002). This is the first time DBI has been described in older adults with ID. Scores were much higher than those observed in the general population and higher scores were associated with higher dependence in Barthel index activities of daily living. © 2017 The British Pharmacological Society.

[Reliability of the PROFUND index to predict 4-year mortality in polypathological patients].

PubMed

Díez-Manglano, Jesús; Del Corral Beamonte, Esther; Ramos Ibáñez, Rosa; Lambán Aranda, María Pilar; Toyas Miazza, Carla; Rodero Roldán, María Del Mar; Ortiz Domingo, Concepción; Munilla López, Eulalia; de Escalante Yangüela, Begoña

2016-09-16

To determine the usefullness of the PROFUND index to assess the risk of global death after 4 years in polypathological patients. Multicenter prospective cohort (Internal Medicine and Geriatrics) study. Polypathological patients admitted between March 1st and June 30th 2011 were included. For each patient, data concerning age, sex, living at home or in a nursing residence, polypathology categories, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs, hemoglobin and creatinine values were gathered, and the PROFUND index was calculated. The follow-up lasted 4 years. We included 441 patients, 324 from Internal Medicine and 117 from Geriatrics, with a mean age of 80.9 (8.7) years. Of them, 245 (55.6%) were women. Heart (62.7%), neurological (41.4%) and respiratory (37.3%) diseases were the most frequent. Geriatrics inpatients were older and more dependants and presented greater cognitive deterioration. After 4 years, 335 (76%) patients died. Mortality was associated with age, dyspnoea, Barthel index<60, delirium, advanced neoplasia and≥4 admissions in the last year. The area under the curve of the PROFUND index was 0.748, 95% CI 0.689-0.806, P<.001 in Internal Medicine and 0.517, 95% CI 0.369-0.666, P=.818 in Geriatrics patients, respectively. The PROFUND index is a reliable tool for predicting long-term global mortality in polypathological patients from Internal Medicine but not from Geriatrics departments. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

The Effects of a Motorized Aquatic Treadmill Exercise Program on Muscle Strength, Cardiorespiratory Fitness, and clinical function in Subacute Stroke Patients -- a Randomized Controlled Pilot Trial.

PubMed

Lee, So Young; Han, Eun Young; Kim, Bo Ryun; Im, Sang Hee

2018-03-12

The aim of this study was to assess the effects of a motorized aquatic treadmill exercise program improve the isometric strength of the knee muscles, cardiorespiratory fitness, arterial stiffness, motor function, balance, functional outcomes and quality of life in subacute stroke patients. Thirty-two patients were randomly assigned to 4-week training sessions of either aquatic therapy(n=19) or land-based aerobic exercise(n=18). Isometric strength was measured using an isokinetic dynamometer. Cardiopulmonary fitness was evaluated using a symptom-limited exercise tolerance test and by measuring brachial ankle pulse wave velocity. Moreover, motor function(Fugl-Meyer Assessment[FMA] and FMA-lower limb[FMA-LL]), balance(Berg Balance Scale[BBS]), Activities of daily living(Korean version of the Modified Barthel Index [K-MBI]), and Quality of life(EQ-5D index) were examined. There were no inter-group differences between demographic and clinical characteristics at baseline(p>0.05). The results shows significant improvements in peak oxygen consumption (p=0.02), maximal isometric strength of the bilateral knee extensors (p<0.01) and paretic knee flexors (p=0.01), FMA (p=0.03), FMA-LL (p=0.01), BBS (p=0.01), K-MBI (p<0.01), and EQ-5D index (p=0.04) after treatment in the aquatic therapy group. However, only significant improvements in maximal isometric strength in the knee extensors (p=0.03) and flexors (p=0.04) were found within the aquatic therapy group and control group. Water-based aerobic exercise performed on a motorized aquatic treadmill had beneficial effect on isometric muscle strength in the lower limb.

A task-specific interactive game-based virtual reality rehabilitation system for patients with stroke: a usability test and two clinical experiments.

PubMed

Shin, Joon-Ho; Ryu, Hokyoung; Jang, Seong Ho

2014-03-06

Virtual reality (VR) is not commonly used in clinical rehabilitation, and commercial VR gaming systems may have mixed effects in patients with stroke. Therefore, we developed RehabMaster™, a task-specific interactive game-based VR system for post-stroke rehabilitation of the upper extremities, and assessed its usability and clinical efficacy. A participatory design and usability tests were carried out for development of RehabMaster with representative user groups. Two clinical trials were then performed. The first was an observational study in which seven patients with chronic stroke received 30 minutes of RehabMaster intervention per day for two weeks. The second was a randomised controlled trial of 16 patients with acute or subacute stroke who received 10 sessions of conventional occupational therapy only (OT-only group) or conventional occupational therapy plus 20 minutes of RehabMaster intervention (RehabMaster + OT group). The Fugl-Meyer Assessment score (FMA), modified Barthel Index (MBI), adverse effects, and drop-out rate were recorded. The requirements of a VR system for stroke rehabilitation were established and incorporated into RehabMaster. The reported advantages from the usability tests were improved attention, the immersive flow experience, and individualised intervention. The first clinical trial showed that the RehabMaster intervention improved the FMA (P = .03) and MBI (P = .04) across evaluation times. The second trial revealed that the addition of RehabMaster intervention tended to enhance the improvement in the FMA (P = .07) but did not affect the improvement in the MBI. One patient with chronic stroke left the trial, and no adverse effects were reported. The RehabMaster is a feasible and safe VR system for enhancing upper extremity function in patients with stroke.

Effects of a 6-Week Aquatic Treadmill Exercise Program on Cardiorespiratory Fitness and Walking Endurance in Subacute Stroke Patients: A PILOT TRIAL.

PubMed

Han, Eun Young; Im, Sang Hee

2017-03-15

To assess the feasibility and safety of a 6-week course of water walking performed using a motorized aquatic treadmill in individuals with subacute stroke for cardiorespiratory fitness, walking endurance, and activities of daily living. Twenty subacute stroke patents were randomly assigned to aquatic treadmill exercise (ATE) or land-based exercise (LBE). The ATE group (n = 10) performed water-based aerobic exercise on a motorized aquatic treadmill, and the LBE group (n = 10) performed land-based aerobic exercise on a cycle ergometer. Both groups performed aerobic exercise for 30 minutes, 5 times per week for 6 weeks. Primary outcome measures were 6-minute walk test for walking endurance and cardiopulmonary fitness parameters of a symptom-limited exercise tolerance test, and secondary measures were Korean version of the Modified Barthel Index (K-MBI) for activities of daily living. All variables were assessed at baseline and at the end of the intervention. The ATE group showed significant improvements in 6-minute walk test (P = .005), peak oxygen uptake (V·o2peak; P = .005), peak heart rate (P = .007), exercise tolerance test duration (P = .005), and K-MBI (P = .008). The LBE group showed a significant improvement only in K-MBI (P = .012). In addition, improvement in V·o2peak was greater in the ATE than in the LBE group. This preliminary study showed that a 6-week ATE program improved peak aerobic capacity and walking endurance in patients with subacute stroke. The improvement in V·o2peak after an ATE exercise program was greater than that observed after an LBE program. Therefore, ATE effectively improves cardiopulmonary fitness in patients with subacute stroke.

The Effect of Virtual Reality Training on Unilateral Spatial Neglect in Stroke Patients

PubMed Central

Kim, Yong Mi; Yun, Gi Jeong; Song, Young Jin; Young, Han Eun

2011-01-01

Objective To investigate the effect of virtual reality training on unilateral spatial neglect in stroke patients. Method Twenty-four stroke patients (14 males and 10 females, mean age=64.7) who had unilateral spatial neglect as a result of right hemisphere stroke were recruited. All patients were randomly assigned to either the virtual reality (VR) group (n=12) or the control group (n=12). The VR group received VR training, which stimulated the left side of their bodies. The control group received conventional neglect therapy such as visual scanning training. Both groups received therapy for 30 minutes a day, five days per week for three weeks. Outcome measurements included star cancellation test, line bisection test, Catherine Bergego scale (CBS), and the Korean version of modified Barthel index (K-MBI). These measurements were taken before and after treatment. Results There were no significant differences in the baseline characteristics and initial values between the two groups. The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment. The changes in line bisection test score and the K-MBI in the VR group were not statistically significant. Conclusion This study suggests that virtual reality training may be a beneficial therapeutic technique on unilateral spatial neglect in stroke patients. PMID:22506138

Handgrip strength is an independent predictor of functional outcome in hip-fracture women: a prospective study with 6-month follow-up.

PubMed

Di Monaco, Marco; Castiglioni, Carlotta; De Toma, Elena; Gardin, Luisa; Giordano, Silvia; Tappero, Rosa

2015-02-01

The objective of this study was to investigate the contribution of handgrip strength in predicting the functional outcome after hip fracture in women.We prospectively investigated white women (N = 193 of 207) who were consecutively admitted to a rehabilitation hospital after a hip fracture. We measured handgrip strength with a Jamar dynamometer (Lafayette Instrument Co, Lafayette, IN), on admission to rehabilitation. Ability to function in activities of daily living was assessed by the Barthel index both on discharge from rehabilitation and at a 6-month follow-up.We found significant correlations between handgrip strength measured before rehabilitation and Barthel index scores assessed both on discharge from rehabilitation (ρ = 0.52, P < 0.001) and after 6 months (ρ = 0.49, P < 0.001). Significant associations between handgrip strength and Barthel index scores persisted after adjustment for age, comorbidities, pressure ulcers, medications in use, concomitant infections, body mass index, hip-fracture type, and Barthel index scores assessed both preinjury and on admission to rehabilitation (P = 0.001). Further adjustments for both Barthel index scores and Timed Up-and-Go test assessed at rehabilitation ending did not erase the significant association between handgrip strength and the Barthel index scores at the 6-month evaluation (P = 0.007). To define successful rehabilitation, we categorized the Barthel index scores as either high (85 or higher) or low (<85). The adjusted odds ratio for 1 SD increase in grip strength was 1.73 (95% confidence interval [CI] 1.05-2.84, P = 0.032) for having a high Barthel index score at the end of inpatient rehabilitation and 2.24 (95% CI 1.06-5.18) for having a high Barthel index score at the 6-month follow-up.Handgrip strength assessed before rehabilitation independently predicted the functional outcome both after inpatient rehabilitation and at a 6-month follow-up in hip-fracture women.

A task-specific interactive game-based virtual reality rehabilitation system for patients with stroke: a usability test and two clinical experiments

PubMed Central

2014-01-01

Background Virtual reality (VR) is not commonly used in clinical rehabilitation, and commercial VR gaming systems may have mixed effects in patients with stroke. Therefore, we developed RehabMaster™, a task-specific interactive game-based VR system for post-stroke rehabilitation of the upper extremities, and assessed its usability and clinical efficacy. Methods A participatory design and usability tests were carried out for development of RehabMaster with representative user groups. Two clinical trials were then performed. The first was an observational study in which seven patients with chronic stroke received 30 minutes of RehabMaster intervention per day for two weeks. The second was a randomised controlled trial of 16 patients with acute or subacute stroke who received 10 sessions of conventional occupational therapy only (OT-only group) or conventional occupational therapy plus 20 minutes of RehabMaster intervention (RehabMaster + OT group). The Fugl-Meyer Assessment score (FMA), modified Barthel Index (MBI), adverse effects, and drop-out rate were recorded. Results The requirements of a VR system for stroke rehabilitation were established and incorporated into RehabMaster. The reported advantages from the usability tests were improved attention, the immersive flow experience, and individualised intervention. The first clinical trial showed that the RehabMaster intervention improved the FMA (P = .03) and MBI (P = .04) across evaluation times. The second trial revealed that the addition of RehabMaster intervention tended to enhance the improvement in the FMA (P = .07) but did not affect the improvement in the MBI. One patient with chronic stroke left the trial, and no adverse effects were reported. Conclusions The RehabMaster is a feasible and safe VR system for enhancing upper extremity function in patients with stroke. PMID:24597650

Effect of Caregiver Driven Robot-Assisted In-Ward Training in Subacute Stroke Patients: A Case Series

PubMed Central

2018-01-01

Objective To evaluate the effect of caregiver driven robot-assisted in-ward training in subacute stroke patients. Methods A retrospective evaluation was performed for patients treated with caregiver driven robot-assisted in-ward training to retain gait function from June 2014 and December 2016. All patients received more than 2 weeks of caregiver driven robot-assisted in-ward training after undergoing conventional programs. The robot was used as a sitting device, a standing frame, or a high-walker depending on functional status of the patient. Patients were evaluated before and after robot training. Patient records were assessed by Korean version of Modified Barthel Index (K-MBI), Functional Independence Measure (FIM), and Functional Ambulation Category (FAC). Results Initially, patients used the robot as a sitting device (n=6), a standing frame (n=7), or a partial body-weight support high-walker (n=2). As patient functions were improved, usage level of the robot was changed to the next level. At the end of the treatment, the robot was used as a sitting device (n=1), a standing frame (n=6), or high-walker (n=8). Scores of K-MBI (Δ17.47±10.72) and FIM (Δ19.80±12.34) were improved in all patients. Conclusion Patients' usage level of the robot and functional scores were improved. Therefore, performing additional caregiver driven robot-assisted in-ward training is feasible and beneficial for subacute stroke patients. PMID:29765872

Effect of Caregiver Driven Robot-Assisted In-Ward Training in Subacute Stroke Patients: A Case Series.

PubMed

Kim, Sang Beom; Lee, Kyeong Woo; Lee, Jong Hwa; Lee, Sook Joung; Park, Jin Gee; Park, Joo Won

2018-04-01

To evaluate the effect of caregiver driven robot-assisted in-ward training in subacute stroke patients. A retrospective evaluation was performed for patients treated with caregiver driven robot-assisted in-ward training to retain gait function from June 2014 and December 2016. All patients received more than 2 weeks of caregiver driven robot-assisted in-ward training after undergoing conventional programs. The robot was used as a sitting device, a standing frame, or a high-walker depending on functional status of the patient. Patients were evaluated before and after robot training. Patient records were assessed by Korean version of Modified Barthel Index (K-MBI), Functional Independence Measure (FIM), and Functional Ambulation Category (FAC). Initially, patients used the robot as a sitting device (n=6), a standing frame (n=7), or a partial body-weight support high-walker (n=2). As patient functions were improved, usage level of the robot was changed to the next level. At the end of the treatment, the robot was used as a sitting device (n=1), a standing frame (n=6), or high-walker (n=8). Scores of K-MBI (Δ17.47±10.72) and FIM (Δ19.80±12.34) were improved in all patients. Patients' usage level of the robot and functional scores were improved. Therefore, performing additional caregiver driven robot-assisted in-ward training is feasible and beneficial for subacute stroke patients.

Medicinal Plants Used by a Mbyá-Guarani Tribe Against Infections: Activity on KPC-Producing Isolates and Biofilm-Forming Bacteria.

PubMed

Brandelli, Clara Lia Costa; Ribeiro, Vanessa Bley; Zimmer, Karine Rigon; Barth, Afonso Luís; Tasca, Tiana; Macedo, Alexandre José

2015-11-01

The traditional use of medicinal plants for treatment of infectious diseases by an indigenous Mbyá-Guarani tribe from South Brazil was assessed by evaluating the antibiotic and antibiofilm activities against relevant bacterial pathogens. Aqueous extracts from 10 medicinal plants were prepared according to indigenous Mbyá-Guarani traditional uses. To evaluate antibiotic (OD600) and antibiofilm (crystal violet method) activities, Pseudomonas aeruginosa ATCC 27853, Staphylococcus epidermidis ATCC 35984 and seven multi-drug resistant Klebsiella pneumoniae carbapenemase (KPC)-producing bacterial clinical isolates were challenged with the extracts. Furthermore, the susceptibility profile of KPC-producing bacteria and the ability of these isolates to form biofilm were evaluated. The plants Campomanesia xanthocarpa, Maytenus ilicifolia, Bidens pilosa and Verbena sp. showed the best activity against bacterial growth and biofilm formation. The majority of KPC-producing isolates, which showed strong ability to form biofilm and a multidrug resistance profile, was inhibited by more than 50% by some extracts. The Enterobacter cloacae (KPC 05) clinical isolate was the only one resistant to all extracts. This study confirms the importance of indigenous traditional medicinal knowledge and describes for the first time the ability of these plants to inhibit biofilm formation and/or bacterial growth of multi-drug resistant KPC-producing isolates.

[Relationship between age, body mass index, dependency and quality of life in malnourished patients after hospital discharge].

PubMed

Casals, Cristina; Vázquez Sánchez, María Ángeles; Casals Sánchez, José Luis; Rioja Vázquez, Rosalía; Martín Salvador, Esperanza; García-Agua Soler, Nuria

2015-04-01

The quality of life assessment means investigating how patients perceive their disease. Malnutrition-specific characteristics make patients more vulnerable, so it is important to know how these factors impact on patients' daily life. To assess the quality of life in malnourished patients who have had hospital admission, and to determine the relationship of the quality of life with age, body mass index, diagnosis of malnutrition, and dependency. Multicenter transversal descriptive study in 106 malnourished patients after hospital admission. The quality of life (SF-12 questionnaire), BMI, functional independency (Barthel index), morbidity, and a dietary intake evaluation were assessed. The relationship between variables was tested by using the Spearman correlation coefficient. The patients of the present study showed a SF-12 mean of 38.32 points. The age was significantly correlated with the SF-12 (r= -0.320, p= 0.001). The BMI was correlated with the SF-12 (r= 0.251, p= 0.011) and its mental component (r= 0.289, p= 0.03). It was also reported a significant correlation between the Barthel index and the SF-12 (r= 0.370, p< 0.001). The general health perception in malnourished patients who have had a hospital admission was lower than the Spanish mean. Moreover, the quality of life in these patients is significantly correlated with age, BMI and functional independency. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Feasibility and effects of newly developed balance control trainer for mobility and balance in chronic stroke patients: a randomized controlled trial.

PubMed

Lee, So Hyun; Byun, Seung Deuk; Kim, Chul Hyun; Go, Jin Young; Nam, Hyeon Uk; Huh, Jin Seok; Jung, Tae Du

2012-08-01

To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients. Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training. There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (p<0.05). Statistically significant improvements on all measurements were observed in the experimental group after 4 weeks total. Comparing the two groups at 2 and 4 weeks of training respectively, 10mWT, TUG, and BBS showed statistically more significant improvements in the experimental group (p<0.05). Balance training with a newly developed BCT is feasible and may be an effective tool to improve balance and gait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.

Effect of virtual reality on cognitive dysfunction in patients with brain tumor.

PubMed

Yang, Seoyon; Chun, Min Ho; Son, Yu Ri

2014-12-01

To investigate whether virtual reality (VR) training will help the recovery of cognitive function in brain tumor patients. Thirty-eight brain tumor patients (19 men and 19 women) with cognitive impairment recruited for this study were assigned to either VR group (n=19, IREX system) or control group (n=19). Both VR training (30 minutes a day for 3 times a week) and computer-based cognitive rehabilitation program (30 minutes a day for 2 times) for 4 weeks were given to the VR group. The control group was given only the computer-based cognitive rehabilitation program (30 minutes a day for 5 days a week) for 4 weeks. Computerized neuropsychological tests (CNTs), Korean version of Mini-Mental Status Examination (K-MMSE), and Korean version of Modified Barthel Index (K-MBI) were used to evaluate cognitive function and functional status. The VR group showed improvements in the K-MMSE, visual and auditory continuous performance tests (CPTs), forward and backward digit span tests (DSTs), forward and backward visual span test (VSTs), visual and verbal learning tests, Trail Making Test type A (TMT-A), and K-MBI. The VR group showed significantly (p<0.05) better improvements than the control group in visual and auditory CPTs, backward DST and VST, and TMT-A after treatment. VR training can have beneficial effects on cognitive improvement when it is combined with computer-assisted cognitive rehabilitation. Further randomized controlled studies with large samples according to brain tumor type and location are needed to investigate how VR training improves cognitive impairment.

Effect of Virtual Reality on Cognitive Dysfunction in Patients With Brain Tumor

PubMed Central

Yang, Seoyon; Son, Yu Ri

2014-01-01

Objective To investigate whether virtual reality (VR) training will help the recovery of cognitive function in brain tumor patients. Methods Thirty-eight brain tumor patients (19 men and 19 women) with cognitive impairment recruited for this study were assigned to either VR group (n=19, IREX system) or control group (n=19). Both VR training (30 minutes a day for 3 times a week) and computer-based cognitive rehabilitation program (30 minutes a day for 2 times) for 4 weeks were given to the VR group. The control group was given only the computer-based cognitive rehabilitation program (30 minutes a day for 5 days a week) for 4 weeks. Computerized neuropsychological tests (CNTs), Korean version of Mini-Mental Status Examination (K-MMSE), and Korean version of Modified Barthel Index (K-MBI) were used to evaluate cognitive function and functional status. Results The VR group showed improvements in the K-MMSE, visual and auditory continuous performance tests (CPTs), forward and backward digit span tests (DSTs), forward and backward visual span test (VSTs), visual and verbal learning tests, Trail Making Test type A (TMT-A), and K-MBI. The VR group showed significantly (p<0.05) better improvements than the control group in visual and auditory CPTs, backward DST and VST, and TMT-A after treatment. Conclusion VR training can have beneficial effects on cognitive improvement when it is combined with computer-assisted cognitive rehabilitation. Further randomized controlled studies with large samples according to brain tumor type and location are needed to investigate how VR training improves cognitive impairment. PMID:25566470

Effect of Robot-Assisted Game Training on Upper Extremity Function in Stroke Patients

PubMed Central

2017-01-01

Objective To determine the effects of combining robot-assisted game training with conventional upper extremity rehabilitation training (RCT) on motor and daily functions in comparison with conventional upper extremity rehabilitation training (OCT) in stroke patients. Methods Subjects were eligible if they were able to perform the robot-assisted game training and were divided randomly into a RCT and an OCT group. The RCT group performed one daily session of 30 minutes of robot-assisted game training with a rehabilitation robot, plus one daily session of 30 minutes of conventional rehabilitation training, 5 days a week for 2 weeks. The OCT group performed two daily sessions of 30 minutes of conventional rehabilitation training. The effects of training were measured by a Manual Function Test (MFT), Manual Muscle Test (MMT), Korean version of the Modified Barthel Index (K-MBI) and a questionnaire about satisfaction with training. These measurements were taken before and after the 2-week training. Results Both groups contained 25 subjects. After training, both groups showed significant improvements in motor and daily functions measured by MFT, MMT, and K-MBI compared to the baseline. Both groups demonstrated similar training effects, except motor power of wrist flexion. Patients in the RCT group were more satisfied than those in the OCT group. Conclusion There were no significant differences in changes in most of the motor and daily functions between the two types of training. However, patients in the RCT group were more satisfied than those in the OCT group. Therefore, RCT could be a useful upper extremity rehabilitation training method. PMID:28971037

Exercising body and mind: an integrated approach to functional independence in hospitalized older people.

PubMed

Mudge, Alison M; Giebel, Andrea J; Cutler, Alison J

2008-04-01

To evaluate the effect of a structured, multi-component, early rehabilitation program on functional status, delirium, and discharge outcomes of older acute medical inpatients. Prospective controlled trial with blinded outcome evaluation. Internal medicine service of a metropolitan tertiary teaching hospital in Brisbane, Australia. One hundred twenty-four consecutive inpatients aged 65 and older admitted from the emergency department to control or intervention medical ward. Exclusions included patients completely dependent before admission or admitted from a nursing home, patients too ill to participate or terminally ill, and patients with length of stay less than 72 hours. Early physiotherapy review with provision of an individualized graduated exercise program and activity diary, progressive encouragement of functional independence by nursing staff and other members of the multidisciplinary team, and cognitive stimulation sessions. Modified Barthel Index (MBI) at admission and discharge, timed up-and-go at admission and discharge, incidence of delirium and falls, measured activity, length of hospital stay, discharge destination, 30-day readmission rate. Intervention and control participants were well matched in terms of age, sex, diagnosis, and functional status. The intervention group had greater improvement in functional status than the control group, with a median MBI improvement of 8.5 versus 3.5 points (P=.03). In the intervention group, there was a reduction in delirium (19.4% vs 35.5%, P=.04) and a trend to reduced falls (4.8% vs 11.3%, P=.19). Length of stay, timed up-and-go, discharge destination, and readmissions did not differ between the groups. This intervention was effective in improving function in a vulnerable patient group.

The Additive Effects of Core Muscle Strengthening and Trunk NMES on Trunk Balance in Stroke Patients

PubMed Central

Ko, Eun Jae; Kim, Dae Yul; Yi, Jin Hwa; Kim, Won; Hong, Jayoung

2016-01-01

Objective To investigate an additive effect of core muscle strengthening (CMS) and trunk neuromuscular electrical stimulation (tNEMS) on trunk balance in stroke patients. Methods Thirty patients with acute or subacute stroke who were unable to maintain static sitting balance for >5 minutes were enrolled and randomly assigned to 3 groups, i.e., patients in the CMS (n=10) group received additional CMS program; the tNMES group (n=10) received additional tNMES over the posterior back muscles; and the combination (CMS and tNMES) group (n=10) received both treatments. Each additional treatment was performed 3 times per week for 20 minutes per day over 3 weeks. Korean version of Berg Balance Scale (K-BBS), total score of postural assessment scale for stroke patients (PASS), Trunk Impairment Scale (TIS), and Korean version of Modified Barthel Index (K-MBI) were evaluated before and after 3 weeks of therapeutic intervention. Results All 3 groups showed improvements in K-BBS, PASS, TIS, and K-MBI after therapeutic interventions, with some differences. The combination group showed more improvements in K-BBS and the dynamic sitting balance of TIS, as compared to the CMS group; and more improvement in K-BBS, as compared to the tNMES group. Conclusion The results indicated an additive effect of CMS and tNMES on the recovery of trunk balance in patients with acute or subacute stroke who have poor sitting balance. Simultaneous application of CMS and tNMES should be considered when designing a rehabilitation program to improve trunk balance in stroke patients. PMID:26949681

Effectiveness of commercial gaming-based virtual reality movement therapy on functional recovery of upper extremity in subacute stroke patients.

PubMed

Choi, Jun Hwan; Han, Eun Young; Kim, Bo Ryun; Kim, Sun Mi; Im, Sang Hee; Lee, So Young; Hyun, Chul Woong

2014-08-01

To investigate the effectiveness of commercial gaming-based virtual reality (VR) therapy on the recovery of paretic upper extremity in subacute stroke patients. Twenty patients with the first-onset subacute stroke were enrolled and randomly assigned to the case group (n=10) and the control group (n=10). Primary outcome was measured by the upper limb score through the Fugl-Meyer Assessment (FMA-UL) for the motor function of both upper extremities. Secondary outcomes were assessed for motor function of both upper extremities including manual function test (MFT), box and block test (BBT), grip strength, evaluated for activities of daily living (Korean version of Modified Barthel Index [K-MBI]), and cognitive functions (Korean version of the Mini-Mental State Examination [K-MMSE] and continuous performance test [CPT]). The case group received commercial gaming-based VR therapy using Wii (Nintendo, Tokyo, Japan), and the control group received conventional occupational therapy (OT) for 30 minutes a day during the period of 4 weeks. All patients were evaluated before and after the 4-week intervention. There were no significant differences in the baseline between the two groups. After 4 weeks, both groups showed significant improvement in the FMA-UL, MFT, BBT, K-MBI, K-MMSE, and correct detection of auditory CPT. However, grip strength was improved significantly only in the case group. There were no significant intergroup differences before and after the treatment. These findings suggested that the commercial gaming-based VR therapy was as effective as conventional OT on the recovery of upper extremity motor and daily living function in subacute stroke patients.

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

PubMed

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

2015-01-01

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

[The relationship between acute inflammatory cytokines, nerve function defect, daily living ability and PSD].

PubMed

Li, Ping; Zhang, Qiao-Lian; Li, Shuang-Ying

2017-02-08

To investigate the correlation between poststroke depression (PSD) and serum levels of inflammatory cytokines, neurologic impairment, daily life ability in patients with acute cerebral infarction at different time. Two hundreds and eighty patients who admitted to our hospital with a diagnosis of acute infarction excluded the patients mismatch conditions were evaluated by Hamilton depres-sion rating scale (HDRS) to diagnose PSD respectively at admission and 3 months after stroke. Serum inflammatory cytokines high-sensitivity C-reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) were determined. NIH stroke scale(NIHSS) and Barthel index for daily life ability were used to evaluate nerve functions. Then we analyzed the correlation between PSD and serum inflammatory cytokines, correlation between PSD and functional impairment and daily life ability at different time. Logistic regression was performed to ana-lyze the risk factors of PSD. The PSD incidence was higher in recovery stage than that in acute stage, but there was no difference. Serum inflammatory cytokines were higher in PSD group at admission than that in non-PSD group. The NIHSS score and Barthel index in PSD group were different from those in non-group at acute and recovery stage. The OR score was 1.765, 1.646, 1.817, 1.188 and 2.015 respec-tively to TNF-α, IL-6 and Barthel index in the acute phase and to NIHSS and Barthel index in recovery stage. The pathogenesis of PSD at different courses of stroke is not same. TNF-α, IL-6 and Barthel index are the independent risk factors of PSD in acute phase, so do NIHSS score and Barthel index in recovery period.

[Early interdisciplinary geriatric rehabilitation after hip fracture : Effective concept or just transfer of costs?].

PubMed

Lögters, T; Hakimi, M; Linhart, W; Kaiser, T; Briem, D; Rueger, J; Windolf, J

2008-09-01

Modern strategies for postoperative care of patients with hip fractures include early discharge from the acute care hospital to inpatient interdisciplinary rehabilitation facilities. Whether these programs are effective for the patients and improve their long-term outcomes or if they simply transfer costs, with a reduction of the inpatient days in the acute care hospital, is currently under discussion. This prospective study included 282 patients with hip fracture admitted to our trauma center were included into the prospective study. The mean patient age was 86+/-8 (65-110) years. All patients were treated operatively. After a mean of 12+/-9 days, the patients underwent inpatient interdisciplinary geriatric rehabilitation for a mean of 27+/-13 (4-103) days. The primary outcome measure was their activities of daily living (Barthel index) before, at the end of rehabilitation, and 1 year after trauma. In addition, patient-related variables were correlated with the Barthel index. With discharge from the acute care hospital, the Barthel index was 42+/-20 points and it increased during rehabilitation to 65+/-26 points. One year later the Barthel index was 67+/-28 points. Ninety percent of patients improved their Barthel index during rehabilitation. Within 1 year, 40% of patients deteriorated in their activities of daily living. Fifty one percent of patients were reintegrated back to their homes. Patients who lived at home before trauma and were reintegrated back to their homes had a significant higher Barthel index (75+/-24) 1 year after trauma than patients who were living in a nursing care facility before the trauma (Barthel index 52+/-27). The variables of age, level of cognition, and type of fracture had no influence on the long-term outcome. An extension of rehabilitation above the mean time period did not improve the sustainable clinical outcome. Postoperative inpatient rehabilitation programs enhance short-term activities of daily living. In particular, patients

Effectiveness of Commercial Gaming-Based Virtual Reality Movement Therapy on Functional Recovery of Upper Extremity in Subacute Stroke Patients

PubMed Central

Choi, Jun Hwan; Kim, Bo Ryun; Kim, Sun Mi; Im, Sang Hee; Lee, So Young; Hyun, Chul Woong

2014-01-01

Objective To investigate the effectiveness of commercial gaming-based virtual reality (VR) therapy on the recovery of paretic upper extremity in subacute stroke patients. Methods Twenty patients with the first-onset subacute stroke were enrolled and randomly assigned to the case group (n=10) and the control group (n=10). Primary outcome was measured by the upper limb score through the Fugl-Meyer Assessment (FMA-UL) for the motor function of both upper extremities. Secondary outcomes were assessed for motor function of both upper extremities including manual function test (MFT), box and block test (BBT), grip strength, evaluated for activities of daily living (Korean version of Modified Barthel Index [K-MBI]), and cognitive functions (Korean version of the Mini-Mental State Examination [K-MMSE] and continuous performance test [CPT]). The case group received commercial gaming-based VR therapy using Wii (Nintendo, Tokyo, Japan), and the control group received conventional occupational therapy (OT) for 30 minutes a day during the period of 4 weeks. All patients were evaluated before and after the 4-week intervention. Results There were no significant differences in the baseline between the two groups. After 4 weeks, both groups showed significant improvement in the FMA-UL, MFT, BBT, K-MBI, K-MMSE, and correct detection of auditory CPT. However, grip strength was improved significantly only in the case group. There were no significant intergroup differences before and after the treatment. Conclusion These findings suggested that the commercial gaming-based VR therapy was as effective as conventional OT on the recovery of upper extremity motor and daily living function in subacute stroke patients. PMID:25229027

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

PubMed

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

2008-01-01

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

A case-control study of quality of life and functional impairment in women with long-standing vertebral osteoporotic fracture.

PubMed

Hall, S E; Criddle, R A; Comito, T L; Prince, R L

1999-01-01

There have been several studies of the impact of vertebral osteoporotic fracture on the quality of life and functionality of individual subjects. To date, however, no direct comparisons with age-matched normal subjects without vertebral fracture have been made. The radiographs of 145 female clinic patients with vertebral fractures were reviewed by the study physicians. The controls were recruited from the electoral role and by media appeal. One hundred and sixty-seven women had radiographs taken to determine those without vertebral fracture. Fracture subjects and controls had to be ambulant and were excluded if they had significant radiologic evidence of degenerative disk or joint disease of the spine. One hundred cases and one hundred controls were matched by 5-year age groups. The number, position and severity of the vertebral fracture on the lateral radiographs of the cases was recorded. Quality of life was measured using the Short Form-36 (SF-36) (maximum score 100) and a utility score calculated from these results (maximum score 1). Two measurements of functionality were employed: the Modified Barthel Index (MBI) to assess the activities of daily living (maximum score 100) and the Timed 'Up & Go' (TUG) that measured the time taken for the subject to rise from sitting in a chair, walk 3 m along a line, return to the chair and sit down. The fracture subjects had 2.9 +/- 1.6 (mean +/- SD) vertebral fractures and the time since last fracture was 5.1 +/- 4.8 years. The SF-36 physical function component summary index results were: fracture subjects 36 +/- 11, controls 48 +/- 9 (p < 0.001). The SF-36 mental health component summary index results were: fracture subjects 50 +/- 11, controls 54 +/- 8 (p < 0.05). The utility scores were: fracture subjects 0.64 +/- 0.08, controls 0.72 +/- 0.07 (p < 0.001). The MBI results were: fracture subjects 97 +/- 5, controls 99 +/- 1 (p < 0.01). The TUG results were: fracture subjects 13.8 +/- 7.3 s, controls 10.1 +/- 4.1 s (p < 0

Functional Improvement in Geriatric Hip Fractures: Does Vitamin D Deficiency Affect the Functional Outcome of Patients With Surgically Treated Intertrochanteric Hip Fractures.

PubMed

Seng, W R D; Belani, M H; Ramason, R; Naidu, G; Doshi, H K

2015-09-01

The "Integrated Care Pathway" for geriatric intertrochanteric (IT) fractures in Singapore's Tan Tock Seng Hospital has shown significant functional recovery in patients' activities of daily living. However, the influence of preoperative vitamin D on functional recovery remains equivocal. This retrospective study therefore aims to determine whether patients with preoperative vitamin D deficiency have poorer functional outcomes. A total of 171 patients who had surgical treatment for IT fractures were recruited in the study. They were categorized into group A (vitamin D deficient) and group B (normal vitamin D). Charlson Comorbidity Index (CCI) score and nutritional parameters including hemoglobin, albumin, and adjusted calcium levels on admission were recorded. The Modified Barthel Index (MBI) score was used to measure functional recovery at the following time intervals: at pre-fall, at discharge after surgery, at 6 months, and at 1-year follow-up. The mean age of both the groups (A: 79.7 years, n = 45; B: 83.0 years, n = 126) was statistically different (P < .05). However, the mean CCI (A: 9.42 and B: 10.13), hemoglobin (A: 12.4 and B 11.1), adjusted calcium (A: 2.39 and B: 2.38), and mean albumin (A: 33.6 and B: 33.0) of the groups were not significantly different. Furthermore, the MBI scores were not significantly different for both groups at preinjury (A: 91.5 and B: 89.4), at discharge (A: 55.2 and B: 58.9), at 6 months (A: 70.9 and B: 75.1), and at 1 year (A: 75.8 and B: 79.4). In our cohort, patients with vitamin D deficiency were younger. However, vitamin D deficiency at time of injury had no significant influence on functional recovery in patients with surgically treated hip fracture in our Integrated Care Pathway. In addition, patients who had a normal vitamin D levels had similar functional scores and improvement postoperatively and at 1 year (A: 82.8% and B: 88.9%).

Skeletal muscle mass is associated with severe dysphagia in cancer patients

PubMed Central

Wakabayashi, Hidetaka; Matsushima, Masato; Uwano, Rimiko; Watanabe, Naoko; Oritsu, Hideyuki; Shimizu, Yoshitaka

2015-01-01

Background The purpose of this study was to assess the association between skeletal muscle mass, activities of daily living (ADLs) and severe dysphagia in cancer patients. Methods A nested case-control study was performed in 111 consecutive cancer patients with dysphagia who were prescribed speech therapy. Skeletal muscle mass comprising the cross-sectional area of the left and right psoas muscles was assessed via abdominal computed tomography at the third lumbar vertebral level. ADLs were evaluated by the Barthel Index. The severity of dysphagia was assessed by the Food Intake Level Scale and was characterized by non-oral feeding or oral food intake at discharge. Univariate and logistic regression analyses were applied to examine the associations between dysphagia, skeletal muscle index (SMI) and ADLs. Results There were 86 men and 25 women (mean age, 70 years). The mean SMI was 5.68 ± 1.74 cm2/m2 in men and 4.43 ± 1.21 cm2/m2 in women. The median Barthel Index score was 20. Thirty-three patients were on non-oral feeding at discharge. The mean SMI did not differ significantly between non-oral feeding and oral food intake groups in t-test. The median Barthel Index score was lower in the non-oral feeding group in Mann–Whitney U test. Logistic regression analysis of the severity of dysphagia adjusted for age, sex, SMI, Barthel Index score, serum albumin, cancer type and stage, and vocal cord paralysis showed that SMI was associated independently with oral food intake at discharge. Barthel Index score showed a tendency to be associated with oral food intake. Conclusions Skeletal muscle mass is associated with severe dysphagia in cancer patients. ADLs show a tendency to be associated with severe dysphagia in cancer patients. PMID:26673551

Bright light therapy as part of a multicomponent management program improves sleep and functional outcomes in delirious older hospitalized adults.

PubMed

Chong, Mei Sian; Tan, Keng Teng; Tay, Laura; Wong, Yoke Moi; Ancoli-Israel, Sonia

2013-01-01

Delirium is associated with poor outcomes following acute hospitalization. A specialized delirium management unit, the Geriatric Monitoring Unit (GMU), was established. Evening bright light therapy (2000-3000 lux; 6-10 pm daily) was added as adjunctive treatment, to consolidate circadian activity rhythms and improve sleep. This study examined whether the GMU program improved sleep, cognitive, and functional outcomes in delirious patients. A total of 228 patients (mean age = 84.2 years) were studied. The clinical characteristics, delirium duration, delirium subtype, Delirium Rating Score (DRS), cognitive status (Chinese Mini-Mental State Examination), functional status (modified Barthel Index [MBI]), and chemical restraint use during the initial and predischarge phase of the patient's GMU admission were obtained. Nurses completed hourly 24-hour patient sleep logs, and from these, the mean total sleep time, number of awakenings, and sleep bouts (SB) were computed. The mean delirium duration was 6.7 ± 4.6 days. Analysis of the delirium subtypes showed that 18.4% had hypoactive delirium, 30.2% mixed delirium, and 51.3% had hyperactive delirium. There were significant improvements in MBI scores, especially for the hyperactive and mixed delirium subtypes (P < 0.05). Significant improvements were noted on the DRS sleep-wake disturbance subscore, for all delirium-subtypes. The mean total sleep time (7.7 from 6.4 hours) (P < 0.05) and length of first SB (6.0 compared with 5.3 hours) (P < 0.05) improved, with decreased mean number of SBs and awakenings. The sleep improvements were mainly seen in the hyperactive delirium subtype. This study shows initial evidence for the clinical benefits (longer total sleep time, increased first SB length, and functional gains) of incorporating bright light therapy as part of a multicomponent delirium management program. The benefits appear to have occurred mainly in patients with hyperactive delirium, which merits further in

Mirror neurons: action observation treatment as a tool in stroke rehabilitation.

PubMed

Franceschini, M; Agosti, M; Cantagallo, A; Sale, P; Mancuso, M; Buccino, G

2010-12-01

The observation of actions performed by others activate in an observer the same neural structures (including mirror neurons) as when he/she actually performs the same actions. The aim of the present study was to assess whether action observation treatment may improve upper limb motor impairment in chronic stroke patients. This was an observational study. Patients were recruited by three Italian Centres for Neurorehabilitation between 2006 and 2008. Twenty-eight chronic stroke patients with upper limb impairment have undergone for four weeks, five days a week, a rehabilitation treatment based on observation of video-clips presenting hand daily actions, followed by the imitation of those same actions with the affected limb. Functional evaluation by means of Modified Barthel Index (MBI), Frenchay Arm Test (FAT) and Fugl Meyer (FM) was carried out twice before treatment (BT1 and BT2), at an interval of 15 days, then after treatment (AT1) and finally at a two-month follow-up (AT2). Wilcoxon Signed Rank test was applied to test differences between scores obtained from functional scales before and after treatment (BT1 vs. BT2; BT2 vs. AT1; AT1 vs. AT2). In all scales, scores did not differ when comparing BT1 with BT2. Scores improved significantly in all scales at AT1 as compared to BT2 (MBI, P=0.026; FAT, P=0.005; FM, P=0.001). This improvement was still present at the two-month follow-up as testified by no score difference between AT1 and AT2. Action Observation Treatment may become a useful strategy in the rehabilitation of stroke patients. The present preliminary study suggests that stimulation of neural structures (including mirror neurons), activated when the patients actually perform the same actions as those observed could constitute a good alternative rehabilitative approach in chronic stroke patients.

Measurement value analysis overall equipment effectiveness (OEE) packaging process in line 2 (Case Study of PT. MBI Tbk)

NASA Astrophysics Data System (ADS)

Rimawan, Erry; Kholil, Muhammad; Hendri

2018-03-01

PT. MBI Tbk is engaged in the manufacture of beverage industry, where the company’s production is based on the magnitude of customer demand that is marketing offices that had been scattered in various regions of Indonesia. In the packaging process steps in PT.MBI through the line 3 lines including racking, canning line, bottling line. In the canning process to existing packing on Line 2 (canning line), there are some machines that are used continuously, among other Depalletizer machine, filler machine, can seamer machine, pasteurizer machine, machine FLD, Wrap Around engine, engine Shrink Wrap. Due to the large demand from customers that is relentless, therefore the calculation of overall equipment effectiveness (OEE) as a whole on line 2 (canning line) is needed in order to make improvements continuously (Continuous Improvement) at line 2 (canning line). This study aims to determine the value of overall equipment effectiveness (OEE) and Losses of the most influential of the big six OEE Losses focused on equipment or machinery as a whole into a single unit that is on the line 2, which will then be known root cause of the losses that occur from the research over the field. From the calculation of overall equipment effectiveness (OEE), there are two ratios are still poor and under world-class standards, while the ratio of the availability of 88.85% of the world-class standards by 90% and the performance ratio of 78.51% of the standard world class by 95%, whereas for quality ratio has entered the world-class standard that is equal to 99.90%. Thus the value of OEE on Line 2 line is below world class standards. In this study there were only five losses, which can be identified, and while the losses were very influential, namely the Speed Reduced Losses, losses, these losses accounted for the largest percentage of the value of the rate of 19.12%, of the results of this study losses occurred due to poor surveillance systems (less good) that causes the employee or

Concomitant upper limb fractures and short-term functional recovery in hip fracture patients: does the site of upper limb injury matter?

PubMed

Di Monaco, Marco; Castiglioni, Carlotta; Vallero, Fulvia; Di Monaco, Roberto; Tappero, Rosa

2015-05-01

The aim of this study was to evaluate functional recovery in a subgroup of hip fracture patients who sustained a simultaneous fracture at the upper limb, taking into account the site of upper limb injury. Of 760 patients admitted consecutively to the authors' rehabilitation hospital because of a fall-related hip fracture, 700 were retrospectively investigated. Functional outcome was assessed using Barthel Index scores. In 49 of the 700 patients, a single fall resulted in both a hip fracture and a fracture of either wrist (n = 34) or proximal humerus (n = 15). The patients with concomitant shoulder fractures had lower median Barthel Index scores after rehabilitation (70 vs. 90, P = 0.003), lower median Barthel Index effectiveness (57.1 vs. 76.9, P = 0.018), and prolonged median length of stay (42 vs. 36 days, P = 0.011) than did the patients with isolated hip fractures. Significant differences persisted after adjustment for six potential confounders. The adjusted odds ratio for achieving a Barthel Index score lower than 85 was 6.71 (95% confidence interval, 1.68-26.81; P = 0.007) for the patients with concomitant shoulder fractures. Conversely, no prognostic disadvantages were associated with concomitant wrist fractures. Data show a worse functional recovery and a prolonged length of stay in the subgroup of hip fracture patients who sustained a concomitant fracture at the proximal humerus, but not at the wrist.

Comprehensive rehabilitation with integrative medicine for subacute stroke: A multicenter randomized controlled trial

PubMed Central

Fang, Jianqiao; Chen, Lifang; Ma, Ruijie; Keeler, Crystal Lynn; Shen, Laihua; Bao, Yehua; Xu, Shouyu

2016-01-01

To determine whether integrative medicine rehabilitation (IMR) that combines conventional rehabilitation (CR) with acupuncture and Chinese herbal medicine has better effects for subacute stroke than CR alone, we conducted a multicenter randomized controlled trial that involved three hospitals in China. Three hundred sixty patients with subacute stroke were randomized into IMR and CR groups. The primary outcome was the Modified Barthel Index (MBI). The secondary outcomes were the National Institutes of Health Stroke Scale (NIHSS), the Fugl-Meyer Assessment (FMA), the mini-mental state examination (MMSE), the Montreal Cognitive Assessment (MoCA), Hamilton’s Depression Scale (HAMD), and the Self-Rating Depression Scale (SDS). All variables were evaluated at week 0 (baseline), week 4 (half-way of intervention), week 8 (after treatment) and week 20 (follow-up). In comparison with the CR group, the IMR group had significantly better improvements (P < 0.01 or P < 0.05) in all the primary and secondary outcomes. There were also significantly better changes from baseline in theses outcomes in the IMR group than in the CR group (P < 0.01). A low incidence of adverse events with mild symptoms was observed in the IMR group. We conclude that conventional rehabilitation combined with integrative medicine is safe and more effective for subacute stroke rehabilitation. PMID:27174221

Factors Associated with Reduced Quality of Life in Polio Survivors in Korea

PubMed Central

Yang, Eun Joo; Lee, Seung Yeol; Kim, Keewon; Jung, Se Hee; Jang, Soong-Nang; Han, Soo Jeong; Kim, Wan-Ho; Lim, Jae-Young

2015-01-01

The purpose of this study is to assess health-related quality of life in polio survivors (PS) compared with that in the general population in Korea. Polio survivors (n = 120) from outpatient clinics at two hospitals, healthy controls (HC, n = 121) and members of the general population with activity limitations (AL, n = 121) recruited through a proportional-allocation, systematic sampling strategy from the Fourth Korean National Health and Nutrition Examination Survey were surveyed with self-rated health-related quality of life (Euro QoL five-dimensions). The proportion of participants who reported problems in mobility, usual activity, and symptoms of anxiety/depression were higher in the PS group compared with the HC and AL groups. There was no significant difference in the self-care dimension across the groups. Polio-specific questionnaire, pain, depression, fatigue, Modified Barthel Index (K-MBI) and Short Physical Performance Battery (SPPB) were assessed in the PS group. Those with post-poliomyelitis syndrome had greater problems in mobility, usual activity, and depression/anxiety. Polio survivors, especially those with more pain and fatigue symptoms, and those who did not have access to medical services had poorer health-related quality of life. These findings afford useful information for potential intervention improving quality of life in polio survivors. PMID:26120843

Social representations of the health care of the Mbyá-Guarani indigenous population by health workers.

PubMed

Falkenberg, Mirian Benites; Shimizu, Helena Eri; Bermudez, Ximena Pamela Díaz

2017-02-06

to analyze the social representations of health care of the Mbyá-Guarani ethnic group by multidisciplinary teams from the Special Indigenous Health District in the south coast of Rio Grande do Sul state (Distrito Sanitário Especial Indígena Litoral Sul do Rio Grande do Sul), Brazil. a qualitative method based on the theory of social representations was used. Data were collected via semi-structured interviews with 20 health workers and by participant observation. The interviews were analyzed with ALCESTE software, which conducts a lexical content analysis using quantitative techniques for the treatment of textual data. there were disagreements in the health care concepts and practices between traditional medicine and biomedicine; however, some progress has been achieved in the area of intermedicality. The ethnic boundaries established between health workers and indigenous peoples based on their representations of culture and family, together with the lack of infrastructure and organization of health actions, are perceived as factors that hinder health care in an intercultural context. a new basis for the process of indigenous health care needs to be established by understanding the needs identified and by agreement among individuals, groups, and health professionals via intercultural exchange. analisar as representações sociais do cuidado em saúde entre trabalhadores que atuam em equipes multidisciplinares no Distrito Sanitário Especial Indígena Litoral Sul do Rio Grande do Sul, junto à etnia Mbyá-Guarani. utilizou-se método qualitativo, fundamentado na teoria das Representações Sociais. Os dados foram coletados por meio de entrevistas semiestruturadas com 20 trabalhadores e da observação participante. As entrevistas analisadas com o software ALCESTE, o qual realiza a análise lexical de conteúdo por meio de técnicas quantitativas de tratamento de dados textuais. verificou-se que existe tensão entre as concepções e práticas de cuidado da

Over- and undersupply in home care: a representative multicenter correlational study.

PubMed

Lahmann, Nils A; Suhr, Ralf; Kuntz, Simone; Kottner, Jan

2015-04-01

Quality assurance and funding of care become a major challenge against the background of demographic changes in western societies. The primary aim of the study was to identify possible misclassification, respectively over and undersupply of care by comparing the Barthel Index of clients of home care service with the level of care (Stage 0, I, II, III) according to the statutory German long-term care insurance. In 2012, a multi-center point prevalence study of 878 randomly selected clients of 100 randomly selected home care services across Germany was conducted. According to a standardized study protocol, demographics, the Barthel Index and the nurses' professional judgment-whether a client requires more nursing care-were assessed. Associations of the Barthel items and professional judgment were analyzed using univariate (Chi-square) and multivariate (logistic regression and classification-regression-tree-models) statistics. In each level of care, the Barthel Index showed large variability e.g. in level II ranging from 0 to 100 points. Multivariate logistic regression regarding possible under- and oversupply revealed occasionally fecal incontinence (2.1; 95 % CI 1.2-3.7), urinary incontinence (2.0; 95 % CI 1.1-3.6), feeding (1.7; 95 % CI 1.0-2.9), immobility (0.2; 95 % CI 0.1-0.6) and to be female (1.8; 95 % CI 1.2-2.6) to be statistically significantly associated. The variability in Barthel Index in each level of care found in this study indicated a large general misclassification of home care clients according to their actual need of care. Professional caregivers identified occasional incontinence, help with eating and drinking and mobility (especially in female clients) as areas of possible under- and oversupply of care. The statutory German long-term care insurance classification should be modified according to the above finding to increase the quality of care in home care clients.

Validity and reliability of a novel measure of activity performance and participation.

PubMed

Murgatroyd, Phil; Karimi, Leila

2016-01-01

To develop and evaluate an innovative clinician-rated measure, which produces global numerical ratings of activity performance and participation. Repeated measures study with 48 community-dwelling participants investigating clinical sensibility, comprehensiveness, practicality, inter-rater reliability, responsiveness, sensitivity and concurrent validity with Barthel Index. Important clinimetric characteristics including comprehensiveness and ease of use were rated >8/10 by clinicians. Inter-rater reliability was excellent on the summary scores (intraclass correlation of 0.95-0.98). There was good evidence that the new outcome measure distinguished between known high and low functional scoring groups, including both responsiveness to change and sensitivity at the same time point in numerous tests. Concurrent validity with the Barthel Index was fair to high (Spearman Rank Order Correlation 0.32-0.85, p > 0.05). The new measure's summary scores were nearly twice as responsive to change compared with the Barthel Index. Other more detailed data could also be generated by the new measure. The Activity Performance Measure is an innovative outcome instrument that showed good clinimetric qualities in this initial study. Some of the results were strong, given the sample size, and further trial and evaluation is appropriate. Implications for Rehabilitation The Activity Performance Measure is an innovative outcome measure covering activity performance and participation. In an initial evaluation, it showed good clinimetric qualities including responsiveness to change, sensitivity, practicality, clinical sensibility, item coverage, inter-rater reliability and concurrent validity with the Barthel Index. Further trial and evaluation is appropriate.

Patients' functioning as predictor of nursing workload in acute hospital units providing rehabilitation care: a multi-centre cohort study

PubMed Central

2010-01-01

Background Management decisions regarding quality and quantity of nurse staffing have important consequences for hospital budgets. Furthermore, these management decisions must address the nursing care requirements of the particular patients within an organizational unit. In order to determine optimal nurse staffing needs, the extent of nursing workload must first be known. Nursing workload is largely a function of the composite of the patients' individual health status, particularly with respect to functioning status, individual need for nursing care, and severity of symptoms. The International Classification of Functioning, Disability and Health (ICF) and the derived subsets, the so-called ICF Core Sets, are a standardized approach to describe patients' functioning status. The objectives of this study were to (1) examine the association between patients' functioning, as encoded by categories of the Acute ICF Core Sets, and nursing workload in patients in the acute care situation, (2) compare the variance in nursing workload explained by the ICF Core Set categories and with the Barthel Index, and (3) validate the Acute ICF Core Sets by their ability to predict nursing workload. Methods Patients' functioning at admission was assessed using the respective Acute ICF Core Set and the Barthel Index, whereas nursing workload data was collected using an established instrument. Associations between dependent and independent variables were modelled using linear regression. Variable selection was carried out using penalized regression. Results In patients with neurological and cardiopulmonary conditions, selected ICF categories and the Barthel Index Score explained the same variance in nursing workload (44% in neurological conditions, 35% in cardiopulmonary conditions), whereas ICF was slightly superior to Barthel Index Score for musculoskeletal conditions (20% versus 16%). Conclusions A substantial fraction of the variance in nursing workload in patients with rehabilitation

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors.

PubMed

Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years ( P <0.001), body mass index (BMI) <23.5 ( P =0.007), Mini-Mental State Examination <20 ( P =0.004), Barthel Index <65 ( P =0.002), hemoglobin <7.69 mmol/L ( P =0.017), serum protein <70 g/L ( P =0.008), albumin <32 g/L ( P =0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49; P <0.001), history of falls (OR =2.55; 95% CI =1.05-6.19; P =0.039), age (OR =1.14; 95% CI =1.05-1.23; P =0.001), and BMI (OR =0.91; 95% CI =0.83-0.99; P =0.034). Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors

PubMed Central

Mazur, Katarzyna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Background Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. Objective Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. Methods Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( χ¯ ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. Results About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years (P<0.001), body mass index (BMI) <23.5 (P=0.007), Mini-Mental State Examination <20 (P=0.004), Barthel Index <65 (P=0.002), hemoglobin <7.69 mmol/L (P=0.017), serum protein <70 g/L (P=0.008), albumin <32 g/L (P=0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76–19.49; P<0.001), history of falls (OR =2.55; 95% CI =1.05–6.19; P=0.039), age (OR =1.14; 95% CI =1.05–1.23; P=0.001), and BMI (OR =0.91; 95% CI =0.83–0.99; P=0.034). Conclusion Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls. PMID:27695303

Measuring the Mutual Effects of a CZT Detector and a 3T MRI for the Development of a Simultaneous MBI/MRI Insert

NASA Astrophysics Data System (ADS)

Tao, Ashley T.; Noseworthy, Michael D.; Farncombe, Troy H.

2016-10-01

A cadmium zinc telluride (CZT) based detector system has been developed with the goal of combining molecular breast imaging (MBI) and magnetic resonance imaging (MRI) to address shortcomings of each modality. The CZT detector system is comprised of four CZT modules tiled in a 2×2 array. Each module consists of 256 pixels (16×16, 2.4 mm pixels) and features a built-in ASIC and FPGA. A custom digital readout circuit board was designed to interface the four modules with a microcontroller to a data acquisition PC. The system was placed within the bore of a 3 T GE Discovery MR750 and imaging performance of each modality evaluated using both sequential and simultaneous imaging protocols. The mean energy resolution of the gamma camera both inside and outside the MRI is 7.3% at 140 keV. The maximum increase in the integral uniformity was 3% when using a gradient echo MRI sequence while the mean differential uniformity when inside the MRI increased by 1%. Spatial resolution varied in a predictable manner from 2.4 mm FWHM at the collimator face to 6.9 mm at 10 cm from the collimator. Performance of the 3 T GE Discovery MR750 using a 16-channel breast RF coil array was measured with and without the gamma camera present using a gradient echo and spoiled gradient echo imaging sequence. A realistic 99mTc-filled breast-like phantom containing two lesions (30:1 lesion to background ratio) was used to assess the feasibility of both serial and simultaneous hybrid imaging. Sequential imaging resulted in a reduction in MRI SNR of 70-80% and a further decrease of 93-98% was observed when performing simultaneous MR/scintigraphy imaging, likely a result of RF interference originating from the CZT detector modules and associated analog electronics. Co-registered scintigraphic and MRI images display negligible geometric distortion when imaged with both simultaneous and serial imaging modes, thus indicating the feasibility of combining MBI with breast MRI.

Effects of Balance Control Training on Functional Outcomes in Subacute Hemiparetic Stroke Patients.

PubMed

Huh, Jin Seok; Lee, Yang-Soo; Kim, Chul-Hyun; Min, Yu-Sun; Kang, Min-Gu; Jung, Tae-Du

2015-12-01

To investigate the efficacy of balance control training using a newly developed balance control trainer (BalPro) on the balance and gait of patients with subacute hemiparetic stroke. Forty-three subacute stroke patients were assigned to either a balance control training (BCT) group or a control group. The BCT group (n=23) was trained with BalPro for 30 minutes a day, 5 days a week for 2 weeks, and received one daily session of conventional physical therapy. The control group (n=20) received two sessions of conventional physical therapy every day for 2 weeks. The primary outcome was assessment with the Berg Balance Scale (BBS). Secondary outcomes were Functional Ambulation Category (FAC), the 6-minute walking test (6mWT), Timed Up and Go (TUG), the Korean version of Modified Barthel Index (K-MBI), and the manual muscle test (MMT) of the knee extensor. All outcome measures were evaluated before and after 2 weeks of training in both groups. There were statistically significant improvements in all parameters except MMT and FAC after 2 weeks of treatment in both groups. After training, the BCT group showed greater improvements in the BBS and the 6mWT than did the control group. Balance control training using BalPro could be a useful treatment for improving balance and gait in subacute hemiparetic stroke patients.

Effects of Balance Control Training on Functional Outcomes in Subacute Hemiparetic Stroke Patients

PubMed Central

Huh, Jin Seok; Lee, Yang-Soo; Kim, Chul-Hyun; Min, Yu-Sun; Kang, Min-Gu

2015-01-01

Objective To investigate the efficacy of balance control training using a newly developed balance control trainer (BalPro) on the balance and gait of patients with subacute hemiparetic stroke. Methods Forty-three subacute stroke patients were assigned to either a balance control training (BCT) group or a control group. The BCT group (n=23) was trained with BalPro for 30 minutes a day, 5 days a week for 2 weeks, and received one daily session of conventional physical therapy. The control group (n=20) received two sessions of conventional physical therapy every day for 2 weeks. The primary outcome was assessment with the Berg Balance Scale (BBS). Secondary outcomes were Functional Ambulation Category (FAC), the 6-minute walking test (6mWT), Timed Up and Go (TUG), the Korean version of Modified Barthel Index (K-MBI), and the manual muscle test (MMT) of the knee extensor. All outcome measures were evaluated before and after 2 weeks of training in both groups. Results There were statistically significant improvements in all parameters except MMT and FAC after 2 weeks of treatment in both groups. After training, the BCT group showed greater improvements in the BBS and the 6mWT than did the control group. Conclusion Balance control training using BalPro could be a useful treatment for improving balance and gait in subacute hemiparetic stroke patients. PMID:26798615

Effects of walkbot gait training on kinematics, kinetics, and clinical gait function in paraplegia and quadriplegia.

PubMed

Hwang, Jongseok; Shin, Yongil; Park, Ji-Ho; Cha, Young Joo; You, Joshua Sung H

2018-04-07

The robotic-assisted gait training (RAGT) system has gained recognition as an innovative, effective paradigm to improve functional ambulation and activities of daily living in spinal cord injury and stroke. However, the effects of the Walkbot robotic-assisted gait training system with a specialized hip-knee-ankle actuator have never been examined in the paraplegia and quadriplegia population. The aim of this study was to determine the long-term effects of Walkbot training on clinical for hips and knee stiffness in individuals with paraplegia or quadriplegia. Nine adults with subacute or chronic paraplegia resulting from spinal cord injury or quadriplegia resulting from cerebral vascular accident (CVA) and/or hypoxia underwent progressive conventional gait retraining combined with the Walkbot RAGT for 5 days/week over an average of 43 sessions for 8 weeks. Clinical outcomes were measured with the Functional Ambulation Category (FAC), Modified Rankin Scale (MRS), Korean version of the Modified Barthel Index (K-MBI), Modified Ashworth Scale (MAS). Kinetic and kinematic data were collected via a built-in Walkbot program. Wilcoxon signed-rank tests showed significant positive intervention effects on K-MBI, maximal hip flexion and extension, maximal knee flexion, active torque in the knee joint, resistive torque, and stiffness in the hip joint (P <  0.05). These findings suggest that the Walkbot RAGT was effective for improving knee and hip kinematics and the active knee joint moment while decreasing hip resistive force. These improvements were associated with functional recovery in gait, balance, mobility and daily activities. These findings suggest that the Walkbot RAGT was effective for improving knee and hip kinematics and the active knee joint moment while decreasing hip resistive force. This is the first clinical evidence for intensive, long-term effects of the Walkbot RAGT on active or resistive moments and stiffness associated with spasticity and functional

Superconducting Bi 2Te: Pressure-induced universality in the (Bi 2) m(Bi 2Te 3) n series

DOE PAGES

Stillwell, Ryan L.; Jeffries, Jason R.; Jenei, Zsolt; ...

2016-03-09

Using high-pressure magnetotransport techniques we have discovered superconductivity in Bi 2Te, a member of the infinitely adaptive (Bi 2)m(Bi 2Te 3)n series, whose end members, Bi and Bi 2Te 3, can be tuned to display topological surface states or superconductivity. Bi 2Te has a maximum T c = 8.6 K at P = 14.5 GPa and goes through multiple high pressure phase transitions, ultimately collapsing into a bcc structure that suggests a universal behavior across the series. High-pressure magnetoresistance and Hall measurements suggest a semi-metal to metal transition near 5.4 GPa, which accompanies the hexagonal to intermediate phase transition seenmore » via x-ray diffraction measurements. In addition, the linearity of H c2 (T) exceeds the Werthamer-Helfand-Hohenberg limit, even in the extreme spin-orbit scattering limit, yet is consistent with other strong spin-orbit materials. Furthermore, considering these results in combination with similar reports on strong spin-orbit scattering materials seen in the literature, we suggest the need for a new theory that can address the unconventional nature of their superconducting states.« less

Social representations of the health care of the Mbyá-Guarani indigenous population by health workers 1

PubMed Central

Falkenberg, Mirian Benites; Shimizu, Helena Eri; Bermudez, Ximena Pamela Díaz

2017-01-01

ABSTRACT Objective: to analyze the social representations of health care of the Mbyá-Guarani ethnic group by multidisciplinary teams from the Special Indigenous Health District in the south coast of Rio Grande do Sul state (Distrito Sanitário Especial Indígena Litoral Sul do Rio Grande do Sul), Brazil. Method: a qualitative method based on the theory of social representations was used. Data were collected via semi-structured interviews with 20 health workers and by participant observation. The interviews were analyzed with ALCESTE software, which conducts a lexical content analysis using quantitative techniques for the treatment of textual data. Results: there were disagreements in the health care concepts and practices between traditional medicine and biomedicine; however, some progress has been achieved in the area of intermedicality. The ethnic boundaries established between health workers and indigenous peoples based on their representations of culture and family, together with the lack of infrastructure and organization of health actions, are perceived as factors that hinder health care in an intercultural context. Conclusion: a new basis for the process of indigenous health care needs to be established by understanding the needs identified and by agreement among individuals, groups, and health professionals via intercultural exchange. PMID:28177056

[Decompressive craniectomy in the management of sylvian infarction].

PubMed

Berhouma, Moncef; Khouja, Néjib; Jemel, Hafedh; Khaldi, Moncef

2006-09-01

Space-occupying middle cerebral artery infarction represents about 10 to 15% of supratentorial ischemic strokes. This syndrome carries a high rate of mortality and requires aggressive surgical decompression. The authors present 6 patients with signs of trans-tentorial herniation operated on between February 2001 and August 2003. Neurological preoperative status was evaluated with Glasgow coma scale score and postoperatively with Barthel index. Three patients had excellent recovery (Barthel Index up to 70), one remained dependant and two died. Younger patients had better prognosis. Decompressive surgery, when done early, should improve mortality rate and even functional outcome. Optimal selection of patients, with the help of Diffusion-Weighted imaging, could vouch good results.

Association of total serum cholesterol with functional outcome following home care rehabilitation in Italian patients with stroke.

PubMed

Cataldo, Maria Concetta; Calcara, Maria Luisa; Caputo, Giuseppe; Mammina, Caterina

2012-04-01

Stroke is a disabling disease. In elderly populations, stroke is the third leading cause of death and the primary cause of reduction in or loss of functional ability and personal autonomy. Possible associations between levels of total serum cholesterol (TC) and both incidence of stroke and functional outcomes after rehabilitation are still under study. To detect positive and negative prognostic factors associated with functional outcomes in first-time stroke patients admitted to an integrated home care rehabilitative program. This study enrolled 141 patients with a first-time stroke who were admitted to a home care rehabilitation program. Primary outcome measures were the Barthel activities of daily living (ADL) and mobility indices at the beginning and end of the rehabilitative treatment. The impact of TC and other demographic and clinical variables was analyzed using bivariate and multivariate logistic regression analyses. Age and Short Portable Mental Status Questionnaire (SPMSQ) score were negatively associated with functional outcome. In contrast, elevated TC was positively associated with a better home rehabilitative treatment outcome. Barthel index score at admission was negatively associated with outcomes assessed by the Barthel ADL index and age with outcomes assessed by the Barthel mobility index. In a multivariate logistic regression analysis, SPMSQ score and elevated TC were significantly associated with outcome. Specifically, higher SPMSQ scores were negatively associated with better rehabilitative treatment outcomes, whereas elevated TC was positively associated. Elevated TC seems to be associated with better functional outcomes in patients with first-time stroke. Copyright © 2012 Elsevier Inc. All rights reserved.

[Functional electrical stimulation based on a working pattern influences function of lower extremity in subjects with early stroke and effects on diffusion tensor imaging: a randomized controlled trial].

PubMed

Chen, Danfeng; Yan, Tiebin; Li, Guandong; Li, Fangming; Liang, Qitang

2014-10-14

To explore the possible mechanisms for improving lower extremity motor function in patients with early stroke through combining magnetic resonance diffusion tensor imaging (DTI) technology and functional electrical stimulation (FES) based on human walking patterns. From August 2012 to September 2013, a total of 48 eligible patients were stratified according to age, gender, disease course, Brunnstrom staging and types of stroke. And the Minimize software was used to divided them randomly into four-channel FES group (n = 18), dual-channel FES group (n = 15) and comfort stimulation group (n = 15). For all three groups, general medication and standard rehabilitation were provided. Based on normal walking pattern design of FES treatment, four-channel FES groups received the stimulations of quadriceps, hamstring, anterior tibialis and medial gastrocnemius. For the dual-channel FES group, the stimulations of tibialis anterior, peroneus longus and peroneus brevis muscles were applied. In comfort electrical stimulation group, the electrode positions were identical to the stimulation group, but there was no current output during stimulation. Before and after 3-week treatment, three groups received weekly rehabilitation evaluations of Fugl-Meyer assessment (FMA), posture assessment of stroke scale (PASS), Brunel balance assessment (BBA), Berg balance scale (BBS) and modified Barthel index (MBI). Before and after treatment, DTI examination was performed for some patients. Among three groups, general patient profiles and pre-treatment evaluations showed no significant difference. For intra-group comparisons versus pre-treatment, at week 1, 2 and 3, the scores of PASS, BBA, BBS, FMA and MBI had statistically significant differences (P < 0.05); At week 3 post-treatment, when four-channel and double-channel FES groups were compared versus pre-treatment, the scores of ipsilateral FA had statistically significant differences (P < 0.05). At week 1 post-treatment, MBI had

The potential impact of multidimesional geriatric assessment in the social security system.

PubMed

Corbi, Graziamaria; Ambrosino, Immacolata; Massari, Marco; De Lucia, Onofrio; Simplicio, Sirio; Dragone, Michele; Paolisso, Giuseppe; Piccioni, Massimo; Ferrara, Nicola; Campobasso, Carlo Pietro

2018-01-12

To evaluate the efficacy of multidimensional geriatric assessment (MGA/CGA) in patients over 65 years old in predicting the release of the accompaniment allowance (AA) indemnity by a Local Medico-Legal Committee (MLC-NHS) and by the National Institute of Social Security Committee (MLC-INPS). In a longitudinal observational study, 200 Italian elder citizens requesting AA were first evaluated by MLC-NHS and later by MLC-INPS. Only MLC-INPS performed a MGA/CGA (including SPMSQ, Barthel Index, GDS-SF, and CIRS). This report was written according to the STROBE guidelines. The data analysis was performed on January 2016. The evaluation by the MLC-NHS and by the MLC-INPS was in agreement in 66% of cases. In the 28%, the AA benefit was recognized by the MLC-NHS, but not by the MLC-INPS. By the multivariate analysis, the best predictors of the AA release, by the MLC-NHS, were represented by gender and the Barthel Index score. The presence of carcinoma, the Barthel Index score, and the SPMQ score were the best predictors for the AA release by MLC-INPS. MGA/CGA could be useful in saving financial resources reducing the risk of incorrect indemnity release. It can improve the accuracy of the impairment assessment in social security system.

Prognosis of Treatment Outcomes by Cognitive and Physical Scales.

PubMed

Jakavonytė-Akstinienė, Agnė; Dikčius, Vytautas; Macijauskienė, Jūratė

2018-01-01

The aim of this study was to assess the possibility of using scales for measuring cognitive and physical functions for a prognosis of care outcomes in elderly patients. The survey was carried out in one of the Vilnius City Hospitals for Nursing and Support Treatment. A total number of 177 respondents were involved in the study. The Mini-Mental State Examination (MMSE), The Barthel Index (BI) and The Morse Fall Scale were used. A statistically significant correlation was revealed between the scores of MMSE and BI (Pearson R = 0.41, p < 0.01); those with severe cognitive impairment were more dependent. A statistically significant correlation (Pearson R = -0.181, p < 0.01) was reported between the scores of MMSE and the Morse Fall Scale - the risk of falling was higher in patients with severe cognitive impairment. The Morse Fall Scale was not suitable for the prognosis of outcomes. The MMSE was suitable for the prognosis of a patient's discharge. The Barthel Index should be considered as the most suitable tool for the prognosis of care outcomes: the sum-score of the Barthel Index above 25 may suggest that the patient would be discharged home; the sum-score below this level was associated with a higher likelihood of patient death.

Physiological Ischemic Training Promotes Brain Collateral Formation and Improves Functions in Patients with Acute Cerebral Infarction.

PubMed

Zhen, Xiaoyue; Zheng, Yu; Hong, Xunning; Chen, Yan; Gu, Ping; Tang, Jinrong; Cheng, Hong; Yuan, Ti-Fei; Lu, Xiao

2016-01-01

To observe the effectiveness and mechanisms of physiological ischemic training (PIT) on brain cerebral collateral formation and functional recovery in patients with acute cerebral infarction. 20 eligible patients with acute cerebral infarction were randomly assigned to either PIT group ( n  = 10) or Control group ( n  = 10). Both groups received 4 weeks of routine rehabilitation therapy, while an additional session of PIT, which consisted of 10 times of maximal voluntary isometric handgrip for 1 min followed by 1 min rest, was prescribed for patients in the PIT groups. Each patient was trained with four sections a day and 5 days a week for 4 weeks. The Fugl-Meyer Assessment (FMA), the Modified Barthel Index (MBI), and the short-form 36-item health survey questionnaire (SF-36) were applied for the evaluation of motor impairment, activity of daily living, and quality of life at the baseline and endpoint. MRI was applied to detect the collateral formation in the brain. The concentration of vascular endothelial growth factor (VEGF) and endothelial progenitor cells (EPCs) number in plasma were also tested at the endpoint. Demographic data were consistent between experimental groups. At the endpoint, the scores of the FMA, MBI, and SF-36 were significantly higher than that at baseline. As compared to the Control group, the score of FMA and SF-36 in PIT group was significantly higher, while no significant difference was detected between groups in terms of MBI. Both groups had significantly higher cerebral blood flow (CBF) level at endpoint as compared to that at baseline. Moreover, the CBF level was even higher in the PIT group as compared to that in the Control group after 4 weeks of training. The same situations were also found in the plasma VEGF and EPCs assessment. In addition, positive correlations were found between FMA score and CBF level ( r  = 0.686, p  < 0.01), CBF level and VEGF concentration ( r  = 0.675, p  < 0.01), and

External validation of the PROFUND index in polypathological patients from internal medicine and acute geriatrics departments in Aragón.

PubMed

Díez-Manglano, Jesús; Cabrerizo García, José Luis; García-Arilla Calvo, Ernesto; Jimeno Saínz, Araceli; Calvo Beguería, Eva; Martínez-Álvarez, Rosa M; Bejarano Tello, Esperanza; Caudevilla Martínez, Aránzazu

2015-12-01

The objective of the study was to validate externally and prospectively the PROFUND index to predict survival of polypathological patients after a year. An observational, prospective and multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data concerning age, gender, comorbidity, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, socio-familial Gijon scale, delirium, number of drugs and number of admissions during the previous year were gathered for each patient. The PROFUND index was calculated. The follow-up lasted 1 year. A Cox proportional regression model was calculated, and was used to analyze the association of the variables to mortality and C-statistic. 465 polypathological patients, 333 from internal medicine and 132 from geriatrics, were included. One-year mortality is associated with age [hazard ratio (HR) 1.52 95 % CI 1.04-2.12; p = 0.01], presence of neoplasia [HR 2.68 95 % CI 1.71-4.18; p = 0.0001] and dependence for basic activities of daily living [HR 2.34 95 % CI 1.61-3.40; p = 0.0009]. In predicting mortality, the PROFUND index shows good discrimination in patients from internal medicine (C-statistics 0.725 95 % CI 0.670-0.781), but a poor one in those from geriatrics (0.546 95 % CI 0.448-0.644). The PROFUND index is a reliable tool for predicting mortality in internal medicine PP patients.

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

PubMed

Mikołajewska, Emilia

2013-01-01

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

Stroke: Hope through Research

MedlinePlus

... the Barthel Index. Imaging for the Diagnosis of Acute Stroke Health care professionals also use a variety ... risk population. top Ongoing Clinical Trials Albumin in Acute Ischemic Stroke (ALIAS) Trial Human serum albumin is ...

Biodex Fall Risk Assessment in the Elderly With Ataxia: A New Age-Dependent Derived Index in Rehabilitation: An Observational Study.

PubMed

Prometti, Paola; Olivares, Adriana; Gaia, Giuseppina; Bonometti, Giampietro; Comini, Laura; Scalvini, Simonetta

2016-03-01

The aim of this study was to evaluate if the Biodex Fall Risk Assessment could provide an age-adjusted index useful for classifying patients at "risk of fall."This was a cohort study conducted on 61 chronic patients, in stable conditions, having a history of ataxia, difficulty in walking or loss of balance, and aged >64 years. These patients were coming from home to our Institute undergoing a period of in-hospital standard rehabilitation. Assessment of clinical parameters was performed at entry. Functional scales (Functional Independence Measure [FIM] for motor and cognitive function, Barthel G, Tinetti POMA), and the Biodex Fall Risk Index (FRI) were performed at entry and discharge. The Normalized FRI, obtained adjusting FRI to the reported maximum predictive FRI for the relevant age, identified 2 types of patients: those with a greater risk of fall than expected for that age, labeled Case 1 (Normalized FRI>1); and those with an equal or even lesser risk of fall than expected for that age, labeled Case 0 (Normalized FRI≤1).FRI, Normalized FRI as well as independent variables as age, sex, pathology group, FIM, BarthelG, were considered in a multiple regression analysis to predict the functional improvement (i.e., delta Tinetti Total score) after rehabilitation.Normalized FRI is useful in assessing patients at risk of falls both before and after rehabilitation. At admission, the Normalized FRI evidenced high fall risk in 46% of patients (Case 1) which decreased to 12% after rehabilitation, being greater than age-predicted in 7 patients (Case 1-1) despite the functional improvement observed after the rehabilitation treatment. Normalized FRI evidenced Case 1-1 patients as neurological, "very old" (86% in age-group 75-84 years), and with serious events at 18 to 24 months' follow-up. Normalized FRI, but not FRI, at admission was a predictor of improvement in Tinetti Total scores.The normalized FRI effectively indicated patients at higher risk of fall, in whom health

Clinical Characteristics of Proper Robot-Assisted Gait Training Group in Non-ambulatory Subacute Stroke Patients

PubMed Central

Kim, Soo Jeong; Lee, Hye Jin; Hwang, Seung Won; Pyo, Hannah; Yang, Sung Phil; Lim, Mun-Hee; Park, Gyu Lee

2016-01-01

Objective To identify the clinical characteristics of proper robot-assisted gait training group using exoskeletal locomotor devices in non-ambulatory subacute stroke patients. Methods A total of 38 stroke patients were enrolled in a 4-week robotic training protocol (2 sessions/day, 5 times/week). All subjects were evaluated for their general characteristics, Functional Ambulatory Classification (FAC), Fugl-Meyer Scale (FMS), Berg Balance Scale (BBS), Modified Rankin Scale (MRS), Modified Barthel Index (MBI), and Mini-Mental Status Examination (MMSE) at 0, 2, and 4 weeks. Statistical analysis were performed to determine significant clinical characteristics for improvement of gait function after robot-assisted gait training. Results Paired t-test showed that all functional parameters except MMSE were improved significantly (p<0.05). The duration of disease and baseline BBS score were significantly (p<0.05) correlated with FAC score in multiple regression models. Receiver operating characteristic (ROC) curve showed that a baseline BBS score of '9' was a cutoff value (AUC, 0.966; sensitivity, 91%–100%; specificity, 85%). By repeated-measures ANOVA, the differences in improved walking ability according to time were significant between group of patients who had baseline BBS score of '9' and those who did not have baseline BBS score of '9' Conclusion Our results showed that a baseline BBS score above '9' and a short duration of disease were highly correlated with improved walking ability after robot-assisted gait training. Therefore, baseline BBS and duration of disease should be considered clinically for gaining walking ability in robot-assisted training group. PMID:27152266

A subacute model of geriatric care for frail older persons: the Tan Tock Seng Hospital experience.

PubMed

Chong, Mei Sian; Empensando, Esmiller F; Ding, Yew Yoong; Tan, Thai Lian

2012-08-01

The subacute care unit in Tan Tock Seng Hospital (TTSH) was set up in May 2009. We examined its impact on the transitions at the nexus between hospital and community sectors, patients' discharge destination and functional performance. We studied patients admitted during the initial 6-month period (May to October 2009). Differences in demographics, length of stay (LOS), comorbidity and severity of illness measures, functional outcomes (modified Barthel Index (MBI)) according to discharge destinations were obtained. We also studied the impact of LOS on the geriatric department and the bill size over the pre- and post-subacute implementation periods. Majority of the subacute patients' hospital stay was in subacute care. Of these patients, 44.9% were discharged home, 24.2% to a slow stream rehabilitation (SSR) setting and 29.2% to nursing homes. 16.9% consisted of a subgroup of dementia patients requiring further behavioural and functional interventions, of which 50% managed to be discharged home. Functional gains were seen during subacute stay; with greatest gains observed in the SSR group. There were no differences in overall LOS nor total bill size (DRG-adjusted) for the geriatric medicine department during the first 6 months of operating this new subacute model compared with the prior 4-month period. We propose this subacute model of geriatric care, which allows right-siting of care and improved functional outcomes. It fulfills the role easing transitions between acute hospital and community sectors. In particular, it provides specialised care to a subgroup of dementia patients with challenging behaviours and is fiscally sound from the wider hospital perspective.

Trade-offs between effectiveness and efficiency in stroke rehabilitation.

PubMed

Koh, Gerald Choon-Huat; Chen, Cynthia; Cheong, Angela; Choo, Tai Bee; Pui, Choi Kwok; Phoon, Fong Ngan; Ming, Chan Kin; Yeow, Tan Boon; Petrella, Robert; Thind, Amardeep; Koh, David; Seng, Chia Kee

2012-12-01

Most stroke research has studied rehabilitation effectiveness and rehabilitation efficiency separately and not investigated the potential trade-offs between these two indices of rehabilitation. To determine whether there is a trade-off between independent factors of rehabilitation effectiveness and rehabilitation efficiency. Using a retrospective cohort study design, we studied all stroke patients (n = 2810) from two sub-acute rehabilitation hospitals from 1996 to 2005, representing 87·5% of national bed-years during the same period. Independent predictors of poorer rehabilitation effectiveness and log rehabilitation efficiency were • older age • race-ethnicity • caregiver availability • ischemic stroke • longer time to admission • dementia • admission Barthel Index score, and • length of stay. Rehabilitation effectiveness was lower in females, and the gender differences were significantly lower in those aged ≤70 years (β -4·7 (95% confidence interval -7·4 to -2·0)). There were trade-offs between effectiveness and efficiency with respect to admission Barthel Index score and length of stay. An increase of 10 in admission Barthel Index score predicted an increase of 3·6% (95% confidence interval 3·2-4·0) in effectiveness but a decrease of 0·04 (95% confidence interval -0·05 to -0·02) in log efficiency (a reduction of efficiency by 1·0 per 30 days). An increase in log length of stay by 1 (length of stay of 2·7 days) predicted an increase of 8·0% (95% confidence interval 5·7-10·3) in effectiveness but a decrease of 0·82 (95% confidence interval -0·90 to -0·74) in log efficiency (equivalent to a reduction in efficiency by 2·3 per 30 days). For optimal rehabilitation effectiveness and rehabilitation efficiency, the admission Barthel Index score was 30-62 and length of stay was 37-41 days. There are trade-offs between effectiveness and efficiency during inpatient sub-acute stroke rehabilitation with respect to admission functional

Development and validation of an ICD-10-based disability predictive index for patients admitted to hospitals with trauma.

PubMed

Wada, Tomoki; Yasunaga, Hideo; Yamana, Hayato; Matsui, Hiroki; Fushimi, Kiyohide; Morimura, Naoto

2018-03-01

There was no established disability predictive measurement for patients with trauma that could be used in administrative claims databases. The aim of the present study was to develop and validate a diagnosis-based disability predictive index for severe physical disability at discharge using the International Classification of Diseases, 10th revision (ICD-10) coding. This retrospective observational study used the Diagnosis Procedure Combination database in Japan. Patients who were admitted to hospitals with trauma and discharged alive from 01 April 2010 to 31 March 2015 were included. Pediatric patients under 15 years old were excluded. Data for patients admitted to hospitals from 01 April 2010 to 31 March 2013 was used for development of a disability predictive index (derivation cohort), while data for patients admitted to hospitals from 01 April 2013 to 31 March 2015 was used for the internal validation (validation cohort). The outcome of interest was severe physical disability defined as the Barthel Index score of <60 at discharge. Trauma-related ICD-10 codes were categorized into 36 injury groups with reference to the categorization used in the Global Burden of Diseases study 2013. A multivariable logistic regression analysis was performed for the outcome using the injury groups and patient baseline characteristics including patient age, sex, and Charlson Comorbidity Index (CCI) score in the derivation cohort. A score corresponding to a regression coefficient was assigned to each injury group. The disability predictive index for each patient was defined as the sum of the scores. The predictive performance of the index was validated using the receiver operating characteristic curve analysis in the validation cohort. The derivation cohort included 1,475,158 patients, while the validation cohort included 939,659 patients. Of the 939,659 patients, 235,382 (25.0%) were discharged with severe physical disability. The c-statistics of the disability predictive index

Functional Independence, Diagnostic Groups, Hospital Stay, and Modality of Payment in Three Croatian Seaside Inpatient Rehabilitation Centers

PubMed Central

Mrčela, Nada Tomasović; Massari, Dražen; Vlak, Tonko

2010-01-01

Aim To determine patients’ functional independence, diagnostic groups, duration of hospital stay, and modality of payment of rehabilitation in major special hospitals for rheumatology and medical rehabilitation on the Croatian seaside. Methods In a cross-sectional study conducted from October 2006 until January 2009, we surveyed 400 patients treated at 3 special hospitals for medical rehabilitation. Their functional independence was assessed by modified Barthel index and they self-evaluated their health using the first item from the 36-Item Short-Form Health Survey questionnaire. Results On admission, almost half of the patients (46%) were fully functionally independent, 33% were slightly dependent, while 21% were moderately or severely dependent. At the end of the hospitalization, significant predictors for the increase in Barthel index were longer hospital stay (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06-1.22), diagnosis of post-procedural musculoskeletal disorders (OR, 4.84; 95% CI, 1.90-10.57), diagnosis of conditions following acute ischemic heart disease (OR, 9.71; 95% CI, 3.40-27.75), and lower Barthel index at admission (OR, 0.96; 95% CI, 0.94-0.97). Of the 97 patients with dorsopathy, 73 (75%) were fully functionally independent and 57 (59%) paid for the treatment either themselves or contributed substantially to the total cost. Conclusion Assessment of patients’ functional status is important for the organization of inpatient rehabilitation. Patients with dorsopathy could be targeted as a population for medical tourism in rehabilitation medicine in order to maximize the use of rehabilitation hospitals. PMID:21162166

Early intensive rehabilitation after oral cancer treatment.

PubMed

Bschorer, Maximilian; Schneider, Daniel; Hennig, Matthias; Frank, Bernd; Schön, Gerhard; Heiland, Max; Bschorer, Reinhard

2018-06-01

The treatment of oral cancer requires an effective rehabilitation strategy such as an early intensive rehabilitation (EIR) program. The medical records and data of 41 patients who participated in an EIR program and 20 control group patients were analyzed. These patients all underwent surgical resection of the primary tumor followed by microsurgical reconstruction using free flaps. The length of stay (LOS) at the acute care hospital was compared between the two groups. Four indexes were used to evaluate the effectiveness of the EIR program. EIR patients stayed an average of 11.6 fewer days at the acute care hospital. All indexes showed significant improvements (p < 0.001). The Barthel Index (BI) and the Early Intensive Rehabilitation Barthel Index (EIR-BI) improved by 36.0 and 103.6 points, respectively. At discharge, the Bogenhausener Dysphagia Score (BODS) had improved to a score of 11.0 compared to the 13.9 at admission. EIR patients had a Work Ability Index (WAI) score of 25.7. Length of stay at the acute care hospital can be reduced using early intensive rehabilitation if patients are transferred to an intensive rehabilitation clinic early. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Effect of CPAP therapy on job productivity and psychosocial occupational health in patients with moderate to severe sleep apnea.

PubMed

Jurádo-Gámez, Bernabé; Guglielmi, Ottavia; Gude-Sampedro, Francisco; Buela-Casal, Gualberto

2015-12-01

The aim of the present study was to assess the effect of continuous positive airflow pressure (CPAP) therapy on burnout symptoms and job productivity, stress, and satisfaction in patients with obstructive sleep apnea syndrome. The sample was composed of 55 patients (mean age 48.5 ± 8.9, BMI 31.1 ± 5.7, AIH 56.8 ± 22.1), diagnosed with obstructive sleep apnea syndrome (OSAS) using polysomnography (PSG) with a therapeutic indication of CPAP. Before and after 6 months of receiving CPAP therapy, participants completed the following questionnaires: the index of the impact of the disease on job productivity (IMPALA), the job content questionnaire(JCQ), the Maslach burnout inventory-general survey (MBI-GS), the Shirom-Melamed burnout questionnaire (SMBQ), the index of job satisfaction, the Epworth sleepiness scale (ESS), and the Pittsburgh sleep quality index (PSQI). We explored the efficacy of CPAP therapy at improving the indices of severity of OSAS using therapeutic PSG. CPAP therapy was associated with a beneficial effect on job productivity (IMPALA) (p = 0.000) and decreasing burnout symptoms such as physical fatigue (SMBQ) (p = 0.000), emotional exhaustion (SMBQ) (p = 0.014), cognitive weariness (SMBQ) (p = 0.004), exhaustion (MBI) (p = 0.000), and cynicism (MBI) (p = 0.002). However, CPAP did not decrease job stress or job dissatisfaction. In patients with severe OSAS, CPAP therapy has a beneficial effect on patients' occupational well-being and job productivity.

Urbanization influences on aquatic communities in northeastern Illinois streams

USGS Publications Warehouse

Fitzpatrick, F.A.; Harris, M.A.; Arnold, T.L.; Richards, K.D.

2004-01-01

Biotic indices and sediment trace element concentrations for 43 streams in northeastern Illinois (Chicago area) from the 1980s and 1990s were examined along an agricultural to urban land cover gradient to explore the relations among biotic integrity, sediment chemistry, and urbanization. The Illinois fish Alternative Index of Biotic Integrity (AIBI) ranged from poor to excellent in agricultural/rural streams, but streams with more than 10 percent watershed urban land (about 500 people/mi2) had fair or poor index scores. A macroinvertebrate index (MBI) showed similar trends. A qualitative habitat index (PIBI) did not correlate to either urban indicator. The AIBI and MBI correlated with urban associated sediment trace element concentrations. Elevated copper concentrations in sediment occurred in streams with greater than 40 percent watershed urban land. The number of intolerant fish species and modified index of biotic integrity scores increased in some rural, urbanizing, and urban streams from the 1980s to 1990s, with the largest increases occurring in rural streams with loamy/sandy surficial deposits. However, smaller increases also occurred in urban streams with clayey surficial deposits and over 50 percent watershed urban land. These data illustrate the potentially complex spatial and temporal relations among biotic integrity, sediment chemistry, watershed urban land, population density, and regional and local geologic setting.

Relationship of cognitive and perceptual abilities to functional independence in adults who have had a stroke.

PubMed

Brown, Ted; Mapleston, Jennifer; Nairn, Allison; Molloy, Andrew

2013-03-01

Most individuals who have had a stroke present with some degree of residual cognitive and/or perceptual impairment. Occupational therapists often utilize standardized cognitive and perceptual assessments with clients to establish a baseline of skill performance as well as to inform goal setting and intervention planning. Being able to predict the functional independence of individuals who have had a stroke based on cognitive and perceptual impairments would assist with appropriate discharge planning and follow-up resource allocation. The study objective was to investigate the ability of the Developmental Test of Visual Perception - Adolescents and Adults (DTVP-A) and the Neurobehavioural Cognitive Status Exam (Cognistat) to predict the functional performance as measured by the Barthel Index of individuals who have had a stroke. Data was collected using the DTVP-A, Cognistat and the Barthal Index from 32 adults recovering from stroke. Two standard multiple regression models were used to determine predictive variables of the functional independence dependent variable. Both the Cognistat and DTVP-A had a statistically significant ability to predict functional performance (as measured by the Barthel Index) accounting for 64.4% and 27.9% of each regression model, respectively. Two Cognistat subscales (Comprehension [beta = 0.48; p < 0.001)] and Repetition [beta = 0.45; p < 0.004]) and one DTVP-A subscale (Copying [beta = 0.46; p < 0.014]) made statistically significant contributions to the regression models as independent variables. On the basis of the regression model findings, it appears that DTVP-A's Copying and the Cognistat's Comprehension and Repetition subscales are useful in predicting the functional independence (as measured by the Barthel Index) in those individuals who have had a stroke. Given the fundamental importance that cognition and perception has for one's ability to function independently, further investigation is warranted to determine other

Differential characteristics in polypathological inpatients in internal medicine departments and acute geriatric units: the PLUPAR study.

PubMed

Díez-Manglano, Jesús; de Escalante Yangüela, Begoña; García-Arilla Calvo, Ernesto; Ubis Díez, Elena; Munilla López, Eulalia; Clerencia Sierra, Mercedes; Revillo Pinilla, Paz; Omiste Sanvicente, Teresa

2013-12-01

To determine whether there are any differences between polypathological patients attended in Internal Medicine departments and acute Geriatric units. A cross-sectional multicenter study was performed. Polypathological patients admitted to an internal medicine or geriatrics department and attended by investigators consecutively between March 1 and June 30, 2011 were included. Data of age, sex, living in a nursing residence or at home, diagnostic category, use of chronic medication, Charlson, Barthel and Lawton-Brody indexes, Pfeiffer questionnaire, delirium during last admission, need of a caregiver, and having a caregiver were gathered. The need of a caregiver was defined when the Barthel index was<60 or Pfeiffer questionnaire ≥ 3 errors. 471 polypathological patients, 337 from internal medicine and 144 from geriatrics units were included. Geriatrics inpatients were older and more frequently female. Cardiac (62.1% vs 49.6%; p=.01), digestive (8.3% vs 3.0%; p=.04) and oncohematological diseases (30.2% vs 18.8%; p=.01) were more frequent in patients of internal medicine units and neurological (66.2% vs 40.2%; p<.001) and locomotive ones (39.1% vs 20.4%; p<.001) in geriatrics inpatients. Charlson index was higher for internal medicine inpatients [4.0(2.1) vs 3.5(2.1); p=.04). Patients attended in geriatrics scored higher in Pfeiffer questionnaire [5.5(3.7) vs 3.8(3.3); p<.001], and lower in Barthel [38.8(32.5) vs 61.2(34.3); p=.001] and Lawton-Brody indexes [0.9(1.6) vs 3.0(2.9); p<.001], and more frequently needed a caregiver (87.8% vs 53.6%; p<.001) and had it. There are differences in disease profile and functional and cognitive situation between polypathological patients of internal medicine and geriatrics departments. © 2013.

Early Mobilization in Ischemic Stroke: A Pilot Randomized Trial of Safety and Feasibility in a Public Hospital in Brazil

PubMed Central

Poletto, Simone Rosa; Rebello, Letícia Costa; Valença, Maria Júlia Monteiro; Rossato, Daniele; Almeida, Andrea Garcia; Brondani, Rosane; Chaves, Márcia Lorena Fagundes; Nasi, Luiz Antônio; Martins, Sheila Cristina Ouriques

2015-01-01

Background The effect of early mobilization after acute stroke is still unclear, although some studies have suggested improvement in outcomes. We conducted a randomized, single-blind, controlled trial seeking to evaluate the feasibility, safety, and benefit of early mobilization for patients with acute ischemic stroke treated in a public teaching hospital in Southern Brazil. This report presents the feasibility and safety findings for the pilot phase of this trial. Methods The primary outcomes were time to first mobilization, total duration of mobilization, complications during early mobilization, falls within 3 months, mortality within 3 months, and medical complications of immobility. We included adult patients with CT- or MRI-confirmed ischemic stroke within 48 h of symptom onset who were admitted from March to November 2012 to the acute vascular unit or general emergency unit of a large urban emergency department (ED) at the Hospital de Clínicas de Porto Alegre. The severity of the neurological deficit on admission was assessed by the National Institutes of Health Stroke Scale (NIHSS). The NIHSS and modified Rankin Scale (mRS, functional outcome) scores were assessed on day 14 or at discharge as well as at 3 months. Activities of daily living (ADL) were measured with the modified Barthel Index (mBI) at 3 months. Results Thirty-seven patients (mean age 65 years, mean NIHSS score 11) were randomly allocated to an intervention group (IG) or a control group (CG). The IG received earlier (p = 0.001) and more frequent (p < 0.0001) mobilization than the CG. Of the 19 patients in the CG, only 5 (26%) underwent a physical therapy program during hospitalization. No complications (symptomatic hypotension or worsening of neurological symptoms) were observed in association with early mobilization. The rates of complications of immobility (pneumonia, pulmonary embolism, and deep vein thrombosis) and mortality were similar in the two groups. No statistically significant

Functional capacity and dependency in transfer and dressing are associated with depressive symptoms in older people.

PubMed

Boström, Gustaf; Conradsson, Mia; Rosendahl, Erik; Nordström, Peter; Gustafson, Yngve; Littbrand, Håkan

2014-01-01

This study examined associations between depressive symptoms and functional capacity, overall dependency in personal activities of daily living (ADLs), and dependency in individual ADL tasks, respectively, in people with a high mean age, large range of functional capacity, and wide spectrum of dependency in ADLs. Cross-sectional data from three studies were used. A total of 392 individuals living in community and residential care facilities were included. Mean age was 86.2 years, 72% were women, 75% were dependent in ADLs, 42% had depression, and 39% had dementia. Depressive symptoms were assessed with the 15-item Geriatric Depression Scale (GDS-15), functional capacity with the Berg Balance Scale (BBS), and ADLs with the Barthel ADL Index. Multiple linear regression analyses with comprehensive adjustments were performed between GDS-15 and BBS, GDS-15 and Barthel ADL Index, and GDS-15 and each individual ADL task, separately. GDS-15 score was associated with BBS score (unstandardized b =-0.03, P=0.008), but not with Barthel ADL Index score (unstandardized b =-0.07, P=0.068). No significant interaction effects of sex, dementia, or living conditions were found in these associations. Among individual ADL tasks, dependency in transfer (unstandardized b =-1.03, P=0.007) and dressing (unstandardized b =-0.70, P=0.035) were associated with depressive symptoms. Functional capacity seems to be independently associated with depressive symptoms in older people living in community and residential care facilities, whereas overall ADL performance may not be associated. Dependency in the individual ADL tasks of transfer and dressing appear to be independently associated with depressive symptoms and may be an important focus of future interdisciplinary multifactorial intervention studies.

Can long-term thiamine treatment improve the clinical outcomes of myotonic dystrophy type 1?

PubMed

Costantini, Antonio; Trevi, Erika; Pala, Maria Immacolata; Fancellu, Roberto

2016-09-01

Myotonic dystrophy type 1, also known as Steinert's disease, is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles, the eyes, and the endocrine system. Thiamine (vitamin B1) is a cofactor of fundamental enzymes involved in the energetic cell metabolism; recent studies described its role in oxidative stress, protein processing, peroxisomal function, and gene expression. Thiamine deficiency is critical mainly in the central and peripheral nervous system, as well as in the muscular cells. Our aim was to investigate the potential therapeutical effects of long-term treatment with thiamine in myotonic dystrophy type 1 in an observational open-label pilot study. We described two patients with myotonic dystrophy type 1 treated with intramuscular thiamine 100 mg twice a week for 12 or 11 months. We evaluated the patients using the grading of muscle strength according to Medical Research Council (MRC), the Muscular Impairment Rating Scale (MIRS), and the Modified Barthel index. High-dose thiamine treatment was well tolerated and effective in improving the motor symptomatology, particularly the muscle strength evaluated with the MRC scale, and the patients' activities of daily living using the Modified Barthel Index. At the end of treatment, the MRC score was 5 in the proximal muscles and 2-4 in the distal muscles (the MRC score before the treatment was 3-4 and 1-3, respectively). The MIRS grade improved by 25% compared to baseline for both patients. In patient #1, the Modified Barthel Index improved by 44%, and in patient #2 by 29%. These findings suggest that clinical outcomes are improved by long-term thiamine treatment.

[Non-invasive ventilation in 'do-not-intubate' patients in a chronic disease hospital. One year follow-up study].

PubMed

Tabernero Huguet, Eva; Gil Alaña, Pilar; Arana-Arri, Eunate; Citores Martín, Leyre; Alkiza Basañez, Ramon; Hernandez Gil, Anibal; Gil Molet, Alejandra

2016-01-01

Elderly patients with multiple morbidity and do not intubate (DNI) orders frequently present with acute respiratory failure. There are data supporting the effectiveness of non-invasive ventilation (NIV) in this context. Our chronic disease hospital developed an integrated care clinical pathway for the use of NIV in acute respiratory failure in the emergency room and wards in 2010. The aim of this study was to assess the outcome of NIV in patients with acute respiratory failure who had a DNI order in a sub-acute care hospital. Observational, one year-follow up study. The main variables were in-hospital mortality and one year mortality. Other variables recorded were: demographics, clinical data, functional data, performance of daily life activities, dementia, arterial blood gases and re-admissions. The study included a total of 102 patients, of which 22% were in institutions. The mean age 81±7.47% males, with a Charlson index 3.7±1, and Barthel index 54±31. The overall mortality during the admission was 33% (34 patients). Among those patients ventilated outside the protocol indication, the mortality was significantly greater, at 71% (P>.05). Overall one-year survival rate was 46%. This survival rate was statistically higher in patients with obesity hypoventilation syndrome and a Barthel >50. NIV is a useful technique in a hospital for chronic patients in an elderly population with a therapeutic ceiling. Despite their disease severity and comorbidity, acceptable survival rates are achieved. A correct case selection is needed. Obesity hypoventilation syndrome and those with Barthel index >50 have a better prognosis. Copyright © 2015 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Preparation and characterization of starch-based loose-fill packaging foams

NASA Astrophysics Data System (ADS)

Fang, Qi

Regular and waxy corn starches were blended in various ratios with biodegradable polymers including polylactic acid (PLA), Eastar Bio Copolyester 14766 (EBC) and Mater-Bi ZF03U (MBI) and extruded with a C. W. Brabender laboratory twin screw extruder using a 3-mm die nozzle at 150°C and 150 rev/min. Physical characteristics including radial expansion, unit density and bulk density and water solubility index, water absorption characteristics, mechanical properties including compressibility, Young's modulus, spring index, bulk compressibility and bulk spring index and abrasion resistance were investigated as affected by the ingredient formulations, i.e. type of polymers, type of starches, polymer to starch ratio and starch moisture content. A completely randomized factorial blocking experimental design was used. Fifty-four treatments resulted. Each treatment was replicated three times. SAS statistical software package was used to analyze the data. Foams made of waxy starch had better radial expansion, lower unit density and bulk density than did foams made of regular starch. Regular starch foams had significantly lower water solubility index than did the waxy starch foams. PLA-starch foams had the lowest compressibility and Young's modulus. MBI-starch foams were the most rigid. All foams had excellent spring indices and bulk spring indices which were comparable to the spring index of commercial expanded polystyrene foam. Correlations were established between the foam mechanical properties and the physical characteristics. Foam compressibility and Young's modulus decreased as increases in radial expansion and decreases in unit and bulk densities. Their relationships were modeled with power law equations. No correlation was observed between spring index and bulk spring index and foam physical characteristics. MBI-starch foams had the highest equilibrium moisture content. EBC-starch and PLA-starch foams had similar water absorption characteristics. No significant

Olfactory function and malnutrition in geriatric patients.

PubMed

Smoliner, Christine; Fischedick, Andrea; Sieber, Cornel C; Wirth, Rainer

2013-12-01

Impaired olfaction is considered to be a risk factor for malnutrition in older adults; however, there is little research on this association. The aim of this study was to investigate whether olfactory deficits are associated with an impaired nutritional status in older patients. Study participants were recruited from a geriatric day hospital. Nutritional status was assessed with body mass index and Mini-Nutritional Assessment. Olfactory function was evaluated with the Sniffin' Sticks test (SST) and subjectively rated by the patient. Self-caring capacity was rated with the Barthel Index and cognitive status with the Mini-Mental State Examination. One hundred ninety-one patients, 71.7% female, were included with a mean age of 79.6 ± 6.3 years. Prevalence of hyposmia was 39.3%, and 31.9% of patients were functionally anosmic. Malnourished patients did not have a significantly lower Sniffin' Sticks test score than patients at nutritional risk or malnourished patients. In linear regression analysis, nutritional status was only influenced by Barthel Index, age, and number of drugs but not by olfactory function. In this sample, olfactory function was not associated with nutritional status.

Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study

PubMed Central

2011-01-01

Introduction Long-term outcomes of elderly patients after medical ICU care are little known. The aim of the study was to evaluate functional status and quality of life of elderly patients 12 months after discharge from a medical ICU. Methods We prospectively studied 112/230 healthy elderly patients (≥65 years surviving at least 12 months after ICU discharge) with full functional autonomy without cognitive impairment prior to ICU entry. The main diagnoses at admission using the Acute Physiology and Chronic Health Evaluation III (APACHE III) classification diagnosis and length of ICU stay and ICU scores (APACHE II, Sepsis-related Organ Failure Assessment (SOFA) and OMEGA) at admission and discharge were collected. Comprehensive geriatric assessment included the presence of the main geriatric syndromes and the application of Lawton, Barthel, and Charlson Indexes and Informant Questionnaire on Cognitive Decline to evaluate functionality, comorbidity and cognitive status, respectively. The EuroQol-5D assessed quality of life. Data were collected at baseline, during ICU and ward stay and 3, 6 and 12 months after hospital discharge. Paired or unpaired T-tests compared differences between groups (continuous variables), whereas the chi-square and Fisher exact tests were used for comparing dichotomous variables. For variables significant (P ≤ 0.1) on univariate analysis, a forward multiple regression analysis was performed. Results Only 48.9% of patients (mean age: 73.4 ± 5.5 years) were alive 12 months after discharge showing a significant decrease in functional autonomy (Lawton and Barthel Indexes) and quality of life (EuroQol-5D) compared to baseline status (P < 0.001, all). Multivariate analysis showed a higher Barthel Index and EQ-5D vas at hospital discharge to be associated factors of full functional recovery (P < 0.01, both). Thus, in patients with a Barthel Index ≥ 60 or EQ-5D vas ≥40 at discharge the hazard ratio for full functional recovery was 4.04 (95

Test-retest reliability and responsiveness of the Barthel Index-based Supplementary Scales in patients with stroke.

PubMed

Lee, Ya-Chen; Yu, Wan-Hui; Hsueh, I-Ping; Chen, Sheng-Shiung; Hsieh, Ching-Lin

2017-10-01

A lack of evidence on the test-retest reliability and responsiveness limits the utility of the BI-based Supplementary Scales (BI-SS) in both clinical and research settings. To examine the test-retest reliability and responsiveness of the BI-based Supplementary Scales (BI-SS) in patients with stroke. A repeated-assessments design (1 week apart) was used to examine the test-retest reliability of the BI-SS. For the responsiveness study, the participants were assessed with the BI-SS and BI (treated as an external criterion) at admission to and discharge from rehabilitation wards. Seven outpatient rehabilitation units and one inpatient rehabilitation unit. Outpatients with chronic stroke. Eighty-four outpatients with chronic stroke participated in the test-retest reliability study. Fifty-seven inpatients completed baseline and follow-up assessments in the responsiveness study. For the test-retest reliability study, the values of the intra-class correlation coefficient and the overall percentage of minimal detectable change for the Ability Scale and Self-perceived Difficulty Scale were 0.97, 12.8%, and 0.78, 35.8%, respectively. For the responsiveness study, the standardized effect size and standardized response mean (representing internal responsiveness) of the Ability Scale and Self-perceived Difficulty Scale were 1.17 and 1.56, and 0.78 and 0.89, respectively. Regarding external responsiveness, the change in score of the Ability Scale had significant and moderate association with that of the BI (r=0.61, P<0.001). The change in score of the Self-perceived Difficulty Scale had non-significant and weak association with that of the BI (r=0.23, P=0.080). The Ability Scale of the BI-SS has satisfactory test-retest reliability and sufficient responsiveness for patients with stroke. However, the Self-perceived Difficulty Scale of the BI-SS has substantial random measurement error and insufficient external responsiveness, which may affect its utility in clinical settings. The findings of this study provide empirical evidence of psychometric properties of the BI-SS for assessing ability and self-perceived difficulty of ADL in patients with stroke.

Burnout syndrome--assessment of a stressful job among intensive care staff.

PubMed

Cubrilo-Turek, Mirjana; Urek, Roman; Turek, Stjepan

2006-03-01

The purpose of the study was to investigate the degree of burnout experienced by intensive care staff particularly, in Medical (MICU) and Surgical Intensive Care Units (SICU) General Hospital "Sveti Duh", Zagreb. A sample group of 41 emergency physicians and nurses from MICU and 30 from SICU was tested. The survey included demographic data and Maslach Burnout Inventory (MBI) scoring test identified by the three main components associated with burnout: emotional exhaustion (MBI-EE), depersonalization (MBI-DEP), and personal accomplishment (MBI-PA) were assessed using 22-item questionnaire. The degrees of burnout were stratified into low, moderate, and high range. Mean total MBI (X +/- SD) were high in both groups: higher for the MICU (65.5 +/- 6.7) than for SICU staff (55.7 +/- 3.8, p < 0.05). MICU staff showed moderate degree of MBI-EE (24.9 +/- 11.2), MBI-DEP (6.0 +/- 5.6), and as well as MBI-PA (34.4 +/- 8.8). The same parameters showed better results among SICU staff: low degree of MBI-EE (17.1 +/- 5.2), as well as low level of MBI-DEP (5.2 +/- 5.0), and moderate degree of MBI-PA (33.7 +/- 9.8). The differences between the groups was statistically significant only for the total MBI, and for MBI-EE (p < 0.05). There were no significant differences between MICU and SICU staff for MBI-DEP or MBI-PA parameters. Overall job burnout represented in a moderate degree. The presence of burnout is a serious phenomenon, because it can lead to psychosomatic complaints, work-associated withdrawal behaviour, and a lower quality of care at intensive care units. Early recognition of burnout phenomenon as a result of prolonged stress and frustration among intensive care staff, contributes to better professional behavior, organizational structure changes in the work environment and better health care quality for critically ill patients.

The Centers for Disease Control and Prevention definition of mucosal barrier injury-associated bloodstream infection improves accurate detection of preventable bacteremia rates at a pediatric cancer center in a low- to middle-income country.

PubMed

Torres, Dara; González, Miriam L; Loera, Adriana; Aguilera, Marco; Relyea, George; Aristizabal, Paula; Caniza, Miguela A

2016-04-01

The US National Healthcare Safety Network has provided a definition of mucosal barrier injury-associated, laboratory-confirmed bloodstream infection (MBI-LCBI) to improve infection surveillance. To date there is little information about its influence in pediatric oncology centers in low- to middle-income countries. To determine the influence of the definition on the rate of central line-associated bloodstream infection (CLABSI) and compare the clinical characteristics of MBI versus non-MBI LCBI cases. We retrospectively applied the National Healthcare Safety Network definition to all CLABSIs recorded at a pediatric oncology center in Tijuana, Mexico, from January 2011 through December 2014. CLABSI events were reclassified according to the MBI-LCBI definition. Clinical characteristics and outcomes of MBI and non-MBI CLABSIs were compared. Of 55 CLABSI events, 44% (24 out of 55) qualified as MBI-LCBIs; all were MBI-LCBI subcategory 1 (intestinal flora pathogens). After the number of MBI-LCBI cases was removed from the numerator, the CLABSI rate during the study period decreased from 5.72-3.22 infections per 1,000 central line days. Patients with MBI-LCBI were significantly younger than non-MBI-LCBI patients (P = .029) and had a significantly greater frequency of neutropenia (100% vs 39%; P = .001) and chemotherapy exposure (87% vs 58%; P = .020) and significantly longer median hospitalization (34 vs 23 days; P = .008). A substantial proportion of CLABSI events at our pediatric cancer center met the MBI-LCBI criteria. Our results support separate monitoring and reporting of MBI and non-MBI-LCBIs in low- to middle-income countries to allow accurate detection and tracking of preventable (non-MBI) bloodstream infections. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The CDC definition of mucosal barrier injury–associated bloodstream infection improves accurate detection of preventable bacteremia rates at a pediatric cancer center in a low- to middle-income country

PubMed Central

Torres, Dara; Gonzalez, Miriam; Loera, Adriana; Aguilera, Marco; Relyea, George; Aristizabal, Paula; Caniza, Miguela A.

2016-01-01

Background The U.S. National Healthcare Safety Network (NHSN) has provided a definition of mucosal barrier injury–associated, laboratory-confirmed bloodstream infection (MBI-LCBI) to improve infection surveillance. To date there is little information about its impact in pediatric oncology centers in low- to middle-income countries. Objectives To determine the impact of the definition on the rate of central line-associated bloodstream infection (CLABSI) and compare the clinical characteristics of MBI vs. non-MBI LCBI cases. Methods We retrospectively applied the NHSN definition to all CLABSIs recorded at a pediatric oncology center in Tijuana, Mexico, from January 2011 through December 2014. CLABSI events were re-classified according to the MBI-LCBI definition. Clinical characteristics and outcomes of MBI and non-MBI CLABSIs were compared. Results Of 55 CLABSI events, 44% (24/55) qualified as MBI-LCBIs; all were MBI-LCBI subcategory 1 (intestinal flora pathogens). After the number of MBI-LCBI cases was removed from the numerator, the CLABSI rate during the study period decreased from 5.72 to 3.22 infections per 1,000 central line days. Patients with MBI-LCBI were significantly younger than non-MBI-LCBI patients (P=0.029) and had a significantly greater frequency of neutropenia (100% vs. 39%, P=0.001) and chemotherapy exposure (87% vs. 58%, P=0.020) and significantly longer median hospitalization (34 vs. 23 days, P=0.008). Conclusion A substantial proportion of CLABSI events at our pediatric cancer center met the MBI-LCBI criteria. Our results support separate monitoring and reporting of MBI and non-MBI– -LCBIs in low- to middle-income countries to allow accurate detection and tracking of preventable (non-MBI) bloodstream infections. PMID:26775931

Functional capacity and dependency in transfer and dressing are associated with depressive symptoms in older people

PubMed Central

Boström, Gustaf; Conradsson, Mia; Rosendahl, Erik; Nordström, Peter; Gustafson, Yngve; Littbrand, Håkan

2014-01-01

Background This study examined associations between depressive symptoms and functional capacity, overall dependency in personal activities of daily living (ADLs), and dependency in individual ADL tasks, respectively, in people with a high mean age, large range of functional capacity, and wide spectrum of dependency in ADLs. Methods Cross-sectional data from three studies were used. A total of 392 individuals living in community and residential care facilities were included. Mean age was 86.2 years, 72% were women, 75% were dependent in ADLs, 42% had depression, and 39% had dementia. Depressive symptoms were assessed with the 15-item Geriatric Depression Scale (GDS-15), functional capacity with the Berg Balance Scale (BBS), and ADLs with the Barthel ADL Index. Multiple linear regression analyses with comprehensive adjustments were performed between GDS-15 and BBS, GDS-15 and Barthel ADL Index, and GDS-15 and each individual ADL task, separately. Results GDS-15 score was associated with BBS score (unstandardized b =−0.03, P=0.008), but not with Barthel ADL Index score (unstandardized b =−0.07, P=0.068). No significant interaction effects of sex, dementia, or living conditions were found in these associations. Among individual ADL tasks, dependency in transfer (unstandardized b =−1.03, P=0.007) and dressing (unstandardized b =−0.70, P=0.035) were associated with depressive symptoms. Conclusion Functional capacity seems to be independently associated with depressive symptoms in older people living in community and residential care facilities, whereas overall ADL performance may not be associated. Dependency in the individual ADL tasks of transfer and dressing appear to be independently associated with depressive symptoms and may be an important focus of future interdisciplinary multifactorial intervention studies. PMID:24523582

Functional Trajectories, Cognition, and Subclinical Cerebrovascular Disease.

PubMed

Dhamoon, Mandip S; Cheung, Ying-Kuen; Gutierrez, Jose; Moon, Yeseon P; Sacco, Ralph L; Elkind, Mitchell S V; Wright, Clinton B

2018-03-01

Cognition and education influence functional trajectories, but whether associations differ with subclinical brain infarcts (SBI) or white matter hyperintensity volume (WMHV) is unknown. We hypothesized that SBI and WMHV moderated relationships between cognitive performance and education and functional trajectories. A total of 1290 stroke-free individuals underwent brain magnetic resonance imaging and were followed for 7.3 years (mean) with annual functional assessments with the Barthel index (range, 0-100). Magnetic resonance imaging measurements included pathology-informed SBI (PI-SBI) and WMHV (% total cranial volume). Generalized estimating equation models tested associations between magnetic resonance imaging variables and baseline Barthel index and change in Barthel index, adjusting for demographic, vascular, cognitive, and social risk factors, and stroke and myocardial infarction during follow-up. We tested interactions among education level, baseline cognitive performance (Mini-Mental State score), and functional trajectories and ran models stratified by levels of magnetic resonance imaging variables. Mean age was 70.6 (SD, 9.0) years; 19% had PI-SBI, and mean WMHV was 0.68%. Education did not modify associations between cognition and functional trajectories. PI-SBI modified associations between cognition and functional trajectories ( P =0.04) with a significant protective effect of better cognition on functional decline seen only in those without PI-SBI. There was no significant interaction for WMHV ( P =0.8). PI-SBI, and greater WMHV, were associated with 2- to 3-fold steeper functional decline, holding cognition constant. PI-SBI moderated the association between cognition and functional trajectories, with 3-fold greater decline among those with PI-SBI (compared with no PI-SBI) and normal baseline cognition. This highlights the strong and independent association between subclinical markers and patient-centered trajectories over time. © 2018 American Heart

Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? a randomized controlled trial

PubMed Central

Xia, Wenguang; Zheng, Chanjuan; Zhu, Suiqiang; Tang, Zhouping

2015-01-01

Objective: To assess the effect of adding acupuncture to standard swallowing training for patients with dysphagia after stroke. Design: Single-blind randomized controlled trial. Setting: Inpatient and outpatient clinics. Subjects: A total of 124 patients with dysphagia after stroke were randomly divided into two groups: acupuncture and control. Interventions: The acupuncture group received standard swallowing training and acupuncture treatment. In comparison, the control group only received standard swallowing training. Participants in both groups received six days of therapy per week for a four-week period. Main measures: The primary outcome measures included the Standardized Swallowing Assessment and the Dysphagia Outcome Severity Scale. The secondary outcome measures included the Modified Barthel Index and Swallowing-Related Quality of Life, which were assessed before and after the four-week therapy period. Results: A total of 120 dysphagic subjects completed the study (60 in acupuncture group and 60 in control group). Significant differences existed in the Standardized Swallowing Assessment, Dysphagia Outcome Severity Scale, Modified Barthel Index, and Swallowing-Related Quality of Life scores of each group after the treatment (P < 0.01). After the four-week treatment, the Standardized Swallowing Assessment (mean difference − 2.9; 95% confidence interval (CI) – 5.0 to − 0.81; P < 0.01), Dysphagia Outcome Severity Scale (mean difference 2.3; 95% CI 0.7 to 1.2; P < 0.01), Modified Barthel Index (mean difference 17.2; 95% CI 2.6 to 9.3; P < 0.05) and Swallowing-Related Quality of Life scores (mean difference 31.4; 95% CI 3.2 to 11.4; P < 0.01) showed more significant improvement in the acupuncture group than the control group. Conclusions: Acupuncture combined with the standard swallowing training may be beneficial for dysphagic patients after stroke. PMID:25819076

Predictive validity of the Sødring Motor Evaluation of Stroke Patients (SMES).

PubMed

Wyller, T B; Sødring, K M; Sveen, U; Ljunggren, A E; Bautz-Holter, E

1996-12-01

The Sødring Motor Evaluation of Stroke Patients (SMES) has been developed as an instrument for the evaluation by physiotherapists of motor function and activities in stroke patients. The predictive validity of the instrument was studied in a consecutive sample of 93 acute stroke patients, assessed in the acute phase and after one year. The outcome measures were: survival, residence at home or in institution, the Barthel ADL index (dichotomized at 19/20), and the Frenchay Activities Index (FAI) (dichotomized at 9/10). The SMES, scored in the acute phase, demonstrated a marginally significant predictive power regarding survival, but was a highly significant predictor regarding the other outcomes. The adjusted odds ratio for a good versus a poor outcome for patients in the upper versus the lower tertile of the SMES arm subscore was 5.4 (95% confidence interval 0.9-59) for survival, 11.5 (2.1-88) for living at home, 86.3 (11-infinity) for a high Barthel score, and 31.4 (5.2-288) for a high FAI score. We conclude that SMES has high predictive validity.

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

ERIC Educational Resources Information Center

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

2011-01-01

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

Central Line-Associated Bloodstream Infections in Neonates with Gastrointestinal Conditions: developing a candidate definition for mucosal barrier injury bloodstream infections

PubMed Central

Coffin, Susan E.; Klieger, Sarah B.; Duggan, Christopher; Huskins, W. Charles; Milstone, Aaron M.; Potter-Bynoe, Gail; Raphael, Bram; Sandora, Thomas J.; Song, Xiaoyan; Zerr, Danielle M.; Lee, Grace M.

2015-01-01

Objectives To develop a candidate definition for central line-associated blood stream infection (CLABSI) in neonates with presumed mucosal barrier injury due to gastrointestinal (MBI-GI) conditions; to evaluate epidemiology and microbiology of MBI-GI CLABSI in infants. Design Multicenter retrospective cohort study Setting Neonatal intensive care units (NICU) from 14 U.S. children’s hospitals and pediatric facilities Methods A multidisciplinary focus group developed a candidate MBI-GI CLABSI definition based on presence of a MBI-GI condition, parenteral nutrition (PN) exposure, and an eligible enteric organism. CLABSI surveillance data from participating hospitals were supplemented by chart review to identify MBI-GI conditions and PN exposure. Results During 2009–12, 410 CLABSI occurred in 376 infants. MBI-GI conditions and PN exposure occurred in 149 (40%) and 324 (86%) of these 376 neonates, respectively. The distribution of pathogens was similar among neonates with versus without MBI-GI conditions and PN exposure. Fifty-nine (16%) of the 376 initial CLABSI episodes met the candidate MBI-GI CLABSI definition. Subsequent versus initial CLABSI were more likely to be caused by an enteric organism (22 of 34, 65% vs. 151 of 376, 40%; p = 0.009) and to meet the candidate MBI-GI CLABSI definition (19 of 34, 56% vs. 59 of 376, 16%; p < 0.01). Conclusions While MBI-GI conditions and PN exposure were common, only 16% of initial CLABSI met the candidate definition of MBI-GI CLABSI. The high proportion of MBI-GI CLABSI among subsequent infections suggests infants with MBI-GI CLABSI should be a population targeted for further surveillance and interventional research. PMID:25333434

Effectiveness of an educational intervention and physical exercise on the functional capacity of patients on haemodialysis.

PubMed

Molina-Robles, Esmeralda; Colomer-Codinachs, Marta; Roquet-Bohils, Marta; Chirveches-Pérez, Emilia; Ortiz-Jurado, Pep; Subirana-Casacuberta, Mireia

To describe the impact of a standard hospital educational intervention including active physical exercises on personal well-being, functional capacity and knowledge of the benefits of prescribed physical activity for patients undergoing haemodialysis. An uncontrolled, quasi-experimental, before-and-after study with repeated measures of response variables at 4, 8 and 12 weeks after participating in an educational and physical exercise hospital intervention. It was performed at the Nephrology Unit at the Hospital Complex in Vic within september and december 2014. The patients' well-being, functional capacity and knowledge were assessed. Assessment tools: NOC nursing indicators, Barthel index scale, FAC Holden, Timed Get Up and Go test and Daniels scale. We included 68 (80.0%) patients and 58 (85.3%) completed, with a mean age of 70.16±13.5 years; 62.1% were males. After 12 weeks, the patients had better scores of personal well-being (2.33±1.2, 3.88±0.8), more autonomy to perform activities of daily living (Barthel: 92.8±12.8; 93.5±13.9), more muscle strength (Daniels Scale: 3.81±0.7, 4.19±0.6) and walked more briskly (Get Up and Go test: 14.98±8.5; 15.65±10.5). All of the score differences were statistically significant (P<05) except the Barthel Index. The standard educational intervention and active exercise performed at hospital level improved the personal well-being, knowledge and functional capacity of patients on haemodialysis. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

The effects of very early mirror therapy on functional improvement of the upper extremity in acute stroke patients.

PubMed

Yeldan, Ipek; Huseyınsınoglu, Burcu Ersoz; Akıncı, Buket; Tarakcı, Ela; Baybas, Sevim; Ozdıncler, Arzu Razak

2015-11-01

[Purpose] The aim of the study was to evaluate the effects of a very early mirror therapy program on functional improvement of the upper extremity in acute stroke patients. [Subjects] Eight stroke patients who were treated in an acute neurology unit were included in the study. [Methods] The patients were assigned alternatively to either the mirror therapy group receiving mirror therapy and neurodevelopmental treatment or the neurodevelopmental treatment only group. The primary outcome measures were the upper extremity motor subscale of the Fugl-Meyer Assessment, Motricity Index upper extremity score, and the Stroke Upper Limb Capacity Scale. Somatosensory assessment with the Ayres Southern California Sensory Integration Test, and the Barthel Index were used as secondary outcome measures. [Results] No statistically significant improvements were found for any measures in either group after the treatment. In terms of minimally clinically important differences, there were improvements in Fugl-Meyer Assessment and Barthel Index in both mirror therapy and neurodevelopmental treatment groups. [Conclusion] The results of this pilot study revealed that very early mirror therapy has no additional effect on functional improvement of upper extremity function in acute stroke patients. Multicenter trials are needed to determine the results of early application of mirror therapy in stroke rehabilitation.

Genomic and Clinical Effects Associated with a Relaxation Response Mind-Body Intervention in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disease

PubMed Central

Jacquart, Jolene; Scult, Matthew A.; Slipp, Lauren; Riklin, Eric Isaac Kagan; Lepoutre, Veronique; Comosa, Nicole; Norton, Beth-Ann; Dassatti, Allison; Rosenblum, Jessica; Thurler, Andrea H.; Surjanhata, Brian C.; Hasheminejad, Nicole N.; Kagan, Leslee; Slawsby, Ellen; Rao, Sowmya R.; Macklin, Eric A.; Fricchione, Gregory L.; Benson, Herbert; Libermann, Towia A.; Korzenik, Joshua; Denninger, John W.

2015-01-01

Introduction Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) can profoundly affect quality of life and are influenced by stress and resiliency. The impact of mind-body interventions (MBIs) on IBS and IBD patients has not previously been examined. Methods Nineteen IBS and 29 IBD patients were enrolled in a 9-week relaxation response based mind-body group intervention (RR-MBI), focusing on elicitation of the RR and cognitive skill building. Symptom questionnaires and inflammatory markers were assessed pre- and post-intervention, and at short-term follow-up. Peripheral blood transcriptome analysis was performed to identify genomic correlates of the RR-MBI. Results Pain Catastrophizing Scale scores improved significantly post-intervention for IBD and at short-term follow-up for IBS and IBD. Trait Anxiety scores, IBS Quality of Life, IBS Symptom Severity Index, and IBD Questionnaire scores improved significantly post-intervention and at short-term follow-up for IBS and IBD, respectively. RR-MBI altered expression of more genes in IBD (1059 genes) than in IBS (119 genes). In IBD, reduced expression of RR-MBI response genes was most significantly linked to inflammatory response, cell growth, proliferation, and oxidative stress-related pathways. In IBS, cell cycle regulation and DNA damage related gene sets were significantly upregulated after RR-MBI. Interactive network analysis of RR-affected pathways identified TNF, AKT and NF-κB as top focus molecules in IBS, while in IBD kinases (e.g. MAPK, P38 MAPK), inflammation (e.g. VEGF-C, NF-κB) and cell cycle and proliferation (e.g. UBC, APP) related genes emerged as top focus molecules. Conclusions In this uncontrolled pilot study, participation in an RR-MBI was associated with improvements in disease-specific measures, trait anxiety, and pain catastrophizing in IBS and IBD patients. Moreover, observed gene expression changes suggest that NF-κB is a target focus molecule in both IBS and IBD—and that

Factors Affecting Role Stress and Burnout among School Counselors

ERIC Educational Resources Information Center

Willingham, Wendy Elizabeth

2009-01-01

The purpose of this study is to determine factors affecting role stress and burnout among practicing school counselors as measured by the Maslach Burnout Inventory-Educators Survey (MBI-ES) and the Role Conflict and Ambiguity Scale. The MBI-ES utilizes three subscales to measure burnout: emotional exhaustion, depersonalization, and personal…

The great contribution: Index Medicus, Index-Catalogue, and IndexCat

PubMed Central

Greenberg, Stephen J.; Gallagher, Patricia E.

2009-01-01

Objective: The systematic indexing of medical literature by the Library of the Surgeon-General's Office (now the National Library of Medicine) has been called “America's greatest contribution to medical knowledge.” In the 1870s, the library launched two indexes: the Index Medicus and the Index-Catalogue of the Library of the Surgeon-General's Office. Index Medicus is better remembered today as the forerunner of MEDLINE, but Index Medicus began as the junior partner of what the library saw as its major publication, the Index-Catalogue. However, the Index-Catalogue had been largely overlooked by many medical librarians until 2004, when the National Library of Medicine released IndexCat, the online version of Index-Catalogue. Access to this huge amount of material raised new questions: What was the coverage of the Index-Catalogue? How did it compare and overlap with the Index Medicus? Method: Over 1,000 randomly generated Index Medicus citations were cross-referenced in IndexCat. Results: Inclusion, form, content, authority control, and subject headings were evaluated, revealing that the relationship between the two publications was neither simple nor static through time. In addition, the authors found interesting anomalies that shed light on how medical literature was selected and indexed in “America's greatest contribution to medical knowledge.” PMID:19404501

[Leeches, phytotherapy and physiotherapy in osteo-arthrosis of the knee--a geriatric case study].

PubMed

Teut, Michael; Warning, Albrecht

2008-10-01

Chronic pain is a serious problem for geriatric patients. Conventional pharmacotherapy with nonsteroidal anti-inflammatory drugs or opiates is often accompanied by serious side effects. An 87-year-old woman with severe joint pain due to osteoarthritis of the knee presented with side effects from fentanyl therapy. She was subsequently treated in an inpatient setting with leeches, phytotherapy, physiotherapy and three single doses of metamizol. Prospective single-case study. Pain reduction was assessed with a numeric rating scale (0-10; 0 = minimum; 10 = maximum), mobility by walking distance, and activities of daily living by Barthel index. The association between complementary therapy and the changes observed in the patient under treatment were evaluated using cognition-based medicine. Under complementary therapy, the patient experienced a clear reduction in pain (from 8 to 3 points on the numeric rating scale); regained the ability to walk (increase in walking distance from 0 to 70 m); and showed improvements in activities of daily living (increase in Barthel index from 45 to 65). An association between pain reduction and the complementary treatment setting seems likely. The role of complementary pain therapy in geriatric patients should be evaluated systematically. 2008 S. Karger AG, Basel

Relationship of white matter lesions and severity of pushing behavior after stroke.

PubMed

Fujino, Yuji; Amimoto, Kazu; Sugimoto, Satoshi; Fukata, Kazuhiro; Inoue, Masahide; Uchino, Akira; Takahashi, Hidetoshi; Makita, Shigeru

2017-12-01

[Purpose] The relationship between white matter lesions (WMLs) and pushing behavior (PB) is still poorly understood. The purpose of this study was to investigate whether damage from WMLs affects the functional outcome of PB after acute stroke. [Subjects and Methods] In total, 37 patients were included. PB was assessed using the standardized Scale for Contraversive Pushing (SCP). Stroke types were classified as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), or lacunar syndrome using the Bamford classification. WML severity was categorized into four groups using the Fazekas visual scale. Thereafter, patients were divided into 4 groups according to the stroke type and/or presence of WMLs. The SCP, Trunk Control Test (TCT), Stroke Impairment Assessment Set (SIAS), and Barthel Index were the outcome measures. [Results] The SCP and TCT in patients with PACI without WMLs were better than those in patients with TACI with or without WMLs. Regarding SCP, TCT, and SIAS, patients with TACI had poorer values compared with PACI, regardless of WML severity. Barthel Index efficiency was not significantly different between the groups. [Conclusion] Our results suggest that moderate to severe WMLs and PACI had a relationship with PB severity and truncal balance.

The Effects of Social Support on Work Stress and Burnout

DTIC Science & Technology

1988-08-01

Classification of MBI Burnout Scores ...... .. 72 2. Characteristics of the Sample . ......... .. 78 3. Characteristics of the Sample... burnout will be operationally defined as the scores achieved on the Maslach Burnout Inventory ( MBI ) (Maslach & Jackson, 1986). The MBI consists of...environment, a measure of social support, and demographics. Burnout was measured via the Maslach Burnout Inventory ( MBI ), developed by Maslach and Jackson

Characterization of the binding of 2-mercaptobenzimidazole to bovine serum albumin.

PubMed

Teng, Yue; Zou, Luyi; Huang, Ming; Zong, Wansong

2015-04-01

2-Mercaptobenzimidazole (MBI) is widely utilized as a corrosion inhibitor, copper-plating brightener and rubber accelerator. The residue of MBI in the environment is potentially harmful to human health. In this article, the interaction of MBI with bovine serum albumin (BSA) was explored using spectroscopic and molecular docking methods under physiological conditions. The positively charged MBI can spontaneously bind with the negatively charged BSA through electrostatic forces with one binding site. The site marker competition experiments and the molecular docking study revealed that MBI bound into site II (subdomain IIIA) of BSA, which further led to some secondary structure and microenvironmental changes of BSA. This work provides useful information on understanding the toxicological actions of MBI at the molecular level. Copyright © 2015 John Wiley & Sons, Ltd.

Adapted low intensity ergometer aerobic training for early and severely impaired stroke survivors: a pilot randomized controlled trial to explore its feasibility and efficacy.

PubMed

Wang, Zun; Wang, Lei; Fan, Hongjuan; Jiang, Wenjun; Wang, Sheng; Gu, Zhaohua; Wang, Tong

2014-09-01

[Purpose] To evaluate the feasibility and efficacy of adapted low intensity ergometer aerobic training for early and severely impaired stroke survivors. [Subjects] The subjects were forty-eight early stroke survivors. [Methods] Eligible subjects were recruited and randomly assigned to an experimental group and a control group. Both groups participated in comprehensive rehabilitation training. Low intensity aerobic training was only performed by the experimental group. Outcome measures were the Fugl-Meyer motor score, Barthel index, exercise test time, peak heart rate, plasma glucose level and serum lipid profiles. [Results] Patients in the experimental group finished 88.6% of the total aerobic training sessions prescribed. In compliant participants (adherence≥80%), aerobic training significantly improved the Barthel index (from 40.1±21.1 to 79.2±14.2), Fugl-Meyer motor score (from 26.4±19.4 to 45.4±12.7), exercise test time (from 12.2±3.62 min to 13.9±3.6 min), 2-hour glucose level (from 9.22±1.16 mmol/L to 7.21±1.36 mmol/L) and homeostasis model of assessment for insulin resistence index (from 1.72±1.01 to 1.28±0.88). [Conclusion] Preliminary findings suggest that early and severely impaired stroke patients may benefit from low intensity ergometer aerobic training.

Experimental and density functional theory study of Raman and SERS spectra of 5-amino-2-mercaptobenzimidazole

NASA Astrophysics Data System (ADS)

Chen, Yufeng; Yang, Jin; Li, Zonglong; Li, Ran; Ruan, Weidong; Zhuang, Zhiping; Zhao, Bing

2016-01-01

Raman spectroscopy, surface-enhanced Raman spectroscopy (SERS) and density functional theory (DFT) simulations were employed to study 5-amino-2-mercaptobenzimidazole (5-A-2MBI) molecules. Ag colloids were used as SERS substrates which were prepared by using hydroxylamine hydrochloride as reducing agent. Raman vibration modes and SERS characteristic peaks of 5-A-2MBI were assigned with the aid of DFT calculations. The molecular electrostatic potential (MEP) of 5-A-2MBI was used to discuss the possible adsorption behavior of 5-A-2MBI on Ag colloids. The spectral analysis showed that 5-A-2MBI molecules were slightly titled via the sulfur atoms adhering to the surfaces of Ag substrates. The obtained SERS spectral intensity decreased when lowering the 5-A-2MBI concentrations. A final detection limit on the concentration of 5 × 10- 7 mol · L- 1 was gained. SERS proved to be a simple, fast and reliable method for the detection and characterization of 5-A-2MBI molecules.

Molecular interaction of 2-mercaptobenzimidazole with catalase reveals a potentially toxic mechanism of the inhibitor.

PubMed

Teng, Yue; Zou, Luyi; Huang, Ming; Zong, Wansong

2014-12-01

2-Mercaptobenzimidazole (MBI) is widely utilized as a corrosion inhibitor, copper-plating brightener and rubber accelerator. The residue of MBI in the environment possesses a potential risk to human health. In this work, the toxic interaction of MBI with the important antioxidant enzyme catalase (CAT) was investigated using spectroscopic and molecular docking methods under physiological conditions. MBI can spontaneously bind with CAT with one binding site through hydrogen bonds and van der Waals forces to form MBI-CAT complex. The molecular docking study revealed that MBI bound into the CAT interface of chains B and C, which led to some conformational and microenvironmental changes of CAT and further resulted in the inhibition of CAT activity. This present study provides direct evidence at a molecular level to show that exposure to MBI could induce changes in the structure and function of the enzyme CAT. Copyright © 2014 Elsevier B.V. All rights reserved.

Satisfaction with rehabilitation in relation to self-perceived quality of life and function among patients with stroke - a 12 month follow-up.

PubMed

Hansson, Eva Ekvall; Beckman, Anders; Wihlborg, Anna; Persson, Sylvia; Troein, Margareta

2013-06-01

Stroke causes complex disability and function, and perceived quality of life has been shown to correlate with satisfaction with care as well as with life in general among stroke patients. The aim of this study was to study the relation of satisfaction with how rehabilitation was provided with self-perceived quality of life, self-perceived function and rehabilitation received, 12 months after the incidence. The subjects were assessed 12 months after the onset of stroke. The Barthel index was used to measure function, and the EuroQol-5D to measure quality of life. To measure satisfaction with how rehabilitation was provided, a questionnaire from the Swedish Stroke Register was used. Two hundred and eighty-three patients participated in the follow-up, 137 women and 146 men, aged between 42 and 95 years (mean age 75.2, SD 11.8). For the majority of patients rehabilitation was initiated at in-hospital care (directly after onset). One hundred and sixty-eight patients considered that rehabilitation was well provided for. Sixty-six regarded that the rehabilitation was only partly provided for and 35 that it was not provided for at all. High value on Barthel Index was associated with satisfaction with how rehabilitation was provided for (OR 2.81). Also, rehabilitation on three or more levels was negatively associated with satisfaction with rehabilitation provision (OR 0.24) and so was being male (OR 0.49). In this study, patients with higher values on Barthel Index were more satisfied with how rehabilitation was provided for. However, male patients and patients who received rehabilitation on three or more levels of care were less satisfied. Given the assumption that patients with more severe dysfunction after stroke are being rehabilitated on more levels, this might imply that it is not the amount of rehabilitation that gives satisfaction but the patients self-perceived function after rehabilitation. © 2012 Nordic College of Caring Science.

Assessment of burnout in veterinary medical students using the Maslach Burnout Inventory-Educational Survey: a survey during two semesters.

PubMed

Chigerwe, Munashe; Boudreaux, Karen A; Ilkiw, Jan E

2014-11-28

Burnout among veterinary students can result from known stressors in the absence of a support system. The objectives of this study were to evaluate use of the Maslach Burnout Inventory-Educator Survey (MBI-ES) to assess burnout in veterinary students and evaluate the factors that predict the MBI-ES scores. The MBI-ES was administered to first (Class of 2016) and second year (Class of 2015) veterinary medical students during the 2012-2013 academic year in the fall and spring semesters. Factor analysis and test reliability for the survey were determined. Mean scores for the subscales determining burnout namely emotional exhaustion (EE), depersonalization (DP) and lack of personal accomplishment (PA) were calculated for both classes in the 2 semesters. Multiple regression analysis was performed to evaluate other factors that predict the MBI-ES scores. A non-probability sampling method was implemented consisting of a voluntary sample of 170 and 123 students in the fall and spring semesters, respectively. Scores for EE, DP and PA were not different between the 2 classes within the same semester. Mean ± SD scores for EE, DP and PA for the fall semester were 22.9 ± 9.6, 5.0 ± 4.8 and 32.3 ± 6.7, respectively. Mean ± SD scores for EE, DP and PA the spring semester were 27.8 ± 10.7, 6.5 ± 6.1and 31.7 ± 6.8, respectively. The EE score was higher in spring compared to fall while DP and PA scores were not different between the 2 semesters. Living arrangements specifically as to whether or not a student lived with another veterinary medical students was the only variable significantly associated with the MBI-ES scores. Students in this study had moderate levels of burnout based on the MBI-ES scores. The MBI-ES was an acceptable instrument for assessing burnout in veterinary medical students. The EE scores were higher in the spring semester as compared to the fall semester. Thus students in the first and second years of veterinary school under the current curriculum

Impact of Protected Sleep Period for Internal Medicine Interns on Overnight Call on Depression, Burnout, and Empathy

PubMed Central

Shea, Judy A.; Bellini, Lisa M.; Dinges, David F.; Curtis, Meredith L.; Tao, Yuanyuan; Zhu, Jingsan; Small, Dylan S.; Basner, Mathias; Norton, Laurie; Novak, Cristina; Dine, C. Jessica; Rosen, Ilene M.; Volpp, Kevin G.

2014-01-01

Background Patient safety and sleep experts advocate a protected sleep period for residents. Objective We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments. Methods We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009–2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal Reactivity Index (IRI). Results A total of 106 interns participated. There were no significant differences between groups in end-of-rotation BDI-II, MBI-HSS, or IRI scores at either location (P > .05). Amount of sleep while on call significantly predicted lower MBI-Emotional Exhaustion (P < .003), MBI-Depersonalization (P < .003), and IRI-Personal Distress (P < .006) at PVAMC, and higher IRI-Perspective Taking (P < .008) at HUP. Conclusions A protected sleep period produced few consistent improvements in depression, burnout, or empathy, although depression was already low at baseline. Possibly the amount of protected time was too small to affect these emotional states or sleep may not be directly related to these scores. PMID:24949128

A brief motivational interviewing as an adjunct to periodontal therapy-A potential tool to reduce relapse in oral hygiene behaviours. A three-year study.

PubMed

Stenman, J; Wennström, J L; Abrahamsson, K H

2018-05-01

To evaluate (ii) whether inclusion of a single motivational interviewing (MI) session, as an adjunct to periodontal therapy, might be beneficial for preventing relapse in oral hygiene behaviours among patients treated for chronic periodontitis and (ii) whether individual and clinical characteristics can be of predictive value for retention of sufficient oral hygiene behaviours. This 3-year follow-up of a previously reported randomized controlled trial (RCT) study of 6-month duration included 26 patients. Patients in the test group had received one MI session by a clinical psychologist before initiation of the periodontal treatment. Otherwise, all patients followed the same treatment protocol for conventional educational intervention and non-surgical periodontal therapy. Efficacy variables assessed for evaluation of the standard of self-performed periodontal infection control were marginal bleeding index (MBI; primary efficacy variable) and plaque score (PI). The patterns of change in MBI and PI scores were similar for test and control groups over the observation period. At 3 years, both groups showed a desirable mean full-mouth MBI of 15%, a figure that was comparable to that at the short-term evaluation after active periodontal treatment. The post-treatment MBI was the only variable identified as a predictor of retained adequate oral hygiene behaviours. A single MI session as an adjunct to conventional periodontal therapy could not be proven to be of long-term beneficial additive effect with regard to prevention of relapse in oral hygiene behaviour. Desirable standard of self-performed infection control after active periodontal treatment predicted the retention of sufficient oral hygiene behaviour over time. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Interactive dynamic scalp acupuncture combined with occupational therapy for upper limb motor impairment in stroke: a randomized controlled trial].

PubMed

Wang, Jun; Pei, Jian; Cui, Xiao; Sun, Kexing; Ni, Huanhuan; Zhou, Cuixia; Wu, Ji; Huang, Mei; Ji, Li

2015-10-01

To compare the clinical efficacy on upper limb motor impairment in stroke between the interactive dynamic scalp acupuncture therapy and the traditional scalp acupuncture therapy. The randomized controlled trial and MINIMIZE layering randomization software were adopted. Seventy patients of upper limb with III to V grade in Brunnstrom scale after stroke were randomized into an interactive dynamic scalp acupuncture group and a traditional scalp acupuncture group, 35 cases in each one. In the interactive dynamic scalp acupuncture group, the middle 2/5 of Dingnieqianxiexian (anterior oblique line of vertex-temporal), the middle 2/5 of Dingniehouxiexian (posterior oblique line of vertex-temporal) and Dingpangerxian (lateral line 2 of vertex) on the affected side were selected as the stimulation areas. Additionally, the rehabilitation training was applied during scalp acupuncture treatment. In the traditional scalp acupuncture group, the scalp stimulation areas were same as the interactive dynamic scalp acupuncture group. But the rehabilitation training was applied separately. The rehabilitation training was applied in the morning and the scalp acupuncture was done in the afternoon. The results in Fugl-Meyer for the upper limb motor function (U-FMA), the Wolf motor function measure scale (WM- FT) and the modified Barthel index in the two groups were compared between the two groups before treatment and in 1 and 2 months of treatment, respectively. After treatment, the U-FMA score, WMFT score and the score of the modified Barthel index were all apparently improved as compared with those before treatment (all P < 0.01). The improvement in the U-FMA score after treatment in the interactive dynamic scalp acupuncture group was better than that in the traditional scalp acupuncture group (P < 0.05). For the patients of IV to V grade in Brunnstrom scale, WMFT score in 2 months of treatment and the score of Barthel index after treatment in the interactive dynamic scalp acupuncture

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

Ratner, D.; Behrens, C.; Ding, Y.

The microbunching instability (MBI) is a well known problem for high brightness electron beams and has been observed at accelerator facilities around the world. Free-electron lasers (FELs) are particularly susceptible to MBI, which can distort the longitudinal phase space and increase the beam’s slice energy spread (SES). Past studies of MBI at the Linac Coherent Light Source (LCLS) relied on optical transition radiation to infer the existence of microbunching. With the development of the x-band transverse deflecting cavity (XTCAV), we can for the first time directly image the longitudinal phase space at the end of the accelerator and complete amore » comprehensive study of MBI, revealing both detailed MBI behavior as well as insights into mitigation schemes. The fine time resolution of the XTCAV also provides the first LCLS measurements of the final SES, a critical parameter for many advanced FEL schemes. As a result, detailed MBI and SES measurements can aid in understanding MBI mechanisms, benchmarking simulation codes, and designing future high- brightness accelerators.« less

Time-resolved imaging of the microbunching instability and energy spread at the Linac Coherent Light Source

DOE PAGES

Ratner, D.; Behrens, C.; Ding, Y.; ...

2015-03-09

The microbunching instability (MBI) is a well known problem for high brightness electron beams and has been observed at accelerator facilities around the world. Free-electron lasers (FELs) are particularly susceptible to MBI, which can distort the longitudinal phase space and increase the beam’s slice energy spread (SES). Past studies of MBI at the Linac Coherent Light Source (LCLS) relied on optical transition radiation to infer the existence of microbunching. With the development of the x-band transverse deflecting cavity (XTCAV), we can for the first time directly image the longitudinal phase space at the end of the accelerator and complete amore » comprehensive study of MBI, revealing both detailed MBI behavior as well as insights into mitigation schemes. The fine time resolution of the XTCAV also provides the first LCLS measurements of the final SES, a critical parameter for many advanced FEL schemes. As a result, detailed MBI and SES measurements can aid in understanding MBI mechanisms, benchmarking simulation codes, and designing future high- brightness accelerators.« less

Randomized clinical trial of nutritional counseling for malnourished hospital patients.

PubMed

Casals, C; García-Agua-Soler, N; Vázquez-Sánchez, M Á; Requena-Toro, M V; Padilla-Romero, L; Casals-Sánchez, J L

2015-01-01

Malnutrition is associated with an increased risk of mortality and morbidity, longer hospital stays and general loss of quality of life. The aim of this study is to assess the impact of dietary counseling for malnourished hospital patients. Prospective, randomized, open-label study of 106 hospital patients with malnutrition (54 in the control group and 52 in the intervention group). The intervention group received dietary counseling, and the control group underwent standard treatment. We determined the patients' nutritional state (body mass index, laboratory parameters, malnutrition universal screening tool), degree of dependence (Barthel index), quality of life (SF-12), degree of satisfaction (CSQ-8), the number and length of readmissions and mortality. The patients who underwent the "intervention" increased their weight at 6 months, while the controls lost weight (difference in body mass index, 2.14kg/m(2); p<.001). The intervention group had better results when compared with the control group in the Malnutrition Universal Screening Tool scores (difference, -1.29; p<.001), Barthel index (difference, 7.49; p=.025), SF-12 (difference, 13.72; p<.001) and CSQ-8 (difference, 4.34, p<.001) and required fewer readmissions (difference, -0.37; p=.04) and shorter stays for readmissions (difference, -6.75; p=.035). Mortality and laboratory parameters were similar for the 2 groups. Nutritional counseling improved the patients' nutritional state, quality of life and degree of dependence and decreased the number of hospital readmissions. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Remote sensing with simulated unmanned aircraft imagery for precision agriculture applications

USGS Publications Warehouse

Hunt, E. Raymond; Daughtry, Craig S.T.; Mirsky, Steven B.; Hively, W. Dean

2014-01-01

An important application of unmanned aircraft systems (UAS) may be remote-sensing for precision agriculture, because of its ability to acquire images with very small pixel sizes from low altitude flights. The objective of this study was to compare information obtained from two different pixel sizes, one about a meter (the size of a small vegetation plot) and one about a millimeter. Cereal rye (Secale cereale) was planted at the Beltsville Agricultural Research Center for a winter cover crop with fall and spring fertilizer applications, which produced differences in biomass and leaf chlorophyll content. UAS imagery was simulated by placing a Fuji IS-Pro UVIR digital camera at 3-m height looking nadir. An external UV-IR cut filter was used to acquire true-color images; an external red cut filter was used to obtain color-infrared-like images with bands at near-infrared, green, and blue wavelengths. Plot-scale Green Normalized Difference Vegetation Index was correlated with dry aboveground biomass ( ${mbi {r}} = 0.58$ ), whereas the Triangular Greenness Index (TGI) was not correlated with chlorophyll content. We used the SamplePoint program to select 100 pixels systematically; we visually identified the cover type and acquired the digital numbers. The number of rye pixels in each image was better correlated with biomass ( ${mbi {r}} = 0.73$ ), and the average TGI from only leaf pixels was negatively correlated with chlorophyll content ( ${mbi {r}} = -0.72$ ). Thus, better information for crop requirements may be obtained using very small pixel sizes, but new algorithms based on computer vision are needed for analysis. It may not be necessary to geospatially register large numbers of photographs with very small pixel sizes. Instead, images could be analyzed as single plots along field transects.

Impact of removing mucosal barrier injury laboratory-confirmed bloodstream infections from central line-associated bloodstream infection rates in the National Healthcare Safety Network, 2014.

PubMed

See, Isaac; Soe, Minn M; Epstein, Lauren; Edwards, Jonathan R; Magill, Shelley S; Thompson, Nicola D

2017-03-01

Central line-associated bloodstream infection (CLABSI) event data reported to the National Healthcare Safety Network from 2014, the first year of required use of the mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI) definition, were analyzed to assess the impact of removing MBI-LCBI events from CLABSI rates. CLABSI rates decreased significantly in some location types after removing MBI-LCBI events, and MBI-LCBI events will be removed from publicly reported CLABSI rates. Published by Elsevier Inc.

Faculty Wellness: Educator Burnout among Otolaryngology Graduate Medical Educators.

PubMed

Kavanagh, Katherine R; Spiro, Jeffrey

2018-06-01

Objectives Burnout is a well-described psychological construct with 3 aspects: exhaustion, depersonalization, and lack of personal accomplishment. The objective of this study was to assess whether faculty members of an otolaryngology residency program exhibit measurable signs and symptoms of burnout with respect to their roles as medical educators. Study Design Cross-sectional survey. Setting Otolaryngology-head and neck surgery residency program. Subjects and Methods Faculty members from an otolaryngology residency program, all of whom are involved in resident education, completed the Maslach Burnout Inventory-Educators Survey (MBI-ES). The surveys were completed anonymously and scored with the MBI-ES scoring key. Results Twenty-three faculty members completed the MBI-ES, and 16 (69.6%) showed symptoms of burnout, as evidenced by unfavorable scores on at least 1 of the 3 indices (emotional exhaustion, depersonalization, or low personal accomplishment). The faculty consistently reported moderate to high personal accomplishment and low depersonalization. There were variable responses in the emotional exhaustion subset, which is typically the first manifestation of the development of burnout. Conclusion To our knowledge, this is the first application of the MBI-ES to investigate burnout among otolaryngology faculty members as related to their role as medical educators. Discovering symptoms of burnout at an early stage affords a unique and valuable opportunity to intervene. Future investigation is underway into potential causes and solutions.

Aquatic Therapy Improves Outcomes for Subacute Stroke Patients by Enhancing Muscular Strength of Paretic Lower Limbs Without Increasing Spasticity: A Randomized Controlled Trial.

PubMed

Zhang, Yue; Wang, Yi-Zhao; Huang, Li-Ping; Bai, Bei; Zhou, Shi; Yin, Miao-Miao; Zhao, Hua; Zhou, Xiao-Na; Wang, Hong-Tu

2016-11-01

The aim of this study was to evaluate the effects of an aquatic exercise program designed to enhance muscular strength in paretic lower limbs in subacute stroke patients. Thirty-six subacute stroke patients were randomly divided to a conventional or an aquatic group (n = 18 each). Outcome measures were assessed at baseline and after 8 wks of training. For the paretic lower limbs, maximum isometric voluntary contraction strength of the rectus femoris and biceps femoris caput longus and the tibialis anterior and lateral gastrocnemius was measured. Cocontraction ratios during knee extension and flexion and ankle dorsiflexion and plantarflexion were calculated respectively. In addition, Modified Ashworth Scale, Functional Ambulation Category, and Barthel Index were assessed. Compared with the conventional intervention, the aquatic intervention resulted in significantly higher knee extension (P = 0.002) and ankle plantarflexion torque (P = 0.002), accompanied with a significantly lower knee extension cocontraction ratio in the paretic limb (P = 0.000). Functional Ambulation Category (P = 0.009) and Barthel Index (P = 0.024) were greater in aquatic group than conventional group posttreatment. Modified Ashworth Scale scores did not show any differences between groups. Aquatic exercise enhanced muscle strength in paretic lower limbs and improved muscle cocontraction without increasing spasticity in subacute stroke patients.

Predicting needs for nursing home admission - does sense of coherence delay nursing home admission in care dependent older people? A longitudinal study.

PubMed

Thygesen, Elin; Saevareid, Hans Inge; Lindstrom, Torill Christine; Nygaard, Harald A; Engedal, Knut

2009-03-01

Objectives.  This study examined predisposing, enabling and need variables (Andersen's Behavioral Model) influencing the need for nursing home admission (NHA) in older people receiving home nursing care. In particular, the potential role of coping ability, measured as 'sense of coherence' (SOC), was studied. Design, sample, and measurements.  A survey with baseline- and follow-up data after a 2-year period was undertaken with 208 patients aged 75+. The measures used were: gender, education, age, social visits, SOC, social provision scale (SPS), self-rated health (SRH), general health questionnaire (GHQ), clinical dementia rating (CDR), Barthel activities of daily living (ADL) index, and registered illnesses (RI). A Cox proportional model was used to examine factors that could explain risk of NHA. Results.  Measures with predictive properties were Barthel ADL index, SPS, SRH, and gender. SOC, along with subjective health complaints, general health questionnaire, RI and social visits did not predict NHA. Conclusions.  It is concluded that the patients' subjective evaluations of both their health and perceived social support were important predictors of future NHA needs, and should be seriously taken into consideration, along with the more commonly used objective measures of ADL and CDR. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

Transcranial magnetic stimulation primes the effects of exercise therapy in multiple sclerosis.

PubMed

Mori, Francesco; Ljoka, Concetta; Magni, Elisabetta; Codecà, Claudia; Kusayanagi, Hajime; Monteleone, Fabrizia; Sancesario, Andrea; Bernardi, Giorgio; Koch, Giacomo; Foti, Calogero; Centonze, Diego

2011-07-01

Exercise therapy (ET) can be beneficial in disabled multiple sclerosis (MS) patients. Intermittent transcranial magnetic theta burst stimulation (iTBS) induces long-term excitability changes of the cerebral cortex and may ameliorate spasticity in MS. We investigated whether the combination of iTBS and a program of ET can improve motor disability in MS patients. In a double-blind, sham-controlled trial, 30 participants were randomized to three different interventions: iTBS plus ET, sham stimulation plus ET, and iTBS alone. Before and after 2 weeks of treatment, measures of spasticity through the modified Ashworth scale (MAS) and the 88 items Multiple Sclerosis Spasticity Score questionnaire (MSSS-88), fatigue through the Fatigue Severity Scale (FSS), daily living activities (ADL) through the Barthel index and health-related quality of life (HRQoL) through the 54 items Multiple Sclerosis Quality of life inventory (MSQoL-54) were collected. iTBS plus ET reduced MAS, MSSS-88, FSS scores, while in the Barthel index and MSQoL-54, physical composite scores were increased. iTBS alone caused a reduction of the MAS score, while none of the measured scales showed significant changes after sham iTBS plus ET. iTBS associated with ET is a promising tool for motor rehabilitation of MS patients.

Effects of daily living occupational therapy and resistance exercise on the activities of daily living and muscular fitness in Guillain-Barré syndrome: a case study.

PubMed

Ko, Kwang-Jun; Ha, Gi-Chul; Kang, Seol-Jung

2017-05-01

[Purpose] The study aimed to investigate the effects of daily living occupational therapy and resistance exercise on the performance of activities of daily living and muscular fitness in a patient with Guillain-Barré syndrome. [Subject and Methods] A 35-year-old man was diagnosed with Guillain-Barré syndrome. He was hospitalized at A Hospital for 3 years, and was discharged from the hospital after he became able to execute daily life activities. After discharge, he performed daily occupational therapy and resistance exercise twice a week for 70 minutes per session for 12 weeks. Performance in the activities of daily living was assessed using the modified Barthel index, and muscular fitness was measured in terms of isokinetic muscular function using the Biodes system. [Results] The subject's Barthel index score improved from 54 points before the intervention to 62 points after 4 weeks, 69 points after 8 weeks, and 79 points after 12 weeks. In addition, his shoulder flexion and extension, knee flexion and extension, and lumbar flexion and extension were improved. [Conclusion] The present study suggests that daily living occupational therapy and resistance exercise are effective in improving the activities of daily living and muscular fitness in a patient recovering from Guillain-Barré syndrome.

[Evaluation of the capacity of elderly patients to make decisions about their health].

PubMed

Atienza-Martín, F J; Garrido-Lozano, M; Losada-Ruiz, C; Rodríguez-Fernández, L M; Revuelta-Pérez, F; Marín-Andrés, G

2013-09-01

To assess the decision-making capacity and variables related to this, in elderly patients in a home care program. A cross-sectional study was conducted on 130 patients assigned to home care program or in social welfare residences of an urban health centre. Demographic variables, as well as comorbidities, social support, institutionalisation, number of drugs used, degree of dependence (Barthel Index), cognitive function (Pfeiffer) were collected. The primary endpoint was the capacity for decision-making about their health assessed using the Aid to Capacity Evaluation (ACE) tool. There was a prevalence of 58.5% capacity. There was an association between ability and independence for activities of daily living (odds ratio (OR): 12.214; Confidence interval 95% (95% CI): 3.90 to 32.29, P <.0001) and function intellectual intact (OR: 282.750, 95% CI 34.0 to 2351.2, P <.0001). Numeric variables associated with the capacity for decision-making that had a more important effect size were the Barthel index (d: -1.398) and Pfeiffer index (d: 3.084). The prevalence of incapacity to make decisions about their health in elderly patients who are cared for in their homes is high. The level of dependence in activities of daily living and the deterioration of intellectual function are factors associated with the presence of this capacity. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment

PubMed Central

Ismail, Zahinoor; Smith, Eric E.; Geda, Yonas; Sultzer, David; Brodaty, Henry; Smith, Gwenn; Agüera-Ortiz, Luis; Sweet, Rob; Miller, David; Lyketsos, Constantine G.

2015-01-01

Neuropsychiatric symptoms (NPS) are common in dementia and in predementia syndromes such as mild cognitive impairment (MCI). NPS in MCI confer a greater risk for conversion to dementia in comparison to MCI patients without NPS. NPS in older adults with normal cognition also confers a greater risk of cognitive decline in comparison to older adults without NPS. Mild behavioral impairment (MBI) has been proposed as a diagnostic construct aimed to identify patients with an increased risk of developing dementia, but who may or may not have cognitive symptoms. We propose criteria that include MCI in the MBI framework, in contrast to prior definitions of MBI. Although MBI and MCI can co-occur, we suggest that they are different and that both portend a higher risk of dementia. These MBI criteria extend the previous literature in this area and will serve as a template for validation of the MBI construct from epidemiologic, neurobiological, treatment, and prevention perspectives. PMID:26096665

[A Concept Analysis for Mind-Body Interaction].

PubMed

Chen, Hsing-Wen; Yeh, Mei-Ling; Rong, Jiin-Ru

2015-08-01

Mind-body interaction (MBI) refers the holistic association and interactive process between wisdom, thinking, belief, and physiological reaction, which critically affects health. The main goal of nursing is to maintain mind and body in a healthy state of well being. Few reports in the literatures have addressed the evaluation and application of MBI. Thus, a conceptual analysis of this subject is worth exploring in depth. This paper analyzes the MBI concept step by step based on the procedures of Walker and Avant. The result defines the characteristics of MBI as (1) being aware of psychosomatic effects, (2) interacting between psychology, neurology, immunology and others, and (3) turning out a bio-psycho-social status. Antecedents include geography, culture, race, gender, age, education, profession, values, personality, experience, and health status. Consequences of MBI include well-being, illness, and death. This paper provides new information on MBI that clarifies its meaning, provides comprehensive cognition, and suggests useful applications.

The Overt Behaviour Scale-Self-Report (OBS-SR) for acquired brain injury: exploratory analysis of reliability and validity.

PubMed

Kelly, Glenn; Simpson, Grahame K; Brown, Suzanne; Kremer, Peter; Gillett, Lauren

2017-05-23

The objectives were to test the properties, via a psychometric study, of the Overt Behaviour Scale-Self-Report (OBS-SR), a version of the OBS-Adult Scale developed to provide a client perspective on challenging behaviours after acquired brain injury. Study sample 1 consisted of 37 patients with primary brain tumour (PBT) and a family-member informant. Sample 2 consisted of 34 clients with other acquired brain injury (mixed brain injury, MBI) and a service-provider informant. Participants completed the OBS-SR (at two time points), and the Awareness Questionnaire (AQ) and Mayo Portland Adaptability Inventory-III (MPAI-III) once; informants completed the OBS-Adult and AQ once only. PBT-informant dyads displayed "good" levels of agreement (ICC 2,k  = .74; OBS-SR global index). Although MBI-informant dyads displayed no agreement (ICC 2,k  = .22; OBS-SR global index), the sub-group (17/29) rated by clinicians as having moderate to good levels of awareness displayed "fair" agreement (ICC 2,k  = .58; OBS-SR global index). Convergent/divergent validity was demonstrated by significant correlations between OBS-SR subscales and MPAI-III subscales with behavioural content (coefficients in the range .36 -.61). Scores had good reliability across one week (ICC 2,k  = .69). The OBS-SR took approximately 15 minutes to complete. It was concluded that the OBS-SR demonstrated acceptable reliability and validity, providing a useful resource in understanding clients' perspectives about their behaviour.

Mindfulness in Motion (MIM): An Onsite Mindfulness Based Intervention (MBI) for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement.

PubMed

Klatt, Maryanna; Steinberg, Beth; Duchemin, Anne-Marie

2015-07-01

A pragmatic mindfulness intervention to benefit personnel working in chronically high-stress environments, delivered onsite during the workday, is timely and valuable to employee and employer alike. Mindfulness in Motion (MIM) is a Mindfulness Based Intervention (MBI) offered as a modified, less time intensive method (compared to Mindfulness-Based Stress Reduction), delivered onsite, during work, and intends to enable busy working adults to experience the benefits of mindfulness. It teaches mindful awareness principles, rehearses mindfulness as a group, emphasizes the use of gentle yoga stretches, and utilizes relaxing music in the background of both the group sessions and individual mindfulness practice. MIM is delivered in a group format, for 1 hr/week/8 weeks. CDs and a DVD are provided to facilitate individual practice. The yoga movement is emphasized in the protocol to facilitate a quieting of the mind. The music is included for participants to associate the relaxed state experienced in the group session with their individual practice. To determine the intervention feasibility/efficacy we conducted a randomized wait-list control group in Intensive Care Units (ICUs). ICUs represent a high-stress work environment where personnel experience chronic exposure to catastrophic situations as they care for seriously injured/ill patients. Despite high levels of work-related stress, few interventions have been developed and delivered onsite for such environments. The intervention is delivered on site in the ICU, during work hours, with participants receiving time release to attend sessions. The intervention is well received with 97% retention rate. Work engagement and resiliency increase significantly in the intervention group, compared to the wait-list control group, while participant respiration rates decrease significantly pre-post in 6/8 of the weekly sessions. Participants value institutional support, relaxing music, and the instructor as pivotal to program success

Mindfulness in Motion (MIM): An Onsite Mindfulness Based Intervention (MBI) for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement

PubMed Central

Klatt, Maryanna; Steinberg, Beth; Duchemin, Anne-Marie

2015-01-01

A pragmatic mindfulness intervention to benefit personnel working in chronically high-stress environments, delivered onsite during the workday, is timely and valuable to employee and employer alike. Mindfulness in Motion (MIM) is a Mindfulness Based Intervention (MBI) offered as a modified, less time intensive method (compared to Mindfulness-Based Stress Reduction), delivered onsite, during work, and intends to enable busy working adults to experience the benefits of mindfulness. It teaches mindful awareness principles, rehearses mindfulness as a group, emphasizes the use of gentle yoga stretches, and utilizes relaxing music in the background of both the group sessions and individual mindfulness practice. MIM is delivered in a group format, for 1 hr/week/8 weeks. CDs and a DVD are provided to facilitate individual practice. The yoga movement is emphasized in the protocol to facilitate a quieting of the mind. The music is included for participants to associate the relaxed state experienced in the group session with their individual practice. To determine the intervention feasibility/efficacy we conducted a randomized wait-list control group in Intensive Care Units (ICUs). ICUs represent a high-stress work environment where personnel experience chronic exposure to catastrophic situations as they care for seriously injured/ill patients. Despite high levels of work-related stress, few interventions have been developed and delivered onsite for such environments. The intervention is delivered on site in the ICU, during work hours, with participants receiving time release to attend sessions. The intervention is well received with 97% retention rate. Work engagement and resiliency increase significantly in the intervention group, compared to the wait-list control group, while participant respiration rates decrease significantly pre-post in 6/8 of the weekly sessions. Participants value institutional support, relaxing music, and the instructor as pivotal to program success

Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study.

PubMed

Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier

2017-01-01

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes

Efficacy of 8- and 4-Session Mindfulness-Based Interventions in a Non-clinical Population: A Controlled Study

PubMed Central

Demarzo, Marcelo; Montero-Marin, Jesus; Puebla-Guedea, Marta; Navarro-Gil, Mayte; Herrera-Mercadal, Paola; Moreno-González, Sergio; Calvo-Carrión, Sandra; Bafaluy-Franch, Laura; Garcia-Campayo, Javier

2017-01-01

Background: Many attempts have been made to abbreviate mindfulness programmes in order to make them more accessible for general and clinical populations while maintaining their therapeutic components and efficacy. The aim of this study was to assess the efficacy of an 8-week mindfulness-based intervention (MBI) programme and a 4-week abbreviated version for the improvement of well-being in a non-clinical population. Method: A quasi-experimental, controlled, pilot study was conducted with pre-post and 6-month follow-up measurements and three study conditions (8- and 4-session MBI programmes and a matched no-treatment control group, with a sample of 48, 46, and 47 participants in each condition, respectively). Undergraduate students were recruited, and mindfulness, positive and negative affect, self-compassion, resilience, anxiety, and depression were assessed. Mixed-effects multi-level analyses for repeated measures were performed. Results: The intervention groups showed significant improvements compared to controls in mindfulness and positive affect at the 2- and 6-month follow-ups, with no differences between 8- vs. 4-session programmes. The only difference between the abbreviated MBI vs. the standard MBI was found in self-kindness at 6 months, favoring the standard MBI. There were marginal differences in anxiety between the controls vs. the abbreviated MBI, but there were differences between the controls vs. the standard MBI at 2- and 6-months, with higher levels in the controls. There were no differences in depression between the controls vs. the abbreviated MBI, but differences were found between the controls vs. the standard MBI at 2- and 6-months, favoring the standard MBI. There were no differences with regard to negative affect and resilience. Conclusion: To our knowledge, this is the first study to directly investigate the efficacy of a standard 8-week MBI and a 4-week abbreviated protocol in the same population. Based on our findings, both programmes

The NLM Indexing Initiative's Medical Text Indexer.

PubMed

Aronson, Alan R; Mork, James G; Gay, Clifford W; Humphrey, Susanne M; Rogers, Willie J

2004-01-01

The Medical Text Indexer (MTI) is a program for producing MeSH indexing recommendations. It is the major product of NLM's Indexing Initiative and has been used in both semi-automated and fully automated indexing environments at the Library since mid 2002. We report here on an experiment conducted with MEDLINE indexers to evaluate MTI's performance and to generate ideas for its improvement as a tool for user-assisted indexing. We also discuss some filtering techniques developed to improve MTI's accuracy for use primarily in automatically producing the indexing for several abstracts collections.

Relationship between Burnout and Body Mass Index in Senior and Middle Managers from the Mexican Manufacturing Industry

PubMed Central

2018-01-01

This research relates Burnout Syndrome (BS) with the Body Mass Index (BMI) among middle and senior managers of the Mexican manufacturing industry. Even though BS incidence is high in the Mexican industrial population, few systematic studies have explored BS and its relationship with other health problems, such as obesity. The goal of this research is to determine the relationship between BS and the BMI in employees with normal weight, overweight, and obesity. We present three structural equation models to relate BS and the BMI. The BMI ranges were determined according to the parameters (normal weight, overweight, and obesity) proposed by the World Health Organization (WHO). The sample includes 361 employees that voluntarily answered a 31-item questionnaire. We measure the levels of BS using the Maslach Burnout Inventory–General Survey (MBI-GS) and analyze anthropometric and sociodemographic data from the participants. Then, we determine the relationships between the variables through structural equation models and estimate the direct, indirect, and total effects in the three models, which show acceptable reliability. As main findings, the normal weight model has a larger explanatory power than the overweight and obesity models. The same research hypotheses were tested and the effects of BS on the BMI differ across the three models. Such results are presented by taking into account that obesity and overweight require additional factors, such as genetic factors and personal eating habits, to be better explained. PMID:29562619

Relationship between Burnout and Body Mass Index in Senior and Middle Managers from the Mexican Manufacturing Industry.

PubMed

Armenta-Hernández, Oziely Daniela; Maldonado-Macías, Aidé; García-Alcaraz, Jorge; Avelar-Sosa, Liliana; Realyvasquez-Vargas, Arturo; Serrano-Rosa, Miguel Angel

2018-03-17

This research relates Burnout Syndrome (BS) with the Body Mass Index (BMI) among middle and senior managers of the Mexican manufacturing industry. Even though BS incidence is high in the Mexican industrial population, few systematic studies have explored BS and its relationship with other health problems, such as obesity. The goal of this research is to determine the relationship between BS and the BMI in employees with normal weight, overweight, and obesity. We present three structural equation models to relate BS and the BMI. The BMI ranges were determined according to the parameters (normal weight, overweight, and obesity) proposed by the World Health Organization (WHO). The sample includes 361 employees that voluntarily answered a 31-item questionnaire. We measure the levels of BS using the Maslach Burnout Inventory-General Survey (MBI-GS) and analyze anthropometric and sociodemographic data from the participants. Then, we determine the relationships between the variables through structural equation models and estimate the direct, indirect, and total effects in the three models, which show acceptable reliability. As main findings, the normal weight model has a larger explanatory power than the overweight and obesity models. The same research hypotheses were tested and the effects of BS on the BMI differ across the three models. Such results are presented by taking into account that obesity and overweight require additional factors, such as genetic factors and personal eating habits, to be better explained.

A Reliability Generalization Meta-Analysis of Coefficient Alpha for the Maslach Burnout Inventory

ERIC Educational Resources Information Center

Wheeler, Denna L.; Vassar, Matt; Worley, Jody A.; Barnes, Laura L. B.

2011-01-01

The purpose of this study was to synthesize internal consistency reliability for the subscale scores on the Maslach Burnout Inventory (MBI). The authors addressed three research questions: (a) What is the mean subscale score reliability for the MBI across studies? (b) What factors are associated with observed variance in MBI subscale score…

Methylammonium Bismuth Iodide as a Lead-Free, Stable Hybrid Organic-Inorganic Solar Absorber.

PubMed

Hoye, Robert L Z; Brandt, Riley E; Osherov, Anna; Stevanović, Vladan; Stranks, Samuel D; Wilson, Mark W B; Kim, Hyunho; Akey, Austin J; Perkins, John D; Kurchin, Rachel C; Poindexter, Jeremy R; Wang, Evelyn N; Bawendi, Moungi G; Bulović, Vladimir; Buonassisi, Tonio

2016-02-18

Methylammonium lead halide (MAPbX3 ) perovskites exhibit exceptional carrier transport properties. But their commercial deployment as solar absorbers is currently limited by their intrinsic instability in the presence of humidity and their lead content. Guided by our theoretical predictions, we explored the potential of methylammonium bismuth iodide (MBI) as a solar absorber through detailed materials characterization. We synthesized phase-pure MBI by solution and vapor processing. In contrast to MAPbX3, MBI is air stable, forming a surface layer that does not increase the recombination rate. We found that MBI luminesces at room temperature, with the vapor-processed films exhibiting superior photoluminescence (PL) decay times that are promising for photovoltaic applications. The thermodynamic, electronic, and structural features of MBI that are amenable to these properties are also present in other hybrid ternary bismuth halide compounds. Through MBI, we demonstrate a lead-free and stable alternative to MAPbX3 that has a similar electronic structure and nanosecond lifetimes. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Wrist fractures and their impact in daily living functionality on elderly people: a prospective cohort study.

PubMed

Vergara, Itziar; Vrotsou, Kalliopi; Orive, Miren; Garcia-Gutierrez, Susana; Gonzalez, Nerea; Las Hayas, Carlota; Quintana, Jose M

2016-01-14

Wrist fractures are the most common arm fractures in older adults. The impact of wrist fractures on daily functionality has been less studied than that of other types and so, less is known about the complexity of factors related to the functional impact of these fractures. This study is aimed to assess the role of individual and health care factors and its association with daily living functional changes after a wrist fracture. A prospective cohort of patients aged 65 or more, affected by a fracture due to a fall, was conducted. These patients were identified at the emergency rooms of the six participating hospitals. As independent factors, the following were studied: socio-demographic data, characteristics of the fracture, health-related quality of life, wrist function and provided treatment. The main outcome was functional status measured by the Barthel Index for daily living basic activities and the Lawton Instrumental Activities of Daily Living (IADL) Scale for daily living instrumental activities. Data were collected at baseline just after the fall and after six months of follow-up. Patients were considered to have deteriorated if their functional status as measured by Barthel Index or Lawton IADL scores decreased in a significant way during the six months of follow up. Barthel Index and/or Lawton IADL scores fell at six months after the fracture in 33% of participants. This functional decline was more frequent in patients with comorbidity (p < 0.0001), polypharmacy (p < 0.0001), low health-related quality of life prior to the fall (p < 0.0001) and lower educational level (p = 0.009). The derived multivariate models show that patients that become dependent six months after the fall, have advanced age, severe chronic diseases, low functional performance prior to the fracture, and repeated episodes of accidental falls. This profile is consistent with a frailty phenotype. Wrist fractures are associated to the occurrence of dependence, especially

Stroke in under-75-year-olds: expectations, concerns and needs.

PubMed

Jerome, D; Dehail, P; Daviet, J-C; Lamothe, G; De Sèze, M-P; Orgogozo, J-M; Mazaux, J-M

2009-01-01

Most studies of functional outcomes in hemiplegic stroke patients use standard disability rating scales (such as the Barthel Index). However, planning the allocation of assistance and resources requires additional information about these patients' expectations and needs. To assess functional independence in daily living and house holding, changes in home settings, type of technical aid and human helps, and expectations in hemiplegic patients 1 to 2 years after the stroke. Sixty-one out of 94 patients admitted to the neurovascular unit of French university hospital for a first-ever documented stroke were consecutively enrolled. The study was restricted to patients under 75, since patients over 75 do not follow the same care network. Patients were examined at their homes or interviewed by phone 17 months (on average) after the stroke. Standard functional assessment tools (such as the Barthel Index and the instrumental activities of daily living [IADL] score) were recorded, along with descriptions of home settings and instrumental and human help. Lastly, patients and caregivers were asked to state their expectations and needs. Although only one person was living in a nursing home after the stroke, 23 (34%) of the other interviewees had needed to make home adjustments or move home. Seven patients (11%) were dependent in terms of the activities of daily living (a Barthel Index below 60) and 11 (18%) had difficulty in maintaining domestic activities and community living (an IADL score over 10). Although the remaining patients had made a good functional recovery, 23 were using technical aids and 28 needed family or caregiver assistance, including 23 patients with full functional independence scores. Twenty-five patients (42%) were suffering from depression as defined by the diagnosis and statistical manual of mental disorders (4th edition, text revision, DSM IV-R). The patients' prime concerns were related to recovery of independence, leisure activities and financial

Mucosal barrier injury laboratory-confirmed bloodstream infection: results from a field test of a new National Healthcare Safety Network definition.

PubMed

See, Isaac; Iwamoto, Martha; Allen-Bridson, Kathy; Horan, Teresa; Magill, Shelley S; Thompson, Nicola D

2013-08-01

To assess challenges to implementation of a new National Healthcare Safety Network (NHSN) surveillance definition, mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI). Multicenter field test. Selected locations of acute care hospitals participating in NHSN central line-associated bloodstream infection (CLABSI) surveillance. Hospital staff augmented their CLABSI surveillance for 2 months to incorporate MBI-LCBI: a primary bloodstream infection due to a selected group of organisms in patients with either neutropenia or an allogeneic hematopoietic stem cell transplant with gastrointestinal graft-versus-host disease or diarrhea. Centers for Disease Control and Prevention (CDC) staff reviewed submitted data to verify whether CLABSIs met MBI-LCBI criteria and summarized the descriptive epidemiology of cases reported. Eight cancer, 2 pediatric, and 28 general acute care hospitals including 193 inpatient units (49% oncology/bone marrow transplant [BMT], 21% adult ward, 20% adult critical care, 6% pediatric, 4% step-down) conducted field testing. Among 906 positive blood cultures reviewed, 282 CLABSIs were identified. Of the 103 CLABSIs that also met MBI-LCBI criteria, 100 (97%) were reported from oncology/BMT locations. Agreement between hospital staff and CDC classification of reported CLABSIs as meeting the MBI-LCBI definition was high (90%; κ = 0.82). Most MBI-LCBIs (91%) occurred in patients meeting neutropenia criteria. Some hospitals indicated that their laboratories' methods of reporting cell counts prevented application of neutropenia criteria; revised neutropenia criteria were created using data from field testing. Hospital staff applied the MBI-LCBI definition accurately. Field testing informed modifications for the January 2013 implementation of MBI-LCBI in the NHSN.

Effects of a physiotherapy and occupational therapy intervention on mobility and activity in care home residents: a cluster randomised controlled trial.

PubMed

Sackley, Catherine M; van den Berg, Maayken E; Lett, Karen; Patel, Smitaa; Hollands, Kristen; Wright, Christine C; Hoppitt, Thomas J

2009-09-01

To compare the clinical effectiveness of a programme of physiotherapy and occupational therapy with standard care in care home residents who have mobility limitations and are dependent in performing activities of daily living. Cluster randomised controlled trial, with random allocation at the level of care home. Care homes within the NHS South Birmingham primary care trust and the NHS Birmingham East and North primary care trust that had more than five beds and provided for people in the care categories "physical disability" and "older people." Care home residents with mobility limitations, limitations in activities of daily living (as screened by the Barthel index), and not receiving end of life care were eligible to take part in the study. A targeted three month occupational therapy and physiotherapy programme. Scores on the Barthel index and the Rivermead mobility index. 24 of 77 nursing and residential homes that catered for residents with mobility limitations and dependency for activities of daily living were selected for study: 12 were randomly allocated to the intervention arm (128 residents, mean age 86 years) and 12 to the control arm (121 residents, mean age 84 years). Participants were evaluated by independent assessors blind to study arm allocation before randomisation (0 months), three months after randomisation (at the end of the treatment period for patients who received the intervention), and again at six months after randomisation. After adjusting for home effect and baseline characteristics, no significant differences were found in mean Barthel index scores at six months post-randomisation between treatment arms (mean effect 0.08, 95% confidence interval -1.14 to 1.30; P=0.90), across assessments (-0.01, -0.63 to 0.60; P=0.96), or in the interaction between assessment and intervention (0.42, -0.48 to 1.32; P=0.36). Similarly, no significant differences were found in the mean Rivermead mobility index scores between treatment arms (0.62, -0.51 to 1

[Relationship between dysphagia and malnutritition in patients over 65 years of age].

PubMed

Galán Sánchez-Heredero, María José; Santander Vaquero, Cecilio; Cortázar Sáez, Milagros; de la Morena López, Felipe; Susi García, Rosario; Martínez Rincón, María Del Carmen

2014-01-01

The main objective of this study was to understand the relationship between oropharyngeal dysphagia, nutritional risk factors and functional impairment in the elderly (>65y) admitted to a medical-surgical hospital unit. Secondary objectives were to determine the prevalence of oropharyngeal dysphagia, the nutritional status and their functional capacity. A cross-sectional observational study was performed. It included patients over 65 years of age admitted to the Gastroenterology-Urology Department in La Princesa University Hospital (Madrid, Spain) during the months of February and March. The following variables were recorded: age, sex, body mass index, family support, diagnosis, comorbidity, oropharyngeal dysphagia (EAT-10 and volume-viscosity evaluation method), malnutrition (Mininutritional Assessment) and functional capacity (Barthel index). A total of 167 patients were recruited, with 30.8% and 15.4% prevalence of dysphagia and malnutrition, respectively. Prevalence of malnutrition increased to 75% in patients with oropharyngeal dysphagia. The logistic regression analysis showed how conditions as low score on the Barthel index (OR 0.97 [95% CI, 0.95-0.99]), comorbidity (OR 7.98 [CI 95%, 3.09-20.61]) and dysphagia (OR 4.07 [CI 95%, 1.57-10.52]) were associated with a greater likelihood of suffering malnutrition. Oropharyngeal dysphagia is one of the most underdiagnosed and underestimated conditions among elderly patients and one that has a greater effect on their nutritional status. Accordingly, we suggest using established diagnostic methods with a multidisciplinary team collaboration for its early detection. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Maslach Burnout Inventory and a Self-Defined, Single-Item Burnout Measure Produce Different Clinician and Staff Burnout Estimates.

PubMed

Knox, Margae; Willard-Grace, Rachel; Huang, Beatrice; Grumbach, Kevin

2018-06-04

Clinicians and healthcare staff report high levels of burnout. Two common burnout assessments are the Maslach Burnout Inventory (MBI) and a single-item, self-defined burnout measure. Relatively little is known about how the measures compare. To identify the sensitivity, specificity, and concurrent validity of the self-defined burnout measure compared to the more established MBI measure. Cross-sectional survey (November 2016-January 2017). Four hundred forty-four primary care clinicians and 606 staff from three San Francisco Aarea healthcare systems. The MBI measure, calculated from a high score on either the emotional exhaustion or cynicism subscale, and a single-item measure of self-defined burnout. Concurrent validity was assessed using a validated, 7-item team culture scale as reported by Willard-Grace et al. (J Am Board Fam Med 27(2):229-38, 2014) and a standard question about workplace atmosphere as reported by Rassolian et al. (JAMA Intern Med 177(7):1036-8, 2017) and Linzer et al. (Ann Intern Med 151(1):28-36, 2009). Similar to other nationally representative burnout estimates, 52% of clinicians (95% CI: 47-57%) and 46% of staff (95% CI: 42-50%) reported high MBI emotional exhaustion or high MBI cynicism. In contrast, 29% of clinicians (95% CI: 25-33%) and 31% of staff (95% CI: 28-35%) reported "definitely burning out" or more severe symptoms on the self-defined burnout measure. The self-defined measure's sensitivity to correctly identify MBI-assessed burnout was 50.4% for clinicians and 58.6% for staff; specificity was 94.7% for clinicians and 92.3% for staff. Area under the receiver operator curve was 0.82 for clinicians and 0.81 for staff. Team culture and atmosphere were significantly associated with both self-defined burnout and the MBI, confirming concurrent validity. Point estimates of burnout notably differ between the self-defined and MBI measures. Compared to the MBI, the self-defined burnout measure misses half of high-burnout clinicians and more

Design of optimal collimation for dedicated molecular breast imaging systems

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

Weinmann, Amanda L.; Hruska, Carrie B.; O'Connor, Michael K.

2009-03-15

Molecular breast imaging (MBI) is a functional imaging technique that uses specialized small field-of-view gamma cameras to detect the preferential uptake of a radiotracer in breast lesions. MBI has potential to be a useful adjunct method to screening mammography for the detection of occult breast cancer. However, a current limitation of MBI is the high radiation dose (a factor of 7-10 times that of screening mammography) associated with current technology. The purpose of this study was to optimize the gamma camera collimation with the aim of improving sensitivity while retaining adequate resolution for the detection of sub-10-mm lesions. Square-hole collimatorsmore » with holes matched to the pixilated cadmium zinc telluride detector elements of the MBI system were designed. Data from MBI patient studies and parameters of existing dual-head MBI systems were used to guide the range of desired collimator resolutions, source-to-collimator distances, pixel sizes, and collimator materials that were examined. General equations describing collimator performance for a conventional gamma camera were used in the design process along with several important adjustments to account for the specialized imaging geometry of the MBI system. Both theoretical calculations and a Monte Carlo model were used to measure the geometric efficiency (or sensitivity) and resolution of each designed collimator. Results showed that through optimal collimation, collimator sensitivity could be improved by factors of 1.5-3.2, while maintaining a collimator resolution of either {<=}5 or {<=}7.5 mm at a distance of 3 cm from the collimator face. These gains in collimator sensitivity permit an inversely proportional drop in the required dose to perform MBI.« less

Effects of a 12-week marching in place and chair rise daily exercise intervention on ADL and functional mobility in frail older adults.

PubMed

Kato, Yoshiji; Islam, Mohammod M; Koizumi, Daisuke; Rogers, Michael E; Takeshima, Nobuo

2018-04-01

[Purpose] To determine the effects of a 12-week intervention consisting of marching in place and chair rising daily exercise on activities of daily living and functional mobility (ability to quickly rise from a chair and walk) in frail older adults. [Subjects and Methods] Thirty-one participants were divided into exercise (n=18, age=77.6 ± 7.2 years; 11 males, 7 females) and non-exercise (n=13, age=79.6 ± 7.7 years; 7 males, 6 females) groups. The exercise group performed 12 weeks of training, 7 days per week, and 20 minutes per session. The exercise program consisted of low to moderate intensity marching in place and chair rising movements. The speed of movements was gradually increased over time. The Barthel index, mean power during chair stand, and time to complete a 10-m walk were assessed before and after the intervention. [Results] Significant improvements were noted in the exercise group compared to the non-exercise group for the Barthel Index (11.6%), mean power (33%), and 10-M walk (14.6%) with a medium effect size, and relative mean power (power/body mass) (32.9%) with a large effect size. [Conclusion] The progressive marching in place and chair rising exercise intervention appears to be effective in improving activities of daily living and functional mobility among frail older adults.

Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.

PubMed

Ru, Xiaojuan; Dai, Hong; Jiang, Bin; Li, Ninghua; Zhao, Xingquan; Hong, Zhen; He, Li; Wang, Wenzhi

2017-07-01

The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors. This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community. Two sampling surveys, at baseline and after intervention, were administered to evaluate the rehabilitation activity undertaken. In intervention communities, stroke survivor's motor function, daily activity, and social activity were evaluated pretreatment and posttreatment, using the Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire. The proportion of individuals participating in rehabilitation-related activity was increased significantly (P < 0.05) in intervention communities, as compared with control communities. In intervention communities, the patients' Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire scores were significantly improved after rehabilitation (P < 0.05) across all ages and disease courses, except for the FAQ scores in patients younger than 50 years (P > 0.05). Community-based rehabilitation appropriate technique increases rehabilitation participation rates and enhances motor function, daily activity, and social activity of stroke survivors.

Effects of supervised whole body vibration exercise on fall risk factors, functional dependence and health-related quality of life in nursing home residents aged 80+.

PubMed

Álvarez-Barbosa, Francisco; del Pozo-Cruz, Jesús; del Pozo-Cruz, Borja; Alfonso-Rosa, Rosa M; Rogers, Michael E; Zhang, Yanxin

2014-12-01

To test the feasibility and effectiveness of whole-body vibration (WBV) therapy on fall risk, functional dependence and health-related quality of life in nursing home residents aged 80+ years. Twenty-nine 80-95 years old volunteers, nursing home residents were randomized to an eight-week WBV intervention group) (n=15) or control group (n=14). Functional mobility was assessed using the timed up and go (TUG) test. Lower limb performance was evaluated using the 30-s Chair Sit to Stand (30-s CSTS) test. Postural stability was measured using a force platform. The Barthel Index was used to assess functional dependence and the EuroQol (EQ-5D) was used to evaluate Health-Related Quality of Life. All outcome measures were assessed at baseline and at a follow-up after 8 weeks. At the 8-week follow up, TUG test (p<0.001), 30-s CSTS number of times (p=0.006), EQ-5Dmobility (p<0.001), EQ-5DVAS (p<0.014), EQ-5Dutility (p<0.001) and Barthel index (p=0.003) improved in the WBV intervention group when compared to the control group. An 8-week WBV-based intervention in a nursing home setting is effective in reducing fall risk factors and quality of life in nursing home residents aged 80+. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Design, synthesis, fabrication and in vitro evalution of mucoadhesive 5-amino-2-mercaptobenzimidazole chitosan as low water soluble drug carriers.

PubMed

Kongsong, Mullika; Songsurang, Kultida; Sangvanich, Polkit; Siralertmukul, Krisana; Muangsin, Nongnuj

2014-11-01

Mucoadhesive thiolated chitosan suitable as a carrier for low water soluble drugs was designed and synthesized by conjugating 5-amino-2-mercaptobenzimidazole (MBI) using methylacrylate (MA) as the linking agent. A 14.4% degree of substitution of MA, as determined by (1)H NMR analysis, and 11.86±0.01μmol thiol groups/g of polymer, as determined by Ellman's method, was obtained. The MBI-MA-chitosan had an 11-fold stronger mucoadhesive property compared to unmodified chitosan at pH 1.2, as determined by the periodic acid: Schiff colorimetric method. Chitosan, MA-chitosan and MBI-MA-chitosan were fabricated as well-formed microspheres using electrospray ionization, including an entrapment efficiency of simvastatin (SV) of over 80% for the MBI-MA-chitosan. The mucoadhesiveness of the SV-loaded MBI-MA-CS microspheres was still higher than that for SV-loaded chitosan at pH 1.2 and 6.4. The SV-loaded MBI-MA-CS microspheres revealed a reduced burst effect and an increased release rate (more than fivefold higher than pure SV) of SV over 12h. Copyright © 2014 Elsevier B.V. All rights reserved.

Defining the student burnout construct: a structural analysis from three burnout inventories.

PubMed

Maroco, João; Campos, Juliana Alvares Duarte Bonini

2012-12-01

College student burnout has been assessed mainly with the Maslach burnout inventory (MBI). However, the construct's definition and measurement with MBI has drawn several criticisms and new inventories have been suggested for the evaluation of the syndrome. A redefinition of the construct of student burnout is proposed by means of a structural equation model, reflecting burnout as a second order factor defined by factors from the MBI-student survey (MBI-SS); the Copenhagen burnout inventory-student survey (CBI-SS) and the Oldenburg burnout inventory-student survey (OLBI-SS). Standardized regression weights from Burnout to Exhaustion and Cynicism from the MBI-SS scale, personal burnout and studies related burnout from the CBI, and exhaustion and disengagement from OLBI, show that these factors are strong manifestations of students' burnout. For college students, the burnout construct is best defined by two dimensions described as "physical and psychological exhaustion" and "cynicism and disengagement".

A telephonic mindfulness-based intervention for persons with sickle cell disease: study protocol for a randomized controlled trial.

PubMed

Williams, Hants; Silva, Susan; Simmons, Leigh Ann; Tanabe, Paula

2017-05-15

One of the most difficult symptoms for persons with sickle cell disease (SCD) to manage is chronic pain. Chronic pain impacts approximately one-third of persons with SCD and is associated with increased pain intensity, pain behavior, and frequency and duration of hospital visits. A promising category of nonpharmacological interventions for managing both physical and affective components of pain are mindfulness-based interventions (MBIs). The primary aim of this study is to conduct a randomized controlled study to evaluate the acceptability and feasibility, as well as to determine the preliminary efficacy, of a telephonic MBI for adults with SCD who have chronic pain. We will enroll 60 adult patients with SCD and chronic pain at an outpatient comprehensive SCD center in the southeastern United States. Patients will be randomized to either an MBI or a wait-listed control group. The MBI group will complete a six-session (60 minutes), telephonically delivered, group-based MBI program. The feasibility, acceptability, and efficacy of the MBI regarding pain catastrophizing will be assessed by administering questionnaires at baseline and weeks 1, 3, and 6. In addition, ten randomly selected MBI participants will complete semistructured interviews to help determine intervention acceptability. In this study protocol, we report detailed methods of the randomized controlled trial. Findings of this study will be useful to determine the acceptability, feasibility, and efficacy of an MBI for persons with SCD and chronic pain. ClinicalTrials.gov identifier: NCT02394587 . Registered on 9 February 2015.

Prevalence of depression in stroke patients with vascular dementia in universiti kebangsaan malaysia medical center.

PubMed

Khoo, K F; Tan, H J; R, Rosdinom; Raymond, A A; M I, Norlinah; A, Shamsul; W Y, Nafisah

2013-04-01

Depression among patients with vascular dementia is frequently overlooked and potentially causes significant morbidity. There is limited data in Malaysia on the subject and this study was conducted to determine the prevalence of depression in vascular dementia (VaD) in UKMMC. This was a cross-sectional study involving diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) criteria and who had a mini mental state examination (MMSE) score of less than 26. All patients were interviewed, examined clinically and their previous brain computer tomography (CT) were reviewed. The prevalence of depression was determined using the Cornell scale of depression. A total of 76 patients were recruited with a mean age of 70.5 ± 9.5 years. The median duration of illness was 2.0 (1.0-4.8) years. The prevalence of depression in the study population was 31.6%. The patients with depression had a significant older mean age (74.5±8.7 years old) compared to those without depression (68.6±9.4 years old). Patients with large artery stroke of less than 3 years had significant higher frequency of depression (53.6%) compared to patients with small artery stroke (23.8%) and patients with right sided large artery stroke had significantly higher frequency of depression compared to left (70% vs. 44.4%). Median MMSE score (17.0) for depressed patients was significantly lower compared with median MMSE score (22.5) for non depressed patients. Median Barthel Index (30.0) for depressed patients was significantly lower compared with median Barthel score for non depressed patients. Depression was prevalent among post stroke patients with VaD in UKMMC particularly for patients with older age, large artery stroke, right sided large artery stroke, low MMSE score and low Barthel Index. Early recognition of high risk patients is important in the holistic management of patients to prevent significant morbidity arising from depression.

Burnout Syndrome Among Medical Students at One University in Serbia: Validity and Reliability of the Maslach Burnout Inventory-Student Survey.

PubMed

Ilic, Milena; Todorovic, Zeljko; Jovanovic, Milena; Ilic, Irena

2017-01-01

The Maslach Burnout Inventory-Student Survey (MBI-SS) contains 15 items that evaluate the following burnout dimensions: Emotional Exhaustion, Cynicism, and Academic Efficacy. The purpose of this study was to evaluate the dimensionality of the MBI-SS on a sample of Serbian medical students (N = 760). The overall Cronbach's α coefficient of the MBI-SS questionnaire was 0.757, while the Cronbach's α coefficients for Emotional Exhaustion, Cynicism, and Academic Efficacy were 0.869, 0.856, and 0.852, respectively. Principal Component Analysis with Oblimin rotation indicated 3 main components that explained 64.9% variance. The confirmatory factor analysis revealed good fit indices (χ 2 /df = 575.74/87, RMSEA = 0.086 (90% Confidence Interval for RMSEA = 0.079 to 0.092), CFI = 0.949, NNFI = 0.939, IFI = 0.949, GFI = 0.904) of the MBI-SS scale. The Serbian version of MBI-SS represents a valid and reliable instrument in the Serbian sample of medical students.

Nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) is associated with qualities of diet and life in Korean cerebral infarction patients.

PubMed

Lim, Hyun Jung; Choue, Ryowon

2010-01-01

Assessment of the nutritional status of patients with cerebral infarction (CI) is important because their nutritional status influences disease outcome. The purpose of this study was to assess the nutritional status of patients with CI using the scored Patient-Generated Subjective Global Assessment (PG-SGA) and to investigate the relation of the quality of their diet and life with their nutritional status. Seventy-three patients with CI were recruited from Kyung Hee University Oriental Medical Center in Seoul, Korea, from May to July 2007. The subjects' PG-SGA, dietary quality (Dietary Diversity Score, Dietary Variety Score, and Diet Quality Index-International), and quality of life (Stroke-Specific Quality of Life, modified Barthel Index, and Beck Depression Inventory) were investigated. The patients were classified by PG-SGA categories as well nourished (26.0%), moderately malnourished (49.3%), or severely malnourished (24.7%). Quality of diet assessed by the Dietary Diversity Score and Dietary Variety Score was significantly lower in severely malnourished patients (P < 0.001). The overall dietary quality expressed by the Diet Quality Index-International was significantly greater in the well-nourished group, followed by the moderately malnourished and severely malnourished groups. Quality of life assessed by the Stroke-Specific Quality of Life and modified Barthel Index was significantly lower in the malnourished group (P < 0.05). Quality of diet (P < 0.001) and life (P < 0.05) in patients with CI were significantly correlated with their nutritional status. The PG-SGA is a useful nutritional assessment tool for patients with CI with stable vital signs. When patients with CI were categorized according to their PG-SGA score, well-nourished patients demonstrated better diet quality and better quality of life. 2010 Elsevier Inc. All rights reserved.

Comorbidity in heart failure. Results of the Spanish RICA Registry.

PubMed

Ruiz-Laiglesia, F-J; Sánchez-Marteles, M; Pérez-Calvo, J-I; Formiga, F; Bartolomé-Satué, J A; Armengou-Arxé, A; López-Quirós, R; Pérez-Silvestre, J; Serrado-Iglesias, A; Montero-Pérez-Barquero, M

2014-12-01

We sought to identify the comorbidities associated with heart failure (HF) in a non-selected cohort of patients, and its influence on mortality and rehospitalization. Data were obtained from the 'Registro de Insuficiencia Cardiaca' (RICA) of the Spanish Society of Internal Medicine. The registry includes patients prospectively admitted in Internal Medicine units for acute HF. Variables included in Charlson Index (ChI) were collected and analysed according to age, gender, left ventricular ejection fraction (LVEF) and Barthel Index. The primary end point of study was the likelihood of rehospitalization and death for any cause during the year after discharge. We included 2051 patients, mean age 78 and 53% females. LVEF was ⩾ 50% in 59.1% of the cohort. There was a high degree of dependency as measured by Barthel Index (14.8 % had an index ≤ 60). Mean ChI was 2.91 (SD ± 2.4). The most frequent comorbidities included in ChI were diabetes mellitus (44.3%), chronic renal impairment (30.8%) and chronic obstructive pulmonary disease (COPD) (27.4%). Age, myocardial infarction, peripheral artery disease, dementia, COPD, chronic renal impairment and diabetes with target-organ damage were all identified as independent prognostic factors for the combined end point of rehospitalization and death at 1 year. However, if multivariate analysis was done including ChI, only this remained as an independent prognostic factor for the combined end point (P < 0.001). HF is a comorbid condition. ChI is a simple and feasible tool for estimating the burden of comorbidities in such population. We believe that a holistic approach to HF would improve prognosis and the relief the pressure exerted on public health services. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Subclinical hyperthyroidism is a risk factor for poor functional outcome after ischemic stroke.

PubMed

Wollenweber, Frank Arne; Zietemann, Vera; Gschwendtner, Andreas; Opherk, Christian; Dichgans, Martin

2013-05-01

Subclinical hyperthyroidism is associated with adverse cardiovascular events, including stroke and atrial fibrillation. However, its impact on functional outcome after stroke remains unexplored. A total of 165 consecutively recruited patients admitted for ischemic stroke were included in this observational prospective study. Blood samples were taken in the morning within 3 days after symptom onset, and patients were divided into the following 3 groups: subclinical hyperthyroidism (0.1< thyroid-stimulating hormone ≤ 0.44 μU/mL), subclinical hypothyroidism (2.5 ≤ thyroid-stimulating hormone <20 μU/mL), and euthyroid state (0.44< thyroid-stimulating hormone <2.5 μU/mL). Patients with overt thyroid dysfunction were excluded. Follow-up took place 3 months after stroke. Primary outcome was functional disability (modified Rankin Scale), and secondary outcome was level of dependency (Barthel Index). Ordinal logistic regression analysis was used to adjust for possible confounders. Variables previously reported to be affected by thyroid function, such as atrial fibrillation, total cholesterol, or body mass index, were included in an additional model. Nineteen patients (11.5%) had subclinical hyperthyroidism, and 23 patients (13.9%) had subclinical hypothyroidism. Patients with subclinical hyperthyroidism had a substantially increased risk of functional disability 3 months after stroke compared with subjects with euthyroid state (odds ratio, 2.63; 95% confidence interval, 1.02-6.82, adjusted for age, sex, smoking status, and time of blood sampling). The association remained significant, when including the baseline NIHSS, TIA, serum CRP, atrial fibrillation, body mass index, and total cholesterol as additional variables (odds ratio, 3.95; 95% confidence interval, 1.25-12.47), and was confirmed by the secondary outcome (Barthel Index: odds ratio, 9.12; 95% confidence interval, 2.08-39.89). Subclinical hyperthyroidism is a risk factor for poor outcome 3 months after

The measurement of disability in the elderly: a systematic review of self-reported questionnaires.

PubMed

Yang, Ming; Ding, Xiang; Dong, Birong

2014-02-01

To analyze the contents and formats of general self-reported questionnaires on disability that are designed for and/or are widely applied in the elderly population to depict a complete picture of this field and help researchers to choose proper tools more efficiently. A broad systematic literature search was performed in September 2013 and included the following databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and PROQOLID. The publication language was limited to English and Chinese. Two review authors independently performed the study selection and data extraction. All of the included instruments were extracted and classified using the International Classification of Functioning, Disability, and Health framework. Of 5569 articles retrieved from the searches and 156 articles retrieved from the pearling, 22 studies (including 24 questionnaires) fulfilled the inclusion criteria. From these, 42 different domains and 458 items were extracted. The most frequently used questionnaire was the Barthel Index followed by the Lawton and Brody Instrumental Activities of Daily Living Scale and the Katz Index of Activities of Daily Living, respectively. The contents and formats of the questionnaires varied considerably. Activities and participation were the most commonly assessed dimensions. In addition, the Activities of Daily Living, mobility and the Instrumental Activities of Daily Living Scale were the most common domains assessed among the included questionnaires. Among the 24 included questionnaires, the most frequently used questionnaires were the Barthel Index, Lawton and Brody Instrumental Activities of Daily Living Scale, and Katz Index of Activities of Daily Living. The content and format of the questionnaires varied considerably, but none of the questionnaires covered all essential dimensions of the International Classification of Functioning, Disability, and Health framework. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All

Can the Maslach Burnout Inventory and Utrecht Work Engagement Scale be used to screen for risk of long-term sickness absence?

PubMed

Roelen, C A M; van Hoffen, M F A; Groothoff, J W; de Bruin, J; Schaufeli, W B; van Rhenen, W

2015-05-01

To investigate the Maslach Burnout Inventory-General Survey (MBI-GS) and the Utrecht Work Engagement Scale (UWES) for their ability to identify non-sicklisted employees at increased risk of long-term sickness absence (LTSA). One-year prospective cohort study including 4,921 employees participating in occupational health surveys in the period 2008-2010. The MBI-GS and UWES were part of the health survey questionnaire and LTSA in the year following the health survey was retrieved from an occupational health register. Associations of baseline MBI-GS and UWES scores with LTSA during 1-year follow-up were stratified by the cause (mental, musculoskeletal, and other somatic illness) of LTSA. Discrimination was assessed by the area (AUC) under the receiver operating characteristic curve and considered practically useful for AUC ≥0.75. During 1-year follow-up, 103 employees (2%) had LTSA due to mental (N = 43), musculoskeletal (N = 31), or other somatic (N = 29) illness. MBI-GS scores were positively and UWES scores negatively associated with mental LTSA, but not musculoskeletal or other somatic LTSA. Discrimination between employees at high and low risk of mental LTSA was moderate: AUC = 0.68 for the MBI-GS and AUC = 0.70 for the UWES. Discrimination did not improve when the MBI-GS and UWES were used simultaneously. The MBI-GS and UWES predicted future mental LTSA in non-sicklisted employees, but discrimination was not practically useful for identifying employees at high risk of LTSA. However, both instruments could be used to select employees for further assessment of mental LTSA risk.

Decay studies of a long lived high spin isomer of /sup 210/Bi

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

Tuggle, D.G.

1976-08-01

A source of approximately 30 ..mu..g of pure (> 90%) /sup 210m/Bi (J..pi.. = 9-) was prepared by irradiating /sup 209/Bi in a nuclear reactor. After chemical separations to remove /sup 210/Po from the irradiated bismuth sample were completed, the /sup 210/Bi was electromagnetically separated from the /sup 209/Bi by a series of two isotope separations to create the source mentioned above. This source was then used to conduct alpha, conversion electron, gamma, gamma-gamma coincidence, and alpha-gamma coincidence spectroscopic studies of the decay of /sup 210m/Bi. The partial half life for the alpha decay of /sup 210m/Bi was measured asmore » 3.0 x 10/sup 6/ yr. A lower limit of 10/sup 13/ years was set for the partial half life for the decay of /sup 210m/Bi to /sup 210/Po. Alpha decay of /sup 210m/Bi to 8 excited states of /sup 206/Tl was observed. A lower limit of 10/sup -4/% was set for the branching ratio of the parity forbidden alpha decay of /sup 210/Bi to the /sup 206/Ti ground state. Theoretical decay rates for the alpha decays of /sup 210m/Bi, /sup 210/Bi, /sup 211/Po, and /sup 211m/Po were calculated using the method developed by Hans Mang. A comparison of the calculated and experimentally measured alpha decay rates of /sup 210m/Bi showed good agreement for the relative alpha decay rates.« less

Dietary intake, nutritional status and rehabilitation outcomes of stroke patients in hospital.

PubMed

Nip, W F R; Perry, L; McLaren, S; Mackenzie, A

2011-10-01

Nutrition affects rehabilitation through its influence on physical and mental functioning, although little attention has been paid to effects on rehabilitation outcomes. The present study aimed to describe nutritional status and food consumption in stroke patients within 2 weeks of hospital admission and before discharge, as well as to investigate the effects of nutritional and dietary factors on rehabilitation outcomes. One hundred patients from a consecutive cohort admitted to a metropolitan hospital with acute stroke were recruited and assessed by a single researcher, with 38 reassessed at discharge. Nutritional status was assessed using Mini-Nutritional Assessment and anthropometric indices and dietary intake was assessed by 1-day weighed dietary records. Rehabilitation outcomes were changes in Barthel index scores and the rehabilitation efficiency index. Few (n = 9; 10%) consumed ≥100% of the estimated average requirement (EAR) for energy within 2 weeks of admission and 13 (33%) had energy intakes <50% of EAR before discharge. A small but increasing proportion (7% at admission, 13% at discharge) were identified as being malnourished across the inpatient stay. Younger age, lower Barthel index and a higher energy intake in the early stages of admission predicted the extent and rate of restoration of functional abilities by discharge (F = 7.503, P = 0.001; F = 14.558, P < 0.001). Given a general finding of nutritional deterioration identified for these patients, as well as the identification of energy intake as a modifiable influence on the extent and rate of recovery, there is clearly scope for the multidisciplinary development of nutritional support for stroke patients to improve rehabilitation outcomes. © 2011 The Authors. Journal of Human Nutrition and Dietetics © 2011 The British Dietetic Association Ltd.

Early or delayed provision of an ankle-foot orthosis in patients with acute and subacute stroke: a randomized controlled trial.

PubMed

Nikamp, Corien Dm; Buurke, Jaap H; van der Palen, Job; Hermens, Hermie J; Rietman, Johan S

2017-06-01

(1) To study the effects of providing ankle-foot orthoses in subjects with (sub)acute stroke; and (2) to study whether the point in time at which an ankle-foot orthosis is provided post-stroke (early or delayed) influences these effects. Randomized controlled trial. Rehabilitation centre. Unilateral hemiparetic stroke subjects with indication for use of an ankle-foot orthosis and maximal six weeks post-stroke. Subjects were randomly assigned to: early provision (at inclusion; Week 1) or delayed provision (eight weeks later; Week 9). 10-metre walk test, 6-minute walk test, Timed Up and Go Test, stairs test, Functional Ambulation Categories, Berg Balance Scale, Rivermead Mobility Index and Barthel Index; assessed in Weeks 1, 3, 9 and 11. A total of 33 subjects were randomized (16 early, 17 delayed). Positive effects of ankle-foot orthoses were found two weeks after provision, both when provided early (significant effects on all outcomes) or delayed (Berg Balance Scale p = 0.011, Functional Ambulation Categories p = 0.008, 6-minute walk test p = 0.005, Timed Up and Go Test p = 0.028). Comparing effects after early and delayed provision showed that early provision resulted in increased levels of improvement on Berg Balance Scale (+5.1 points, p = 0.002), Barthel Index (+1.9 points, p = 0.002) and non-significant improvements on 10-metre walk test (+0.14 m/s, p = 0.093) and Timed Up and Go Test (-5.4 seconds, p = 0.087), compared with delayed provision. We found positive effects of providing ankle-foot orthoses in (sub)acute stroke subjects that had not used these orthoses before.

Sarcopenia is an independent risk factor of dysphagia in hospitalized older people.

PubMed

Maeda, Keisuke; Akagi, Junji

2016-04-01

Sarcopenia can cause varying physical function disorders, including dysphagia. Malnutrition, a potential result of dysphagia, can also cause sarcopenia. However, the association between sarcopenia and dysphagia is not fully understood, despite evidence suggesting correlations between deglutition disorders and degenerative loss of muscle mass. The present study investigated the prevalence of dysphagia among patients with sarcopenia, and the association between the two conditions. We included 224 older adults (mean age 82.5 ± 8.4 years; 37.9% men). Individuals who had a stroke or other diseases that could directly cause dysphagia were excluded. Logistic regression analyses were carried out after adjusting for potential causes of sarcopenia, including malnutrition, a low activity of daily living levels and aging, to investigate the relationship between the skeletal muscle index (SMI), prevalence of sarcopenia diagnosed based on a low SMI and grip strength, and swallowing functions. The Mini-Nutritional Assessment short form was used to assess their nutritional status, and the Barthel Index was used to evaluate their activities of daily living. The prevalences of sarcopenia and dysphagia were 76.8% and 30.0%, respectively. Multivariate analysis showed that Barthel Index, SMI and presence of sarcopenia were significant independent factors for the prevalence of dysphagia, after adjusting for sex, age and nutritional status. Furthermore, subgroup analysis showed that SMI in males, and both hand-grip strength and SMI in females were lower in dysphagic subjects than in non-dysphagic subjects (P ≤ 0.01). Sarcopenia was an independent risk factor for dysphagia among older individuals. However, further studies are required to define causality. © 2015 Japan Geriatrics Society.

[Predictors of drug-resistant pathogens in community-onset pneumonia: Are factors considered in health-care-associated pneumonia useful in the emergency department?

PubMed

Torres Bonafonte, Olga H; Gil Olivas, Eva; Pérez Macho, Estefanía; Pacho Pacho, Cristina; Mateo Roca, Miriam; Casademont Pou, Jordi; Ruiz Hidalgo, Domingo

2017-10-01

To analyze factors related to drug-resistant pathogens (DRPs) in community-onset pneumonia (COP) and whether previously suggested criteria are useful in our emergency-department. Prospective 1-year study of adults coming to the emergency department for COP. We assessed the usefulness of criteria used in health-care-associated pneumonia (HCAP), as well the Shorr index, the Barthel index, and clinical suspicion of resistant pathogens. Data were analyzed by multiple logistic regression and the area under the receiver operating characteristic curve (AUC). We included 139 patients with a mean (SD) age of 75.9 (15.3) years; 63.3% were men. Forty-nine COP patients (35.2%) were at risk for DRP-caused pneumonia according to HCAP criteria; 43 (30.9%) according to the Shorr index, and 56 (40.3%) according to the Aliberti index. A score of less than 60 derived from the Barthel index was recorded for 25 patients (18%). Clinical suspicion of a DRP was recorded for 11 (7.9%). A DRP was isolated in 5 patients (3.6%) (3, Pseudomonas aeruginosa; 2, methicillin-resistant Staphylococcus aureus). Multiple logistic regression analysis identified 2 predictors of DRP-caused COP: hospital admission within the last 90 days (odds ratio [OR], 8.92; 95% CI, 1.92-41.45) and initial arterial blood oxygen saturation (OR, 0.85; 95% CI, 0.74-0.98). The AUC was 0.91 (95% CI, 0.85-0.98). The model identified 22 patients (16.8%) at risk for DRP-caused pneumonia. The positive and negative predictive values were 20% and 99.1%, respectively, for the model 90-day period (vs 8.7% and 98.9%, respectively, for criteria used in HCAP). Hospitalization within the 90-day period before a COP emergency and arterial blood oxygen saturation were good predictors of DRP in our setting. Criteria of DRP in HCAP, on the other hand, had lower ability to identify patients at risk in COP.

Flat Foot in a Random Population and its Impact on Quality of Life and Functionality

PubMed Central

Gonzalez-Martin, Cristina; Alonso-Tajes, Francisco; Seoane-Pillado, Teresa; Pertega-Diaz, Sonia; Perez-Garcia, Sergio; Seijo-Bestilleiro, Rocio; Balboa-Barreiro, Vanesa

2017-01-01

Introduction Flat foot is a common deformity in adults. It is characterized by medial rotation and plantar flexion of the talus, eversion of the calcaneus, collapsed medial arch and abduction of the forefoot. Aim The aim of this study was to determine the prevalence of flat foot and its impact on quality of life, dependence, foot pain, disability and functional limitation among random population of 40-year-old and above. Materials and Methods A cross-sectional study in a random population sample from Cambre (A Coruña-Spain) (n=835) was performed (α =0.05; Precision=±3.4%). The diagnosis of flat foot was stablished by the study of the footprint obtained with a pedograph. Anthropometric variables were studied, Charlson’s Comorbidity Index, function and state of foot (Foot Function Index (FFI), Foot Health Status Questionnaire (FHSQ)), quality of life (SF-36), and dependence for activities of daily living (Barthel and Lawton index). A logistic and linear multiple regression analysis was performed. Results The prevalence of flat foot was 26.62%. Patients with flat foot were significantly older (65.73±11.04 vs 61.03±11.45-year-old), showed a higher comorbidity index (0.92±1.49 vs 0.50±0.98), had a greater BMI (31.45±5.55 vs 28.40±4.17) and greater foot size (25.16±1.66 vs 24.82±1.65). The presence of flat foot diminishes the quality of life, as measured by the FHSQ, and foot function, measured by the FFI. The presence of flat foot does not alter the physical and mental dimension of the SF-36 or the degree of dependence. Conclusion Flat foot was associated with age, Charlson’s Comorbidity Index, BMI and foot size. The SF-36, Barthel and Lawton questionnaires remained unaltered by the presence of flat foot. The FHSQ and FFI questionnaires did prove to be sensitive to the presence of flat foot in a significant manner. PMID:28571173

The interaction of 2-mercaptobenzimidazole with human serum albumin as determined by spectroscopy, atomic force microscopy and molecular modeling.

PubMed

Li, Yuqin; Jia, Baoxiu; Wang, Hao; Li, Nana; Chen, Gaopan; Lin, Yuejuan; Gao, Wenhua

2013-04-01

The interaction of 2-mercaptobenzimidazole (MBI) with human serum albumin (HSA) was studied in vitro by equilibrium dialysis under normal physiological conditions. This study used fluorescence, ultraviolet-visible spectroscopy (UV-vis), Fourier transform infrared (FT-IR), circular dichroism (CD) and Raman spectroscopy, atomic force microscopy (AFM) and molecular modeling techniques. Association constants, the number of binding sites and basic thermodynamic parameters were used to investigate the quenching mechanism. Based on the fluorescence resonance energy transfer, the distance between the HSA and MBI was 2.495 nm. The ΔG(0), ΔH(0), and ΔS(0) values across temperature indicated that the hydrophobic interaction was the predominant binding Force. The UV, FT-IR, CD and Raman spectra confirmed that the HSA secondary structure was altered in the presence of MBI. In addition, the molecular modeling showed that the MBI-HSA complex was stabilized by hydrophobic forces, which resulted from amino acid residues. The AFM results revealed that the individual HSA molecule dimensions were larger after interaction with MBI. Overall, this study suggested a method for characterizing the weak intermolecular interaction. In addition, this method is potentially useful for elucidating the toxigenicity of MBI when it is combined with the biomolecular function effect, transmembrane transport, toxicological testing and other experiments. Copyright © 2012 Elsevier B.V. All rights reserved.

Burnout of Formal Caregivers of Children with Cerebral Palsy.

PubMed

Vicentic, Sreten; Sapic, Rosa; Damjanovic, Aleksandar; Vekic, Berislav; Loncar, Zlatibor; Dimitrijevic, Ivan; Ilankovic, Andrej; Jovanovic, Aleksandar A

2016-01-01

Burnout syndrome is under-researched within caregivers (CGs) of children with cerebral palsy. The primary aim was to determine the burnout level of formal CGs of children with cerebral palsy (G1) and to compare it with a control group (G2) of professional pediatric nurses, and second, to correlate the level of depression and anxiety with the burnout level. In a total sample of 60 CGs, the Maslach Burnout Inventory Human Services Survey (MBI-HSS), consisting of three structural units - emotional exhaustion (MBIEE) subscale, depersonalization (MBI-DP) subscale and personal accomplishment (MBI-PA) subscale - was used to measure burnout. The Beck Anxiety Inventory (BAI) was used for the assessment of anxiety, and the Beck Depression Inventory (BDI) for depression. A significant difference was shown on the MBI-EE subscale and on the BDI test (p<0.05), in both cases higher scores were obtained by G1. High burnout was observed in all subscales, on the MBI-EE subscale registered 50% of CGs in G1, and 17% in control G2. Correlation of the MBI-EE subscale with BDI and BAI tests was highly significant (p<0.01). These findings indicate the need for future research aimed at formulating preventive strategies for caregivers' mental health. Better care for caregivers would provide them with better professional satisfaction, and consequently would lead to better care for patients.

Molecular breast tomosynthesis with scanning focus multi-pinhole cameras

NASA Astrophysics Data System (ADS)

van Roosmalen, Jarno; Goorden, Marlies C.; Beekman, Freek J.

2016-08-01

Planar molecular breast imaging (MBI) is rapidly gaining in popularity in diagnostic oncology. To add 3D capabilities, we introduce a novel molecular breast tomosynthesis (MBT) scanner concept based on multi-pinhole collimation. In our design, the patient lies prone with the pendant breast lightly compressed between transparent plates. Integrated webcams view the breast through these plates and allow the operator to designate the scan volume (e.g. a whole breast or a suspected region). The breast is then scanned by translating focusing multi-pinhole plates and NaI(Tl) gamma detectors together in a sequence that optimizes count yield from the volume-of-interest. With simulations, we compared MBT with existing planar MBI. In a breast phantom containing different lesions, MBT improved tumour-to-background contrast-to-noise ratio (CNR) over planar MBI by 12% and 111% for 4.0 and 6.0 mm lesions respectively in case of whole breast scanning. For the same lesions, much larger CNR improvements of 92% and 241% over planar MBI were found in a scan that focused on a breast region containing several lesions. MBT resolved 3.0 mm rods in a Derenzo resolution phantom in the transverse plane compared to 2.5 mm rods distinguished by planar MBI. While planar MBI cannot provide depth information, MBT offered 4.0 mm depth resolution. Our simulations indicate that besides offering 3D localization of increased tracer uptake, multi-pinhole MBT can significantly increase tumour-to-background CNR compared to planar MBI. These properties could be promising for better estimating the position, extend and shape of lesions and distinguishing between single and multiple lesions.

S100b and BNP predict functional neurological outcome after intracerebral hemorrhage

PubMed Central

James, Michael L.; Blessing, Robert; Phillips-Bute, Barbara G.; Bennett, Ellen; Laskowitz, Daniel T.

2009-01-01

Objective To determine the predictive value of S100b and brain natriuretic peptide (BNP) to accurately and quickly determine discharge prognosis after primary supratentorial intracerebral hemorrhage (ICH). Methods After IRB approval and informed consent, blood samples were obtained and analyzed from 28 adult patients consecutively admitted to the neuroscience intensive care unit with computed tomography-proven supratentorial ICH from June 2003 and December 2004 within the first 24 h after symptom onset for S100b and BNP. Functional outcomes on discharge were dichotomized to favorable (mRS<3) or unfavorable. Results BNP (a neurohormone) and S100b (a marker of glial activation) were found to be independently highly predictive of functional neurological outcome at the time of discharge as measured by modified Rankin Score (BNP:p<0.01, r=0.46; S100b: p<0.01, r=0.42) and Barthel Index (BNP:p<0.01, r=0.54; s100b:p<0.01, r=0.50). Although inclusion of either biomarker produced additive value when included with traditional clinical prognostic variables, such as the ICH Score (Barthel index: p<0.01, r=0.66; mRS:p<0.01, r=0.96), little predictive power is added with inclusion of both biomarkers in a regression model for neurological outcome. Conclusions Serum S100b and BNP levels in the first 24 h after injury accurately predict neurological function at discharge after supratentorial ICH. PMID:19505208

Effect of virtual reality-based rehabilitation on upper-extremity function in patients with brain tumor: controlled trial.

PubMed

Yoon, Jisun; Chun, Min Ho; Lee, Sook Joung; Kim, Bo Ryun

2015-06-01

The aim of this study was to evaluate the benefit of virtual reality-based rehabilitation on upper-extremity function in patients with brain tumor. Patients with upper-extremity dysfunction were divided into age-matched and tumor type-matched two groups. The intervention group performed the virtual reality program 30 mins per session for 9 sessions and conventional occupational therapy 30 mins per session for 6 sessions for 3 wks, whereas the control group received conventional occupational therapy alone 30 mins per session for 15 sessions for 3 wks. The Box and Block test, the Manual Function test, and the Fugl-Meyer scale were used to evaluate upper-extremity function. The Korean version of the Modified Barthel Index was used to assess activities of daily living. Forty patients completed the study (20 for each group). Each group exhibited significant posttreatment improvements in the Box and Block test, Manual Function test, Fugl-Meyer scale, and Korean version of the Modified Barthel Index scores. The Box and Block test, the Fugl-Meyer scale, and the Manual Function test showed greater improvements in shoulder/elbow/forearm function in the intervention group and hand function in the control group. Virtual reality-based rehabilitation combined with conventional occupational therapy may be more effective than conventional occupational therapy, especially for proximal upper-extremity function in patients with brain tumor. Further studies considering hand function, such as use of virtual reality programs that targeting hand use, are required.

Walkability Index

EPA Pesticide Factsheets

The Walkability Index dataset characterizes every Census 2010 block group in the U.S. based on its relative walkability. Walkability depends upon characteristics of the built environment that influence the likelihood of walking being used as a mode of travel. The Walkability Index is based on the EPA's previous data product, the Smart Location Database (SLD). Block group data from the SLD was the only input into the Walkability Index, and consisted of four variables from the SLD weighted in a formula to create the new Walkability Index. This dataset shares the SLD's block group boundary definitions from Census 2010. The methodology describing the process of creating the Walkability Index can be found in the documents located at ftp://newftp.epa.gov/EPADataCommons/OP/WalkabilityIndex.zip. You can also learn more about the Smart Location Database at https://edg.epa.gov/data/Public/OP/Smart_Location_DB_v02b.zip.

Preliminary Investigation of a Mindfulness-Based Intervention for Social Anxiety Disorder That Integrates Compassion Meditation and Mindful Exposure.

PubMed

Koszycki, Diana; Thake, Jennifer; Mavounza, Céline; Daoust, Jean-Philippe; Taljaard, Monica; Bradwejn, Jacques

2016-05-01

This study evaluated the feasibility and initial efficacy of a 12-week group mindfulness-based intervention tailored for persons with social anxiety disorder (MBI-SAD). The intervention includes elements of the standard mindfulness-based stress reduction program, explicit training in self-compassion aimed at cultivating a more accepting and kinder stance toward oneself, and use of exposure procedures to help participants practice responding mindfully to internal experiences evoked by feared social situations. Participants were randomly assigned to the MBI-SAD (n = 21) or a waitlist (WL) (n = 18) control group. Feasibility was assessed by the number of participants who completed at least 75% of the 12 weekly group sessions. Primary efficacy outcomes were clinician- and self-rated measures of social anxiety. Other outcomes included clinician ratings of illness severity and self-rated depression, social adjustment, mindfulness, and self-compassion. The MBI-SAD was acceptable and feasible, with 81% of participants attending at least 75% of sessions. The MBI-SAD fared better than WL in improving social anxiety symptom severity (p ≤ 0.0001), depression (p ≤ 0.05), and social adjustment (p ≤ 0.05). The intervention also enhanced self-compassion (p ≤ 0.05), and facets of mindfulness (observe and aware; p ≤ .05). MBI-SAD treatment gains were maintained at 3-month follow-up. These preliminary findings suggest that an MBI that integrates explicit training in self-compassion and mindful exposure is a feasible and promising intervention for social anxiety disorder. The next step is to compare the MBI-SAD to the gold standard of cognitive-behavior therapy to determine equivalence or noninferiority and to explore mediators and moderators of treatment outcome.

Robotics FAQ Index

Science.gov Websites

faqs.org Robotics FAQ Index faqs.org faqs.org - Internet FAQ Archives Robotics FAQ Index [By Updates | Archive Stats | Search | Help] Internet RFC Index Usenet FAQ Index Other FAQs Documents Tools

Grip strength and its determinants among older people in different healthcare settings

PubMed Central

Roberts, Helen C; Syddall, Holly; Butchart, Joe; Sparkes, Jonathan; Ritchie, Jan; Kerr, Alastair; Cooper, Cyrus; Sayer, Avan Aihie

2013-01-01

Background Low muscle strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community dwelling older people but the epidemiology of grip strength of older people in rehabilitation or long term care has been little explored. Objective To describe grip strength of older people in rehabilitation and nursing home settings. Design Cross-sectional epidemiological study. Setting 3 healthcare settings in one town. Subjects 101 inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents. Methods Grip strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, mini mental state examination (MMSE), nutritional status, and number of falls in the last year were recorded. Results Grip strength differed substantially between healthcare settings for both men and women (p<0.0001). Nursing home residents had the lowest age-adjusted mean grip strength and community rehabilitation referrals the highest. Broadly higher grip strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However after mutual adjustment for these factors, the difference in grip strength between settings remained significant. Barthel score was the characteristic most strongly associated with grip strength. Conclusions Older people in rehabilitation and care home settings had lower grip strength than reported for those living at home. Furthermore grip strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether grip strength may help identify people at risk of adverse health outcomes within these settings. PMID:23926093

CENDI Indexing Workshop

NASA Technical Reports Server (NTRS)

1994-01-01

The CENDI Indexing Workshop held at NASA Headquarters, Two Independence Square, 300 E Street, Washington, DC, on September 21-22, 1994 focused on the following topics: machine aided indexing, indexing quality, an indexing pilot project, the MedIndEx Prototype, Department of Energy/Office of Scientific and Technical Information indexing activities, high-tech coding structures, category indexing schemes, and the Government Information Locator Service. This publication consists mostly of viewgraphs related to the above noted topics. In an appendix is a description of the Government Information Locator Service.

EJSCREEN Indexes 2015 Public

EPA Pesticide Factsheets

There is an EJ Index for each environmental indicator. There are eight EJ Indexes in EJSCREEN reflecting the 8 environmental indicators. The EJ Index names are: Particulate Matter (PM2.5), Ozone Traffic Proximity and Volume, Lead Paint Indicator, Proximity to Risk Management Plan Sites, Proximity to National Priorities List Sites, Proximity to Treatment Storage and Disposal Facilities, and Proximity to Major Direct Water Dischargers. The EJ index is constructed as follows: EJ Index = (Environmental Indicator) * (Demographic Index for Block Group - Demographic Index for U.S.) * (Block Group Population)The EJ index is constructed as follows: EJ Index = (Environmental Indicator) * (Demographic Index for Block Group - Demographic Index for U.S.) * (Block Group Population)

[Overload in the informal caregivers of patients with multiple comorbidities in an urban area].

PubMed

Álvarez-Tello, Margarita; Casado-Mejía, Rosa; Ortega-Calvo, Manuel; Ruiz-Arias, Esperanza

2012-01-01

The aim of the study was, to determine the profile of the family caregiver of patients with multiple pathologies, identify factors associated with overload, and construct predictive models using items from the Caregiver Strain Index (CSI). A cross-sectional study of caregivers of patients with multiple comorbidities who attended an urban health centre. Data were collected from health records and questionnaires (Barthel index, Pfeiffer index, and CSI). Statistical analysis was performed using measures of central tendency and dispersion, and by building multivariate models with binary logistic regression with the CSI items as predictors (program R version 2.14.0). The sample included 67 caregivers, with a mean age of 64.69 years (standard deviation=12.71, median 62 years), of whom 74.6% were women, 35.8% were wives, and 32.8% were daughters. The level of dependence of the patients cared for was total/severe in 77.6%, and moderate in 12% (Barthel), and 47.8% had some level of cognitive impairment (Pfeiffer). A CSI equal or greater than 7 was seen in 47.8% of caregivers, identifying life problems in more than 40% of them such as, restriction of social life, physical exertion, discomfort with change, bad behaviour, personal and family emotional changes, and sleep disturbances. Item 4 of the CSI, analysing the social restriction, was the one that showed a greater significance in the predictive multivariate model. Item 12 (economic burden) was the most significant with age in patients with cognitive impairment. Women tend to take the role of caregiver at an earlier age than men in the urban environment studied, and items from CSI showed that items 4 (social restrictions) and 12 (economic burden) have more significance in the predictive models constructed with Binary Logistic Regression. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Cognitive impairment is independently associated with definitive and possible sarcopenia in hospitalized older adults: The prevalence and impact of comorbidities.

PubMed

Maeda, Keisuke; Akagi, Junji

2017-07-01

Older adults often present with several comorbidities, including sarcopenia. However, the prevalence of sarcopenia and its associations with other comorbidities in hospitalized older adults are unknown. The present study aimed to determine the prevalence of sarcopenia, and its associations with other comorbidities in hospitalized older adults. The present cross-sectional study included 619 patients admitted to a geriatric hospital. The prevalence of comorbidities in the presence and absence of sarcopenia, nutritional status (according to body mass index and the Mini-Nutritional Assessment-Short Form), and activities of daily living (according to the Barthel Index) were assessed. Sarcopenia was defined as skeletal muscle loss evaluated by both bioelectrical impedance and handgrip strength analyses. Of the 619 participants (mean age 83.0 ± 8.2 years), 417 (67.4%) and 87 (14.1%) had definitive and possible sarcopenia, respectively. The prevalence rates of cognitive impairment and stroke were significantly higher in patients with definitive sarcopenia and those with possible sarcopenia than in those without sarcopenia (cognitive impairment 54.4%, 70.1% and 20.9%, respectively, P < 0.001; stroke 31.2%, 48.3% and 19.1%, respectively, P < 0.001). Multivariate logistic regression analysis showed that cognitive impairment was independently associated with sarcopenia after adjusting for age, sex, the Mini-Nutritional Assessment-Short Form score, Barthel Index and primary disease (adjusted odds ratio 1.98, 95% confidence interval 1.06-3.71; P = 0.032). Sarcopenia might be highly prevalent among hospitalized older adults. Furthermore, cognitive impairment might be an independent explanatory variable of sarcopenia. Therefore, further studies on sarcopenia in patients with cognitive impairment are warranted. Geriatr Gerontol Int 2017; 17: 1048-1056. © 2016 Japan Geriatrics Society.

Index/Ring Finger Ratio, Hand and Foot Index: Gender Estimation Tools.

PubMed

Gupta, Sonia; Gupta, Vineeta; Tyagi, Nutan; Ettishree; Bhagat, Sinthia; Dadu, Mohit; Anthwal, Nishita; Ashraf, Tahira

2017-06-01

Gender estimation from dismembered human body parts and skeletal remains in cases of mass disasters, explosions, and assaults cases is an imperative element of any medico-legal investigations and has been a major challenge for forensic scientists. The aim of the present study was to estimate the gender by using index and ring finger length ratio, hand and foot index along with the correlation of both the hand and foot index to determine the vital role of all the indices in establishing gender identity. A descriptive cross-sectional study was done on 300 subjects (150 males and 150 females). Various anthropometric measurements like hand length, hand breadth and hand index, Index Finger Length (IFL), Ring Finger Length (RFL) and IFL/RFL ratio as well as foot length, foot breadth and foot index were estimated in millimeters (mm) with the help of sliding-anthropometric caliper. The data was analysed using independent t-test and Pearson correlation coefficient test. A probability value (p) of ≤ 0.05 was considered statistically significant. The index and ring finger ratio was found to be higher in females as compared to males. The hand and foot index was more in males than in females. The index and ring finger length ratio, hand and foot index between males and females was found to be statistically significant for both hands and feet. A statistically significant correlation was determined between hand indexes versus foot index. This study can be useful to establish the gender of a dismembered hand or foot when subjected for medicolegal examination.

Nucleic acid indexing

DOEpatents

Guilfoyle, Richard A.; Guo, Zhen

2001-01-01

A restriction site indexing method for selectively amplifying any fragment generated by a Class II restriction enzyme includes adaptors specific to fragment ends containing adaptor indexing sequences complementary to fragment indexing sequences near the termini of fragments generated by Class II enzyme cleavage. A method for combinatorial indexing facilitates amplification of restriction fragments whose sequence is not known.

Nucleic acid indexing

DOEpatents

Guilfoyle, Richard A.; Guo, Zhen

1999-01-01

A restriction site indexing method for selectively amplifying any fragment generated by a Class II restriction enzyme includes adaptors specific to fragment ends containing adaptor indexing sequences complementary to fragment indexing sequences near the termini of fragments generated by Class II enzyme cleavage. A method for combinatorial indexing facilitates amplification of restriction fragments whose sequence is not known.

Bounds and inequalities relating h-index, g-index, e-index and generalized impact factor: an improvement over existing models.

PubMed

Abbas, Ash Mohammad

2012-01-01

In this paper, we describe some bounds and inequalities relating h-index, g-index, e-index, and generalized impact factor. We derive the bounds and inequalities relating these indexing parameters from their basic definitions and without assuming any continuous model to be followed by any of them. We verify the theorems using citation data for five Price Medalists. We observe that the lower bound for h-index given by Theorem 2, [formula: see text], g ≥ 1, comes out to be more accurate as compared to Schubert-Glanzel relation h is proportional to C(2/3)P(-1/3) for a proportionality constant of 1, where C is the number of citations and P is the number of papers referenced. Also, the values of h-index obtained using Theorem 2 outperform those obtained using Egghe-Liang-Rousseau power law model for the given citation data of Price Medalists. Further, we computed the values of upper bound on g-index given by Theorem 3, g ≤ (h + e), where e denotes the value of e-index. We observe that the upper bound on g-index given by Theorem 3 is reasonably tight for the given citation record of Price Medalists.

Can we derive an 'exchange rate' between descriptive and preference-based outcome measures for stroke? Results from the transfer to utility (TTU) technique

PubMed Central

Mortimer, Duncan; Segal, Leonie; Sturm, Jonathan

2009-01-01

'moderate to severe' index- and item-based Barthel algorithm were neither clinically nor statistically significant when 'low severity' SF-36 transformations were used to predict AQoL scores for patients in the NIHSS = 0 and NIHSS = 1–5 subgroups and when 'moderate to severe severity' transformations were used to predict AQoL scores for patients in the NIHSS ≥ 6 subgroup. In contrast, the difference between mean predicted and mean observed AQoL scores from the NIHSS algorithms and from the 'low severity' Barthel algorithms reached levels that could mask minimally important differences on the AQoL scale. Conclusion While our NIHSS to AQoL transformations proved unsuitable for most applications, our findings demonstrate that stroke-relevant outcome measures such as the SF-36 and Barthel Index can be adequately transformed to preference-based measures for the purposes of economic evaluation. PMID:19371444

Quality of life declines after first ischemic stroke

PubMed Central

Dhamoon, M.S.; Moon, Y.P.; Paik, M.C.; Boden-Albala, B.; Rundek, T.; Sacco, R.L.; Elkind, M.S.V.

2010-01-01

Objectives: Quality of life (QOL) after stroke is poorly characterized. We sought to determine long-term natural history and predictors of QOL among first ischemic stroke survivors without stroke recurrence or myocardial infarction (MI). Methods: In the population-based, multiethnic Northern Manhattan Study, QOL was prospectively assessed at 6 months and annually for 5 years using the Spitzer QOL index (QLI), a 10-point scale. Functional status was assessed using the Barthel Index (BI) at regular intervals, and cognition using the Mini-Mental State Examination at 1 year. Generalized estimating equations estimated the association between patient characteristics and repeated QOL measures over 5 years. Follow-up was censored at death, recurrent stroke, or MI. Results: There were 525 incident ischemic stroke patients ≥40 years (mean age 68.6 ± 12.4 years). QLI declined after stroke (annual change −0.10, 95% confidence interval −0.17 to −0.04), after adjusting for age, sex, race-ethnicity, education, insurance, depressed mood, stroke severity, bladder continence, and stroke laterality. This decline remained when BI ≥95 was added to the model as a time-dependent covariate, and functional status also predicted QLI. Changes in QLI over time differed by insurance status (p for interaction = 0.0017), with a decline for those with Medicaid/no insurance (p < 0.0001) but not Medicare/private insurance (p = 0.98). Conclusions: In this population-based study, QOL declined annually up to 5 years after stroke among survivors free of recurrence or MI and independently of other risk factors. QLI declined more among Medicaid patients and was associated with age, mood, stroke severity, urinary incontinence, functional status, cognition, and stroke laterality. GLOSSARY BI = Barthel Index; CAD = coronary artery disease; CHF = congestive heart failure; CI = confidence interval; CUMC = Columbia University Medical Center; DM = diabetes mellitus; GEE = generalized estimating

Occupational therapy for stroke patients not admitted to hospital: a randomised controlled trial.

PubMed

Walker, M F; Gladman, J R; Lincoln, N B; Siemonsma, P; Whiteley, T

1999-07-24

Patients who have a stroke are not always admitted to hospital, and 22-60% remain in the community, frequently without coordinated rehabilitation. We aimed to assess the efficacy of an occupational therapy intervention for patients with stroke who were not admitted to hospital. In this single-blind randomised controlled trial, consecutive stroke patients on a UK community register in Nottingham and Derbyshire were allocated randomly to up to 5 months of occupational therapy at home or to no intervention (control group) 1 month after their stroke. The aim of the occupational therapy was to encourage independence in personal and instrumental activities of daily living. Patients were assessed on outcome measures at baseline (before randomisation) and at 6 months. The primary outcome measure was the score on the extended activities of daily living (EADL) scale at 6 months. Other outcome measures included the Barthel index, the general health questionnaire 28, the carer strain index, and the London handicap scale. All assessments were done by an independent assessor who was unaware of treatment allocation. The analysis included only data from completed questionnaires. 185 patients were included: 94 in the occupational therapy group and 91 in the control group. 22 patients were not assessed at 6 months. At follow-up, patients who had occupational therapy had significantly higher median scores than the controls on: the EADL scale (16 vs 12, p<0.01, estimated difference 3 [95% CI 1 to 4]); the Barthel index (20 vs 18, p<0.01, difference 1, [0-1]); the carer strain index (1 vs 3, p<0.05, difference 1 [0 to 2]); and the London handicap scale (76 vs 65, p<0.05, difference 7, [0.3 to 13.5]). There were no significant differences on the general health questionnaire between the patient or carer. Occupational therapy significantly reduced disability and handicap in patients with stroke who were not admitted to hospital.

An occupational therapy intervention for residents with stroke related disabilities in UK care homes (OTCH): cluster randomised controlled trial.

PubMed

Sackley, Catherine M; Walker, Marion F; Burton, Christopher R; Watkins, Caroline L; Mant, Jonathan; Roalfe, Andrea K; Wheatley, Keith; Sheehan, Bart; Sharp, Leslie; Stant, Katie E; Fletcher-Smith, Joanna; Steel, Kerry; Wilde, Kate; Irvine, Lisa; Peryer, Guy

2015-02-05

To evaluate the clinical efficacy of an established programme of occupational therapy in maintaining functional activity and reducing further health risks from inactivity in care home residents living with stroke sequelae. Pragmatic, parallel group, cluster randomised controlled trial. 228 care homes (>10 beds each), both with and without the provision of nursing care, local to 11 trial administrative centres across the United Kingdom. 1042 care home residents with a history of stroke or transient ischaemic attack, including those with language and cognitive impairments, not receiving end of life care. 114 homes (n=568 residents, 64% from homes providing nursing care) were allocated to the intervention arm and 114 homes (n=474 residents, 65% from homes providing nursing care) to standard care (control arm). Participating care homes were randomised between May 2010 and March 2012. Targeted three month programme of occupational therapy, delivered by qualified occupational therapists and assistants, involving patient centred goal setting, education of care home staff, and adaptations to the environment. Primary outcome at the participant level: scores on the Barthel index of activities of daily living at three months post-randomisation. Secondary outcome measures at the participant level: Barthel index scores at six and 12 months post-randomisation, and scores on the Rivermead mobility index, geriatric depression scale-15, and EuroQol EQ-5D-3L questionnaire, at all time points. 64% of the participants were women and 93% were white, with a mean age of 82.9 years. Baseline characteristics were similar between groups for all measures, personal characteristics, and diagnostic tests. Overall, 2538 occupational therapy visits were made to 498 participants in the intervention arm (mean 5.1 visits per participant). No adverse events attributable to the intervention were recorded. 162 (11%) died before the primary outcome time point, and 313 (30%) died over the 12 months of

An occupational therapy intervention for residents with stroke related disabilities in UK care homes (OTCH): cluster randomised controlled trial

PubMed Central

Sackley, Catherine M; Walker, Marion F; Burton, Christopher R; Watkins, Caroline L; Mant, Jonathan; Roalfe, Andrea K; Wheatley, Keith; Sheehan, Bart; Sharp, Leslie; Stant, Katie E; Fletcher-Smith, Joanna; Steel, Kerry; Wilde, Kate; Irvine, Lisa

2015-01-01

Objective To evaluate the clinical efficacy of an established programme of occupational therapy in maintaining functional activity and reducing further health risks from inactivity in care home residents living with stroke sequelae. Design Pragmatic, parallel group, cluster randomised controlled trial. Setting 228 care homes (>10 beds each), both with and without the provision of nursing care, local to 11 trial administrative centres across the United Kingdom. Participants 1042 care home residents with a history of stroke or transient ischaemic attack, including those with language and cognitive impairments, not receiving end of life care. 114 homes (n=568 residents, 64% from homes providing nursing care) were allocated to the intervention arm and 114 homes (n=474 residents, 65% from homes providing nursing care) to standard care (control arm). Participating care homes were randomised between May 2010 and March 2012. Intervention Targeted three month programme of occupational therapy, delivered by qualified occupational therapists and assistants, involving patient centred goal setting, education of care home staff, and adaptations to the environment. Main outcome measures Primary outcome at the participant level: scores on the Barthel index of activities of daily living at three months post-randomisation. Secondary outcome measures at the participant level: Barthel index scores at six and 12 months post-randomisation, and scores on the Rivermead mobility index, geriatric depression scale-15, and EuroQol EQ-5D-3L questionnaire, at all time points. Results 64% of the participants were women and 93% were white, with a mean age of 82.9 years. Baseline characteristics were similar between groups for all measures, personal characteristics, and diagnostic tests. Overall, 2538 occupational therapy visits were made to 498 participants in the intervention arm (mean 5.1 visits per participant). No adverse events attributable to the intervention were recorded. 162 (11%) died

Dose reduction in molecular breast imaging

NASA Astrophysics Data System (ADS)

Wagenaar, Douglas J.; Chowdhury, Samir; Hugg, James W.; Moats, Rex A.; Patt, Bradley E.

2011-10-01

Molecular Breast Imaging (MBI) is the imaging of radiolabeled drugs, cells, or nanoparticles for breast cancer detection, diagnosis, and treatment. Screening of broad populations of women for breast cancer with mammography has been augmented by the emergence of breast MRI in screening of women at high risk for breast cancer. Screening MBI may benefit the sub-population of women with dense breast tissue that obscures small tumors in mammography. Dedicated breast imaging equipment is necessary to enable detection of early-stage tumors less than 1 cm in size. Recent progress in the development of these instruments is reviewed. Pixellated CZT for single photon MBI imaging of 99mTc-sestamibi gives high detection sensitivity for early-stage tumors. The use of registered collimators in a near-field geometry gives significantly higher detection efficiency - a factor of 3.6-, which translates into an equivalent dose reduction factor given the same acquisition time. The radiation dose in the current MBI procedure has been reduced to the level of a four-view digital mammography study. In addition to screening of selected sub-populations, reduced MBI dose allows for dual-isotope, treatment planning, and repeated therapy assessment studies in the era of molecular medicine guided by quantitative molecular imaging.

[Analysis of the activity of mobile rehabilitation-physiotherapy units in primary care].

PubMed

López-Liria, Remedios; Padilla Góngora, David; Catalán Matamoros, Daniel; Arrebola López, Clara; Garrido Fernández, Pablo; Martínez Cortés, María Del Carmen; Zurita Ortega, Félix

2010-05-01

To describe the home care provided by mobile rehabilitation-physiotherapy teams as a response to the needs of the dependent population, the characteristics of their application, and the results they have on patients and their functional independence. A descriptive, cross-sectional study from 2004 to June 2007. Community setting. Mobile rehabilitation-physiotherapy teams from Primary Care in Almeria. A total of 1093 patients were included in the programme. Data were collected on, the state of the patients' health (primary disabling process, reasons for inclusion in the treatment, initial and final functional assessment and Barthel Index); details of physiotherapy treatment, and number of sessions. Of the total sample, the mean age was 78 years and 64.2% were female. The mean waiting time for their assessment was 4 days and there was a wide variety of primary disabling processes described. There was a high percentage of symptoms of severe motor deterioration, pain and muscle weakness. Physiotherapy treatment was given in 88.6%, physiotherapy and occupational therapy in 11.1%, and orthopaedic treatment in 0.3%, of the patients. The mean number of sessions was 12.85. The variation in the Barthel Index after the final therapy was given was, 61.9% for kinesiotherapy, 10.2% combined with electrotherapy, and 14.5% for kinesiotherapy and carer education. Valuable information is provided as regards the characteristics of the geriatric and dependent population, as well as the physiotherapy help they are receiving, and also how the procedure is carried out. Copyright 2009 Elsevier España, S.L. All rights reserved.

Definite (microbiologically confirmed) tuberculous meningitis: predictors and prognostic impact.

PubMed

Jha, Sneh Kumar; Garg, Ravindra Kumar; Jain, Amita; Malhotra, Hardeep Singh; Verma, Rajesh; Sharma, Praveen Kumar

2015-12-01

Microbiological confirmation cannot be obtained in approximately two-third patients with tuberculous meningitis. In this study, we sought to identify epidemiological, clinical, cerebrospinal fluid, and imaging parameters that could indicate the possibility of microbiological confirmation among patients with suspected tuberculous meningitis. In this prospective observational study, patients with tuberculous meningitis were evaluated for clinical, laboratory (cerebrospinal fluid microscopy, culture, and polymerase chain reaction), and neuroimaging parameters. All patients received anti-tuberculosis drugs and corticosteroids. The patients were followed for a period of 6 months. Among 118 cases of tuberculous meningitis, there were 43 (36 %) definite (microbiologically confirmed) cases, 59 (50 %) probable and 16 (14 %) possible cases. Among 43 definite cases, tuberculosis polymerase chain reaction (PCR) was positive in 42 (35 %) patients, culture was positive in 1 case and microscopy, after Ziehl-Neelsen staining, was positive in 3 cases. Three factors, modified Barthel index score at admission ≤12 (p = 0.008), cerebrospinal fluid total cell count >100/mm(3) (p = 0.016), and basal exudates on imaging (p = 0.015), were significantly associated with definite tuberculous meningitis. Among 20 patients who died within 6 months, 13 belonged to definite tuberculous meningitis group (p < 0.001). Stage III tuberculous meningitis (p = 0.004), baseline-modified Barthel index score ≤12 (p = 0.013), and positive tuberculosis PCR (p = 0.007) were independently associated with poor outcome on multivariate analysis. Severe disability, cerebrospinal fluid cells >100 mm(3), and basal exudates are significantly related to the presence of microbiologically confirmed definite tuberculous meningitis. Microbiologically confirmed tuberculous meningitis is associated with poorer outcome.

[Mobile geriatric rehabilitation in nursing homes, in short-term care facilities and private homes : Setting-specific analysis of nationwide treatment documentation (Part 2)].

PubMed

Pippel, Kristina; Meinck, M; Lübke, N

2017-06-01

Mobile geriatric rehabilitation can be provided in the setting of nursing homes, short-term care (STC) facilities and exclusively in private homes. This study analyzed the common features and differences of mobile rehabilitation interventions in various settings. Stratified by setting 1,879 anonymized mobile geriatric rehabilitation treatments between 2011 and 2014 from 11 participating institutions were analyzed with respect to patient, process and outcome-related features. Significant differences between the settings nursing home (n = 514, 27 %), STC (n = 167, 9 %) and private homes (n = 1198, 64 %) were evident for mean age (83 years, 83 years and 80 years, respectively), percentage of women (72 %, 64 % and 55 %), degree of dependency on pre-existing care (92 %, 76 % and 64 %), total treatment sessions (TS, 38 TS, 42 TS and 41 TS), treatment duration (54 days, 61 days and 58 days) as well as the Barthel index at the start of rehabilitation (34 points, 39 points and 46 points) and the gain in the Barthel index (15 points, 21 points and 18 points), whereby the gain in the capacity for self-sufficiency was significant in all settings. The setting-specific evaluation of mobile geriatric rehabilitation showed differences for relevant patient, process and outcome-related features. Compared to inpatient rehabilitation mobile rehabilitation in all settings made an above average contribution to the rehabilitation of patients with pre-existing dependency on care. The gains in the capacity for self-sufficiency achieved in all settings support the efficacy of mobile geriatric rehabilitation under the current prerequisites for applicability.

Eleven years' experience with Intrathecal Baclofen - Complications, risk factors.

PubMed

Pucks-Faes, Elke; Hitzenberger, Gabriel; Matzak, Heinrich; Fava, Elena; Verrienti, Giulio; Laimer, Ilse; Fritz, Josef; Saltuari, Leopold

2018-05-01

Treatment with intrathecal baclofen (ITB) is commonly used in patients with severe spasticity. However, complications may occur after implantation of the ITB-device, albeit mainly procedure- and device-related problems. The aim of the study was to assess surgical- as well as catheter- and pump-related complications and define their risk factors. We retrospectively evaluated all patients with an implanted ITB-device who were treated at the Department of Neurology, Hochzirl Hospital, Zirl, Austria, between 2006 and 2016. Twenty-nine of 116 (25%) patients experienced 32 complications: 5 procedure- and 27 device-related (4 pump- and 23 catheter-associated) problems occurred. Risk factors for sustaining any complication were a spinal localization of lesion (odds ratio [OR] OR 2.71, p  = .021), other catheter types than an Ascenda ® catheter (OR 3.87, p  = .041), a lower modified Rankin Scale (median 4 vs. 5; OR 2.86, p  = .015) and a higher Barthel Index (median 53 vs. 0; OR 2.84, p  = .006). The median time from the last ITB-related surgery to the first complication was 18 (IQR 1-57) months. Overall, 47% complications occurred within the first year after any surgical procedure regarding the ITB-device, thereof 25% within the first month. Procedure- and device-related complications are frequent after implantation of an ITB-device with catheter-associated complications as the most frequently encountered problems. Patients with a spinal origin of spasticity, a lower modified Rankin Scale and a higher Barthel Index have a higher risk to sustain a complication.

Effect of conventional physical therapy and Pilates in functionality, respiratory muscle strength and ability to exercise in hospitalized chronic renal patients: a randomized controlled trial.

PubMed

Sarmento, Lais A; Pinto, Juliana Sst; da Silva, Ana Pp; Cabral, Cristina Mn; Chiavegato, Luciana D

2017-04-01

To compare the effect of conventional physical therapy and Pilates on function, restoration, and exercise ability in hospitalized chronic renal patients. A total of 56 inpatients were randomized into two groups: Conventional physical therapy and Pilates. The primary outcomes were functionality (Barthel Index), respiratory muscle strength (manovacuometry), and ability to exercise (step test) evaluated in the following periods: preintervention, after the 5th session, and after the 10th session or at discharge. Three months after randomization, the Barthel Index was applied over the phone. At the end of the 10 sessions or at discharge, the length of hospital stay was calculated and the level of satisfaction with physical therapy care was assessed (MedRisk). Linear mixed models were used for the primary outcomes and the Student's t-test was used for length of stay and satisfaction. There was no significant between-group difference in functionality (MD -1.3; 95% CI -2.8 to 5.4), inspiratory and expiratory muscle strength (MD -1.3; 95% CI -7.3 to 4.5/MD -4.5; 95% CI -0.7 to 9.7, respectively), performance in the step test (MD -3.3; 95% CI -6.2 to 12.8), patient satisfaction with physical therapy care (MD -2.0; 95% CI -5.1 to 9.1), and length of stay (MD 4.5; 95% CI -15.9 to 6.8). Both interventions, conventional physical therapy and Pilates, showed improvements and there is no difference between them. Therefore both can be used in chronic renal patients.

Physical Disabilities Related to the Depressive Mental States of Japanese Patients with Subacute Myelo-optico-neuropathy.

PubMed

Konishi, Tetsuro

2018-05-18

Objective The aim of this study was to clarify the clinical conditions related to the depressive mental states in Japanese patients with subacute myelo-optico-neuropathy (SMON), caused by clioquinol intoxication more than 40 years previously. Materials and methods The changes in the mental states with aging were investigated in 25 Japanese SMON patients (mean age: 77.2 years old, range: 53-90) using a Japanese version of the Zung Self-rating Depression Scale (J-SDS) questionnaires with supportive interviews by the clinical psychotherapist and medical checkup records. These mental and medical examinations were repeated more than twice within 2 to 11 years' interval. The J-SDS questionnaires were also examined in 25 age-matched non-SMON elderly people. Results The total J-SDS scores of most of the SMON patients decreased with age without significant changes in the mean Barthel index scores during this study period. The mean J-SDS scores at the first and latest studies were significantly higher than in the age-matched healthy elderly people. The total J-SDS scores of the latest study were significantly correlated with the degree of physical disability, such as the inverse total Barthel index scores, severity of SMON or gait disturbance, but not with the age. Conclusion The total J-SDS scores of most of the SMON patients tended to decrease with age. Repeating mental supportive interviews and medical examinations by experts helped to improve the depressive mental state and revealed close relationship between the mental state and the physical disabilities of the SMON patients.

Bobath or motor relearning programme? A comparison of two different approaches of physiotherapy in stroke rehabilitation: a randomized controlled study.

PubMed

Langhammer, B; Stanghelle, J K

2000-08-01

To examine whether two different physiotherapy regimes caused any differences in outcome in rehabilitation after acute stroke. A double-blind study of patients with acute first-ever stroke. Sixty-one patients were consecutively included, block randomized into two groups, and stratified according to gender and hemiplegic site. Group 1 (33 patients) and group 2 (28 patients) had physiotherapy according to Motor Relearning Programme (MRP) and Bobath, respectively. The supplemental treatment did not differ in the two groups. The Motor Assessment Scale (MAS), the Sødring Motor Evaluation Scale (SMES), the Barthel ADL Index and the Nottingham Health Profile (NHP) were used. The following parameters were also registered: length of stay in the hospital, use of assistive devices for mobility, and the patient's accommodation after discharge from the hospital. Patients treated according to MRP stayed fewer days in hospital than those treated according to Bobath (mean 21 days versus 34 days, p = 0.008). Both groups improved in MAS and SMES, but the improvement in motor function was significantly better in the MRP group. The two groups improved in Barthel ADL Index without significant differences between the groups. However, women treated by MRP improved more in ADL than women treated by Bobath. There were no differences between the groups in the life quality test (NHP), use of assistive devices or accommodation after discharge from the hospital. The present study indicates that physiotherapy treatment using the MRP is preferable to that using the Bobath programme in the acute rehabilitation of stroke patients.

Motor recovery of stroke patients after rehabilitation: one-year follow-up study.

PubMed

Kuptniratsaikul, Vilai; Kovindha, Apichana; Suethanapornkul, Sumalee; Massakulpan, Pornpimon; Permsirivanich, Wutichai; Kuptniratsaikul, Patcharawimol Srisa-An

2017-01-01

Purpose To investigate motor recovery of stroke patients 1 year after rehabilitation. Materials and Methods A cross-sectional study of 192 stroke patients discharged from rehabilitation wards in nine tertiary hospitals was conducted. Motor recovery was assessed using the Brunnstrom motor recovery stages (BMRS), at 6 and 12 months after discharge. Factors related to the BMRS of the hand, arm and leg were analyzed. Results The mean age of patients was 62.2 years (57.3% male). Significantly more patients presented improvement of at least one BMRS of the hand, arm and leg compared with those with decreasing BMRS (p < 0.001). The percentage of patients with BMRS III- VI at 6 months was greater than that at discharge, but the recovery at 12 months was slightly higher than that at 6 months. It seems that motor recovery from stroke was near maximal at six months. Regarding the factors related to motor recovery, only lengths of stay (LOS) <30 d during the first admission and Barthel index at discharge ≥10 were related to the improvement of BMRS of the hand, arm and leg on multivariate analysis. Additionally, no complication at discharge was associated with the improvement of BMRS of the leg. Conclusions Approximately half of our stroke patients had motor improvement of at least one stage of BMRS at one year. Motor recovery after stroke at the end of the first year was associated with shorter LOS during the first admission, higher discharge Barthel index score and absence of complications at discharge.

Role of resilience and social support in alleviating depression in patients receiving maintenance hemodialysis.

PubMed

Liu, Yueh-Min; Chang, Hong-Jer; Wang, Ru-Hwa; Yang, Li-King; Lu, Kuo-Cheng; Hou, Yi-Chou

2018-01-01

Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs) and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES) and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD). In this descriptive, correlational study, 194 older patients undergoing HD were enrolled from the HD centers of three hospitals in northern Taiwan. The Barthel ADL Index, RES scale, Inventory of Socially Supportive Behavior, and Beck Depression Inventory-II were used. Hierarchical regression analysis was applied to evaluate the interaction of RES and social support with illness severity, demographics, and ADLs. Of the total participants, 45.9% experienced depressive symptoms. Demographic analysis showed that men and those with high educational level and income and financial independence had less depression ( p <0.01). Patients with a higher Barthel Index (n=103), RES scale (n=33), and social support (n=113) showed less depressive symptoms ( p <0.01). We found a significant negative correlation between depressive symptoms and social support ( r =-0.506, p <0.01) and RES ( r =-0.743, p <0.01). Hierarchical regression analysis showed that RES could buffer the effects of symptom severity on depression ( b =-0.436, p <0.01), but social support did not exert a buffering effect. The severity of illness symptoms and ADLs were the major determinants of depressive symptoms. High RES could alleviate depressive symptoms in the older patients undergoing HD.

[Posture and gait disorders and the incidence of falling in patients with Parkinson].

PubMed

Cano-de la Cuerda, R; Macías-Jiménez, A I; Cuadrado-Pérez, M L; Miangolarra-Page, J C; Morales-Cabezas, M

Although falls are one of the main causes of morbidity and mortality in patients with Parkinson's disease, studies about its incidence and predicting factors are scarce. Our study involved 25 patients with PD (15 males and 10 females; age: 75.8 +/- 6.5 years). A closed survey was used to determine a retrospective record of falls during the last year. An analysis was performed to examine whether there was a relationship with Hoehn and Yahr staging, the score on the Up and Go scale or the Barthel index and with possible risk factors for falls. All the patients had suffered falls at some time over the last year (mean number of falls: 6.5 +/- 3.8). 56% of the falls happened during the phases of the day when patient mobility was at its highest. A significant correlation was found between the number of falls and the Hoehn and Yahr and the Up and Go scores. The number of falls was significantly higher in patients with loss of postural reflexes, the need for help in order to walk, and blockage and festination phenomena. No association was found with fear of falling, visual alterations or postural lateralisation. Association with the Barthel index and dependence for activities of daily living reached almost significant levels. Postural instability and disorders affecting gait appear to be the factors that give patients with PD a greater propensity to fall. Patients who present such alterations should be submitted to rehabilitation therapy aimed at preventing them from falling.

Development of indoor environmental index: Air quality index and thermal comfort index

NASA Astrophysics Data System (ADS)

Saad, S. M.; Shakaff, A. Y. M.; Saad, A. R. M.; Yusof, A. M.; Andrew, A. M.; Zakaria, A.; Adom, A. H.

2017-03-01

In this paper, index for indoor air quality (also known as IAQI) and thermal comfort index (TCI) have been developed. The IAQI was actually modified from previous outdoor air quality index (AQI) designed by the United States Environmental Protection Agency (US EPA). In order to measure the index, a real-time monitoring system to monitor indoor air quality level was developed. The proposed system consists of three parts: sensor module cloud, base station and service-oriented client. The sensor module cloud (SMC) contains collections of sensor modules that measures the air quality data and transmit the captured data to base station through wireless. Each sensor modules includes an integrated sensor array that can measure indoor air parameters like Carbon Dioxide, Carbon Monoxide, Ozone, Nitrogen Dioxide, Oxygen, Volatile Organic Compound and Particulate Matter. Temperature and humidity were also being measured in order to determine comfort condition in indoor environment. The result from several experiments show that the system is able to measure the air quality presented in IAQI and TCI in many indoor environment settings like air-conditioner, chemical present and cigarette smoke that may impact the air quality. It also shows that the air quality are changing dramatically, thus real-time monitoring system is essential.

A prospective observational study of outcomes from rehabilitation of elderly patients with moderate to severe cognitive impairment.

PubMed

Vassallo, Michael; Poynter, Lynn; Kwan, Joseph; Sharma, Jagdish C; Allen, Stephen C

2016-09-01

To evaluate rehabilitation outcomes in patients with moderate to severe cognitive impairment. Prospective observational cohort study. Rehabilitation unit for older people. A total of 116 patients (70F) mean age (SD) 86.3 (6.4). Group 1: 89 patients with moderate cognitive impairment (Mini-Mental State Examination 11-20); and Group 2: 27 patients with severe cognitive impairment (Mini-Mental State Examination 0-10). A personalised rehabilitation plan. Barthel Activity of Daily Living score on admission and discharge, length of stay and discharge destination. Of 116 patients, 64 (55.2%) showed an improvement in Barthel score. Mini-Mental State Examination was significantly higher in those who improved, 15.4 (SD 3.7) vs.13.2 (SD 5.1): p = 0.01. The mean Barthel score improved in both groups; Group 1 - 14.7 (SD 19.1) vs. Group 2 - 9.3 (SD 16.3): p = 0.17. Of 84 home admissions in Group 1, more patients returning home showed improvements of at least 5 points in the Barthel score compared with nursing/residential home discharges (32/37 - 86.5% vs. 10/28 - 35.7%: p = 0.0001). In Group 2 of 17 home admissions, 6/6 (100%) home discharges showed improvement compared with 3/7 (42.8%) discharges to nursing/residential home (p = 0.07). In Group 1, a discharge home was associated with significantly greater improvement in number of Barthel items than a nursing/residential home discharge (3.27 (SD 2.07) vs. 1.86 (SD 2.32): p = 0.007). A similar non-significant pattern was noted for severe cognitive impairment patients (3.5 (3.06) vs. 1.14 (1.06); p = 0.1). Patients with moderate to severe cognitive impairment demonstrated significant improvements in Barthel score and Barthel items showing that such patients can and do improve with rehabilitation. © The Author(s) 2015.

[Analysis of occupational burnout and its influencing factors of colliery migrant workers in Guizhou Province].

PubMed

Zhao, Xiaodeng; Tuo, Anxie; Peng, Anhui; He, Wanjing; Zhu, Peijia; Yan, Zheng

2015-11-01

To understand the status of occupational burnout of colliery migrant workers and its influencing factors. The occupational burnout of 1161 colliery migrant workers in Jinsha County, Guizhou Province was measured with MBI-GS and the self-made questionnaire. All dimensions of MBI-GS Cronbach's α coefficient was in the range of 0.86-0.88, all 15 items of MBI-GS were subjected to factor analysis, and three latent factors were identified, which explained 68.86% of the total variance and consisted with the theory model. The score of occupational burnout of each dimension, differences in different individual characteristics (physical examination, sleep, et al) were statistically significant (P <0.05). The influence factors of occupational burnout of colliery migrant workers were physical examination, chronic disease, smoking, physical exercise, sleep, initial work in coal mine, production post and labor intensity. MBI-GS can be used to study the occupational burnout of colliery migrant workers. Different individual characteristics effect the occurrence of occupational burnout.

Assessment of Burnout and Associated Risk Factors Among Pharmacy Practice Faculty in the United States

PubMed Central

Yam, Lily; Lee, Kelly C.

2017-01-01

Objectives. To measure the level of burnout among pharmacy practice faculty members at US colleges and schools of pharmacy and to identify factors associated with burnout. Methods. Using a cross-sectional, electronic, anonymous survey-design, we measured faculty burnout (n=2318) at US colleges and schools of pharmacy using the Maslach Burnout Inventory-Educators Survey (MBI-ES), which measures burnout dimensions: emotional exhaustion, depersonalization, and personal accomplishment. We assessed MBI-ES scores, demographics and possible predictors of burnout. Results. The response rate was 32.7% (n=758). Emotional exhaustion was identified in 41.3% and was higher in women, assistant professors, and those without a hobby. Participants without a mentor had higher scores of depersonalization. Those with children ages 1-12 years had higher emotional exhaustion and depersonalization compared to those with older children. Conclusion. Pharmacy practice faculty members at US colleges and schools of pharmacy are suffering from burnout, exhibited mainly through emotional exhaustion. PMID:28630516

Retrospective indexing (RI) - A computer-aided indexing technique

NASA Technical Reports Server (NTRS)

Buchan, Ronald L.

1990-01-01

An account is given of a method for data base-updating designated 'computer-aided indexing' (CAI) which has been very efficiently implemented at NASA's Scientific and Technical Information Facility by means of retrospective indexing. Novel terms added to the NASA Thesaurus will therefore proceed directly into both the NASA-RECON aerospace information system and its portion of the ESA-Information Retrieval Service, giving users full access to material thus indexed. If a given term appears in the title of a record, it is given special weight. An illustrative graphic representation of the CAI search strategy is presented.

[Effects of residents' care needs classification (and misclassification) in nursing homes: the example of SOSIA classification].

PubMed

Nebuloni, G; Di Giulio, P; Gregori, D; Sandonà, P; Berchialla, P; Foltran, F; Renga, G

2011-01-01

Since 2003, the Lombardy region has introduced a case-mix reimbursement system for nursing homes based on the SOSIA form which classifies residents into eight classes of frailty. In the present study the agreement between SOSIA classification and other well documented instruments, including Barthel Index, Mini Mental State Examination and Clinical Dementia Rating Scale is evaluated in 100 nursing home residents. Only 50% of residents with severe dementia have been recognized as seriously impaired when assessed with SOSIA form; since misclassification errors underestimate residents' care needs, they determine an insufficient reimbursement limiting nursing home possibility to offer care appropriate for the case-mix.

Negative index effects from a homogeneous positive index prism

NASA Astrophysics Data System (ADS)

Marcus, Sherman W.; Epstein, Ariel

2017-12-01

Cellular structured negative index metamaterials in the form of a right triangular prism have often been tested by observing the refraction of a beam across the prism hypotenuse which is serrated in order to conform to the cell walls. We show that not only can this negative index effect be obtained from a homogeneous dielectric prism having a positive index of refraction, but in addition, for sampling at the walls of the cellular structure, the phase in the material has the illusory appearance of moving in a negative direction. Although many previous reports relied on refraction direction and phase velocity of prism structures to verify negative index design, our investigation indicates that to unambiguously demonstrate material negativity additional empirical evidence is required.

Understanding Burnout and Promoting Engagement among Adjunct Faculty in Community Colleges

ERIC Educational Resources Information Center

Bates, Michael Alan

2012-01-01

This mixed methods study explored the phenomenon of job burnout among adjunct faculty at two suburban Illinois community colleges. The Maslach Burnout Inventory-Educators' Survey (MBI-ES) was administered to adjuncts at both colleges to determine overall levels of burnout for the three dimensions of burnout--emotional exhaustion,…

Modeling-Oriented Assessment in K-12 Science Education: A Synthesis of Research from 1980 to 2013 and New Directions

ERIC Educational Resources Information Center

Namdar, Bahadir; Shen, Ji

2015-01-01

Scientific modeling has been advocated as one of the core practices in recent science education policy initiatives. In modeling-based instruction (MBI), students use, construct, and revise models to gain scientific knowledge and inquiry skills. Oftentimes, the benefits of MBI have been documented using assessments targeting students' conceptual…

Investigation of Microbunching Instabilities in Modern Recirculating Accelerators

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

Tsai, Cheng

Particle accelerators are machines to accelerate and store charged particles, such as electrons or protons, to the energy levels for various scientific applications. A collection of charged particles usually forms a particle beam. There are three basic types of particle accelerators: linear accelerators (linac), storage-ring (or circular) accelerators, and recirculating accelerators. In a linac, particles are accelerated and pass through once along a linear or straight beamline. Storage-ring accelerators propel particles around a circular track and repetitively append the energy to the stored beam. The third type, also the most recent one in chronology, the recirculating accelerator, is designed tomore » accelerate the particle beam in a short section of linac, circulate the beam, and then either continue to accelerate for energy boost or decelerate it for energy recovery. The beam properties of a linac machine are set at best by the initial particle sources. For storage rings, the beam equilibria are instead determined by the overall machine design. The modern recirculating machines share with linacs the advantages to both accelerate and preserve the beam with high beam quality, as well as efficiently reuse the accelerating components. The beamline design in such a machine configuration can however be much more complicated than that of linacs. As modern accelerators push toward the high-brightness or high-intensity frontier by demanding particles in a highly charged bunch (about nano-Coulomb per bunch) to concentrate in an ever-decreasing beam phase space (transverse normalized emittance about 1 μm and relative energy spread of the order of 10^-5 in GeV beam energy), the interaction amongst particles via their self-generated electromagnetic fields can potentially lead to coherent instabilities of the beam and thus pose significant challenges to the machine design and operation. In the past decade and a half, microbunching instability (MBI) has been one of the

Cognitive impairment and dependence of patients with diabetes older than 65 years old in an urban area (DERIVA study).

PubMed

Rodríguez-Sánchez, Emiliano; Mora-Simón, Sara; Patino-Alonso, María C; Pérez-Arechaederra, Diana; Recio-Rodríguez, José I; Gómez-Marcos, Manuel A; Valero-Juan, Luis F; García-Ortiz, Luis

2016-02-01

We analyzed the associations between diabetes and cognitive impairment (CI) and dependence in a population of patients 65 years or older. Cross-sectional study. We randomly selected 311 participants over the age of 65 living in an urban area of Spain. The mean age of the cohort was 75.89 ± 7.12 years, and 69 of the individuals (22.2%) had diabetes. Two questionnaires were used to assess cognitive performance (MMSE and Seven Minute Screen Test), and two assessments were used to evaluate patient dependence (Barthel Index and Lawton-Brody Index). Clinical information and sociodemographic data were also gathered. Nearly one quarter of patients with diabetes (21.7%) lived alone. Diabetic patients were more sedentary (p = .033) than non-diabetic patients. Roughly one sixth (15.3%) of the diabetics and 10.1% of the non-diabetics were depressed (p = .332). CI was present in 26.1% of the diabetics and 14.5% of non-diabetics (p = .029). Diabetic patients had a MMSE score that was significantly worse than non-diabetics (24.88 ± 4.74 vs 26.05 ± 4.03; p <.05), but no differences were found in the Seven Minute Screen Test. Logistic regressions revealed that the presence of diabetes was independently associated with CI (adjusted for age, gender, years of education, sedentary lifestyle, body mass index, diastolic blood pressure, cholesterol, and depression (OR = 2.940, p = .013). Patients with diabetes showed greater dependence, as measured by the Barthel Index (p = .03) and Lawton-Brody Index (p <.01). Nevertheless, when dependence (dependence or not dependence for each questionnaire) used as a dependent variable in the logistic regression analyses, no significant association with diabetes was found, after adjusting for confounding variables. Diabetic patients over the age of 65 are more likely to present CI but not dependence. These findings support the need to include both a functional and cognitive assessment as necessary components

The factorial validity of the Maslach Burnout Inventory-Student Survey in China.

PubMed

Hu, Qiao; Schaufeli, Wilmar B

2009-10-01

The dimensional structure of the Maslach Burnout Inventory-Student Survey (MBI-SS) was investigated using data collected from three samples of Chinese students in two high schools, a university, and a nursing school, respectively (total N = 1,499; 36% males, 64% females; M age 19.0 yr., SD = 1.3). Single group Confirmatory Factor Analyses corroborated the hypothesized three-factor model for the composite sample as well as for the three independent samples. Subsequent multigroup analyses revealed that the three-dimensional structure of the MBI-SS is partially invariant across three samples. It is concluded that the MBI-SS can be used to assess burnout in Chinese students.

Cheyne-Stokes Respiration in Patients with First-Ever Lacunar Stroke

PubMed Central

Bonnin-Vilaplana, Marc; Arboix, Adrià; Parra, Olga; García-Eroles, Luis; Montserrat, Josep M.; Massons, Joan

2012-01-01

The aim of this single-center prospective study was to assess the presence of Cheyne-Stokes respiration (CSR) and CSR-related variables in 68 consecutive patients with radiologically proven first-ever lacunar stroke undergoing a respiratory sleep study using a portable respiratory polygraph within the first 48 hours of stroke onset. CSR was diagnosed in 14 patients (20.6%). Patients with CSR as compared with those without CSR showed a significantly higher mean (standard deviation, SD) apnea-hypopnea index (AHI) (34.9 (21.7) versus 18.5 (14.4), P = 0.001) and central apnea index (13.1 (13.8) versus 1.8 (3.4), P = 0.0001) as well as higher scores of the Barthel index and the Canadian Neurological scale as a measure of stroke severity, and longer hospital stay. CSR was present in one of each five patients with lacunar stroke. The presence of CSR was associated with a trend towards a higher functional stroke severity and worse prognosis. PMID:23471518

The Sickness Impact Profile as a measure of the health status of noncognitively impaired nursing home residents.

PubMed

Rothman, M L; Hedrick, S; Inui, T

1989-03-01

The Sickness Impact Profile (SIP) is a multidimensional, behaviorally based measure of the health status that has been successfully used in a wide range of applications. The characteristics of this measure have not been assessed with nursing home residents. The purpose of this study was to assess the feasibility, reliability (internal consistency), validity, and comprehensiveness of the SIP as a measure of the health status of a selected group of nursing home residents. One hundred sixty-eight veterans residing in community and VA nursing homes responded to a questionnaire consisting of the SIP, Index of Activities of Daily Living, Barthel Index, Life Satisfaction Index Z, and the Philadelphia Geriatric Center Morale Scale. In general, the respondents correctly interpreted instructions; reliability and validity were supported; and the SIP was found to provide a comprehensive assessment of physical function. Adding a measure of psychologic well-being to a study protocol involving this population may, however, provide additional useful information regarding this construct.

A Study and Model of Machine-Like Indexing Behavior by Human Indexers.

ERIC Educational Resources Information Center

McAllister, Caryl

Although a large part of a document retrieval system's resources are devoted to indexing, the question of how people do subject indexing has been the subject of much conjecture and only a little experimentation. This dissertation examines the relationships between a document being indexed and the index terms assigned to that document in an attempt…

A Framework for Model-Based Inquiry through Agent-Based Programming

ERIC Educational Resources Information Center

Xiang, Lin; Passmore, Cynthia

2015-01-01

There has been increased recognition in the past decades that model-based inquiry (MBI) is a promising approach for cultivating deep understandings by helping students unite phenomena and underlying mechanisms. Although multiple technology tools have been used to improve the effectiveness of MBI, there are not enough detailed examinations of how…

Chapter 6: Implementation of Model-Based Instruction--The Induction Years

ERIC Educational Resources Information Center

Gurvitch, Rachel; Blankenship, Bonnie Tjeerdsma

2008-01-01

In previous chapters, student teachers' views and the use of model-based instruction (MBI) were determined to be largely positive. But do these positive attitudes and the actual use of MBI continue after completing a teacher education program? Many novice teachers experience "washout" when the attitudes and instructional practices they…

The Factorial Validity of The Maslach Burnout Inventory--General Survey in Representative Samples of Eight Different Occupational Groups

ERIC Educational Resources Information Center

Langballe, Ellen Melbye; Falkum, Erik; Innstrand, Siw Tone; Aasland, Olaf Gjerlow

2006-01-01

The Maslach Burnout Inventory--General Survey (MBI-GS) is designed to measure the three subdimensions (exhaustion, cynicism, and professional efficacy) of burnout in a wide range of occupations. This article examines the factorial validity of the MBI-GS across eight different occupational groups in Norway: lawyers, physicians, nurses, teachers,…

7 CFR 5.1 - Parity index and index of prices received by farmers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 1 2010-01-01 2010-01-01 false Parity index and index of prices received by farmers... § 5.1 Parity index and index of prices received by farmers. (a) The parity index and related indices... farmers, interest, taxes, and farm wage rates, as revised May 1976 and published in the May 28, 1976, and...

Structural validity of the Maslach Burnout Inventory and influence of depressive symptoms in banking workplace: Unfastening the occupational conundrum.

PubMed

Valente, Maria do Socorro da Silva; Wang, Yuan-Pang; Menezes, Paulo Rossi

2018-06-04

Burnout and mental disorders have been reported in the financial industry. This study aims to examine the structural validity of the Maslach Burnout Inventory (MBI) and to investigate the connection between the dimensions of burnout and depressive symptoms in a sample of 1046 bank employees from North Brazil who completed the MBI and the Patient Health Questionnaire-9 (PHQ-9. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to cross-check the factorial structure of the MBI. One-way analysis of variance and correlation analysis were applied to elucidate the relationship between burnout and depressive symptoms. Both 3-factor and 4-factor oblique solutions were plausible EFA models of the burnout syndrome. Results of CFA supported the 19-item 4-factor structure as the best fitting model to data, with two exhaustion factors ("exhausted" and "strained"), depersonalization, and personal accomplishment. The PHQ-9 total score and individual score of depressive items were significantly correlated with all MBI dimensions, notably with the emotional exhaustion dimension. The moderate-to-high correlation observed between burnout and depression suggest the potential utility of the MBI for evaluating burnout among bank employees as well as to point out the need to evaluate systematically the burnout and depressive symptoms given to their potential association. Copyright © 2018. Published by Elsevier B.V.

California Nitrogen Index

USDA-ARS?s Scientific Manuscript database

The California N Index User Manual is designed to help you become accustomed to the software environment in which the N Index runs. This manual will use an example scenario to demonstrate how to use the N Index to assess nitrogen losses. The objective of this theoretical example is to guide you towa...

Functional versus Nonfunctional Rehabilitation in Chronic Ischemic Stroke: Evidences from a Randomized Functional MRI Study

PubMed Central

Pelicioni, Maristela C. X.; Novaes, Morgana M.; Peres, Andre S. C.; Lino de Souza, Altay A.; Minelli, Cesar; Fabio, Soraia R. C.; Pontes-Neto, Octavio M.; Santos, Antonio C.; de Araujo, Draulio B.

2016-01-01

Motor rehabilitation of stroke survivors may include functional and/or nonfunctional strategy. The present study aimed to compare the effect of these two rehabilitation strategies by means of clinical scales and functional Magnetic Resonance Imaging (fMRI). Twelve hemiparetic chronic stroke patients were selected. Patients were randomly assigned a nonfunctional (NFS) or functional (FS) rehabilitation scheme. Clinical scales (Fugl-Meyer, ARA test, and modified Barthel) and fMRI were applied at four moments: before rehabilitation (P1) and immediately after (P2), 1 month after (P3), and three months after (P4) the end of rehabilitation. The NFS group improved significantly and exclusively their Fugl-Meyer scores at P2, P3, and P4, when compared to P1. On the other hand, the FS group increased significantly in Fugl-Meyer at P2, when compared to P1, and also in their ARA and Barthel scores. fMRI inspection at the individual level revealed that both rehabilitation schemes most often led to decreased activation sparseness, decreased activity of contralesional M1, increased asymmetry of M1 activity to the ipsilesional side, decreased perilesional activity, and decreased SMA activity. Increased M1 asymmetry with rehabilitation was also confirmed by Lateralization Indexes. Our clinical analysis revealed subtle differences between FS and NFS. PMID:26839716

Symptomatic pain and fibromyalgia treatment through multidisciplinary approach for primary care.

PubMed

Gonzalez Gonzalez, Jaime; del Teso Rubio, Maria del Mar; Waliño Paniagua, Carmen Nelida; Criado-Alvarez, Juan Jose; Sanchez Holgado, Javier

2015-01-01

Fibromyalgia is a chronic disease of unknown etiology characterized by widespread muscle pain, with occupational, familial, social, physical and psychological performance involvement. The multidisciplinary approach to the disease leads to improvement in quality of life and symptomatology. To evaluate the improvement of activities of daily living (ADL) and quality of life following a multidisciplinary intervention (Health Primary Care and Occupational Therapy). Pretest-posttest study performed with a simple random sample of 21 patients with fibromyalgia (range 16-55 years). The measurement was performed with the Barthel scale (ADL), the scale of Lawton and Brody (IADL), the FIQ questionnaire, and no standardized surveys to assess the pre and post intervention situation. An intervention on motor skills (basic motor skills, pool exercise, outdoor exercise, restructuring, occupational performance and graded activity and intervention in ADL) was performed, combining pharmacological control of their symptoms and treatment. Fibromyalgia patients are not fully satisfied with their treatment; Primary Care receives a score of 6.89, and Hospital Care 5.79, improving the Barthel, Lawton and Brody and FIQ indexes, being statistically significant (p<.05). After the combined procedure the number of independent women in ADL and IADL increases. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Cultural Validation of the Maslach Burnout Inventory for Korean Students

ERIC Educational Resources Information Center

Shin, Hyojung; Puig, Ana; Lee, Jayoung; Lee, Ji Hee; Lee, Sang Min

2011-01-01

The purpose of this study was to examine the factorial validity of the MBI-SS in Korean students. Specifically, we investigated whether the original three-factor structure of the MBI-SS was appropriate for use with Korean students. In addition, by running multi-group structural equation model analyses with factorial invariance tests simultaneously…

Examining the Social-Emotional Impact of a Brief Mindfulness Program for Students in Special Education

ERIC Educational Resources Information Center

Cevasco, Molly

2017-01-01

As the popularity of both clinic- and school-based mindfulness-based interventions (MBI's) has grown, high quality empirical support for the efficacy of these interventions has been limited. School-based MBI's are gaining popularity as components of strong social-emotional learning curricula, and they are typically delivered as part of a universal…

A Structural Equation Model of Burnout and Job Exit among Child Protective Services Workers.

ERIC Educational Resources Information Center

Drake, Brett; Yadama, Gautam N.

1996-01-01

Uses a structural equation model to examine the three elements of the Maslach Burnout Inventory (MBI)--emotional exhaustion, depersonalization, and personal accomplishment--in relation to job exit among child protective services workers over a 15-month period. The model was supported, showing the relevance of all three MBI elements of job exit.…

Status of fisher in the northern Idaho panhandle and adjacent mountain ranges

Treesearch

Michael Lucid; L. Robinson; S. Cushman; L. Allen; M. Schwartz; K. Pilgrim

2013-01-01

The Multi-species Baseline Initiative (MBI) is a collaborative of organizations which is conducting a comprehensive inventory for fisher (Martes pennanti) and other wildlife species across the Idaho Panhandle and adjacent mountain ranges. From 2010-2012, MBI partners established 112 forest carnivore bait stations to collect photographs and DNA from 22 wildlife species...

Varying Associations Between Body Mass Index and Physical and Cognitive Function in Three Samples of Older Adults Living in Different Settings.

PubMed

Kiesswetter, Eva; Schrader, Eva; Diekmann, Rebecca; Sieber, Cornel Christian; Volkert, Dorothee

2015-10-01

The study investigates variations in the associations between body mass index (BMI) and (a) physical and (b) cognitive function across three samples of older adults living in different settings, and moreover determines if the association between BMI and physical function is confounded by cognitive abilities. One hundred ninety-five patients of a geriatric day hospital, 322 persons receiving home care (HC), and 183 nursing home (NH) residents were examined regarding BMI, cognitive (Mini-Mental State Examination), and physical function (Barthel Index for activities of daily living). Differences in Mini-Mental State Examination and activities of daily living scores between BMI groups (<22, 22-<25, 25-<30, 30-<35, ≥35kg/m(2)) were tested by analysis of covariance considering relevant confounders. Activities of daily living and Mini-Mental State Examination impairments increased from the geriatric day hospital over the HC to the NH sample, whereas prevalence rates of obesity and severe obesity (35%, 33%, 25%) decreased. In geriatric day hospital patients cognitive and physical function did not differ between BMI groups. In the HC and NH samples, cognitive abilities were highest in obese and severely obese subjects. Unadjusted mean activities of daily living scores differed between BMI groups in HC receivers (51.6±32.2, 61.8±26.1, 67.5±28.3, 72.0±23.4, 66.2±24.2, p = .002) and NH residents (35.6±28.6, 48.1±25.7, 39.9±28.7, 50.8±24.0, 57.1±28.2, p = .029). In both samples significance was lost after adjustment indicating cognitive function as dominant confounder. In older adults the associations between BMI and physical and cognitive function were dependent on the health and care status corresponding to the setting. In the HC and the NH samples, cognitive status, as measured by the Mini-Mental State Examination, emerged as an important confounder within the association between BMI and physical function. © The Author 2015. Published by Oxford University Press

17 CFR 41.14 - Transition period for indexes that cease being narrow-based security indexes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... provision. An index that is a narrow-based security index that becomes a broad-based security index for no...-five days. An index that is a narrow-based security index that becomes a broad-based security index for...

17 CFR 41.14 - Transition period for indexes that cease being narrow-based security indexes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... provision. An index that is a narrow-based security index that becomes a broad-based security index for no...-five days. An index that is a narrow-based security index that becomes a broad-based security index for...

17 CFR 41.14 - Transition period for indexes that cease being narrow-based security indexes.

Code of Federal Regulations, 2013 CFR

2013-04-01

... provision. An index that is a narrow-based security index that becomes a broad-based security index for no...-five days. An index that is a narrow-based security index that becomes a broad-based security index for...

17 CFR 41.14 - Transition period for indexes that cease being narrow-based security indexes.

Code of Federal Regulations, 2012 CFR

2012-04-01

... provision. An index that is a narrow-based security index that becomes a broad-based security index for no...-five days. An index that is a narrow-based security index that becomes a broad-based security index for...

Subspace-Aware Index Codes

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

Kailkhura, Bhavya; Theagarajan, Lakshmi Narasimhan; Varshney, Pramod K.

In this paper, we generalize the well-known index coding problem to exploit the structure in the source-data to improve system throughput. In many applications (e.g., multimedia), the data to be transmitted may lie (or can be well approximated) in a low-dimensional subspace. We exploit this low-dimensional structure of the data using an algebraic framework to solve the index coding problem (referred to as subspace-aware index coding) as opposed to the traditional index coding problem which is subspace-unaware. Also, we propose an efficient algorithm based on the alternating minimization approach to obtain near optimal index codes for both subspace-aware and -unawaremore » cases. In conclusion, our simulations indicate that under certain conditions, a significant throughput gain (about 90%) can be achieved by subspace-aware index codes over conventional subspace-unaware index codes.« less

Subspace-Aware Index Codes

DOE PAGES

Kailkhura, Bhavya; Theagarajan, Lakshmi Narasimhan; Varshney, Pramod K.

2017-04-12

In this paper, we generalize the well-known index coding problem to exploit the structure in the source-data to improve system throughput. In many applications (e.g., multimedia), the data to be transmitted may lie (or can be well approximated) in a low-dimensional subspace. We exploit this low-dimensional structure of the data using an algebraic framework to solve the index coding problem (referred to as subspace-aware index coding) as opposed to the traditional index coding problem which is subspace-unaware. Also, we propose an efficient algorithm based on the alternating minimization approach to obtain near optimal index codes for both subspace-aware and -unawaremore » cases. In conclusion, our simulations indicate that under certain conditions, a significant throughput gain (about 90%) can be achieved by subspace-aware index codes over conventional subspace-unaware index codes.« less

Transcriptome Analysis Suggests That Chromosome Introgression Fragments from Sea Island Cotton (Gossypium barbadense) Increase Fiber Strength in Upland Cotton (Gossypium hirsutum).

PubMed

Lu, Quanwei; Shi, Yuzhen; Xiao, Xianghui; Li, Pengtao; Gong, Juwu; Gong, Wankui; Liu, Aiying; Shang, Haihong; Li, Junwen; Ge, Qun; Song, Weiwu; Li, Shaoqi; Zhang, Zhen; Rashid, Md Harun Or; Peng, Renhai; Yuan, Youlu; Huang, Jinling

2017-10-05

As high-strength cotton fibers are critical components of high quality cotton, developing cotton cultivars with high-strength fibers as well as high yield is a top priority for cotton development. Recently, chromosome segment substitution lines (CSSLs) have been developed from high-yield Upland cotton ( Gossypium hirsutum ) crossed with high-quality Sea Island cotton ( G. barbadense ). Here, we constructed a CSSL population by crossing CCRI45, a high-yield Upland cotton cultivar, with Hai1, a Sea Island cotton cultivar with superior fiber quality. We then selected two CSSLs with significantly higher fiber strength than CCRI45 (MBI7747 and MBI7561), and one CSSL with lower fiber strength than CCRI45 (MBI7285), for further analysis. We sequenced all four transcriptomes at four different time points postanthesis, and clustered the 44,678 identified genes by function. We identified 2200 common differentially-expressed genes (DEGs): those that were found in both high quality CSSLs (MBI7747 and MBI7561), but not in the low quality CSSL (MBI7285). Many of these genes were associated with various metabolic pathways that affect fiber strength. Upregulated DEGs were associated with polysaccharide metabolic regulation, single-organism localization, cell wall organization, and biogenesis, while the downregulated DEGs were associated with microtubule regulation, the cellular response to stress, and the cell cycle. Further analyses indicated that three genes, XLOC_036333 [mannosyl-oligosaccharide-α-mannosidase ( MNS1 )], XLOC_029945 ( FLA8 ), and XLOC_075372 ( snakin-1 ), were potentially important for the regulation of cotton fiber strength. Our results suggest that these genes may be good candidates for future investigation of the molecular mechanisms of fiber strength formation and for the improvement of cotton fiber quality through molecular breeding. Copyright © 2017 Lu et al.

Burnout and Engagement in University Students: A Cross-National Study.

ERIC Educational Resources Information Center

Schaufeli, Wilmar B.; Martinez, Isabel M.; Pinto, Alexandra Marques; Salanova, Marisa; Bakker, Arnold B.

2002-01-01

Examines burnout and engagement among college students from Spain, Portugal, and the Netherlands using the Maslach Burnout Inventory Student Survey (MBI-SS) and the Utrecht Work Engagement Scale for students. Overall, these two instruments may be used for such a purpose, but both instruments, particularly the MBI-SS, do not pass a rigorous test of…

Predicting fiber refractive index from a measured preform index profile

NASA Astrophysics Data System (ADS)

Kiiveri, P.; Koponen, J.; Harra, J.; Novotny, S.; Husu, H.; Ihalainen, H.; Kokki, T.; Aallos, V.; Kimmelma, O.; Paul, J.

2018-02-01

When producing fiber lasers and amplifiers, silica glass compositions consisting of three to six different materials are needed. Due to the varying needs of different applications, substantial number of different glass compositions are used in the active fiber structures. Often it is not possible to find material parameters for theoretical models to estimate thermal and mechanical properties of those glass compositions. This makes it challenging to predict accurately fiber core refractive index values, even if the preform index profile is measured. Usually the desired fiber refractive index value is achieved experimentally, which is expensive. To overcome this problem, we analyzed statistically the changes between the measured preform and fiber index values. We searched for correlations that would help to predict the Δn-value change from preform to fiber in a situation where we don't know the values of the glass material parameters that define the change. Our index change models were built using the data collected from preforms and fibers made by the Direct Nanoparticle Deposition (DND) technology.

Chemical Compositions and Aroma Evaluation of Volatile Oil from the Industrial Cultivation Medium of Enterococcus faecalis.

PubMed

Ono, Toshirou; Usami, Atsushi; Nakaya, Satoshi; Maeba, Keisuke; Yonejima, Yasunori; Toyoda, Masanori; Ikeda, Atsushi; Miyazawa, Mitsuo

2015-01-01

Enterococcus faecalis is one of the major lactic acid bacterium (LAB) species colonizing the intestines of animals and humans. The characteristic odor of the volatile oils obtained from both the liquid medium after incubation (MAI) and liquid medium before incubation (MBI) in the cultivation process of E. faecalis was investigated to determine the utility of the liquid medium. In total, fifty-six and thirty-two compounds were detected in the volatile oils from the MAI (MAI oil) and MBI (MBI oil), respectively. The principle components of MAI oil were 2,5-dimethylpyrazine (19.3%), phenylacetaldehyde (19.3%), and phenylethyl alcohol (9.3%). The aroma extract dilution analysis (AEDA) method was performed using gas chromatography-olfactometry (GC-O). The total number of aroma-active compounds identified in the volatile oil from MBI and MAI was thirteen compounds; in particular, 5-methyl-2-furanmethanol, phenylacetaldehyde, and phenylethyl alcohol were the most primary aroma-active compounds in MAI oil. These results imply that the industrial cultivation medium after incubation of E. faecalis may be utilized as a source of volatile oils.

Promoting collaboration skills on reflection concept through multimedia-based integrated instruction

NASA Astrophysics Data System (ADS)

Hermawan, Hermawan; Siahaan, Parsaoran; Suhendi, Endi; Samsudin, Achmad

2017-05-01

Multimedia-Based Integrated Instructions (MBI2) has been developed to promote the collaboration skills on reflection concepts turn into more real and meaningful learning. The initial design of MBI2 in the form of a multimedia computer that allows users to explore the concept of the overall reflectance of the light through the conceptual and practical aspects that have been developed. MBI2has been developed to promoteone of the skills that the 21st-century skills to students'junior high school that is collaboration skill in order to compete in the future life. The ability to collaborate is divided into five aspects, namely contributions, time management, problem-solving, working with others and research techniques. Research methods utiliseed in this study is an exploration and instructional development 4D model (define, design, develop and disseminate). Based on data analysis, it can be concluded that the development of integrated multimedia-based instruction (MBI2) on the concept of reflection through the 4D developing model was effectively to enhance collaboration skills of students'junior high school.

KSC Construction Cost Index

NASA Technical Reports Server (NTRS)

Brown, J. A.

1983-01-01

Kennedy Space Center cost Index aids in conceptual design cost estimates. Report discusses development of KSC Cost Index since January 1974. Index since January 1974. Index provides management, design engineers, and estimators an up-to-data reference for local labor and material process. Also provides mount and rate of change in these costs used to predict future construction costs.

29. TRACK LAYOUT, INDEX TO DRAWINGS AND INDEX TO MATERIALS, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. TRACK LAYOUT, INDEX TO DRAWINGS AND INDEX TO MATERIALS, REED & STEM ARCHITECTS, ST. PAUL, NEW YORK, 1909 (Burlington Northern Collection, Seattle, Washington) - Union Passenger Station Concourse, 1713 Pacific Avenue, Tacoma, Pierce County, WA

INDEXING MECHANISM

DOEpatents

Kock, L.J.

1959-09-22

A device is presented for loading and unloading fuel elements containing material fissionable by neutrons of thermal energy. The device comprises a combination of mechanical features Including a base, a lever pivotally attached to the base, an Indexing plate on the base parallel to the plane of lever rotation and having a plurality of apertures, the apertures being disposed In rows, each aperture having a keyway, an Index pin movably disposed to the plane of lever rotation and having a plurality of apertures, the apertures being disposed in rows, each aperture having a keyway, an index pin movably disposed on the lever normal to the plane rotation, a key on the pin, a sleeve on the lever spaced from and parallel to the index pin, a pair of pulleys and a cable disposed between them, an open collar rotatably attached to the sleeve and linked to one of the pulleys, a pin extending from the collar, and a bearing movably mounted in the sleeve and having at least two longitudinal grooves in the outside surface.

Role of resilience and social support in alleviating depression in patients receiving maintenance hemodialysis

PubMed Central

Liu, Yueh-Min; Chang, Hong-Jer; Wang, Ru-Hwa; Yang, Li-King; Lu, Kuo-Cheng; Hou, Yi-Chou

2018-01-01

Background Patients who undergo hemodialysis encounter challenges including role changes, physical degeneration, and difficulty in performing activities of daily living (ADLs) and self-care. These challenges deteriorate their physiological and psychosocial conditions, resulting in depression. High resilience (RES) and social support can alleviate stress and depression. This study evaluated the importance of RES and social support in managing depression in elderly patients undergoing maintenance hemodialysis (HD). Patients and methods In this descriptive, correlational study, 194 older patients undergoing HD were enrolled from the HD centers of three hospitals in northern Taiwan. The Barthel ADL Index, RES scale, Inventory of Socially Supportive Behavior, and Beck Depression Inventory-II were used. Hierarchical regression analysis was applied to evaluate the interaction of RES and social support with illness severity, demographics, and ADLs. Results Of the total participants, 45.9% experienced depressive symptoms. Demographic analysis showed that men and those with high educational level and income and financial independence had less depression (p<0.01). Patients with a higher Barthel Index (n=103), RES scale (n=33), and social support (n=113) showed less depressive symptoms (p<0.01). We found a significant negative correlation between depressive symptoms and social support (r=−0.506, p<0.01) and RES (r=−0.743, p<0.01). Hierarchical regression analysis showed that RES could buffer the effects of symptom severity on depression (b=−0.436, p<0.01), but social support did not exert a buffering effect. Conclusion The severity of illness symptoms and ADLs were the major determinants of depressive symptoms. High RES could alleviate depressive symptoms in the older patients undergoing HD. PMID:29535526

Restarting antiplatelet therapy after spontaneous intracerebral hemorrhage: Functional outcomes.

PubMed

Chen, Ching-Jen; Ding, Dale; Buell, Thomas J; Testai, Fernando D; Koch, Sebastian; Woo, Daniel; Worrall, Bradford B

2018-05-30

To compare the functional outcomes and health-related quality of life metrics of restarting vs not restarting antiplatelet therapy (APT) in patients presenting with intracerebral hemorrhage (ICH) in the ERICH (Ethnic/Racial Variations of Intracerebral Hemorrhage) study. Adult patients aged 18 years and older who were on APT before ICH and were alive at hospital discharge were included. Patients were dichotomized based on whether or not APT was restarted after hospital discharge. The primary outcome was a modified Rankin Scale score of 0-2 at 90 days. Secondary outcomes were excellent outcome (modified Rankin Scale score 0-1), mortality, Barthel Index, and health status (EuroQol-5 dimensions [EQ-5D] and EQ-5D visual analog scale scores) at 90 days. The APT and no APT cohorts comprised 127 and 732 patients, respectively. Restarting APT was associated with lower rates of good functional outcome (36.5% vs 40.8%; p = 0.021) and lower Barthel Index scores at 90 days ( p = 0.041). The 2 cohorts were then matched in a 1:1 ratio, and the matched cohorts each comprised 107 patients. No difference in primary outcome was observed between restarting vs not restarting APT (35.5% vs 43.9%; p = 0.105). There were also no differences between the secondary outcomes of the 2 cohorts. Restarting APT in patients with ICH of mild to moderate severity after acute hospitalization is not associated with worse functional outcomes or health-related quality of life at 90 days. In patients with significant cardiovascular risk factors who experience an ICH, restarting APT remains the decision of the treating practitioner. © 2018 American Academy of Neurology.

Effects of Navigated Repetitive Transcranial Magnetic Stimulation After Stroke.

PubMed

Chervyakov, Alexander V; Poydasheva, Alexandra G; Lyukmanov, Roman H; Suponeva, Natalia A; Chernikova, Ludmila A; Piradov, Michael A; Ustinova, Ksenia I

2018-03-01

The purpose of this study was to test the effects of navigated repetitive transcranial magnetic stimulation, delivered in different modes, on motor impairments and functional limitations after stroke. The study sample included 42 patients (58.5 ± 10.7 years; 26 males) who experienced a single unilateral stroke (1-12 months previously) in the area of the middle cerebral artery. Patients completed a course of conventional rehabilitation, together with 10 sessions of navigated repetitive transcranial magnetic stimulation or sham stimulation. Stimulation was scheduled five times a week over two consecutive weeks in an inpatient clinical setting. Patients were randomly assigned to one of four groups and received sham stimulation (n = 10), low-frequency (1-Hz) stimulation of the nonaffected hemisphere (n = 11), high-frequency (10-Hz) stimulation of the affected hemisphere (n = 13), or sequential combination of low- and high-frequency stimulations (n = 8). Participants were evaluated before and after stimulation with clinical tests, including the arm and hand section of the Fugl-Meyer Assessment Scale, modified Ashworth Scale of Muscle Spasticity, and Barthel Index of Activities of Daily Living. Participants in the three groups receiving navigated repetitive transcranial magnetic stimulation showed improvements in arm and hand functions on the Fugl-Meyer Stroke Assessment Scale. Ashworth Scale of Muscle Spasticity and Barthel Index scores were significantly reduced in groups receiving low- or high-frequency stimulation alone. Including navigated repetitive transcranial magnetic stimulation in a conventional rehabilitation program positively influenced motor and functional recovery in study participants, demonstrating the clinical potential of the method. The results of this study will be used for designing a large-scale clinical trial.

Higher dose intra-arterial milrinone and intra-arterial combined milrinone-nimodipine infusion as a rescue therapy for refractory cerebral vasospasm.

PubMed

Duman, Enes; Karakoç, Fatma; Pinar, H Ulas; Dogan, Rafi; Fırat, Ali; Yıldırım, Erkan

2017-12-01

Background Cerebral vasospasm (CV) is a major cause of delayed morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Various cerebral protectants have been tested in patients with aneurysmal SAH. We aimed to research the success rate of treatment of CV via intra-arterial milrinone injection and aggressive pharmacological therapy for refractory CV. Methods A total of 25 consecutive patients who received intra-arterial milrinone and nimodipine treatment for CV following SAH between 2014 and 2017 were included in the study. Patients who underwent surgical clipping were excluded. Refractory vasospasm was defined as patients with CV refractory to therapies requiring ≥3 endovascular interventions. Overall, six patients had refractory CV. Long-term neurological outcome was assessed 6-18 months after SAH using a modified Rankin score and Barthel index. Results The median modified Rankin scores were 1 (min: 0, max: 3) and Barthel index scores were 85 (min: 70, max: 100) From each vasospastic territory maximal 10-16 mg milrinone was given to patients; a maximum of 24 mg milrinone was given to each patient in a session and a maximum of 42 mg milrinone was given to a patient in a day. Both milrinone and nimodipine were given to three patients. There was a large vessel diameter increase after milrinone and nimodipine injections. No patient died due to CV; only one patient had motor dysfunction on the right lower extremity. Conclusion Higher doses of milrinone can be used effectively to control refractory CV. For exceptional patients with refractory CV, high dose intra-arterial nimodipine and milrinone infusion can be used as a rescue therapy.

Co-variation of tests commonly used in stroke rehabilitation.

PubMed

Langhammer, Birgitta; Stanghelle, Johan Kvalvik

2006-12-01

The aim of the present study was to analyse the co-variation of different tests commonly used in stroke rehabilitation, and specifically used in a recent randomized, controlled study of two different physiotherapy models in stroke rehabilitation. Correlations of the performed tests and recordings from previous work were studied. The test results from three-month, one-year and four-year follow-up were analysed in an SPSS Version 11 statistical package with Pearson and Spearman correlations. There was an expected high correlation between the motor function tests, both based on partial and total scores. The correlations between Nottingham Health Profile Part 1 and Motor Assessment Scale (MAS), Sødring Motor Evaluation Scale (SMES), the Berg Balance Scale (BBS) and Barthel Activities of Daily Living (ADL) index were low for all items except physical condition. The correlations between registered living conditions, assistive devices, recurrent stroke, motor function (MAS, SMES), ADL (Barthel ADL index) and balance (BBS) were high. The same variables showed weak or poor correlation to the Nottingham Health Profile (NHP). The co-variations of motor function tests and functional tests were high, but the co-variations of motor, functional and self-reported life-quality tests were poor. The patients rated themselves on a higher functional level in the self-reported tests than was observed objectively in the performance-based tests. A possible reason for this is that the patients may have been unaware they modified their performance to adjust for physical decline, and consequently overestimate their physical condition. This result underlines the importance of both performance-based and self-reported tests as complementary tools in a rehabilitation process.

Outcome of older persons admitted to intensive care unit, mortality, prognosis factors, dependency scores and ability trajectory within 1 year: a prospective cohort study.

PubMed

Level, Claude; Tellier, Eric; Dezou, Patrick; Chaoui, Karim; Kherchache, Aissa; Sejourné, Philippe; Rullion-Pac Soo, Anne Marie

2017-12-06

The outcome and functional trajectory of older persons admitted to intensive care (ICU) unit remain a true question for critical care physicians and geriatricians, due to the heterogeneity of geriatric population, heterogeneity of practices and absence of guidelines. To describe the 1-year outcome, prognosis factors and functional trajectory for older people admitted to ICU. In a prospective 1-year cohort study, all patients aged 75 years and over admitted to our ICU were included according to a global comprehensive geriatric assessment. Follow-up was conducted for 1 year survivors, in particular, ability scores and living conditions. Of 188 patients included [aged 82.3 ± 4.7 years, 46% of admissions, median SAPS II 53.5 (43-74), ADL of Katz's score 4.2 ± 1.6, median Barthel's index 71 (55-90), AGGIR scale 4.5 ± 1.5], the ICU, hospital and 1-year mortality were, respectively, 34, 42.5 and 65.5%. Prognosis factors were: SAPS 2, mechanical ventilation, comorbidity (Lee's and Mc Cabe's scores), disability scores (ADL of Katz's score, Barthel's index and AGGIR scale), admission creatinin, hypoalbuminemia, malignant haemopathy, cognitive impairment. One-year survivors lived in their own home for 83%, with a preserved physical ability, without significant variation of the three ability assessed scores compared to prior ICU admission. The mortality of older people admitted to ICU is high, with a significant impact of disabilty scores, and preserved 1-year survivor independency. Other studies, including a better comprehensive geriatric assessment, seem necessary to determine a predictive "phenotype" of survival with a "satisfactory" level of autonomy.

Is independence of older adults safe considering the risk of falls?

PubMed

Talarska, Dorota; Strugała, Magdalena; Szewczyczak, Marlena; Tobis, Sławomir; Michalak, Michał; Wróblewska, Izabela; Wieczorowska-Tobis, Katarzyna

2017-03-14

Falls affect approx. 30% of elderly population per year. They cause major injuries and reduce independence of the older adults' functioning. The main objective of the study was to evaluate the degree of independence and find the fall risk factors in the study group. The study included 506 - older adults. The study group included patients from GP clinics and members of two senior centers. The study duration was 12 months. Our study tools included EASY- Care Standard 2010 questionnaire, Abbreviated Mental Test Score (AMTS), Index Barthel, Instrumental Activities of Daily Living Scale (IADL), Geriatric Depression Scale (GDS), Timed Up and Go (TUG). The study included 357 (70.6%) female and 149 (29.4%) male subjects. The mean age of the study group patients was 75.7 years ± 8.0. Most of the older adult subjects were independent in both basic (Index Barthel) and instrumental (IADL) activities. Gait fluency evaluated in TUG scale found slow and unsteady gait in 33.7% of the subjects. 27.5% of the subjects used mobility aids when walking. In the Risk of falls scale, 131 subjects (25.89%) were at risk of falls. According to logistic regression the main risk of fall determinants (p <0.05) in the study group were: age, previous falls, feet problems, lack of regular care, impaired vision, urinary incontinence, pain, sleeping disorders, and lowered mood. Risk of falls increases in people less independent in terms of basic and complex life activities and in people with depression. Most of the risk factors can be modified. It is necessary to develop a standard procedure aimed at preventing falls in the elderly.

Quality of life in people with Parkinson's disease: the relevance of social relationships and communication.

PubMed

Takahashi, Kayoko; Kamide, Naoto; Suzuki, Makoto; Fukuda, Michinari

2016-01-01

[Purpose] Maintaining high quality of life is crucial for the rehabilitation of patients with Parkinson's disease. The quality of life scales currently in use do not assess all quality of life domains or their importance for each individual. Therefore, a new quality of life measure, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, was used to investigate quality of life in people with Parkinson's disease. [Subjects and Methods] Fifteen people with idiopathic Parkinson's disaese (average age = 80.0 years, standard deviation = 10.3 years, Hoehn & Yahr stages 1-4) were interviewed using the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting. Its quality of life constructs were tested by comparing them against disease-specific quality of life (39-items Parkinson's Disease Questionnaire), motor functioning (Unified Parkinson's Disease Rating Scale Part III), and activities of daily living (Barthel Index). [Results] Social connections such as "family" and "friends" were revealed as important constructs of life satisfaction. The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting was not significantly correlated with the 39-items Parkinson's Disease Questionnaire, Unified Parkinson's Disease Rating Scale Part III, or Barthel Index but was significantly correlated with the "communication" dimension of the 39-items Parkinson's Disease Questionnaire. [Conclusion] The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting detected various domains of quality of life, especially social relationships with family and friends. "Being heard" was also revealed as an essential component of life satisfaction, as it provides patients with a feeling of acceptance and assurance, possibly resulting in better quality of life.

[Predictive factors of functional decline at hospital discharge in elderly patients hospitalised due to acute illness].

PubMed

Condorhuamán-Alvarado, Patricia Ysabel; Menéndez-Colino, Rocío; Mauleón-Ladrero, Coro; Díez-Sebastián, Jesús; Alarcón, Teresa; González-Montalvo, Juan Ignacio

To compare baseline characteristics and those found during hospitalisation as predictors of functional decline at discharge (FDd) in elderly patients hospitalised due to acute illness. A review was made of the computerized records of patients admitted to a Geriatric Acute Unit of a tertiary hospital over a 10 year period. A record was made of demographic, clinical, functional and health-care variables. Functional decline at discharge (FDd) was defined by the difference between the previous Barthel Index (pBI) and the discharge Barthel Index (dBI). The percentage of FDd (%FDd=(pBI-dBI/pBI)×100) was calculated. The variables associated with greater %FDd in the bivariate analysis were included in multivariate logistic regression models. The predictive capacity of each model was assessed using the area under the ROC curve. The factors associated with greater %FDd were advanced age, female gender, to live in a nursing home, cognitive impairment, better baseline functional status and worse functional status at admission, number of diagnoses, and prolonged stay. The area under the ROC curve for the predictive models of %FDd was 0.638 (95% CI: 0.615-0.662) based on the previous situation, 0.756 (95% CI: 0.736-0.776) based on the situation during admission, and 0.952 (95% CI: 0.944-0.959) based on a combination of these factors. The overall assessment of patient characteristics, both during admission and baseline, may have greater value in prediction of FDd than analysis of factors separately in elderly patients hospitalised due to acute illness. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: a systematic review and meta-analysis.

PubMed

Peng, Le; Zhang, Chao; Zhou, Lan; Zuo, Hong-Xia; He, Xiao-Kuo; Niu, Yu-Ming

2018-04-01

To investigate the effectiveness of traditional manual acupuncture combined with rehabilitation therapy versus rehabilitation therapy alone for shoulder hand syndrome after stroke. PubMed, EMBASE, the Cochrane Library, Chinese Biomedicine Database, China National Knowledge Infrastructure, VIP Information Database, Wan Fang Database and reference lists of the eligible studies were searched up to July 2017 for relevant studies. Randomized controlled trials that compared the combined effects of traditional manual acupuncture and rehabilitation therapy to rehabilitation therapy alone for shoulder hand syndrome after stroke were included. Two reviewers independently screened the searched records, extracted the data and assessed risk of bias of the included studies. The treatment effect sizes were pooled in a meta-analysis using RevMan 5.3 software. A total of 20 studies involving 1918 participants were included in this study. Compared to rehabilitation therapy alone, the combined therapy significantly reduced pain on the visual analogue scale and improved limb movement on the Fugl-Meyer Assessment scale and the performance of activities of daily living (ADL) on the Barthel Index scale or Modified Barthel Index scale. Of these, the visual analogue scale score changes were significantly higher (mean difference = 1.49, 95% confidence interval = 1.15-1.82, P < 0.00001) favoring the combined therapy after treatment, with severe heterogeneity ( I 2  = 71%, P = 0.0005). Current evidence suggests that traditional manual acupuncture integrated with rehabilitation therapy is more effective in alleviating pain, improving limb movement and ADL. However, considering the relatively low quality of available evidence, further rigorously designed and large-scale randomized controlled trials are needed to confirm the results.

The effects of Lactobacillus reuteri probiotics combined with azithromycin on peri-implantitis: A randomized placebo-controlled study.

PubMed

Tada, Hiroaki; Masaki, Chihiro; Tsuka, Shintaro; Mukaibo, Taro; Kondo, Yusuke; Hosokawa, Ryuji

2018-01-01

The aim of this randomized placebo-controlled clinical study was to investigate the effects of a probiotic tablet containing Lactobacillus reuteri in peri-implantitis patients. Subjects comprised 30 patients with mild to moderate peri-implantitis. A baseline clinical examination and microbiological assessment were conducted, followed by an antibiotics treatment (azithromycin, 500mg, once a day for 3 days). Subjects were divided into probiotic and placebo groups. The clinical examination and bacterial sampling were performed 0, 4, 12 and 24 weeks after the intake of probiotics. The clinical examination included probing pocket depth (PPD), bleeding on probing (BOP), the modified plaque index (mPI), and modified bleeding index (mBI). The number of bacteria was assessed using the PCR-invader method. The Wilcoxon rank-sum test and Wilcoxon signed-rank test with Bonferroni corrections were used for data analyses. Although the number of bacteria decreased after the administration of azithromycin in both groups, they increased again thereafter. No significant difference was observed in bacterial numbers between the two groups. Although PPD in the probiotics group was significantly lower at 4 and 24 weeks than at 0 weeks (p<0.05), a significant decrease did not occur in the placebo group. The mBI score at 24 weeks was significantly lower in the probiotics group than in the placebo group (p<0.05). No significant difference was observed in BOP or mPI between the two groups. These results suggested that probiotics prevent inflammation by affecting host responses rather than improving microbial flora in peri-implant sulci in peri-implantitis patients. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

A Randomised Controlled Trial of a Brief Online Mindfulness-Based Intervention on Paranoia in a Non-Clinical Sample.

PubMed

Shore, Robert; Strauss, Clara; Cavanagh, Kate; Hayward, Mark; Ellett, Lyn

2018-01-01

Paranoia is common and distressing in the general population and can impact on health, emotional well-being and social functioning, such that effective interventions are needed. Brief online mindfulness-based interventions (MBIs) have been shown to reduce symptoms of anxiety and depression in non-clinical samples; however, at present, there is no research investigating whether they can reduce paranoia. The current study explored whether a brief online MBI increased levels of mindfulness and reduced levels of paranoia in a non-clinical population. The mediating effect of mindfulness on any changes in paranoia was also investigated. One hundred and ten participants were randomly allocated to either a 2-week online MBI including 10 min of daily guided mindfulness practice or to a waitlist control condition. Measures of mindfulness and paranoia were administered at baseline, post-intervention and 1-week follow-up. Participants in the MBI group displayed significantly greater reductions in paranoia compared to the waitlist control group. Mediation analysis demonstrated that change in mindfulness skills (specifically the observe, describe and non-react facets of the FFMQ) mediated the relationship between intervention type and change in levels of paranoia. This study provides evidence that a brief online MBI can significantly reduce levels of paranoia in a non-clinical population. Furthermore, increases in mindfulness skills from this brief online MBI can mediate reductions in non-clinical paranoia. The limitations of the study are discussed.

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

PubMed Central

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

2015-01-01

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

PR-Index: Using the h-Index and PageRank for Determining True Impact.

PubMed

Gao, Chao; Wang, Zhen; Li, Xianghua; Zhang, Zili; Zeng, Wei

2016-01-01

Several technical indicators have been proposed to assess the impact of authors and institutions. Here, we combine the h-index and the PageRank algorithm to do away with some of the individual limitations of these two indices. Most importantly, we aim to take into account value differences between citations-evaluating the citation sources by defining the h-index using the PageRank score rather than with citations. The resulting PR-index is then constructed by evaluating source popularity as well as the source publication authority. Extensive tests on available collections data (i.e., Microsoft Academic Search and benchmarks on the SIGKDD innovation award) show that the PR-index provides a more balanced impact measure than many existing indices. Due to its simplicity and similarity to the popular h-index, the PR-index may thus become a welcome addition to the technical indices already in use. Moreover, growth dynamics prior to the SIGKDD innovation award indicate that the PR-index might have notable predictive power.

PR-Index: Using the h-Index and PageRank for Determining True Impact

PubMed Central

Gao, Chao; Wang, Zhen; Li, Xianghua; Zhang, Zili; Zeng, Wei

2016-01-01

Several technical indicators have been proposed to assess the impact of authors and institutions. Here, we combine the h-index and the PageRank algorithm to do away with some of the individual limitations of these two indices. Most importantly, we aim to take into account value differences between citations-evaluating the citation sources by defining the h-index using the PageRank score rather than with citations. The resulting PR-index is then constructed by evaluating source popularity as well as the source publication authority. Extensive tests on available collections data (i.e., Microsoft Academic Search and benchmarks on the SIGKDD innovation award) show that the PR-index provides a more balanced impact measure than many existing indices. Due to its simplicity and similarity to the popular h-index, the PR-index may thus become a welcome addition to the technical indices already in use. Moreover, growth dynamics prior to the SIGKDD innovation award indicate that the PR-index might have notable predictive power. PMID:27627767

Heel-ball (HB) index: sexual dimorphism of a new index from foot dimensions.

PubMed

Krishan, Kewal; Kanchan, Tanuj; Passi, Neelam; DiMaggio, John A

2012-01-01

The present research is aimed to introduce Heel-ball (HB) index from foot dimensions and determine whether this index exhibits sexual dimorphism. The study was conducted on a sample of 303 North Indian individuals (154 men, and 149 women) aged between 13 and 18 years. The stature, body weight, foot breadth at the ball (BBAL), and foot breadth at heel (BHEL) were measured. The HB index was derived by the formula BHEL × 100/BBAL. Although the mean HB index was larger in women in both feet it showed statistically significant sex differences in the right foot only. The study shows that while the foot dimensions show a positive correlation with stature and weight, the HB index is independent of the stature and weight of an individual. This novel index (HB index) may be utilized in sex determination when a part of the foot is brought for medico-legal investigation. © 2011 American Academy of Forensic Sciences.

Reflective random indexing for semi-automatic indexing of the biomedical literature.

PubMed

Vasuki, Vidya; Cohen, Trevor

2010-10-01

The rapid growth of biomedical literature is evident in the increasing size of the MEDLINE research database. Medical Subject Headings (MeSH), a controlled set of keywords, are used to index all the citations contained in the database to facilitate search and retrieval. This volume of citations calls for efficient tools to assist indexers at the US National Library of Medicine (NLM). Currently, the Medical Text Indexer (MTI) system provides assistance by recommending MeSH terms based on the title and abstract of an article using a combination of distributional and vocabulary-based methods. In this paper, we evaluate a novel approach toward indexer assistance by using nearest neighbor classification in combination with Reflective Random Indexing (RRI), a scalable alternative to the established methods of distributional semantics. On a test set provided by the NLM, our approach significantly outperforms the MTI system, suggesting that the RRI approach would make a useful addition to the current methodologies.

Indexes of severity: conceptual development.

PubMed Central

Krischer, J P

1979-01-01

A discussion of severity index development is presented in relation to conceptual issues in index definition, analytic issues in index formulation and validation issues in index application. The CHOP index is discussed along with six severity indexes described in an earlier paper dealing with underlying concepts to illustrate the material presented. Replies are provided to specific questions raised in an accompanying paper discussing the Injury Severity Score. This conceptual material is presented to provide a foundation for severity index development, to suggest criteria to be used in their formulation and testing, and to identify analyses that can lead to the successful selection and application of an index for a defined purpose. PMID:468553

A novel structural risk index for primary spontaneous pneumothorax: Ankara Numune Risk Index.

PubMed

Akkas, Yucel; Peri, Neslihan Gulay; Kocer, Bulent; Kaplan, Tevfik; Alhan, Aslihan

2017-07-01

In this study, we aimed to reveal a novel risk index as a structural risk marker for primary spontanoeus pneumothorax using body mass index and chest height, structural risk factors for pneumothorax development. Records of 86 cases admitted between February 2014 and January 2015 with or without primary spontaneous pneumothorax were analysed retrospectively. The patients were allocated to two groups as Group I and Group II. The patients were evaluated with regard to age, gender, pneumothorax side, duration of hospital stay, treatment type, recurrence, chest height and transverse diameter on posteroanterior chest graphy and body mass index. Body mass index ratio per cm of chest height was calculated by dividing body mass index with chest height. We named this risk index ratio which is defined first as 'Ankara Numune Risk Index'. Diagnostic value of Ankara Numune Risk Index value for prediction of primary spontaneous pneumothorax development was analysed with Receiver Operating Characteristics curver. Of 86 patients, 69 (80.2%) were male and 17 (19.8%) were female. Each group was composed of 43 (50%) patients. When Receiver Operating Characteristics curve analysis was done for optimal limit value 0.74 of Ankara Numune Risk Index determined for prediction of pneumothorax development risk, area under the curve was 0.925 (95% Cl, 0.872-0.977, p < 0.001). Ankara Numune Risk Index is one of the structural risk factors for prediction of primary spontaneous pneumothorax development however it is insufficient for determining recurrence. Copyright © 2015. Published by Elsevier Taiwan.

Kirchhoff Index of Cyclopolyacenes

NASA Astrophysics Data System (ADS)

Wang, Yan; Zhang, Wenwen

2010-10-01

The resistance distance between two vertices of a connected graph G is computed as the effective resistance between them in the corresponding network constructed from G by replacing each edge with a unit resistor. The Kirchhoff index of G is the sum of resistance distances between all pairs of vertices. In this paper, following the method of Y. J. Yang and H. P. Zhang in the proof of the Kirchhoff index of the linear hexagonal chain, we obtain the Kirchhoff index of cyclopolyacenes, denoted by HRn, in terms of its Laplacian spectrum. We show that the Kirchhoff index of HRnis approximately one third of its Wiener index.

The NLM Indexing Initiative.

PubMed Central

Aronson, A. R.; Bodenreider, O.; Chang, H. F.; Humphrey, S. M.; Mork, J. G.; Nelson, S. J.; Rindflesch, T. C.; Wilbur, W. J.

2000-01-01

The objective of NLM's Indexing Initiative (IND) is to investigate methods whereby automated indexing methods partially or completely substitute for current indexing practices. The project will be considered a success if methods can be designed and implemented that result in retrieval performance that is equal to or better than the retrieval performance of systems based principally on humanly assigned index terms. We describe the current state of the project and discuss our plans for the future. PMID:11079836

New Concepts in Indexing *

PubMed Central

Shank, Russell

1965-01-01

Recent trends in indexing emphasize mechanical, not intellectual, developments. Mechanized operations have produced indexes in depth (1) of information on limited areas of science or (2) utilizing limited parameters for analysis. These indexes may include only citations or both useful data and citations of source literature. Both keyword-in-context and citation indexing seem to be passing the test of the marketplace. Mechanical equipment has also been successfully used to manipulate EAM cards for production of index copy. Information centers are increasingly being used as control devices in narrowly defined subject areas. Authors meet growing pressures to participate in information control work by preparing abstracts of their own articles. Mechanized image systems persist, although large systems are scarce and the many small systems may bring only limited relief for information control and retrieval problems. Experimentation and limited development continue on theory and technique of automatic indexing and abstracting. PMID:14306025

Body mass index

MedlinePlus

... page: //medlineplus.gov/ency/article/007196.htm Body mass index To use the sharing features on this ... your height is to figure out your body mass index (BMI). You and your health care provider ...

INDEXABILITY AND OPTIMAL INDEX POLICIES FOR A CLASS OF REINITIALISING RESTLESS BANDITS.

PubMed

Villar, Sofía S

2016-01-01

Motivated by a class of Partially Observable Markov Decision Processes with application in surveillance systems in which a set of imperfectly observed state processes is to be inferred from a subset of available observations through a Bayesian approach, we formulate and analyze a special family of multi-armed restless bandit problems. We consider the problem of finding an optimal policy for observing the processes that maximizes the total expected net rewards over an infinite time horizon subject to the resource availability. From the Lagrangian relaxation of the original problem, an index policy can be derived, as long as the existence of the Whittle index is ensured. We demonstrate that such a class of reinitializing bandits in which the projects' state deteriorates while active and resets to its initial state when passive until its completion possesses the structural property of indexability and we further show how to compute the index in closed form. In general, the Whittle index rule for restless bandit problems does not achieve optimality. However, we show that the proposed Whittle index rule is optimal for the problem under study in the case of stochastically heterogenous arms under the expected total criterion, and it is further recovered by a simple tractable rule referred to as the 1-limited Round Robin rule. Moreover, we illustrate the significant suboptimality of other widely used heuristic: the Myopic index rule, by computing in closed form its suboptimality gap. We present numerical studies which illustrate for the more general instances the performance advantages of the Whittle index rule over other simple heuristics.

INDEXABILITY AND OPTIMAL INDEX POLICIES FOR A CLASS OF REINITIALISING RESTLESS BANDITS

PubMed Central

Villar, Sofía S.

2016-01-01

Motivated by a class of Partially Observable Markov Decision Processes with application in surveillance systems in which a set of imperfectly observed state processes is to be inferred from a subset of available observations through a Bayesian approach, we formulate and analyze a special family of multi-armed restless bandit problems. We consider the problem of finding an optimal policy for observing the processes that maximizes the total expected net rewards over an infinite time horizon subject to the resource availability. From the Lagrangian relaxation of the original problem, an index policy can be derived, as long as the existence of the Whittle index is ensured. We demonstrate that such a class of reinitializing bandits in which the projects’ state deteriorates while active and resets to its initial state when passive until its completion possesses the structural property of indexability and we further show how to compute the index in closed form. In general, the Whittle index rule for restless bandit problems does not achieve optimality. However, we show that the proposed Whittle index rule is optimal for the problem under study in the case of stochastically heterogenous arms under the expected total criterion, and it is further recovered by a simple tractable rule referred to as the 1-limited Round Robin rule. Moreover, we illustrate the significant suboptimality of other widely used heuristic: the Myopic index rule, by computing in closed form its suboptimality gap. We present numerical studies which illustrate for the more general instances the performance advantages of the Whittle index rule over other simple heuristics. PMID:27212781

Confirmatory Factor Analysis of Burnout Dimensions: Correlations with Job Stressors and Aspects of Social Support and Job Satisfaction

DTIC Science & Technology

1992-02-01

1986) revision of the Maslach and Jackson (1981) Maslach Burnout Inventory (MBI). Results of confirmatory factor analyses conducted on data... Maslach organizational issues: depersonalization was and Jackson (1981) Maslach Burnout Inventory related to decision-making policies, personal (MBI). The...manage- (1989). The dimensionality of a modified ment interventions to respond to different mani- form of the Maslach Burnout Inventory for festations

A Theoretical Framework for Turnover Intention of Air Force Enlisted Information Systems Personnel

DTIC Science & Technology

2003-03-25

Maslach Burnout Inventory -Human Services Survey (MBI-HSS) ( Maslach et al., 2001) and widely confirmed as psychometrically sound (e.g...et al.’s (1996) modified scale to measure job burnout in production-oriented industries, the Maslach Burnout Inventory -General Survey (MBI-GS...Schutte, Nico, Salla Toppinen, Raija Kalimo, and Wilmar Schaufeli. “The Factorial Validity of the Maslach Burnout Inventory -General Survey

New generic indexing technology

NASA Technical Reports Server (NTRS)

Freeston, Michael

1996-01-01

There has been no fundamental change in the dynamic indexing methods supporting database systems since the invention of the B-tree twenty-five years ago. And yet the whole classical approach to dynamic database indexing has long since become inappropriate and increasingly inadequate. We are moving rapidly from the conventional one-dimensional world of fixed-structure text and numbers to a multi-dimensional world of variable structures, objects and images, in space and time. But, even before leaving the confines of conventional database indexing, the situation is highly unsatisfactory. In fact, our research has led us to question the basic assumptions of conventional database indexing. We have spent the past ten years studying the properties of multi-dimensional indexing methods, and in this paper we draw the strands of a number of developments together - some quite old, some very new, to show how we now have the basis for a new generic indexing technology for the next generation of database systems.

17 CFR 41.14 - Transition period for indexes that cease being narrow-based security indexes.

Code of Federal Regulations, 2014 CFR

2014-04-01

... day tolerance provision. An index that is a narrow-based security index that becomes a broad-based... than forty-five days. An index that is a narrow-based security index that becomes a broad-based...

Semi automatic indexing of PostScript files using Medical Text Indexer in medical education.

PubMed

Mollah, Shamim Ara; Cimino, Christopher

2007-10-11

At Albert Einstein College of Medicine a large part of online lecture materials contain PostScript files. As the collection grows it becomes essential to create a digital library to have easy access to relevant sections of the lecture material that is full-text indexed; to create this index it is necessary to extract all the text from the document files that constitute the originals of the lectures. In this study we present a semi automatic indexing method using robust technique for extracting text from PostScript files and National Library of Medicine's Medical Text Indexer (MTI) program for indexing the text. This model can be applied to other medical schools for indexing purposes.

Long-Term Survival After Intravenous Thrombolysis for Ischemic Stroke: A Propensity Score-Matched Cohort With up to 10-Year Follow-Up.

PubMed

Muruet, Walter; Rudd, Anthony; Wolfe, Charles D A; Douiri, Abdel

2018-03-01

Intravenous thrombolysis with alteplase is one of the few approved treatments for acute ischemic stroke; nevertheless, little is known about its long-term effects on survival and recovery because clinical trials follow-up times are limited. Patients registered between January 2005 and December 2015, to the population-based South London Stroke Register of first-ever strokes. Propensity score was used to match thrombolyzed and control cases to a 1:2 ratio by demographical and clinical covariates. The primary outcome was survival up to 10 years using Kaplan-Meier estimates, Cox proportional hazards, and restricted mean survival time. Secondary outcomes included stroke recurrence and functional status (Barthel Index and Frenchay Activities Index scores) at 5 years. From 2052 ischemic strokes, 246 treated patients were matched to 492 controls. Median follow-up time 5.45 years (interquartile range, 4.56). Survival was higher in the treatment group (median, 5.72 years) compared with control group (4.98 years, stratified log-rank test <0.001). The number needed to treat to prevent 1 death at 5 years was 12 and 20 at 10 years. After Cox regression analysis, thrombolysis reduced risk of mortality by 37% (hazard ratio, 0.63; 95% confidence interval [CI], 0.48-0.82) at 10 years; however, after introducing a multiplicative interaction term into the model, mortality risk reduction was 42% (hazard ratio, 0.58; 95% CI, 0.40-0.82) at 10 years for those arriving within 3 hours to the hospital. On average, in a 10-year period, treated patients lived 1 year longer than controls. At 5 years, thrombolysis was associated with independence (Barthel Index≥90; odds ratio, 3.76; 95% CI, 1.22-13.34) and increased odds of a higher Frenchay Activities Index (proportional odds ratio, 2.37; 95% CI, 1.16-4.91). There was no difference in stroke recurrence. Thrombolysis with intravenous alteplase is associated with improved long-term survival and functional status after ischemic stroke. © 2018

Optofluidic refractive-index sensor in step-index fiber with parallel hollow micro-channel.

PubMed

Lee, H W; Schmidt, M A; Uebel, P; Tyagi, H; Joly, N Y; Scharrer, M; Russell, P St J

2011-04-25

We present a simple refractive index sensor based on a step-index fiber with a hollow micro-channel running parallel to its core. This channel becomes waveguiding when filled with a liquid of index greater than silica, causing sharp dips to appear in the transmission spectrum at wavelengths where the glass-core mode phase-matches to a mode of the liquid-core. The sensitivity of the dip-wavelengths to changes in liquid refractive index is quantified and the results used to study the dynamic flow characteristics of fluids in narrow channels. Potential applications of this fiber microstructure include measuring the optical properties of liquids, refractive index sensing, biophotonics and studies of fluid dynamics on the nanoscale.

Malaysian Education Index (MEI): An Online Indexing and Repository System

ERIC Educational Resources Information Center

Kabilan, Muhammad Kamarul; Ismail, Hairul Nizam; Yaakub, Rohizani; Yusof, Najeemah Mohd; Idros, Sharifah Noraidah Syed; Umar, Irfan Naufal; Arshad, Muhammad Rafie Mohd.; Idrus, Rosnah; Rahman, Habsah Abdul

2010-01-01

This "Project Sheet" describes an on-going project that is being carried out by a group of educational researchers, computer science researchers and librarians from Universiti Sains Malaysia, Penang. The Malaysian Education Index (MEI) has two main functions--(1) Online Indexing System, and (2) Online Repository System. In this brief…

An Absolute Index (Ab-index) to Measure a Researcher’s Useful Contributions and Productivity

PubMed Central

Biswal, Akshaya Kumar

2013-01-01

Bibliographic analysis has been a very powerful tool in evaluating the effective contributions of a researcher and determining his/her future research potential. The lack of an absolute quantification of the author’s scientific contributions by the existing measurement system hampers the decision-making process. In this paper, a new metric system, Absolute index (Ab-index), has been proposed that allows a more objective comparison of the contributions of a researcher. The Ab-index takes into account the impact of research findings while keeping in mind the physical and intellectual contributions of the author(s) in accomplishing the task. The Ab-index and h-index were calculated for 10 highly cited geneticists and molecular biologist and 10 young researchers of biological sciences and compared for their relationship to the researchers input as a primary author. This is the first report of a measuring method clarifying the contributions of the first author, corresponding author, and other co-authors and the sharing of credit in a logical ratio. A java application has been developed for the easy calculation of the Ab-index. It can be used as a yardstick for comparing the credibility of different scientists competing for the same resources while the Productivity index (Pr-index), which is the rate of change in the Ab-index per year, can be used for comparing scientists of different age groups. The Ab-index has clear advantage over other popular metric systems in comparing scientific credibility of young scientists. The sum of the Ab-indices earned by individual researchers of an institute per year can be referred to as Pr-index of the institute. PMID:24391941

Journal article overlap among Index Medicus, Science Citation Index, Biological Abstracts, and Chemical Abstracts.

PubMed Central

Poyer, R K

1984-01-01

Journal article overlap is defined as the same journal article being indexed by two or more services. Using journal references from seventy dissertations written in the preclinical sciences, the extent of journal article overlap among Index Medicus, Science Citation Index, Biological Abstracts, and Chemical Abstracts was examined. Of the 7,969 journal references cited, 92% were indexed by at least two of these services; 591 articles were covered by only one of the services, and 55 articles were not indexed. A discussion of the advantages and costs of journal article overlap is presented. PMID:6388693

Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach?

PubMed

Morreale, Manuela; Marchione, Pasquale; Pili, Antonio; Lauta, Antonella; Castiglia, Stefano F; Spallone, Aldo; Pierelli, Francesco; Giacomini, Patrizia

2016-02-01

Early/intensive mobilization may improve functional recovery after stroke but it is not clear which kind of "mobilization" is more effective. Proprioceptive neuromuscular facilitation (PNF) and cognitive therapeutic exercise (CTE) are widespread applied in post-stroke rehabilitation but their efficacy and safety have not been systematically investigated. To compare PNF and CTE methods in a two different time setting (early versus standard approach) in order to evaluate different role of time and techniques in functional recovery after acute ischemic stroke. We designed a prospectical multicenter blinded interventional study of early versus standard approach with two different methods by means of both PNF and CTE. A discrete stroke-dedicated area for out-of-thrombolysis patients, connected with two different comprehensive stroke centres in two different catchment areas. Three hundred and forty consecutive stroke patient with first ever sub-cortical ischemic stroke in the mean cerebral artery (MCA) territory and contralateral hemiplegia admitted within 6 and 24 hours from symptoms onset. All patients were randomly assigned by means of a computer generated randomization sequence in blocks of 4 to one to the 4 interventional groups: early versus delayed rehabilitation programs with Kabat's schemes or Perfetti's technique. Patients in both delayed group underwent to a standard protocol in the acute phase. disability at 3-12 months. Disability measures: modified Rankin Score and Barthel Index. Safety outcome: immobility-related adverse events. Six-Minute Walking Test, Motricity Index, Mini-Mental State Examination, Beck Depression Inventory. Disability was not different between groups at 3 months but Barthel Index significantly changed between early versus delayed groups at 12 months (P=0.01). Six-Minute Walking Test (P=0.01) and Motricity Index in both upper (P=0.01) and lower limbs (P=0.001) increased in early versus delayed groups regardless rehabilitation schedule. A

Burnout among physical therapist assistant program directors: a nationwide survey and analysis.

PubMed

Berry, Justin W; Hosford, Charles C

2014-01-01

The purpose of this study was to assess burnout in directors of physical therapist assistant (PTA) programs and to analyze the relationship between individual and institutional variables and burnout. Surveys were completed by 120 directors from accredited PTA programs. The surveys consisted of demographic information and the Maslach Burnout Inventory-Educators Survey (MBI-ES). The MBI-ES assesses burnout in the areas of emotional exhaustion, depersonalization, and personal accomplishment. PTA program directors showed moderate levels of emotional exhaustion, low levels of depersonalization, and high levels of personal accomplishment. Gender, the number of faculty in a department, and length of academic contract had no correlation with participant burnout levels. Significantly lower levels of emotional exhaustion were found in participants who were in their current position for more than 11 years and those who planned to remain in their current position or within higher education for at least 5 additional years. A significant negative correlation was found between participant age and depersonalization. PTA program directors and their institutions should develop strategies to minimize the effects of burnout in younger program directors and those in the early years of their position.

Cytochrome p450 turnover: regulation of synthesis and degradation, methods for determining rates, and implications for the prediction of drug interactions.

PubMed

Yang, Jiansong; Liao, Mingxiang; Shou, Magang; Jamei, Masoud; Yeo, Karen Rowland; Tucker, Geoffrey T; Rostami-Hodjegan, Amin

2008-06-01

In vivo enzyme levels are governed by the rates of de novo enzyme synthesis and degradation. A current lack of consensus on values of the in vivo turnover half-lives of human cytochrome P450 (CYP) enzymes places a significant limitation on the accurate prediction of changes in drug concentration-time profiles associated with interactions involving enzyme induction and mechanism (time)-based inhibition (MBI). In the case of MBI, the full extent of inhibition is also sensitive to values of enzyme turnover half-life. We review current understanding of CYP regulation, discuss the pros and cons of various in vitro and in vivo approaches used to estimate the turnover of specific CYPs and, by simulation, consider the impact of variability in estimates of CYP turnover on the prediction of enzyme induction and MBI in vivo. In the absence of consensus on values for the in vivo turnover half-lives of key CYPs, a sensitivity analysis of predictions of the pharmacokinetic effects of enzyme induction and MBI to these values should be an integral part of the modelling exercise, and the selective use of values should be avoided.

Predicting pavement condition index using international roughness index in Washington DC.

DOT National Transportation Integrated Search

2014-09-01

A number of pavement condition indices are used to conduct pavement management assessments, two of which are the : International Roughness Index (IRI) and Pavement Condition Index (PCI). The IRI is typically measured using specialized : equipment tha...

Quality indexing with computer-aided lexicography

NASA Technical Reports Server (NTRS)

Buchan, Ronald L.

1992-01-01

Indexing with computers is a far cry from indexing with the first indexing tool, the manual card sorter. With the aid of computer-aided lexicography, both indexing and indexing tools can provide standardization, consistency, and accuracy, resulting in greater quality control than ever before. A brief survey of computer activity in indexing is presented with detailed illustrations from NASA activity. Applications from techniques mentioned, such as Retrospective Indexing (RI), can be made to many indexing systems. In addition to improving the quality of indexing with computers, the improved efficiency with which certain tasks can be done is demonstrated.

Refractive index sensor based on a polymer fiber directional coupler for low index sensing.

PubMed

Lee, Kwang Jo; Liu, Xiaoqi; Vuillemin, Nelly; Lwin, Richard; Leon-Saval, Sergio G; Argyros, Alexander; Kuhlmey, Boris T

2014-07-14

We propose, numerically analyze and experimentally demonstrate a novel refractive index sensor specialized for low index sensing. The device is based on a directional coupler architecture implemented in a single microstructured polymer optical fiber incorporating two waveguides within it: a single-mode core and a satellite waveguide consisting of a hollow high-index ring. This hollow channel is filled with fluid and the refractive index of the fluid is detected through changes to the wavelength at which resonant coupling occurs between the two waveguides. The sensor design was optimized for both higher sensitivity and lower detection limit, with simulations and experiments demonstrating a sensitivity exceeding 1.4 × 10(3) nm per refractive index unit. Simulations indicate a detection limit of ~2 × 10(-6) refractive index units is achievable. We also numerically investigate the performance for refractive index changes localized at the surface of the holes, a case of particular importance for biosensing.

Indexing Theory and Retrieval Effectiveness.

ERIC Educational Resources Information Center

Robertson, Stephen E.

1978-01-01

Describes recent attempts to make explicit connections between the indexing process and the use of the index or information retrieval system, particularly the utility-theoretic and automatic indexing models of William Cooper and Stephen Harter. Theory and performance, information storage and retrieval, search stage feedback, and indexing are also…

Site index comparisons among hardwoods

Treesearch

Richard M. Godman

1992-01-01

Site index is one of the more easily measured indicators of the productive capacity of an area for a given species. In mixed stands, the site index of one species can be used to predict the site index of another. Site index also illustrates growth differences among species.

An index for evaluating difficulty of Chewing Index for chewable tablets.

PubMed

Gupta, Abhay; Chidambaram, Nallaperumal; Khan, Mansoor A

2015-02-01

Chewing difficulty index, a potential measure of difficulty in chewing the chewable tablets, has been described herein as the product of tablet thickness and tablet hardness measured under the diametral loading. The proposed index was evaluated by measuring the dimensions and mechanical strength of commercial and in-house prepared chewable tablets. Data collected on tablets with different thickness but same hardness or tensile strength suggests that the proposed index provides a good assessment of the force needed to chew the chewable tablets. Influence of brief exposure to salivary fluid during chewing on the mechanical strength of the chewable tablets was also evaluated. Thirty seconds exposure to the simulated salivary fluid was also found to significantly reduce (p < 0.05) the hardness and the chewing difficulty index of a number of evaluated chewable tablet drug products.

[Measurement of the evaluative capacity of the CVP-35 questionnaire for perceiving the quality of professional life].

PubMed

Martín Fernández, Jesús; Gómez Gascón, Tomás; Martínez García-Olalla, Carlos; del Cura González, María Isabel; Cabezas Peña, María Carmen; García Sánchez, Salvador

2008-07-01

To establish the CVP-35 evaluative properties to measure the professional quality of life (PQL). Prospective, observational study. A primary care area in the Community of Madrid, Spain. A total of 149 sanitary workers with some burnout sign measured by Maslach Burnout Inventory (MBI) participated. They fulfilled MBI, Goldberg Health Questionnaire (GHQ-28), and CVP-35 questionnaires at the beginning and after a year of follow-up, in which 73 subjects took part in activities for coping stress. It was assessed the change of PQL and their domains managerial support (PQL-MS), work load (PQL-WL), intrinsic motivation (PQL-IM) for the subjects with variations at the MBI, or GHQ-28 punctuation greater than 0.5 SD of the initial distribution. Variations in CVP-35 and their domains correlate weakly with changes in MBI and GHQ-28 (r<0.500), but they are congruent with the conceptual model. In the individuals with significant variations in the GHQ-28, they appreciate an average change in PQL and their domains between 0.18 and 0.55 points (absolute value). In those with significant variations in the MBI domains, PQL presented average absolute variations between 0.23 and 0.45 points, PQL-MS between 0.30 and 0.67, PQL-WL between 0.01 and 0.55 and PQL-IM between 0.22 and 0.83 points. CVP-35 is a sensitive-to-change instrument under population point of view. Changes in PQL perception or in any of their domains of 0.5 points could be pointed as relevant.

The Management Standards Indicator Tool and evaluation of burnout.

PubMed

Ravalier, J M; McVicar, A; Munn-Giddings, C

2013-03-01

Psychosocial hazards in the workplace can impact upon employee health. The UK Health and Safety Executive's (HSE) Management Standards Indicator Tool (MSIT) appears to have utility in relation to health impacts but we were unable to find studies relating it to burnout. To explore the utility of the MSIT in evaluating risk of burnout assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). This was a cross-sectional survey of 128 borough council employees. MSIT data were analysed according to MSIT and MBI-GS threshold scores and by using multivariate linear regression with MBI-GS factors as dependent variables. MSIT factor scores were gradated according to categories of risk of burnout according to published MBI-GS thresholds, and identified priority workplace concerns as demands, relationships, role and change. These factors also featured as significant independent variables, with control, in outcomes of the regression analysis. Exhaustion was associated with demands and control (adjusted R (2) = 0.331); cynicism was associated with change, role and demands (adjusted R (2) =0.429); and professional efficacy was associated with managerial support, role, control and demands (adjusted R (2) = 0.413). MSIT analysis generally has congruence with MBI-GS assessment of burnout. The identification of control within regression models but not as a priority concern in the MSIT analysis could suggest an issue of the setting of the MSIT thresholds for this factor, but verification requires a much larger study. Incorporation of relationship, role and change into the MSIT, missing from other conventional tools, appeared to add to its validity.

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation \\1\\

Code of Federal Regulations, 2010 CFR

1998-10-01

... 45 Public Welfare 1 1998-10-01 1998-10-01 false Subject Index to Title IX Preamble and Regulation \\1\\ Index Subject Index to Title IX Preamble and Regulation \\1\\ GENERAL ADMINISTRATION... FINANCIAL ASSISTANCE Procedures [Interim] Interim procedures. Pt. 86, Index Subject Index to Title IX...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation \\1\\

Code of Federal Regulations, 2010 CFR

1997-10-01

... 45 Public Welfare 1 1997-10-01 1997-10-01 false Subject Index to Title IX Preamble and Regulation \\1\\ Index Subject Index to Title IX Preamble and Regulation \\1\\ GENERAL ADMINISTRATION... FINANCIAL ASSISTANCE Procedures [Interim] Interim procedures. Pt. 86, Index Subject Index to Title IX...

Index to NASA News Releases 1995

NASA Technical Reports Server (NTRS)

1996-01-01

This issue of the index to NASA News Releases contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, during 1995. The index is arranged in six sections: Subject index, Personal name index, News release number index, Accession number index, Speeches, and News releases.

A Study to Determine the Extent of Social Support and Burnout among Nurses at Womack Army Community Hospital

DTIC Science & Technology

1986-07-01

Maslach Burnout Inventory (MBI) 15 Comparison of Means and Standard Deviations for the Social Support Subscales 16... Maslach and Jackson followed closely their definition of burnout and designed the Maslach Burnout Inventory to assess the three aspects of the syndrome...34, "How many employees report to you?", etc. Part II: Maslach’s Burnout Inventory (MBI). This measure was developed by Christina A. Maslach and

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2002-10-01

... 45 Public Welfare 1 2002-10-01 2002-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare GENERAL ADMINISTRATION... FINANCIAL ASSISTANCE Procedures [Interim] Interim procedures. Pt. 86, Index Subject Index to Title IX...

The influence of institutionalization on the perception of autonomy and quality of life in old people.

PubMed

Cobo, Carmen María Sarabia

2014-12-01

To evaluate the influence exercised by institutionalization on the autonomy and perception of quality of life among the institutionalized elderly. The study is quasi-experimental (interrupted time series) and longitudinal. The sample is composed for 104 elderly people who went into a three nursing home in Santander, Spain. To assess the quality of life and dependence two scales were used: the Barthel Index and Lawton Index. There was an important relationship between autonomy and independence and their deterioration due to their institutionalisation, such as the physical and social aspects. It´s important to point out that the dependence of the elderly is a complex phenomenon, which admits many types of intervention, including the customary ones referring to more classic welfare actions which tend to supplant the absence of autonomy in everyday life by facilitating services and attention to make up for this need, without having to resort to institutionalization.

The Europe 2020 Index

ERIC Educational Resources Information Center

Pasimeni, Paolo

2013-01-01

This paper presents a new index to quantify, measure and monitor the progress towards the objectives of the Europe 2020 strategy. This index is based on a set of relevant, accepted, credible, easy to monitor and robust indicators presented by the European Commission at the time the strategy was launched. The internal analysis of the index shows…

36 CFR 200.5 - Indexes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Indexes. 200.5 Section 200.5..., AND PROCEDURES Functions and Procedures § 200.5 Indexes. Publication of the indexes described in § 200.... However, copies of the indexes are available for public review in the Forest Service headquarters office...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation \\1\\

Code of Federal Regulations, 2010 CFR

2000-10-01

... 45 Public Welfare 1 2000-10-01 2000-10-01 false Subject Index to Title IX Preamble and Regulation \\1\\ Index Subject Index to Title IX Preamble and Regulation \\1\\ Public Welfare DEPARTMENT OF... procedures. Pt. 86, Index Subject Index to Title IX Preamble and Regulation \\1\\ 1 Preamble paragraph numbers...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation \\1\\

Code of Federal Regulations, 2010 CFR

1999-10-01

... 45 Public Welfare 1 1999-10-01 1999-10-01 false Subject Index to Title IX Preamble and Regulation \\1\\ Index Subject Index to Title IX Preamble and Regulation \\1\\ Public Welfare DEPARTMENT OF... procedures. Pt. 86, Index Subject Index to Title IX Preamble and Regulation \\1\\ 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2003-10-01

... 45 Public Welfare 1 2003-10-01 2003-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare DEPARTMENT OF HEALTHAND.... Pt. 86, Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2009-07-01

... 34 Education 1 2009-07-01 2009-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title IX... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2015-07-01

... 34 Education 1 2015-07-01 2015-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2003-07-01

... 34 Education 1 2003-07-01 2003-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title IX... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2016-07-01

... 34 Education 1 2016-07-01 2016-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2007-07-01

... 34 Education 1 2007-07-01 2007-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2004-07-01

... 34 Education 1 2004-07-01 2004-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2012-07-01

... 34 Education 1 2012-07-01 2012-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2008-07-01

... 34 Education 1 2008-07-01 2008-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2004-10-01

... 45 Public Welfare 1 2004-10-01 2004-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare DEPARTMENT OF HEALTHAND.... Pt. 86, Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2006-07-01

... 34 Education 1 2006-07-01 2006-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2002-07-01

... 34 Education 1 2002-07-01 2002-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Regulations of the Offices of the Department...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2014-07-01

... 34 Education 1 2014-07-01 2014-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2005-07-01

... 34 Education 1 2005-07-01 2005-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2001-10-01

... 45 Public Welfare 1 2001-10-01 2001-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare DEPARTMENT OF HEALTHAND.... Pt. 86, Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in...

34 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2013-07-01

... 34 Education 1 2013-07-01 2013-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation \\1\\

Code of Federal Regulations, 2010 CFR

1996-10-01

... 45 Public Welfare 1 1996-10-01 1996-10-01 false Subject Index to Title IX Preamble and Regulation \\1\\ Index Subject Index to Title IX Preamble and Regulation \\1\\ NONDISCRIMINATION ON THE BASIS OF SEX... Procedures [Interim] Interim procedures. Pt. 86, Index Subject Index to Title IX Preamble and Regulation \\1...

34 CFR Subject Index to Title IX... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2017-07-01

... 34 Education 1 2017-07-01 2017-07-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Education Regulations of the Offices of the...] Procedures. Subject Index Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers...

Gradient index retroreflector

DOEpatents

Layne, Clyde B.

1988-01-01

A retroreflector is formed of a graded index lens with a reflective coating at one end. The lens has a length of an odd multiple of a quarter period thereof. Hexagonally shaped graded index lenses may be closely packed in an array to form a retroreflecting surface.

EJSCREEN Version 1, EJ Index Alternatives

EPA Pesticide Factsheets

This map service displays alternative environmental justice (EJ) indexes used in EJSCREEN. The alternative EJ indexes combine each of the 12 environmental indicators and one of two demographic indexes using different methods than the Primary EJ Index. EJ Index Alternative 1 is a combination of a blockgroup environmental factor, the populaiton of the blockgroup, and the demographic index. This EJ Index measures how much a particular place contributes to the total burden faced by subpopulations highlighted by the demographic index. EJ Index Alternative 2 is a combination of a blockgroup environmental factor and the demographic index. Two options are presented for both EJ Index Alternative 1 and Alternative 2-- they are combined with the primary demographic index and alternative demographic index. EJSCREEN is an environmental justice screening tool that provides EPA with a nationally consistent approach to screening for potential areas of EJ concern that may warrant further investigation. The EJ indexes are block group level results that combine multiple demographic factors with a single environmental variable (such as proximity to traffic) that can be used to help identify communities living with the greatest potential for negative environmental and health effects. The EJSCREEN tool is currently for internal EPA use only. It is anticipated that as users become accustomed to this new tool, individual programs within the Agency will develop program use guidelines a

Comparison of immediate implant placement in infected and non-infected extraction sockets: a systematic review and meta-analysis.

PubMed

Lee, Jungwon; Park, Dueun; Koo, Ki-Tae; Seol, Yang-Jo; Lee, Yong-Moo

2018-04-03

This review aimed to investigate the feasibility of immediate implant placement in infected extraction sockets. We performed electronic and manual searches up to March 2017 to obtain data from randomized controlled trials (RCTs) and nonrandomized controlled clinical trials (CCTs). Using a fixed-effects model to assess the difference in survival rate (primary outcome), we evaluated the risk difference for immediate implant placement in infected and non-infected sites. We estimated the weighted mean differences (WMDs) of the change in marginal bone loss (MBL), probing depth (PD), modified bleeding index (mBI), marginal gingival level (MGL) and width of keratinized gingiva (WKG) at baseline and latest follow-up. In total, five studies (0 RCT, five CCTs) were included in the systematic review and three studies were included in the meta-analysis. The risk difference for immediate implant placement in an infected extraction socket compared with that in a non-infected socket was -0.02. WMDs for MBL, PD, mBI, MGL and WKG between the two groups were 0.32, 0.12, 0.07, -0.06, 0.20 and 0.51, respectively. No statistical differences were observed between the two groups, except for the change in WKG. Implants can be placed in infected extraction sockets after thorough socket debridement. For aesthetics, WKG should be considered when performing immediate implant placement in infected sites.

Burnout, quality of life and emotional profile in general practitioners and psychiatrists.

PubMed

Vicentic, Sreten; Gasic, Miroslava Jasovic; Milovanovic, Aleksandar; Tosevski, Dusica Lecic; Nenadovic, Milutin; Damjanovic, Aleksandar; Kostic, Bojana Dunjic; Jovanovic, Aleksandar A

2013-01-01

Many studies confirm that psychological factors and burnout in physicians are interconnected. It is however not known, whether quality of life is another factor that plays a role in this connection.The aim of this study was to explore the correlation between quality of life and emotional profile with the level of burnout in physicians. 120 physicians participated in this study, i.e., sixty general practitioners (GPs) and sixty psychiatrists. The General Health Questionnaire (GHQ) and the Maslach Burnout Inventory (MBI) were used to measure the job stress. The Quality of Life (QOL) and the Emotions Profile Index (EPI) were used to determine quality of life and emotional profile. Data were analyzed using methods of single and multiple correlation and regression methods. The QOL was higher in psychiatrists as a direct consequence of questions about finances and friendship. Analysis by gender showed that the growth of the burnout risk level (MBI) correlated with the growth of number of women who had stress coping problems. This research suggests that quality of life and individual factors represent a very significant role in burnout among physicians. Further researches in a bigger sample are required in order to identify key factors of quality of life related to burnout reducing, as well as for improvement of supervision strategies, including more the relevance of psychological profile of physicians.

The lead-lag relationship between stock index and stock index futures: A thermal optimal path method

NASA Astrophysics Data System (ADS)

Gong, Chen-Chen; Ji, Shen-Dan; Su, Li-Ling; Li, Sai-Ping; Ren, Fei

2016-02-01

The study of lead-lag relationship between stock index and stock index futures is of great importance for its wide application in hedging and portfolio investments. Previous works mainly use conventional methods like Granger causality test, GARCH model and error correction model, and focus on the causality relation between the index and futures in a certain period. By using a non-parametric approach-thermal optimal path (TOP) method, we study the lead-lag relationship between China Securities Index 300 (CSI 300), Hang Seng Index (HSI), Standard and Poor 500 (S&P 500) Index and their associated futures to reveal the variance of their relationship over time. Our finding shows evidence of pronounced futures leadership for well established index futures, namely HSI and S&P 500 index futures, while index of developing market like CSI 300 has pronounced leadership. We offer an explanation based on the measure of an indicator which quantifies the differences between spot and futures prices for the surge of lead-lag function. Our results provide new perspectives for the understanding of the dynamical evolution of lead-lag relationship between stock index and stock index futures, which is valuable for the study of market efficiency and its applications.

12 CFR 34.22 - Index.

Code of Federal Regulations, 2010 CFR

2010-01-01

... an index or combination of indices to which changes in the interest rate will be linked. This index... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Index. 34.22 Section 34.22 Banks and Banking... Mortgages § 34.22 Index. (a) In general. If a national bank makes an ARM loan to which 12 CFR 226.19(b...

Fiber optic refractive index monitor

DOEpatents

Weiss, Jonathan David

2002-01-01

A sensor for measuring the change in refractive index of a liquid uses the lowest critical angle of a normal fiber optic to achieve sensitivity when the index of the liquid is significantly less than the index of the fiber core. Another embodiment uses a liquid filled core to ensure that its index is approximately the same as the liquid being measured.

An Analytical Study on an Orthodontic Index: Index of Complexity, Outcome and Need (ICON)

PubMed Central

Torkan, Sepide; Pakshir, Hamid Reza; Fattahi, Hamid Reza; Oshagh, Morteza; Momeni Danaei, Shahla; Salehi, Parisa; Hedayati, Zohreh

2015-01-01

Statement of the Problem The validity of the Index of Complexity, Outcome and Need (ICON) which is an orthodontic index developed and introduced in 2000 should be studied in different ethnic groups. Purpose The aim of this study was to perform an analysis on the ICON and to verify whether this index is valid for assessing both the need and complexity of orthodontic treatment in Iran. Materials and Method Five orthodontists were asked to score pre-treatment diagnostic records of 100 patients with a uniform distribution of different types of malocclusions determined by Dental Health Component of the Index of Treatment Need. A calibrated examiner also assessed the need for orthodontic treatment and complexity of the cases based on the ICON index as well as the Index of Orthodontic Treatment Need (IOTN). 10 days later, 25% of the cases were re-scored by the panel of experts and the calibrated orthodontist. Results The weighted kappa revealed the inter-examiner reliability of the experts to be 0.63 and 0.51 for the need and complexity components, respectively. ROC curve was used to assess the validity of the index. A new cut-off point was adjusted at 35 in lieu of 43 as the suggested cut-off point. This cut-off point showed the highest level of sensitivity and specificity in our society for orthodontic treatment need (0.77 and 0.78, respectively), but it failed to define definite ranges for the complexity of treatment. Conclusion ICON is a valid index in assessing the need for treatment in Iran when the cut-off point is adjusted to 35. As for complexity of treatment, the index is not validated for our society. It seems that ICON is a well-suited substitute for the IOTN index. PMID:26331142

Universal Index System

NASA Technical Reports Server (NTRS)

Kelley, Steve; Roussopoulos, Nick; Sellis, Timos; Wallace, Sarah

1993-01-01

The Universal Index System (UIS) is an index management system that uses a uniform interface to solve the heterogeneity problem among database management systems. UIS provides an easy-to-use common interface to access all underlying data, but also allows different underlying database management systems, storage representations, and access methods.

[Mobile geriatric rehabilitation in functionally severely impaired patients. Investigations on effectiveness].

PubMed

Schulz, R; Knauf, W; Püllen, R

2014-02-01

Mobile geriatric rehabilitation is an outpatient rehabilitative treatment in which a multidisciplinary team treats elderly patients at home. This kind of treatment has been performed in rare cases in Germany but there are no data available on the effectiveness in patients with severe cognitive and functional impairment. In a retrospective study design the data of all patients who had participated in mobile geriatric rehabilitation between 1 September 2009 and 23 May 2011 were evaluated. Before treatment a comprehensive geriatric assessment was performed and after treatment an assessment of mobility and activities of daily living (ADL). After 6 months a random sample of 20 patients were contacted by telephone to check the ADL. A total of 87 patients were treated between 1 September 2009 and 23 May 2011. The median age was 83 years and 56 % of the patients lived in nursing homes. Only 24 % of the patients had MMSE scores > 23 points, 77 patients completed the treatment with an assessment and in these patients the ADL could be improved significantly (Barthel index at the beginning 36.2 points and on completion 50.9 points, p < 0.001). The Barthel index 6 months after treatment was only 1.25 points lower compared to the assessment at the end of the treatment. Significant improvement after therapy could also be demonstrated in the mobility assessment (timed up and go test, Tinetti mobility score and Esslinger transfer scale). The results of this non-randomized and non-blinded trial indicated the efficacy of mobile geriatric rehabilitation. In functionally and cognitively impaired elderly patients ADL and mobility can be improved. These effects seem to persist for at least for 6 months.

Prevalence of infections among residents of Residential Care Homes for the Elderly in Hong Kong.

PubMed

Choy, C Sm; Chen, H; Yau, C Sw; Hsu, E K; Chik, N Y; Wong, A Ty

2016-08-01

A point prevalence study was conducted to study the epidemiology of common infections among residents in Residential Care Homes for the Elderly in Hong Kong and their associated factors. Residential Care Homes for the Elderly in Hong Kong were selected by stratified single-stage cluster random sampling. All residents aged 65 years or above from the recruited homes were surveyed. Infections were identified using standardised definitions. Demographic and health information-including medical history, immunisation record, antibiotic use, and activities of daily living (as measured by Barthel Index)-was collected by a survey team to determine any associated factors. Data were collected from 3857 residents in 46 Residential Care Homes for the Elderly from February to May 2014. A total of 105 residents had at least one type of infection based on the survey definition. The overall prevalence of all infections was 2.7% (95% confidence interval, 2.2%-3.4%). The three most common infections were of the respiratory tract (1.3%; 95% confidence interval, 0.9%-1.9%), skin and soft tissue (0.7%; 95% confidence interval, 0.5%-1.0%), and urinary tract (0.5%; 95% confidence interval, 0.3%-0.9%). Total dependence in activities of daily living, as indicated by low Barthel Index score of 0 to 20 (odds ratio=3.0; 95% confidence interval, 1.4-6.2), and presence of a wound or stoma (odds ratio=2.7; 95% confidence interval, 1.4-4.9) were significantly associated with presence of infection. This survey provides information about infections among residents in Residential Care Homes for the Elderly in the territory. Local data enable us to understand the burden of infections and formulate targeted measures for prevention.

A cross-sectional study of quality of life in incident stroke survivors in rural northern Tanzania.

PubMed

Howitt, Suzanne C; Jones, Matthew P; Jusabani, Ahmed; Gray, William K; Aris, Eric; Mugusi, Ferdinand; Swai, Mark; Walker, Richard W

2011-08-01

The aim of this study was to evaluate changes to, and predictors of, quality of life (QOL) in a community-based cohort of stroke survivors from an earlier stroke incidence study in rural northern Tanzania. Patients were assessed 1-5 years after their incident stroke. The study cohort was compared with an age- and sex-matched control group from the same rural district within a cross-sectional design. Patients and controls were asked a series of questions relating to their QOL [World Health Organization quality of life, abbreviated version (WHOQOL-BREF)], levels of anxiety and depression [hospital anxiety and depression (HAD) scale], cognitive function [community screening instrument for dementia (CSI-D) screening tool], socioeconomic status and demographic characteristics (e.g. age, sex, education and abode). Patients were further assessed for functional outcome and disability (Barthel index, modified Rankin scale), post-stroke care and psychosocial functioning. Patients (n = 58) were found to have significantly lower QOL than controls (n = 58) in all six domains of the WHOQOL-BREF. Gender, socioeconomic status, cognitive function and time elapsed since stroke were not associated with QOL. Older patients and those with more impaired motor function and disability (Barthel index, modified Rankin score) had significantly poorer physical health-related QOL. Greater anxiety and depression, reduced muscle power and less involvement in social events were significantly correlated with lower physical and psychological health-related QOL. To our knowledge, this is the first long-term study of QOL in survivors of incident stroke in Sub-Saharan Africa (SSA). Poorer QOL was associated with greater levels of physical disability, anxiety and depression and reduced social interaction. Demographic factors appear to be much less significant. Modifying these QOL predictors could be important in planning effective post-stroke care within a stretched healthcare system.

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

PubMed Central

Maeda, Keisuke; Koga, Takayuki; Akagi, Junji

2018-01-01

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

Grip strength as a frailty diagnostic component in geriatric inpatients.

PubMed

Dudzińska-Griszek, Joanna; Szuster, Karolina; Szewieczek, Jan

2017-01-01

Frailty has emerged as a key medical syndrome predictive of comorbidity, disability, institutionalization and death. As a component of the five frailty phenotype diagnostic criteria, patient grip strength deserves attention as a simple and objective measure of the frailty syndrome. The aim of this study was to assess conditions that influence grip strength in geriatric inpatients. The study group consisted of 80 patients aged 78.6±7.0 years [Formula: see text], with 68.8% women, admitted to the Department of Geriatrics. A comprehensive geriatric assessment was complemented with assessment for the frailty phenotype as described by Fried et al for all patients in the study group. Functional assessment included Barthel Index of Activities of Daily Living (Barthel Index), Instrumental Activities of Daily Living Scale and Mini-Mental State Examination. Three or more frailty criteria were positive in 32 patients (40%), while 56 subjects (70%) fulfilled the frailty criterion of weakness (grip strength test). Multivariate linear regression analysis revealed that two independent measures showed positive association with grip strength - Mini-Mental State Examination score (β=0.239; P =0.001) and statin use (β=0.213; P =0.002) - and four independent measures were negatively associated with grip strength - female sex (β=-0.671; P <0.001), C-reactive protein (β=-0.253; P <0.001), prior myocardial infarction (β=-0.190; P =0.006) and use of an antidepressant (β=-0.163; P =0.018). Low physical activity was identified as the only independent qualitative frailty component associated with 2-year mortality in multivariate logistic regression analysis after adjustment for age and sex (odds ratio =6.000; 95% CI =1.357-26.536; P =0.018). Cognitive function, somatic comorbidity and medical treatment affect grip strength as a measure of physical frailty in geriatric inpatients. Grip strength was not predictive of 2-year mortality in this group.

Effects of the visual-feedback-based force platform training with functional electric stimulation on the balance and prevention of falls in older adults: a randomized controlled trial.

PubMed

Li, Zhen; Wang, Xiu-Xia; Liang, Yan-Yi; Chen, Shu-Yan; Sheng, Jing; Ma, Shao-Jun

2018-01-01

Force platform training with functional electric stimulation aimed at improving balance may be effective in fall prevention for older adults. Aim of the study is to evaluate the effects of the visual-feedback-based force platform balance training with functional electric stimulation on balance and fall prevention in older adults. A single-centre, unblinded, randomized controlled trial was conducted. One hundred and twenty older adults were randomly allocated to two groups: the control group ( n  = 60, one-leg standing balance exercise, 12 min/d) or the intervention group ( n  = 60, force platform training with functional electric stimulation, 12 min/d). The training was provided 15 days a month for 3 months by physical therapists. Medial-lateral and anterior-posterior maximal range of sway with eyes open and closed, the Berg Balance Scale, the Barthel Index, the Falls Efficacy scale-International were assessed at baseline and after the 3-month intervention. A fall diary was kept by each participant during the 6-month follow-up. On comparing the two groups, the intervention group showed significantly decreased ( p  < 0.01) medial-lateral and anterior-posterior maximal range of sway with eyes open and closed. There was significantly higher improvement in the Berg Balance Scale ( p  < 0.05), the Barthel Index ( p  < 0.05) and the Falls Efficacy Scale-International ( p  < 0.05), along with significantly lesser number of injurious fallers ( p  < 0.05), number of fallers ( p  < 0.05), and fall rates ( p  < 0.05) during the 6-month follow-up in the intervention group. This study showed that the visual feedback-based force platform training with functional electric stimulation improved balance and prevented falls in older adults.

Magnesium for treatment of acute lacunar stroke syndromes: further analysis of the IMAGES trial.

PubMed

Aslanyan, Stella; Weir, Christopher J; Muir, Keith W; Lees, Kennedy R

2007-04-01

A prespecified interaction analysis of the neutral Intravenous Magnesium Efficacy in Stroke (IMAGES) trial revealed significant benefit from magnesium (Mg) in patients with noncortical stroke. Post hoc analysis indicated that this effect was seen in lacunar clinical syndromes (LACS), interaction P=0.005. We have now examined whether this interaction could be explained by confounding baseline factors. LACS was defined on the basis of neurological signs and did not include imaging. We investigated the interaction between baseline variables and Mg treatment on global outcome. We used logistic-regression models to test whether the Mg-LACS interaction remained significant after adjusting for stratification variables, sex, a novel stroke severity score, and baseline variables that had an interaction with treatment (P<0.1). The Mg (n=383) and placebo (n=382) groups of LACS patients were well matched on baseline factors. In addition to LACS, we found an interaction between beneficial Mg treatment effect and younger age (P=0.003), higher baseline diastolic blood pressure (P=0.02), higher mean blood pressure (P=0.02), and absence of ischemic heart disease (P=0.07). Even so, the adjusted Mg-LACS interaction remained significant (odds ratio [OR] 0.57; 95% CI, 0.39 to 0.83; P=0.003). In the LACS subgroup, Mg improved Barthel Index <95 (OR 0.73; 95% CI, 0.55 to 0.98), modified Rankin Scale >1 (OR 0.67; 95% CI, 0.50 to 0.91), and global outcome (OR 0.70; 95% CI, 0.53 to 0.92) but not Barthel Index <60 or mortality. The positive treatment effect of Mg in LACS cannot be ascribed to general issues of severity, time to treatment, blood pressure, or other baseline factors; equally, this finding may be due to chance. A large trial of Mg treatment in LACS appears justified.

Acromegaly and aging: a comparative cross-sectional study.

PubMed

Hatipoglu, Esra; Yuruyen, Mehmet; Keskin, Ela; Yavuzer, Hakan; Niyazoglu, Mutlu; Doventas, Alper; Erdincler, Deniz Suna; Beger, Tanju; Kadioglu, Pinar; Gundogdu, Sadi

2015-02-01

Cognitive and functional geriatric assessment may change in acromegaly. Herein we aimed to determine at which points geriatric assessment of the cases with acromegaly differs from that of general elderly population. In this comparative cross-sectional study, a total of 30 cases with acromegaly (controlled n = 14, uncontrolled n = 16) and 30 gender and body-mass index-matched cases without acromegaly (control group, CG) above 60 years old were included. Cognitive functions were evaluated on the basis of the mini-mental state exam (MMSE). Affective status was determined using the geriatric depression scale. Activities of daily living (ADL) were ranked according to the Barthel index while instrumental activities of daily living (IADL) were graded on the basis of the Lawton scale. Nutritional status was evaluated using the mini-nutritional assessment (MNA). Body composition was measured through bioimpedance analysis. Functional mobility was determined using the Timed Up and Go test (TUG) and muscle strength with the handgrip strength test. Scores on the MMSE were significantly lower in the elderly cases with acromegaly than in the cases without acromegaly (p < 0.001). Dementia was more frequent in the acromegaly group than in the CG (p = 0.04). Total MNA scores were significantly lower in cases with acromegaly than in the CG (p = 0.006). More subjects in the acromegaly group (33%) were at greater risk of malnutrition than in the CG (3%) (p = 0.003). There was greater moderate functional impairment based on Barthel ADL in the acromegaly group than in the CG (p = 0.04). Acromegaly may impair cognitive functions, functional mobility and instrumental daily living activities in the geriatric population. With acromegaly, the risk of malnutrition may also increase. Copyright © 2014 Elsevier Ltd. All rights reserved.

Randomized controlled trial of early rehabilitation after intracerebral hemorrhage stroke: difference in outcomes within 6 months of stroke.

PubMed

Liu, Ning; Cadilhac, Dominique A; Andrew, Nadine E; Zeng, Lingxia; Li, Zongfang; Li, Jin; Li, Yan; Yu, Xuewen; Mi, Baibing; Li, Zhe; Xu, Honghai; Chen, Yangjing; Wang, Juan; Yao, Wanxia; Li, Kuo; Yan, Feng; Wang, Jue

2014-12-01

Mechanisms, acute management, and outcomes for patients who experience intracerebral hemorrhage may differ from patients with ischemic stroke. Studies of very early rehabilitation have been mainly undertaken in patients with ischemic stroke, and it is unknown if benefits apply to those with intracerebral hemorrhage. We hypothesized that early rehabilitation, within 48 hours of stroke, would improve survival and functional outcomes in patients with intracerebral hemorrhage. This was a multicenter, randomized controlled study, with blinded assessment of outcome at 3 and 6 months. Eligible patients were randomized to receive standard care or standard care plus early rehabilitation. Primary outcome includes survival. Secondary outcomes includes health-related quality of life using the 36-item Short Form Questionnaire, function measured with the modified Barthel Index, and anxiety measured with the Zung Self-Rated Anxiety Scale. Two hundred forty-three of 326 patients were randomized (mean age, 59 years; 56% men). At 6 months, patients receiving standard care were more likely to have died (adjusted hazard ratio, 4.44; 95% confidence interval [CI], 1.24-15.87); for morbidity outcomes, a 6-point difference in the Physical Component Summary score of the 36-item Short Form Questionnaire (95% CI, 4.2-8.7), a 7-point difference for the Mental Component Summary score (95% CI, 4.5-9.5), a 13-point difference in Modified Barthel Index scores (95% CI, 6.8-18.3), and a 6-point difference in Self-Rating Anxiety Scale scores (95% CI, 4.4-8.3) was reported in favor of the intervention groups. For the first time, we have shown that commencing rehabilitation within 48 hours of intracerebral hemorrhage improves survival and functional outcomes at 6 months after stroke in hospitalized patients in China. http://www.chictr.org/en. Unique identifier: ChiCTR-TRC-13004039. © 2014 American Heart Association, Inc.

Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial.

PubMed

Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia; Skerris, Anja; Skou, Christina; Christoffersen, Jane; Seest, Line Skou; Poulsen, Mai Bang; Rønholt, Finn; Overgaard, Karsten

2016-03-01

To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. Interventional, randomised, safety/efficacy open-label trial. University hospital stroke unit in collaboration with three municipalities. Seventy-one eligible stroke patients (41 women) with focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. Thirty-eight patients were randomised to home-based rehabilitation during hospitalization and for up to four weeks after discharge to replace part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome measures were the modified Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body Mass Index and treatment-associated economy. Thirty-one intervention and 30 control patients completed the study. Patients in the intervention group achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training in minutes highly correlated with mRS, Barthel, Motor Assessment Scale and EuroQol-5D™ scores (P-values ranging from P<0.00001 to P=0.01). Economical estimations of intervention costs were lower than total costs of standard treatment. Early home-based rehabilitation reduced disability and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective. © The Author(s) 2015.

Effects of Action Observational Training Plus Brain-Computer Interface-Based Functional Electrical Stimulation on Paretic Arm Motor Recovery in Patient with Stroke: A Randomized Controlled Trial.

PubMed

Kim, TaeHoon; Kim, SeongSik; Lee, ByoungHee

2016-03-01

The purpose of this study was to investigate whether action observational training (AOT) plus brain-computer interface-based functional electrical stimulation (BCI-FES) has a positive influence on motor recovery of paretic upper extremity in patients with stroke. This was a hospital-based, randomized controlled trial with a blinded assessor. Thirty patients with a first-time stroke were randomly allocated to one of two groups: the BCI-FES group (n = 15) and the control group (n = 15). The BCI-FES group administered to AOT plus BCI-FES on the paretic upper extremity five times per week during 4 weeks while both groups received conventional therapy. The primary outcomes were the Fugl-Meyer Assessment of the Upper Extremity, Motor Activity Log (MAL), Modified Barthel Index and range of motion of paretic arm. A blinded assessor evaluated the outcomes at baseline and 4 weeks. All baseline outcomes did not differ significantly between the two groups. After 4 weeks, the Fugl-Meyer Assessment of the Upper Extremity sub-items (total, shoulder and wrist), MAL (MAL-Activity of Use and Quality of Movement), Modified Barthel Index and wrist flexion range of motion were significantly higher in the BCI-FES group (p < 0.05). AOT plus BCI-based FES is effective in paretic arm rehabilitation by improving the upper extremity performance. The motor improvements suggest that AOT plus BCI-based FES can be used as a therapeutic tool for stroke rehabilitation. The limitations of the study are that subjects had a certain limited level of upper arm function, and the sample size was comparatively small; hence, it is recommended that future large-scale trials should consider stratified and lager populations according to upper arm function. Copyright © 2015 John Wiley & Sons, Ltd.

Children's Stress Index.

ERIC Educational Resources Information Center

Sherman, Dianne, Ed.

1993-01-01

This double issue of the "ZPG Reporter" focuses on the theme of ZPG's Children's Stress Index", the first national survey of children's well-being based on population- related pressures. Using an extensive list of social, economic, and environmental factors that affect the lives of children, the index ranks 828 cities, counties, and…

[Therapeutic effect observation of post-stroke shoulder pain treated with the touching-periosteum needling technique of the meridian muscle region theory].

PubMed

Yuan, Haiguang; Liu, Zhibin; Feng, Weixing

2017-10-12

To evaluate the pain severity, the motor function of the upper limb and the quality of life in the patients of post-stroke shoulder pain treated with the touching-periosteum needling technique of the meridian muscle region theory. One hundred and six cases of post-stroke shoulder pain were randomized into an observation group and a control group, 53 cases in each one. In the observation group, the touching-periosteum needle technique and the rehabilitation training were used on the bases of the theory of meridian muscle region. The points were Jianyuci , Binaoci , Jianliaoci , Jianqianci , Quchi (LI 11), Shousanli (LI 10) and Waiguan (TE 5) on the affected side. The needles were inserted obliquely, at 45°degrees at those extra points to the tendon knots till the needle tips touching periosteum. The needles were manipulated to ensure the qi arrival and then retained for 30 min. The rehabilitation was applied, such as the anti-spasmodic posture, bridge-style movement on the bed, weight transition and balance training, joint activity maintenance training, passive and active movement of shoulder joint, the training for activities of daily living (ADL) and Bobath technique. In the control group, the routine acupuncture and the rehabilitation training were used. The acupints were Jianyu (LI 15), Binao (LI 14), Jianliao (TE 14), Jianqian (Extra), Quchi (LI 11), Shousanli (LI 10) and Waiguan (TE 5). The rehabilitation training was the same as the observation group. The treatment was given once every day, 6 treatments a week. After 20 treatments, the visual analogue scale (VAS), Fugl-Meyer (FMA) score and Barthel (MBI) score were adopted to evaluate the pain severity, the motor function of the upper limb and the ADL. The clinical therapeutic effects were evaluated in the two groups. The VAS scores were reduced after treatment as compared with those before treatment in the two groups, and FMA and MBI scores were all increased as compared with those before treatment

The relationship between foot posture index, ankle equinus, body mass index and intermetatarsal neuroma.

PubMed

Naraghi, Reza; Bremner, Alexandra; Slack-Smith, Linda; Bryant, Alan

2016-01-01

The main purpose of this study was to investigate the presence of an association between intermetatarsal neuroma and foot type, as measured by the Foot Posture Index. The study also examined whether there was a relationship between foot type and the interspace affected with intermetatarsal neuroma, and whether ankle equinus or body mass index had an effect. In total, 100 participants were recruited from The University of Western Australia's Podiatry Clinic, 68 of whom were diagnosed with inter-metatarsal neuroma from 2009 to 2015. There were 32 control participants recruited from 2014 to 2015. The age of subjects was recorded, as were weight and height, which were used to calculate body mass index. The foot posture index and ankle dorsiflexion were measured using standard technique. Independent t-tests and Kruskal-Wallis tests were used to compare differences in foot posture index, body mass index and ankle dorsiflexion between the inter-metatarsal neuroma and control groups. Multivariable logistic regression was also used to model relationships for outcome. The 68 intermetatarsal neuroma subjects had a mean age of 52 years (range 20 to 74 years) and comprised of 56 females and 12 males. The 32 control subjects had a mean age of 49 years (range 24 to 67 years) with 26 females and six males. There were no significant differences between the control and the intermetatarsal neuroma groups with respect to the mean foot posture index scores of the left and right foot ( p =  0.21 and 0.87, respectively). Additionally no significant differences were detected between the affected intermetatarsal neuroma interspace and foot posture index ( p  = 0.27 and 0.47, respectively). There was no significant difference in mean body mass index between the intermetatarsal neuroma (26.9 ± 5.7) and control groups (26.5 ± 4.1) ( p  = 0.72). There was, however, a significant difference in mean ankle dorsiflexion between the intermetatarsal neuroma and control

The ZJU index is a powerful index for identifying NAFLD in the general Chinese population.

PubMed

Li, Linman; You, Wenyi; Ren, Wei

2017-10-01

The ZJU index is a novel model for detecting non-alcoholic fatty liver disease (NAFLD) that it is calculated based on combination of the body mass index, fasting plasma glucose, triglycerides, and the serum alanine aminotransferase-to-aspartate transaminase ratio. We aimed to evaluate the diagnostic accuracy of the ZJU index in detecting NAFLD in the Chinese population. This was a cross-sectional study. Anthropometric measurements, laboratory data, and ultrasonography features were collected through a standard protocol. The ZJU index, fatty liver index, hepatic steatosis index, lipid accumulation product, and visceral adiposity index were calculated. Then the predictive values of the five indices were compared according to the area under receiver-operating characteristic curve (AUROC) values. A total of 19,804 participants were recruited, of whom 7324 participants were diagnosed with NFALD and 12,480 subjects were regarded as controls. The AUROC value for NAFLD identification by the ZJU index was 0.925 (95% confidence interval [CI]: 0.919-0.931), which was significantly higher than the values for the other four models (P < 0.001). Furthermore, from age 31 years to >60 years, the AUROC for the ZJU increased from 87.1 to 95.4%, values which were also greater than those for the other four indices. Analysis by sex also showed that the performance of the ZJU index in males and females was better than that of the other four indices. The ZJU index is an accurate and easy to employ tool for identifying NAFLD in the general Chinese population.

On the refractive index of sodium iodide solutions for index matching in PIV

NASA Astrophysics Data System (ADS)

Bai, Kunlun; Katz, Joseph

2014-04-01

Refractive index matching has become a popular technique for facilitating applications of modern optical diagnostic techniques, such as particle image velocimetry, in complex systems. By matching the refractive index of solid boundaries with that of the liquid, unobstructed optical paths can be achieved for illumination and image acquisition. In this research note, we extend previously provided data for the refractive index of aqueous solutions of sodium iodide (NaI) for concentrations reaching the temperature-dependent solubility limit. Results are fitted onto a quadratic empirical expression relating the concentration to the refractive index. Temperature effects are also measured. The present range of indices, 1.333-1.51, covers that of typical transparent solids, from silicone elastomers to several recently introduced materials that could be manufactured using rapid prototyping. We also review briefly previous measurements of the refractive index, viscosity, and density of NaI solutions, as well as prior research that has utilized this fluid.

Regional Hospital Input Price Indexes

PubMed Central

Freeland, Mark S.; Schendler, Carol Ellen; Anderson, Gerard

1981-01-01

This paper describes the development of regional hospital input price indexes that is consistent with the general methodology used for the National Hospital Input Price Index. The feasibility of developing regional indexes was investigated because individuals inquired whether different regions experienced different rates of increase in hospital input prices. The regional indexes incorporate variations in cost-share weights (the amount an expense category contributes to total spending) associated with hospital type and location, and variations in the rate of input price increases for various regions. We found that between 1972 and 1979 none of the regional price indexes increased at average annual rates significantly different from the national rate. For the more recent period 1977 through 1979, the increase in one Census Region was significantly below the national rate. Further analyses indicated that variations in cost-share weights for various types of hospitals produced no substantial variations in the regional price indexes relative to the national index. We consider these findings preliminary because of limitations in the availability of current, relevant, and reliable data, especially for local area wage rate increases. PMID:10309557

Heart rate variability in elite sprinters: effects of gender and body position.

PubMed

Abad, Cesar; Kobal, Ronaldo; Kitamura, Katia; Gil, Saulo; Pereira, Lucas; Loturco, Irineu; Nakamura, Fábio

2017-07-01

To describe the heart rate variability (HRV) of high-level sprinters in both the supine and standing positions, the HRV of 7 male (24 ± 6 years; 80 ± 8 kg and 182 ± 7 cm) and 11 female (27 ± 5 years; 61 ± 4 kg; 167 ± 5 cm) high-level Brazilian sprinters was measured in the standing and supine body positions in both the time and frequency domains. The heart rate (HR) and the time (SDNN, RMSSD) and frequency (LF; HF and LF:HF) domains of the HRV were assessed. Natural log-transformations (ln) of all HRV indices were log-transformed prior to analysis to reduce bias arising from non-uniformity of error. The Cohen's effect size and magnitude-based inference (MBI) were obtained for comparisons. The results suggest higher cardiac autonomic stress in the standing position than in the supine for both genders. With the exception of the lnSDNN that showed possibly MBI in female athletes, all other HRV indices presented a likely or almost certainly MBI. Male athletes demonstrated a higher lnSDNN in the supine body position (very likely MBI) and a higher HR in the standing position (very likely MBI) than females. In conclusion, elite sprinters (independent of the gender) present lower HRV in the standing position than in the supine position, but males present a more notable change in cardiac autonomic stress than female athletes. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Quarantine document system indexing procedure

NASA Technical Reports Server (NTRS)

1972-01-01

The Quarantine Document System (QDS) is described including the indexing procedures and thesaurus of indexing terms. The QDS consists of these functional elements: acquisition, cataloging, indexing, storage, and retrieval. A complete listing of the collection, and the thesaurus are included.

Brief training in mindfulness meditation reduces symptoms in patients with a chronic or recurrent lifetime history of depression: A randomized controlled study.

PubMed

Winnebeck, Emilia; Fissler, Maria; Gärtner, Matti; Chadwick, Paul; Barnhofer, Thorsten

2017-12-01

Training in mindfulness has been introduced to the treatment of depression as a means of relapse prevention. However, given its buffering effects on maladaptive responses to negative mood, mindfulness training would be expected to be particularly helpful in those who are currently suffering from symptoms. This study investigated whether a brief and targeted mindfulness-based intervention can reduce symptoms in acutely depressed patients. Seventy-four patients with a chronic or recurrent lifetime history were randomly allocated to receive either a brief mindfulness-based intervention (MBI) encompassing three individual sessions and regular home practice or a control condition that combined psycho-educational components and regular rest periods using the same format as the MBI. Self-reported severity of symptoms, mindfulness in every day life, ruminative tendencies and cognitive reactivity were assessed before and after intervention. Treatment completers in the MBI condition showed pronounced and significantly stronger reductions in symptoms than those in the control condition. In the MBI group only, patients showed significant increases in mindfulness, and significant reductions in ruminative tendencies and cognitive reactivity. Brief targeted mindfulness interventions can help to reduce symptoms and buffer maladaptive responses to negative mood in acutely depressed patients with chronic or recurrent lifetime history. Copyright © 2017 Elsevier Ltd. All rights reserved.

Teacher Burnout: A Comparison of Two Cultures Using Confirmatory Factor and Item Response Models

PubMed Central

Denton, Ellen-ge; Chaplin, William F.; Wall, Melanie

2014-01-01

The present study addresses teacher burnout and in particular cultural differences and similarities in burnout. We used the Maslach Burnout Inventory Education Survey (MBI-ES) as the starting point for developing a latent model of burnout in two cultures; Jamaica W.I. teachers (N= 150) and New York City teachers (N= 150). We confirm a latent 3 factor structure, using a subset of the items from the MBI-ES that adequately fit both samples. We tested different degrees of measurement invariance (model fit statistics, scale reliabilities, residual variances, item thresholds, and total variance) to describe and compare cultural differences. Results indicate some differences between the samples at the structure and item levels. We found that factor variances were slightly higher in the New York City teacher sample. Emotional Exhaustion (EE) was a more informative construct for differentiating among teachers at moderate levels of burnout, as opposed to extreme high or low levels of burnout, in both cultures. In contrast, Depersonalization in the Workplace (DW) was more informative at the more extreme levels of burnout among both teacher samples. By studying the influence of culture on the experience of burnout we can further our understanding of burnout and potentially discover factors that might prevent burnout among primary and secondary school teachers. PMID:25729572

Examining the Effects of Model-Based Inquiry on Concepetual Understanding and Engagement in Science

NASA Astrophysics Data System (ADS)

Baze, Christina L.

Model-Based Inquiry (MBI) is an instructional model which engages students in the scientific practices of modeling, explanation, and argumentation while they work to construct explanations for natural phenomena. This instructional model has not been previously studied at the community college level. The purpose of this study is to better understand how MBI affects the development of community college students' conceptual understanding of evolution and engagement in the practices of science. Mixed-methods were employed to collect quantitative and qualitative data through the multiple-choice Concepts Inventory of Natural Selection, student artifacts, and semi-structured interviews. Participants were enrolled in Biology Concepts, an introductory class for non-science majors, at a small, rural community college in the southwestern United States. Preliminary data shows that conceptual understanding is not adversely affected by the implementation of MBI, and that students gain valuable insights into the practices of science. Specifically, students who participated in the MBI intervention group gained a better understanding of the role of models in explaining and predicting phenomena and experienced feeling ownership of their ideas, an appropriate depth of thinking, more opportunities for collaboration, and coherence and context within the unit. Implications of this study will be of interest to postsecondary science educators and researchers who seek to reform and improve science education.

A critical evaluation of the experimental design of studies of mechanism based enzyme inhibition, with implications for in vitro-in vivo extrapolation.

PubMed

Ghanbari, F; Rowland-Yeo, K; Bloomer, J C; Clarke, S E; Lennard, M S; Tucker, G T; Rostami-Hodjegan, A

2006-04-01

The published literature on mechanism based inhibition (MBI) of CYPs was evaluated with respect to experimental design, methodology and data analysis. Significant variation was apparent in the dilution factor, ratio of preincubation to incubation times and probe substrate concentrations used, and there were some anomalies in the estimation of associated kinetic parameters (k(inact), K(I), r). The impact of the application of inaccurate values of k(inact) and K(I) when extrapolating to the extent of inhibition in vivo is likely to be greatest for those compounds of intermediate inhibitory potency, but this also depends on the fraction of the net clearance of substrate subject to MBI and the pre-systemic and systemic exposure to the inhibitor. For potent inhibitors, the experimental procedure is unlikely to have a material influence on the maximum inhibition. Nevertheless, the bias in the values of the kinetic parameters may influence the time for recovery of enzyme activity following re-synthesis of the enzyme. Careful attention to the design of in vitro experiments to obtain accurate kinetic parameters is necessary for a reliable prediction of different aspects of the in vivo consequences of MBI. The review calls for experimental studies to quantify the impact of study design in studies of MBI, with a view to better harmonisation of protocols.

Is the Carli index flawed?: assessing the case for the new retail price index RPIJ.

PubMed

Levell, Peter

2015-02-01

The paper discusses the recent decision of the UK's Office for National Statistics to replace the controversial Carli index with the Jevons index in a new version of the retail price index-RPIJ. In doing so we make three contributions to the way that price indices should be selected for measures of consumer price inflation when quantity information is not available (i.e. at the 'elementary' level). Firstly, we introduce a new price bouncing test under the test approach for choosing index numbers. Secondly, we provide empirical evidence on the performance of the Carli and Jevons indices in different contexts under the statistical approach. Thirdly, applying something analogous to the principle of insufficient reason, we argue contrary to received wisdom in the literature, that the economic approach can be used to choose indices at the elementary level, and moreover that it favours the use of the Jevons index. Overall, we conclude that there is a case against the Carli index and that the Jevons index is to be preferred.

Experimental comparison between speech transmission index, rapid speech transmission index, and speech intelligibility index.

PubMed

Larm, Petra; Hongisto, Valtteri

2006-02-01

During the acoustical design of, e.g., auditoria or open-plan offices, it is important to know how speech can be perceived in various parts of the room. Different objective methods have been developed to measure and predict speech intelligibility, and these have been extensively used in various spaces. In this study, two such methods were compared, the speech transmission index (STI) and the speech intelligibility index (SII). Also the simplification of the STI, the room acoustics speech transmission index (RASTI), was considered. These quantities are all based on determining an apparent speech-to-noise ratio on selected frequency bands and summing them using a specific weighting. For comparison, some data were needed on the possible differences of these methods resulting from the calculation scheme and also measuring equipment. Their prediction accuracy was also of interest. Measurements were made in a laboratory having adjustable noise level and absorption, and in a real auditorium. It was found that the measurement equipment, especially the selection of the loudspeaker, can greatly affect the accuracy of the results. The prediction accuracy of the RASTI was found acceptable, if the input values for the prediction are accurately known, even though the studied space was not ideally diffuse.

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2011 CFR

2011-10-01

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45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2010-10-01

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45 CFR Subject Index to Title IX... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2006-10-01

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45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2013-10-01

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45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2009-10-01

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45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare Department of Health and... Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in brackets [ ]. A...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare DEPARTMENT OF HEALTH AND... Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in brackets [ ]. A...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2005-10-01

... 45 Public Welfare 1 2005-10-01 2005-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare DEPARTMENT OF HEALTH AND... Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in brackets [ ]. A...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2007-10-01

... 45 Public Welfare 1 2007-10-01 2007-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare DEPARTMENT OF HEALTHAND... Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in brackets [ ]. A...

45 CFR Subject Index to Title Ix... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2008-10-01

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45 CFR Subject Index to Title IX... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2016-10-01

... 45 Public Welfare 1 2016-10-01 2016-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare Department of Health and... Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in brackets [ ]. A...

45 CFR Subject Index to Title IX... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2017-10-01

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45 CFR Subject Index to Title IX... - Subject Index to Title IX Preamble and Regulation 1

Code of Federal Regulations, 2010 CFR

2015-10-01

... 45 Public Welfare 1 2015-10-01 2015-10-01 false Subject Index to Title IX Preamble and Regulation 1 Index Subject Index to Title IX Preamble and Regulation 1 Public Welfare Department of Health and... Subject Index to Title IX Preamble and Regulation 1 1 Preamble paragraph numbers are in brackets [ ]. A...

CubeIndexer: Indexer for regions of interest in data cubes

NASA Astrophysics Data System (ADS)

Chilean Virtual Observatory; Araya, Mauricio; Candia, Gabriel; Gregorio, Rodrigo; Mendoza, Marcelo; Solar, Mauricio

2015-12-01

CubeIndexer indexes regions of interest (ROIs) in data cubes reducing the necessary storage space. The software can process data cubes containing megabytes of data in fractions of a second without human supervision, thus allowing it to be incorporated into a production line for displaying objects in a virtual observatory. The software forms part of the Chilean Virtual Observatory (ChiVO) and provides the capability of content-based searches on data cubes to the astronomical community.

Microelectromechanical reciprocating-tooth indexing apparatus

DOEpatents

Allen, James J.

1999-01-01

An indexing apparatus is disclosed that can be used to rotate a gear or move a rack in a precise, controllable manner. The indexing apparatus, based on a reciprocating shuttle driven by one or more actuators, can be formed either as a micromachine, or as a millimachine. The reciprocating shuttle of the indexing apparatus can be driven by a thermal, electrostatic or electromagnetic actuator, with one or more wedge-shaped drive teeth of the shuttle being moveable to engage and slide against indexing teeth on the gear or rack, thereby moving the gear or rack. The indexing apparatus can be formed by either surface micromachining processes or LIGA processes, depending on the size of the apparatus that is to be formed.

Indexing and Retrieval for the Web.

ERIC Educational Resources Information Center

Rasmussen, Edie M.

2003-01-01

Explores current research on indexing and ranking as retrieval functions of search engines on the Web. Highlights include measuring search engine stability; evaluation of Web indexing and retrieval; Web crawlers; hyperlinks for indexing and ranking; ranking for metasearch; document structure; citation indexing; relevance; query evaluation;…

32 CFR 296.3 - Indexes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Indexes. 296.3 Section 296.3 National Defense... PROGRAM NATIONAL RECONNAISSANCE OFFICE FREEDOM OF INFORMATION ACT PROGRAM REGULATION § 296.3 Indexes. (a... and executive order requirements, that it is unnecessary and impracticable to publish an index of the...

32 CFR 701.39 - Vaughn index.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Vaughn index. 701.39 Section 701.39 National... DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.39 Vaughn index. Itemized index, correlating... agency's nondisclosure justification. The index may contain such information as: date of document...

1 CFR 8.4 - Indexes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Indexes. 8.4 Section 8.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER SPECIAL EDITIONS OF THE FEDERAL REGISTER CODE OF FEDERAL REGULATIONS § 8.4 Indexes. A subject index to the entire Code shall be annually revised and separately...

1 CFR 8.4 - Indexes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Indexes. 8.4 Section 8.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER SPECIAL EDITIONS OF THE FEDERAL REGISTER CODE OF FEDERAL REGULATIONS § 8.4 Indexes. A subject index to the entire Code shall be annually revised and separately...

7 CFR 2710.3 - Indexes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Indexes. 2710.3 Section 2710.3 Agriculture..., DEPARTMENT OF AGRICULTURE AVAILABILITY OF INFORMATION TO THE PUBLIC § 2710.3 Indexes. (a) Background. 5 U.S.C... current indexes providing identifying information for the public with regard to any records which are made...

7 CFR 2811.3 - Indexes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Indexes. 2811.3 Section 2811.3 Agriculture... AVAILABILITY OF INFORMATION TO THE PUBLIC § 2811.3 Indexes. (a) Background. 15 U.S.C. 552(a)(2) also requires that each agency maintain and make available for public inspection and copying current indexes provided...

1 CFR 8.4 - Indexes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Indexes. 8.4 Section 8.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER SPECIAL EDITIONS OF THE FEDERAL REGISTER CODE OF FEDERAL REGULATIONS § 8.4 Indexes. A subject index to the entire Code shall be annually revised and separately...

1 CFR 8.4 - Indexes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Indexes. 8.4 Section 8.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER SPECIAL EDITIONS OF THE FEDERAL REGISTER CODE OF FEDERAL REGULATIONS § 8.4 Indexes. A subject index to the entire Code shall be annually revised and separately...

1 CFR 8.4 - Indexes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Indexes. 8.4 Section 8.4 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER SPECIAL EDITIONS OF THE FEDERAL REGISTER CODE OF FEDERAL REGULATIONS § 8.4 Indexes. A subject index to the entire Code shall be annually revised and separately...

[ATD index in Perthes disease].

PubMed

Grzegorzewski, Andrzej; Synder, Marek; Szymczak, Wiesław; Kowalewski, Maciej; Kozłowski, Piotr

2003-01-01

Authors present an estimation of articulo-trochanteric-distance (ATD) and ATD index in patients with Perthes disease and if there is any correlation between ATD and ATD index and age at the onset, gender, type of treatment, Herring and Stulberg classification. The study population consisted of 242 patients (35 female and 207 male) who had reached skeletal maturity at last follow up. The mean age at the onset of symptoms was 7 years and 4 months. All patients were treated by containment methods (bed rest and traction in abduction, brace, Petri cast, varus osteotomy, Salter osteotomy and shelf operation). ATD was estimated according to the Edgren methods and ATD index was calculated as relation ATD on Perthes site to ATD in normal joint. The late results were classified according to the Stulberg classification. Statistical analysis did not revealed any correlation between the age at the onset, gender and ATD index and ATD during last follow up. Both parameters decreased with poor results according to the Stulberg classifications. ATD index and ATD were statistically significant less after surgical treatment than after non-operative treatment. The same relations were seen between patients with leg length discrepancy (LLD) and without LLD. Patients in Herring group A had statistically significant bigger both parameters than patients in group B, C and patients in Herring group B than C. Articulo-trochanteric-distance and ATD index decreased during follow up and ATD decreased also in normal joint. In our opinion ATD index is a more reliable radiological parameter than ATD. ATD index decreases with bigger necrosis of the femoral head and poor result according to the Stulberg classification. This parameter is an evidence of the dysfunction proximal femoral growth plate in patients with LLD. The most decreased ATD index was observed after surgical treatment. There was no correlation between the age at the onset, gender and ATD index at last follow up.

[Changes in index-F and index-delta 4P in normal pregnancy, labor and the puerperium].

PubMed

Kamada, T

1984-04-01

Index-F and index-delta 4P (cortisol and progesterone which are not bound to corticosteroid-binding globulin (CBG) in the umbilical cord vein and the maternal blood were determined during pregnancy, at delivery and puerperium. Index-F and index-delta 4P were calculated as the total cortisol or total progesterone X% unbound to CBG divided by 100. The level of index-F showed a gradual rise during pregnancy, and in late pregnancy reached about 1.5 times as high as that of non-pregnant women, whereas the total cortisol level was about 3.3 times. Near delivery, index-F was almost completely stable, but at delivery, it increased suddenly in proportion to the rise in the total cortisol level. This rise is probably due to stress. In the umbilical cord vein blood, the level of index-F was 1.5 times higher than that in the maternal plasma before delivery; however the total cortisol level was lower than that of the maternal plasma. The levels of both index-delta 4P and total progesterone showed a gradual increase during pregnancy in parallel, and each value in late pregnancy was about 4.5 to 4.9 times that of early pregnant women. At or near delivery, the level of index-delta 4P was almost stable and no decrease occurred. In the umbilical cord vein plasma, the levels of index-delta 4P and total progesterone were extremely high. However, the meaning of these results isn't clear.

Indexing Temporal XML Using FIX

NASA Astrophysics Data System (ADS)

Zheng, Tiankun; Wang, Xinjun; Zhou, Yingchun

XML has become an important criterion for description and exchange of information. It is of practical significance to introduce the temporal information on this basis, because time has penetrated into all walks of life as an important property information .Such kind of database can track document history and recover information to state of any time before, and is called Temporal XML database. We advise a new feature vector on the basis of FIX which is a feature-based XML index, and build an index on temporal XML database using B+ tree, donated TFIX. We also put forward a new query algorithm upon it for temporal query. Our experiments proved that this index has better performance over other kinds of XML indexes. The index can satisfy all TXPath queries with depth up to K(>0).

Spatial Frequency Multiplexing of Fiber-Optic Interferometric Refractive Index Sensors Based on Graded-Index Multimode Fibers

PubMed Central

Liu, Li; Gong, Yuan; Wu, Yu; Zhao, Tian; Wu, Hui-Juan; Rao, Yun-Jiang

2012-01-01

Fiber-optic interferometric sensors based on graded-index multimode fibers have very high refractive-index sensitivity, as we previously demonstrated. In this paper, spatial-frequency multiplexing of this type of fiber-optic refractive index sensors is investigated. It is estimated that multiplexing of more than 10 such sensors is possible. In the multiplexing scheme, one of the sensors is used to investigate the refractive index and temperature responses. The fast Fourier transform (FFT) of the combined reflective spectra is analyzed. The intensity of the FFT spectra is linearly related with the refractive index and is not sensitive to the temperature.

7 CFR 370.3 - Index.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Index. 370.3 Section 370.3 Agriculture Regulations of... AGRICULTURE FREEDOM OF INFORMATION § 370.3 Index. Pursuant to the regulations in § 1.4(b) of this title, APHIS will maintain and make available for public inspection and copying a current index providing...

7 CFR 412.3 - Index.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Index. 412.3 Section 412.3 Agriculture Regulations of... AGRICULTURE PUBLIC INFORMATION-FREEDOM OF INFORMATION § 412.3 Index. 5 U.S.C. 552(a)(2) requires that each agency publish, or otherwise make available, a current index of all materials available for public...

Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment.

PubMed

West, Colin P; Dyrbye, Liselotte N; Satele, Daniel V; Sloan, Jeff A; Shanafelt, Tait D

2012-11-01

Burnout is a common problem among physicians and physicians-in-training. The Maslach Burnout Inventory (MBI) is the gold standard for burnout assessment, but the length of this well-validated 22-item instrument can limit its feasibility for survey research. To evaluate the concurrent validity of two questions relative to the full MBI for measuring the association of burnout with published outcomes. DESIGN, PARTICIPANTS, AND MAIN MEASURES: The single questions "I feel burned out from my work" and "I have become more callous toward people since I took this job," representing the emotional exhaustion and depersonalization domains of burnout, respectively, were evaluated in published studies of medical students, internal medicine residents, and practicing surgeons. We compared predictive models for the association of each question, versus the full MBI, using longitudinal data on burnout and suicidality from 2006 and 2007 for 858 medical students at five United States medical schools, cross-sectional data on burnout and serious thoughts of dropping out of medical school from 2007 for 2222 medical students at seven United States medical schools, and cross-sectional data on burnout and unprofessional attitudes and behaviors from 2009 for 2566 medical students at seven United States medical schools. We also assessed results for longitudinal data on burnout and perceived major medical errors from 2003 to 2009 for 321 Mayo Clinic Rochester internal medicine residents and cross-sectional data on burnout and both perceived major medical errors and suicidality from 2008 for 7,905 respondents to a national survey of members of the American College of Surgeons. Point estimates of effect for models based on the single-item measures were uniformly consistent with those reported for models based on the full MBI. The single-item measures of emotional exhaustion and depersonalization exhibited strong associations with each published outcome (all p ≤ 0.008). No conclusion regarding

Association of medical student burnout with residency specialty choice.

PubMed

Enoch, Lindsey; Chibnall, John T; Schindler, Debra L; Slavin, Stuart J

2013-02-01

Given the trend among medical students away from primary care medicine and toward specialties that allow for more controllable lifestyles, the identification of factors associated with specialty choice is important. Burnout is one such factor. The purpose of this study was to examine the associations between burnout and residency specialty choice in terms of provision for a less versus more controllable lifestyle (e.g. internal medicine versus dermatology) and a lower versus higher income (e.g. paediatrics versus anaesthesiology). A survey was sent to 165 Year 4 medical students who had entered the residency matching system. Students answered questions about specialty choice, motivating factors (lifestyle, patient care and prestige) and perceptions of medicine as a profession. They completed the Maslach Burnout Inventory-Human Services (MBI), which defines burnout in relation to emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Burnout and other variables were tested for associations with specialty lifestyle controllability and income. A response rate of 88% (n = 145) was achieved. Experiences of MBI-EE, MBI-DP and MBI-PA burnout were reported by 42 (29%), 26 (18%) and 30 (21%) students, respectively. Specialties with less controllable lifestyles were chosen by 87 (60%) students and lower-income specialties by 81 (56%). Adjusted odds ratios (ORs) indicated that the choice of a specialty with a more controllable lifestyle was associated with higher MBI-EE burnout (OR = 1.77, 95% confidence interval [CI] 1.06-2.96), as well as stronger lifestyle- and prestige-related motivation, and weaker patient care-related motivation. The choice of a higher-income specialty was associated with lower MBI-PA burnout (OR = 0.56, 95% CI 0.32-0.98), weaker lifestyle- and patient care-related motivation, and stronger prestige-related motivation. Specialty choices regarding lifestyle controllability and income were associated with the amount and type of

18 CFR 342.3 - Indexing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Indexing. 342.3 Section....3 Indexing. (a) Rate changes. A rate charged by a carrier may be changed, at any time, to a level... December 31, 1994. (5) When an initial rate, or rate changed by a method other than indexing, takes effect...

18 CFR 342.3 - Indexing.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Indexing. 342.3 Section....3 Indexing. (a) Rate changes. A rate charged by a carrier may be changed, at any time, to a level... December 31, 1994. (5) When an initial rate, or rate changed by a method other than indexing, takes effect...

18 CFR 342.3 - Indexing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Indexing. 342.3 Section....3 Indexing. (a) Rate changes. A rate charged by a carrier may be changed, at any time, to a level... December 31, 1994. (5) When an initial rate, or rate changed by a method other than indexing, takes effect...

18 CFR 342.3 - Indexing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Indexing. 342.3 Section....3 Indexing. (a) Rate changes. A rate charged by a carrier may be changed, at any time, to a level... December 31, 1994. (5) When an initial rate, or rate changed by a method other than indexing, takes effect...

7 CFR 798.3 - Index.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Index. 798.3 Section 798.3 Agriculture Regulations of... RECORDS AVAILABILITY OF INFORMATION TO THE PUBLIC § 798.3 Index. 5 U.S.C. 552(a)(2) requires that each agency publish or otherwise make available a current index of all materials required to be made available...

Machine-Aided Indexing of Technical Literature

ERIC Educational Resources Information Center

Klingbiel, Paul H.

1973-01-01

To index at the Defense Documentation Center (DDC), an automated system must choose single words or phrases rapidly and economically. Automation of DDC's indexing has been machine-aided from its inception. A machine-aided indexing system is described that indexes one million words of text per hour of CPU time. (22 references) (Author/SJ)

Computer aided indexing at NASA

NASA Technical Reports Server (NTRS)

Buchan, Ronald L.

1987-01-01

The application of computer technology to the construction of the NASA Thesaurus and in NASA Lexical Dictionary development is discussed in a brief overview. Consideration is given to the printed and online versions of the Thesaurus, retrospective indexing, the NASA RECON frequency command, demand indexing, lists of terms by category, and the STAR and IAA annual subject indexes. The evolution of computer methods in the Lexical Dictionary program is traced, from DOD and DOE subject switching to LCSH machine-aided indexing and current techniques for handling natural language (e.g., the elimination of verbs to facilitate breakdown of sentences into words and phrases).

Measurement of refractive index profile of non-symmetric, complex silica preforms with high refractive index differences

NASA Astrophysics Data System (ADS)

Probostova, Jana; Slanicka, Jiri; Mrazek, Jan; Podrazky, Ondrej; Benda, Adam; Peterka, Pavel

2016-04-01

Refractive index profile measurement is a key instrument for characterization of optical properties of preforms, which are used for drawing of high-quality optical fibers. Common industrial optical preform analyzers have been designed for measurement of simple symmetric structures such as step-index or graded-index preforms with refractive index close to the silica (n=1.457 at 633 nm). However, these conditions are usually far from more complex structures used in fiber lasers or in fiber sensor area. Preforms for the drawing of advanced optical fibers, such as Bragg, microstructure or photonic crystal fibers, are usually constituted from stacks with non-symmetric internal structure or composed of alternating layers with high refractive index contrasts. In this paper we present comparison of refractive index profile measurements of simple as well as complex structures with high refractive index differences simulating the Bragg structures. Commercial Photon Kinetics 2600 preform analyzer was used for the refractive index profile measurements. A set of concentrically arranged silica tubes was welded to form a complex preforms. Free space between the tubes was filled by immersion with varying refractive indices to simulate the Bragg structure. Up to three tubes were used for the analysis and the refractive indices of immersion were changed from 1.4 to 1.5. When refractive index of immersion was independently measured the structure of preform was defined. Profiles of these "known" structures were compared to measured data processed by originally proposed algorithm. The work provides an extension of issues of refractive index profile measurements in non-symmetric complex silica structures by a commercial preform analyzer and proposes more convenient methods of numeric data processing.

The convergent and discriminant validity of burnout measures in sport: a multi-trait/multi-method analysis.

PubMed

Cresswell, Scott L; Eklund, Robert C

2006-02-01

Athlete burnout research has been hampered by the lack of an adequate measurement tool. The Athlete Burnout Questionnaire (ABQ) and the Maslach Burnout Inventory General Survey (MBI-GS) are two recently developed self-report instruments designed to assess burnout. The convergent and discriminant validity of the ABQ and MBI-GS were assessed through multi-trait/multi-method analysis with a sporting population. Overall, the ABQ and the MBI-GS displayed acceptable convergent validity with matching subscales highly correlated, and satisfactory internal discriminant validity with lower correlations between non-matching subscales. Both scales also indicated an adequate discrimination between the concepts of burnout and depression. These findings add support to previous findings in non-sporting populations that depression and burnout are separate constructs. Based on the psychometric results, construct validity analysis and practical considerations, the results support the use of the ABQ to assess athlete burnout.

Health Care Provider Burnout in a United States Military Medical Center During a Period of War.

PubMed

Sargent, Paul; Millegan, Jeffrey; Delaney, Eileen; Roesch, Scott; Sanders, Martha; Mak, Heather; Mallahan, Leonard; Raducha, Stephanie; Webb-Murphy, Jennifer

2016-02-01

Provider burnout can impact efficiency, empathy, and medical errors. Our study examines burnout in a military medical center during a period of war. A survey including the Maslach Burnout Inventory (MBI), deployment history, and work variables was distributed to health care providers. MBI subscale means were calculated and associations between variables were analyzed. Approximately 60% of 523 respondents were active duty and 34% had deployed. MBI subscale means were 19.99 emotional exhaustion, 4.84 depersonalization, and 40.56 personal accomplishment. Frustration over administrative support was associated with high emotional exhaustion and depersonalization; frustration over life/work balance was associated with high emotional exhaustion. Levels of burnout in our sample were similar to civilian medical centers. Sources of frustration were related to administrative support and life/work balance. Deployment had no effect on burnout levels. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Is the Carli index flawed?: assessing the case for the new retail price index RPIJ

PubMed Central

Levell, Peter

2015-01-01

The paper discusses the recent decision of the UK's Office for National Statistics to replace the controversial Carli index with the Jevons index in a new version of the retail price index—RPIJ. In doing so we make three contributions to the way that price indices should be selected for measures of consumer price inflation when quantity information is not available (i.e. at the ‘elementary’ level). Firstly, we introduce a new price bouncing test under the test approach for choosing index numbers. Secondly, we provide empirical evidence on the performance of the Carli and Jevons indices in different contexts under the statistical approach. Thirdly, applying something analogous to the principle of insufficient reason, we argue contrary to received wisdom in the literature, that the economic approach can be used to choose indices at the elementary level, and moreover that it favours the use of the Jevons index. Overall, we conclude that there is a case against the Carli index and that the Jevons index is to be preferred. PMID:25673922

Glycemic index and disease.

PubMed

Pi-Sunyer, F Xavier

2002-07-01

It has been suggested that foods with a high glycemic index are detrimental to health and that healthy people should be told to avoid these foods. This paper takes the position that not enough valid scientific data are available to launch a public health campaign to disseminate such a recommendation. This paper explores the glycemic index and its validity and discusses the effect of postprandial glucose and insulin responses on food intake, obesity, type 1 diabetes, and cardiovascular disease. Presented herein are the reasons why it is premature to recommend that the general population avoid foods with a high glycemic index.

JSC document index

NASA Technical Reports Server (NTRS)

1988-01-01

The Johnson Space Center (JSC) document index is intended to provide a single source listing of all published JSC-numbered documents their authors, and the designated offices of prime responsibility (OPR's) by mail code at the time of publication. The index contains documents which have been received and processed by the JSC Technical Library as of January 13, 1988. Other JSC-numbered documents which are controlled but not available through the JSC Library are also listed.

Comparing the Palmer Drought Index and the Standardized Precipitation Index for Zagreb Gric Observatory

NASA Astrophysics Data System (ADS)

Pandzic, K.; Likso, T.

2012-04-01

Conventional Palmer Drought Index (PDI) and recent Standardized Precipitation Index (SPI) for Zagreb Gric Observatory are compared by spectral analysis technique. Data for a period 1862-2010 are used. The results indicate that SPI is simpler for interpretation but PDI more comprehensive index. On the other side, lack of temperature within SPI, make impossible application of it on climate change interpretation. Possible applications of them in irrigation scheduling system is considered as well for drought risk assessment.

Mangrove vulnerability index using GIS

NASA Astrophysics Data System (ADS)

Yunus, Mohd Zulkifli Mohd; Ahmad, Fatimah Shafinaz; Ibrahim, Nuremira

2018-02-01

Climate change, particularly its associated sea level rise, is major threat to mangrove coastal areas, and it is essential to develop ways to reduce vulnerability through strategic management planning. Environmental vulnerability can be understood as a function of exposure to impacts and the sensitivity and adaptive capacity of ecological systems towards environmental tensors. Mangrove vulnerability ranking using up to 14 parameters found in study area, which is in Pulau Kukup and Sg Pulai, where 1 is low vulnerability and 5 is very high vulnerability. Mangrove Vulnerability Index (MVI) is divided into 3 main categories Physical Mangrove Index (PMI), Biological Mangrove Index (BMI) and Hazard Mangrove Index (HMI).

[The prevalence of burnout and the related factors among some medical students in Korea].

PubMed

Choi, Jaewon; Son, Shill Lee; Kim, Suh Hee; Kim, Hyunsoo; Hong, Jee-Young; Lee, Moo-Sik

2015-12-01

This study was conducted to examine the relationship between the prevalence of burnout and its related factors in medical students in Korea. All available medical students in the metropolitan city of Daejeon, Korea, were asked to answer self-administered questionnaires from July 1 to July 26 in 2013. A total of 534 medical students participated. The Maslach Burnout Inventory-Student Survey (MBI-SS) and structured questionnaires on related factors were used. Confirmatory factor analysis and Cronbach's α were used to verify the applicability of the MBI-SS to medical students in Korea. We also performed chi-square test and logistic regression analysis to identify the factors that were associated with burnout. The MBI-SS was reliable and valid in measuring burnout in Korean medical students. Our confirmatory factor analysis approved and explained the appropriateness of the model fit. The prevalence of burnout among medical students was 26.4% (n=141). Suchrates were higher in students who were female, experienced greater levels of depression, had poor academic performance, feared dropping out, and were stressed by the poor quality of the class facilities. The MBI-SS is a valid instrument to measure academic burnout in Korean medical students. Further studies should be performed, because improvements in the mental health of medical students will benefit these doctors-to-be and their future patients.

An analytical method to screen for six thyreostatic drug residues in the thyroid gland and muscle tissues of food producing animals by liquid chromatography with ultraviolet absorption detection and liquid chromatography/mass spectrometry.

PubMed

Asea, Philip E; MacNeil, James D; Boison, Joe O

2006-01-01

A method was developed and validated to screen for residues of the thyreostatic drugs, tapazole (TAP), mercaptobenzimidazole (MBI), thiouracil (TU), methylthiouracil (MTU), propylthiouracil (PrTU), and phenylthiouracil (PhTU) in bovine, equine, ovine, and porcine thyroid and muscle tissues at concentrations > or = 5 ng/g using 2-methoxy-mercaptobenzimidazole (MeMBI) and dimethylthiouracil (DMTU) as internal standards. In this method, the drugs were solvent extracted from thyroid and muscle tissue and cleaned up on an amino-propyl solid-phase extraction (SPE) cartridge. The unretained fraction containing TAP and MBI and the internal standard, MeMBI, was collected as Fraction 1. The retained fraction containing TU, MTU, PrTU, PhTU, and the internal standard, DMTU, was eluted with 3% acetic acid-isopropanol as Fraction 2. Fraction 1 was further cleaned up on an alumina B SPE cartridge and analyzed by gradient elution on a C18 high-performance liquid chromatography (HPLC) column with ultraviolet detection at wavelengths of 255 and 300 nm. Fraction 2 was taken to dryness, derivatized with 4-chloro-7-nitrobenzo-2-furazan at pH 8, and analyzed by gradient elution on a C18 LC column with mass spectrometry (MS) detection. Any "presumptive positive" test results were submitted for further analysis by LC/MS/MS. The validated method was applied to the analysis of over 300 thyroid tissue samples.

Nocturnal periodic limb movements decrease antioxidant capacity in post-stroke women.

PubMed

Chen, C-Y; Yu, C-C; Chen, C-L

2016-04-01

Considerable evidence suggests that periodic limb movements during sleep (PLMS) are associated with cardiovascular risk and poor stroke outcome. However, the pathogenesis for this association in stroke patients remains largely unknown. This cross-sectional study enrolled 112 consecutive patients who were admitted to rehabilitation ward due to ischemic stroke. Polysomnography and laboratory tests for oxidative stress and inflammatory biomarkers including C-reactive protein, interleukin 6, total antioxidant capacity (TAC), and urinary 8-hydroxy-2-deoxyguanosine were conducted. Patients were stratified into three categories according to their PLMS index. Patients in the PLMS index ≥15 group were significantly older (P = 0.011), presented a significantly higher National Institute of Health Stroke Scale at stroke onset (P = 0.032), and lower Barthel index (P = 0.035) than patients in the PLMS index <5 group. The level of TAC differed significantly (P = 0.018) among the three groups. Multivariate linear regression analyses show that the PLMS index was negatively and independently correlated with TAC (P = 0.024) in women. Besides, multivariate logistic regression analyses also reveal that patients with a PLMS index ≥15 compared with the referent PLMS index <5 had a 7.58-fold increased relative hazard for stroke recurrence (odds ratio 7.58, [1.31-43.88], P = 0.024). This study suggests that PLMS was independently associated with decreased antioxidant capacity in women with ischemic stroke. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Increasing farmers' adoption of agricultural index insurance: The search for a better index

NASA Astrophysics Data System (ADS)

Muneepeerakul, C. P.

2015-12-01

The weather index insurance promises to provide farmers' financial resilience when struck by adverse weather conditions, owing to its minimal moral hazard, low transaction cost, and swift compensation. Despite these advantages, the index insurance has so far received low level of adoption. One of the major causes is the presence of "basis risk"—the risk of getting an insurance payoff that falls short of the actual losses. One source of this basis risk is the production basis risk—the probability that the selected weather indexes and their thresholds do not correspond to actual damages. Here, we investigate how to reduce this production basis risk, using current knowledge in non-linear analysis and stochastic modeling from the fields of ecology and hydrology. We demonstrate how the inclusion of rainfall stochasticity can reduce production basis risk while identifying events that do not need to be insured. Through these findings, we show how much we can improve farmers' adoption of agricultural index insurance under different design contexts.

Evaluation of left ventricular Tei index (index of myocardial performance) in healthy dogs and dogs with mitral regurgitation.

PubMed

Teshima, Kenji; Asano, Kazushi; Iwanaga, Koji; Koie, Hiroshi; Uechi, Masami; Kato, Yuka; Kutara, Kenji; Kanno, Nobuyuki; Seki, Mamiko; Edamura, Kazuya; Hasegawa, Atsuhiko; Tanaka, Shigeo

2007-02-01

The left ventricular (LV) Tei index (index of myocardial performance) has been demonstrated to be clinically useful in estimating comprehensive LV function, including the systolic and diastolic performances, in various human cardiac diseases. The purposes of this study were to validate the correlation between the LV Tei index and LV function obtained by cardiac catheterization in healthy dogs, and to evaluate the LV Tei index in dogs with naturally occurring mitral regurgitation (MR). In healthy dogs, the LV Tei index was significantly correlated with the LV peak +dP/dt (r = -0.89) and LV peak -dP/dt (r=0.87). The LV Tei index significantly increased in dogs with MR compared with normal dogs and significantly increased with progressively more severe clinical signs due to heart failure. The elevation of the LV Tei index in dogs with symptomatic MR appears to be associated with shortening of ejection time. The LV Tei index significantly increased with age and was not correlated with heart rate and body weight in normal dogs. In conclusion, our study demonstrated that the LV Tei index was measurable in dogs and not influenced by heart rate and body weight. The LV Tei index significantly increased with the progression of clinical signs in MR dogs. In particular, the elevation of the LV Tei index in dogs with symptomatic MR due to shortening of ejection time may suggest LV systolic dysfunction and the decrement of forward stroke volume.

New weather index

NASA Astrophysics Data System (ADS)

Scientists at the National Oceanic and Atmospheric Administration (NOAA) and the University of Delaware have refined the wind-chill factor, a common measurement of weather discomfort, into a new misery register called the weather stress index. In addition to the mix of temperature and wind speed data used to calculate wind chill, the recipe for the index adds two new ingredients—humidity and a dash of benchmark statistics—to estimate human reaction to weather conditions. NOAA says that the weather stress index estimates human reaction to weather conditions and that the reaction depends on variations from the ‘normal’ conditions in the locality involved.Discomfort criteria for New Orleans, La., and Bismarck, N.D., for example, differ drastically. According to NOAA, when it's the middle of winter and it's -10°C with a relative humidity of 80% and 24 km/h winds, persons in New Orleans would be highly stressed while those in Bismarck wouldn't bat an eye.

Evolutionary dynamics of collective index insurance.

PubMed

Pacheco, Jorge M; Santos, Francisco C; Levin, Simon A

2016-03-01

Index-based insurances offer promising opportunities for climate-risk investments in developing countries. Indeed, contracts conditional on, e.g., weather or livestock indexes can be cheaper to set up than conventional indemnity-based insurances, while offering a safety net to vulnerable households, allowing them to eventually escape poverty traps. Moreover, transaction costs by insurance companies may be additionally reduced if contracts, instead of arranged with single households, are endorsed by collectives of households that bear the responsibility of managing the division of the insurance coverage by its members whenever the index is surpassed, allowing for additional flexibility in what concerns risk-sharing and also allowing insurance companies to avoid the costs associated with moral hazard. Here we resort to a population dynamics framework to investigate under which conditions household collectives may find collective index insurances attractive, when compared with individual index insurances. We assume risk sharing among the participants of each collective, and model collective action in terms of an N-person threshold game. Compared to less affordable individual index insurances, we show how collective index insurances lead to a coordination problem in which the adoption of index insurances may become the optimal decision, spreading index insurance coverage to the entire population. We further investigate the role of risk-averse and risk-prone behaviors, as well as the role of partial correlation between insurance coverage and actual loss of crops, and in which way these affect the original coordination thresholds.

[Clinical application of the "Stop walking while talking test". Relationship with geriatric assessment parameters and other tests of balance and gait].

PubMed

González-Ávila, Bárbara; Roqueta, Cristina; Farriols, Cristina; Álvaro, Margarita; Roig, Alba; Cervera, Anton Maria; Miralles, Ramón

To assess the relationship between the Stop Walking While Talking (SWWT) test and some parameters of the geriatric assessment, as well as other tests of balance and gait. A prospective, observational and cross-sectional study conducted on 108 patients (62% women), with a mean age of 80.5±8.4 years. Twenty-three of them were living at home, 24 in a nursing home, and 61 in an intermediate care unit. A record was made of the Barthel index, Mini-Mental State Examination of Folstein (MMSE), comorbidity (Charlson index), the presence of previous falls, and fear of falling. Timed Up and Go (TUG), Tinetti test, and Stop Walking While Talking (SWWT) test, were performed on all the patients. Based on the results of the SWWT test patients were divided in two groups: "stoppers" and "non-stoppers". All patients were able to walk (with or without walking aids). The stoppers group of patients had a mean age 82.2±8.7; Barthel index 64.6±20.7; MMSE 21.6±5.1; Charlson index 1.8±1.7, and the non-stoppers 78.5±7.6 (P=.024), 86.0±18.1 (P<.001), 24.3±4.0 (P=.004), and 1.3±1.6 (P=.130), respectively. Of the 58 stoppers patients, 39 (67.2%) had a previous fall, and 19 (32.8%) had not (P=.002); 43 (74.1%) had fear of falling, and 15 (25.9%) had not (P<0.009). Of the 63 patients with TUG>20seconds, 52 (82.5%) were stoppers and 11 (17.5%) non-stoppers. Of the 31 with TUG between 10-20seconds, 5 (16.1%) were stoppers and 26 (83.9%) non-stoppers. Of the 14 with TUG<10 seconds, 1 (7.1%) were stoppers, and 13 (92.9%) non-stoppers (P<0.0001). The score of Tinetti test in the stoppers group was 15.4±5.2, and in non-stoppers 23.9±4.6 (P<0.001). Those in the stopper group were significantly older, were more dependent in activities of daily living, had greater cognitive impairment, more previous falls, had greater fear of falling, lower scores on the Tinetti test, and longer times in the TUG. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

Aeronautical Engineering: 1983 cumulative index

NASA Technical Reports Server (NTRS)

1984-01-01

This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (158) through NASA SP-7037 (169) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, report number, and accession number indexes.

Fried frailty phenotype assessment components as applied to geriatric inpatients.

PubMed

Bieniek, Joanna; Wilczyński, Krzysztof; Szewieczek, Jan

2016-01-01

Management of geriatric patients would be simplified if a universally accepted definition of frailty for clinical use was defined. Among definitions of frailty, Fried frailty phenotype criteria constitute a common reference frame for many geriatric studies. However, this reference frame has been tested primarily in elderly patients presenting with relatively good health status. The aim of this article was to assess the usefulness and limitations of Fried frailty phenotype criteria in geriatric inpatients, characterized by comorbidity and functional impairments, and to estimate the frailty phenotype prevalence in this group. Five hundred consecutive patients of the university hospital subacute geriatric ward, aged 79.0±8.4 years (67% women and 33% men), participated in this cross-sectional study. Comprehensive geriatric assessment and Fried frailty phenotype component evaluation were performed in all patients. Multimorbidity (6.0±2.8 diseases) characterized our study group, with a wide range of clinical conditions and functional states (Barthel Index of Activities of Daily Living 72.2±28.2 and Mini-Mental State Examination 23.6±7.1 scores). All five Fried frailty components were assessed in 65% of patients (95% confidence interval [CI] =60.8-69.2) (diagnostic group). One or more components were not feasible to be assessed in 35% of the remaining patients (nondiagnostic group) because of lack of past patient's body mass control and/or cognitive or physical impairment. Patients from the nondiagnostic group, as compared to patients from the diagnostic group, presented with more advanced age, higher prevalence of dementia, lower prevalence of hypertension, lower systolic and diastolic blood pressure, body mass index, Mini-Mental State Examination and Barthel Index of Activities of Daily Living. Despite diagnostic limitations, we found ≥3 positive criteria (thus, frailty diagnosis) in 54.2% of the study group (95% CI =49.8-58.6), with prevalence from 31.7% in

Design, development and use of the spectrometer for investigating coherent THz radiation produced by micro-bunching instabilities at Diamond Light Source

NASA Astrophysics Data System (ADS)

Finn, Aiveen; Karataev, Pavel; Rehm, Guenther

2016-07-01

Schottky barrier diodes (SBDs) are known for their low noise, ultra-fast response and excellent sensitivity. They are often implemented as detectors in the millimetre wavelength regime. Micro-bunch instabilities (MBI) have been detected at many light sources around the world including the Diamond Light Source, UK. These MBI can result in bursts of coherent synchrotron radiation (CSR) with millimetre wavelengths. More research needs to be carried out with regards to the dynamics of MBI in order to confirm the simulations and to eventually harness the power of the CSR bursts. A single shot spectrometer has been designed and is under operation at the Diamond Light Source (DLS). It is composed of eight SBDs ranging from 33-1000 GHz. Unlike previous measurements carried out, each of the SBDs has been individually characterised thus making the results obtained comparable to simulations. In this paper, we present the assessment of each SBD in the spectrometer and the first results of the spectrometer's use in the beam.

on the clinical validity of the maslach burnout inventory and the burnout measure.

PubMed

Schaufeli, W B; Bakker, A B; Hoogduin, K; Schaap, C; Kladler, A

2001-09-01

Abstract Current knowledge about burnout suffers from a healthy worker bias since only working - and thus relatively healthy - employees have been investigated. The main objective of this study is to examine - for the first time among employees who sought psychological treatment - the validity of the two most widely used burnout instruments; the Maslach Burnout Inventory (MBI) and the Burnout Measure (BM). Two groups were distinguished: a "burned out" group (n = 71) that suffers from work-related neurasthenia (according to ICD-10 criteria), and a "non-burned out" group (n = 68). Results show that: (1) the validity of the three-factor structure of the MBI and the BM is confirmed; (2) burnout can partly be differentiated from other mental syndromes (e.g., anxiety and depression); and (3) two MBI-scales (Emotional Exhaustion and Depersonalization) and one BM-scale (Exhaustion) are able to discriminate between burned out and non-burned out employees. The practical implications of these results are discussed.

Masculine body ideologies as a non-gynocentric framework for the psychological study of the male body.

PubMed

Rosenmann, Amir; Kaplan, Danny

2014-09-01

Psychological research of the body disproportionately centers on body-appearance concerns. Grounded in women's experience of objectification, it neglects much of men's bodily experience. To address this we introduce Masculine Body Ideologies (MBI), a set of belief systems that prescribe how men should engage with their bodies. Three MBI ideal-types are identified and situated within broader masculinity ideologies: unattended, functional body ideology associated with traditional masculinity rooted in modern industrial society; metrosexual body ideology associated with post-industrial, consumer masculinity and reemploying signifiers of body functionality to form an objectified body esthetics; and holistic body ideology emphasizing inner-harmony, authenticity and expressivity, manifesting post-industrial trends of self-aware masculinity. As a normative framework, MBI underscores how similar body practices may be motivated by different body concerns associated with alternative body ideologies. This framework can clarify conceptual and empirical inconsistencies in studies of male body-appearance concerns and inform emerging research and mental-health considerations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Self-healing coatings based on halloysite clay polymer composites for protection of copper alloys.

PubMed

Abdullayev, Elshad; Abbasov, Vagif; Tursunbayeva, Asel; Portnov, Vasiliy; Ibrahimov, Hikmat; Mukhtarova, Gulbaniz; Lvov, Yuri

2013-05-22

Halloysite clay nanotubes loaded with corrosion inhibitors benzotriazole (BTA), 2-mercaptobenzimidazole (MBI), and 2-mercaptobenzothiazole (MBT) were used as additives in self-healing composite paint coating of copper. These inhibitors form protective films on the metal surface and mitigate corrosion. Mechanisms involved in the film formation have been studied with optical and electron microscopy, UV-vis spectrometry, and adhesivity tests. Efficiency of the halloysite lumen loading ascended in the order of BTA < MBT < MBI; consequently, MBI and MBT halloysite formulations have shown the best protection. Inhibitors were kept in the tubes buried in polymeric paint layer for a long time and release was enhanced in the coating defects exposed to humid media with 20-50 h, sufficient for formation of protective layer. Anticorrosive performance of the halloysite-based composite acrylic and polyurethane coatings have been demonstrated for 110-copper alloy strips exposed to 0.5 M aqueous NaCl for 6 months.

Energy Index For Aircraft Maneuvers

NASA Technical Reports Server (NTRS)

Chidester, Thomas R. (Inventor); Lynch, Robert E. (Inventor); Lawrence, Robert E. (Inventor); Amidan, Brett G. (Inventor); Ferryman, Thomas A. (Inventor); Drew, Douglas A. (Inventor); Ainsworth, Robert J. (Inventor); Prothero, Gary L. (Inventor); Romanowski, Tomothy P. (Inventor); Bloch, Laurent (Inventor)

2006-01-01

Method and system for analyzing, separately or in combination, kinetic energy and potential energy and/or their time derivatives, measured or estimated or computed, for an aircraft in approach phase or in takeoff phase, to determine if the aircraft is or will be put in an anomalous configuration in order to join a stable approach path or takeoff path. A 3 reference value of kinetic energy andor potential energy (or time derivatives thereof) is provided, and a comparison index .for the estimated energy and reference energy is computed and compared with a normal range of index values for a corresponding aircraft maneuver. If the computed energy index lies outside the normal index range, this phase of the aircraft is identified as anomalous, non-normal or potentially unstable.

Is burnout related to allostatic load?

PubMed

Langelaan, Saar; Bakker, Arnold B; Schaufeli, Wilmar B; van Rhenen, Willem; van Doornen, Lorenz J P

2007-01-01

Burnout has a negative impact on physical health, but the mechanisms underlying this relation remain unclear. To elucidate these mechanisms, possible mediating physiological systems or risk factors for adverse health in burned-out employees should be investigated. The aim of the present study among 290 Dutch managers was to explore whether allostatic load mediates the relationship between burnout and physical health. Burned-out managers, as identified with the Maslach Burnout Inventory General Survey (MBI-GS), were compared with a healthy control group with regard to their allostatic load. The allostatic load index included eight parameters: Body-mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), C-reactive protein (CRP), high-density lipoprotein (HDL), cholesterol, glycosylated hemoglobin (HbA1C) and glucose. Contrary to expectations, burned-out managers did not differ from healthy managers with regard to their scores on the allostatic load index. An additional analysis, using groups of managers in the extreme deciles of exhaustion (the core symptom of burnout), did also not reveal differences in allostatic load. Burnout seems not to be associated with this proxy measure of allostatic load. The mediating physiological mechanisms between burnout and objective physical health remain to be elucidated.

Fine-Scale Population Estimation by 3D Reconstruction of Urban Residential Buildings

PubMed Central

Wang, Shixin; Tian, Ye; Zhou, Yi; Liu, Wenliang; Lin, Chenxi

2016-01-01

Fine-scale population estimation is essential in emergency response and epidemiological applications as well as urban planning and management. However, representing populations in heterogeneous urban regions with a finer resolution is a challenge. This study aims to obtain fine-scale population distribution based on 3D reconstruction of urban residential buildings with morphological operations using optical high-resolution (HR) images from the Chinese No. 3 Resources Satellite (ZY-3). Specifically, the research area was first divided into three categories when dasymetric mapping was taken into consideration. The results demonstrate that the morphological building index (MBI) yielded better results than built-up presence index (PanTex) in building detection, and the morphological shadow index (MSI) outperformed color invariant indices (CIIT) in shadow extraction and height retrieval. Building extraction and height retrieval were then combined to reconstruct 3D models and to estimate population. Final results show that this approach is effective in fine-scale population estimation, with a mean relative error of 16.46% and an overall Relative Total Absolute Error (RATE) of 0.158. This study gives significant insights into fine-scale population estimation in complicated urban landscapes, when detailed 3D information of buildings is unavailable. PMID:27775670

Exploring Volumetrically Indexed Cups

ERIC Educational Resources Information Center

Jones, Dustin L.

2011-01-01

This article was inspired by a set of 12 cylindrical cups, which are volumetrically indexed; that is to say, the volume of cup "n" is equal to "n" times the volume of cup 1. Various sets of volumetrically indexed cylindrical cups are explored. I demonstrate how this children's toy is ripe for mathematical investigation, with connections to…

Enhanced index tracking modelling in portfolio optimization

NASA Astrophysics Data System (ADS)

Lam, W. S.; Hj. Jaaman, Saiful Hafizah; Ismail, Hamizun bin

2013-09-01

Enhanced index tracking is a popular form of passive fund management in stock market. It is a dual-objective optimization problem, a trade-off between maximizing the mean return and minimizing the risk. Enhanced index tracking aims to generate excess return over the return achieved by the index without purchasing all of the stocks that make up the index by establishing an optimal portfolio. The objective of this study is to determine the optimal portfolio composition and performance by using weighted model in enhanced index tracking. Weighted model focuses on the trade-off between the excess return and the risk. The results of this study show that the optimal portfolio for the weighted model is able to outperform the Malaysia market index which is Kuala Lumpur Composite Index because of higher mean return and lower risk without purchasing all the stocks in the market index.

Automatic inference of indexing rules for MEDLINE.

PubMed

Névéol, Aurélie; Shooshan, Sonya E; Claveau, Vincent

2008-11-19

Indexing is a crucial step in any information retrieval system. In MEDLINE, a widely used database of the biomedical literature, the indexing process involves the selection of Medical Subject Headings in order to describe the subject matter of articles. The need for automatic tools to assist MEDLINE indexers in this task is growing with the increasing number of publications being added to MEDLINE. In this paper, we describe the use and the customization of Inductive Logic Programming (ILP) to infer indexing rules that may be used to produce automatic indexing recommendations for MEDLINE indexers. Our results show that this original ILP-based approach outperforms manual rules when they exist. In addition, the use of ILP rules also improves the overall performance of the Medical Text Indexer (MTI), a system producing automatic indexing recommendations for MEDLINE. We expect the sets of ILP rules obtained in this experiment to be integrated into MTI.

Macdonald index and chiral algebra

NASA Astrophysics Data System (ADS)

Song, Jaewon

2017-08-01

For any 4d N = 2 SCFT, there is a subsector described by a 2d chiral algebra. The vacuum character of the chiral algebra reproduces the Schur index of the corresponding 4d theory. The Macdonald index counts the same set of operators as the Schur index, but the former has one more fugacity than the latter. We conjecture a prescription to obtain the Macdonald index from the chiral algebra. The vacuum module admits a filtration, from which we construct an associated graded vector space. From this grading, we conjecture a notion of refined character for the vacuum module of a chiral algebra, which reproduces the Macdonald index. We test this prescription for the Argyres-Douglas theories of type ( A 1 , A 2 n ) and ( A 1 , D 2 n+1) where the chiral algebras are given by Virasoro and \\widehat{su}(2) affine Kac-Moody algebra. When the chiral algebra has more than one family of generators, our prescription requires a knowledge of the generators from the 4d.

Macdonald index and chiral algebra

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

Song, Jaewon

For any 4dN = 2 SCFT, there is a subsector described by a 2d chiral algebra. The vacuum character of the chiral algebra reproduces the Schur index of the corresponding 4d theory. The Macdonald index counts the same set of operators as the Schur index, but the former has one more fugacity than the latter. Here, we conjecture a prescription to obtain the Macdonald index from the chiral algebra. The vacuum module admits a filtration, from which we construct an associated graded vector space. From this grading, we conjecture a notion of refined character for the vacuum module of a chiral algebra, which reproduces the Macdonald index. We test this prescription for the Argyres-Douglas theories of type (A 1, A 2n) and (A 1, D 2n+1) where the chiral algebras are given by Virasoro andmore » $$ˆ\\atop{su}$$(2) affine Kac-Moody algebra. When the chiral algebra has more than one family of generators, our prescription requires a knowledge of the generators from the 4d.« less

Macdonald index and chiral algebra

DOE PAGES

Song, Jaewon

2017-08-10

For any 4dN = 2 SCFT, there is a subsector described by a 2d chiral algebra. The vacuum character of the chiral algebra reproduces the Schur index of the corresponding 4d theory. The Macdonald index counts the same set of operators as the Schur index, but the former has one more fugacity than the latter. Here, we conjecture a prescription to obtain the Macdonald index from the chiral algebra. The vacuum module admits a filtration, from which we construct an associated graded vector space. From this grading, we conjecture a notion of refined character for the vacuum module of a chiral algebra, which reproduces the Macdonald index. We test this prescription for the Argyres-Douglas theories of type (A 1, A 2n) and (A 1, D 2n+1) where the chiral algebras are given by Virasoro andmore » $$ˆ\\atop{su}$$(2) affine Kac-Moody algebra. When the chiral algebra has more than one family of generators, our prescription requires a knowledge of the generators from the 4d.« less

Refractive Index of Sodium Iodide

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

Jellison Jr, Gerald Earle; Boatner, Lynn A; Ramey, Joanne Oxendine

2012-01-01

The refractive index of sodium iodide, an important scintillator material that is widely used for radiation detection, is based on a single measurement made by Spangenberg at one wavelength using the index-matching liquid immersion method (Z. Kristallogr., 57, 494-534 (1923)). In the present paper, we present new results for the refractive index of sodium iodide as measured by the minimum deviation technique at six wavelengths between 436 nm (n=1.839 0.002) and 633 nm (n=1.786 0.002). These 6 measurements can be fit to a Sellmeier model, resulting in a 2 of 1.02, indicating a good fit to the data. In addition,more » we report on ellipsometry measurements, which suggest that the near-surface region of the air sensitive NaI crystal seriously degrades, even in a moisture-free environment, resulting in a significantly lower value of the refractive index near the surface. First-principles theoretical calculations of the NaI refractive index that agree with the measured values within 0.025-0.045 are also presented and discussed.« less

Equivalences of the multi-indexed orthogonal polynomials

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

Odake, Satoru

2014-01-15

Multi-indexed orthogonal polynomials describe eigenfunctions of exactly solvable shape-invariant quantum mechanical systems in one dimension obtained by the method of virtual states deletion. Multi-indexed orthogonal polynomials are labeled by a set of degrees of polynomial parts of virtual state wavefunctions. For multi-indexed orthogonal polynomials of Laguerre, Jacobi, Wilson, and Askey-Wilson types, two different index sets may give equivalent multi-indexed orthogonal polynomials. We clarify these equivalences. Multi-indexed orthogonal polynomials with both type I and II indices are proportional to those of type I indices only (or type II indices only) with shifted parameters.

Evaluation of right ventricular Tei index (index of myocardial performance) in healthy dogs and dogs with tricuspid regurgitation.

PubMed

Teshima, Kenji; Asano, Kazushi; Iwanaga, Koji; Koie, Hiroshi; Uechi, Masami; Kato, Yuka; Kutara, Kenji; Edamura, Kazuya; Hasegawa, Atsuhiko; Tanaka, Shigeo

2006-12-01

Right ventricular (RV) Tei index (index of myocardial performance) has been demonstrated to be clinically useful in estimating RV function in various human cardiac diseases. The purposes of this study were to validate the correlation between RV Tei index and RV function obtained by cardiac catheterization in healthy dogs, and to evaluate the RV Tei index in dogs with tricuspid regurgitation (TR). In healthy dogs, the RV Tei index significantly correlated with the RV peak +dP/dt (r=-0.80, p<0.0001) and -dP/dt (r=0.69, p=0.0001). In normal dogs, the RV Tei index was not significantly correlated with heart rate, body weight, and age. The RV Tei index significantly increased in dogs with moderate to severe TR (0.39 +/- 0.35, p=0.0015), filariasis (0.46 +/- 0.16, p=0.0131), and trivial to mild TR and severe mitral regurgitation (MR; 0.61 +/- 0.14, p=0.0017) when compared with the normal dogs (0.17 +/- 0.10). In addition, the RV Tei index in dogs with TR significantly increased in association with pulmonary hypertension [PH(-), 0.19 +/- 0.09; PH(+), 0.65 +/- 0.14; respectively p<0.0001]. Our study has demonstrated that RV Tei index is a feasible approach to estimate RV function in dogs and is not influenced by heart rate, body weight, and aging. Further investigations are required to clarify the clinical significance of RV Tei index in dogs with right-sided cardiac diseases.

Fine-grained indexing of the biomedical literature: MeSH subheading attachment for a MEDLINE indexing tool.

PubMed

Névéol, Aurélie; Shooshan, Sonya E; Mork, James G; Aronson, Alan R

2007-10-11

This paper reports on the latest results of an Indexing Initiative effort addressing the automatic attachment of subheadings to MeSH main headings recommended by the NLM's Medical Text Indexer. Several linguistic and statistical approaches are used to retrieve and attach the subheadings. Continuing collaboration with NLM indexers also provided insight on how automatic methods can better enhance indexing practice. The methods were evaluated on corpus of 50,000 MEDLINE citations. For main heading/subheading pair recommendations, the best precision is obtained with a post-processing rule method (58%) while the best recall is obtained by pooling all methods (64%). For stand-alone subheading recommendations, the best performance is obtained with the PubMed Related Citations algorithm. Significant progress has been made in terms of subheading coverage. After further evaluation, some of this work may be integrated in the MEDLINE indexing workflow.

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

Weinmann, Amanda L.; Hruska, Carrie B.; Conners, Amy L.

Purpose: Molecular breast imaging (MBI) is a dedicated nuclear medicine breast imaging modality that employs dual-head cadmium zinc telluride (CZT) gamma cameras to functionally detect breast cancer. MBI has been shown to detect breast cancers otherwise occult on mammography and ultrasound. Currently, a MBI-guided biopsy system does not exist to biopsy such lesions. Our objective was to consider the utility of a novel conical slant-hole (CSH) collimator for rapid (<1 min) and accurate monitoring of lesion position to serve as part of a MBI-guided biopsy system. Methods: An initial CSH collimator design was derived from the dimensions of a parallel-holemore » collimator optimized for MBI performed with dual-head CZT gamma cameras. The parameters of the CSH collimator included the collimator height, cone slant angle, thickness of septa and cones of the collimator, and the annular areas exposed at the base of the cones. These parameters were varied within the geometric constraints of the MBI system to create several potential CSH collimator designs. The CSH collimator designs were evaluated using Monte Carlo simulations. The model included a breast compressed to a thickness of 6 cm with a 1-cm diameter lesion located 3 cm from the collimator face. The number of particles simulated was chosen to represent the count density of a low-dose, screening MBI study acquired with the parallel-hole collimator for 10 min after a {approx}150 MBq (4 mCi) injection of Tc-99m sestamibi. The same number of particles was used for the CSH collimator simulations. In the resulting simulated images, the count sensitivity, spatial resolution, and accuracy of the lesion depth determined from the lesion profile width were evaluated. Results: The CSH collimator design with default parameters derived from the optimal parallel-hole collimator provided 1-min images with error in the lesion depth estimation of 1.1 {+-} 0.7 mm and over 21 times the lesion count sensitivity relative to 1-min

Automatic inference of indexing rules for MEDLINE

PubMed Central

Névéol, Aurélie; Shooshan, Sonya E; Claveau, Vincent

2008-01-01

Background: Indexing is a crucial step in any information retrieval system. In MEDLINE, a widely used database of the biomedical literature, the indexing process involves the selection of Medical Subject Headings in order to describe the subject matter of articles. The need for automatic tools to assist MEDLINE indexers in this task is growing with the increasing number of publications being added to MEDLINE. Methods: In this paper, we describe the use and the customization of Inductive Logic Programming (ILP) to infer indexing rules that may be used to produce automatic indexing recommendations for MEDLINE indexers. Results: Our results show that this original ILP-based approach outperforms manual rules when they exist. In addition, the use of ILP rules also improves the overall performance of the Medical Text Indexer (MTI), a system producing automatic indexing recommendations for MEDLINE. Conclusion: We expect the sets of ILP rules obtained in this experiment to be integrated into MTI. PMID:19025687

Machine-aided indexing for NASA STI

NASA Technical Reports Server (NTRS)

Wilson, John

1987-01-01

One of the major components of the NASA/STI processing system is machine-aided indexing (MAI). MAI is a computer process that generates a set of indexing terms selected from NASA's thesaurus, is used for indexing technical reports, is based on text, and is reviewed by indexers. This paper summarizes the MAI objectives and discusses the NASA Lexical Dictionary, subject switching, and phrase matching or natural languages. The benefits of using MAI are mentioned, and MAI production improvement and the future of MAI are briefly addressed.

AGARD Index of Publications (1952-1970). Part III: Author Index, Part IV: Addendum to Part I,

DTIC Science & Technology

When the AGARD Index of Publications 1952-1970 was published in June 1972, no Author Index was provided. Experience with the basic document has...therefore contains both an Author Index of all publications and papers from 1952-1970 and, in addition, an Addendum containing a listing of the titles of all individual papers that were omitted from the basic document.

Stator Indexing in Multistage Compressors

NASA Technical Reports Server (NTRS)

Barankiewicz, Wendy S.

1997-01-01

The relative circumferential location of stator rows (stator indexing) is an aspect of multistage compressor design that has not yet been explored for its potential impact on compressor aerodynamic performance. Although the inlet stages of multistage compressors usually have differing stator blade counts, the aft stages of core compressors can often have stage blocks with equal stator blade counts in successive stages. The potential impact of stator indexing is likely greatest in these stages. To assess the performance impact of stator indexing, researchers at the NASA Lewis Research Center used the 4 ft diameter, four-stage NASA Low Speed Axial Compressor for detailed experiments. This compressor has geometrically identical stages that can circumferentially index stator rows relative to each other in a controlled manner; thus it is an ideal test rig for such investigations.

Beyond the Kubler index

USGS Publications Warehouse

Eberl, D.D.; Velde, B.

1989-01-01

The value of peak width at half-height for the illite 001 XRD reflection is known as the Kubler index or the illite 'crystallinity' index. This measurement, which has been related to the degree of metamorphism of very low-grade, pelitic rocks, is a function of at least two crystal-chemical factors: (1) illite X-ray scattering domain size; and (2) illite structural distortions (especially swelling). Reynolds' NEWMOD computer program is used to construct a grid with which these two contributions to illite peak width can be determined independently from measurements of the 001 peak width at half-height and the Srodofi intensity ratio. This method yields more information about changes undergone by illite during metamorphism than application of the Kubler index method alone.

1 CFR 6.2 - Analytical subject indexes.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Analytical subject indexes. 6.2 Section 6.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.2 Analytical subject indexes. Analytical subject indexes covering the contents of the Federal...

1 CFR 6.2 - Analytical subject indexes.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Analytical subject indexes. 6.2 Section 6.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.2 Analytical subject indexes. Analytical subject indexes covering the contents of the Federal...

An atmospheric dispersion index for prescribed burning

Treesearch

Leonidas G. Lavdas

1986-01-01

A numerical index that estimates the atmosphere's capacity to disperse smoke from prescribed burning is described. The physical assumptions and mathematical development of the index are given in detail. A preliminary interpretation of dispersion index values is offered. A FORTRAN subroutine package for computing the index is included.

1 CFR 6.2 - Analytical subject indexes.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1 General Provisions 1 2014-01-01 2012-01-01 true Analytical subject indexes. 6.2 Section 6.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.2 Analytical subject indexes. Analytical subject indexes covering the contents of the Federal...

1 CFR 6.2 - Analytical subject indexes.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Analytical subject indexes. 6.2 Section 6.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.2 Analytical subject indexes. Analytical subject indexes covering the contents of the Federal...

1 CFR 6.2 - Analytical subject indexes.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1 General Provisions 1 2013-01-01 2012-01-01 true Analytical subject indexes. 6.2 Section 6.2 General Provisions ADMINISTRATIVE COMMITTEE OF THE FEDERAL REGISTER THE FEDERAL REGISTER INDEXES AND ANCILLARIES § 6.2 Analytical subject indexes. Analytical subject indexes covering the contents of the Federal...

Machine aided indexing from natural language text

NASA Technical Reports Server (NTRS)

Silvester, June P.; Genuardi, Michael T.; Klingbiel, Paul H.

1993-01-01

The NASA Lexical Dictionary (NLD) Machine Aided Indexing (MAI) system was designed to (1) reuse the indexing of the Defense Technical Information Center (DTIC); (2) reuse the indexing of the Department of Energy (DOE); and (3) reduce the time required for original indexing. This was done by automatically generating appropriate NASA thesaurus terms from either the other agency's index terms, or, for original indexing, from document titles and abstracts. The NASA STI Program staff devised two different ways to generate thesaurus terms from text. The first group of programs identified noun phrases by a parsing method that allowed for conjunctions and certain prepositions, on the assumption that indexable concepts are found in such phrases. Results were not always satisfactory, and it was noted that indexable concepts often occurred outside of noun phrases. The first method also proved to be too slow for the ultimate goal of interactive (online) MAI. The second group of programs used the knowledge base (KB), word proximity, and frequency of word and phrase occurrence to identify indexable concepts. Both methods are described and illustrated. Online MAI has been achieved, as well as several spinoff benefits, which are also described.

45 CFR 502.6 - Current index.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Current index. 502.6 Section 502.6 Public Welfare..., DEPARTMENT OF JUSTICE RULES OF PRACTICE PUBLIC INFORMATION-FREEDOM OF INFORMATION ACT § 502.6 Current index. The Commission will maintain and make available for public inspection and copying, current indexes...

12 CFR 1402.11 - Current index.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Current index. 1402.11 Section 1402.11 Banks... the Farm Credit System Insurance Corporation § 1402.11 Current index. The Farm Credit System Insurance Corporation will make available for public inspection and copying a current index to provide identifying...

47 CFR 42.4 - Index of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Index of records. 42.4 Section 42.4... RECORDS OF COMMUNICATION COMMON CARRIERS General Instructions § 42.4 Index of records. Each carrier shall maintain at its operating company headquarters a master index of records. The master index shall identify...

A simple centrality index for scientific social recognition

NASA Astrophysics Data System (ADS)

Kinouchi, Osame; Soares, Leonardo D. H.; Cardoso, George C.

2018-02-01

We introduce a new centrality index for bipartite networks of papers and authors that we call K-index. The K-index grows with the citation performance of the papers that cite a given researcher and can be seen as a measure of scientific social recognition. Indeed, the K-index measures the number of hubs, defined in a self-consistent way in the bipartite network, that cites a given author. We show that the K-index can be computed by simple inspection of the Web of Science platform and presents several advantages over other centrality indexes, in particular Hirsch h-index. The K-index is robust to self-citations, is not limited by the total number of papers published by a researcher as occurs for the h-index and can distinguish in a consistent way researchers that have the same h-index but very different scientific social recognition. The K-index easily detects a known case of a researcher with inflated number of papers, citations and h-index due to scientific misconduct. Finally, we show that, in a sample of twenty-eight physics Nobel laureates and twenty-eight highly cited non-Nobel-laureate physicists, the K-index correlates better to the achievement of the prize than the number of papers, citations, citations per paper, citing articles or the h-index. Clustering researchers in a K versus h plot reveals interesting outliers that suggest that these two indexes can present complementary independent information.

Fine-Grained Indexing of the Biomedical Literature: MeSH Subheading Attachment for a MEDLINE Indexing Tool

PubMed Central

Névéol, Aurélie; Shooshan, Sonya E.; Mork, James G.; Aronson, Alan R.

2007-01-01

Objective This paper reports on the latest results of an Indexing Initiative effort addressing the automatic attachment of subheadings to MeSH main headings recommended by the NLM’s Medical Text Indexer. Material and Methods Several linguistic and statistical approaches are used to retrieve and attach the subheadings. Continuing collaboration with NLM indexers also provided insight on how automatic methods can better enhance indexing practice. Results The methods were evaluated on corpus of 50,000 MEDLINE citations. For main heading/subheading pair recommendations, the best precision is obtained with a post-processing rule method (58%) while the best recall is obtained by pooling all methods (64%). For stand-alone subheading recommendations, the best performance is obtained with the PubMed Related Citations algorithm. Conclusion Significant progress has been made in terms of subheading coverage. After further evaluation, some of this work may be integrated in the MEDLINE indexing workflow. PMID:18693897

Precise determination of the refractive index of suspended particles: light transmission as a function of refractive index mismatch

NASA Astrophysics Data System (ADS)

McClymer, J. P.

2016-08-01

Many fluids appear white because refractive index differences lead to multiple scattering. In this paper, we use safe, low-cost commercial index matching fluids to quantitatively study light transmission as a function of index mismatch, reduce multiple scattering to allow single scattering probes, and to precisely determine the index of refraction of suspended material. The transmission profile is compared with Rayleigh-Gans and Mie theory predictions. The procedure is accessible as a student laboratory project, while providing advantages over other standard methods of measuring the refractive index of an unknown nanoparticle, making it valuable to researchers.

45 CFR 1100.4 - Current index.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Current index. 1100.4 Section 1100.4 Public... INFORMATION § 1100.4 Current index. Each agency shall maintain and make available for public inspection and copying a current index providing identifying information for the public as to any matter which is issued...

22 CFR 212.23 - Current index.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Current index. 212.23 Section 212.23 Foreign... Inspection and Copying § 212.23 Current index. USAID maintains and makes available for public inspection and copying a current index providing identifying information for the public as to any matter which has been...

30 CFR 250.1401 - Index table.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Index table. 250.1401 Section 250.1401 Mineral... OPERATIONS IN THE OUTER CONTINENTAL SHELF Outer Continental Shelf (OCS) Civil Penalties § 250.1401 Index table. The following table is an index of the sections in this subpart: § 250.1401Table Definitions...

11 CFR 110.17 - Price index increase.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 11 Federal Elections 1 2010-01-01 2010-01-01 false Price index increase. 110.17 Section 110.17... PROHIBITIONS § 110.17 Price index increase. (a) Price index increases for party committee expenditure... 11 CFR 109.32 and 110.8 shall be increased by the percent difference between the price index, as...

17 CFR 240.3a55-4 - Exclusion from definition of narrow-based security index for indexes composed of debt securities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... narrow-based security index for indexes composed of debt securities. 240.3a55-4 Section 240.3a55-4... Miscellaneous Exemptions § 240.3a55-4 Exclusion from definition of narrow-based security index for indexes composed of debt securities. (a) An index is not a narrow-based security index if: (1)(i) Each of the...

The heat rate index indicator

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

Lasasso, M.; Runyan, B.; Napoli, J.

1995-06-01

This paper describes a method of tracking unit performance through the use of a reference number called the Heat Rate Index Indicator. The ABB Power Plant Controls OTIS performance monitor is used to determine when steady load conditions exist and then to collect controllable and equipment loss data which significantly impact thermal efficiency. By comparing these loss parameters to those found during the previous heat balance, it is possible to develop a new adjusted heat rate curve. These impacts on heat rate are used to changes the shape of the tested heat rate curve by the appropriate percentages over amore » specified load range. Mathcad is used to determine the Heat Rate Index by integrating for the areas beneath the adjusted heat rate curve and a heat rate curve that represents the unit`s ideal heat rate curve is the Heat Rate Index. An index of 1.0 indicates that the unit is operating at an ideal efficiency, while an index of less than 1.0 indicates that the unit is operating at less than ideal conditions. A one per cent change in the Heat Rate Index is equivalent to a one percent change in heat rate. The new shape of the adjusted heat rate curve and the individual curves generated from the controllable and equipment loss parameters are useful for determining performance problems in specific load ranges.« less

An automatic indexing method for medical documents.

PubMed Central

Wagner, M. M.

1991-01-01

This paper describes MetaIndex, an automatic indexing program that creates symbolic representations of documents for the purpose of document retrieval. MetaIndex uses a simple transition network parser to recognize a language that is derived from the set of main concepts in the Unified Medical Language System Metathesaurus (Meta-1). MetaIndex uses a hierarchy of medical concepts, also derived from Meta-1, to represent the content of documents. The goal of this approach is to improve document retrieval performance by better representation of documents. An evaluation method is described, and the performance of MetaIndex on the task of indexing the Slice of Life medical image collection is reported. PMID:1807564

Index to NASA news releases and speeches, 1993

NASA Technical Reports Server (NTRS)

1994-01-01

This issue of the Index to NASA News Releases and Speeches contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, and a selected listing of speeches presented by members of the Headquarters staff during 1993. The index is arranged in six sections: subject index, personal names index, news release number index, accession number index, speeches, and news releases.

Index to NASA news releases and speeches, 1987

NASA Technical Reports Server (NTRS)

1988-01-01

This issue of the Index to NASA News Releases and Speeches contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, and a selected listing of speeches presented by members of the Headquarters staff during 1987. The index is arranged in six sections: Subject Index, Personal Names Index, News Release Number Index, Accession Number Index, and Speeches and News Releases.

Index to NASA news releases and speeches, 1989

NASA Technical Reports Server (NTRS)

1990-01-01

This issue of the Index to NASA News Releases and Speeches contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, and a selected listing of speeches presented by members of the Headquarters staff during 1989. The index is arranged in six sections: Subject Index, Personal Names Index, News Release Number Index, Accession Number Index, and Speeches and News Releases.

Index to NASA news releases and speeches, 1988

NASA Technical Reports Server (NTRS)

1989-01-01

This issue of the Index to NASA News Releases and Speeches contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, and a selected listing of speeches presented by members of the Headquarters staff during 1988. The index is arranged in six sections: Subject Index, Personal Names Index, News Release Number Index, Accession Number Index, and Speeches and News Releases.

Index to NASA news releases and speeches, 1986

NASA Technical Reports Server (NTRS)

1987-01-01

This issue of the Index to NASA News Releases and Speeches contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, and a selected listing of speeches presented by members of the Headquarters staff during 1986. The index is arranged in six sections: Subject Index, Personal Names Index, News Release Number Index, Accession Number Index, and Speeches and News Releases.

Index to NASA news releases and speeches, 1991

NASA Technical Reports Server (NTRS)

1992-01-01

This issue of the annual index to NASA Releases and Speeches contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, and a selected listing of speeches presented by members of the Headquarters staff during 1991. The index is arranged in six sections: Subject Index, Personal Name Index, News Release Number Index, Accession Number Index, and Speeches and News Releases Indices.

Index to NASA news releases and speeches, 1992

NASA Technical Reports Server (NTRS)

1993-01-01

This issue of the Index to NASA News Releases and Speeches contains a listing of news releases distributed by the Office of Public Affairs, NASA Headquarters, and a selected listing of speeches presented by members of the Headquarters staff during 1992. The index is arranged in six sections: subject index, personal names index, news release number index, accession number index, speeches, and news releases.

Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals.

PubMed

West, Colin P; Dyrbye, Liselotte N; Sloan, Jeff A; Shanafelt, Tait D

2009-12-01

Burnout has negative effects on work performance and patient care. The current standard for burnout assessment is the Maslach Burnout Inventory (MBI), a well-validated instrument consisting of 22 items answered on a 7-point Likert scale. However, the length of the MBI can limit its utility in physician surveys. To evaluate the performance of two questions relative to the full MBI for measuring burnout. Cross-sectional data from 2,248 medical students, 333 internal medicine residents, 465 internal medicine faculty, and 7,905 practicing surgeons. The single questions with the highest factor loading on the emotional exhaustion (EE) ("I feel burned out from my work") and depersonalization (DP) ("I have become more callous toward people since I took this job") domains of burnout were evaluated in four large samples of medical students, internal medicine residents, internal medicine faculty, and practicing surgeons. Spearman correlations between the single EE question and the full EE domain score minus that question ranged from 0.76-0.83. Spearman correlations between the single DP question and the full DP domain score minus that question ranged from 0.61-0.72. Responses to the single item measures of emotional exhaustion and depersonalization stratified risk of high burnout in the relevant domain on the full MBI, with consistent patterns across the four sampled groups. Single item measures of emotional exhaustion and depersonalization provide meaningful information on burnout in medical professionals.

On Atom-Bond Connectivity Index

NASA Astrophysics Data System (ADS)

Zhou, Bo; Xing, Rundan

2011-02-01

The atom-bond connectivity (ABC) index, introduced by Estrada et al. in 1998, displays an excellent correlation with the formation heat of alkanes. We give upper bounds for this graph invariant using the number of vertices, the number of edges, the Randíc connectivity indices, and the first Zagreb index. We determine the unique tree with the maximum ABC index among trees with given numbers of vertices and pendant vertices, and the n-vertex trees with the maximum, and the second, the third, and the fourth maximum ABC indices for n ≥ 6.

Parameter analysis of a photonic crystal fiber with raised-core index profile based on effective index method

NASA Astrophysics Data System (ADS)

Seraji, Faramarz E.; Rashidi, Mahnaz; Khasheie, Vajieh

2006-08-01

Photonic crystal fibers (PCFs) with a stepped raised-core profile and one layer equally spaced holes in the cladding are analyzed. Using effective index method and considering a raised step refractive index difference between the index of the core and the effective index of the cladding, we improve the characteristic parameters such as numerical aperture and V-parameter, and reduce its bending loss to about one tenth of a conventional PCF. Implementing such a structure in PCFs may be one step forward to achieve low loss PCFs for communication applications.

22 CFR 303.7 - Index of records.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Index of records. 303.7 Section 303.7 Foreign... Index of records. The Peace Corps will maintain a current index identifying any matter within the scope of § 303.4 or § 303.5(b)(1) through (5). The index will be maintained and made available for public...

12 CFR 602.9 - Current FOIA index.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Current FOIA index. 602.9 Section 602.9 Banks... Records of the Farm Credit Administration § 602.9 Current FOIA index. FCA will make a current index available for public inspection and copying, as required by the FOIA. We will give you an index for the cost...

Association between fat mass index and fat-free mass index values and cardiovascular risk in adolescents

PubMed Central

de Oliveira, Patrícia Morais; da Silva, Fabiana Almeida; Oliveira, Renata Maria Souza; Mendes, Larissa Loures; Pereira, Michele; Cândido, Ana Paula Carlos

2016-01-01

Abstract Objective: To describe the association between fat mass index and fat-free mass index values and factors associated with cardiovascular risk in adolescents in the city of Juiz de Fora, Minas Gerais. Methods: Cross-sectional study was with 403 adolescents aged 10–14 years, from public and private schools. Anthropometric, clinical, and biochemical measurements were obtained, as well as self-reported time spent performing physical exercises, sedentary activities and sexual maturation stage. Results: Regarding the nutritional status, 66.5% of the adolescents had normal weight, 19.9% were overweight and 10.2% were obese. For both genders, the fat mass index was higher in adolescents who had high serum triglycerides, body mass index and waist circumference. Conclusions: Adolescents who had anthropometric, clinical and biochemical characteristics considered to be at risk for the development of cardiovascular disease had higher values of fat mass index. Different methodologies for the assessment of body composition make health promotion and disease prevention more effective. PMID:26542380