[The effect of neurorehabilitation on the functional state and muscle tone of upper limb in patients after ischaemic stroke].

PubMed

Klimkiewicz, Paulina; Kubsik, Anna; Jankowska, Agnieszka; Woldańska-Okońska, Marta

2014-03-01

Rehabilitation of upper limb in patients after ischemic stroke is a major challenge for modern neurorehabilitation. Function of upper limb of patients after ischemic stroke returns on the end of the rehabilitation comparing with another parts of the body. Below presents two groups of patients after ischemic stroke who were rehabilitated with use of the following methods: kinesiotherapy combined with NDT- Bobath method and kinesiotherapy only. The aim of this study was to assess the impact of kinesiotherapy only and NDT- Bobath method combined with kinesiotherapy on the functional state and muscle tone of upper limb in patients after ischemic stroke. The study involved a group of 40 patients after ischemic stroke with motor control and muscle tone problems of upper limb. Patients were divided into two groups, each of them included 20 people. Upper limb in group I was rehabilitated with the use of kinesiotherapy exercise however group II with the use of kinesiotherapy exercise combined with NDT- Bobath method (Neurodevelopmental Treatment Bobath). To evaluate the patients before and after rehabilitation muscle tone Asworth scale was used and to assess functional status Rivermead Motor Assessment (RMAIII) scale was used. After 5 weeks of rehabilitation in group II in majority patients were observed decrease of muscle tone and improvement in upper limb functional status. In group I the muscle tone were also decreased and functional status were better but in smaller impact than in II group. Classical kinesiotherapy combined with the NDT-Bobath method gives better results in neurorehabilitation of upper limb than the use of kinesiotherapy exercises only in patients after ischemic stroke.

Analysis and evaluation of functional status of lower extremity amputee-appliance systems: an integrated approach.

PubMed

Ganguli, S

1976-11-01

This paper introduces an integrated, objective and biomechanically sound approach for the analysis and evaluation of the functional status of lower extremity amputee-appliance systems. The method is demonstrated here in its application to the unilateral lower extremity amputee-axillary crutches system and the unilateral below-knee amputee-PTB prosthesis system, both of which are commonly encountered in day-to-day rehabilitation practice.

Extended, continuous measures of functional status in community dwelling persons with Alzheimer’s and related dementia: Infrastructure, performance, tradeoffs, preliminary data, and promise

PubMed Central

Zylstra, Bradley; Netscher, George; Jacquemot, Julien; Schaffer, Michael; Shen, Galen; Bowhay, Angela D.; Braley, Tamara L.; Possin, Katherine L.; Miller, Bruce L.; Bayen, Alexandre M.; Bonasera, Stephen J.; Schenk, A. Katrin

2018-01-01

Background The past decades have seen phenomenal growth in the availability of inexpensive and powerful personal computing devices. Efforts to leverage these devices to improve health care outcomes promise to remake many aspects of healthcare delivery, but remain in their infancy. New method We describe the development of a mobile health platform designed for daily measures of functional status in ambulatory, community dwelling subjects, including those who have Alzheimer’s disease or related neurodegenerative disorders. Using Smartwatches and Smartphones we measure subject overall activity and outdoor location (to derive their lifespace). These clinically-relevant measures allow us to track a subject’s functional status in their natural environment over prolonged periods of time without repeated visits to healthcare providers. Functional status metrics are integrated with medical information and caregiver reports, which are used by a caregiving team to guide referrals for physician/APRN/NP care. Comparison with Existing Methods We describe the design tradeoffs involved in all aspects of our current system architecture, focusing on decisions with significant impact on system cost, performance, scalability, and user-adherence. Results We provide real-world data from current subject enrollees demonstrating system accuracy and reliability. Conclusions We document real-world feasibility in a group of men and women with dementia that Smartwatches/Smartphones can provide long-term, relevant clinical data regarding individual functional status. We describe the underlying considerations of this system so that interested organizations can adapt and scale our approach to their needs. Finally, we provide a potential agenda to guide development of future systems. PMID:28865985

Classification of toddler nutritional status using fuzzy inference system (FIS)

NASA Astrophysics Data System (ADS)

Permatasari, Dian; Azizah, Isnaini Nur; Hadiat, Hanifah Latifah; Abadi, Agus Maman

2017-08-01

Nutrition is a major health problem and concern for parents when it is relating with their toddler. The nutritional status is an expression of the state caused by the status of the balance between the number of intake of nutrients and the amount needed by the body for a variety of biological functions. The indicators that often used to determine the nutritional status is the combination of Weight (W) and Height (H) symbolized by W/H, because it describe a sensitive and specific nutritional status. This study aims to apply the Fuzzy Inference System Mamdani method to classify the nutritional status of toddler. The inputs are weight and height of the toddler. There are nine rules that used and the output is nutritional status classification consisting of four criteria: stunting, wasting, normal, and overweight. Fuzzy Inference System that be used is Mamdani method and the defuzzification use Centroid Method. The result of this study is compared with Assessment Anthropometric Standard of Toddler Nutritional Status by Ministry of Health. The accuracy level of this fuzzy model is about 84%.

The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary knee osteoarthritis patients.

PubMed

Aciksoz, Semra; Akyuz, Aygul; Tunay, Servet

2017-12-01

To investigate the effect of the self-administered superficial local hot and cold applications on pain, and the functional status and the quality of life in primary knee osteoarthritis patients. Superficial local hot and cold application is used as a nonpharmacological method for the treatment of knee osteoarthritis. However, various guidelines for the management of knee osteoarthritis have conflicting recommendation for hot and cold therapy. A randomised clinical trial design. The sample consisted of patients (n = 96) who were diagnosed with primary knee osteoarthritis. During the application stage, patients were designated to the hot and cold application groups and administered hot and cold application twice a day for 3 weeks together with standard osteoarthritis treatment. The control group only used standard osteoarthritis treatment. The data were collected with a Descriptive Information Form, a Pain Scale, the WOMAC Osteoarthritis Index, the Nottingham Health Profile (NHP) and a Patient Satisfaction Evaluation Form. Outcome measures included pain intensity, functional status and quality of life. We found decreased primary measurement pain scores and improved functional status scores and quality of life scores after the application programme compared to the pre-application stage in both the hot and cold application groups. Once the application was completed, the pain scores, functional status scores and quality-of-life scores on the second measurements were found to be still statistically lower than the pre-application scores but higher than the first measurement ([p < .001, χ 2  = 48.000; p < .001, χ 2  = 34.000], [p < .001, χ 2  = 22.000; p = .001 χ 2 =14.000] and [p = .005, χ 2  = 16.000; p = .001, χ 2  = 12.500]). There was no difference in the perceived pain, functional status and quality of life between the pre-application, postapplication and 2 weeks postapplication periods of the individuals in three groups (p > .05). It was found that both hot and cold application resulted in a mild improvement in pain, functional status and quality of life, but this improvement was not sufficient to create a significant difference between the groups. This study contributes to the literature on hot and cold application methods as self-management strategies for patients with knee osteoarthritis. © 2017 John Wiley & Sons Ltd.

A method for measuring quality of life through subjective weighting of functional status.

PubMed

Stineman, Margaret G; Wechsler, Barbara; Ross, Richard; Maislin, Greg

2003-04-01

To apply a new tool to understand the quality of life (QOL) implications of patients' functional status. Results from the Features-Resource Trade-Off Game were used to form utility weights by ranking functional activities by the relative value of achieving independence in each activity compared with all other component activities. The utility weights were combined with patients' actual levels of performance across the same activities to produce QOL-weighted functional status scores and to form "value rulers" to order activities by perceived importance. Persons with severe disabilities living in the community and clinicians practicing in various rehabilitation disciplines. Two panels of 5 consumers with disabilities and 2 panels of 5 rehabilitation clinicians. The 4 panels played the Features Resource Trade-Off Game by using the FIMT(TM) instrument definitions. Utility weights for each of the 18 FIM items, QOL-weighted FIM scores, and value rulers. All 4 panels valued the achievement of independence in cognitive and communication activities more than independence in physical activities. Consequently, the unweighted FIM scores of patients who have severe physical disabilities but relatively intact cognitive skills will underestimate QOL, while inflating QOL in those with low levels of independence in cognition and communication but higher physical function. Independence in some activities is more valued than in others; thus, 2 people with the same numeric functional status score could experience very different QOL. QOL-weighted functional status scores translate objectively measured functional status into its subjective meaning. This new technology for measuring subjective function-related QOL has a variety of applications to clinical, educational, and research practices.

[Nutritional status of adults with cystic fibrosis - current methods of assessment].

PubMed

Szabla, Anna; Skorupa, Wojciech; Milewska, Magdalena; Weker, Halina

2015-11-01

Cystic fibrosis (CF) is one of the most frequent monogenic disease in the Caucasian population, inherited in an autosomal recessive pattern. This is a multiple organ disease and its main manifestations include pulmonary and gastrointestinal dysfunction. The exocrine pancreatic deficiency results in impaired digestion and absorption what may lead to malnutrition and vitamins and minerals deficiencies. The life expectancy of cystic fibrosis patients has been increasing over the past years, so there is a need to verify usefulness of existing or create new methods of nutritional status assessment. The aim of this paper was presentation current data on the methods of assessment and monitoring of nutritional status. Particular attention has been paid to appropriate nutritional support in prevention and treatment of malnutrition patients with cystic fibrosis. On the basis of recent literature we can conclude that the advanced nutritional status assessment is recommended in patient with CF by using anthropometrical methods, body composition analysis and biochemical data. Good nutritional status is connected with pulmonary functions, quality and life length. © 2015 MEDPRESS.

Marginal regression approach for additive hazards models with clustered current status data.

PubMed

Su, Pei-Fang; Chi, Yunchan

2014-01-15

Current status data arise naturally from tumorigenicity experiments, epidemiology studies, biomedicine, econometrics and demographic and sociology studies. Moreover, clustered current status data may occur with animals from the same litter in tumorigenicity experiments or with subjects from the same family in epidemiology studies. Because the only information extracted from current status data is whether the survival times are before or after the monitoring or censoring times, the nonparametric maximum likelihood estimator of survival function converges at a rate of n(1/3) to a complicated limiting distribution. Hence, semiparametric regression models such as the additive hazards model have been extended for independent current status data to derive the test statistics, whose distributions converge at a rate of n(1/2) , for testing the regression parameters. However, a straightforward application of these statistical methods to clustered current status data is not appropriate because intracluster correlation needs to be taken into account. Therefore, this paper proposes two estimating functions for estimating the parameters in the additive hazards model for clustered current status data. The comparative results from simulation studies are presented, and the application of the proposed estimating functions to one real data set is illustrated. Copyright © 2013 John Wiley & Sons, Ltd.

Physical Function and Health Status in Aging Puerto Rican Adults: The Boston Puerto Rican Health Study

PubMed Central

Castaneda-Sceppa, Carmen; Price, Lori Lyn; Noel, Sabrina E.; Midle, Jennifer Bassett; Falcon, Luis M.; Tucker, Katherine L.

2015-01-01

Objectives This article describes physical function in Puerto Rican older adults and examines associations between health status and physical function. It also assesses relationships between physical function and disability. Method This study uses a cross-sectional study of Puerto Ricans 45 to 75 years in Boston (N = 1,357). Measures included performance-based physical function (handgrip strength, walking speed, balance, chair stands, foot tapping), health conditions (obesity, diabetes, depressive symptomatology, history of heart disease, heart attack, stroke, and arthritis), and self-reported disability (activities of daily living, instrumental activities of daily living). Results Older women (60-75 years) had the poorest physical function. Poor physical function was associated with obesity, diabetes, depression, history of heart attack, stroke, and arthritis, after adjusting for age, sex, education, income, and lifestyle (p < .05). Physical function and disability were correlated (p < .01). Discussion Health status among Puerto Ricans appears to contribute to poor physical function. Targeted interventions to improve strength, endurance, and balance are needed to combat physical frailty and its consequences in this population. PMID:20495158

Self-Reported Functional Status among the Old-Old: A Comparison of Two Israeli Cohorts

PubMed Central

Litwin, Howard; Shrira, Amit; Shmotkin, Dov

2012-01-01

OBJECTIVES To examine differences in functional status among two successive cohorts. METHODS The study was a comparative analysis of Jewish respondents aged 75–94 from two nationwide random samples: the Cross-Sectional and Longitudinal Aging Study (1989–1992; N =1200) and the Survey of Health, Ageing, and Retirement in Europe (2005–2006; N =379). Self-reported functional limitation and disability were compared by means of logistic regressions and MANCOVA, controlling for age, gender, origin, education, marital status, income, self-rated health, and home care receipt. RESULTS Reported functional limitation decreased in the later cohort (SHARE-Israel), but ADL- and IADL-disability increased. Receipt of home care moderated these effects. ADL- and IADL-disability increased among home-care-receiving respondents in the later cohort whereas functional limitation decreased among respondents not in receipt of home care. DISCUSSION The findings suggest that different measures used to assess the disablement process capture different aspects, and that contextual factors influence how older people rate their own functional capacity. PMID:22422761

Inter-Relationships of Functional Status in Cerebral Palsy: Analyzing Gross Motor Function, Manual Ability, and Communication Function Classification Systems in Children

ERIC Educational Resources Information Center

Hidecker, Mary Jo Cooley; Ho, Nhan Thi; Dodge, Nancy; Hurvitz, Edward A.; Slaughter, Jaime; Workinger, Marilyn Seif; Kent, Ray D.; Rosenbaum, Peter; Lenski, Madeleine; Messaros, Bridget M.; Vanderbeek, Suzette B.; Deroos, Steven; Paneth, Nigel

2012-01-01

Aim: To investigate the relationships among the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) in children with cerebral palsy (CP). Method: Using questionnaires describing each scale, mothers reported GMFCS, MACS, and CFCS levels in 222…

Profile of patients with chronic obstructive pulmonary disease classified as physically active and inactive according to different thresholds of physical activity in daily life

PubMed Central

Furlanetto, Karina C.; Pinto, Isabela F. S.; Sant’Anna, Thais; Hernandes, Nidia A.; Pitta, Fabio

2016-01-01

ABSTRACT Objective To compare the profiles of patients with chronic obstructive pulmonary disease (COPD) considered physically active or inactive according to different classifications of the level of physical activity in daily life (PADL). Method Pulmonary function, dyspnea, functional status, body composition, exercise capacity, respiratory and peripheral muscle strength, and presence of comorbidities were assessed in 104 patients with COPD. The level of PADL was quantified with a SenseWear Armband activity monitor. Three classifications were used to classify the patients as physically active or inactive: 30 minutes of activity/day with intensity >3.2 METs, if age ≥65 years, and >4 METs, if age <65 years; 30 minutes of activity/day with intensity >3.0 METs, regardless of patient age; and 80 minutes of activity/day with intensity >3.0 METs, regardless of patient age. Results In all classifications, when compared with the inactive group, the physically active group had better values of anthropometric variables (higher fat-free mass, lower body weight, body mass index and fat percentage), exercise capacity (6-minute walking distance), lung function (forced vital capacity) and functional status (personal care domain of the London Chest Activity of Daily Living). Furthermore, patients classified as physically active in two classifications also had better peripheral and expiratory muscle strength, airflow obstruction, functional status, and quality of life, as well as lower prevalence of heart disease and mortality risk. Conclusion In all classification methods, physically active patients with COPD have better exercise capacity, lung function, body composition, and functional status compared to physically inactive patients. PMID:27683835

Examining the Association Between Comorbidity Indexes and Functional Status in Hospitalized Medicare Fee-for-Service Beneficiaries

PubMed Central

Graham, James E.; Resnik, Linda; Karmarkar, Amol M.; Deutsch, Anne; Tan, Alai; Al Snih, Soham; Ottenbacher, Kenneth J.

2016-01-01

Background Medicare data from acute hospitals do not contain information on functional status. This lack of information limits the ability to conduct rehabilitation-related health services research. Objective The purpose of this study was to examine the associations between 5 comorbidity indexes derived from acute care claims data and functional status assessed at admission to an inpatient rehabilitation facility (IRF). Comorbidity indexes included tier comorbidity, Functional Comorbidity Index (FCI), Charlson Comorbidity Index, Elixhauser Comorbidity Index, and Hierarchical Condition Category (HCC). Design This was a retrospective cohort study. Methods Medicare beneficiaries with stroke, lower extremity joint replacement, and lower extremity fracture discharged to an IRF in 2011 were studied (N=105,441). Data from the beneficiary summary file, Medicare Provider Analysis and Review (MedPAR) file, and Inpatient Rehabilitation Facility–Patient Assessment Instrument (IRF-PAI) file were linked. Inpatient rehabilitation facility admission functional status was used as a proxy for acute hospital discharge functional status. Separate linear regression models for each impairment group were developed to assess the relationships between the comorbidity indexes and functional status. Base models included age, sex, race/ethnicity, disability, dual eligibility, and length of stay. Subsequent models included individual comorbidity indexes. Values of variance explained (R2) with each comorbidity index were compared. Results Base models explained 7.7% of the variance in motor function ratings for stroke, 3.8% for joint replacement, and 7.3% for fracture. The R2 increased marginally when comorbidity indexes were added to base models for stroke, joint replacement, and fracture: Charlson Comorbidity Index (0.4%, 0.5%, 0.3%), tier comorbidity (0.2%, 0.6%, 0.5%), FCI (0.4%, 1.2%, 1.6%), Elixhauser Comorbidity Index (1.2%, 1.9%, 3.5%), and HCC (2.2%, 2.1%, 2.8%). Limitation Patients from 3 impairment categories were included in the sample. Conclusions The 5 comorbidity indexes contributed little to predicting functional status. The indexes examined were not useful as proxies for functional status in the acute settings studied. PMID:26564253

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

Chronic disease, functional health status, and demographics: a multi-dimensional approach to risk adjustment.

PubMed Central

Hornbrook, M C; Goodman, M J

1996-01-01

OBJECTIVE. The goal of this study was to develop unbiased risk-assessment models to be used for paying health plans on the basis of enrollee health status and use propensity. We explored the risk structure of adult employed HMO members using self-reported morbidities, functional status, perceived health status, and demographic characteristics. DATA SOURCES/STUDY SETTING. Data were collected on a random sample of members of a large, federally qualified, prepaid group practice, hospital-based HMO located in the Pacific Northwest. STUDY DESIGN. Multivariate linear nonparametric techniques were used to estimate risk weights on demographic, morbidity, and health status factors at the individual level. The dependent variable was annual real total health plan expense for covered services for the year following the survey. Repeated random split-sample validation techniques minimized outlier influences and avoided inappropriate distributional assumptions required by parametric techniques. DATA COLLECTION/EXTRACTION METHODS. A mail questionnaire containing an abbreviated medical history and the RAND-36 Health Survey was administered to a 5 percent sample of adult subscribers and their spouses in 1990 and 1991, with an overall 44 percent response rate. Utilization data were extracted from HMO automated information systems. Annual expenses were computed by weighting all utilization elements by standard unit costs for the HMO. PRINCIPAL FINDINGS. Prevalence of such major chronic diseases as heart disease, diabetes, depression, and asthma improve prediction of future medical expense; functional health status and morbidities are each better than simple demographic factors alone; functional and perceived health status as well as demographic characteristics and diagnoses together yield the best prediction performance and reduce opportunities for selection bias. We also found evidence of important interaction effects between functional/perceived health status scales and disease classes. CONCLUSIONS. Self-reported morbidities and functional health status are useful risk measures for adults. Risk-assessment research should focus on combining clinical information with social survey techniques to capitalize on the strengths of both approaches. Disease-specific functional health status scales should be developed and tested to capture the most information for prediction. PMID:8698586

Combining item response theory with multiple imputation to equate health assessment questionnaires.

PubMed

Gu, Chenyang; Gutman, Roee

2017-09-01

The assessment of patients' functional status across the continuum of care requires a common patient assessment tool. However, assessment tools that are used in various health care settings differ and cannot be easily contrasted. For example, the Functional Independence Measure (FIM) is used to evaluate the functional status of patients who stay in inpatient rehabilitation facilities, the Minimum Data Set (MDS) is collected for all patients who stay in skilled nursing facilities, and the Outcome and Assessment Information Set (OASIS) is collected if they choose home health care provided by home health agencies. All three instruments or questionnaires include functional status items, but the specific items, rating scales, and instructions for scoring different activities vary between the different settings. We consider equating different health assessment questionnaires as a missing data problem, and propose a variant of predictive mean matching method that relies on Item Response Theory (IRT) models to impute unmeasured item responses. Using real data sets, we simulated missing measurements and compared our proposed approach to existing methods for missing data imputation. We show that, for all of the estimands considered, and in most of the experimental conditions that were examined, the proposed approach provides valid inferences, and generally has better coverages, relatively smaller biases, and shorter interval estimates. The proposed method is further illustrated using a real data set. © 2016, The International Biometric Society.

Functional Impairment and Occupational Outcome in Adults with ADHD

ERIC Educational Resources Information Center

Gjervan, Bjorn; Torgersen, Terje; Nordahl, Hans M.; Rasmussen, Kirsten

2012-01-01

Objective: ADHD is associated with poor functional outcomes. The objectives were to investigate the prevalence of functional impairment and occupational status in a clinically referred sample of adults with ADHD and explore factors predicting occupational outcome. Method: A sample of 149 adults with a confirmed diagnosis of ADHD participated in…

Development of Standard Reference Materials to support assessment of iodine status for nutritional and public health purposes.

PubMed

Long, Stephen E; Catron, Brittany L; Boggs, Ashley Sp; Tai, Susan Sc; Wise, Stephen A

2016-09-01

The use of urinary iodine as an indicator of iodine status relies in part on the accuracy of the analytical measurement of iodine in urine. Likewise, the use of dietary iodine intake as an indicator of iodine status relies in part on the accuracy of the analytical measurement of iodine in dietary sources, including foods and dietary supplements. Similarly, the use of specific serum biomarkers of thyroid function to screen for both iodine deficiency and iodine excess relies in part on the accuracy of the analytical measurement of those biomarkers. The National Institute of Standards and Technology has been working with the NIH Office of Dietary Supplements for several years to develop higher-order reference measurement procedures and Standard Reference Materials to support the validation of new routine analytical methods for iodine in foods and dietary supplements, for urinary iodine, and for several serum biomarkers of thyroid function including thyroid-stimulating hormone, thyroglobulin, total and free thyroxine, and total and free triiodothyronine. These materials and methods have the potential to improve the assessment of iodine status and thyroid function in observational studies and clinical trials, thereby promoting public health efforts related to iodine nutrition. © 2016 American Society for Nutrition.

Decision support methodology to establish priorities on the inspection of structures

NASA Astrophysics Data System (ADS)

Cortes, V. Juliette; Sterlacchini, Simone; Bogaard, Thom; Frigerio, Simone; Schenato, Luca; Pasuto, Alessandro

2014-05-01

For hydro-meteorological hazards in mountain areas, the regular inspection of check dams and bridges is important due to the effect of their functional status on water-sediment processes. Moreover, the inspection of these structures is time consuming for organizations due to their extensive number in many regions. However, trained citizen-volunteers can support civil protection and technical services in the frequency, timeliness and coverage of monitoring the functional status of hydraulic structures. Technicians should evaluate and validate these reports to get an index for the status of the structure. Thus, preventive actions could initiate such as the cleaning of obstructions or to pre-screen potential problems for a second level inspection. This study proposes a decision support methodology that technicians can use to assess an index for three parameters representing the functional status of the structure: a) condition of the structure at the opening of the stream flow, b) level of obstruction at the structure and c) the level of erosion in the stream bank. The calculation of the index for each parameter is based upon fuzzy logic theory to handle ranges in precision of the reports and to convert the linguistic rating scales into numbers representing the structure's status. A weighting method and multi-criteria method (Analytic Hierarchy Process- AHP and TOPSIS), can be used by technicians to combine the different ratings according to the component elements of the structure and the completeness of the reports. Finally, technicians can set decision rules based on the worst rating and a threshold for the functional indexes. The methodology was implemented as a prototype web-based tool to be tested with technicians of the Civil Protection in the Fella basin, Northern Italy. Results at this stage comprise the design and implementation of the web-based tool with GIS interaction to evaluate available reports and to set priorities on the inspection of structures. Keywords Decision-making, Multi-criteria methods, Torrent control structures, Web-based tools.

Status of Complex Langevin

NASA Astrophysics Data System (ADS)

Seiler, Erhard

2018-03-01

I review the status of the Complex Langevin method, which was invented to make simulations of models with complex action feasible. I discuss the mathematical justification of the procedure, as well as its limitations and open questions. Various pragmatic measures for dealing with the existing problems are described. Finally I report on the progress in the application of the method to QCD, with the goal of determining the phase diagram of QCD as a function of temperature and baryonic chemical potential.

The Questions about Behavioral Function (QABF): Current Status as a Method of Functional Assessment

ERIC Educational Resources Information Center

Matson, Johnny L.; Tureck, Kimberly; Rieske, Robert

2012-01-01

Functional assessment has now entered the mainstream for evaluation and to aid in the treatment of challenging behaviors, while experimental functional analysis was at the forefront of this movement, this particular methodology has proven to be impractical, and thus has limited utility in real world settings. As a result of these factors…

Association between smoking status and the parameters of vascular structure and function in adults: results from the EVIDENT study

PubMed Central

2013-01-01

Background The present study analyses the relation between smoking status and the parameters used to assess vascular structure and function. Methods This cross-sectional, multi-centre study involved a random sample of 1553 participants from the EVIDENT study. Measurements: The smoking status, peripheral augmentation index and ankle-brachial index were measured in all participants. In a small subset of the main population (265 participants), the carotid intima-media thickness and pulse wave velocity were also measured. Results After controlling for the effect of age, sex and other risk factors, present smokers have higher values of carotid intima-media thickness (p = 0.011). Along the same lines, current smokers have higher values of pulse wave velocity and lower mean values of ankle-brachial index but without statistical significance in both cases. Conclusions Among the parameters of vascular structure and function analysed, only the IMT shows association with the smoking status, after adjusting for confounders. PMID:24289208

Association between maternal nutritional status in pregnancy and offspring cognitive function during childhood and adolescence; a systematic review.

PubMed

Veena, Sargoor R; Gale, Catharine R; Krishnaveni, Ghattu V; Kehoe, Sarah H; Srinivasan, Krishnamachari; Fall, Caroline Hd

2016-08-12

The mother is the only source of nutrition for fetal growth including brain development. Maternal nutritional status (anthropometry, macro- and micro-nutrients) before and/or during pregnancy is therefore a potential predictor of offspring cognitive function. The relationship of maternal nutrition to offspring cognitive function is unclear. This review aims to assess existing evidence linking maternal nutritional status with offspring cognitive function. Exposures considered were maternal BMI, height and weight, micronutrient status (vitamins D, B12, folate and iron) and macronutrient intakes (carbohydrate, protein and fat). The outcome was any measure of cognitive function in children aged <18 years. We considered observational studies and trials with allocation groups that differed by single nutrients. We searched Medline/PubMed and the Cochrane Library databases and reference lists of retrieved literature. Two reviewers independently extracted data from relevant articles. We used methods recommended by the Centre for Reviews and Dissemination, University of York and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of 16,143 articles identified, 38 met inclusion criteria. Most studies were observational, and from high-income settings. There were few randomized controlled trials. There was consistent evidence linking maternal obesity with lower cognitive function in children; low maternal BMI has been inadequately studied. Among three studies of maternal vitamin D status, two showed lower cognitive function in children of deficient mothers. One trial of folic acid supplementation showed no effects on the children's cognitive function and evidence from 13 observational studies was mixed. Among seven studies of maternal vitamin B12 status, most showed no association, though two studies in highly deficient populations suggested a possible effect. Four out of six observational studies and two trials (including one in an Iron deficient population) found no association of maternal iron status with offspring cognitive function. One trial of maternal carbohydrate/protein supplementation showed no effects on offspring cognitive function. Current evidence that maternal nutritional status during pregnancy as defined by BMI, single micronutrient studies, or macronutrient intakes influences offspring cognitive function is inconclusive. There is a need for more trials especially in populations with high rates of maternal undernutrition. Registered in PROSPERO CRD42013005702 .

Depression, disability and functional status among community dwelling older adults in South Africa: Evidence from the first South African National Income Dynamics Study

PubMed Central

Tomita, Andrew; Burns, Jonathan K

2013-01-01

Objectives This study examined the relationship between depression and functional status among a community-dwelling elderly population of 65 years and older in South Africa. Method Data from the first wave of the South African National Income Dynamics Study (SA-NIDS) was used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n=1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Functional status, pertaining to both difficulty and dependency in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Results Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependency in ADL (adjusted OR=2.57 [CI: 1.03-6.41]), IADL (adjusted OR=2.76 [CI: 1.89-4.04]) and PFM (adjusted OR=1.66 [CI: 1.18-2.33]) but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. Conclusion The relationship between depression symptoms and function is complex. Functional characteristics between older and younger older populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. PMID:23512338

Systems, methods and apparatus for quiesence of autonomic safety devices with self action

NASA Technical Reports Server (NTRS)

Hinchey, Michael G. (Inventor); Sterritt, Roy (Inventor)

2011-01-01

Systems, methods and apparatus are provided through which in some embodiments an autonomic environmental safety device may be quiesced. In at least one embodiment, a method for managing an autonomic safety device, such as a smoke detector, based on functioning state and operating status of the autonomic safety device includes processing received signals from the autonomic safety device to obtain an analysis of the condition of the autonomic safety device, generating one or more stay-awake signals based on the functioning status and the operating state of the autonomic safety device, transmitting the stay-awake signal, transmitting self health/urgency data, and transmitting environment health/urgency data. A quiesce component of an autonomic safety device can render the autonomic safety device inactive for a specific amount of time or until a challenging situation has passed.

Status and analysis of test standard for on-board charger

NASA Astrophysics Data System (ADS)

Hou, Shuai; Liu, Haiming; Jiang, Li; Chen, Xichen; Ma, Junjie; Zhao, Bing; Wu, Zaiyuan

2018-05-01

This paper analyzes the test standards of on -board charger (OBC). In the process of testing, we found that there exists some problems in test method and functional status, such as failed to follow up the latest test standards, estimated loosely, rectification uncertainty and consistency. Finally, putting forward some own viewpoints on these problems.

Predictors of Depressive Symptoms in Caregivers of Patients with Heart Failure

PubMed Central

Chung, Misook L.; Pressler, Susan J.; Dunbar, Sandra B.; Lennie, Terry A.; Moser, Debra K.; Endowed, Gill

2010-01-01

Background Millions of family members deliver informal care and support to patients with heart failure (HF). Caregivers of patients with HF suffer from depressive symptoms, but factors associated with depressive symptoms are unknown. The purposes of this study were (1) to examine differences between caregivers with and without depressive symptoms in patients’ characteristics and caregivers’ functional status, caregiving burden (time devoted to caregiving, difficulty of caregiving tasks, and overall perceived caregiving distress), and perceived control; and (2) to determine predictors of depressive symptoms of caregivers. Method A total of 109 caregivers (mean age of 57 years; spousal caregiver 79%) and patients with HF participated in this study. Depressive symptoms, perceived control, and functional status of both patients and caregivers were assessed using the Beck Depression Inventory-II (BDI-II), the Control Attitudes Scale-Revised, and the Duke Activity Status Index, respectively. Caregivers’ burden (time and difficulty of caregiving tasks and burden) were assessed using the Oberst Caregiving Burden Scale, and the Zarit Burden Interview. Results The 27.5% of HF caregivers with depressive symptoms (BDI-II ≥ 14) had poorer functional status, lower perceived control, higher perceived caregiving distress, experienced more caregiving difficulty and spent more time in caregiving tasks than caregivers without depressive symptoms. Controlling for age and gender in a multiple regression, caregivers’ own functional disability (sβ = -.307, P < .001), perceived control (sβ = -.304, P < .001), and caregiver burden (sβ =.316, P = .002) explained 45% of the variance in caregivers’ depressive symptoms. Patients’ NYHA class and functional status did not predict caregivers’ depressive symptoms. Conclusion Caregivers’ poor functional status, overall perception of caregiving distress, and perceived control were associated with depressive symptoms. Depressed caregivers of patients with HF may benefit from interventions that improve caregivers’ perceived control, address the caregiving burden and improve or assist with caregivers’ functional status. PMID:20714239

[THE CORRECTION OF TROPHIC DISORDERS IN CHILDREN OF CHRONIC GASTRODUODENITIS WITH METHOD LOW-FREQUENCY LIGHT-MAGNETOTHERAPY].

PubMed

Kolosova, T A; Sadovnikova, I V; Belousova, T E

2015-01-01

The results of a survey of school children with chronic gastroduodenitis when applying at an early period the medical rehabilitation with method low-frequency light-magnetotherapy. During treatment of hospital was evaluated vegetative-trophic status with methods of cardiointervalography and thermovision functional tests. In normalizes clinical parameters was correction in dynamics of the vegetative status in children, it confirms the effectiveness of the therapy. It is proved, that the use of low-frequency light-magnetotherapy has a positive effect on the vegetative--trophic provision an organism and normalizes the vegetative dysfunction.

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

PubMed Central

Bourne, Paul Andrew

2009-01-01

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

Functional status and use of healthcare facilities in long‐term survivors of transient ischaemic attack or minor ischaemic stroke

PubMed Central

van Wijk, I; Lindeman, E; Kappelle, L J; van Gijn, J; Koudstaal, P J; Gorter, J W; Algra, A

2006-01-01

Background Stroke may have a major effect on survivors and on the healthcare system. Aims To study the functional status and use of healthcare facilities in long‐term survivors of a transient ischaemic attack (TIA) or minor ischaemic stroke (MIS) and evaluate associations with baseline and follow‐up characteristics. Methods Follow‐up of patients who had participated in the Dutch TIA Trial or the European Atrial Fibrillation Trial was extended to a mean period of 15.6 years. Patients were interviewed through a postal questionnaire (n = 468) and a sample of this group was also interviewed at home (n = 198). Demographic data, information on comorbidity, functional status (Barthel Index, Frenchay Activities Index and modified Rankin Scale) and use of healthcare facilities were recorded. Results About one third of the survivors interviewed at home experienced any residual disability and 26% were moderately to severely handicapped. Factors associated with poor functional status were advanced age and the presence of any infarct on a baseline computed tomography scan, the recurrence of a new major stroke or the presence of comorbidity of locomotion. One third of survivors used any kind of professional care, which was predominantly related to the functional status at follow‐up. Conclusions Recurrent stroke and the presence of comorbidity of locomotion are important determinants of long‐term disability of survivors of a TIA or an MIS, which, in turn, is strongly associated with the long‐term use of professional care. The need for measuring comorbidity with regard to functional status is recommended in research on stroke outcome. PMID:16735396

Fish Consumption, Sleep, Daily Functioning, and Heart Rate Variability

PubMed Central

Hansen, Anita L.; Dahl, Lisbeth; Olson, Gina; Thornton, David; Graff, Ingvild E.; Frøyland, Livar; Thayer, Julian F.; Pallesen, Staale

2014-01-01

Study Objectives: This study investigated the effects of fatty fish on sleep, daily functioning and biomarkers such as heart rate variability (HRV), vitamin D status (serum 25-hydroxyvitamin D (25OHD), and eicosapentaenoic acid (EPA, 20:5n-3) + docosahexaenoic acid (DHA, 22:6n-3) in red blood cells. Moreover the relationship among sleep, daily functioning, HRV, vitamin D status, and levels of EPA+DHA was investigated. Methods: Ninety-five male forensic patients from a secure forensic inpatient facility in the USA were randomly assigned into a Fish or a Control group. The Fish group received Atlantic salmon three times per week from September to February, and the Control group was provided an alternative meal (e.g., chicken, pork, beef), but with the same nutritional value as their habitual diet, three times per week during the same period. Sleep (sleep latency, sleep efficiency, actual sleep time, and actual wake time), self-perceived sleep quality and daily functioning, as well as vitamin D status, EPA+DHA, and HRV, were assessed pre- and post-intervention period. Results: There was a significant increase in sleep latency from pre- to post-test in the Control group. The Fish group reported better daily functioning than the Control group during post-test. Fish consumption throughout the wintertime had also an effect on resting HRV and EPA+DHA, but not on vitamin D status. However, at post-test, the vitamin D status in the Fish group was still closer to the level regarded as optimal compared to the Control group. Vitamin D status correlated negatively with actual wake time and positively with sleep efficiency during pre-test, as well as positively with daily functioning and sleep quality during post-test. Finally, HRV correlated negatively with sleep latency and positively with daily functioning. Conclusions: Fish consumption seemed to have a positive impact on sleep in general and also on daily functioning, which may be related to vitamin D status and HRV. Citation: Hansen AL, Dahl L, Olson G, Thornton D, Graff IE, Frøyland L, Thayer JF, Pallesen S. Fish consumption, sleep, daily functioning, and heart rate variability. J Clin Sleep Med 2014;10(5):567-575. PMID:24812543

Association of nutritional status and functional capacity in gastrointestinal cancer patients.

PubMed

Pérez-Cruz, Elizabeth; Camacho-Limas, Christian Patricio

To determine the nutritional status and its association with functional capacity in patients with digestive tract cancer. We retrospectively studied all adult patients hospitalized who were diagnosed as having a cancer of the digestive tract. Nutritional status and functional capacity were assessed. Descriptive statistic and odds ratio were used to determine the association in SPSS 14.0. 57 patients were included, 96% had weight loss. Using subjective global assessment (SGA) as a method of screening, 82.5% of the patients were found malnutrition and by biochemical and immunological test 82% and 65% respectively. Functional capacity was assessed by Karnofsky index, finding that 75.5% of the patients have some activity limitation. Results show an association between malnutrition by SGA and limitation in functional capacity (c2 = 1.56; p = 0.212; OR: 2.46; 95% confidence interval [95% CI]: 0.581-10.465). In addition, we observe an association between the total lymphocyte count and limitation in functional capacity (χ2 = 6.94; p = 0.008; OR: 5.23; 95% CI: 1.441-19.025). Malnutrition in patients with digestive tract cancer was associated with limitation in functional capacity. Copyright: © 2017 SecretarÍa de Salud

Somatic and Functional Status of Boys from Various Social and Environmental Categories

ERIC Educational Resources Information Center

Domaradzki, Jaroslaw; Ignasiak, Zofia; Slawinska, Teresa

2009-01-01

Study aim: To assess the somatic and fitness status of adolescent boys from polluted industrial areas. Material and methods: A group of 313 boys aged 11-15 years from 5 villages located in the copper mine area in South-Western Poland were classified by the degree of lead and cadmium pollution (high--very high) and by parents' education…

Psychophysical and Patient Factors as Determinants of Pain, Function and Health Status in Shoulder Disorders

PubMed Central

Uddin, Zakir; MacDermid, Joy C.; Moro, Jaydeep; Galea, Victoria; Gross, Anita R.

2016-01-01

Objective: To estimate the extent to which psychophysical quantitative sensory test (QST) and patient factors (gender, age and comorbidity) predict pain, function and health status in people with shoulder disorders. To determine if there are gender differences for QST measures in current perception threshold (CPT), vibration threshold (VT) and pressure pain (PP) threshold and tolerance. Design: A cross-sectional study design. Setting: MacHAND Clinical Research Lab at McMaster University. Subjects: 34 surgical and 10 nonsurgical participants with shoulder pain were recruited. Method: Participants completed the following patient reported outcomes: pain (Numeric Pain Rating, Pain Catastrophizing Scale, Shoulder Pain and Disability Index) and health status (Short Form-12). Participants completed QST at 4 standardized locations and then an upper extremity performance-based endurance test (FIT-HaNSA). Pearson r’s were computed to determine the relationships between QST variables and patient factors with either pain, function or health status. Eight regression models were built to analysis QST’s and patient factors separately as predictors of either pain, function or health status. An independent sample t-test was done to evaluate the gender effect on QST. Results: Greater PP threshold and PP tolerance was significantly correlated with higher shoulder functional performance on the FIT-HANSA (r =0.31-0.44) and lower self-reported shoulder disability (r = -0.32 to -0.36). Higher comorbidity was consistently correlated (r =0.31-0.46) with more pain, and less function and health status. Older age was correlated to more pain intensity and less function (r =0.31-0.57). In multivariate models, patient factors contributed significantly to pain, function or health status models (r2 =0.19-0.36); whereas QST did not. QST was significantly different between males and females [in PP threshold (3.9 vs. 6.2, p < .001) and PP tolerance (7.6 vs. 2.6, p < .001) and CPT (1.6 vs. 2.3, p =.02)]. Conclusion: Psychophysical dimensions and patient factors (gender, age and comorbidity) affect self-reported and performance-based outcome measures in people with shoulder disorders. PMID:29399220

Coming together and pulling apart: Exploring the influence of functional status on co-resident relationships in assisted living.

PubMed

Sandhu, Navtej K; Kemp, Candace L; Ball, Mary M; Burgess, Elisabeth O; Perkins, Molly M

2013-12-01

Social relationships can have considerable influence on physical and mental well-being in later life, particularly for those in long-term care settings such as assisted living (AL). Research set in AL suggests that other residents are among the most available social contacts and that co-resident relationships can affect life satisfaction, quality of life, and well-being. Functional status is a major factor influencing relationships, yet AL research has not studied in-depth or systematically considered the role it plays in residents' relationships. This study examines the influences of physical and mental function on co-resident relationships in AL and identifies the factors shaping the influence of functional status. We present an analysis of qualitative data collected over a one-year period in two distinct AL settings. Data collection included: participant observation, informal interviews, and formal in-depth interviews with staff, residents, administrators and visitors, as well as surveys with residents. Grounded theory methods guided our data collection and analysis. Our analysis identified the core category, "coming together and pulling apart", which signifies that functional status is multi-directional, fluid, and operates in different ways in various situations and across time. Key facility- (e.g., admission and retention practices, staff intervention) and resident-level (e.g., personal and situational characteristics) factors shape the influence of functional status on co-resident relationships. Based on our findings, we suggest strategies for promoting positive relationships among residents in AL, including the need to educate staff, families, and residents. © 2013.

The Study of Cognitive Function and Related Factors in Patients With Heart Failure

PubMed Central

Ghanbari, Atefeh; Moaddab, Fatemeh; Salari, Arsalan; Kazemnezhad Leyli, Ehsan; Sedghi Sabet, Mitra; Paryad, Ezzat

2013-01-01

Background: Cognitive impairment is increasingly recognized as a common adverse consequence of heart failure. Both Heart failure and cognitive impairment are associated with frequent hospitalization and increased mortality, particularly when they occur simultaneously. Objectives: To determine cognitive function and related factors in patients with heart failure. Materials and Methods: In this descriptive cross-sectional study, we assessed 239 patients with heart failure. Data were collected by Mini Mental status Examination, Charlson comorbidity index and NYHA classification system. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test, chi-square test, t-test and logistic regression analysis. Results: The mean score of cognitive function was 21.68 ± 4.51. In total, 155 patients (64.9%) had cognitive impairment. Significant associations were found between the status of cognitive impairment and gender (P < 0.002), education level (P < 0.000), living location (P < 0.000), marital status (P < 0.03), living arrangement (P < 0.001 ), employment status (P < 0.000), income (P < 0.02), being the head of family (P < 0.03), the family size (P < 0.02), having a supplemental insurance (P < 0.003) and the patient’s comorbidities (P < 0.02). However, in logistic regression analysis, only education and supplementary insurance could predict cognitive status which indicates that patients with supplementary insurance and higher education levels were more likely to maintain optimal cognitive function. Conclusions: More than a half of the subjects had cognitive impairment. As the level of patients cognitive functioning affects their behaviors and daily living activities, it is recommended that patients with heart failure should be assessed for their cognitive functioning. PMID:25414874

Coming Together and Pulling Apart: Exploring the Influence of Functional Status on Co-resident Relationships in Assisted Living

PubMed Central

Sandhu, Navtej K.; Kemp, Candace L.; Ball, Mary M.; Burgess, Elisabeth O.; Perkins, Molly M.

2013-01-01

Social relationships can have considerable influence on physical and mental well-being in later life, particularly for those in long-term care settings such as assisted living (AL). Research set in AL suggests that other residents are among the most available social contacts and that co-resident relationships can affect life satisfaction, quality of life, and well-being. Functional status is a major factor influencing relationships, yet AL research has not studied in-depth or systematically considered the role it plays in residents’ relationships. This study examines the influences of physical and mental function on co-resident relationships in AL and identifies the factors shaping the influence of functional status. We present an analysis of qualitative data collected over a one-year period in two distinct AL settings. Data collection included: participant observation, informal interviews, and formal in-depth interviews with staff, residents, administrators and visitors, as well as surveys with residents. Grounded theory methods guided our data collection and analysis. Our analysis identified the core category, “coming together and pulling apart”, which signifies that functional status is multi-directional, fluid, and operates in different ways in various situations and across time. Key facility- (e.g., admission and retention practices, staff intervention) and resident-level (e.g., personal and situational characteristics) factors shape the influence of functional status on co-resident relationships. Based on our findings, we suggest strategies for promoting positive relationships among residents in AL, including the need to educate staff, families, and residents. PMID:24300052

Functional Impairments in Children with ADHD: Unique Effects of Age and Comorbid Status

ERIC Educational Resources Information Center

Booster, Genery D.; DuPaul, George J.; Eiraldi, Ricardo; Power, Thomas J.

2012-01-01

Objective: Children with ADHD and comorbid disorders display poorer overall functioning compared with children with ADHD alone, though little research has examined the differential impact of externalizing versus internalizing comorbidities. Method: This study examined the impact of internalizing and externalizing comorbidities on the academic and…

Effects of free leucine supplementation and resistance training on muscle strength and functional status in older adults: a randomized controlled trial

PubMed Central

Trabal, Joan; Forga, Maria; Leyes, Pere; Torres, Ferran; Rubio, Jordi; Prieto, Esther; Farran-Codina, Andreu

2015-01-01

Objective To assess the effect of free leucine supplementation combined with resistance training versus resistance training only on muscle strength and functional status in older adults. Methods This was a randomized, double-blind, placebo-controlled, parallel study with two intervention groups. Thirty older adults were randomly assigned to receive either 10 g leucine/day (leucine group [LG], n=15) or a placebo (control group [CG], n=15), plus resistance training over a 12-week period. Maximal overcoming isometric leg strength, functional status, nutritional status, body composition, health-related quality of life, depression, and dietary intake were assessed at 4 and 12 weeks. Missing data at 12 weeks were handled using mixed models for repeated measurements for data imputation. Results Twenty-four subjects completed the 4-week assessment and eleven completed the 12-week intervention. Clinically significant gains were found in isometric leg strength at both assessment time points. Analysis of the effect size also showed how participants in LG outperformed those in CG for chair stands and the timed up and go test. No significant changes were observed for the rest of the outcomes. Conclusion Our combined analysis showed moderate changes in isometric leg muscle strength and certain components of functional status. The magnitude of changes found on these outcomes should be qualified as a positive effect of the concomitant intervention. PMID:25926725

Method and system for providing work machine multi-functional user interface

DOEpatents

Hoff, Brian D [Peoria, IL; Akasam, Sivaprasad [Peoria, IL; Baker, Thomas M [Peoria, IL

2007-07-10

A method is performed to provide a multi-functional user interface on a work machine for displaying suggested corrective action. The process includes receiving status information associated with the work machine and analyzing the status information to determine an abnormal condition. The process also includes displaying a warning message on the display device indicating the abnormal condition and determining one or more corrective actions to handle the abnormal condition. Further, the process includes determining an appropriate corrective action among the one or more corrective actions and displaying a recommendation message on the display device reflecting the appropriate corrective action. The process may also include displaying a list including the remaining one or more corrective actions on the display device to provide alternative actions to an operator.

Recovery Expectations and Long-term Prognosis of Patients With Coronary Heart Disease

PubMed Central

Barefoot, John C.; Brummett, Beverly H.; Williams, Redford B.; Siegler, Ilene C.; Helms, Michael J.; Boyle, Stephen H.; Clapp-Channing, Nancy E.; Mark, Daniel B.

2013-01-01

Background Expectations of patients regarding their prospects for recovery have been shown to predict subsequent physical and social functioning. Evidence regarding the impact of expectations on clinical outcomes is limited. Methods At the inpatient service of a tertiary care hospital, we evaluated beliefs of patients undergoing coronary angiography about their prognosis as predictors of long-term survival and 1-year functional status. Baseline assessments, including a measure of expectations for recovery, were obtained during hospitalization with mortality follow-up for approximately 15 years. Patients with significant obstructive coronary artery disease were interviewed while in the hospital and enrolled in follow-up. Functional status was assessed at baseline and 1 year later with questionnaires reflecting physical capabilities. Analyses controlled for age, sex, disease severity, comorbidities, treatments, demographics, depressive symptoms, social support, and functional status. There were 1637 total deaths, 885 from cardiovascular causes, in the 2818 patients in these analyses. The outcomes were total mortality, cardiovascular mortality, and 1-year functional status. Results Expectations were positively associated with survival after controlling for background and clinical disease indicators. For a difference equivalent to an inter-quartile range of expectations, the hazard ratio (HR) for total mortality was 0.76 (95% confidence interval [CI], 0.71–0.82) and 0.76 (95% CI, 0.69–0.83) for cardiovascular mortality. The HRs were 0.83 (95% CI, 0.76–0.91) and 0.79 (95% CI, 0.70–0.89) with further adjustments for demographic and psychosocial covariates. Similar associations (P<.001) were observed for functional status. Conclusion Recovery expectations at baseline were positively associated with long-term survival and functioning in patients with coronary artery disease. PMID:21357800

Power Source Status Estimation and Drive Control Method for Autonomous Decentralized Hybrid Train

NASA Astrophysics Data System (ADS)

Furuya, Takemasa; Ogawa, Kenichi; Yamamoto, Takamitsu; Hasegawa, Hitoshi

A hybrid control system has two main functions: power sharing and equipment protection. In this paper, we discuss the design, construction and testing of a drive control method for an autonomous decentralized hybrid train with 100-kW-class fuel cells (FC) and 36-kWh lithium-ion batteries (Li-Batt). The main objectives of this study are to identify the operation status of the power sources on the basis of the input voltage of the traction inverter and to estimate the maximum traction power control basis of the power-source status. The proposed control method is useful in preventing overload operation of the onboard power sources in an autonomous decentralized hybrid system that has a flexible main circuit configuration and a few control signal lines. Further, with this method, the initial cost of a hybrid system can be reduced and the retrofit design of the hybrid system can be simplified. The effectiveness of the proposed method is experimentally confirmed by using a real-scale hybrid train system.

The impact of menopause on functional status in women with rheumatoid arthritis.

PubMed

Mollard, Elizabeth; Pedro, Sofia; Chakravarty, Eliza; Clowse, Megan; Schumacher, Rebecca; Michaud, Kaleb

2018-05-01

The aim of this study was to investigate the association of menopause with functional status outcomes in women with RA. Participants were women in a US-wide observational cohort who developed RA before menopause. The HAQ measured functional status. We controlled for confounding variables and used univariate and multivariable generalized estimating equation methods with the sandwich estimator of variance. Best models were selected using the quasi-likelihood under the independence model criterion. A sensitivity analysis was performed using linear mixed effects regression models. A total of 8189 women were eligible. Of these, 2005 (24.5%) were pre-menopausal, 611 (7.5%) transitioned through menopause during the study, and 5573 (68.1%) were post-menopausal. Within each respective group, the mean (s.d.) ages were 39.7 (7.8), 50.7 (3.4) and 62.3 (9.3) years. Our results showed that women who were pre-menopausal had less functional decline as measured by the HAQ compared with women who were post-menopausal; these results were robust and strong even after adjustment for other significant factors. The ever-use of hormonal replacement therapy, ever having a pregnancy, and longer length of reproductive life were associated with less functional decline. After menopause, the trajectory of functional decline worsened and accelerated in women with RA. The results suggest that menopausal status is associated with functional decline in women with RA. Furthermore, menopause is associated with a worsening progression of functional decline. These data indicate that menopause has a significant impact on the level and rate of functional decline in women with RA.

The effect of Laser and taping on pain, functional status and quality of life in patients with fibromyalgia syndrome: A placebo- randomized controlled clinical trial.

PubMed

Vayvay, Emre Serdar; Tok, Damla; Turgut, Elif; Tunay, Volga Bayrakci

2016-01-01

Conservative treatments have been proved to be effective to control pain and optimize function in fibromyalgia, however there is need for scientific evidence to make better clinical application across various physiotherapy applications. The aim of this study was to investigate the effects of Laser and taping applications on pain, flexibility, anxiety, depression, functional status and quality of life in patients with fibromyalgia syndrome. Forty-five female patients with fibromyalgia syndrome were included to the study and randomly allocated into three treatment groups; Laser (n= 15), placebo Laser (n= 15), and taping applications (n= 15). Visual analogue scale for pain intensity, trunk flexibility, Fibromyalgia Impact Questionnaire for functional status, Short Form 36 Questionnaire for quality of life and health status, and Beck Depression Inventory for anxiety level were evaluated before and after three weeks interventions. There were decreased pain severity in activity (p= 0.028), anxiety level (p= 0.01) and improved general health status, quality of life (p= 0.01) found at Laser group, whereas there were increased trunk flexibility, flexion (p= 0.03), extension (p= 0.02) found at taping group. After interventions, there were decreased pain severity for whole groups at night for Laser group (p= 0.04), placebo Laser group (p= 0.001), taping group (p= 0.01) and improved functional status found for Laser group (p= 0.001), placebo Laser group (p= 0.001), taping group (p= 0.01). Kinesiotape application had a similar effect on parameters in FMS patient, so this method could be preferred instead of Laser application for rehabilitation program.

Relationship between Functional Visual Acuity and Useful Field of View in Elderly Drivers

PubMed Central

Negishi, Kazuno; Masui, Sachiko; Mimura, Masaru; Fujita, Yoshio; Tsubota, Kazuo

2016-01-01

Purpose To investigate the relationship between the functional visual acuity (FVA) and useful field of view (UFOV) in elderly drivers and assess the usefulness of the FVA test to screen driving aptitude in elderly drivers. Methods This study included 45 elderly drivers (31 men, 14 women; mean age, 68.1 years) and 30 younger drivers (26 men, 4 women; mean age, 34.2 years) who drive regularly. All participants underwent measurement of the binocular corrected distant visual acuity (CDVA), binocular corrected distant FVA (CDFVA), and Visual Field with Inhibitory Tasks Elderly Version (VFIT-EV) to measure UFOV. The tear function and cognitive status also were evaluated. Results The CDVA, the CDFVA, cognitive status, and the correct response rate (CAR) of the VFIT-EV were significantly worse in the elderly group than in the control group (P = 0.000 for all parameters). The cognitive status was correlated significantly with the CDVA (r = -0.301, P = 0.009), CDFVA (r = -0.402, P = 0.000), and the CAR of the VFIT-EV (r = 0.348, P = 0.002) in all subjects. The results of the tear function tests were not correlated with the CDVA, CDFVA, or VFIT-EV in any subjects. Stepwise regression analysis for all subjects in the elderly and control groups showed that the CDFVA predicted the CAR most significantly among the clinical factors evaluated. Conclusion The FVA test is a promising method to screen the driving aptitude, including both visual and cognitive functions, in a short time. PMID:26808364

Higher Order Heavy Quark Corrections to Deep-Inelastic Scattering

NASA Astrophysics Data System (ADS)

Blümlein, Johannes; DeFreitas, Abilio; Schneider, Carsten

2015-04-01

The 3-loop heavy flavor corrections to deep-inelastic scattering are essential for consistent next-to-next-to-leading order QCD analyses. We report on the present status of the calculation of these corrections at large virtualities Q2. We also describe a series of mathematical, computer-algebraic and combinatorial methods and special function spaces, needed to perform these calculations. Finally, we briefly discuss the status of measuring αs (MZ), the charm quark mass mc, and the parton distribution functions at next-to-next-to-leading order from the world precision data on deep-inelastic scattering.

Application of Entropy Method in River Health Evaluation Based on Aquatic Ecological Function Regionalization

NASA Astrophysics Data System (ADS)

Shi, Yan-ting; Liu, Jie; Wang, Peng; Zhang, Xu-nuo; Wang, Jun-qiang; Guo, Liang

2017-05-01

With the implementation of water environment management in key basins in China, the monitoring and evaluation system of basins are in urgent need of innovation and upgrading. In view of the heavy workload of existing evaluation methods and the cumbersome calculation of multi-factor weighting method, the idea of using entroy method to assess river health based on aquatic ecological function regionalization was put forward. According to the monitoring data of songhua river in the year of 2011-2015, the entropy weight method was used to calculate the weight of 9 evaluation factors of 29 monitoring sections, and the river health assessment was carried out. In the study area, the river health status of the biodiversity conservation function area (4.111 point) was good, the water conservation function area (3.371 point), the habitat maintenance functional area (3.262 point), the agricultural production maintenance functional area (3.695 point) and the urban supporting functional area (3.399 point) was light pollution.

Which Assessment Method of Malnutrition in Head and Neck Cancer?

PubMed

Saroul, Nicolas; Pastourel, Rémy; Mulliez, Aurélien; Farigon, Nicolas; Dupuch, Vincent; Mom, Thierry; Boirie, Yves; Gilain, Laurent

2018-06-01

Objective To assess the value of several diagnostic methods of nutritional status during the initial management of a head and neck cancer. Study Design Single-center prospective study. Setting Tertiary referral center. Subjects and Methods Ninety patients with head and neck cancer participated in the study. Assessment of their nutritional status was made with anthropometric, biological, body, and muscle measurements (the last by computed tomography: L3 muscle mass index [L3MMI]). Assessment of muscle performance (functional reflection of nutritional status) was made via the Short Physical Performance Battery test. The malnutrition thresholds were set according to the literature. Results Mean body mass index (BMI) was 24.6 ± 5.4 kg/m 2 . Mean weight loss and albumin levels were -4.5 ± 10.5 kg and 37.1 ± 5.2 g/L, respectively. Fourteen percent of patients were diagnosed as malnourished on the basis of BMI, 54% according to the Nutritional Risk Index (NRI), and 58% by L3MMI. There was 64% agreement between NRI and L3MMI ( P < .001). All patients identified as malnourished by BMI were considered as such by the other assessment methods; however, many malnourished patients had normal or high BMI. The Short Physical Performance Battery score was low particularly among patients considered to be the most undernourished by the other methods. Conclusion NRI and L3MMI are the best methods to identify patients as being malnourished. Functional muscle assessment can determine the severity of malnutrition.

Regression analysis of informative current status data with the additive hazards model.

PubMed

Zhao, Shishun; Hu, Tao; Ma, Ling; Wang, Peijie; Sun, Jianguo

2015-04-01

This paper discusses regression analysis of current status failure time data arising from the additive hazards model in the presence of informative censoring. Many methods have been developed for regression analysis of current status data under various regression models if the censoring is noninformative, and also there exists a large literature on parametric analysis of informative current status data in the context of tumorgenicity experiments. In this paper, a semiparametric maximum likelihood estimation procedure is presented and in the method, the copula model is employed to describe the relationship between the failure time of interest and the censoring time. Furthermore, I-splines are used to approximate the nonparametric functions involved and the asymptotic consistency and normality of the proposed estimators are established. A simulation study is conducted and indicates that the proposed approach works well for practical situations. An illustrative example is also provided.

Position Description Analysis: A Method for Describing Academic Roles and Functions.

ERIC Educational Resources Information Center

Renner, K. Edward; Skibbens, Ronald J.

1990-01-01

The Position Description Analysis method for assessing the discrepancy between status quo and specializations needed by institutions to meet new demands and expectations is presented using Dalhousie University (Nova Scotia) as a case study. Dramatic realignment of fields of specialization and change strategies accommodating the aging professoriate…

Vitamin B12 status of pregnant Indian women and cognitive function in their 9-year-old children

PubMed Central

Bhate, Vidya; Deshpande, Swapna; Bhat, Dattatray; Joshi, Niranjan; Ladkat, Rasika; Watve, Sujala; Fall, Caroline; de Jager, Celeste A.; Refsum, Helga; Yajnik, Chittaranjan

2009-01-01

Background Recent research has highlighted the influence of maternal factors on the health of the offspring. Intrauterine experiences may program metabolic, cardiovascular, and psychiatric disorders. We have shown that maternal vitamin B12 status affects adiposity and insulin resistance in the child. Vitamin B12 is important for brain development and function. Objective We investigated the relationship between maternal plasma vitamin B12 status during pregnancy and the child's cognitive function at 9 years of age. Methods We studied children born in the Pune Maternal Nutrition Study. Two groups of children were selected on the basis of maternal plasma vitamin B12 concentration at 28 weeks of gestation: group 1 (n = 49) included children of mothers with low plasma vitamin B12 (lowest decile, < 77 pM) and group 2 (n = 59) children of mothers with high plasma vitamin B12 (highest decile, > 224 pM). Results Children from group 1 performed more slowly than those from group 2 on the Color Trail A test (sustained attention, 182 vs. 159 seconds; p < .05) and the Digit Span Backward test (short-term memory, p <.05), after appropriate adjustment for confounders. There were no differences between group 1 and group 2 on other tests of cognitive function (intelligence, visual agnosia). Conclusions Maternal vitamin B12 status in pregnancy influences cognitive function in offspring. PMID:19227049

Force Exertion Capacity Measurements in Haptic Virtual Environments

ERIC Educational Resources Information Center

Munih, Marko; Bardorfer, Ales; Ceru, Bojan; Bajd, Tadej; Zupan, Anton

2010-01-01

An objective test for evaluating functional status of the upper limbs (ULs) in patients with muscular distrophy (MD) is presented. The method allows for quantitative assessment of the UL functional state with an emphasis on force exertion capacity. The experimental measurement setup and the methodology for the assessment of maximal exertable force…

Heterogeneity in the Pharmacological Treatment of Children with ADHD: Cognitive, Behavioral, and Social Functioning Differences

ERIC Educational Resources Information Center

Graziano, Paulo A.; Geffken, Gary R.; Lall, Ayesha S.

2011-01-01

Objective: To investigate the extent to which children with ADHD in various medication statuses (i.e., medication naive, pure stimulant, stimulant plus another medication, nonstimulants) varied on cognitive or academic, behavioral, and social functioning during a psychoeducational assessment battery. Method: Participants for this study consisted…

Social Functioning in Predominantly Inattentive and Combined Subtypes of Children with ADHD

ERIC Educational Resources Information Center

Solanto, Mary V.; Pope-Boyd, Sabrina A.; Tryon, Warren W.; Stepak, Brenda

2009-01-01

Objective: The objective of this study was to compare the social functioning of children with the Combined (CB) and Predominantly Inattentive (PI) subtypes of Attention Deficit/Hyperactivity Disorder (ADHD), controlling for comorbidity and medication-status, which may have confounded the results of previous research. Method: Parents and teachers…

Influence of fatigue on construction workers’ physical and cognitive function

PubMed Central

Zhang, M.; Murphy, L. A.; Fang, D.

2015-01-01

Background Despite scientific evidence linking workers’ fatigue to occupational safety (due to impaired physical or cognitive function), little is known about this relationship in construction workers. Aims To assess the association between construction workers’ reported fatigue and their perceived difficulties with physical and cognitive functions. Methods Using data from a convenience sample of US construction workers participating in the 2010–11 National Health Interview Survey two multivariate weighted logistic regression models were built to predict difficulty with physical and with cognitive functions associated with workers’ reported fatigue, while controlling for age, smoking status, alcohol consumption status, sleep hygiene, psychological distress and arthritis status. Results Of 606 construction workers surveyed, 49% reported being ‘tired some days’ in the past 3 months and 10% reported ‘tired most days or every day’. Compared with those feeling ‘never tired’, workers who felt ‘tired some days’ were significantly more likely to report difficulty with physical function (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] 1.17–3.51) and cognitive function (AOR = 2.27; 95% CI 1.06–4.88) after controlling for potential confounders. Conclusions Our results suggest an association between reported fatigue and experiencing difficulties with physical and cognitive functions in construction workers. PMID:25701835

Cognitive Correlates of Functional Abilities in Individuals with Mild Cognitive Impairment: Comparison of Questionnaire, Direct Observation and Performance-based Measures

PubMed Central

Schmitter-Edgecombe, Maureen; Parsey, Carolyn M.

2014-01-01

The relationship between and the cognitive correlates of several proxy measures of functional status were studied in a population with mild cognitive impairment (MCI). Participants were 51 individuals diagnosed with MCI and 51 cognitively healthy older adults (OA). Participants completed performance-based functional status tests, standardized neuropsychological tests, and performed eight activities of daily living (e.g., watered plants, filled medication dispenser) while under direct observation in a campus apartment. An informant interview about everyday functioning was also conducted. Compared to the OA control group, the MCI group performed more poorly on all proxy measures of everyday functioning. The informant-report of instrumental activities of daily living (IADL) did not correlate with the two performance-based measures; however, both the informant-report IADL and the performance-based everyday problem-solving test correlated with the direct observation measure. After controlling for age and education, cognitive predictors did not explain a significant amount of variance in the performance-based measures; however, performance on a delayed memory task was a unique predictor for the informant-report IADL, and processing speed predicted unique variance for the direct observation score. These findings indicate that differing methods for evaluating functional status are not assessing completely overlapping aspects of everyday functioning in the MCI population. PMID:24766574

Cognitive correlates of functional abilities in individuals with mild cognitive impairment: comparison of questionnaire, direct observation, and performance-based measures.

PubMed

Schmitter-Edgecombe, Maureen; Parsey, Carolyn M

2014-01-01

The relationship between, and the cognitive correlates of, several proxy measures of functional status were studied in a population with mild cognitive impairment (MCI). Participants were 51 individuals diagnosed with MCI and 51 cognitively healthy older adults (OA). Participants completed performance-based functional status tests and standardized neuropsychological tests, and performed eight activities of daily living (e.g., watered plants, filled medication dispenser) while under direct observation in a campus apartment. An informant interview about everyday functioning was also conducted. Compared to the OA control group, the MCI group performed more poorly on all proxy measures of everyday functioning. The informant report of instrumental activities of daily living (IADL) did not correlate with the two performance-based measures; however, both the informant-report IADL and the performance-based everyday problem-solving test correlated with the direct observation measure. After controlling for age and education, cognitive predictors did not explain a significant amount of variance in the performance-based measures; however, performance on a delayed memory task was a unique predictor for the informant-report IADL, and processing speed predicted unique variance for the direct observation score. These findings indicate that differing methods for evaluating functional status are not assessing completely overlapping aspects of everyday functioning in the MCI population.

Sex-specific role of education on the associations of socioeconomic status indicators with obesity risk: A population-based study in South Korea

PubMed Central

Chung, Woojin; Lim, Seung-ji; Lee, Sunmi

2018-01-01

Background No study of obesity risk for people in developed countries has conducted a multi-dimensional analysis of the association of socioeconomic status with obesity. In this paper, we investigated if education functions as either a confounder or an effect modifier in the association of another socioeconomic status indicator with obesity. Methods This cross-sectional study analyzed data of an adult population sample (10,905 men and 14,580 women) from the Korea National Health and Nutrition Examination Survey (2010–2014). The study performed multivariate logistic regression analyses for three education levels and four indicators of socioeconomic status (i.e., marital status, residential area, occupation, and income). Results The overall prevalence of obesity was 38.1% in men and 29.1% in women (p < 0.001). In men, while education functioned as an effect modifier in the association between marital status and obesity (p for interaction = 0.006), it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction < 0.001) in the association between residential area and obesity. In contrast, in women, education functioned as a confounder in the association of residential area with obesity (p = 0.010). However, it functioned as both a confounder (p < 0.001) and an effect modifier (p for interaction = 0.012) in the association between income and obesity. A prediction showed that unlike in women, education was positively associated with obesity risk for some socioeconomic indicator groups in men; for example, in a rural resident group, a higher level of education increased the probability of being obese by 19.7%. Conclusions The present study suggests the need to examine sex-specific studies regarding the role of education on the association between other socioeconomic status indicators and obesity. This should be considered in planning education policies to reduce the risk of obesity. PMID:29298319

Self-reported health and functional limitations among older people in the Kassena-Nankana District, Ghana

PubMed Central

Debpuur, Cornelius; Welaga, Paul; Wak, George; Hodgson, Abraham

2010-01-01

Background Ghana is experiencing significant increases in its ageing population, yet research on the health and quality of life of older people is limited. Lack of data on the health and well-being of older people in the country makes it difficult to monitor trends in the health status of adults and the impact of social policies on their health and welfare. Research on ageing is urgently required to provide essential data for policy formulation and programme implementation. Objective To describe the health status and identify factors associated with self-rated health (SRH) among older adults in a rural community in northern Ghana. Methods The data come from a survey on Adult Health and Ageing in the Kassena-Nankana District involving 4,584 people aged 50 and over. Survey participants answered questions pertaining to their health status, including self-rated overall health, perceptions of well-being and quality of life, and self-reported assessment of functioning on a range of different health domains. Socio-demographic information such as age, sex, marital status and education were obtained from a demographic surveillance database. Results The majority of older people rated their health status as good, with the oldest old reporting poorer health. Multivariate regression analysis showed that functional ability and sex are significant factors in SRH status. Adults with higher levels of functional limitations were much more likely to rate their health as being poorer compared with those having lower disabilities. Household wealth was significantly associated with SRH, with wealthier adults more likely to rate their health as good. Conclusion The depreciation in health and daily functioning with increasing age is likely to increase people's demand for health care and other services as they grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect and promote the health and well-being of older people. PMID:20963186

Ratios of One-Carbon Metabolites Are Functional Markers of B-Vitamin Status in a Norwegian Coronary Angiography Screening Cohort.

PubMed

Ulvik, Arve; Hustad, Steinar; McCann, Adrian; Midttun, Øivind; Nygård, Ottar K; Ueland, Per M

2017-06-01

Background: Functional (metabolic) markers of B-vitamin status, including plasma total homocysteine (tHcy) for folate and plasma methylmalonic acid (MMA) for vitamin B-12, suffer from moderate sensitivity and poor specificity. Ratios of metabolites belonging to the same pathway may have better performance characteristics. Objective: We evaluated the ratios of tHcy to total cysteine (tCys; Hcy:Cys), tHcy to creatinine (Hcy:Cre), and tHcy to tCys to creatinine (Hcy:Cys:Cre) as functional markers of B-vitamin status represented by a summary score composed of folate, cobalamin, betaine, pyridoxal 5'-phosphate (PLP), and riboflavin concentrations measured in plasma. Methods: Cross-sectional data were obtained from a cohort of patients with stable angina pectoris (2994 men and 1167 women) aged 21-88 y. The relative contribution of the B-vitamin score, age, sex, smoking, body mass index, and markers of renal function and inflammation to the variance of the functional B-vitamin markers was calculated by using multiple linear regression. Results: Compared with tHcy alone, Hcy:Cys, Hcy:Cre, and Hcy:Cys:Cre all showed improved sensitivity and specificity for detecting plasma B-vitamin status. Improvements in overall performance ranged from 4-fold for Hcy:Cys to ∼8-fold for Hcy:Cys:Cre and were particularly strong in subjects with the common 5,10-methylenetetrahydrofolate reductase (MTHFR) 677CC genotype. Conclusions: Ratios of tHcy to tCys and/or creatinine showed a severalfold improvement over tHcy alone as functional markers of B-vitamin status in Norwegian coronary angiography screenees. The biological rationale for these ratios is discussed in terms of known properties of enzymes involved in the catabolism of homocysteine and synthesis of creatine and creatinine. © 2017 American Society for Nutrition.

Extended, continuous measures of functional status in community dwelling persons with Alzheimer's and related dementia: Infrastructure, performance, tradeoffs, preliminary data, and promise.

PubMed

Zylstra, Bradley; Netscher, George; Jacquemot, Julien; Schaffer, Michael; Shen, Galen; Bowhay, Angela D; Braley, Tamara L; Possin, Katherine L; Miller, Bruce L; Bayen, Alexandre M; Bonasera, Stephen J; Schenk, A Katrin

2018-04-15

The past decades have seen phenomenal growth in the availability of inexpensive and powerful personal computing devices. Efforts to leverage these devices to improve health care outcomes promise to remake many aspects of healthcare delivery, but remain in their infancy. We describe the development of a mobile health platform designed for daily measures of functional status in ambulatory, community dwelling subjects, including those who have Alzheimer's disease or related neurodegenerative disorders. Using Smartwatches and Smartphones we measure subject overall activity and outdoor location (to derive their lifespace). These clinically-relevant measures allow us to track a subject's functional status in their natural environment over prolonged periods of time without repeated visits to healthcare providers. Functional status metrics are integrated with medical information and caregiver reports, which are used by a caregiving team to guide referrals for physician/APRN/NP care. COMPARISON: with Existing Methods We describe the design tradeoffs involved in all aspects of our current system architecture, focusing on decisions with significant impact on system cost, performance, scalability, and user-adherence. We provide real-world data from current subject enrollees demonstrating system accuracy and reliability. We document real-world feasibility in a group of men and women with dementia that Smartwatches/Smartphones can provide long-term, relevant clinical data regarding individual functional status. We describe the underlying considerations of this system so that interested organizations can adapt and scale our approach to their needs. Finally, we provide a potential agenda to guide development of future systems. Copyright © 2017 Elsevier B.V. All rights reserved.

System for monitoring an industrial process and determining sensor status

DOEpatents

Gross, K.C.; Hoyer, K.K.; Humenik, K.E.

1995-10-17

A method and system for monitoring an industrial process and a sensor are disclosed. The method and system include generating a first and second signal characteristic of an industrial process variable. One of the signals can be an artificial signal generated by an auto regressive moving average technique. After obtaining two signals associated with one physical variable, a difference function is obtained by determining the arithmetic difference between the two pairs of signals over time. A frequency domain transformation is made of the difference function to obtain Fourier modes describing a composite function. A residual function is obtained by subtracting the composite function from the difference function and the residual function (free of nonwhite noise) is analyzed by a statistical probability ratio test. 17 figs.

System for monitoring an industrial process and determining sensor status

DOEpatents

Gross, K.C.; Hoyer, K.K.; Humenik, K.E.

1997-05-13

A method and system are disclosed for monitoring an industrial process and a sensor. The method and system include generating a first and second signal characteristic of an industrial process variable. One of the signals can be an artificial signal generated by an auto regressive moving average technique. After obtaining two signals associated with one physical variable, a difference function is obtained by determining the arithmetic difference between the two pairs of signals over time. A frequency domain transformation is made of the difference function to obtain Fourier modes describing a composite function. A residual function is obtained by subtracting the composite function from the difference function and the residual function (free of nonwhite noise) is analyzed by a statistical probability ratio test. 17 figs.

System for monitoring an industrial process and determining sensor status

DOEpatents

Gross, Kenneth C.; Hoyer, Kristin K.; Humenik, Keith E.

1995-01-01

A method and system for monitoring an industrial process and a sensor. The method and system include generating a first and second signal characteristic of an industrial process variable. One of the signals can be an artificial signal generated by an auto regressive moving average technique. After obtaining two signals associated with one physical variable, a difference function is obtained by determining the arithmetic difference between the two pairs of signals over time. A frequency domain transformation is made of the difference function to obtain Fourier modes describing a composite function. A residual function is obtained by subtracting the composite function from the difference function and the residual function (free of nonwhite noise) is analyzed by a statistical probability ratio test.

System for monitoring an industrial process and determining sensor status

DOEpatents

Gross, Kenneth C.; Hoyer, Kristin K.; Humenik, Keith E.

1997-01-01

A method and system for monitoring an industrial process and a sensor. The method and system include generating a first and second signal characteristic of an industrial process variable. One of the signals can be an artificial signal generated by an auto regressive moving average technique. After obtaining two signals associated with one physical variable, a difference function is obtained by determining the arithmetic difference between the two pairs of signals over time. A frequency domain transformation is made of the difference function to obtain Fourier modes describing a composite function. A residual function is obtained by subtracting the composite function from the difference function and the residual function (free of nonwhite noise) is analyzed by a statistical probability ratio test.

The effect of manual therapy and exercise in patients with chronic low back pain: Double blind randomized controlled trial.

PubMed

Ulger, Ozlem; Demirel, Aynur; Oz, Müzeyyen; Tamer, Seval

2017-11-06

To determine the effects of spinal stabilization exercises (SSE) and manual therapy methods on pain, function and quality of life (QoL) levels in individuals with chronic low back pain (CLBP). A total of one-hundred thirteen patients diagnosed as CLBP were enrolled to the study. The patients allocated into Spinal Stabilization group (SG) and manual therapy group (MG), randomly. While SSE performed in SG, soft tissue mobilizations, muscle-energy techniques, joint mobilizations and manipulations were performed in MG. While the severity of pain was assessed with Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form 36 (SF-36) assessments were performed to evaluate the functional status and QoL, respectively. All assessments were repeated before and after the treatment. Intragroup analyses both treatments were effective in terms of sub parameters of pain, function and life quality (p< 0.05). Inter group analyses, there was more reduction in pain and improvement in functional status in favor of MG (p< 0.05). This study showed that SSE and manual therapy methods have the same effects on QoL, while the manual treatment is more effective on the pain and functional parameters in particular.

Early-Life Selenium Status and Cognitive Function at 5 and 10 Years of Age in Bangladeshi Children

PubMed Central

Skröder, Helena; Tofail, Fahmida; Vahter, Marie

2017-01-01

Background: In older adults, selenium status has been positively associated with cognitive function. We recently reported a positive association between maternal selenium status in pregnancy and children’s cognitive function at 1.5 y. Objective: We followed up the children to assess if prenatal and childhood selenium status was associated with cognitive abilities at 5 and 10 y. Methods: This longitudinal cohort study was nested in Maternal and Infant Nutrition Interventions in Matlab (MINIMat), a population-based, randomized supplementation trial in pregnancy in rural Bangladesh. Selenium in maternal blood [erythrocyte fraction (Ery-Se) at baseline] and in child hair and urine was measured using inductively coupled plasma mass spectrometry. Children’s cognition at 5 and 10 y was assessed using the Wechsler Preschool and Primary Scale of Intelligence™ and the Wechsler Intelligence Scale for Children®, respectively. In total, 1,408 children were included. Results: Multivariable-adjusted linear regression analyses showed that prenatal selenium status was positively associated with children’s cognitive function at 5 and 10 y. An increase in maternal Ery-Se from the fifth to the 95th percentile [median: 0.44μg/g hemoglobin (Hb)] was associated with an increase in full developmental score of 3.5 [95% confidence interval (CI): 0.1, 7.0], corresponding to 0.16 standard deviation (SD) at 5 y, and 8.1 (95% CI: 3.8, 13), corresponding to 0.24 SD at 10 y. In addition, urine and hair selenium concentrations at 5 and 10 y of age were positively associated with cognitive function at 10 y, although associations were inverse for concentrations ≥98th percentile. Some associations were slightly stronger for girls than for boys. Conclusions: Measures of prenatal and childhood (below the 98th percentile) selenium status were associated with higher cognitive function scores at 5 and 10 y of age. https://doi.org/10.1289/EHP1691 PMID:29116931

The assessment of function. Part II: clinical perspective of a javelin thrower with low back and groin pain

PubMed Central

Reiman, Michael P; Manske, Robert C

2012-01-01

Assessment of an individual’s functional ability can be complex. This assessment should also be individualized and adaptable to changes in functional status. In the first article of this series, we operationally defined function, discussed the construct of function, examined the evidence as it relates to assessment methods of various aspects of function, and explored the multi-dimensional nature of the concept of function. In this case report, we aim to demonstrate the utilization of a multi-dimensional assessment method (functional performance testing) as it relates to a high-level athlete presenting with pain in the low back and groin. It is our intent to demonstrate how the clinician should continually adapt their assessment dependent on the current functional abilities of the patients. PMID:23633887

The physical functional capacity of frail elderly persons undergoing ambulatory rehabilitation is related to their nutritional status.

PubMed

Chevalier, S; Saoud, F; Gray-Donald, K; Morais, J A

2008-12-01

To estimate the prevalence of malnutrition in frail elders undergoing rehabilitation and the association between their nutritional status and physical function. Observational study of new participants undergoing ambulatory rehabilitation. Two Geriatric Day Hospitals (GDH) in Montreal, Quebec. 121 women and 61 men. Evaluation of nutritional status, body composition and physical function. The nutritional status was assessed with a composite index based on anthropometric measurements and serum albumin, as well as using the Mini Nutritional Assessment (MNA) questionnaire. Patients were classified as well-nourished, having mild/at risk of malnutrition or malnourished. Body composition was estimated by bioimpedance and handgrip strength and gait speed by standard methods. 13% of patients were found to be mildly malnourished, whereas 6% were malnourished. Malnourished patients were older and had worse cognition, lower BMI, and % body fat (all p<0.05). Malnourished patients and those with mild malnutrition had lower weight, triceps skinfold thickness, muscle and fat mass (all, p<0.003). Handgrip strength was different according to the nutritional status (p=0.034) and correlated with muscle mass (r=0.65, p<0.001). MNA classified 53% of patients as being at risk whereas 3% were malnourished and it correlated with gait speed (r=0.26, p=0.001). There is a high prevalence of patients in GDH at risk or with mild malnutrition. Being malnourished was associated with worse physical performance, which suggests that a nutritional intervention may be of benefit in improving their physical function.

Investigation of a dual modal method for bone pathologies using quantitative ultrasound and photoacoustics

NASA Astrophysics Data System (ADS)

Steinberg, Idan; Gannot, Israel; Eyal, Avishay

2015-03-01

Osteoporosis is a widespread disease that has a catastrophic impact on patient's lives and overwhelming related healthcare costs. In recent works, we have developed a multi-spectral, frequency domain photoacoustic method for the evaluation of bone pathologies. This method has great advantages over pure ultrasonic or optical methods as it provides both molecular information from the bone absorption spectrum and bone mechanical status from the characteristics of the ultrasound propagation. These characteristics include both the Speed of Sound (SOS) and Broadband Ultrasonic Attenuation (BUA). To test the method's quantitative predictions, we have constructed a combined ultrasound and photoacoustic setup. Here, we experimentally present a dual modality system, and compares between the methods on bone samples in-vitro. The differences between the two modalities are shown to provide valuable insight into the bone structure and functional status.

Application and interpretation of functional data analysis techniques to differential scanning calorimetry data from lupus patients.

PubMed

Kendrick, Sarah K; Zheng, Qi; Garbett, Nichola C; Brock, Guy N

2017-01-01

DSC is used to determine thermally-induced conformational changes of biomolecules within a blood plasma sample. Recent research has indicated that DSC curves (or thermograms) may have different characteristics based on disease status and, thus, may be useful as a monitoring and diagnostic tool for some diseases. Since thermograms are curves measured over a range of temperature values, they are considered functional data. In this paper we apply functional data analysis techniques to analyze differential scanning calorimetry (DSC) data from individuals from the Lupus Family Registry and Repository (LFRR). The aim was to assess the effect of lupus disease status as well as additional covariates on the thermogram profiles, and use FD analysis methods to create models for classifying lupus vs. control patients on the basis of the thermogram curves. Thermograms were collected for 300 lupus patients and 300 controls without lupus who were matched with diseased individuals based on sex, race, and age. First, functional regression with a functional response (DSC) and categorical predictor (disease status) was used to determine how thermogram curve structure varied according to disease status and other covariates including sex, race, and year of birth. Next, functional logistic regression with disease status as the response and functional principal component analysis (FPCA) scores as the predictors was used to model the effect of thermogram structure on disease status prediction. The prediction accuracy for patients with Osteoarthritis and Rheumatoid Arthritis but without Lupus was also calculated to determine the ability of the classifier to differentiate between Lupus and other diseases. Data were divided 1000 times into separate 2/3 training and 1/3 test data for evaluation of predictions. Finally, derivatives of thermogram curves were included in the models to determine whether they aided in prediction of disease status. Functional regression with thermogram as a functional response and disease status as predictor showed a clear separation in thermogram curve structure between cases and controls. The logistic regression model with FPCA scores as the predictors gave the most accurate results with a mean 79.22% correct classification rate with a mean sensitivity = 79.70%, and specificity = 81.48%. The model correctly classified OA and RA patients without Lupus as controls at a rate of 75.92% on average with a mean sensitivity = 79.70% and specificity = 77.6%. Regression models including FPCA scores for derivative curves did not perform as well, nor did regression models including covariates. Changes in thermograms observed in the disease state likely reflect covalent modifications of plasma proteins or changes in large protein-protein interacting networks resulting in the stabilization of plasma proteins towards thermal denaturation. By relating functional principal components from thermograms to disease status, our Functional Principal Component Analysis model provides results that are more easily interpretable compared to prior studies. Further, the model could also potentially be coupled with other biomarkers to improve diagnostic classification for lupus.

Adaption of the AMDIS Method to Flight Status on the VCAM Instrument

NASA Technical Reports Server (NTRS)

Mandrake, Lukas; Bornstein, Benjamin J.; Lee, Seungwon; Bue, Brian D.

2011-01-01

Software has been developed to function onboard the International Space Station (ISS) to help safeguard human health by detecting compounds of concern in the cabin atmosphere, both in identity and concentration.

A novel method for determining human ex vivo submaximal skeletal muscle mitochondrial function

PubMed Central

Hey-Mogensen, Martin; Gram, Martin; Jensen, Martin Borch; Lund, Michael Taulo; Hansen, Christina Neigaard; Scheibye-Knudsen, Morten; Bohr, Vilhelm A; Dela, Flemming

2015-01-01

Abstract Despite numerous studies, there is no consensus about whether mitochondrial function is altered with increased age. The novelty of the present study is the determination of mitochondrial function at submaximal activity rates, which is more physiologically relevant than the ex vivo functionality protocols used previously. Muscle biopsies were taken from 64 old or young male subjects (aged 60–70 or 20–30 years). Aged subjects were recruited as trained or untrained. Muscle biopsies were used for the isolation of mitochondria and subsequent measurements of DNA repair, anti-oxidant capacity and mitochondrial protein levels (complexes I–V). Mitochondrial function was determined by simultaneous measurement of oxygen consumption, membrane potential and hydrogen peroxide emission using pyruvate + malate (PM) or succinate + rotenone (SR) as substrates. Proton leak was lower in aged subjects when determined at the same membrane potential and was unaffected by training status. State 3 respiration was lower in aged untrained subjects. This effect, however, was alleviated in aged trained subjects. H2O2 emission with PM was higher in aged subjects, and was exacerbated by training, although it was not changed when using SR. However, with a higher manganese superoxide dismuthase content, the trained aged subjects may actually have lower or similar mitochondrial superoxide emission compared to the untrained subjects. We conclude that ageing and the physical activity level in aged subjects are both related to changes in the intrinsic functionality of the mitochondrion in skeletal muscle. Both of these changes could be important factors in determining the metabolic health of the aged skeletal muscle cell. Key points The present study utilized a novel method aiming to investigate mitochondrial function in human skeletal muscle at submaximal levels and at a predefined membrane potential. The effect of age and training status was investigated using a cross-sectional design. Ageing was found to be related to decreased leak regardless of training status. Increased training status was associated with increased mitochondrial hydrogen peroxide emission. PMID:26096709

Fifteen-Year Follow-Up of Thyroid Status in Adults with Down Syndrome

ERIC Educational Resources Information Center

Prasher, V.; Ninan, S.; Haque, S.

2011-01-01

Background: The natural history of thyroid function in adults with Down syndrome is relatively unknown with limited long-term follow-up data. Method: This study investigated annual thyroid function tests in 200 adults with Down syndrome over a 15-year period. Results: For healthy adults with Down syndrome there is a gradual increase in thyroxine…

[Structural analysis of the functional status of the brain as affected by bemethyl using pattern recognition theory].

PubMed

Bobkov, Iu G; Machula, A I; Morozov, Iu I; Dvalishvili, E G

1987-11-01

Evoked visual potentials in associated, parietal and second somatosensory zones of the neocortex were analysed in trained cats using implanted electrodes. The influence of bemethyl on the structure of behavioral reactions was analysed using theoretical methods of perceptual images, particularly the method of cluster analysis. Bemethyl was shown to increase the level of interaction between the functional elements of the system, leading to a more stable resolution of problems facing the system, as compared to the initial state.

An overview of international literature from cystic fibrosis registries 2. Neonatal screening and nutrition/growth.

PubMed

Salvatore, Donatello; Buzzetti, Roberto; Baldo, Ermanno; Forneris, Maria Pia; Lucidi, Vincenzina; Manunza, Daniela; Marinelli, Italo; Messore, Barbara; Neri, Anna Silvia; Raia, Valeria; Furnari, Maria Lucia; Mastella, Gianni

2010-03-01

This is the second article related to a review of the literature based on data from national cystic fibrosis (CF) registries up to June 2008 and covering a total of 115 studies. It focuses on two topics: neonatal screening (NS) and nutritional status, with particular reference to growth. Ten papers meeting the inclusion criteria were found on the topic of NS and its impact on the course of the disease, and were analyzed according to a dedicated grid. The issue of nutrition was addressed by 14 studies, analyzed according to similar criteria. Most of the studies report benefits of early diagnosis by NS, albeit to variable degrees. The benefits were assessed in terms of better nutritional status and growth, but also in terms of lower overall morbidity rate as compared to subjects diagnosed by symptoms. The main biases of these studies, which partly undermine the validity of their results, are also analyzed. A part of our analysis on nutrition/growth is dedicated to the identification of the most suitable parameters to define malnutrition: in children older than two years the body mass index percentile (BMIp) appears to be the most sensitive and significantly associated with respiratory function. Better nutritional status and satisfactory growth appear to be associated with better lung function and lower risk of death. The relationship between nutritional status and socio-economic status is also of interest. CF registry studies support the outcome of cohort observational studies i.e. that pre-symptomatic early diagnosis is beneficial, especially in terms of nutritional status and growth. Studies on nutrition indicate that good nutritional status is associated with better respiratory function and prognosis. Regarding methods, the need emerged to manage potential biases of this kind of non randomized studies, resorting to suitable statistical techniques, such as matching and stratification and, above all, to multivariate methods able to provide estimates adjusted for the main covariates tested. Copyright (c) 2009 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

[Present status of clinical and fundamental threpsology].

PubMed

Kostiuchenko, L N; Ruchkina, I N; Kuz'mina, T N

2009-01-01

A good nutrition status is one of the impotant prerequisites of good health. Malnutrition in hospital leads to increased complication, morbidity and mortality rates. Whenever the gastrointestinal tract cannot fulfil its function or must be rested (during intestinal desease), parenteral administration of nutrients (or simultative parenteral and enteral alimitation) is necessary. Nowday perspectives of nutrition support in patients whith intestinal deseases, methods of easily diagnosed of malnutrition are the problems of this article.

Predictors of functional status at service entry and discharge among young people with first episode psychosis.

PubMed

Cotton, S M; Lambert, M; Schimmelmann, B G; Filia, K; Rayner, V; Hides, L; Foley, D L; Ratheesh, A; Watson, A; Rodger, P; McGorry, P D; Conus, P

2017-05-01

Most patients with first episode psychosis (FEP) are neither studying nor employed (have a poor functional status) when first accessing care. Knowledge of the characteristics of patients with poor functioning and the features influencing functional status over time may pave the way to better treatment. A medical file audit was used to collect data on premorbid, entry, treatment and 18-month outcome characteristics on 661 FEP patients who consecutively attended the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia, between 1998 and 2000. Functional status was ascertained using the modified vocational status index and was rated at baseline (poor or good) and according to its evolution over the treatment period (stable good, stable poor, deteriorating or improved functional status). 52.0% of patients had a poor functional status at service entry. They were more likely to be male with a non-affective psychosis. They also had lower levels of premorbid global functioning and education, and were more likely to have self-reported histories of learning disability, forensic issues, traumatic experiences and substance use. At service entry, they had more severe symptoms and poorer global functioning. 37% of these patients maintained a poor functional status at discharge, and 18% of those with a good functional status at service entry experienced a decline. Although psychosocial interventions might assist a young person with FEP with working towards functional goals, for some, the impact of factors such as ongoing substance use and forensic issues on functional status needs to be addressed.

Health-Related Quality of Life, Functional Status, and Cardiac Event-Free Survival in Patients With Heart Failure.

PubMed

Wu, Jia-Rong; Lennie, Terry A; Frazier, Susan K; Moser, Debra K

2016-01-01

Health-related quality of life (HRQOL), functional status, and cardiac event-free survival are outcomes used to assess the effectiveness of interventions in patients with heart failure (HF). However, the nature of the relationships among HRQOL, functional status, and cardiac event-free survival remains unclear. The purpose of this study is to examine the nature of the relationships among HRQOL, functional status, and cardiac event-free survival in patients with HF. This was a prospective, observational study of 313 patients with HF that was a secondary analysis from a registry. At baseline, patient demographic and clinical data were collected. Health-related quality of life was assessed using the Minnesota Living With Heart Failure Questionnaire and functional status was measured using the Duke Activity Status Index. Cardiac event-free survival data were obtained by patient interview, hospital database, and death certificate review. Multiple linear and Cox regressions were used to explore the relationships among HRQOL, functional status, and cardiac event-free survival while adjusting for demographic and clinical factors. Participants (n = 313) were men (69%), white (79%), and aged 62 ± 11 years. Mean left ventricular ejection fraction was 35% ± 14%. The mean HRQOL score of 32.3 ± 20.6 indicated poor HRQOL. The mean Duke Activity Status Index score of 16.2 ± 12.9 indicated poor functional status. Cardiac event-free survival was significantly worse in patients who had worse HRQOL or poorer functional status. Patients who had better functional status had better HRQOL (P < .001). Health-related quality of life was not a significant predictor of cardiac event-free survival after entering functional status in the model (P = .54), demonstrating that it was a mediator of the relationship between HRQOL and outcome. Functional status was a mediator between HRQOL and cardiac event-free survival. These data suggest that intervention studies to improve functional status are needed.

Posthospitalization home health care use and changes in functional status in a Medicare population.

PubMed

Hadley, J; Rabin, D; Epstein, A; Stein, S; Rimes, C

2000-05-01

The objective of this work was to estimate the effect of Medicare beneficiaries' use of home health care (HHC) for 6 months after hospital discharge on the change in functional status over a 1-year period beginning before hospitalization. Data came from the Medicare Current Beneficiary Survey, which is a nationally representative sample of Medicare beneficiaries, in-person interview data, and Medicare claims for 1991 through 1994 for 2,127 nondisabled, community-dwelling, elderly Medicare beneficiaries who were hospitalized within 6 months of their annual in-person interviews. Econometric estimation with the instrumental variable method was used to correct for observational data bias, ie, the nonrandom allocation of discharged beneficiaries to the use of posthospitalization HHC. The analysis estimates a first-stage model of HHC use from which an instrumental variable estimate is constructed to estimate the effect on change in functional status. The instrumental variable estimates suggest that HHC users experienced greater improvements in functional status than nonusers as measured by the change in a continuous scale based on the number and mix of activities of daily living and instrumental activities of daily living before and after hospitalization. The estimated improvement in functional status could be as large as 13% for a 10% increase in HHC use. In contrast, estimation with the observational data on HHC use implies that HHC users had poorer health outcomes. Adjusting for potential observational data bias is critical to obtaining estimates of the relationship between the use of posthospitalization HHC and the change in health before and after hospitalization. After adjustment, the results suggest that efforts to constrain Medicare's spending for HHC, as required by the Balanced Budget Act of 1997, may lead to poorer health outcomes for some beneficiaries.

Cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation

PubMed Central

Zanettini, Renzo; Gatto, Gemma; Mori, Ileana; Pozzoni, Maria Beatrice; Pelenghi, Stefano; Martinelli, Luigi; Klugmann, Silvio

2014-01-01

Background Evaluation of patient outcomes following transcatheter aortic valve implantation (TAVI) has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life. Results On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic activities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be transferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at discharge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days (range: 192–738 days), five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently. Conclusions Patients referred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up. PMID:25593575

Effect of Functional Status on the Quality of Bowel Preparation in Elderly Patients Undergoing Screening and Surveillance Colonoscopy

PubMed Central

Kumar, Akash; Lin, Lisa; Bernheim, Oren; Bagiella, Emilia; Jandorf, Lina; Itzkowitz, Steven H.; Shah, Brijen J.

2016-01-01

Background/Aims Optimal bowel preparation is essential for successful screening or for surveillance colonoscopy (SC). Inadequate bowel preparation is associated with older age, the male gender, and the presence of certain comorbidities. However, the association between patients’ functional status and bowel preparation quality has not been studied. We prospectively examined the relationship between functional status, namely, the ability to perform activities of daily living (ADLs) and ambulate, and the quality of bowel preparation in elderly patients undergoing SC. Methods Before undergoing SC, 88 elderly patients were surveyed regarding their functional status, specifically regarding their ability to perform ADLs and ambulate a quarter of a mile. Gastroenterologists then determined the quality of the bowel preparation, which was classified as either adequate or inadequate. Then, the frequency of inadequate bowel preparation in patients who did or did not experience difficulty performing ADLs and ambulating was calculated. Results Difficulty ambulating (unadjusted odds ratio [OR], 4.83; p<0.001), difficulty performing ADLs (OR, 2.93; p=0.001), and history of diabetes (OR, 2.88; p=0.007) were significant univariate predictors of inadequate bowel preparation. After adjusting for the above variables, only difficulty ambulating (adjusted OR, 5.78; p=0.004) was an independent predictor of inadequate bowel preparation. Conclusions Difficulty with ambulation is a strong predictor of inadequate bowel preparation in elderly patients undergoing SC. PMID:27021501

Kinematic Analysis of Gait Following Intra-articular Corticosteroid Injection into the Knee Joint with an Acute Exacerbation of Arthritis

PubMed Central

Mehta, Saurabh; Szturm, Tony; El-Gabalawy, Hani S.

2011-01-01

ABSTRACT Purpose: The objective of this study was to examine the effects of intra-articular corticosteroid injection (ICI) on ipsilateral knee flexion/extension, ankle dorsiflexion/plantarflexion (DF/PF), and hip abduction/adduction (abd/add) during stance phase in people with an acute exacerbation of rheumatoid arthritis (RA) of the knee joint. The study also assessed the effects of ICI on spatiotemporal parameters of gait and functional status in this group. Methods: Nine people with an exacerbation of RA of the knee were recruited. Kinematic and spatiotemporal gait parameters were obtained for each participant. Knee-related functional status was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). Spatiotemporal gait parameters and joint angles (knee flexion, ankle DF/PF, hip abd/add) of the affected side were compared pre- and post-ICI. Results: Data for eight people were available for analysis. Median values for knee flexion and ankle PF increased significantly following ICI. Gait parameters of cadence, velocity, bilateral stride length, bilateral step length, step width, double-support percentage, and step time on the affected side also showed improvement. Pain and knee-related functional status as measured by the KOOS showed improvement. Conclusions: This study demonstrated a beneficial short-term effect of ICI on knee-joint movements, gait parameters, and knee-related functional status in people with acute exacerbation of RA of the knee. PMID:22942516

Preconception Maternal Iodine Status Is Positively Associated with IQ but Not with Measures of Executive Function in Childhood

PubMed Central

Robinson, Sian M; Crozier, Sarah R; Miles, Elizabeth A; Gale, Catharine R; Calder, Philip C; Cooper, Cyrus; Inskip, Hazel M; Godfrey, Keith M

2018-01-01

Abstract Background Adverse effects of severe maternal iodine deficiency in pregnancy on fetal brain development are well-established, but the effects of milder deficiency are uncertain. Most studies examine iodine status in pregnancy; less is known about iodine nutrition before conception. Objective We examined relations between maternal preconception iodine status and offspring cognitive function, within a prospective mother-offspring cohort. Methods Maternal iodine status was assessed through the use of the ratio of iodine:creatinine concentrations (I/Cr) in spot urine samples [median (IQR) period before conception 3.3 y (2.2–4.7 y)]. Childhood cognitive function was assessed at age 6–7 y. Full-scale IQ was assessed via the Wechsler Abbreviated Scale of Intelligence, and executive function through the use of tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Analyses (n = 654 mother-child dyads) were adjusted for potential confounders including maternal intelligence, education, and breastfeeding duration. Results The median (IQR) urinary iodine concentration was 108.4 µg/L (62.2–167.8 µg/L) and the I/Cr ratio 114 µg/g (76–164 µg/g). The preconception I/Cr ratio was positively associated with child IQ, before and after adjustment for potential confounding influences [β = 0.13 (95% CI: 0.04, 0.21)/SD, P = 0.003]. 8.9% of women had a preconception urinary I/Cr ratio <50 µg/g; compared with those with an I/Cr ratio ≥150 µg/g, the IQ of their offspring was 0.49 (95% CI: 0.79, 0.18) SD lower. There were no associations with the executive function outcomes assessed via CANTAB, before or after adjustment for confounders. Conclusion The positive association between iodine status before conception and child IQ provides some support for demonstrated links between low maternal iodine status in pregnancy and poorer cognitive function reported in other studies. However, given the negative effects on school performance previously observed in children born to iodine-deficient mothers, the lack of associations with measures of executive function in the present study was unexpected. Further data are needed to establish the public health importance of low preconception iodine status. PMID:29767745

Preference-based Health status in a German outpatient cohort with multiple sclerosis

PubMed Central

2013-01-01

Background To prospectively determine health status and health utility and its predictors in patients with multiple sclerosis (MS). Methods A total of 144 MS patients (mean age: 41.0 ±11.3y) with different subtypes (patterns of progression) and severities of MS were recruited in an outpatient university clinic in Germany. Patients completed a questionnaire at baseline (n = 144), 6 months (n = 65) and 12 months (n = 55). Health utilities were assessed using the EuroQol instrument (EQ-5D, EQ VAS). Health status was assessed by several scales (Expanded Disability Severity Scale (EDSS), Modified Fatigue Impact Scale (M-FIS), Functional Assessment of MS (FAMS), Beck Depression Inventory (BDI-II) and Multiple Sclerosis Functional Composite (MSFC)). Additionally, demographic and socioeconomic parameters were assessed. Multivariate linear and logistic regressions were applied to reveal independent predictors of health status. Results Health status is substantially diminished in MS patients and the EQ VAS was considerably lower than that of the general German population. No significant change in health-status parameters was observed over a 12-months period. Multivariate analyses revealed M-FIS, BDI-II, MSFC, and EDSS to be significant predictors of reduced health status. Socioeconomic and socio-demographic parameters such as working status, family status, number of household inhabitants, age, and gender did not prove significant in multivariate analyses. Conclusion MS considerably impairs patients’ health status. Guidelines aiming to improve self-reported health status should include treatment options for depression and fatigue. Physicians should be aware of depression and fatigue as co-morbidities. Future studies should consider the minimal clinical difference when health status is a primary outcome. PMID:24089999

The Association of Daily Physical Symptoms with Future Health

PubMed Central

Leger, Kate A.; Charles, Susan T.; Ayanian, John Z.; Almeida, David M.

2015-01-01

Rationale Daily physical symptoms play a critical role in health and illness experiences. Despite their daily prevalence, the ability of these symptoms to predict future health status is debated. Objective The current study examined whether physical symptom reports predict future health outcomes independent of trait measures of emotion. Methods Participants (N = 1189) who completed both Midlife in the United States (MIDUS) Surveys I and II as well as the National Study of Daily Experiences (NSDE) reported their daily physical symptoms at baseline and number of reported chronic conditions and functional disability nearly 10 years later. Results Physical symptoms at baseline significantly predicted the occurrence of chronic conditions and functional impairment at long-term follow-up, even after adjusting for self-reported affect, self-reported health, and previous health status. Conclusion Findings suggest that daily physical symptoms are unique indicators of future health status. PMID:26364011

The Nutrition, Aging, and Memory in Elders (NAME) study: design and methods for a study of micronutrients and cognitive function in a homebound elderly population.

PubMed

Scott, Tammy M; Peter, Inga; Tucker, Katherine L; Arsenault, Lisa; Bergethon, Peter; Bhadelia, Rafeeque; Buell, Jennifer; Collins, Lauren; Dashe, John F; Griffith, John; Hibberd, Patricia; Leins, Drew; Liu, Timothy; Ordovas, Jose M; Patz, Samuel; Price, Lori Lyn; Qiu, Wei Qiao; Sarnak, Mark; Selhub, Jacob; Smaldone, Lauren; Wagner, Carey; Wang, Lixia; Weiner, Daniel; Yee, Jacqueline; Rosenberg, Irwin; Folstein, Marshal

2006-06-01

Micronutrient status can affect cognitive function in the elderly; however, there is much to learn about the precise effects. Understanding mediating factors by which micronutrient status affects cognitive function would contribute to elders' quality of life and their ability to remain in the home. The Nutrition, Aging, and Memory in Elders (NAME) Study is designed to advance the current level of knowledge by investigating potential mediating factors by which micronutrient status contributes to cognitive impairment and central nervous system abnormalities in the elderly. NAME targets homebound elders because they are understudied and particularly at risk for poor nutritional status. Subjects are community-based elders aged 60 and older, recruited through area Aging Services Access Points. The NAME core data include demographics; neuropsychological testing and activities of daily living measures; food frequency, health and behavioral questionnaires; anthropometrics; gene status; plasma micronutrients, homocysteine, and other blood determinants. A neurological examination, psychiatric examination, and brain MRI and volumetric measurements are obtained from a sub-sample. Preliminary data from first 300 subjects are reported. These data show that the NAME protocol is feasible and that the enrolled subjects are racially diverse, at-risk, and had similar basic demographics to the population from which they were drawn. The goal of the NAME study is to evaluate novel relationships between nutritional factors and cognitive impairment. These data may provide important information on potential new therapeutic strategies and supplementation standards for the elderly to maintain cognitive function and potentially reduce the public health costs of dementia.

Association among SNAP-25 Gene "Dd"eI and "Mnl"I Polymorphisms and Hemodynamic Changes during Methylphenidate Use: A Functional Near-Infrared Spectroscopy Study

ERIC Educational Resources Information Center

Oner, Ozgur; Akin, Ata; Herken, Hasan; Erdal, Mehmet Emin; Ciftci, Koray; Ay, Mustafa Ertan; Bicer, Duygu; Oncu, Bedriye; Bozkurt, Ozlem Hekim; Munir, Kerim; Yazgan, Yanki

2011-01-01

Objective: To investigate the interaction of treatment-related hemodynamic changes with genotype status for Synaptosomal associated protein 25 (SNAP-25) gene in participants with attention deficit hyperactivity disorder (ADHD) on and off single dose short-acting methylphenidate treatment with functional near-infrared spectroscopy (fNIRS). Method:…

Noise-resistant spectral features for retrieving foliar chemical parameters

USDA-ARS?s Scientific Manuscript database

Foliar chemical constituents are important indicators for understanding vegetation growing status and ecosystem functionality. Provided the noncontact and nondestructive traits, the hyperspectral analysis is a superior and efficient method for deriving these parameters. In practical implementation o...

A prospective multipractice investigation of patients with full-thickness rotator cuff tears: the importance of comorbidities, practice, and other covariables on self-assessed shoulder function and health status.

PubMed

Harryman, Douglas T; Hettrich, Carolyn M; Smith, Kevin L; Campbell, Barry; Sidles, John A; Matsen, Frederick A

2003-04-01

Rotator cuff tears are among the most common conditions of the shoulder. One of the major difficulties in studying patients with rotator cuff tears is that the clinical expression of these tears varies widely and different practices may have substantially different patient populations. The goals of the present prospective multipractice study were to use patient self-assessment questionnaires (1) to identify some of the characteristics of patients with rotator cuff tears, other than the size of the cuff tear, that are correlated with shoulder function, and (2) to determine whether there are significant differences in these characteristics among patients from the practices of different surgeons. Ten surgeons enrolled a total of 333 patients with a full-thickness tear of the supraspinatus tendon into this prospective study. Each patient completed self-assessment questionnaires that included items regarding demographic characteristics, prior treatment, medical and social comorbidities, general health status, and shoulder function. As expected, patients who had an infraspinatus tendon tear as well as a supraspinatus tendon tear had significantly worse ability to use the arm overhead compared with those who had a supraspinatus tear alone (p < 0.005). However, shoulder function and health status were correlated with patient characteristics other than the size of the rotator cuff tear. The number of shoulder functions that were performable was correlated with the subscales of the Short Form-36 and was inversely associated with medical and social comorbidities. The patients from the ten different surgeon practices showed significant differences in almost every parameter, including age, gender, method of tear documentation, tear size, prior treatment, medical and social comorbidities, general health status, and shoulder function. Clinical studies on the natural history of rotator cuff tears and the effectiveness of treatment must control for a wide range of variables, many of which do not pertain directly to the shoulder. Patients from the practices of different surgeons cannot be assumed to be similar with respect to these variables. Patient self-assessment questionnaires appear to offer a practical method of uniform assessment across different practices.

Quantile Regression Models for Current Status Data

PubMed Central

Ou, Fang-Shu; Zeng, Donglin; Cai, Jianwen

2016-01-01

Current status data arise frequently in demography, epidemiology, and econometrics where the exact failure time cannot be determined but is only known to have occurred before or after a known observation time. We propose a quantile regression model to analyze current status data, because it does not require distributional assumptions and the coefficients can be interpreted as direct regression effects on the distribution of failure time in the original time scale. Our model assumes that the conditional quantile of failure time is a linear function of covariates. We assume conditional independence between the failure time and observation time. An M-estimator is developed for parameter estimation which is computed using the concave-convex procedure and its confidence intervals are constructed using a subsampling method. Asymptotic properties for the estimator are derived and proven using modern empirical process theory. The small sample performance of the proposed method is demonstrated via simulation studies. Finally, we apply the proposed method to analyze data from the Mayo Clinic Study of Aging. PMID:27994307

The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12

PubMed Central

Hoffman, D L; Dukes, E M

2008-01-01

Objective The current review describes how the health status profile of people with fibromyalgia (FM) compares to that of people in the general population and patients with other health conditions. Methods A review of 37 studies of FM that measured health status with the 36-item Medical Outcomes Study Short-Form Health Survey (SF-36) or the 12-item Short-Form Health Survey (SF-12). Results Studies performed worldwide showed that FM groups were significantly more impaired than people in the general population on all eight health status domains assessed. These domains include physical functioning, role functioning difficulties caused by physical problems, bodily pain, general health, vitality (energy vs. fatigue), social functioning, role functioning difficulties caused by emotional problems and mental health. FM groups had mental health summary scores that fell 1 standard deviation (SD) below the general population mean, and physical health summary scores that fell 2 SD below the general population mean. FM groups also had a poorer overall health status compared to those with other specific pain conditions. FM groups had similar or significantly lower (poorer) physical and mental health status scores compared to those with rheumatoid arthritis, osteoarthritis, osteoporosis, systemic lupus erythematosus, myofacial pain syndrome, primary Sjögren's syndrome and others. FM groups scored significantly lower than the pain condition groups mentioned above on domains of bodily pain and vitality. Health status impairments in pain and vitality are consistent with core features of FM. Conclusions People with FM had an overall health status burden that was greater in magnitude compared to people with other specific pain conditions that are widely accepted as impairing. Review Criteria Studies in this review were identified through a search of electronic databases (MEDLINE: 1990–2006; EMBASE: 1990–2006). Search terms included: ‘fibromyalgia’, ‘health status’, ‘quality of life’, ‘SF-36’ and ‘SF-12’. Reference lists from published articles were also searched. Studies were selected if they were published in the English language between 1990 and (March) 2006 and assessed health status with a validated version of the SF-36 or the SF-12. Message for the Clinic Although FM is a controversial construct, studies performed worldwide showed that the health status profile of people with FM was remarkably consistent. People with FM had significant impairments in both mental and physical health status domains. People with FM had a poorer overall health status than people with specific pain conditions that are widely accepted as impairing. PMID:18039330

Clinically relevant determinants of body composition, function and nutritional status as mortality predictors in lung cancer patients.

PubMed

Kovarik, Miroslav; Hronek, Miloslav; Zadak, Zdenek

2014-04-01

Lung cancer belongs to the type of tumors with a relatively high frequency of malnutrition, sarcopenia and cachexia, severe metabolic syndromes related to impairment of physical function and quality of life, resistance to therapy and short survival. Inexpensive and accessible methods of evaluating changes in body composition, physical function and nutrition status are for this reason of great importance for clinical practice to enable the early identification, monitoring, preventing and treatment of these nutritional deficiencies. This could lead to improved outcomes in the quality of life, physical performance and survival of patients with lung cancer. The aim of this article is to summarize the recent knowledge for the use of such methods, their predictability for patient outcomes and an association with other clinically relevant parameters, specifically with lung cancer patients, because such an article collectively describing their practical application in clinical practice is lacking. The interest of this article is in the use of anthropometry, handgrip dynamometry, bioelectrical impedance analysis derived phase angle and nutritional screening questionnaires in lung cancer patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Percutaneous Intraductal Radiofrequency Ablation for Extrahepatic Distal Cholangiocarcinoma: A Method for Prolonging Stent Patency and Achieving Better Functional Status and Quality of Life

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

Wu, Tian-tian, E-mail: matthewwu1979@hotmail.com; Li, Wei-min, E-mail: weimin-li-surgery@126.com; Li, Hu-cheng, E-mail: hucheng-li-surgery@126.com

PurposeThe clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA.MethodsData from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement. Procedure-related complications, stent patency,more » patient survival, and postoperative serum bilirubin concentrations were compared between the two groups. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire was administered to evaluate functional status, improvement in clinical manifestations, and quality of life.ResultsThe RFA group had a longer median stent patency than the control group (p = 0.001 for uncovered SEMs placement). Higher functional well-being, hepatobiliary-specific cancer subscale, Trial Outcome Index, and total FACT-Hep scores were observed during post-procedure follow-up in the RFA group. However, median survival did not differ significantly between the two groups (p > 0.05).ConclusionsProlongation of stent patency and better functional status and quality of life, which are all important clinical endpoints, were observed in patients treated with intraductal RFA. Prospective randomized controlled clinical trials are necessary to further investigate the clinical efficacy and long-term benefits of intraductal RFA.« less

The relation of functional visual acuity measurement methodology to tear functions and ocular surface status.

PubMed

Kaido, Minako; Ishida, Reiko; Dogru, Murat; Tsubota, Kazuo

2011-09-01

To investigate the relation of functional visual acuity (FVA) measurements with dry eye test parameters and to compare the testing methods with and without blink suppression and anesthetic instillation. A prospective comparative case series. Thirty right eyes of 30 dry eye patients and 25 right eyes of 25 normal subjects seen at Keio University School of Medicine, Department of Ophthalmology were studied. FVA testing was performed using a FVA measurement system with two different approaches, one in which measurements were made under natural blinking conditions without topical anesthesia (FVA-N) and the other in which the measurements were made under the blink suppression condition with topical anesthetic eye drops (FVA-BS). Tear function examinations, such as the Schirmer test, tear film break-up time, and fluorescein and Rose Bengal vital staining as ocular surface evaluation, were performed. The mean logMAR FVA-N scores and logMAR Landolt visual acuity scores were significantly lower in the dry eye subjects than in the healthy controls (p < 0.05), while there were no statistical differences between the logMAR FVA-BS scores of the dry eye subjects and those of the healthy controls. There was a significant correlation between the logMAR Landolt visual acuities and the logMAR FVA-N and logMAR FVA-BS scores. The FVA-N scores correlated significantly with tear quantities, tear stability and, especially, the ocular surface vital staining scores. FVA measurements performed under natural blinking significantly reflected the tear functions and ocular surface status of the eye and would appear to be a reliable method of FVA testing. FVA measurement is also an accurate predictor of dry eye status.

Quality of life in overweight and obese young Chinese children: a mixed-method study

PubMed Central

2013-01-01

Background Obesity among young children in Hong Kong has become a public health problem. This study explored associations between Chinese parent reported children’s quality of life (QoL), socio-demographics and young children’s weight status from 27 preschool settings. Methods A mixed-method approach, including quantitative and qualitative tools, was employed for this cross-sectional study. Quantitative data were collected from 336 Chinese parents of children aged 2–7 years. Paediatric Quality of Life Inventory 4.0 (PedsQL, v 4.0) and a questionnaire about parents’ socio-demographics were used. In-depth interviews with mothers, teachers and children from a larger sample were the basis of 10 case studies. Quantitative data were analysed using chi-square analysis, one-way ANOVA and logistic regression. Qualitative data were analysed according to a multi-level framework that established linkages with quantitative data. Results The children’s Body Mass Index (BMI) ranged from 11.3 to 28.0 kg/m2 and was classified into four weight groups. ANOVAs showed that the normal-weight children had significantly higher PedsQL scores in Physical Functioning than obese children (mean difference = 14.19, p < .0083) and significantly higher scores in School Functioning than overweight children (mean difference = 10.15, p < .0083). Results of logistic regression showed that relative to normal-weight children, obese children had a 2–5 times higher odds of showing problems in Physical, Social Functioning and School Performance. Overweight children had 2 times higher odds of problems in Social Functioning, and underweight children had a 2 times higher odds of problems in Physical Functioning. Children’s age (χ2 = 21.71, df = 3, p < 0.01), and housing (χ2 = 33.00, df = 9, p < 0.01) were associated with their weight. The case studies further act as a supplement to the quantitative data that children showed emotional problems across different abnormal weight statues; and the association between children’s weight status and well-being might be affected by multiple childcare arrangements and familial immigration status. Conclusions This study is one of only a few studies that have examined parents’, teachers’ and young children’s own perceptions of the children’s quality of life across different weight statuses. The results are discussed in terms of their implications for intervention. PMID:23496917

Functional Limitations and Nativity Status among Older Arab, Asian, Black, Hispanic, and White Americans

PubMed Central

Dallo, Florence J.; Booza, Jason; Nguyen, Norma D.

2013-01-01

Background To examine the association between nativity status (foreign and US-born) by race/ethnicity (Arab, Asian, black, Hispanic, white) on having a functional limitation. Methods We used American Community Survey data (2001-2007; n=1,964,777; 65+ years) and estimated odds ratios (95% confidence intervals). Results In the crude model, foreign-born Blacks, Hispanics and Arabs were more likely, while Asians were less likely to report having a functional limitation compared to white. In the fully adjusted model, Blacks, Hispanics, and Asians were less likely, while Arabs were more likely to report having a functional limitation. In both the crude and fully adjusted models, US-born Blacks and Hispanics were more likely, while Asians and Arabs were less likely to report having a functional limitation compared to whites. Discussion Policies and programs tailored to foreign-born Arab Americans may help prevent or delay the onset of disability, especially when initiated shortly after their arrival to the US. PMID:24165988

Client Functional Assessment Data as Management Information: Woodrow Wilson Rehabilitation Center's Management Information System

PubMed Central

Steidle, Ernest F.

1983-01-01

This paper describes the design of a functional assessment system, a component of a management information system (MIS) that supports a comprehensive rehabilitation facility. Products of the subsystem document the functional status of rehabilitation clients through process evaluation reporting and outcomes reporting. The purpose of this paper is to describe the design of this MIS component. The environment supported, the integration requirements and the needed development approach is unique, requiring significant input from health care professionals, medical informatics specialists, statisticians and program evaluators. Strategies for the implementation of the functional assessment system are the major results reported in this paper. They are most useful to the systems designer or management engineer in a human service delivery setting. MIS plan development, computer file structure and access methods, and approaches to scheduling applications is described. Finally, the development of functional status measures is discussed. Application of the methodologies described will facilitate similar efforts towards systems development in other human service delivery settings.

Low skeletal muscle mass index is associated with function and nutritional status in residents in a Turkish nursing home.

PubMed

Tufan, Asli; Bahat, Gulistan; Ozkaya, Hilal; Taşcıoğlu, Didem; Tufan, Fatih; Saka, Bülent; Akin, Sibel; Karan, Mehmet Akif

2016-09-01

To determine the prevalence of low muscle mass (LMM) and the relationship between LMM with functional and nutritional status as defined using the LMM evaluation method of European Working Group on Sarcopenia in Older People (EWGSOP) criteria among male residents in a nursing home. Male residents aged >60 years of a nursing home located in Turkey were included in our study. Their body mass index (BMI) kg/m 2 , skeletal muscle mass (SMM-kg) and skeletal muscle mass index (SMMI-kg/m 2 ) were calculated. The participants were regarded as having low SMMI if they had SMMI <9.2 kg/m 2 according to our population specific cut-off point. Functional status was evaluated with Katz activities of daily living (ADL) and Lawton Instrumental Activities of Daily Living (IADL). Nutritional assessment was performed using the Mini Nutritional Assessment (MNA). The number of drugs taken and chronic diseases were recorded. One hundred fifty-seven male residents were enrolled into the study. Their mean age was 73.1 ± 6.7 years with mean ADL score of 8.9 ± 2.0 and IADL score of 8.7 ± 4.6. One hundred twelve (71%) residents were aged >70 years. Thirty-five men (23%) had low SMMI in group aged >60 years, and twenty-eight subjects (25%) in the group aged >70 years. MNA scores were significantly lower in residents with low SMMI compared with having normal SMMI (17.1 ± 3.4 versus 19.6 ± 2.5, p = 0.005). BMI was significantly lower in the residents with low SMMI compared with normal SMMI (19.6 ± 2.7 versus 27.1 ± 4.1, p< 0.001). ADL scores were significantly different between residents with low SMMI and normal SMMI in those aged >70 years (8.1 ± 2.6 versus 9.1 ± 1.6, p = 0.014). In regression analyses, the only factor associated with better functional status was the lower age (p = 0.04) while the only factor associated with better nutrition was higher SMMI (p = 0.01). Low SMMI detected by LMM evaluation method of EWGSOP criteria is prevalent among male nursing home residents. There is association of low SMMI with nutritional status and probably with functional status within the nursing home setting using the EWGSOP criteria with Turkish normative reference cut-off value.

Expert system for testing industrial processes and determining sensor status

DOEpatents

Gross, K.C.; Singer, R.M.

1998-06-02

A method and system are disclosed for monitoring both an industrial process and a sensor. The method and system include determining a minimum number of sensor pairs needed to test the industrial process as well as the sensor for evaluating the state of operation of both. The technique further includes generating a first and second signal characteristic of an industrial process variable. After obtaining two signals associated with one physical variable, a difference function is obtained by determining the arithmetic difference between the pair of signals over time. A frequency domain transformation is made of the difference function to obtain Fourier modes describing a composite function. A residual function is obtained by subtracting the composite function from the difference function and the residual function (free of nonwhite noise) is analyzed by a statistical probability ratio test. 24 figs.

Expert system for testing industrial processes and determining sensor status

DOEpatents

Gross, Kenneth C.; Singer, Ralph M.

1998-01-01

A method and system for monitoring both an industrial process and a sensor. The method and system include determining a minimum number of sensor pairs needed to test the industrial process as well as the sensor for evaluating the state of operation of both. The technique further includes generating a first and second signal characteristic of an industrial process variable. After obtaining two signals associated with one physical variable, a difference function is obtained by determining the arithmetic difference between the pair of signals over time. A frequency domain transformation is made of the difference function to obtain Fourier modes describing a composite function. A residual function is obtained by subtracting the composite function from the difference function and the residual function (free of nonwhite noise) is analyzed by a statistical probability ratio test.

Health-Related Quality of Life and Quality of Sexual Life in Obese Subjects

PubMed Central

Di Lazzaro, Luca; Pinto, Alessandro; Migliaccio, Silvia; Lenzi, Andrea; Donini, Lorenzo M.

2014-01-01

The increased prevalence of obesity represents, currently, one of the major public health issues, due to its consequences on physical and psychological health status as well as on the psychosocial functioning. As defined by the World Health Organization, sexual health is “a state of physical, emotional, mental, and social well-being in relation to sexuality.” The aim of the present study was to explore the relationship between sexual life in obese subjects and quality of life, psychological status, and disability. Methods. 95 obese subjects were recruited from June 2012 to February 2013 and underwent physical examination and measures for the assessment of quality of life, sexual life, psychological status, and disability. Results. In obese subjects sexual life was related to gender, age, psychological status, disability, and quality of life. Conclusion. As obesity is a multifactorial disease, and is accompanied by multiple comorbidities, it is difficult to identify a single causative factor responsible for the impairment of sexual life in obese subjects; thus, a thorough, multidimensional evaluation including sexual function assessment should be performed in obese people. PMID:24707290

Review of basic medical results of the Salyut-7-Soyuz-T 8-month manned flight

NASA Astrophysics Data System (ADS)

Gazenko, O. G.; Schulzhenko, E. B.; Grigoriev, A. I.; Atkov, O. Yu.; Egorov, A. D.

This paper presents the results of medical investigations performed in the Salyut-7 8-month mission in which a professional physician took part. The paper contains anthropometric measurements, results of investigating the vestibular function, cardiovascular function at rest and in response to multi-step tests (with emphasis on echocardiographic measurements), metabolic parameters and hormonal status. It also discusses medical aspects of the extravehicular activity. The medical investigations, although some new methods were applied, provided the continuity of methodical approaches and data accumulated in previous missions.

Risk Evaluation of Construction Workers' Exposure to Silica Dust and the Possible Lung Function Impairments.

PubMed

Tavakol, Elahe; Azari, Mansour; Zendehdel, Rezvan; Salehpour, Sousan; Khodakrim, Soheila; Nikoo, Saeed; Saranjam, Behzad

2017-06-01

Aerosols generated during construction activities are an integral part of building operations. Considering the nature of materials used in construction activities, respirable dust contains crystalline silica and particulates not otherwise specified (PNOS). Due to lack of data regarding the occupational health status of Iranian construction workers, the objective of this study was to evaluate occupational exposure to silica and to examine their respiratory health status. In this cross sectional study, 85 construction workers and 40 controls (without active exposure to construction dust) were studied. The workers' exposure to PNOS and silica aerosols was monitored by the NIOSH method No.0600 and a new Fourier transform infrared spectroscopy (FTIR)-based method, respectively. All subjects were also monitored for lung function parameters, such as forced expiratory volume/forced vital capacity (FEV 1 /FVC), peak expiratory flow rate (PEFR), forced expiratory flow (FEF 25-75 ), FVC, and FEV 1 . The mean exposure of workers to respirable PNOS and silica was 9.8 (0.35) and 0.13 (0.019) mg/m 3 , respectively. The groups of construction workers showed significant differences in exposure to PNOS ( P < 0.001) and silica ( P = 0.007). The mean pulmonary function parameters, including FEV 1 % and FVC%, were significantly lower among construction workers, compared to the control group ( P < 0.001 and P = 0.009, respectively). The pulmonary status of 51.8% of construction workers showed moderate restriction, while 4.70% exhibited obstruction. Considering the construction workers' excessive exposure to PNOS and silica, besides depressed lung function parameters, they can be classified as a high-risk group for respiratory diseases.

Functional Status in ICU Survivors and out of hospital outcomes: a cohort study

PubMed Central

Rydingsward, Jessica E.; Horkan, Clare M.; Mogensen, Kris M.; Quraishi, Sadeq A.; Amrein, Karin; Christopher, Kenneth B.

2016-01-01

Objective Functional status at hospital discharge may be a risk factor for adverse events among survivors of critical illness. We sought to examine the association between functional status at hospital discharge in survivors of critical care and risk of 90-day all-cause mortality after hospital discharge. Design Single center retrospective cohort study Setting Academic Medical Center Patients 10,343 adults who received critical care from 1997 to 2011 and survived hospitalization. Interventions None Measurements and Main Results The exposure of interest was functional status determined at hospital discharge by a licensed physical therapist and rated based on qualitative categories adapted from the Functional Independence Measure. The main outcome was 90-day post hospital discharge all-cause mortality. A categorical risk prediction score was derived and validated based on a logistic regression model of the function grades for each assessment. In an adjusted logistic regression model, the lowest quartile of functional status at hospital discharge was associated with an increased odds of 90-day post-discharge mortality compared to patients with independent functional status [OR=7.63 (95%CI 3.83, 15.22; P<0.001)]. In patients who had at least seven days of physical therapy treatment prior to hospital discharge (N=2,293), the adjusted odds of 90-day post-discharge mortality in patients with marked improvement in functional status at discharge was 64% less than patients with no change in functional status [OR 0.36 (95%CI 0.24–0.53); P<0.001]. Conclusions Lower functional status at hospital discharge in survivors of critical illness is associated with increased post-discharge mortality. Further, patients whose functional status improves before discharge have decreased odds of post-discharge mortality. PMID:26929191

Relationship Between the Functional Status Scale and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category Scales FREE

PubMed Central

Pollack, Murray M.; Holubkov, Richard; Funai, Tomohiko; Clark, Amy; Moler, Frank; Shanley, Thomas; Meert, Kathy; Newth, Christopher J. L.; Carcillo, Joseph; Berger, John T.; Doctor, Allan; Berg, Robert A.; Dalton, Heidi; Wessel, David L.; Harrison, Rick E.; Dean, J. Michael; Jenkins, Tammara L.

2015-01-01

Importance Functional status assessment methods are important as outcome measures for pediatric critical care studies. Objective To investigate the relationships between the 2 functional status assessment methods appropriate for large-sample studies, the Functional Status Scale (FSS) and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category (POPC/PCPC) scales. Design, Setting, and Participants Prospective cohort study with random patient selection at 7 sites and 8 children’s hospitals with general/medical and cardiac/cardiovascular pediatric intensive care units (PICUs) in the Collaborative Pediatric Critical Care Research Network. Participants included all PICU patients younger than 18 years. Main Outcomes and Measures Functional Status Scale and POPC/PCPC scores determined at PICU admission (baseline) and PICU discharge. We investigated the association between the baseline and PICU discharge POPC/PCPC scores and the baseline and PICU discharge FSS scores, the dispersion of FSS scores within each of the POPC/PCPC ratings, and the relationship between the FSS neurologic components (FSS-CNS) and the PCPC. Results We included 5017 patients. We found a significant (P < .001) difference between FSS scores in each POPC or PCPC interval, with an FSS score increase with each worsening POPC/PCPC rating. The FSS scores for the good and mild disability POPC/PCPC ratings were similar and increased by 2 to 3 points for the POPC/PCPC change from mild to moderate disability, 5 to 6 points for moderate to severe disability, and 8 to 9 points for severe disability to vegetative state or coma. The dispersion of FSS scores within each POPC and PCPC rating was substantial and increased with worsening POPC and PCPC scores. We also found a significant (P < .001) difference between the FSS-CNS scores between each of the PCPC ratings with increases in the FSS-CNS score for each higher PCPC rating. Conclusions and Relevance The FSS and POPC/PCPC system are closely associated. Increases in FSS scores occur with each higher POPC and PCPC rating and with greater magnitudes of change as the dysfunction severity increases. However, the dispersion of the FSS scores indicated a lack of precision in the POPC/PCPC system when compared with the more objective and granular FSS. The relationship between the PCPC and the FSS-CNS paralleled the relationship between the FSS and POPC/PCPC system. PMID:24862461

The natural history of adult pulmonary Langerhans cell histiocytosis: a prospective multicentre study.

PubMed

Tazi, Abdellatif; de Margerie, Constance; Naccache, Jean Marc; Fry, Stéphanie; Dominique, Stéphane; Jouneau, Stéphane; Lorillon, Gwenaël; Bugnet, Emmanuelle; Chiron, Raphael; Wallaert, Benoit; Valeyre, Dominique; Chevret, Sylvie

2015-03-14

The natural history of pulmonary Langerhans cell histiocytosis (PLCH) has been unclear due to the absence of prospective studies. The rate of patients who experience an early progression of their disease is unknown. Additionally, conflicting effects of smoking cessation on the outcome of PLCH have been reported. In this prospective, multicentre study, 58 consecutive patients with newly diagnosed PLCH were comprehensively evaluated over a two-year period. Our objectives were to estimate the incidence of early progression of the disease and to evaluate the impact of smoking status on lung function outcomes. Lung function deterioration was defined as a decrease of at least 15% in FEV1 and/or FVC and/or DLCO, compared with baseline values. At each visit, smoking status was recorded based on the patients' self-reports and urinary cotinine measurements that were blinded for the patients. The cumulative incidence of lung function outcomes over time was estimated using the non-parametric Kaplan-Meier method. Multivariate Cox models with time-dependent covariates were used to calculate the hazards ratios of the lung function deterioration associated with smoking status with adjustment for potential confounders. The cumulative incidence of lung function deterioration at 24 months was 38% (22% for FEV1 and DLCO, and 9% for FVC). In the multivariate analysis, smoking status and PaO2 at inclusion were the only factors associated with the risk of lung function deterioration. The patients' smoking statuses markedly changed over time. Only 20% of the patients quit using tobacco for the entire study period. Nevertheless, being a non-smoker was associated with a decreased risk of subsequent lung function deterioration, even after adjustment for baseline predictive factors. By serial lung computed tomography, the extent of cystic lesions increased in only 11% of patients. Serial lung function evaluation on a three- to six-month basis is essential for the follow-up of patients with recently diagnosed PLCH to identify those who experience an early progression of their disease. These patients are highly addicted to tobacco, and robust efforts should be undertaken to include them in smoking cessation programs. ClinicalTrials.gov: No: NCT01225601 .

SPIKE: AI scheduling techniques for Hubble Space Telescope

NASA Astrophysics Data System (ADS)

Johnston, Mark D.

1991-09-01

AI (Artificial Intelligence) scheduling techniques for HST are presented in the form of the viewgraphs. The following subject areas are covered: domain; HST constraint timescales; HTS scheduling; SPIKE overview; SPIKE architecture; constraint representation and reasoning; use of suitability functions by scheduling agent; SPIKE screen example; advantages of suitability function framework; limiting search and constraint propagation; scheduling search; stochastic search; repair methods; implementation; and status.

An Objective Method of Measuring Psychological States Associated With Changes in Neural Function: Content Analysis of Verbal Behavior.

ERIC Educational Resources Information Center

Gottschalk, Louis A.

This paper examines the use of content analysis of speech in the objective recording and measurement of changes in emotional and cognitive function of humans in whom natural or experimental changes in neural status have occurred. A brief description of the data gathering process, details of numerous physiological effects, an anxiety scale, and a…

Long-term outcome after resection of brainstem hemangioblastomas in von Hippel-Lindau disease

PubMed Central

Wind, Joshua J.; Bakhtian, Kamran D.; Sweet, Jennifer A.; Mehta, Gautam U.; Thawani, Jayesh P.; Asthagiri, Ashok R.; Oldfield, Edward H.; Lonser, Russell R.

2016-01-01

Object Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome and management of these tumors, the authors analyzed the long-term results in patients who underwent resection of brainstem hemangioblastomas. Methods Consecutive patients with VHL disease who underwent resection of brainstem hemangioblastomas with a follow-up of 12 months or more were included in this study. Serial functional assessments, radiographic examinations, and operative records were analyzed. Results Forty-four patients (17 male and 27 female) underwent 51 operations for resection of 71 brainstem hemangioblastomas. The most common presenting symptoms were headache, swallowing difficulties, singultus, gait difficulties, and sensory abnormalities. The mean follow-up was 5.9 ± 5.0 years (range 1.0–20.8 years). Immediately after 34 operations (66.7%), the patients remained at their preoperative functional status; they improved after 8 operations (15.7%) and worsened after 9 operations (17.6%) as measured by the McCormick scale. Eight (88.9%) of the 9 patients who were worse immediately after resection returned to their preoperative status within 6 months. Two patients experienced functional decline during long-term follow-up (beginning at 2.5 and 5 years postoperatively) caused by extensive VHL disease–associated CNS disease. Conclusions Generally, resection of symptomatic brainstem hemangioblastomas is a safe and effective management strategy in patients with VHL disease. Most patients maintain their preoperative functional status, although long-term decline in functional status may occur due to VHL disease–associated progression. PMID:20932100

Mathematical enhancement of data from scientific measuring instruments

NASA Technical Reports Server (NTRS)

Ioup, J. W.

1982-01-01

The accuracy of any physical measurement is limited by the instruments performing it. The proposed activities of this grant are related to the study of and application of mathematical techniques of deconvolution. Two techniques are being investigated: an iterative method and a function continuation Fourier method. This final status report describes the work performed during the period July 1 to December 31, 1982.

Assessment methods for rehabilitation.

PubMed

Biefang, S; Potthoff, P

1995-09-01

Diagnostics and evaluation in medical rehabilitation should be based on methods that are as objective as possible. In this context quantitative methods are an important precondition. We conducted for the German Pensions Insurance Institutions (which are in charge of the medical and vocational rehabilitation of workers and employees) a survey on assessment methods for rehabilitation which included an evaluation of American literature, with the aim to indicate procedures that can be considered for adaptation in Germany and to define further research requirements. The survey identified: (1) standardized procedures and instrumented tests for the assessment of musculoskeletal, cardiopulmonary and neurophysiological function; (2) personality, intelligence, achievement, neuropsychological and alcoholism screening tests for the assessment of mental or cognitive function; (3) rating scales and self-administered questionnaires for the assessment of Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL Scales); (4) generic profiles and indexes as well as disease-specific measures for the assessment of health-related quality of life and health status; and (5) rating scales for vocational assessment. German equivalents or German versions exist only for a part of the procedures identified. Translation and testing of Anglo-Saxon procedures should have priority over the development of new German methods. The following procedures will be taken into account: (a) instrumented tests for physical function, (b) IADL Scales, (c) generic indexes of health-related quality of life, (d) specific quality of life and health status measures for disorders of the circulatory system, metabolic system, digestive organs, respiratory tract and for cancer, and (e) vocational rating scales.

Factors Associated With Early Functional Outcome After Hip Fracture Surgery

PubMed Central

Cong, Guang-Ting; Nwachukwu, Benedict U.; Patt, Minda L.; Desai, Pingal; Zambrana, Lester; Lane, Joseph M.

2016-01-01

Background: Hip fractures are common in the elderly and are likely to become more prevalent as the US population ages. Early functional status is an indicator of longer term outcome, yet in-hospital predictors of functional recovery, particularly time of surgery and composition of support staff, after hip fracture surgery have not been well studied. Methods: Ninety-nine consecutive patients underwent hip fracture surgery by a single surgeon between 2009 and 2013. Surgery after 48 hours was deemed as surgical delay, and surgery after 5 pm was deemed as after hours. Surgical support staff experience was determined by experts from our institution as well as documented level of training. Functional status was determined by independent ambulation on postoperative day (POD) 3. Results: On POD3, 48 (79%) of 62 patients with no delay were able to ambulate, whereas only 14 (38%) of 37 patients with delayed surgery were able to ambulate (P < .001). This relationship persisted when adjusted for American Society of Anesthesiologist classification. No delay in patients older than 80 (odds ratio [OR], 6.91; 95% confidence interval [CI], 2.16-22.10) and females (OR, 7.05; 95% CI, 2.34-21.20) was associated with greater chance of early ambulation. After-hours surgery was not associated with ambulation (P = .35). Anesthesiologist and circulating nurse experience had no impact on patient’s ambulatory status; however, nonorthopedic scrub technicians were associated with worse functional status (OR 7.50; 95% CI, 1.46-38.44, P = .01). Conclusion: Surgical delay and nonorthopedic scrub technicians are associated with worse early functional outcome after hip fracture surgery. Surgical delay should be avoided in older patients and women. More work should be done to understand the impact of surgical team composition on outcome. PMID:26929850

Self-assembled software and method of overriding software execution

DOEpatents

Bouchard, Ann M.; Osbourn, Gordon C.

2013-01-08

A computer-implemented software self-assembled system and method for providing an external override and monitoring capability to dynamically self-assembling software containing machines that self-assemble execution sequences and data structures. The method provides an external override machine that can be introduced into a system of self-assembling machines while the machines are executing such that the functionality of the executing software can be changed or paused without stopping the code execution and modifying the existing code. Additionally, a monitoring machine can be introduced without stopping code execution that can monitor specified code execution functions by designated machines and communicate the status to an output device.

Alpha-beta coordination method for collective search

DOEpatents

Goldsmith, Steven Y.

2002-01-01

The present invention comprises a decentralized coordination strategy called alpha-beta coordination. The alpha-beta coordination strategy is a family of collective search methods that allow teams of communicating agents to implicitly coordinate their search activities through a division of labor based on self-selected roles and self-determined status. An agent can play one of two complementary roles. An agent in the alpha role is motivated to improve its status by exploring new regions of the search space. An agent in the beta role is also motivated to improve its status, but is conservative and tends to remain aggregated with other agents until alpha agents have clearly identified and communicated better regions of the search space. An agent can select its role dynamically based on its current status value relative to the status values of neighboring team members. Status can be determined by a function of the agent's sensor readings, and can generally be a measurement of source intensity at the agent's current location. An agent's decision cycle can comprise three sequential decision rules: (1) selection of a current role based on the evaluation of the current status data, (2) selection of a specific subset of the current data, and (3) determination of the next heading using the selected data. Variations of the decision rules produce different versions of alpha and beta behaviors that lead to different collective behavior properties.

[Quantitative measurement of axial rigidity, functional status and health-related quality of life in patients with Parkinson's disease].

PubMed

Cano de la Cuerda, Roberto; Vela, Lydia; Miangolarra-Page, Juan Carlos; Macías-Macías, Yolanda; Muñoz-Hellín, Elena

2010-08-16

Rigidity is a cardinal symptom of Parkinson's disease (PD). Clinically, rigidity is usually assessed by passively flexing and extending a patient's limb. Few studies have assessed rigidity in trunk muscles in PD patients. To develop an objective measurement to quantify trunk rigidity in PD patients, and to examine its relationship with disease severity using the Hoehn and Yahr staging score (HY) and the Unified Parkinson's Disease Rating Scale III (UPDRS-III), disease duration, functional status with the Schwab & England activities of daily living scale and health related quality of life (HRQoL) was assessed with the European Quality of Life-5 Dimensions and Parkinson's Disease Questionnaire-39 items (PDQ-39). An isokinetic dynamometer Biodex System 3 was employed to assess trunk rigidity in 36 PD patients. Passive trunk flexion and extension at 3 angular velocities, 30 degrees/s, 45 degrees/s and 60 degrees /s were applied and resistive torques were recorded as trunk flexor and extensors rigidity. Significant correlations between trunk flexors-extensors tone and HY staging score, UPDRS-III, disease duration and functional status at 30 degrees/s, 45 degrees/s and 60 degrees/s were obtained. Trunk rigidity was correlated with the HRQoL assessed with the PDQ-39. Our results suggest that the 30 degrees/s, 45 degrees/s and 60 degrees/s angular velocities of this objective method was valid to assess trunk rigidity and was correlated with disease severity, disease duration, functional status and HRQoL in PD patients.

Positron Emission Tomography: Human Brain Function and Biochemistry.

ERIC Educational Resources Information Center

Phelps, Michael E.; Mazziotta, John C.

1985-01-01

Describes the method, present status, and application of positron emission tomography (PET), an analytical imaging technique for "in vivo" measurements of the anatomical distribution and rates of specific biochemical reactions. Measurements and image dynamic biochemistry link basic and clinical neurosciences with clinical findings…

Cardiovascular Disease is Associated with COPD Severity and Reduced Functional Status and Quality of Life

PubMed Central

Black-Shinn, Jennifer L.; Kinney, Gregory L.; Wise, Anastasia L.; Regan, Elizabeth A.; Make, Barry; Krantz, Mori J.; Barr, R. Graham; Murphy, James R.; Lynch, David; Silverman, Edwin K.; Crapo, James D.; Hokanson, John E.

2015-01-01

Introduction Smoking is a major risk factor for both cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD). More individuals with COPD die from CVD than respiratory causes and the risk of developing CVD appears to be independent of smoking burden. Although CVD is a common comorbid condition within COPD, the nature of its relationships to COPD affection status and severity, and functional status is not well understood. Methods The first 2,500 members of the COPDGene cohort were evaluated. Subjects were current and former smokers with a minimum 10 pack year history of cigarette smoking. COPD was defined by spirometry as an FEV1/FVC < lower limit of normal (LLN) with further identification of severity by FEV1 percent of predicted (GOLD stages 2, 3, and 4) for the main analysis. The presence of physician-diagnosed self-reported CVD was determined from a medical history questionnaire administered by a trained staff member. Results A total of 384 (15%) had pre-existing CVD. Self-reported CVD was independently related to COPD (Odds Ratio=1.61, 95% CI=1.18–2.20, p=0.01) after adjustment for covariates with CHF having the greatest association with COPD. Within subjects with COPD, pre-existing self-reported CVD placed subjects at greater risk of hospitalization due to exacerbation, higher BODE index, and greater St. George’s questionnaire score. The presence of self-reported CVD was associated with a shorter six-minute walk distance in those with COPD (p<0.05). Conclusions Self-reported CVD was independently related to COPD with presence of both self-reported CVD and COPD associated with a markedly reduced functional status and reduced quality of life. Identification of CVD in those with COPD is an important consideration in determining functional status. PMID:24831864

Childhood Sexual Abuse Moderates the Association between Sexual Functioning and Sexual Distress in Women

PubMed Central

Stephenson, Kyle R.; Hughan, Corey P.; Meston, Cindy M.

2012-01-01

Objective To assess the degree to which a history of CSA moderates the association between sexual functioning and sexual distress in women. Method Women with (n = 105, M age = 33.71, 66.1% Caucasian) and without (n = 71, M age = 32.63, 74.7% Caucasian) a history of CSA taking part in a larger clinical trial completed self-report questionnaires at intake including the Sexual Satisfaction Scale for Women (SSS-W), the Female Sexual Function Index (FSFI), and the Trauma History Questionnaire (THQ). Results Desire, arousal, lubrication, and orgasm interacted with sexual abuse status in predicting sexual distress such that sexual functioning was more weakly associated with distress for women with a history of CSA. This disconnect was more pronounced for women who were abused by a family member. Conclusion CSA status serves as an important moderator of the association between sexual functioning and sexual distress in women. Specifically, women with a history of CSA show higher levels of distress in the context of good sexual functioning as compared to women without a history of CSA. Possible explanations and clinical implications are discussed. PMID:22391416

A social network analysis of the goal scoring passing networks of the 2016 European Football Championships.

PubMed

Mclean, Scott; Salmon, Paul M; Gorman, Adam D; Stevens, Nicholas J; Solomon, Colin

2018-02-01

In the current study, social network analysis (SNA) and notational analysis (NA) methods were applied to examine the goal scoring passing networks (GSPN) for all goals scored at the 2016 European Football Championships. The aim of the study was to determine the GSPN characteristics for the overall tournament, between the group and knock out stages, and for the successful and unsuccessful teams. The study also used degree centrality (DC) metrics as a novel method to determine the relative contributions of the pitch locations involved in the GSPN. To determine changes in GSPN characteristics as a function of changing score line, the analysis considered the match status of the game when goals were scored. There were significant differences for SNA metrics as a function of match status, and for the DC metrics in the comparison of the different pitch locations. There were no differences in the SNA metrics for the GSPN between teams in the group and knock out stages, or between the successful and unsuccessful teams. The results indicate that the GSPN had low values for network density, cohesion, connections, and duration. The networks were direct in terms of pitch zones utilised, where 85% of the GSPN included passes that were played within zones or progressed through the zones towards the goal. SNA and NA metrics were significantly different as a function of changing match status. The current study adds to the previous research on goal scoring in football, and demonstrates a novel method to determine the prominent pitch zones involved in the GSPN. These results have implications for match analysis and the coaching process. Copyright © 2017 Elsevier B.V. All rights reserved.

New-onset refractory status epilepticus

PubMed Central

Foreman, Brandon P.; Alvarez, Vincent; Cabrera Kang, Christian; Probasco, John C.; Jongeling, Amy C.; Meyers, Emma; Espinera, Alyssa; Haas, Kevin F.; Schmitt, Sarah E.; Gerard, Elizabeth E.; Gofton, Teneille; Kaplan, Peter W.; Lee, Jong W.; Legros, Benjamin; Szaflarski, Jerzy P.; Westover, Brandon M.; LaRoche, Suzette M.; Hirsch, Lawrence J.

2015-01-01

Objectives: The aims of this study were to determine the etiology, clinical features, and predictors of outcome of new-onset refractory status epilepticus. Methods: Retrospective review of patients with refractory status epilepticus without etiology identified within 48 hours of admission between January 1, 2008, and December 31, 2013, in 13 academic medical centers. The primary outcome measure was poor functional outcome at discharge (defined as a score >3 on the modified Rankin Scale). Results: Of 130 cases, 67 (52%) remained cryptogenic. The most common identified etiologies were autoimmune (19%) and paraneoplastic (18%) encephalitis. Full data were available in 125 cases (62 cryptogenic). Poor outcome occurred in 77 of 125 cases (62%), and 28 (22%) died. Predictors of poor outcome included duration of status epilepticus, use of anesthetics, and medical complications. Among the 63 patients with available follow-up data (median 9 months), functional status improved in 36 (57%); 79% had good or fair outcome at last follow-up, but epilepsy developed in 37% with most survivors (92%) remaining on antiseizure medications. Immune therapies were used less frequently in cryptogenic cases, despite a comparable prevalence of inflammatory CSF changes. Conclusions: Autoimmune encephalitis is the most commonly identified cause of new-onset refractory status epilepticus, but half remain cryptogenic. Outcome at discharge is poor but improves during follow-up. Epilepsy develops in most cases. The role of anesthetics and immune therapies warrants further investigation. PMID:26296517

Kyphosis and Decline in Physical Function Over 15 Years in Older Community-Dwelling Women: The Study of Osteoporotic Fractures

PubMed Central

2013-01-01

Background Maintaining physical function is an important prerequisite for preserving independence in later life. Greater degrees of kyphosis in the thoracic spine are prevalent in older persons and accompanied by reduced physical function in multiple cross-sectional studies. It is unknown whether kyphosis predicts worse physical function over time. Methods. We retrospectively assessed whether greater magnitude of kyphosis is associated with decline in self-reported and objectively measured physical function over 15 years. Digitized Cobb angle kyphosis (T4–T12) was derived from supine lateral thoracic spine radiographs in a cohort of 1,196 women aged 65 and older (mean = 69.3 years [SD = 4.0]). Using regression models, we evaluated associations of baseline kyphosis with both self-reported functional status and objectively measured gait speed, grip strength, and timed chair stands cross-sectionally and as change assessed over 15 years. Results. In cross-sectional multivariate analyses, with each 10-degree increment of kyphosis, grip strength was 0.24kg lower (p = .02), but there were no significant associations between kyphosis and functional status, gait speed, or timed chair stand, likely reflecting the high functioning study participants. In multivariate longitudinal analysis, with each 10-degree increment in baseline kyphosis, there was 0.07 point additional decline in functional status (p = .09), 0.01 m/s more decline in gait speed (p = .07), and 0.32 s greater decline in time to complete five chair stands (p = .004), but no association with decline in grip strength. Conclusions. Greater magnitude of kyphosis may predict worsening lower extremity function over time in older women. Early recognition and preventative measures against kyphosis progression may help preserve physical function over the long term. PMID:23633167

17-Year Outcome of Preterm Infants with Diverse Neonatal Morbidities: Part 1, Impact on Physical, Neurological, and Psychological Health Status

PubMed Central

Sullivan, Mary C.; Msall, Michael E.; Miller, Robin J.

2012-01-01

Purpose The purpose of this study was to comprehensively examine physical, neurological, and psychological health in a U.S. sample of 180 infants at age 17. Design & Methods The World Health Organization International Classification of Functioning, Disability and Health model framed the health-related domains and contextual factors. Assessments included growth, chronic conditions, neurological status, and psychological health. Results Physical health, growth, and neurological outcomes were poorer in the preterm groups. Minor neurological impairment was related to integrative function. Preterm survivors reported higher rates of depression, anxiety, and inattention/hyperactivity. Practice Implications Complex health challenges confront preterm survivors at late adolescence suggesting the necessity of continued health surveillance. PMID:22734876

Acoustical Method of Whole-Body Hydration Status Monitoring.

PubMed

Sarvazyan, A P; Tsyuryupa, S N; Calhoun, M; Utter, A

2016-07-01

An acoustical handheld hydration monitor (HM) for assessing the water balance of the human body was developed. Dehydration is a critical public health problem. Many elderly over age of 65 are particularly vulnerable as are infants and young children. Given that dehydration is both preventable and reversible, the need for an easy-to-perform method for the detection of water imbalance is of the utmost clinical importance. The HM is based on an experimental fact that ultrasound velocity in muscle is a linear function of water content and can be referenced to the hydration status of the body. Studies on the validity of HM for the assessment of whole-body hydration status were conducted in the Appalachian State University, USA, on healthy young adults and on elderly subjects residing at an assisted living facility. The HM was able to track changes in total body water during periods of acute dehydration and rehydration in athletes and day-to-day and diurnal variability of hydration in elderly. Results of human studies indicate that HM has a potential to become an efficient tool for detecting abnormal changes in the body hydration status.

Acoustical method of whole-body hydration status monitoring

NASA Astrophysics Data System (ADS)

Sarvazyan, A. P.; Tsyuryupa, S. N.; Calhoun, M.; Utter, A.

2016-07-01

An acoustical handheld hydration monitor (HM) for assessing the water balance of the human body was developed. Dehydration is a critical public health problem. Many elderly over age of 65 are particularly vulnerable as are infants and young children. Given that dehydration is both preventable and reversible, the need for an easy-to-perform method for the detection of water imbalance is of the utmost clinical importance. The HM is based on an experimental fact that ultrasound velocity in muscle is a linear function of water content and can be referenced to the hydration status of the body. Studies on the validity of HM for the assessment of whole-body hydration status were conducted in the Appalachian State University, USA, on healthy young adults and on elderly subjects residing at an assisted living facility. The HM was able to track changes in total body water during periods of acute dehydration and rehydration in athletes and day-to-day and diurnal variability of hydration in elderly. Results of human studies indicate that HM has a potential to become an efficient tool for detecting abnormal changes in the body hydration status.

Nuclear fuels status

NASA Technical Reports Server (NTRS)

Kania, Michael

1991-01-01

A discussion on coated particle fuel performance from a modular High Temperature Gas Reactor (HTGR) is presented along with experimental results. The following topics are covered: (1) the coated particle fuel concept; (2) the functional requirements; (3) performance limiting mechanisms; (4) fuel performance; and (5) methods/techniques for characterizing performance.

Oral nutritional supplements containing n-3 polyunsaturated fatty acids affect quality of life and functional status in lung cancer patients during multimodality treatment: an RCT

PubMed Central

van der Meij, B S; Langius, J A E; Spreeuwenberg, M D; Slootmaker, S M; Paul, M A; Smit, E F; van Leeuwen, P A M

2012-01-01

Background/Objectives: Our objective was to investigate effects of an oral nutritional supplement containing n-3 polyunsaturated fatty acids (FAs) on quality of life, performance status, handgrip strength and physical activity in patients with non-small cell lung cancer (NSCLC) undergoing multimodality treatment. Subjects/Methods: In a double-blind experiment, 40 patients with stage III NSCLC were randomised to receive 2 cans/day of a protein- and energy-dense oral nutritional supplement containing n-3 polyunsaturated FAs (2.02 g eicosapentaenoic acid+0.92 g docosahexaenoic acid/day) or an isocaloric control supplement, during multimodality treatment. Quality of life, Karnofsky Performance Status, handgrip strength and physical activity (by wearing an accelerometer) were assessed. Effects of intervention were analysed by generalised estimating equations. P-values <0.05 were regarded as statistically significant. Results: The intervention group reported significantly higher on the quality of life parameters, physical and cognitive function (B=11.6 and B=20.7, P<0.01), global health status (B=12.2, P=0.04) and social function (B=22.1, P=0.04) than the control group after 5 weeks. The intervention group showed a higher Karnofsky Performance Status (B=5.3, P=0.04) than the control group after 3 weeks. Handgrip strength did not significantly differ between groups over time. The intervention group tended to have a higher physical activity than the control group after 3 and 5 weeks (B=6.6, P=0.04 and B=2.5, P=0.05). Conclusion: n-3 Polyunsaturated FAs may beneficially affect quality of life, performance status and physical activity in patients with NSCLC undergoing multimodality treatment. PMID:22234041

Classification of TP53 Mutations and HPV Predict Survival in Advanced Larynx Cancer

PubMed Central

Scheel, Adam; Bellile, Emily; McHugh, Jonathan B.; Walline, Heather M.; Prince, Mark E.; Urba, Susan; Wolf, Gregory T.; Eisbruch, Avraham; Worden, Francis; Carey, Thomas E.; Bradford, Carol

2016-01-01

OBJECTIVE Assess TP53 functional mutations in the context of other biomarkers in advanced larynx cancer. STUDY DESIGN Prospective analysis of pretreatment tumor TP53, HPV, Bcl-xL and cyclin D1 status in stage III and IV larynx cancer patients in a clinical trial. METHODS TP53 exons 4-9 from 58 tumors were sequenced. Mutations were grouped using three classifications based on their expected function. Each functional group was analyzed for response to induction chemotherapy, time to surgery, survival, HPV status, p16INK4a, Bcl-xl and cyclin D1 expression. RESULTS TP53 Mutations were found in 22/58 (37.9%) patients with advanced larynx cancer, including missense mutations in 13/58 (22.4%) patients, nonsense mutations in 4/58 (6.9%), and deletions in 5/58 (8.6%). High risk HPV was found in 20/52 (38.5%) tumors. A classification based on crystal Evolutionary Action score of p53 (EAp53) distinguished missense mutations with high risk for decreased survival from low risk mutations (p=0.0315). A model including this TP53 classification, HPV status, cyclin D1 and Bcl-xL staining significantly predicts survival (p=0.0017). CONCLUSION EAp53 functional classification of TP53 mutants and biomarkers predict survival in advanced larynx cancer. PMID:27345657

Benchmarking Outpatient Rehabilitation Clinics Using Functional Status Outcomes.

PubMed

Gozalo, Pedro L; Resnik, Linda J; Silver, Benjamin

2016-04-01

To utilize functional status (FS) outcomes to benchmark outpatient therapy clinics. Outpatient therapy data from clinics using Focus on Therapeutic Outcomes (FOTO) assessments. Retrospective analysis of 538 clinics, involving 2,040 therapists and 90,392 patients admitted July 2006-June 2008. FS at discharge was modeled using hierarchical regression methods with patients nested within therapists within clinics. Separate models were estimated for all patients, for those with lumbar, and for those with shoulder impairments. All models risk-adjusted for intake FS, age, gender, onset, surgery count, functional comorbidity index, fear-avoidance level, and payer type. Inverse probability weighting adjusted for censoring. Functional status was captured using computer adaptive testing at intake and at discharge. Clinic and therapist effects explained 11.6 percent of variation in FS. Clinics ranked in the lowest quartile had significantly different outcomes than those in the highest quartile (p < .01). Clinics ranked similarly in lumbar and shoulder impairments (correlation = 0.54), but some clinics ranked in the highest quintile for one condition and in the lowest for the other. Benchmarking models based on validated FS measures clearly separated high-quality from low-quality clinics, and they could be used to inform value-based-payment policies. © Health Research and Educational Trust.

ACADEMIC OUTCOMES IN CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS

PubMed Central

Zelko, Frank; Beebe, Dean; Baker, Aimee; Nelson, Shannen M; Ali, Aisha; Cedeno, Adlin; Dina, Blair; Klein-Gitelman, Marisa S; Ying, Jun; Brunner, Hermine I

2012-01-01

Objective To explore academic outcomes in childhood-onset systemic lupus erythematosus (cSLE) and their relationship to variables such as demographic and socioeconomic status, neurocognitive functioning, behavioral/emotional adjustment, and cSLE disease status. Methods Forty pairs of children diagnosed with cSLE and healthy best-friend controls were rated by parents on a standardized scale of school competence. Information about participants’ demographic and socioeconomic status was obtained, along with measures of cSLE disease activity and damage. All participants received formal neurocognitive testing and were also rated on standardized scales of behavioral/emotional adjustment and executive functioning. Results Compared to healthy controls, school competence was rated as lower in the cSLE group, although the groups did not differ significantly on indices of cognitive, behavioral, emotional, or executive functioning. School competence ratings were correlated with reading and mathematics achievement test scores in both groups, and with ratings of mental self-regulation in the cSLE group. School competence ratings were correlated with measures of cSLE disease activity and treatment intensity. Conclusion cSLE is associated with inferior parent-rated academic outcomes compared to those noted in demographically-matched peers, despite similar neurocognitive function. The adverse academic outcomes which distinguish children with cSLE from their demographically-matched peers appear to be mediated by SLE disease activity and treatment. PMID:22807373

Carpal tunnel syndrome, the search for a cost-effective surgical intervention: a randomised controlled trial.

PubMed Central

Lorgelly, Paula K.; Dias, Joseph J.; Bradley, Mary J.; Burke, Frank D.

2005-01-01

OBJECTIVE: There is insufficient evidence regarding the clinical and cost-effectiveness of surgical interventions for carpal tunnel syndrome. This study evaluates the cost, effectiveness and cost-effectiveness of minimally invasive surgery compared with conventional open surgery. PATIENTS AND METHODS: 194 sufferers (208 hands) of carpal tunnel syndrome were randomly assigned to each treatment option. A self-administered questionnaire assessed the severity of patients' symptoms and functional status pre- and postoperatively. Treatment costs were estimated from resource use and hospital financial data. RESULTS: Minimally invasive carpal tunnel decompression is marginally more effective than open surgery in terms of functional status, but not significantly so. Little improvement in symptom severity was recorded for either intervention. Minimally invasive surgery was found to be significantly more costly than open surgery. The incremental cost effectiveness ratio for functional status was estimated to be 197 UK pounds, such that a one percentage point improvement in functioning costs 197 UK pounds when using the minimally invasive technique. CONCLUSIONS: Minimally invasive carpal tunnel decompression appears to be more effective but more costly. Initial analysis suggests that the additional expense for such a small improvement in function and no improvement in symptoms would not be regarded as value-for-money, such that minimally invasive carpal tunnel release is unlikely to be considered a cost-effective alternative to the traditional open surgery procedure. PMID:15720906

Direct and indirect effects of nutritional status, physical function and cognitive function on activities of daily living in Japanese older adults requiring long-term care.

PubMed

Kamo, Tomohiko; Nishida, Yuusuke

2014-10-01

To identify the direct and indirect effects of nutritional status, physical function, and cognitive function on activities of daily living in Japanese older adults requiring long-term care. In total, 179 participants aged ≥ 65 years who were eligible for long-term care insurance (mean age 85.5 ± 7.8 years) were recruited for this study. Nutritional status (Mini Nutritional Assessment, Short Form) and physical function (Short Physical Performance Battery) were examined. Activities of daily living, cognitive function and frailty were assessed using the Barthel Index, Mini-Mental State Examination and Clinical Frailty Scale, respectively. Path analysis was used to determine relationships between these factors and the activities of daily living. For Japanese older adults requiring long-term care, pathways were modeled for nutritional status, physical function and the activities of daily living. The total effect of nutritional status was 0.516 (P<0.001). The indirect effect of nutritional status through physical function on the activities of daily living was 0.458 (P<0.001). Finally, no significant direct effect of nutritional status on activities of daily living was observed (b=0.058, P=0.258). The present study identified the complex pathway from nutritional status to the activities of daily living through physical function in aged Japanese people requiring long-term care. These findings suggest that maintaining good nutritional status and nutritional support might delay physical function decline, and prolong the activities of daily living. © 2013 Japan Geriatrics Society.

Assessment of nutritional status in the elderly: a proposed function-driven model.

PubMed

Engelheart, Stina; Brummer, Robert

2018-01-01

There is no accepted or standardized definition of 'malnutrition'. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness. We propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people. The presented model could be interpreted as the nutritional status is conditional to a person's optimal function or situation. Another way of looking at it might be that a person's nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain. Nutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting.

Assessing the Utility of Item Response Theory Models: Differential Item Functioning.

ERIC Educational Resources Information Center

Scheuneman, Janice Dowd

The current status of item response theory (IRT) is discussed. Several IRT methods exist for assessing whether an item is biased. Focus is on methods proposed by L. M. Rudner (1975), F. M. Lord (1977), D. Thissen et al. (1988) and R. L. Linn and D. Harnisch (1981). Rudner suggested a measure of the area lying between the two item characteristic…

Factors associated with the nutritional status of children less than 5 years of age

PubMed Central

Miglioli, Teresa Cristina; Fonseca, Vania Matos; Gomes, Saint Clair; da Silva, Katia Silveira; de Lira, Pedro Israel Cabral; Batista, Malaquias

2015-01-01

OBJECTIVE To analyze if the nutritional status of children aged less than five years is related to the biological conditions of their mothers, environmental and socioeconomic factors, and access to health services and social programs. METHODS This cross-sectional population-based study analyzed 664 mothers and 790 children using canonical correlation analysis. Dependent variables were characteristics of the children (weight/age, height/age, BMI/age, hemoglobin, and retinol serum levels). Independent variables were those related to the mothers’ nutritional status (BMI, hemoglobin, and retinol serum levels), age, environmental and socioeconomic factors and access to health service and social programs. A < 0.05 significance level was adopted to select the interpreted canonical functions (CF) and ± 0.40 as canonical load value of the analyzed variables. RESULTS Three canonical functions were selected, concentrating 89.9% of the variability of the relationship among the groups. In the first canonical function, weight/age (-0.73) and height/age (-0.99) of the children were directly related to the mother’s height (-0.82), prenatal appointments (-0.43), geographical area of the residence (-0.41), and household income per capita (-0.42). Inverse relationship between the variables related to the children and people/room (0.44) showed that the larger the number of people/room, the poorer their nutritional status. Rural residents were found to have the worse nutritional conditions. In the second canonical function, the BMI of the mother (-0.48) was related to BMI/age and retinol of the children, indicating that as women gained weight so did their children. Underweight women tended to have children with vitamin A deficiency. In the third canonical function, hemoglobin (-0.72) and retinol serum levels (-0.40) of the children were directly related to the mother’s hemoglobin levels (-0.43). CONCLUSIONS Mothers and children were associated concerning anemia, vitamin A deficiency and anthropometric markers. Living in rural areas is a determining factor for the families health status. PMID:26398874

A Comparison of Functional Outcome in Patients Sustaining Major Trauma: A Multicentre, Prospective, International Study

PubMed Central

Rainer, Timothy H.; Yeung, Hiu Hung; Gabbe, Belinda J.; Yuen, Kai Y.; Ho, Hiu F.; Kam, Chak W.; Chang, Annice; Poon, Wai S.; Cameron, Peter A.; Graham, Colin A.

2014-01-01

Objectives To compare 6 month and 12 month health status and functional outcomes between regional major trauma registries in Hong Kong and Victoria, Australia. Summary Background Data Multicentres from trauma registries in Hong Kong and the Victorian State Trauma Registry (VSTR). Methods Multicentre, prospective cohort study. Major trauma patients and aged ≥18 years were included. The main outcome measures were Extended Glasgow Outcome Scale (GOSE) functional outcome and risk-adjusted Short-Form 12 (SF-12) health status at 6 and 12 months after injury. Results 261 cases from Hong Kong and 1955 cases from VSTR were included. Adjusting for age, sex, ISS, comorbid status, injury mechanism and GCS group, the odds of a better functional outcome for Hong Kong patients relative to Victorian patients at six months was 0.88 (95% CI: 0.66, 1.17), and at 12 months was 0.83 (95% CI: 0.60, 1.12). Adjusting for age, gender, ISS, GCS, injury mechanism and comorbid status, Hong Kong patients demonstrated comparable mean PCS-12 scores at 6-months (adjusted mean difference: 1.2, 95% CI: −1.2, 3.6) and 12-months (adjusted mean difference: −0.4, 95% CI: −3.2, 2.4) compared to Victorian patients. Keeping age, gender, ISS, GCS, injury mechanism and comorbid status, there was no difference in the MCS-12 scores of Hong Kong patients compared to Victorian patients at 6-months (adjusted mean difference: 0.4, 95% CI: −2.1, 2.8) or 12-months (adjusted mean difference: 1.8, 95% CI: −0.8, 4.5). Conclusion The unadjusted analyses showed better outcomes for Victorian cases compared to Hong Kong but after adjusting for key confounders, there was no difference in 6-month or 12-month functional outcomes between the jurisdictions. PMID:25157522

Cognitive function in older adults according to current socioeconomic status.

PubMed

Zhang, Michael; Gale, Shawn D; Erickson, Lance D; Brown, Bruce L; Woody, Parker; Hedges, Dawson W

2015-01-01

Cognitive function may be influenced by education, socioeconomic status, sex, and health status. Furthermore, aging interacts with these factors to influence cognition and dementia risk in late life. Factors that may increase or decrease successful cognitive aging are of critical importance, particularly if they are modifiable. The purpose of this study was to determine if economic status in late life is associated with cognition independent of socioeconomic status in early life. Cross-sectional demographic, socioeconomic, and cognitive function data were obtained in 2592 older adults (average age 71.6 years) from the Center for Disease Control's National Health and Nutrition Examination Survey (NHANES) and analyzed with linear regression modeling. Cognitive function, as measured with a test of processing speed, was significantly associated with poverty index scores after adjusting for educational attainment as an estimate of childhood socioeconomic status, ethnic background, age, health status, and sex (P < 0.001). Our findings suggest that current economic status is independently associated with cognitive function in adults over age 60 years.

Functional Status of Long-Term Breast Cancer Survivors: Demonstrating Chronicity.

ERIC Educational Resources Information Center

Polinsky, Margaret L.

1994-01-01

Surveyed 223 breast cancer survivors 16 months to 32 years from original surgery to assess their current physical, psychological, and social functional status. Although general measures of functioning indicated high physical, psychological, and social functional status, measures specific to breast cancer diagnosis and treatment indicated problems…

Supporting women with advanced breast cancer: the impact of altered functional status on their social roles.

PubMed

Chen, Bai Qi Peggy; Parmar, Monica P; Gartshore, Kimberley

2014-01-01

Despite early detection of breast cancer and the progress of treatment modalities, metastasis-specific symptoms continue to impact women's functional status and daily living. The aim of this study was to explore the experience of altered functional status and social roles of women with advanced breast cancer. Using qualitative descriptive methodology, semi-structured interviews were conducted with 10 women diagnosed with advanced breast cancer and altered functional status attending a tertiary care cancer centre. Results illustrated the adaptive experience of women living with their illness as they reshaped their social roles to fit with their altered functional status and advanced disease. These findings highlight the opportunity for supportive care nursing interventions to facilitate the behavioural and cognitive transitions that are experienced by women with advanced breast cancer and altered functional status. These results may have implications for women with other advanced chronic diseases, though more research is required.

The influence of knee pain location on symptoms, functional status and knee-related quality of life in older adults with chronic knee pain: data from the Osteoarthritis Initiative

PubMed Central

Farrokhi, Shawn; Chen, Yi-Fan; Piva, Sara R.; Fitzgerald, G. Kelley; Jeong, Jong-Hyeon; Kwoh, C. Kent

2015-01-01

Objective To evaluate whether knee pain location can influence symptoms, functional status and knee-related quality of life in older adults with chronic knee pain. Methods A total of 2959 painful knees from the Osteoarthritis Initiative database were analyzed. Trained interviewers recorded patient-reported location of knee pain. Painful knees were divided into three groups of patellofemoral only pain, tibiofemoral only pain, and combined pain. Self-reported knee-specific symptoms, functional status and knee-related quality of life were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). Results The most common knee pain pattern was tibiofemoral only pain (62%), followed by patellofemoral only pain (23%) and combined pain (15%). The combined pain pattern was associated with greater odds of reporting pain, symptoms, sports or recreational activity limitations and lower knee-related quality of life compared to either isolated knee pain patterns, after adjusting for demographics and radiographic disease severity. Individual item analysis further revealed that patients with combined pain had greater odds of reporting difficulty with daily weightbearing activities that required knee bending compared to tibiofemoral or patellofemoral only pain patterns. Furthermore, symptoms, functional status, and knee-related quality of life were comparable between patients with patellofemoral and tibiofemoral only pain patterns, after adjusting for demographics and radiographic disease severity. Discussion Combined patellofemoral and tibiofemoral pain is associated with poorer clinical presentation compared to isolated knee pain from either location. Additionally, patellofemoral pain in isolation may be as important as tibiofemoral pain in causing symptoms and functional limitation in older adults with chronic knee pain. PMID:26308705

Objective Integrated Assessment of Functional Outcomes in Reduction Mammaplasty

PubMed Central

Passaro, Ilaria; Malovini, Alberto; Faga, Angela; Toffola, Elena Dalla

2013-01-01

Background: The aim of our study was an objective integrated assessment of the functional outcomes of reduction mammaplasty. Methods: The study involved 17 women undergoing reduction mammaplasty from March 2009 to June 2011. Each patient was assessed before surgery and 2 months postoperatively with the original association of 4 subjective and objective assessment methods: a physiatric clinical examination, the Roland Morris Disability Questionnaire, the Berg Balance Scale, and a static force platform analysis. Results: All of the tests proved multiple statistically significant associated outcomes demonstrating a significant improvement in the functional status following reduction mammaplasty. Surgical correction of breast hypertrophy could achieve both spinal pain relief and recovery of performance status in everyday life tasks, owing to a muscular postural functional rearrangement with a consistent antigravity muscle activity sparing. Pain reduction in turn could reduce the antalgic stiffness and improved the spinal range of motion. In our sample, the improvement of the spinal range of motion in flexion matched a similar improvement in extension. Recovery of a more favorable postural pattern with reduction of the anterior imbalance was demonstrated by the static force stabilometry. Therefore, postoperatively, all of our patients narrowed the gap between the actual body barycenter and the ideal one. The static force platform assessment also consistently confirmed the effectiveness of an accurate clinical examination of functional impairment from breast hypertrophy. Conclusions: The static force platform assessment might help the clinician to support the diagnosis of functional impairment from a breast hypertrophy with objectively based data. PMID:25289256

Vitamin B-12 status and neurologic function in older people: a cross-sectional analysis of baseline trial data from the Older People and Enhanced Neurological Function (OPEN) study.

PubMed

Miles, Lisa M; Allen, Elizabeth; Mills, Kerry; Clarke, Robert; Uauy, Ricardo; Dangour, Alan D

2016-09-01

Aging is associated with a progressive decline in vitamin B-12 status. Overt vitamin B-12 deficiency causes neurologic disturbances in peripheral and central motor and sensory systems, but the public health impact for neurologic disease of moderately low vitamin B-12 status in older people is unclear. Evidence from observational studies is limited by heterogeneity in the definition of vitamin B-12 status and imprecise measures of nerve function. We aimed to determine whether vitamin B-12 status is associated with electrophysiologic indexes of peripheral or central neurologic function in asymptomatic older people with moderately low vitamin B-12 status. We used a cross-sectional analysis of baseline data from the Older People and Enhanced Neurological Function study conducted in Southeast England. This trial investigated the effectiveness of vitamin B-12 supplementation on electrophysiologic indexes of neurologic function in asymptomatic older people (mean age: 80 y) with moderately low vitamin B-12 status (serum vitamin B-12 concentrations ≥107 and <210 pmol/L without anemia, n = 201). Vitamin B-12 status was assessed with the use of total vitamin B-12, holotranscobalamin, and a composite indicator of vitamin B-12 status (cB-12). Electrophysiologic measures of sensory and motor components of peripheral and central nerve function were assessed in all participants by a single observer. In multivariate models, there was no evidence of an association of vitamin B-12, holotranscobalamin, or cB-12 with any nerve conduction outcome. There was also no evidence of an association of vitamin B-12 status with clinical markers of neurologic function. This secondary analysis of high-quality trial data did not show any association of any measure of vitamin B-12 status with either peripheral or central neurologic function or any clinical markers of neurologic function in older people with moderately low vitamin B-12 status. The results of this study are unlikely to be generalizable to a less healthy older population with more severe vitamin B-12 deficiency. This trial was registered at www.controlled-trials.com as ISRCTN54195799. © 2016 American Society for Nutrition.

[Research and implementation of a real-time monitoring system for running status of medical monitors based on the internet of things].

PubMed

Li, Yiming; Qian, Mingli; Li, Long; Li, Bin

2014-07-01

This paper proposed a real-time monitoring system for running status of medical monitors based on the internet of things. In the aspect of hardware, a solution of ZigBee networks plus 470 MHz networks is proposed. In the aspect of software, graphical display of monitoring interface and real-time equipment failure alarm is implemented. The system has the function of remote equipment failure detection and wireless localization, which provides a practical and effective method for medical equipment management.

[Analysis of the characteristics of the older adults with depression using data mining decision tree analysis].

PubMed

Park, Myonghwa; Choi, Sora; Shin, A Mi; Koo, Chul Hoi

2013-02-01

The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method. A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs. The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease. The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status

PubMed Central

Finan, P. H.; Haythornthwaite, J. A.; Kadan, M.; Regan, K. R.; Herman, J. M.; Efron, J.; Diaz, L. A.; Azad, N. S.

2014-01-01

Purpose Research examining effects of ostomy use on sexual outcomes is limited. Patients with colorectal cancer were compared on sexual outcomes and body image based on ostomy status (never, past, and current ostomy). Differences in depression were also examined. Methods Patients were prospectively recruited during clinic visits and by tumor registry mailings. Patients with colorectal cancer (N = 141; 18 past ostomy; 25 current ostomy; and 98 no ostomy history) completed surveys assessing sexual outcomes (medical impact on sexual function, Female Sexual Function Index, International Index of Erectile Function), body image distress (Body Image Scale), and depressive symptoms (Center for Epidemiologic Studies Depression Scale—Short Form). Clinical information was obtained through patient validated self-report measures and medical records. Results Most participants reported sexual function in the dysfunctional range using established cut-off scores. In analyses adjusting for demographic and medical covariates and depression, significant group differences were found for ostomy status on impact on sexual function (p <.001), female sexual function (p =.01), and body image (p <.001). The current and past ostomy groups reported worse impact on sexual function than those who never had an ostomy (p <.001); similar differences were found for female sexual function. The current ostomy group reported worse body image distress than those who never had an ostomy (p <.001). No differences were found across the groups for depressive symptoms (p =.33) or male sexual or erectile function (p values≥.59). Conclusions Colorectal cancer treatment puts patients at risk for sexual difficulties and some difficulties may be more pronounced for patients with ostomies as part of their treatment. Clinical information and support should be offered. PMID:24091721

Influence of educational status on executive function and functional balance in individuals with Parkinson disease.

PubMed

Souza, Carolina de Oliveira; Voos, Mariana Callil; Francato, Débora Valente; Chien, Hsin Fen; Barbosa, Egberto Reis

2013-03-01

This study investigated whether educational status influenced how people with Parkinson disease (PD) performed on Parts A, B, and DELTA of the Trail Making Test (TMT) and on the Berg Balance Scale (BBS). Recent studies have shown that educational status may influence cognitive and motor test performance. We gave the TMT and the BBS to assess executive function and functional balance in 28 people with PD (Hoehn and Yahr score between 2 and 3) and 30 healthy elderly people. Participants reported their number of years of formal education. We divided each group of participants by educational status: low (4 to 10 years of education) or high (≥11 years). In both the PD (P=0.018) and control (P=0.003) groups, participants with low educational status performed worse on the TMT Part B than did those with high educational status. Within the PD group, the less-educated participants scored worse on the BBS than did the more educated (P<0.001); this difference was not significant between the more- and less-educated controls (P=0.976). Whether or not they had PD, less-educated people performed worse than more-educated people on the TMT Part B. Educational status affected executive function, but PD status did not. Among individuals with PD, educational status influenced functional balance.

Assessment of nutritional status in the elderly: a proposed function-driven model

PubMed Central

Engelheart, Stina; Brummer, Robert

2018-01-01

Background There is no accepted or standardized definition of ‘malnutrition’. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness. Objective We propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people. Design and results The presented model could be interpreted as the nutritional status is conditional to a person’s optimal function or situation. Another way of looking at it might be that a person’s nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain. Conclusions Nutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting. PMID:29720931

Associations between neurocognitive functioning and social and occupational resilience among South African women exposed to childhood trauma.

PubMed

Denckla, C A; Consedine, N S; Spies, G; Cherner, M; Henderson, D C; Koenen, K C; Seedat, S

2017-01-01

Background : Prior research on adaptation after early trauma among black South African women typically assessed resilience in ways that lacked contextual specificity. In addition, the neurocognitive correlates of social and occupational resilience have not been investigated. Objective : The primary aim of this exploratory study was to identify domains of neurocognitive functioning associated with social and occupational resilience, defined as functioning at a level beyond what would be expected given exposure to childhood trauma. Methods : A sample of black South African women, N  = 314, completed a neuropsychological battery, a questionnaire assessing exposure to childhood trauma, and self-report measures of functional status. We generated indices of social and occupational resilience by regressing childhood trauma exposure on social and occupational functioning, saving the residuals as indices of social and occupational functioning beyond what would be expected given exposure to childhood trauma. Results : Women with lower non-verbal memory evidenced greater social and occupational resilience above and beyond the effects attributable to age, education, HIV status, and depressive and posttraumatic stress symptoms. In addition, women with greater occupational resilience exhibited lower semantic language fluency and processing speed. Conclusion : Results are somewhat consistent with prior studies implicating memory effects in impairment following trauma, though our findings suggest that reduced abilities in these domains may be associated with greater resilience. Studies that use prospective designs and objective assessment of functional status are needed to determine whether non-verbal memory, semantic fluency, and processing speed are implicated in the neural circuitry of post-traumatic exposure resilience.

The Functional Status of Patients with AIDS Attending Antiretroviral Treatment Center

PubMed Central

Thejus, TJ; Jeeja, MC; Jayakrishnan, T

2009-01-01

Aims: To assess the functional status of patients with Acquired immunodeficiency syndrome (AIDS) registered in the Anti-Retroviral Treatment (ART) center. Materials and Methods: Design: Descriptive study. Study setting: ART center in Calicut Medical College, Kerala, India. Subjects: Cohorts of AIDS patients attending the ART center during the year 2007. Data collection: Done prospectively from the secondary data available from the center. Outcome measures: The demographic, morbidity, functional status and laboratory parameters were collected. Data processing was done using Excel datasheet and analysis were done using Epi info 2003. Results: One hundred and ninety-five patients received care during this period; 69% were males. The mean age was 38±9 years; 80% of them were married and in 50% of their spouses also tested positive for HIV. The mean CD4 count was 127 cells/microliter. The majority (90%) were categorized as WHO Stage 3 or 4 of HIV. Only 52% of them were able to perform their usual work in or outside their house; the rest were not able to lead an economically productive life. Thirty-six per cent were only able to perform activities of daily living; 12% were bedridden. The functional status of the patients positively correlated with WHO disease stage (P = < 0-0001), and CD4 count and hemoglobin levels negatively correlated with staging (P = <0.001). 62% are having any of the opportunistic infections. Conclusion: Fifty per cent of the AIDS patients are disabled and need support and care. As AIDS is a growing problem, community-based palliative care for AIDS patients should be strengthened in India. PMID:20606857

Ambulatory cancer and US general population reference values and cutoff scores for the functional assessment of cancer therapy.

PubMed

Pearman, Timothy; Yanez, Betina; Peipert, John; Wortman, Katy; Beaumont, Jennifer; Cella, David

2014-09-15

Health-related quality of life (HRQOL) measures are commonly used in oncology research. Interest in their use for monitoring or screening is increasing. The Functional Assessment of Cancer Therapy (FACT) is one of the most widely used HRQOL instruments. Consequently, oncology researchers and practitioners have an increasing need for reference values for the Functional Assessment of Cancer Therapy-General (FACT-G) and its 7-item rapid version, the Functional Assessment of Cancer Therapy-General 7 (FACT-G7), to compare FACT scores across specific subgroups of patients in research trials and practice. The objectives of this study are to provide 1) reference values from a sample of the general US adult population and a sample of adults diagnosed with cancer and 2) cutoff scores for quality of life. A sample of the general US population (N = 1075) and a sample of patients with cancer from 12 studies (N = 5065) were analyzed. Cutoff scores were established using distribution- and anchor-based methods. Mean values for the cancer sample were analyzed by performance status, cancer type, and disease status. Also, t tests and established criteria for meaningful differences were used to compare values. FACT-G and FACT-G7 scores in the general US population sample and cancer sample were generally comparable. Among the sample of patients with cancer, FACT-G and FACT-G7 scores worsened with declining performance status and increasing disease status. These data will aid interpretation of the magnitude and meaning of FACT scores, and allow for comparisons of scores across studies. © 2014 American Cancer Society.

[Legal capacity and instruments assessing cognitive functions in patients with dementia].

PubMed

Voskou, P; Papageorgiou, S; Economou, A; Douzenis, A

2017-01-01

The term "legal capacity" refers to the ability of a person to make a valid declaration of his will or to accept such a declaration. This ability constitutes the main condition for the validity of the legal transaction. The legal transaction includes issues that are adjusted by the Civil Code with which the relations of the citizens in a society are regulated. General practitioners and legal advisors, in any case of a person with cognitive impairment of various severity, should take into account that the assessment tests of the cognitive functions are not by themselves diagnostic of the dementia and they cannot be used as the only way of evaluation of the capacity of patients with cognitive impairment or possible dementia to respond to the needs of everyday life and in more complex decisions, such as the legal capacity. The existing methods for the assessment of the cognitive functions are valuable, mainly, for the detection of any cognitive impairment which may not be perceptible during the clinical evaluation of the patient and secondly for the detection of any changes in the cognitive status of the patient during its following up. The description and study of the instruments which are frequently used in the international scientific society for the assessment of the cognitive functions of the patients with mild cognitive impairment or dementia, during the evaluation of the legal capacity of these patients. The literature relevant to the existing methods assessing the cognitive functions during the evaluation of the legal capacity of patients with dementia was reviewed. The scientific database searched was Pubmed, Medline and Scopus. The key-words used were cognitive functions, dementia, instruments, legal capacity. Various instruments which assess the cognitive functions have been developed and can be grouped in 4 categories. The first one includes instruments used for the general assessment of the cognitive status. These instruments can be extensive or short and consist of subtests for the evaluation of several cognitive functions (memory, attention, perception, speech). The second category includes instruments for the specific assessment of the cognitive status, namely specific tests for one cognitive domain (for example, memory, speech flow, naming). The third category consists of methods which are based on the clinical evaluation during the interview with the patient and his familiars, giving emphasis on the frontal functions of the patient. Finally, the fourth group includes instruments which assess the executive functions of the patients. There is a great need for the development of more studies for the methods/instruments with which the cognitive functions of patients with probable dementia can be assessed during the evaluation of the legal capacity of these patients. The challenge for the scientists is to develop a clinically applicable instrument for the quick and reliable assessment of the legal capacity of people with dementia. The assessment of this ability should be done in relation with the needs, the feelings and the values of the patient.

Benefits of Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis

PubMed Central

Swigris, Jeffrey J.; Fairclough, Diane L.; Morrison, Marianne; Make, Barry; Kozora, Elizabeth; Brown, Kevin K.; Wamboldt, Frederick S.

2013-01-01

BACKGROUND Information on the benefits of pulmonary rehabilitation (PR) in patients with idiopathic pulmonary fibrosis (IPF) is growing, but PR’s effects on certain important outcomes is lacking. METHODS We conducted a pilot study of PR in IPF and analyzed changes in functional capacity, fatigue, anxiety, depression, sleep, and health status from baseline to after completion of a standard, 6-week PR program. RESULTS Six-min walk distance improved a mean ± standard error 202 ± 135 feet (P = .01) from baseline. Fatigue Severity Scale score also improved significantly, declining an average 1.5 ± 0.5 points from baseline. There were trends toward improvement in anxiety, depression, and health status. CONCLUSIONS PR improves functional capacity and fatigue in patients with IPF. (ClinicalTrials.gov registration NCT00692796.) PMID:21333082

Water homeostasis, frailty and congnitive function in the nursing home

USDA-ARS?s Scientific Manuscript database

The goal of this study is to develop and test a practical clinical method to assess frailty in nursing homes and to investigate the relationship between cognitive status of the elderly and the balance between water compartments of their body composition. This is a cross-sectional study, conducted a...

eMethylsorb: electrochemical quantification of DNA methylation at CpG resolution using DNA-gold affinity interactions.

PubMed

Sina, Abu Ali Ibn; Howell, Sidney; Carrascosa, Laura G; Rauf, Sakandar; Shiddiky, Muhammad J A; Trau, Matt

2014-11-07

We report a simple electrochemical method referred to as "eMethylsorb" for the detection of DNA methylation. The method relies on the base dependent affinity interaction of DNA with gold. The methylation status of DNA is quantified by monitoring the electrochemical current as a function of the relative adsorption level of bisulphite treated DNA samples onto a bare gold electrode. This method can successfully distinguish methylated and unmethylated epigenotypes at single CpG resolution.

Nutritional status according to Mini Nutritional Assessment is related to functional status in geriatric patients--independent of health status.

PubMed

Schrader, E; Baumgärtel, C; Gueldenzoph, H; Stehle, P; Uter, W; Sieber, C C; Volkert, D

2014-03-01

The aim of this study was to investigate the relationship between nutritional and functional status in acute geriatric patients including mobility and considering health status. Cross-sectional study. Hospital. 205 geriatric patients (median age 82.0 (IQR: 80-86) years, 69.3% women). Nutritional status was determined by Mini Nutritional Assessment (MNA) and patients were categorized as well-nourished (≥ 24 points), at risk of malnutrition (17-23.5 points) or as malnourished (< 17 points). Functional status was determined by Barthel Index (BI) and Timed 'Up and Go' Test (TUG) and related to MNA categories. Using binary multiple logistic regression the impact of nutritional status on functional status was examined, adjusted for health status. 60.3% of the patients were at risk of malnutrition and 29.8% were malnourished. Ability to perform basic activities of daily living (ADL) decreased with declining nutritional status. The proportion of patients unable to perform the TUG increased with worsening of nutritional status (45.0% vs. 50.4% vs. 77.0%, p<0.01). After adjusting for age, gender, number of diagnoses, disease severity and cognitive function, a higher MNA score significantly lowered the risk of being dependent in ADL (OR 0.85, 95 % CI 0.77-0.94) and inability to perform the TUG (OR 0.90, 95 % CI 0.82-0.99). Nutritional status according to MNA was related to ADL as well as to mobility in acute geriatric patients. This association remained after adjusting for health status.

a Heuristic Approach for Multi Objective Distribution Feeder Reconfiguration: Using Fuzzy Sets in Normalization of Objective Functions

NASA Astrophysics Data System (ADS)

Milani, Armin Ebrahimi; Haghifam, Mahmood Reza

2008-10-01

The reconfiguration is an operation process used for optimization with specific objectives by means of changing the status of switches in a distribution network. In this paper each objectives is normalized with inspiration from fuzzy sets-to cause optimization more flexible- and formulized as a unique multi-objective function. The genetic algorithm is used for solving the suggested model, in which there is no risk of non-liner objective functions and constraints. The effectiveness of the proposed method is demonstrated through the examples.

Association between social factors and performance during Functional Capacity Evaluations: a systematic review.

PubMed

Ansuategui Echeita, Jone; van Holland, Berry J; Gross, Douglas P; Kool, Jan; Oesch, Peter; Trippolini, Maurizio A; Reneman, Michiel F

2018-03-09

Determine the association of different social factors with Functional Capacity Evaluation (FCE) performance in adults. A systematic literature search was performed in MEDLINE, CINAHL, and PsycINFO electronic databases. Studies were eligible if they studied social factor's association with the performance of adults undergoing FCE. Studies were assessed on methodological quality and quality of evidence. The review was performed using best-evidence synthesis methods. Thirteen studies were eligible and 11 social factors were studied. Considerable heterogeneity regarding measurements, populations, and methods existed among the studies. High quality of evidence was found for the association of FCE performance with the country of FCE and examiner's fear behavior; moderate quality of evidence with previous job salary; and low or very low quality of evidence with compensation status, litigation status, type of instruction, time of day (workday), primary or mother language, and ethnicity. Other social factors were not studied. Evidence for associations of various social factors with FCE performance was found, but robust conclusions about the strength of the associations cannot be made. Quality of evidence ranged from high to very low. Further research on social factors, also within a biopsychosocial context, is necessary to provide a better understanding of FCE performance. Implications for Rehabilitation Research on Functional Capacity Evaluation (FCE) performance and its association with biopsychosocial factors have scarcely addressed the impact of social factors, limiting full understanding of FCE results. The social factors, healthcare (examiner's fear behavior and type of instruction), personal or cultural systems (country of FCE, primary or mother language, and ethnicity), workplace system (previous job salary, time of day (workday)), and legislative and insurance system (compensation and litigation status), have a bearing in FCE performance. Better understanding of factors associating with functional capacity provide insights in FCE, allowing clinicians to improve the evaluations and interpretations of the assessment and better design the rehabilitation program. Better understanding of factors that influence FCE performance, and of unstudied factors, will allow researchers guidance to further investigate the construct of functional capacity.

Branched-chain amino acids to tyrosine ratio value as a potential prognostic factor for hepatocellular carcinoma.

PubMed

Ishikawa, Toru

2012-05-07

The prognosis of hepatocellular carcinoma (HCC) depends on tumor extension as well as hepatic function. Hepatic functional reserve is recognized as a factor affecting survival in the treatment of HCC; the Child-Pugh classification system is the most extensively used method for assessing hepatic functional reserve in patients with chronic liver disease, using serum albumin level to achieve accurate assessment of the status of protein metabolism. However, insufficient attention has been given to the status of amino acid (AA) metabolism in chronic liver disease and HCC. Fischer's ratio is the molar ratio of branched-chain AAs (BCAAs: leucine, valine, isoleucine) to aromatic AAs (phenylalanine, tyrosine) and is important for assessing liver metabolism, hepatic functional reserve and the severity of liver dysfunction. Although this ratio is difficult to determine in clinical situations, BCAAs/tyrosine molar concentration ratio (BTR) has been proposed as a simpler substitute. BTR correlates with various liver function examinations, including markers of hepatic fibrosis, hepatic blood flow and hepatocyte function, and can thus be considered as reflecting the degree of hepatic impairment. This manuscript examines the literature to clarify whether BTR can serve as a prognostic factor for treatment of HCC.

Evidence for a Cystic Fibrosis Enteropathy

PubMed Central

Adriaanse, Marlou P. M.; van der Sande, Linda J. T. M.; van den Neucker, Anita M.; Menheere, Paul P. C. A.; Dompeling, Edward; Buurman, Wim A.; Vreugdenhil, Anita C. E.

2015-01-01

Background Previous studies have suggested the existence of enteropathy in cystic fibrosis (CF), which may contribute to intestinal function impairment, a poor nutritional status and decline in lung function. This study evaluated enterocyte damage and intestinal inflammation in CF and studied its associations with nutritional status, CF-related morbidities such as impaired lung function and diabetes, and medication use. Methods Sixty-eight CF patients and 107 controls were studied. Levels of serum intestinal-fatty acid binding protein (I-FABP), a specific marker for enterocyte damage, were retrospectively determined. The faecal intestinal inflammation marker calprotectin was prospectively studied. Nutritional status, lung function (FEV1), exocrine pancreatic insufficiency (EPI), CF-related diabetes (CFRD) and use of proton pump inhibitors (PPI) were obtained from the medical charts. Results Serum I-FABP levels were elevated in CF patients as compared with controls (p<0.001), and correlated negatively with FEV1 predicted value in children (r-.734, p<0.05). Faecal calprotectin level was elevated in 93% of CF patients, and correlated negatively with FEV1 predicted value in adults (r-.484, p<0.05). No correlation was found between calprotectin levels in faeces and sputum. Faecal calprotectin level was significantly associated with the presence of CFRD, EPI, and PPI use. Conclusion This study demonstrated enterocyte damage and intestinal inflammation in CF patients, and provides evidence for an inverse correlation between enteropathy and lung function. The presented associations of enteropathy with important CF-related morbidities further emphasize the clinical relevance. PMID:26484665

Executive Function Subcomponents and their Relations to Everyday Functioning in Healthy Older Adults

PubMed Central

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2016-01-01

Everyday functioning and its executive functioning cognitive correlates (i.e., switching, inhibition, and updating) were investigated in healthy older adults (HOAs) using multiple methods of functional status. In addition to whether computerized experimental tasks would better dissociate these subcomponents than neuropsychological measures of executive functioning, we were also interested in the contributions of both experimental and neuropsychological measures of executive function subcomponents to functional abilities. Seventy HOAs (45 young-old and 25 old-old) and 70 younger adults completed executive function and neuropsychological tests. In addition to self- and informant questionnaires of functional abilities, HOAs completed two performance-based measures. An aging effect was found on all executive function measures. Old-old older adults and their informants did not report more functional difficulties but demonstrated more difficulties on performance-based measures relative to young-old participants. For the HOAs, after controlling for age and education, the neuropsychological measures of executive functioning, but not experimental measures, explained a significant amount of variance in the informant-report and both performance-based measures. Updating measures differentially predicted performance-based measures, while switching was important for questionnaire and performance-based measures. The contribution of executive functioning to functional status when measured with experimental measures specifically designed to isolate the executive subcomponent was not as strong as hypothesized. Further research examining the value of isolating executive function subcomponents in neuropsychological assessment and the prediction of functional abilities in older adults is warranted. PMID:27206842

Executive function subcomponents and their relations to everyday functioning in healthy older adults.

PubMed

McAlister, Courtney; Schmitter-Edgecombe, Maureen

2016-10-01

Everyday functioning and its executive functioning cognitive correlates (i.e., switching, inhibition, and updating) were investigated in healthy older adults (HOAs) using multiple methods of functional status. In addition to whether computerized experimental tasks would better dissociate these subcomponents than neuropsychological measures of executive functioning, we were also interested in the contributions of both experimental and neuropsychological measures of executive function subcomponents to functional abilities. Seventy HOAs (45 young-old and 25 old-old) and 70 younger adults completed executive function and neuropsychological tests. In addition to self- and informant questionnaires of functional abilities, HOAs completed two performance-based measures. An aging effect was found on all executive function measures. Old-old older adults and their informants did not report more functional difficulties but demonstrated more difficulties on performance-based measures than did young-old participants. For the HOAs, after controlling for age and education, the neuropsychological measures of executive functioning, but not experimental measures, explained a significant amount of variance in the informant-report and both performance-based measures. Updating measures differentially predicted performance-based measures, while switching was important for questionnaire and performance-based measures. The contribution of executive functioning to functional status when measured with experimental measures specifically designed to isolate the executive subcomponent was not as strong as hypothesized. Further research examining the value of isolating executive function subcomponents in neuropsychological assessment and the prediction of functional abilities in older adults is warranted.

Measurement of Exercise Tolerance before Surgery (METS) study: a protocol for an international multicentre prospective cohort study of cardiopulmonary exercise testing prior to major non-cardiac surgery.

PubMed

Wijeysundera, Duminda N; Pearse, Rupert M; Shulman, Mark A; Abbott, Tom E F; Torres, Elizabeth; Croal, Bernard L; Granton, John T; Thorpe, Kevin E; Grocott, Michael P W; Farrington, Catherine; Myles, Paul S; Cuthbertson, Brian H

2016-03-11

Preoperative functional capacity is considered an important risk factor for cardiovascular and other complications of major non-cardiac surgery. Nonetheless, the usual approach for estimating preoperative functional capacity, namely doctors' subjective assessment, may not accurately predict postoperative morbidity or mortality. 3 possible alternatives are cardiopulmonary exercise testing; the Duke Activity Status Index, a standardised questionnaire for estimating functional capacity; and the serum concentration of N-terminal pro-B-type natriuretic peptide (NT pro-BNP), a biomarker for heart failure and cardiac ischaemia. The Measurement of Exercise Tolerance before Surgery (METS) Study is a multicentre prospective cohort study of patients undergoing major elective non-cardiac surgery at 25 participating study sites in Australia, Canada, New Zealand and the UK. We aim to recruit 1723 participants. Prior to surgery, participants undergo symptom-limited cardiopulmonary exercise testing on a cycle ergometer, complete the Duke Activity Status Index questionnaire, undergo blood sampling to measure serum NT pro-BNP concentration and have their functional capacity subjectively assessed by their responsible doctors. Participants are followed for 1 year after surgery to assess vital status, postoperative complications and general health utilities. The primary outcome is all-cause death or non-fatal myocardial infarction within 30 days after surgery, and the secondary outcome is all-cause death within 1 year after surgery. Both receiver-operating-characteristic curve methods and risk reclassification table methods will be used to compare the prognostic accuracy of preoperative subjective assessment, peak oxygen consumption during cardiopulmonary exercise testing, Duke Activity Status Index scores and serum NT pro-BNP concentration. The METS Study has received research ethics board approval at all sites. Participant recruitment began in March 2013, and 1-year follow-up is expected to finish in 2016. Publication of the results of the METS Study is anticipated to occur in 2017. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Inferior vestibular neuritis: diagnosis using VEMP].

PubMed

Walther, L E; Repik, I

2012-02-01

Vestibular evoked myogenic potentials (VEMP) are a new method to establish the functional status of the otolith organs. The sacculocollic reflex of the cervical VEMP to air conduction (AC) reflects predominantly saccular function due to saccular afferents to the inferior vestibular nerve. We describe a case of inferior vestibular neuritis as a rare differential diagnosis of vestibular neuritis. Clinical signs were a normal caloric response, unilaterally absent AC cVEMPs and bilaterally preserved ocular VEMPs (AC oVEMPs).

County Variation in Children's and Adolescent's Health Status and School District Performance in California

PubMed Central

Jung, Sunyoung

2008-01-01

Objectives. We examined the association between county-level estimates of children's health status and school district performance in California. Methods. We used 3 data sources: the California Health Interview Survey, district archives from the California Department of Education, and census-based estimates of county demographic characteristics. We used logistic regression to estimate whether a school district's failure to meet adequate yearly progress goals in 2004 to 2005 was a function of child and adolescent's health status. Models included district- and county-level fixed effects and were adjusted for the clustering of districts within counties. Results. County-level changes in children's and adolescent's health status decreased the likelihood that a school district would fail to meet adequate yearly progress goals during the investigation period. Health status did not moderate the relatively poor performance of predominantly minority districts. Conclusions. We found empirical support that area variation in children's and adolescent's health status exerts a contextual effect on school district performance. Future research should explore the specific mechanisms through which area-level child health influences school and district achievement. PMID:18309137

Pre-fracture nutritional status is predictive of functional status at discharge during the acute phase with hip fracture patients: A multicenter prospective cohort study.

PubMed

Inoue, Tatsuro; Misu, Syogo; Tanaka, Toshiaki; Sakamoto, Hiroki; Iwata, Kentaro; Chuman, Yuki; Ono, Rei

2017-10-01

Malnutrition is common in patients with hip fractures, and elderly patients with hip fractures lose functional independence and often fail to recover previous functional status. The aim of this study was to determine whether pre-fracture nutritional status predicts functional status of patients with hip fracture at discharge from acute hospitals. In the present multicenter prospective cohort study, pre-fracture nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF). At discharge from acute hospitals, functional status was evaluated using a functional independent measurement instrument (FIM). Subsequently, multiple regression analyses were performed using FIM as the dependent variable and MNA-SF as the independent variable. Among the 204 patients analyzed in the present study, the mean length of hospital stay was 26.2 ± 12.6 days, and according to MNA-SF assessments, 51 (25.0%) patients were malnourished, 98 (48.0%) were at risk of malnutrition, and 55 (27.0%) were well-nourished before fracture. At discharge, FIM scores were higher in patients who were well-nourished than in those who were malnourished or were at risk of malnutrition (p < 0.01). After adjustment for confounding factors, multiple regression analyses showed that MNA-SF was a significant independent predictor for FIM at discharge (well-nourished vs. malnourished, β = -0.86, p < 0.01). Pre-fracture nutritional status was a significant independent predictor for functional status at discharge during the acute phase, warranting early assessment of nutritional status and early intervention for successful postoperative rehabilitation. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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

Kennedy, Colin, E-mail: crk1@soton.ac.uk; Bull, Kim; Chevignard, Mathilde

Purpose: To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial. Methods and Materials: Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded. Results: Data were provided by 151 ofmore » 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011). Conclusions: Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life.« less

The relation of education and cognitive activity to mini-mental state in old age: the role of functional fitness status.

PubMed

Ihle, Andreas; Gouveia, Élvio R; Gouveia, Bruna R; Freitas, Duarte L; Jurema, Jefferson; Ornelas, Rui T; Antunes, António M; Muniz, Bárbara R; Kliegel, Matthias

2018-06-01

It remains unclear so far whether the role of cognitive reserve for cognitive functioning in old age may differ between individuals with low, compared to those with high functional fitness status. Therefore, the present study set out to investigate the relation of education and cognitive leisure activity as key markers of cognitive reserve to mini-mental state in old age (as an indicator of the extent of cognitive impairment) and its interplay with functional fitness status in a large sample of older adults. We assessed MMSE in 701 older adults ( M  = 70.4 years, SD = 6.9, range: 60-91). We measured functional fitness status using the Senior Fitness Test battery and interviewed individuals on their education and cognitive leisure activity. Results showed that better functional fitness status, longer education, and greater engagement in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education and cognitive leisure activity to MMSE scores were significantly larger in individuals with low, compared to those with high functional fitness status. In conclusion, cognitive functioning in old age may more strongly depend on cognitive reserve accumulated during the life course in older adults with low, compared to those with high functional fitness status. These findings may be explained by cross-domain compensation effects in vulnerable individuals and may (at least partly) account for the large variability in cognitive reserve-cognition relations debated in the literature.

Obstructive Sleep Apnea is Related to Impaired Cognitive and Functional Status after Stroke.

PubMed

Aaronson, Justine A; van Bennekom, Coen A M; Hofman, Winni F; van Bezeij, Tijs; van den Aardweg, Joost G; Groet, Erny; Kylstra, Wytske A; Schmand, Ben

2015-09-01

Obstructive sleep apnea (OSA) is a common sleep disorder in stroke patients and is associated with prolonged hospitalization, decreased functional outcome, and recurrent stroke. Research on the effect of OSA on cognitive functioning following stroke is scarce. The primary objective of this study was to compare stroke patients with and without OSA on cognitive and functional status upon admission to inpatient rehabilitation. Case-control study. 147 stroke patients admitted to a neurorehabilitation unit. N/A. All patients underwent sleep examination for diagnosis of OSA. We assessed cognitive status by neuropsychological examination and functional status by two neurological scales and a measure of functional independence. We included 80 stroke patients with OSA and 67 stroke patients without OSA. OSA patients were older and had a higher body mass index than patients without OSA. OSA patients performed worse on tests of attention, executive functioning, visuoperception, psychomotor ability, and intelligence than those without OSA. No differences were found for vigilance, memory, and language. OSA patients had a worse neurological status, lower functional independence scores, and a longer period of hospitalization in the neurorehabilitation unit than the patients without OSA. OSA status was not associated with stroke type or classification. Obstructive sleep apnea (OSA) is associated with a lower cognitive and functional status in patients admitted for stroke rehabilitation. This underlines the importance of OSA as a probable prognostic factor, and calls for well-designed randomized controlled trials to study its treatability. © 2015 Associated Professional Sleep Societies, LLC.

Expression and sub-cellular localization of an epigenetic regulator, co-activator arginine methyltransferase 1 (CARM1), is associated with specific breast cancer subtypes and ethnicity

PubMed Central

2013-01-01

Background Co-Activator Arginine Methyltransferase 1(CARM1) is an Estrogen Receptor (ER) cofactor that remodels chromatin for gene regulation via methylation of Histone3. We investigated CARM1 levels and localization across breast cancer tumors in a cohort of patients of either European or African ancestry. Methods We analyzed CARM1 levels using tissue microarrays with over 800 histological samples from 549 female cancer patients from the US and Nigeria, Africa. We assessed associations between CARM1 expression localized to the nucleus and cytoplasm for 11 distinct variables, including; ER status, Progesterone Receptor status, molecular subtypes, ethnicity, HER2+ status, other clinical variables and survival. Results We found that levels of cytoplasmic CARM1 are distinct among tumor sub-types and increased levels are associated with ER-negative (ER-) status. Higher nuclear CARM1 levels are associated with HER2 receptor status. EGFR expression also correlates with localization of CARM1 into the cytoplasm. This suggests there are distinct functions of CARM1 among molecular tumor types. Our data reveals a basal-like subtype association with CARM1, possibly due to expression of Epidermal Growth Factor Receptor (EGFR). Lastly, increased cytoplasmic CARM1, relative to nuclear levels, appear to be associated with self-identified African ethnicity and this result is being further investigated using quantified genetic ancestry measures. Conclusions Although it is known to be an ER cofactor in breast cancer, CARM1 expression levels are independent of ER. CARM1 has distinct functions among molecular subtypes, as is indicative of its sub-cellular localization and it may function in subtype etiology. These sub-cellular localization patterns, indicate a novel role beyond its ER cofactor function in breast cancer. Differential localization among ethnic groups may be due to ancestry-specific polymorphisms which alter the gene product. PMID:23663560

Health Outcomes Associated with Self-Reported Vision Impairment in Older Adults

ERIC Educational Resources Information Center

Steinman, Bernard A.

2016-01-01

Introduction: To compare the health status of older adults with and without vision impairment, this study employed a disability framework consisting of four stages, progressing from risk factors; through pathology and impairments that result in declining functioning; and eventually to disability. Methods: Data from five rounds (1999 to 2008) of…

The current status and portability of our sequence handling software.

PubMed Central

Staden, R

1986-01-01

I describe the current status of our sequence analysis software. The package contains a comprehensive suite of programs for managing large shotgun sequencing projects, a program containing 61 functions for analysing single sequences and a program for comparing pairs of sequences for similarity. The programs that have been described before have been improved by the addition of new functions and by being made very much easier to use. The major interactive programs have 125 pages of online help available from within them. Several new programs are described including screen editing of aligned gel readings for shotgun sequencing projects; a method to highlight errors in aligned gel readings, new methods for searching for putative signals in sequences. We use the programs on a VAX computer but the whole package has been rewritten to make it easy to transport it to other machines. I believe the programs will now run on any machine with a FORTRAN77 compiler and sufficient memory. We are currently putting the programs onto an IBM PC XT/AT and another micro running under UNIX. PMID:3511446

Gas chromatography-mass spectrometry of biofluids and extracts.

PubMed

Emwas, Abdul-Hamid M; Al-Talla, Zeyad A; Yang, Yang; Kharbatia, Najeh M

2015-01-01

Gas chromatography-mass spectrometry (GC-MS) has been widely used in metabonomics analyses of biofluid samples. Biofluids provide a wealth of information about the metabolism of the whole body and from multiple regions of the body that can be used to study general health status and organ function. Blood serum and blood plasma, for example, can provide a comprehensive picture of the whole body, while urine can be used to monitor the function of the kidneys, and cerebrospinal fluid (CSF) will provide information about the status of the brain and central nervous system (CNS). Different methods have been developed for the extraction of metabolites from biofluids, these ranging from solvent extracts, acids, heat denaturation, and filtration. These methods vary widely in terms of efficiency of protein removal and in the number of metabolites extracted. Consequently, for all biofluid-based metabonomics studies, it is vital to optimize and standardize all steps of sample preparation, including initial extraction of metabolites. In this chapter, recommendations are made of the optimum experimental conditions for biofluid samples for GC-MS, with a particular focus on blood serum and plasma samples.

The Association Between Childhood Emotional Functioning and Adulthood Inflammation Is Modified by Early-Life Socioeconomic Status

PubMed Central

Appleton, Allison A.; McCormick, Marie C.; Loucks, Eric B.; Buka, Stephen L.; Koenen, Karestan C.; Kubzansky, Laura D.

2013-01-01

Objective Identifying interrelationships among childhood social disadvantage, emotional functioning and adult health may help illustrate how health disparities may become embedded early in life, yet few have considered how these factors are associated. We examined whether the association of child emotional functioning and adult health risk was modified by child socioeconomic status (CSES), or whether child emotional functioning mediated the association of CSES and adult health risk. Method We studied 430 adult offspring (mean age 42 years) of Collaborative Perinatal Project participants, a cohort of pregnant women enrolled in 1959–1966 (Broman, Nichols, & Kennedy, 1975; Niswander & Gordon, 1972). Child emotional functioning was assessed by psychologist ratings at age 7 and included inappropriate self regulation (ISR) and distress proneness. CSES measures included parental education, household income, and parental occupation. Adult health risk was measured by the inflammatory marker C-reactive protein (CRP). Hypotheses were tested with multiple linear regression. Effect modification was evaluated via interaction terms and stratification of fully adjusted models by CSES. Mediation by child emotional functioning was evaluated via coefficient changes. Results There was no evidence that child emotional functioning mediated the association of CSES and CRP. Significant interactions were observed for ISR and low income (b = 1.67, SE = 0.70, p < .05), and distress proneness and low (b = 3.14, SE = 1.47, p < .05) and middle (b = 3.52, SE = 1.46, p < .05) income. Stratified models indicated that associations of child emotion with CRP varied significantly by level of parental education, household income and occupation. Conclusion The highest levels of adult inflammation were observed among those with childhood emotional problems who were also exposed to low socioeconomic status as children. This study suggests adulthood disparities in CRP may have developmental origins in childhood adversity. PMID:22329424

Assessment of the nutritional status of the elderly and its correlates.

PubMed

Agarwalla, Rashmi; Saikia, Anku Moni; Baruah, Rupali

2015-01-01

The percentage of elderly is growing rapidly and malnutrition is not uncommon in the elderly. The present study was carried out to assess the nutritional status of the elderly using the Mini Nutritional Assessment (MNA) tool, and to study the various epidemiological factors influencing their nutritional status. This cross-sectional study was done from July 2012 to August 2013 in Boko-Bongaon Block, Kamrup District, Assam, India. The elderly, those over 60 years of age, who met the inclusion criteria participated in the study. A total of 30 clusters were selected and 12 elderly from each cluster were taken to achieve the desired sample size of 360. Nutritional status was assessed by the MNA tool and a 24-h dietary recall method. Out of the total of 360 elderly persons, 15% were found to be malnourished and 55% were at risk of malnutrition. The association between nutritional status and older age group, female gender, dependent functional status, dependent financial status and inadequate calorie intake was found to be significant. The present findings reveal that malnutrition is not an uncommon problem in the elderly, and further studies are needed in this regard.

Information technologies in optimization process of monitoring of software and hardware status

NASA Astrophysics Data System (ADS)

Nikitin, P. V.; Savinov, A. N.; Bazhenov, R. I.; Ryabov, I. V.

2018-05-01

The article describes a model of a hardware and software monitoring system for a large company that provides customers with software as a service (SaaS solution) using information technology. The main functions of the monitoring system are: provision of up-todate data for analyzing the state of the IT infrastructure, rapid detection of the fault and its effective elimination. The main risks associated with the provision of these services are described; the comparative characteristics of the software are given; author's methods of monitoring the status of software and hardware are proposed.

[Molecular imaging; current status and future prospects in USA].

PubMed

Kobayashi, Hisataka

2007-02-01

The goal of this review is to introduce the definition, current status, and future prospects of the molecular imaging, which has recently been a hot topic in medicine and the biological science in USA. In vivo imaging methods to visualize the molecular events and functions in organs or animals/humans are overviewed and discussed especially in combinations of imaging modalities (machines) and contrast agents(chemicals) used in the molecular imaging. Next, the close relationship between the molecular imaging and the nanotechnology, an important part of nanomedicine, is stressed from the aspect of united multidisciplinary sciences such as physics, chemistry, biology, and medicine.

Functional health status of adolescents after the Fontan procedure -- comparison with their siblings.

PubMed

Manlhiot, Cedric; Knezevich, Stevan; Radojewski, Elizabeth; Cullen-Dean, Geraldine; Williams, William G; McCrindle, Brian W

2009-09-01

Studies have suggested that patients who have undergone the Fontan procedure experience lower functional health status and diminished exercise capacity compared with other children. To compare the functional health status of Fontan patients with and without siblings, assess whether there are any differences between Fontan patients and their siblings, and determine associated factors. A cross-sectional, single-centre, observational study was performed on Fontan patients 10 to 20 years of age, and their sibling closest in age, followed in a tertiary pediatric hospital. Functional health status was measured by the Child Health Questionnaire Child Form and the Pediatric Quality of Life Inventory. A total of 68 patients and 38 siblings were enrolled. Patients with siblings scored significantly lower on numerous domains of physical functional status than those without siblings. Compared with their matched siblings, Fontan patients reported significantly lower scores in all domains of the Pediatric Quality of Life Inventory and on physical (but not psychosocial) domains of the Child Health Questionnaire Child Form. Factors associated with increased patient-sibling differences included younger patient age, female sex, intracardiac lateral tunnel Fontan connection and lower ejection fraction at the time of study enrollment. Adolescents with Fontan physiology reported a lower functional health status in physical domains than their siblings, but had similar status in psychosocial domains. Having a sibling was associated with lower reported functional health status, suggesting an important effect of self-perceived physical limitations over true limitations.

Facial Transplantation Surgery Introduction

PubMed Central

2015-01-01

Severely disfiguring facial injuries can have a devastating impact on the patient's quality of life. During the past decade, vascularized facial allotransplantation has progressed from an experimental possibility to a clinical reality in the fields of disease, trauma, and congenital malformations. This technique may now be considered a viable option for repairing complex craniofacial defects for which the results of autologous reconstruction remain suboptimal. Vascularized facial allotransplantation permits optimal anatomical reconstruction and provides desired functional, esthetic, and psychosocial benefits that are far superior to those achieved with conventional methods. Along with dramatic improvements in their functional statuses, patients regain the ability to make facial expressions such as smiling and to perform various functions such as smelling, eating, drinking, and speaking. The ideas in the 1997 movie "Face/Off" have now been realized in the clinical field. The objective of this article is to introduce this new surgical field, provide a basis for examining the status of the field of face transplantation, and stimulate and enhance facial transplantation studies in Korea. PMID:26028914

Facial transplantation surgery introduction.

PubMed

Eun, Seok-Chan

2015-06-01

Severely disfiguring facial injuries can have a devastating impact on the patient's quality of life. During the past decade, vascularized facial allotransplantation has progressed from an experimental possibility to a clinical reality in the fields of disease, trauma, and congenital malformations. This technique may now be considered a viable option for repairing complex craniofacial defects for which the results of autologous reconstruction remain suboptimal. Vascularized facial allotransplantation permits optimal anatomical reconstruction and provides desired functional, esthetic, and psychosocial benefits that are far superior to those achieved with conventional methods. Along with dramatic improvements in their functional statuses, patients regain the ability to make facial expressions such as smiling and to perform various functions such as smelling, eating, drinking, and speaking. The ideas in the 1997 movie "Face/Off" have now been realized in the clinical field. The objective of this article is to introduce this new surgical field, provide a basis for examining the status of the field of face transplantation, and stimulate and enhance facial transplantation studies in Korea.

Relationships Between Changes in Patient-Reported Health Status and Functional Capacity in Outpatients With Heart Failure

PubMed Central

Flynn, Kathryn E.; Lin, Li; Moe, Gordon W.; Howlett, Jonathan G.; Fine, Lawrence J.; Spertus, John A.; McConnell, Timothy R.; Piña, Ileana L.; Weinfurt, Kevin P.

2011-01-01

Background Heart failure trials use a variety of measures of functional capacity and quality of life. Lack of formal assessments of the relationships between changes in multiple aspects of patient-reported health status and measures of functional capacity over time limit the ability to compare results across studies. Methods Using data from HF-ACTION (N = 2331), we used Pearson correlation coefficients and predicted change scores from linear mixed-effects modeling to demonstrate associations between changes in patient-reported health status measured with the EQ-5D visual analog scale (VAS) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) and changes in peak VO2 and 6-minute walk distance at 3 and 12 months. We examined a 5-point change in KCCQ within individuals to provide a framework for interpreting changes in these measures. Results After adjustment for baseline characteristics, correlations between changes in the VAS and changes in peak VO2 and 6-minute walk distance ranged from 0.13 to 0.28, and correlations between changes in the KCCQ overall and subscale scores and changes in peak VO2 and 6-minute walk distance ranged from 0.18 to 0.34. A 5-point change in KCCQ was associated with a 2.50 ml/kg/min change in peak VO2 (95% confidence interval, 2.21–2.86) and a 112-meter change in 6-minute walk distance (95% confidence interval, 96–134). Conclusions Changes in patient-reported health status are not highly correlated with changes in functional capacity. Our findings generally support the current practice of considering a 5-point change in the KCCQ within individuals to be clinically meaningful. Trial Registration clinicaltrials.gov Identifier: NCT00047437 PMID:22172441

Clinical and demographic characteristics and functional status of the patients with fibromyalgia syndrome

PubMed Central

Sahin, Nilay; Atik, Aziz; Dogan, Erdal

2014-01-01

OBJECTIVE: To investigate the clinical and demographic characteristics and functional status of the patients with fibromyalgia syndrome (FMS). METHODS: Ninety-four patients with the diagnosis of FMS were included in the study. All patients were evaluated with short form 36 for quality of life (SF-36), pain, depression, benign joint hypermobility syndrome (BJHS), myofacial pain syndrome (MPS), and demogrophic characteristics. End-point measurements were SF-36 for quality of life, visual analogue scale, Beck Depression Index, anamnesis, and physical examination. RESULTS: The majority of the patients were women who were suffering from generalised pain with a median age of 40.4. Mostly depression and sleep disorders were accompanying the syndrome. Physical examination revealed MPS and BJHS in most of the patients. CONCLUSION: BJHS and MPS must also be investigated in patients with the diagnosis of FMS. PMID:28058309

Longitudinal construct validity: establishment of clinical meaning in patient evaluative instruments.

PubMed

Liang, M H

2000-09-01

Although widely used and reported in research for the evaluation of groups, measures of health status and health-related quality of life have had little application in clinical practice for the assessment of individual patients. One of the principal barriers is the demonstration that these measures add clinically significant information to measures of function or symptoms alone. Here, we review the methods for evaluation of construct validity in longitudinal studies and make recommendations for nomenclature, reporting of study results, and future research agenda. Analytical review. The terms "sensitivity" and "responsiveness" have been used interchangeably, and there are few studies that evaluate the extent to which health status or health-related quality-of life measures capture clinically important changes ("responsiveness"). Current methods of evaluating responsiveness are not standardized or evaluated. Approaches for the assessment of a clinically significant or meaningful change are described; rather than normative information, however, standardized transition questions are proposed. They would be reported routinely and as separate axes of description to capture individual perceptions. Research in methods to assess the subject's evaluation of the importance and magnitude of a measured change are critical if health status and health-related quality-of-life measures are to have an impact on patient care.

Variation in Major Depressive Disorder Onset by Place of Origin Among U.S. Latinos.

PubMed

Lee, Sungkyu; Park, Yangjin

2017-09-01

Using a nationally representative sample of 2514 U.S. Latinos, this study examined the extent to which major depressive disorder (MDD) onset differs by place of origin and the factors associated with it. The Kaplan-Meier method estimated the survival and hazard functions for MDD onset by place of origin, and Cox proportional hazards models identified its associative factors. Approximately 13% of the sample had experienced MDD in their lifetimes. Cuban respondents showed the highest survival function, while Puerto Ricans showed the lowest. With the entire sample, the smoothed hazard function showed that the risk of MDD onset peaked in the late 20s and early 80s. Puerto Rican respondents showed the highest risk of MDD during their 20s and 30s, whereas Cuban respondents showed a relatively stable pattern over time. The results from the Cox proportional hazards model indicated that age, sex, and marital status were significantly related to MDD onset (p < .05). In addition, the effect of U.S.-born status on MDD onset was greater among Mexican respondents than among Puerto Ricans. Findings from the present study demonstrate that different Latino subgroups experience different and unique patterns of MDD onset over time. Future research should account for the role of immigration status in examining MDD onset.

Validation of the Malay Version of the Inventory of Functional Status after Childbirth Questionnaire

PubMed Central

Noor, Norhayati Mohd; Aziz, Aniza Abd.; Mostapa, Mohd Rosmizaki; Awang, Zainudin

2015-01-01

Objective. This study was designed to examine the psychometric properties of Malay version of the Inventory of Functional Status after Childbirth (IFSAC). Design. A cross-sectional study. Materials and Methods. A total of 108 postpartum mothers attending Obstetrics and Gynaecology Clinic, in a tertiary teaching hospital in Malaysia, were involved. Construct validity and internal consistency were performed after the translation, content validity, and face validity process. The data were analyzed using Analysis of Moment Structure version 18 and Statistical Packages for the Social Sciences version 20. Results. The final model consists of four constructs, namely, infant care, personal care, household activities, and social and community activities, with 18 items demonstrating acceptable factor loadings, domain to domain correlation, and best fit (Chi-squared/degree of freedom = 1.678; Tucker-Lewis index = 0.923; comparative fit index = 0.936; and root mean square error of approximation = 0.080). Composite reliability and average variance extracted of the domains ranged from 0.659 to 0.921 and from 0.499 to 0.628, respectively. Conclusion. The study suggested that the four-factor model with 18 items of the Malay version of IFSAC was acceptable to be used to measure functional status after childbirth because it is valid, reliable, and simple. PMID:25667932

A New Paradigm of Technology-Enabled ‘Vital Signs’ for Early Detection of Health Change for Older Adults.

PubMed

Rantz, Marilyn J; Skubic, Marjorie; Popescu, Mihail; Galambos, Colleen; Koopman, Richelle J; Alexander, Gregory L; Phillips, Lorraine J; Musterman, Katy; Back, Jessica; Miller, Steven J

2015-01-01

Environmentally embedded (nonwearable) sensor technology is in continuous use in elder housing to monitor a new set of ‘vital signs' that continuously measure the functional status of older adults, detect potential changes in health or functional status, and alert healthcare providers for early recognition and treatment of those changes. Older adult participants' respiration, pulse, and restlessness are monitored as they sleep. Gait speed, stride length, and stride time are calculated daily, and automatically assess for increasing fall risk. Activity levels are summarized and graphically displayed for easy interpretation. Falls are detected when they occur and alerts are sent immediately to healthcare providers, so time to rescue may be reduced. Automated health alerts are sent to healthcare staff, based on continuously running algorithms applied to the sensor data, days and weeks before typical signs or symptoms are detected by the person, family members, or healthcare providers. Discovering these new functional status ‘vital signs', developing automated methods for interpreting them, and alerting others when changes occur have the potential to transform chronic illness management and facilitate aging in place through the end of life. Key findings of research in progress at the University of Missouri are discussed in this viewpoint article, as well as obstacles to widespread adoption.

Biomarkers of Nutrition for Development (BOND)—Vitamin A Review1234

PubMed Central

Tanumihardjo, Sherry A; Russell, Robert M; Stephensen, Charles B; Craft, Neal E; Haskell, Marjorie J; Lietz, Georg; Schulze, Kerry; Raiten, Daniel J

2016-01-01

The Biomarkers of Nutrition for Development (BOND) project is designed to provide evidence-informed advice to anyone with an interest in the role of nutrition in health. The BOND program provides information with regard to selection, use, and interpretation of biomarkers of nutrient exposure, status, function, and effect, which will be especially useful for readers who want to assess nutrient status. To accomplish this objective, expert panels are recruited to evaluate the literature and to draft comprehensive reports on the current state of the art with regard to specific nutrient biology and available biomarkers for assessing nutritional status at the individual and population levels. Phase I of the BOND project includes the evaluation of biomarkers for 6 nutrients: iodine, folate, zinc, iron, vitamin A, and vitamin B-12. This review of vitamin A is the current article in this series. Although the vitamin was discovered >100 y ago, vitamin A status assessment is not trivial. Serum retinol concentrations are under homeostatic control due in part to vitamin A’s use in the body for growth and cellular differentiation and because of its toxic properties at high concentrations. Furthermore, serum retinol concentrations are depressed during infection and inflammation because retinol-binding protein (RBP) is a negative acute-phase reactant, which makes status assessment challenging. Thus, this review describes the clinical and functional indicators related to eye health and biochemical biomarkers of vitamin A status (i.e., serum retinol, RBP, breast-milk retinol, dose-response tests, isotope dilution methodology, and serum retinyl esters). These biomarkers are then related to liver vitamin A concentrations, which are usually considered the gold standard for vitamin A status. With regard to biomarkers, future research questions and gaps in our current understanding as well as limitations of the methods are described. PMID:27511929

Asexuality Development among Middle Aged and Older Men

PubMed Central

Huang, Yan-Ping; Chen, Bin; Ping, Ping; Wang, Hong-Xiang; Hu, Kai; Yang, Hao; Zhang, Tao; Feng, Tan; Jin, Yan; Han, Yin-Fa; Wang, Yi-Xin; Huang, Yi-Ran

2014-01-01

Objectives To assess erectile function in middle-aged and older men with asexuality status and further analyze their specific reasons for this condition. Subjects and Methods Men who had regular sexual intercourse attempts (sex frequency≥1 time per month) were classified into mild erectile dysfunction (ED), moderate to severe ED and non-ED according to International Index of Erectile Function-5, and men having no sexual intercourse attempts for at least 6 months were defined as having an asexuality status. The risk factors associated with ED were collected in a sample of 1,531 Chinese men aged 40 to 80 years, and the self-report reasons for asexuality were recorded in asexual cohort individually. Comparative analyses and multivariate regression models were conducted among these groups. Results The prevalence rates of ED and asexuality status were 49.9% and 37.2%. The asexuality status group had higher risk factors than the moderate to severe ED group in terms of old age (age≥65, adjusted odds ratio (OR) 17.69 versus (Vs.) 7.19), diabetes (crude OR: 2.40 Vs. 2.36) and hypertension (crude OR: 1.78 Vs. 1.72). The specific reasons for the asexuality status were “erectile difficulty” (52.9%), “do not care about sexuality” (53.5%)”, “no longer necessary to have sexuality at this age” (47.7%), “severe stress” (44.4%), “severe fatigue” (26.3%) and “masturbation” (26.9%). Conclusions Men with an asexual status suffer from higher risk factors for ED than men with moderate to severe ED. The majority of this asexual status could be attributed to a full ED, although the reasons for this transient asexuality also involved sexual attitudes and interests, sexual partners and masturbation. PMID:24667838

[Cognitive impairment, nutritional status and clinical profile in chronic obstructive pulmonary disease].

PubMed

López Torres, Isabel; Torres-Sánchez, Irene; Martín Salvador, Adelina; Ortiz Rubio, Araceli; Rodríguez Alzueta, Elisabeth; Valenza, Marie Carmen

2014-11-01

Chronic obstructive pulmonary disease (COPD) is a progressive disease with a prevalence that increases with the aging of the subject. It presents a high prevalence of comorbidities, such as cognitive decline, which is gaining great clinical relevance in recent years. Factors such as pulmonary function, hypoxemia, hypercapnia or exacerbations contribute to the decline of cognitive functions. The nutritional status has been added to these factors as contributing to cognitive function decline when presenting in COPD. To evidence the relationship between cognitive decline, nutritional status and the clinical profile of patients admitted because of an acute exacerbation of COPD (AECOPD). 110 subjects hospitalized because of COPD, divided in two groups according to their nutritional status and assessment of cognitive decline at admittance, nutritional status and clinical profile. Significant differences between groups concerning nutritional status in anthropometric variables (sex and IMC), functional ability (Barthel index and Daily Life Activities Scale), quality of life (Euroqol- 5D y SGRQ), sleep quality (Pittsburgh), mood (HAD) and cognitive decline (MoCa attention, MoCa abstraction). (p<0.05). Cognitive function is affected in COPD patients with an altered nutritional status when compared to those with a normal nutritional status. The nutritional decline is a factor contributing to the impairment of cognitive functions in this kind of patients, particularly a decline in attention and abstraction ability. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

[The influence of high-tone power therapy on the functional status of patients with multiple sclerosis].

PubMed

Kubsik, Anna; Klimkiewicz, Paulina; Klimkiewicz, Robert; Jankowska, Katarzyna; Jankowska, Agnieszka; Woldańska-Okońska, Marta

2014-07-01

Multiple sclerosis is a chronic, inflammatory, demyelinating disease of the central nervous system, which is characterized by diverse symptomatology. Most often affects people at a young age gradually leading to their disability. Looking for new therapies to alleviate neurological deficits caused by the disease. One of the alternative methods of therapy is high - tone power therapy. The article is a comparison of high-tone power therapy and kinesis in improving patients with multiple sclerosis. The aim of this study was to evaluate the effectiveness of high-tone power therapy and exercises in kinesis on the functional status of patients with multiple sclerosis. The study involved 20 patients with multiple sclerosis, both sexes, treated at the Department of Rehabilitation and Physical Medicine in Lodz. Patients were randomly divided into two groups studied. In group high-tone power therapy applied for 60 minutes, while in group II were used exercises for kinesis. Treatment time for both groups of patients was 15 days. To assess the functional status scale was used: Expanded Disability Status Scale of Kurtzke (EDSS), as well as by Barthel ADL Index. Assessment of quality of life were made using MSQOL Questionnaire-54. For the evaluation of gait and balance using Tinetti scale, and pain VAS rated, and Laitinen. Changes in muscle tone was assessed on the basis of the Ashworth scale. Both group I and II improved on scales conducted before and after therapy. In group I, in which the applied high-tone power therapy, reported statistically significant results in 9 out of 10 tested parameters, while in group II, which was used in the exercises in kinesis an improvement in 6 out of 10 tested parameters. Correlating the results of both the test groups in relation to each other did not show statistically significant differences. High-Tone Power Therapy beneficial effect on the functional status of patients with multiple sclerosis. Obtaining results in terms of number of tested parameters allows for the use of this therapy in the comprehensive improvement of patients with multiple sclerosis. Exercises from the scheme kinesis favorable impact on the functional status of patients with MS and are essential in the rehabilitation of these patients. In any group, no adverse effects were observed.

Biosynthetic Polymers as Functional Materials

PubMed Central

2016-01-01

The synthesis of functional polymers encoded with biomolecules has been an extensive area of research for decades. As such, a diverse toolbox of polymerization techniques and bioconjugation methods has been developed. The greatest impact of this work has been in biomedicine and biotechnology, where fully synthetic and naturally derived biomolecules are used cooperatively. Despite significant improvements in biocompatible and functionally diverse polymers, our success in the field is constrained by recognized limitations in polymer architecture control, structural dynamics, and biostabilization. This Perspective discusses the current status of functional biosynthetic polymers and highlights innovative strategies reported within the past five years that have made great strides in overcoming the aforementioned barriers. PMID:27375299

[Primary Study on Noninvasive Detection of Vascular Function Based on Finger Temperature Change].

PubMed

Dong, Qing; Li, Xia; Wan, Yungao; Lu, Gaoquan; Wang, Xinxin; Zhang, Kuan

2016-02-01

By studying the relationship between fingertip temperature changes and arterial function during vascular reactivity test, we established a new non-invasive method for detecting vascular function, in order to provide an assistance for early diagnosis and prevention of cardiovascular diseases. We customized three modules respectively for blood occlusion, measurement of finger temperature and blood oxygen acquisition, and then we established the hardware of data acquisition system. And the software was programmed with Labview. Healthy subjects [group A, n = 24, (44.6 ± 9.0) years] and subjects with cardiovascular diseases [group B, n = 33, (57.2 ± 9.9) years)] were chosen for the study. Subject's finger temperature, blood oxygen and occlusion pressure of block side during and after unilateral arm brachial artery occlusion were recorded, as well as some other regular physiological indexes. By time-domain analysis, we extracted 12 parameters from fingertip temperature signal, including the initial temperature (Ti), temperature rebound (TR), the time of the temperature recovering to initial status (RIt) and other parameters from the finger temperature signal. We in the experiment also measured other regular physiological body mass index (BMI), systolic blood pressure (SBP), diastiolic blood pressure (DBP) and so on. Results showed that 8 parameters difference between the two group of data were significant. based on the statistical results. A discriminant function of vascular function status was established afterwards. We found in the study that the changes of finger temperature during unilateral arms brachial artery occlusion and open were closely related to vascular function. We hope that the method presented in this article could lay a foundation of early detection of vascular function.

Factors affecting symptoms and functionality of patients with carpal tunnel syndrome: a retrospective study

PubMed Central

Yucel, Hulya

2015-01-01

[Purpose] The aim of this retrospective study was to determine the associations between clinical, physical, and neurophysiological outcomes and self-reported symptoms and functions of patients after surgical carpal tunnel release. [Subjects and Methods] Among 261 patients who had undergone open surgical carpal tunnel release within the last three years, 83 (mean age 50.27 ± 11.13 years) participated in this study. Their socio-demographics and comorbidities were recorded. The intensity of pain, paresthesia, and fatigue symptoms in the hand were assessed by means of a Visual Analogue Scale, the Semmes-Weinstein Monofilaments test of light touch pressure sensation, and Jamar dynamometry for measurement of grip and pinch strengths. The Boston Carpal Tunnel Questionnaire evaluated the severity of symptoms and hand functional status, and the variables were analyzed by multivariate linear regression. [Results] The severity of the symptoms and functional status of release surgery patients was associated with diabetes mellitus, migraine, night pain, paresthesia and fatigue symptoms, impaired light touch pressure, and lack of medical treatment. [Conclusion] Appropriate post-surgery treatment programs for these factors should be taken into consideration to help patients obtain optimal functionality and health in their daily lives. PMID:25995565

Computer integrated manufacturing/processing in the HPI. [Hydrocarbon Processing Industry

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

Yoshimura, J.S.

1993-05-01

Hydrocarbon Processing and Systemhouse Inc., developed a comprehensive survey on the status of computer integrated manufacturing/processing (CIM/CIP) targeted specifically to the unique requirements of the hydrocarbon processing industry. These types of surveys and other benchmarking techniques can be invaluable in assisting companies to maximize business benefits from technology investments. The survey was organized into 5 major areas: CIM/CIP planning, management perspective, functional applications, integration and technology infrastructure and trends. The CIM/CIP planning area dealt with the use and type of planning methods to plan, justify implement information technology projects. The management perspective section addressed management priorities, expenditure levels and implementationmore » barriers. The functional application area covered virtually all functional areas of organization and focused on the specific solutions and benefits in each of the functional areas. The integration section addressed the needs and integration status of the organization's functional areas. Finally, the technology infrastructure and trends section dealt with specific technologies in use as well as trends over the next three years. In February 1993, summary areas from preliminary results were presented at the 2nd International Conference on Productivity and Quality in the Hydrocarbon Processing Industry.« less

Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia

PubMed Central

Ascher-Svanum, Haya; Stensland, Michael; Zhao, Zhongyun; Kinon, Bruce J

2005-01-01

Background Previous research indicated that women are more vulnerable than men to adverse psychological consequences of weight gain. Other research has suggested that weight gain experienced during antipsychotic therapy may also psychologically impact women more negatively. This study assessed the impact of acute treatment-emergent weight gain on clinical and functional outcomes of patients with schizophrenia by patient gender and antipsychotic treatment (olanzapine or haloperidol). Methods Data were drawn from the acute phase (first 6-weeks) of a double-blind randomized clinical trial of olanzapine versus haloperidol in the treatment of 1296 men and 700 women with schizophrenia-spectrum disorders. The associations between weight change and change in core schizophrenia symptoms, depressive symptoms, and functional status were examined post-hoc for men and women and for each medication group. Core schizophrenia symptoms (positive and negative) were measured with the Brief Psychiatric Rating Scale (BPRS), depressive symptoms with the BPRS Anxiety/Depression Scale and the Montgomery-Asberg Depression Rating Scale, and functional status with the mental and physical component scores on the Medical Outcome Survey-Short Form 36. Statistical analysis included methods that controlled for treatment duration. Results Weight gain during 6-week treatment with olanzapine and haloperidol was significantly associated with improvements in core schizophrenia symptoms, depressive symptoms, mental functioning, and physical functioning for men and women alike. The conditional probability of clinical response (20% reduction in core schizophrenia symptom), given a clinically significant weight gain (at least 7% of baseline weight), showed that about half of the patients who lost weight responded to treatment, whereas three-quarters of the patients who had a clinically significant weight gain responded to treatment. The positive associations between therapeutic response and weight gain were similar for the olanzapine and haloperidol treatment groups. Improved outcomes were, however, more pronounced for the olanzapine-treated patients, and more olanzapine-treated patients gained weight. Conclusions The findings of significant relationships between treatment-emergent weight gain and improvements in clinical and functional status at 6-weeks suggest that patients who have greater treatment-emergent weight gain are more likely to benefit from treatment with olanzapine or haloperidol regardless of gender. PMID:15649317

The Relationship between Dignity Status and Quality of Life in Iranian Terminally Ill Patients with Cancer

PubMed Central

Hosseini, Abbas; Rezaei, Masoud; Bahrami, Masoud; Abbasi, Mohammad; Hariri, Hesammodin

2017-01-01

Background: Palliative care is an approach that has been used to care for terminally ill patients. The current study was performed to assess the association between the status of patient dignity and quality of life (QOL) in Iranian terminally ill patients with cancer. Materials and Methods: This descriptive correlational study was conducted on 210 end-stage cancer patients (102 men and 108 women) who were referred to Seyed Al-Shohada Hospital, Isfahan, Iran, in 2015. To assess dignity status, we used the Patient Dignity Inventory. The Persian version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was used for QOL assessment. Results: There was a significant negative association between total dignity status and QOL scales. In addition, significant negative relationship was observed between dignity-related domains (loss of worth sense: r = −0.50, P < 0.001; anxiety and uncertainty: r = −0.51, P < 0.001; symptom distress: r = −0.62, P < 0.001; and loss of autonomy: r = −0.61, P < 0.001) and functional scale and some subscales of the QOL scale. In contrast, a significant positive relationship was found between dignity-related domains, and total symptom scale and fatigue. No significant relationship was observed between different items of dignity and global health status/QOL scale. Conclusions: High dignity status in terminally ill patients was associated with higher QOL in terms of functional intactness and lower symptom distress. Further studies are necessary to shed light to our findings. PMID:28706540

Nutritional Status and Energy Intake as Predictors of Functional Status After Cardiac Rehabilitation in Elderly Inpatients With Heart Failure　- A Retrospective Cohort Study.

PubMed

Katano, Satoshi; Hashimoto, Akiyoshi; Ohori, Katsuhiko; Watanabe, Ayako; Honma, Remi; Yanase, Rimi; Ishigo, Tomoyuki; Fujito, Takefumi; Ohnishi, Hirofumi; Tsuchihashi, Kazufumi; Ishiai, Sumio; Miura, Tetsuji

2018-05-25

Whether the short-term effect of cardiac rehabilitation (CR) in elderly patients with heart failure (HF) is influenced by nutritional status is uncertain, so the present study investigated the effect of nutritional status on functional recovery after CR in elderly HF inpatients.Methods and Results:We enrolled 145 patients admitted for treatment of HF who were aged ≥65 years and had a low functional status defined as a Barthel index (BI) score ≤85 points at the commencement of CR. Nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF) and total energy intake per day. The primary endpoint was functional status determined by the BI score at discharge. The median CR period was 20 days (interquartile range: 14-34 days), and 87 patients (60%) were functionally dependent (BI score ≤85) at discharge. Multivariate logistic regression analysis showed that MNA-SF score (odds ratio [OR]: 0.76, P=0.02) and total energy intake at the commencement of CR (OR: 0.91, P=0.02) were independent predictors of functional dependence after CR. MNA-SF score ≤7 and total energy intake ≤24.5 kcal/kg/day predicted functional dependence at discharge with moderate sensitivity and specificity. MNA-SF score and total energy intake at the commencement of CR are novel predictors of the extent of functional recovery of elderly HF inpatients after in-hospital CR.

Designing a national plan for improving sexual health in Iran: An experience of an Islamic country

PubMed Central

Damari, Behzad; Tabrizchi, Narges; Riazi-Isfahani, Sahand

2016-01-01

Background: Prevalence of sexual dysfunction varies from 20% to 40% in men and women in different studies in Iran. Despite its high prevalence, it seems that this issue has been neglected, particularly in Islamic countries. The aim of this study was to assess sexual health in Iran. This was a mixed method study. Methods: Data were collected through evaluating country’s sexual health programs and literature review. Sexual health status was drafted and formed following a sound analysis by stakeholders. After conducting interviews and focus group discussions, the main points of the meetings, influencing factors of the present status and oncoming strategies were obtained upon experts’ opinions. Results: Review of general policies and the literature showed that although there is adequate support for improving sexual health status in the country, sexual health status has been decreased in the last decade. Based on Iranian sexual health indicators and experts’ opinions, the focus points could be divided into the following groups: Structural and functional –political, legal-behavior, and cultural. Conclusion: Breaking the taboo of sexual health issues would require attention from the policy makers especially in Islamic nations to facilitate the steps on the road to sexual health. In this regard, clarified vision, strategic goals and interventional policies are proposed. An inter-sectional cooperation is needed to implement interventions to promote sexual health status. PMID:27683648

The Palliative Function of Hostile Sexism among High and Low-Status Chilean Students

PubMed Central

Vargas-Salfate, Salvador

2017-01-01

Previous studies have demonstrated that justifying the social, economic, and political systems is associated with psychological well-being, which has been termed as the palliative function of ideology. However, little research has been conducted on gender stereotypes among children, comparing by socioeconomic status. This study aimed to fill this gap in the system justification literature. We present data from the Chilean version of the International Survey of Children Well-Being (ISCWeB), which was conducted in 2012. We found that the palliative function of gender stereotypes is present among this sample, being qualified by a socioeconomic status by hostile gender stereotype interaction. In other words, the effect on the psychological well-being was observed in low-status, but not in high-status students. These results extend the previous knowledge about the palliative function of the ideology, suggesting why the low-status members of a society actively engage in system justification. PMID:29046657

Functional Status Change Among Children With Extracorporeal Membrane Oxygenation to Support Cardiopulmonary Resuscitation in a Pediatric Cardiac ICU: A Single Institution Report.

PubMed

Beshish, Asaad G; Baginski, Mathew R; Johnson, Thomas J; Deatrick, Barry K; Barbaro, Ryan P; Owens, Gabe E

2018-04-13

The purpose of this study is to describe the functional status of survivors from extracorporeal cardiopulmonary resuscitation instituted during in-hospital cardiac arrest using the Functional Status Scale. We aimed to determine risk factors leading to the development of new morbidity and unfavorable functional outcomes. This was a single-center retrospective chart review abstracting patient characteristics/demographic data, duration of cardiopulmonary resuscitation, duration of extracorporeal membrane oxygenation support, as well as maximum lactate levels within 2 hours before and after extracorporeal cardiopulmonary resuscitation. Cardiac arrest was defined as the administration of chest compressions for a nonperfusing cardiac rhythm. Extracorporeal cardiopulmonary resuscitation was defined by instituting extracorporeal membrane oxygenation during active chest compressions. Functional Status Scale scores were calculated at admission and on hospital discharge for patients who survived. Patients admitted in the pediatric cardiac ICU at C.S. Mott Children's Hospital from January 1, 2005, to December 31, 2015. Children less than 18 years who underwent extracorporeal cardiopulmonary resuscitation. Not applicable. Of 608 extracorporeal membrane oxygenation events during the study period, 80 were extracorporeal cardiopulmonary resuscitation (14%). There were 40 female patients (50%). Median age was 40 days (interquartile range, 9-342 d). Survival to hospital discharge was 48% (38/80). Median Functional Status Scale score at admission was 6 (interquartile range, 6-6) and at hospital discharge 9 (interquartile range, 8-11). Out of 38 survivors, 19 (50%) had a change of Functional Status Scale score greater than or equal to 3, that is consistent with new morbidity, and 26 (68%) had favorable functional outcomes with a change in Functional Status Scale score of less than 5. This is the first extracorporeal cardiopulmonary resuscitation report to examine changes in Functional Status Scale from admission (baseline) to discharge as a measure of overall functional outcome. Half of surviving patients (19/38) had new morbidity, while 68% (26/38) had favorable outcomes. Lactate levels, duration of cardiopulmonary resuscitation, and duration of extracorporeal membrane oxygenation were not found to be risk factors for the development of new morbidity and poor functional outcomes. Functional Status Scale may be used as a metric to monitor improvement of extracorporeal cardiopulmonary resuscitation outcomes and help guide research initiatives to decrease morbidity in this patient population.

Relationship between periodontal status and intellectual function among community-dwelling elderly persons.

PubMed

Moriya, Shingo; Tei, Kanchu; Toyoshita, Yoshifumi; Koshino, Hisashi; Inoue, Nobuo; Miura, Hiroko

2012-06-01

The aim of this study was to indicate the relationship between periodontal status and intellectual function in the elderly. Periodontal status has been shown to be related to demographic, socioeconomic, and psychological status. Intellectual function is a significant indicator of health status. Nevertheless, the relationship between periodontal status and intellectual function has not been elucidated in detail among the elderly. A total of 152 community-dwelling elderly persons, aged 70-74 years, were enrolled in the study. Periodontal status was evaluated using the WHO Community Periodontal Index of Treatment Needs (CPITN). Intellectual function was assessed by four neuropsychological tests: Raven's Coloured Progressive Matrices (RCPM) test, the Verbal Paired Associates 1 (VerPA) task and the Visual Paired Associates 1 (VirPA) task, extracted from the Wechsler Memory Scale Revised Edition, and the Block Design subtest, extracted from the Wechsler Adult Intelligence Scales, Third Edition. Correlations between CPITN and each test were examined using Spearman rank correlation coefficients. The ordinal regression model was constructed with CPITN as the dependent variable and neuropsychological test as the principal independent variable to adjust for demographic factors, general health, lifestyle and oral health behaviour. Significant correlations were found between the RCPM test, the VerPA task, the Visual Paired Associates 1 and CPITN. In the ordinal regression model, CPITN was significantly related to measures of RCPM after adjusting for demographic factors, general health status, lifestyle and oral health behaviour. Intellectual function is considered a significant indicator of periodontal status among community-dwelling elderly persons. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Functional status and health-related quality of life among allogeneic transplant patients at hospital discharge: a comparison of sociodemographic, disease, and treatment characteristics

PubMed Central

Cooke, Liz; Williams, Anna Cathy; Bhatia, Smita; Popplewell, Leslie; Uman, Gwen; Forman, Stephen

2012-01-01

Purpose The purpose of this paper is to report the findings of a study of hematopoietic cell transplant patients, describing the needs of allogeneic transplant patients at the time of discharge in regard to their functional status, quality of life (QOL), and caregiver information and comparing these needs across a number of sociodemographic, disease, and treatment characteristics. The findings of this study are part of a larger mixed-methods study, representing one data time point of the larger study. Methods This paper will discuss the baseline data collected at the time of discharge for 282 allogeneic transplant patients, which include sociodemographic data combined with disease, treatment, functional status, and QOL data to present a comprehensive portrait of the transplant patient at discharge. Results Mean age was 48 years, males represented 52%, and 22% of the patients were Hispanic. The majority of the patients had acute leukemia (55%), were diagnosed within the last 3 years, and had matched unrelated (52%) transplants. The time from transplant to discharge averaged 30 days. Mean scores for QOL (scale = 1–10, with 10 = best QOL) included a low score of 5.7 for both psychological and social well-being, 6.3 for overall QOL, and 7.1 for both physical and spiritual well-being. Males had significantly higher QOL than females, as did non-Hispanics. Patients with Hodgkin’s disease had significantly lower overall QOL scores. Conclusions Our results highlight the physical, psychological, social, and spiritual challenges which present for patients and their caregivers at the time of hospital discharge following allogeneic transplant. PMID:22318502

Gap Detection and Temporal Modulation Transfer Function as Behavioral Estimates of Auditory Temporal Acuity Using Band-Limited Stimuli in Young and Older Adults

PubMed Central

Shen, Yi

2015-01-01

Purpose Gap detection and the temporal modulation transfer function (TMTF) are 2 common methods to obtain behavioral estimates of auditory temporal acuity. However, the agreement between the 2 measures is not clear. This study compares results from these 2 methods and their dependencies on listener age and hearing status. Method Gap detection thresholds and the parameters that describe the TMTF (sensitivity and cutoff frequency) were estimated for young and older listeners who were naive to the experimental tasks. Stimuli were 800-Hz-wide noises with upper frequency limits of 2400 Hz, presented at 85 dB SPL. A 2-track procedure (Shen & Richards, 2013) was used for the efficient estimation of the TMTF. Results No significant correlation was found between gap detection threshold and the sensitivity or the cutoff frequency of the TMTF. No significant effect of age and hearing loss on either the gap detection threshold or the TMTF cutoff frequency was found, while the TMTF sensitivity improved with increasing hearing threshold and worsened with increasing age. Conclusion Estimates of temporal acuity using gap detection and TMTF paradigms do not seem to provide a consistent description of the effects of listener age and hearing status on temporal envelope processing. PMID:25087722

LABORATORY MEASURES OF EXERCISE CAPACITY AND VENTRICULAR CHARACTERISTICS AND FUNCTION ARE WEAKLY ASSOCIATED WITH FUNCTIONAL HEALTH STATUS AFTER FONTAN

PubMed Central

McCrindle, Brian W.; Zak, Victor; Sleeper, Lynn A.; Paridon, Stephen M.; Colan, Steven D.; Geva, Tal; Mahony, Lynn; Li, Jennifer S.; Breitbart, Roger E.; Margossian, Renee; Williams, Richard V.; Gersony, Welton M.; Atz, Andrew M.

2009-01-01

Background Patients after Fontan are at risk for suboptimal functional health status, and associations with laboratory measures are important for planning interventions and outcome measures for clinical trials. Methods and Results Parents completed the generic Child Health Questionnaire (CHQ) for 511 Fontan Cross-Sectional Study patients aged 6–18 years (61% male). Associations of CHQ Physical and Psychosocial Functioning Summary Scores (FSS) with standardized measurements from prospective exercise testing, echocardiography, magnetic resonance imaging (MRI), and measurement of brain natriuretic peptide (BNP) were determined by regression analyses. For exercise variables for maximal effort patients only, the final model showed higher Physical FSS was associated only with higher maximum work rate, accounting for 9% of variation in Physical FSS. For echocardiography, lower Tei index (particularly for patients with extracardiac lateral tunnel connections), lower indexed end-systolic volume, and the absence of atrioventricular valve regurgitation for patients having Fontan at age <2 years were associated with higher Physical FSS, accounting for 14% of variation in Physical FSS. For MRI, lower mass to end-diastolic volume ratio, and mid-quartiles of indexed end-systolic volume (non-linear) were associated with higher Physical FSS, accounting for 11% of variation. Lower BNP was significantly but weakly associated with higher Physical FSS (1% of variation). Significant associations for Psychosocial FSS with laboratory measures were fewer and weaker than for Physical FSS. Conclusions In relatively healthy Fontan patients, laboratory measures account for a small proportion of the variation in functional health status and, therefore, may not be optimal surrogate endpoints for trials of therapeutic interventions. PMID:20026781

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% CI: 1.58 to 10.33; P = 0.005) and 6.1 (95% CI: 1.9 to 19.9; P < 0.01), respectively. Geriatric syndromes increased after ICU stay and remained significantly increased during follow-up (P < 0.001). Conclusions The survival rate of elderly medical patients 12 months after discharge from the ICU is low (49%), although functional status and quality of life remained similar to baseline in most of the survivors. However, there was a two-fold increase in the prevalence of geriatric syndromes. PMID:21443796

Lung function decline over 25 years of follow-up among black and white adults in the ARIC study cohort.

PubMed

Mirabelli, Maria C; Preisser, John S; Loehr, Laura R; Agarwal, Sunil K; Barr, R Graham; Couper, David J; Hankinson, John L; Hyun, Noorie; Folsom, Aaron R; London, Stephanie J

2016-04-01

Interpretation of longitudinal information about lung function decline from middle to older age has been limited by loss to follow-up that may be correlated with baseline lung function or the rate of decline. We conducted these analyses to estimate age-related decline in lung function across groups of race, sex, and smoking status while accounting for dropout from the Atherosclerosis Risk in Communities Study. We analyzed data from 13,896 black and white participants, aged 45-64 years at the 1987-1989 baseline clinical examination. Using spirometry data collected at baseline and two follow-up visits, we estimated annual population-averaged mean changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) by race, sex, and smoking status using inverse-probability-weighted independence estimating equations conditioning-on-being-alive. Estimated rates of FEV1 decline estimated using inverse-probability-weighted independence estimating equations conditioning on being alive were higher among white than black participants at age 45 years (e.g., male never smokers: black: -29.5 ml/year; white: -51.9 ml/year), but higher among black than white participants by age 75 (black: -51.2 ml/year; white: -26). Observed differences by race were more pronounced among men than among women. By smoking status, FEV1 declines were larger among current than former or never smokers at age 45 across all categories of race and sex. By age 60, FEV1 decline was larger among former and never than current smokers. Estimated annual declines generated using unweighted generalized estimating equations were smaller for current smokers at younger ages in all four groups of race and sex compared with results from weighted analyses that accounted for attrition. Using methods accounting for dropout from an approximately 25-year health study, estimated rates of lung function decline varied by age, race, sex, and smoking status, with largest declines observed among current smokers at younger ages. Published by Elsevier Ltd.

Shoulder Pain, Functional Status, and Health-Related Quality of Life after Head and Neck Cancer Surgery

PubMed Central

Wang, Hsiao-Lan; Keck, Juanita F.; Weaver, Michael T.; Mikesky, Alan; Bunnell, Karen; Buelow, Janice M.; Rawl, Susan M.

2013-01-01

Head and neck cancer (HNC) patients experience treatment-related complications that may interfere with health-related quality of life (HRQOL). The purpose of this study was to describe the symptom experience (shoulder pain) and functional status factors that are related to global and domain-specific HRQOL at one month after HNC surgery. In this exploratory study, we examined 29 patients. The outcome variables included global HRQOL as well as physical, functional, emotional, and social well-being. Symptom experience and functional status factors were the independent variables. In the symptom experience variables, shoulder pain distress was negatively associated with physical well-being (R 2 = 0.24). Among the functional status variables, eating impairment was negatively related to global HRQOL (R 2 = 0.18) and physical well-being (R 2 = 0.21). Speaking impairment and impaired body image explained a large amount of the variance in functional well-being (R 2 = 0.45). This study provided initial results regarding symptom experience and functional status factors related to poor HRQOL in the early postoperative period for HNC patients. PMID:24455274

Associations of Child Maltreatment and Intimate Partner Violence with Psychological Adjustment among Low SES, African American Children

ERIC Educational Resources Information Center

Kaslow, Nadine J.; Thompson, Martie P.

2008-01-01

Objective: This study assessed the unique and interactive effects of child maltreatment and mothers' physical intimate partner violence (IPV) status on low-SES African American children's psychological functioning. Methods: Mothers were recruited from a large, inner-city hospital, and those who met eligibility criteria were asked to complete a…

School Performance and Poverty: The Mediating Role of Executive Functions

ERIC Educational Resources Information Center

Korzeniowski, C.; Cupani, M.; Ison, M.; Difabio, H.

2016-01-01

Introduction: This study aims at analyzing whether EFs may predict the SP of children from different low socioeconomic strata, having controlled the effects of age and socioeconomic status (SES). Method: The sample included 178 Argentine children of both genders (52% boys), between 6 and 10 years of age, belonging to the upper-low SES (41%),…

An optimized method for measuring methylmalonic acid in low volumes of serum using UPLC-MS/MS

USDA-ARS?s Scientific Manuscript database

Background: Methylmalonic acid (MMA) is a metabolic intermediate which is transformed to succinic acid (SA) by a vitamin B12-dependent catalytic step. MMA is broadly used as a clinical biomarker of functional vitamin B12 status. However, currently validated protocols use between 100 -1000 µL of se...

Predictors of Optimal Cognitive Aging in 80+ Women: The Women’s Health Initiative Memory Study

PubMed Central

Rapp, Stephen R.; Hogan, Patricia E.; Driscoll, Ira; Tindle, Hilary A.; Smith, J. Carson; Kesler, Shelli R.; Zaslavsky, Oleg; Rossom, Rebecca C.; Ockene, Judith K.; Yaffe, Kristine; Manson, JoAnn E.; Resnick, Susan M.; Espeland, Mark A.

2016-01-01

Background. Independent predictors of preserved cognitive functioning and factors associated with maintaining high preserved cognitive function in women ≥80 years remain elusive. Methods. Two thousand two hundred twenty-eight women with a mean age of 85 years who participated in the Women’s Health Initiative Memory Study were classified as cognitively normal (n = 1,905, 85.5%), mild cognitive impairment (n = 88, 3.9%), dementia (n = 121, 5.4%) or other cognitive impairment (n = 114, n = 5.1%) by central adjudication. Global cognitive functioning was assessed using telephone interview for cognitive status-modified in those women who did not meet cognitive impairment criteria. Differences between women grouped by cognitive status with respect to each potential risk factor were assessed using chi-squared tests and t-tests. Backward stepwise logistic regression was used to select factors that were independently associated with cognitive status. Results. Factors associated with preserved cognitive functioning were younger age, higher education, and family incomes, being non-Hispanic white, better emotional wellbeing, fewer depressive symptoms, more insomnia complaints, being free of diabetes, and not carrying the apolipoprotein E-epsilon 4 allele. Cognitively normal women who demonstrated sustained high preserved cognition were younger, more educated, and endorsed better self-reported general health, emotional wellbeing, and higher physical functioning. Conclusions. Addressing sociodemographic disparities such as income inequality, and targeting interventions to improve depressive symptoms and vascular risk factors, including diabetes, may play an important role in preserving cognition among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical, cognitive, and psychosocial functioning may promote maintenance of high preserved cognitive health in the oldest-old. PMID:26858326

Neurocognitive complaints and functional status among patients with chronic fatigue syndrome and fibromyalgia.

PubMed

Schmaling, Karen B; Betterton, Karran L

2016-05-01

The purpose of this study was to conduct a longitudinal examination of cognitive complaints and functional status in patients with chronic fatigue syndrome (CFS) alone and those who also had fibromyalgia (CFS/FM). A total of 93 patients from a tertiary care fatigue clinic were evaluated on four occasions, each 6 months apart. Each evaluation included a tender point assessment, and self-reported functional status and cognitive complaints. Patients with CFS/FM reported significantly worse physical functioning, more bodily pain, and more cognitive difficulties (visuo-perceptual ability and verbal memory) than patients with CFS alone. Over time, bodily pain decreased only for participants with CFS alone. Verbal memory problems were associated with more bodily pain for both patient groups, whereas visuo-perceptual problems were associated with worse functional status for patients with CFS alone. This study adds to the literature on functional status, longitudinal course, and cognitive difficulties among patients with CFS and those with CFS and FM. The results suggest that patients with CFS/FM are more disabled, have more cognitive complaints, and improve more slowly over time than patients with CFS alone. Specific cognitive difficulties are related to worse functional status, which supports the addition of cognitive difficulties to the FM case criteria.

Assessing Smart Phones for Generating Life-space Indicators.

PubMed

Wan, Neng; Qu, Wenyu; Whittington, Jackie; Witbrodt, Bradley C; Henderson, Mary Pearl; Goulding, Evan H; Schenk, A Katrin; Bonasera, Stephen J; Lin, Ge

2013-04-01

Life-space is a promising method for estimating older adults' functional status. However, traditional life-space measures are costly and time consuming because they often rely on active subject participation. This study assesses the feasibility of using the global positioning system (GPS) function of smart phones to generate life-space indicators. We first evaluated the location accuracy of smart phone collected GPS points versus those acquired by a commercial GPS unit. We then assessed the specificity of the smart phone processed life-space information against the traditional diary method. Our results suggested comparable location accuracy between the smart phone and the standard GPS unit in most outdoor situations. In addition, the smart phone method revealed more comprehensive life-space information than the diary method, which leads to higher and more consistent life-space scores. We conclude that the smart phone method is more reliable than traditional methods for measuring life-space. Further improvements will be required to develop a robust application of this method that is suitable for health-related practices.

Does Severity of Depression Predict Magnitude of Productivity Loss?

PubMed Central

Beck, Arne; Crain, A. Lauren; Solberg, Leif I.; Unützer, Jürgen; Glasgow, Russell E.; Maciosek, Michael V.; Whitebird, Robin

2014-01-01

PURPOSE Depression is associated with lowered work functioning, including absence, productivity impairment, and decreased job retention. However, few studies have examined depression symptoms across a continuum of severity in relationship to the magnitude of work impairment in a large and heterogeneous patient population. This study assessed the relationship between depression symptom severity and productivity loss among patients initiated on antidepressants. METHODS Data were obtained from patients participating in the DIAMOND Initiative (Depression Improvement Across Minnesota: Offering a New Direction), a statewide quality improvement collaborative to provide enhanced depression care. Patients newly started on antidepressants were surveyed with the Patient Health Questionnaire (PHQ-9), a measure of depression symptom severity, the Work Productivity and Activity Impairment questionnaire (WPAI) a measure of productivity loss, and items on health status and demographics. RESULTS We analyzed data from the 771 patients who reported current employment. General linear models adjusting for demographics and health status showed a significant linear, monotonic relationship between depression symptom severity and productivity loss (p<.0001). Even minor levels of depression symptoms were associated with decrements in work function. Greater productivity loss also was associated with full-time vs. part-time employment status (p<.001), fair or poor health (p=.05), and “not coupled” marital status (p=.07). CONCLUSIONS This study illustrated the relationship between the severity of depression symptoms and work function, suggesting that even minor levels of depression are associated with productivity loss. Employers may find it beneficial to invest in effective treatments for employees across the continuum of depression severity. PMID:25295792

Effectiveness of the second-stage rehabilitation in stroke patients with cognitive impairment.

PubMed

Milinavičienė, Eglė; Rastenytė, Daiva; Kriščiūnas, Aleksandras

2011-01-01

The aim of this study was to evaluate the recovery of functional status and effectiveness of the second-stage rehabilitation depending on the degree of cognitive impairment in stroke patients. The study sample comprised 226 stroke patients at the Viršužiglis Hospital of rehabilitation, Hospital of Lithuanian University of Health Sciences. Functional status was evaluated with the Functional Independence Measure, cognitive function with the Mini-Mental Status Examination scale, and severity of neurologic condition with the National Institutes of Health Stroke Scale. The patients were divided into 4 study groups based on cognitive impairment: severe, moderate, mild, or no impairment. More than half (53%) of all cases were found to have cognitive impairment, while patients with different degree of cognitive impairment were equally distributed: mild impairment (18%), moderate impairment (17%), and severe impairment (18%). Improvement of functional status was observed in all study groups (P<0.001). In the patients with moderate and severe cognitive impairment, cognitive recovery was significantly more expressed than in other study groups (P<0.001). Insufficient recovery of functional status was significantly associated with hemiplegia (OR, 11.15; P=0.015), urinary incontinence (OR, 14.91; P<0.001), joint diseases (OR, 5.52; P=0.022), heart diseases (OR, 4.10; P=0.041), and severe cognitive impairment (OR, 15.18; P<0.001), while moderate and mild cognitive impairment was not associated with the recovery of functional status. During the second-stage rehabilitation of stroke patients, functional status as well as cognitive and motor skills were improved both in patients with and without cognitive impairment; however, the patients who were diagnosed with severe or moderate cognitive impairment at the beginning of second-stage rehabilitation showed worse neurological and functional status during the whole second-stage rehabilitation than the patients with mild or no cognitive impairment.

The relationships between oral status, physical and mental health, nutritional status and diet type in elderly Japanese women with dementia.

PubMed

Sadamori, Shinsuke; Hayashi, Syouji; Hamada, Taizo

2008-12-01

To suggest methods for maintaining an adequate nutritional status for elderly patients with dementia by evaluating the relationships between oral status, physical and mental health, and feeding conditions. Feeding difficulties in dementia patients are related to food intake, and failure to eat may be associated with weight loss in long-term care facilities. The relationship between compromised oral function and diet is still unclear. A cross-sectional study of 94 elderly women with dementia (mean age 89.6 +/- 5.6 years) from a nursing home was undertaken to investigate their oral, physical and mental and nutritional status. There were significant differences in serum albumin (p = 0.0284), N-ADL (p = 0.0005), NM scale (p = 0.0004) and HDS-R (p = 0.0004) between denture wearers and non-denture wearers. However, there were no significant differences in body mass index between denture wearers and non-denture wearers. A suitable type of diet and assistance with feeding could maintain the nutritional status of elderly patients with dementia if they are still feeding themselves. The nutritional support team will benefit from the participation of a dentist.

Risk factors for poor work functioning of persons with schizophrenia in rural China.

PubMed

Ran, Mao-Sheng; Chen, Sheying; Chen, Elaina Y; Ran, Bo-Yu; Tang, Cui-Ping; Lin, Fu-Rong; Li, Li; Li, Si-Gan; Mao, Wen-Jun; Hu, Shi-Hui

2011-11-01

The long-term work performance of persons with schizophrenia in the community is unclear. This study examined the status of long-term work functioning and the predictors of poor work status among patients with schizophrenia in a Chinese rural area. A 10-year follow-up investigation (1994-2004) of a cohort (n = 510) of persons with schizophrenia was conducted in Xinjin County, Chengdu, China. Compared with baseline data, work functioning of patients with schizophrenia deteriorated after 10 years. The rates of not working increased significantly from 12.0% in 1994 to 23.0% in 2004. Bivariate analyses showed that the poor work functioning in 2004 was significantly associated with male gender, older age, older age of first onset, higher level of education, longer duration of illness, lower family economic status, lack of caregivers, poor work status in 1994, living in shabby or unstable house, marked symptoms, and higher score on the Social Disability Screening Schedule (SDSS). In multiple logistic regression analyses, higher score of SDSS and poor work status in 1994 were identified as unique predictors of poor work status in 2004. The status of work functioning of persons with schizophrenia decreased over the course of the illness. The risk factors for poor work functioning and specific socio-cultural environment should be considered in planning community mental health services and rehabilitation for these patients.

Physicians' impression on the elders' functionality influences decision making for emergency care.

PubMed

Rodríguez-Molinero, Alejandro; López-Diéguez, María; Tabuenca, Ana I; de la Cruz, Juan J; Banegas, José R

2010-09-01

This study analyzes the elements that compose the emergency physicians' criterion for selecting elderly patients for intensive care treatment. This issue has not been studied in-depth. A cross-sectional study was conducted at 4 university teaching hospitals, covering 101 randomly selected elderly patients admitted to emergency department and their respective physicians. Physicians were asked to forecast their plans for treatment or therapeutic abstention, in the event that patients might require aggressive measures (cardiopulmonary resuscitation or admission to critical care units). Data were collected on physicians' reasons for taking such decisions and their patients' functional capacity and cognitive status (Katz index and Informant Questionnaire on Cognitive Decline in the Elderly). A logistic regression model was constructed taking physicians' decisions as the dependent variables and adjusting for patient factors and physician impressions. The functional status reported by reliable informants and the mental status measured by validated instruments were not coincident with the physicians' perception (functional status κ, 0.47; mental status κ, 0.26). A multivariate analysis showed that the age and the functional and mental status of patients, as perceived by the physicians, were the variables that better explained the physicians' decisions. Physicians' impressions on the functional and mental status of their patients significantly influenced their selection of patients for high-intensity treatments despite the fact that some of these impressions were not correct. Copyright © 2010 Elsevier Inc. All rights reserved.

Mobile Phone-Based Measures of Activity, Step Count, and Gait Speed: Results From a Study of Older Ambulatory Adults in a Naturalistic Setting

PubMed Central

Aung, Thawda; Whittington, Jackie; High, Robin R; Goulding, Evan H; Schenk, A Katrin

2017-01-01

Background Cellular mobile telephone technology shows much promise for delivering and evaluating healthcare interventions in cost-effective manners with minimal barriers to access. There is little data demonstrating that these devices can accurately measure clinically important aspects of individual functional status in naturalistic environments outside of the laboratory. Objective The objective of this study was to demonstrate that data derived from ubiquitous mobile phone technology, using algorithms developed and previously validated by our lab in a controlled setting, can be employed to continuously and noninvasively measure aspects of participant (subject) health status including step counts, gait speed, and activity level, in a naturalistic community setting. A second objective was to compare our mobile phone-based data against current standard survey-based gait instruments and clinical physical performance measures in order to determine whether they measured similar or independent constructs. Methods A total of 43 ambulatory, independently dwelling older adults were recruited from Nebraska Medicine, including 25 (58%, 25/43) healthy control individuals from our Engage Wellness Center and 18 (42%, 18/43) functionally impaired, cognitively intact individuals (who met at least 3 of 5 criteria for frailty) from our ambulatory Geriatrics Clinic. The following previously-validated surveys were obtained on study day 1: (1) Late Life Function and Disability Instrument (LLFDI); (2) Survey of Activities and Fear of Falling in the Elderly (SAFFE); (3) Patient Reported Outcomes Measurement Information System (PROMIS), short form version 1.0 Physical Function 10a (PROMIS-PF); and (4) PROMIS Global Health, short form version 1.1 (PROMIS-GH). In addition, clinical physical performance measurements of frailty (10 foot Get up and Go, 4 Meter walk, and Figure-of-8 Walk [F8W]) were also obtained. These metrics were compared to our mobile phone-based metrics collected from the participants in the community over a 24-hour period occurring within 1 week of the initial assessment. Results We identified statistically significant differences between functionally intact and frail participants in mobile phone-derived measures of percent activity (P=.002, t test), active versus inactive status (P=.02, t test), average step counts (P<.001, repeated measures analysis of variance [ANOVA]) and gait speed (P<.001, t test). In functionally intact individuals, the above mobile phone metrics assessed aspects of functional status independent (Bland-Altman and correlation analysis) of both survey- and/or performance battery-based functional measures. In contrast, in frail individuals, the above mobile phone metrics correlated with submeasures of both SAFFE and PROMIS-GH. Conclusions Continuous mobile phone-based measures of participant community activity and mobility strongly differentiate between persons with intact functional status and persons with a frailty phenotype. These measures assess dimensions of functional status independent of those measured using current validated questionnaires and physical performance assessments to identify functional compromise. Mobile phone-based gait measures may provide a more readily accessible and less-time consuming measure of gait, while further providing clinicians with longitudinal gait measures that are currently difficult to obtain. PMID:28974482

Sufficient vitamin K status combined with sufficient vitamin D status is associated with better lower extremity function: a prospective analysis of two knee osteoarthritis cohorts

USDA-ARS?s Scientific Manuscript database

Objective: Vitamins K and D are important for the function of vitamin K-dependent proteins in joint tissues. It is unclear if these nutrients are mutually important to functional outcomes related to knee osteoarthritis (OA). This study aimed to evaluate the association of vitamin K and D status with...

Nutritional Strategies Facing an Older Demographic: The Nutrition UP 65 Study Protocol

PubMed Central

2016-01-01

Background The population of Portugal is aging. The lack of data on older adults’ nutritional status and the lack of nutrition knowledge amongst health professionals, caregivers, and older adults themselves, remains a challenge. Objective The Nutrition UP 65 study aims to reduce nutritional inequalities in the older Portuguese adult population and improve knowledge regarding older Portuguese adults’ nutritional status, specifically relating to undernutrition, obesity, sarcopenia, frailty, hydration, sodium, and vitamin D statuses. Methods A representative sample of older Portuguese adults was selected. Sociodemographic, lifestyle, anthropometric, functional, and clinical data were collected. Sodium excretion, hydration, and vitamin D statuses were assessed. Results Data collection (n=1500) took place between December, 2015 and June, 2016. Results will be disseminated in national and international scientific journals, and via Portuguese media. Conclusions Nutrition UP 65 results will provide evidence for the design and implementation of effective preventive public health strategies regarding the elderly. These insights may represent relevant health gains and costs savings. PMID:27628097

Health and functional status and utilization of health care services among holocaust survivors and their counterparts in Israel.

PubMed

Iecovich, Esther; Carmel, Sara

2010-01-01

To examine differences in health and functional status and in utilization of health services between holocaust survivors and their counterparts; and (b) to investigate if holocaust survivor status is a significant predictor of health status, functional status, and utilization of health services. The study included 1255 respondents of whom 272 were holocaust survivors. Interviews were conducted face-to-face at the respondents' homes. Participants were asked about their health (self-rated health and comorbidity) and functional (ADL and IADL) status, utilization of inpatient and outpatient health care services, age, gender, education, marital status, length of residence in Israel, and if they were holocaust survivors. Holocaust survivors, who were frailer and more chronically ill compared to their counterparts, visited their family physician and the nurse at the health care clinic more often than their counterparts did, and received more homecare services. Yet, there were no differences between them in the utilization of other health care services such as visits to specialists, emergency department, and hospitalizations. Holocaust survivors are more homebound due to more morbidity and functional limitations and therefore receive more health home care services that offset the utilization of other health services. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Effect of nutritional status in individuals with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation.

PubMed

Günay, Ersin; Kaymaz, Dicle; Selçuk, Nursel Türkoglu; Ergün, Pinar; Sengül, Fatma; Demir, Nese

2013-11-01

Chronic obstructive pulmonary disease (COPD) is considered a worldwide major public health problem. Weight loss, muscle and fat mass depletion are common nutritional problems in COPD patients and are determinant factors in pulmonary function, health status, disability and mortality. We aimed to assess the relationships between nutritional status and perception of dyspnoea, pulmonary function tests (PFT), exercise capacity and health-related quality of life (HRQoL) using the subjective global assessment (SGA) in COPD patients who were referred for pulmonary rehabilitation programme. A total of 163 patients with stable COPD who are candidates for outpatient pulmonary rehabilitation programme were included in this study. Nutritional status for all patients was assessed by SGA. Association of SGA scores (A, B and C) and anthropometric measurements, PFT, dyspnoea scales (Medical Research Council and resting BORG scale), HRQoL (St. George Respiratory Questionnaire and Chronic Respiratory Diseases Questionnaire) and exercise testing (shuttle walking test) were studied for statistical significance. Based on SGA, 9.2% of patients were severely malnourished (SGA-C). There were significant decreases in forced expiratory volume in the first second (FEV1 ) (P = 0.009), Medical Research Council scales (P < 0.001) and exercise capacity (incremental shuttle walking test (P = 0.001) and endurance shuttle walking test (P = 0.009)) in SGA-C. Deterioration in anthropometric measurements and HRQoL measures were observed in malnourished patients. Identifying the nutritional status and determining any requirement for nutritional supplement is an important component of comprehensive pulmonary rehabilitation programme. SGA is an easy and practical method to assess nutritional status in pulmonary rehabilitation candidate patients with stable COPD. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

Patient-Reported Functional Status in Outpatients With Advanced Cancer: Correlation With Physician-Reported Scores and Survival.

PubMed

Popovic, Gordana; Harhara, Thana; Pope, Ashley; Al-Awamer, Ahmed; Banerjee, Subrata; Bryson, John; Mak, Ernie; Lau, Jenny; Hannon, Breffni; Swami, Nadia; Le, Lisa W; Zimmermann, Camilla

2018-06-01

Performance status measures are increasingly completed by patients in outpatient cancer settings, but are not well validated for this use. We assessed performance of a patient-reported functional status measure (PRFS, based on the Eastern Cooperative Oncology Group [ECOG]), compared with the physician-completed ECOG, in terms of agreement in ratings and prediction of survival. Patients and physicians independently completed five-point PRFS (lay version of ECOG) and ECOG measures on first consultation at an oncology palliative care clinic. We assessed agreement between PRFS and ECOG using weighted Kappa statistics, and used linear regression to determine factors associated with the difference between PRFS and ECOG ratings. We used the Kaplan-Meier method to estimate the patients' median survival, categorized by PRFS and ECOG, and assessed predictive accuracy of these measures using the C-statistic. For the 949 patients, there was moderate agreement between PRFS and ECOG (weighted Kappa 0.32; 95% CI: 0.28-0.36). On average, patients' ratings of performance status were worse by 0.31 points (95% CI: 0.25-0.37, P < 0.0001); this tendency was greater for younger patients (P = 0.002) and those with worse symptoms (P < 0.0001). Both PRFS and ECOG scores correlated well with overall survival; the C-statistic was higher for the average of PRFS and ECOG scores (0.619) than when reported individually (0.596 and 0.604, respectively). Patients tend to rate their performance status worse than physicians, particularly if they are younger or have greater symptom burden. Prognostic ability of performance status could be improved by using the average of patients and physician scores. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

A Cross-Sectional Study of Nutrient Intake and Health Status among Older Adults in Yogyakarta Indonesia

PubMed Central

Arjuna, Tony; Soenen, Stijn; Hasnawati, Rasita Amelia; Lange, Kylie; Chapman, Ian; Luscombe-Marsh, Natalie D.

2017-01-01

Many communities around the world, particularly developing countries including Indonesia, are experiencing population ageing. There is little knowledge regarding the impact of malnutrition, or its prevalence within rural compared to urban areas, on the nutritional, functional and mental status of community-living older residents in these countries. Hence, a cross-sectional study was conducted to determine socio-demographic and anthropometric characteristics, nutritional, mental and functional status, and energy and nutrient intake of community-dwelling Indonesians from both rural and urban areas of Yogyakarta. Older individuals were included in the study if they had been living in Yogyakarta for the last year and were aged ≥65 years (n = 527; mean ± SD age of 74 ± 7 years). Rural compared with urban participants had a lower level of education and income, more hospital admissions, less dietary protein intake, lower cognitive function, poorer nutritional status and grip strength, but faster gait speed while being more dependent on assistance to perform daily activities (all p < 0.05). Cognitive function was more strongly associated than nutritional status with physical function. Rural older Indonesians living in Yogyakarta were more likely than urban older people to be malnourished and cognitively impaired, and to have associated reductions in functional capacity and independence. Strategies to improve cognitive function and nutritional status are therefore important for the wellbeing of Indonesian citizens. PMID:29137185

Length of psychiatric hospitalization is correlated with CYP2D6 functional status in inpatients with major depressive disorder

PubMed Central

Ruaño, Gualberto; Szarek, Bonnie L; Villagra, David; Gorowski, Krystyna; Kocherla, Mohan; Seip, Richard L; Goethe, John W; Schwartz, Harold I

2016-01-01

Aim This study aimed to determine the effect of the CYP2D6 genotype on the length of hospitalization stay for patients treated for major depressive disorder. Methods A total of 149 inpatients with a diagnosis of major depressive disorder at the Institute of Living, Hartford Hospital (CT, USA), were genotyped to detect altered alleles in the CYP2D6 gene. Prospectively defined drug metabolism indices (metabolic reserve, metabolic alteration and allele alteration) were determined quantitatively and assessed for their relationship to length of hospitalization stay. Results Hospital stay was significantly longer in deficient CYP2D6 metabolizers (metabolic reserve <2) compared with functional or suprafunctional metabolizers (metabolic reserve ≥2; 7.8 vs 5.7 days, respectively; p = 0.002). Conclusion CYP2D6 enzymatic functional status significantly affected length of hospital stay, perhaps due to reduced efficacy or increased side effects of the medications metabolized by the CYP2D6 isoenzyme. Functional scoring of CYP2D6 alleles may have a substantial impact on the quality of care, patient satisfaction and the economics of psychiatric treatment. PMID:23734807

Health status and suicide in the second half of life

PubMed Central

Conwell, Yeates; Duberstein, Paul R.; Hirsch, Jameson K.; Conner, Kenneth R.; Eberly, Shirley; Caine, Eric D.

2010-01-01

Objective To examine the associations of suicide in the second half of life with medical and psychiatric illness, functional limitations, and reported use of inpatient, ambulatory, and home health care services. Method A retrospective case-control design was used to compare 86 people over age 50 years who died by suicide with a comparison group of 86 living community participants that were individually matched on age, gender, race, and county of residence. Results Suicide decedents had more Axis I diagnoses, including current mood and anxiety disorders, worse physical health status, and greater impairment in functional capacity. They were more likely to have required psychiatric treatment, medical, or surgical hospitalization in the last year, and visiting nurse or home health aide services. In a multivariate model, the presence of any active Axis I disorder and any impairment in instrumental activities of daily living (IADL) made independent contributions to suicide risk. Conclusions Mental illness, physical illness, and associated functional impairments represent domains of risk for suicide in this age group. In addition to individuals with psychiatric illness, those with severe or comorbid physical illness and functional disability who require inpatient and home care services should be targeted for screening and preventive interventions. PMID:19582758

Household Wealth and Neurocognitive Development Disparities among School-aged Children in Nepal

PubMed Central

Patel, Shivani A; Murray-Kolb, Laura E; LeClerq, Steven C; Khatry, Subarna K; Tielsch, James M; Katz, Joanne; Christian, Parul

2013-01-01

Background Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal. Methods We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home environment, and schooling pattern. Results We observed a positive gradient in child neurocognitive performance by household wealth. After adjusting for child and household control factors, disparities between children in the highest and lowest wealth quintiles persisted in intellectual and motor function, but not executive function. No statistically significant wealth-based differentials in outcomes remained after accounting for nutritional status, home environment, and schooling patterns. The largest differences in neurocognitive development were associated with schooling pattern. Conclusions Household wealth patterns child neurocognitive development in rural Nepal, likely through its influence on nutritional status, the home environment, and schooling. In the current context, improving early and regular schooling in this setting is critical to addressing wealth-based disparities in outcomes. PMID:24118003

Relationship between patient-reported and objective measurements of hand function in patients with rheumatoid arthritis.

PubMed

Günay, S M; Tuna, Z; Oskay, D

2016-12-31

Rheumatoid arthritis (RA) often results in impairments in upper extremities, especially in the small joints of hand. Involvement of hand brings limitations in activities of daily living. However, it is commonly observed that patient-reported functional status of hand does not always corresponds to their actual physical performance in the clinical setting. The aim of this pilot study is to investigate the relationship between patient self-reported and objectively measured hand functions in patients with RA. Twenty-six patients (51±13 years) with RA diagnosis participated in the study. Hand grip and pinch (lateral, bipod, tripod) strengths were measured and Jebsen Hand Function Test (JHFT) was performed for objective functional performance. Duruöz Hand Index and Beck Depression Inventory - Turkish version were completed by patients. Grip and all three-pinch strength results significantly correlated with Duruöz Hand Index scores (p<0.05). JHFT results except the sentence writing also correlated with the Duruöz scores (p<0.05). Our results showed that self-reported outcome scales might be used for determining functional level of hand in patients with RA in rheumatology practice. Objective quantitative functional tests are the best methods in evaluating functional level of hand, but require valid and reliable equipment with accurate calibration. Therefore, in case of unavailability of objective assessment tools, patient-reported scales may also reflect the real status of hand functions.

Validation of the PROMIS Physical Function Measures in a Diverse U.S. Population-Based Cohort of Cancer Patients

PubMed Central

Jensen, Roxanne E.; Potosky, Arnold L.; Reeve, Bryce B.; Hahn, Elizabeth; Cella, David; Fries, James; Smith, Ashley Wilder; Keegan, Theresa H.M.; Wu, Xiao-Cheng; Paddock, Lisa; Moinpour, Carol M.

2016-01-01

Purpose To evaluate the validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function measures in a diverse, population-based cancer sample. Methods Cancer patients 6–13 months post diagnosis (n=4,840) were recruited for the Measuring Your Health (MY-Health) study. Participants were diagnosed between 2010–2013 with non-Hodgkin lymphoma or cancers of the colorectum, lung, breast, uterus, cervix, or prostate. Four PROMIS Physical Function short forms (4a, 6b, 10a, and 16) were evaluated for validity and reliability across age and race-ethnicity groups. Covariates included gender, marital status, education level, cancer site and stage, comorbidities, and functional status. Results PROMIS Physical Function short forms showed high internal consistency (Cronbach’s α =0.92 – 0.96), convergent validity (Fatigue, Pain Interference, FACT Physical Well-Being all r≥0.68) and discriminant validity (unrelated domains all r≤0.3) across survey short forms, age, and race-ethnicity. Known group differences by demographic, clinical, and functional characteristics performed as hypothesized. Ceiling effects for higher-functioning individuals were identified on most forms. Conclusions This study provides strong evidence that PROMIS Physical Function measures are valid and reliable in multiple race-ethnicity and age groups. Researchers selecting specific PROMIS short forms should consider the degree of functional disability in their patient population to ensure that length and content are tailored to limit response burden. PMID:25935353

Physical function and independence 1 year after myocardial infarction: observations from the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status registry.

PubMed

Dodson, John A; Arnold, Suzanne V; Reid, Kimberly J; Gill, Thomas M; Rich, Michael W; Masoudi, Frederick A; Spertus, John A; Krumholz, Harlan M; Alexander, Karen P

2012-05-01

Acute myocardial infarction (AMI) may contribute to health status declines including "independence loss" and "physical function decline." Despite the importance of these outcomes for prognosis and quality of life, their incidence and predictors have not been well described. We studied 2,002 patients with AMI enrolled across 24 sites in the TRIUMPH registry who completed assessments of independence and physical function at the time of AMI and 1 year later. Independence was evaluated by the EuroQol-5D (mobility, self-care, and usual activities), and physical function was assessed with the Short Form-12 physical component score. Declines in ≥1 level on EuroQol-5D and >5 points in PCS were considered clinically significant changes. Hierarchical, multivariable, modified Poisson regression models accounting for within-site variability were used to identify predictors of independence loss and physical function decline. One-year post AMI, 43.0% of patients experienced health status declines: 12.8% independence loss alone, 15.2% physical function decline alone, and 15.0% both. After adjustment, variables that predicted independence loss included female sex, nonwhite race, unmarried status, uninsured status, end-stage renal disease, and depression. Variables that predicted physical function decline were uninsured status, lack of cardiac rehabilitation referral, and absence of pre-AMI angina. Age was not predictive of either outcome after adjustment. >40% of patients experience independence loss or physical function decline 1 year after AMI. These changes are distinct but can occur simultaneously. Although some risk factors are not modifiable, others suggest potential targets for strategies to preserve patients' health status. Copyright © 2012 Mosby, Inc. All rights reserved.

Patient-Reported Outcome Measures (PROM) as A Preoperative Assessment Tool.

PubMed

Kim, Sunghye; Duncan, Pamela W; Groban, Leanne; Segal, Hannah; Abbott, Rica Moonyeen; Williamson, Jeff D

2017-11-28

Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades. Preoperative depression has been linked to postoperative delirium, complications, persistent pain, longer lengths of stay, and mortality. Socioeconomic status associates with overall and cancer-free survival. Low socioeconomic status has also been connected to medication non- compliance. Social support can predict overall and cancer- free survival, as well as physical, social and emotional quality of life. Poor functional status and frailty have been related to postoperative complications, longer lengths of stay, post-discharge institutionalization, and higher costs. Preoperative cognitive impairment also associates with self-medication management errors, postoperative cognitive impairment, delirium, complications and mortality. In addition, a greater tendency for reduced adherence to preoperative medication instructions has been linked to health illiteracy. Preoperative malnutrition is prevalent and associates with postoperative morbidity. Efficient and effective assessments of social and behavioral determinants of health, functional status, health literacy, patient's perception of health, and preferences for self-management may improve postoperative management and surgical outcomes, particularly among vulnerable patients undergoing elective surgery who might have subtle physical, social, or psychological deficits or challenges, otherwise missed upon routine evaluation. Patient Reported Outcome Measures (PROMs) can be used to effectively and efficiently collect these factors in the preoperative period, thereby identifying areas that can be intervened preemptively. (Partially Funded by the National Institute on Aging and the Wake Forest University Claude D. Pepper Older Americans Independence Center.).

Examining acute rehabilitation outcomes for children with total functional dependence after traumatic brain injury: a pilot study.

PubMed

Kramer, Megan E; Suskauer, Stacy J; Christensen, James R; DeMatt, Ellen J; Trovato, Melissa K; Salorio, Cynthia F; Slomine, Beth S

2013-01-01

To examine in a pilot cohort factors associated with functional outcome at discharge and 3-month follow-up after discharge from inpatient rehabilitation in children with severe traumatic brain injury (TBI) who entered rehabilitation with the lowest level of functional skills. Thirty-nine children and adolescents (3-18 years old) who sustained a severe TBI and had the lowest possible rating at rehabilitation admission on the Functional Independence Measure for Children (total score = 18). Retrospective review of data collected as part of routine clinical care. At discharge, 59% of the children were partially dependent for basic activities, while 41% remained dependent for basic activities. Initial Glasgow Coma Scale score, time to follow commands, and time from injury to rehabilitation admission were correlated with functional status at discharge. Time to follow commands and time from injury to rehabilitation admission were correlated with functional status at 3-month follow-up. Changes in functional status during the first few weeks of admission were associated with functional status at discharge and follow-up. Even children with the most severe brain injuries, who enter rehabilitation completely dependent for all daily activities, have the potential to make significant gains in functioning by discharge and in the following few months. Assessment of functional status early in the course of rehabilitation contributes to the ability to predict outcome from severe TBI.

Will isomalto-oligosaccharides, a well-established functional food in Asia, break through the European and American market? The status of knowledge on these prebiotics.

PubMed

Goffin, Dorothee; Delzenne, Nathalie; Blecker, Christophe; Hanon, Emilien; Deroanne, Claude; Paquot, Michel

2011-05-01

This critical review article presents the current state of knowledge on isomalto-oligosaccharides, some well known functional oligosaccharides in Asia, to evaluate their potential as emergent prebiotics in the American and European functional food market. It includes first a unique inventory of the different families of compounds which have been considered as IMOs and their specific structure. A description has been given of the different production methods including the involved enzymes and their specific activities, the substrates, and the types of IMOs produced. Considering the structural complexity of IMO products, specific characterization methods are described, as well as purification methods which enable the body to get rid of digestible oligosaccharides. Finally, an extensive review of their techno-functional and nutritional properties enables placing IMOs inside the growing prebiotic market. This review is of particular interest considering that IMO commercialization in America and Europe is a topical subject due to the recent submission by Bioneutra Inc. (Canada) of a novel food file to the UK Food Standards Agency, as well as several patents for IMO production.

Northeastern Regional Forest Fragmentation Assessment: Rationale, Methods, and Comparisons With Other Studies

Treesearch

Andrew Lister; Rachel Riemann; Tonya Lister; Will McWilliams

2005-01-01

Forest fragmentation is thought to impact many biotic and abiotic processes important to ecosystem function. We assessed forest fragmentation in 13 Northeastern States to gain a greater understanding of the trends in and status of this region?s forests. We reclassified and then statistically filtered and updated classified Landsat imagery from the early 1990s, and...

Employment among Working-Age Adults with Multiple Sclerosis: A Data-Mining Approach to Identifying Employment Interventions

ERIC Educational Resources Information Center

Bishop, Malachy; Chan, Fong; Rumrill, Phillip D., Jr.; Frain, Michael P.; Tansey, Timothy N.; Chiu, Chung-Yi; Strauser, David; Umeasiegbu, Veronica I.

2015-01-01

Purpose: To examine demographic, functional, and clinical multiple sclerosis (MS) variables affecting employment status in a national sample of adults with MS in the United States. Method: The sample included 4,142 working-age (20-65 years) Americans with MS (79.1% female) who participated in a national survey. The mean age of participants was…

Nutrition management methods effective in increasing weight, survival time and functional status in ALS patients: a systematic review.

PubMed

Kellogg, Jaylin; Bottman, Lindsey; Arra, Erin J; Selkirk, Stephen M; Kozlowski, Frances

2018-02-01

Poor prognosis and decreased survival time correlate with the nutritional status of patients with amyotrophic lateral sclerosis (ALS). Various studies were reviewed which assessed weight, body mass index (BMI), survival time and ALS functional rating scale revised (ALSFRS-R) in order to determine the best nutrition management methods for this patient population. A systematic review was conducted using CINAHL, Medline, and PubMed, and various search terms in order to determine the most recent clinical trials and observational studies that have been conducted concerning nutrition and ALS. Four articles met criteria to be included in the review. Data were extracted from these articles and were inputted into the Data Extraction Tool (DET) provided by the Academy of Nutrition and Dietetics (AND). Results showed that nutrition supplementation does promote weight stabilisation or weight gain in individuals with ALS. Given the low risk and low cost associated with intervention, early and aggressive nutrition intervention is recommended. This systematic review shows that there is a lack of high quality evidence regarding the efficacy of any dietary interventions for promoting survival in ALS or slowing disease progression; therefore more research is necessary related to effects of nutrition interventions.

Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial.

PubMed

Badrasawi, M; Shahar, Suzana; Zahara, A M; Nor Fadilah, R; Singh, Devinder Kaur Ajit

2016-01-01

Frailty is a biological syndrome of decreased reserve and resistance to stressors due to decline in multiple physiological systems. Amino acid deficiency, including L-carnitine, has been proposed to be associated with its pathophysiology. Nevertheless, the efficacy of L-carnitine supplementation on frailty status has not been documented. Thus, this study aimed to determine the effect of 10-week L-carnitine supplement (1.5 g/day) on frailty status and its biomarkers and also physical function, cognition, and nutritional status among prefrail older adults in Klang Valley, Malaysia. This study is a randomized, double-blind, placebo-controlled clinical trial conducted among 50 prefrail subjects randomized into two groups (26 in L-carnitine group and 24 in placebo group). Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit, selected frailty biomarkers (interleukin-6, tumor necrosis factor-alpha, and insulin-like growth factor-1), physical function, cognitive function, nutritional status and biochemical profile. The results indicated that the mean scores of Frailty Index score and hand grip test were significantly improved in subjects supplemented with L-carnitine ( P <0.05 for both parameters) as compared to no change in the placebo group. Based on Fried criteria, four subjects (three from the L-carnitine group and one from the control group) transited from prefrail status to robust after the intervention. L-carnitine supplementation has a favorable effect on the functional status and fatigue in prefrail older adults.

Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial

PubMed Central

Badrasawi, M; Shahar, Suzana; Zahara, AM; Nor Fadilah, R; Singh, Devinder Kaur Ajit

2016-01-01

Background Frailty is a biological syndrome of decreased reserve and resistance to stressors due to decline in multiple physiological systems. Amino acid deficiency, including L-carnitine, has been proposed to be associated with its pathophysiology. Nevertheless, the efficacy of L-carnitine supplementation on frailty status has not been documented. Thus, this study aimed to determine the effect of 10-week L-carnitine supplement (1.5 g/day) on frailty status and its biomarkers and also physical function, cognition, and nutritional status among prefrail older adults in Klang Valley, Malaysia. Methodology This study is a randomized, double-blind, placebo-controlled clinical trial conducted among 50 prefrail subjects randomized into two groups (26 in L-carnitine group and 24 in placebo group). Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit, selected frailty biomarkers (interleukin-6, tumor necrosis factor-alpha, and insulin-like growth factor-1), physical function, cognitive function, nutritional status and biochemical profile. Results The results indicated that the mean scores of Frailty Index score and hand grip test were significantly improved in subjects supplemented with L-carnitine (P<0.05 for both parameters) as compared to no change in the placebo group. Based on Fried criteria, four subjects (three from the L-carnitine group and one from the control group) transited from prefrail status to robust after the intervention. Conclusion L-carnitine supplementation has a favorable effect on the functional status and fatigue in prefrail older adults. PMID:27895474

Analysis of biomedical time signals for characterization of cutaneous diabetic micro-angiopathy

NASA Astrophysics Data System (ADS)

Kraitl, Jens; Ewald, Hartmut

2007-02-01

Photo-plethysmography (PPG) is frequently used in research on microcirculation of blood. It is a non-invasive procedure and takes minimal time to be carried out. Usually PPG time series are analyzed by conventional linear methods, mainly Fourier analysis. These methods may not be optimal for the investigation of nonlinear effects of the hearth circulation system like vasomotion, autoregulation, thermoregulation, breathing, heartbeat and vessels. The wavelet analysis of the PPG time series is a specific, sensitive nonlinear method for the in vivo identification of hearth circulation patterns and human health status. This nonlinear analysis of PPG signals provides additional information which cannot be detected using conventional approaches. The wavelet analysis has been used to study healthy subjects and to characterize the health status of patients with a functional cutaneous microangiopathy which was associated with diabetic neuropathy. The non-invasive in vivo method is based on the radiation of monochromatic light through an area of skin on the finger. A Photometrical Measurement Device (PMD) has been developed. The PMD is suitable for non-invasive continuous online monitoring of one or more biologic constituent values and blood circulation patterns.

Method for concurrent execution of primitive operations by dynamically assigning operations based upon computational marked graph and availability of data

NASA Technical Reports Server (NTRS)

Mielke, Roland V. (Inventor); Stoughton, John W. (Inventor)

1990-01-01

Computationally complex primitive operations of an algorithm are executed concurrently in a plurality of functional units under the control of an assignment manager. The algorithm is preferably defined as a computationally marked graph contianing data status edges (paths) corresponding to each of the data flow edges. The assignment manager assigns primitive operations to the functional units and monitors completion of the primitive operations to determine data availability using the computational marked graph of the algorithm. All data accessing of the primitive operations is performed by the functional units independently of the assignment manager.

Chronic disorders of consciousness: role of neuroimaging

NASA Astrophysics Data System (ADS)

Kremneva, E.; Sergeev, D.; Zmeykina, E.; Legostaeva, L.; Piradov, M.

2017-08-01

Chronic disorders of consciousness are clinically challenging conditions, and advanced methods of imaging for better understanding of diagnosis and prognosis are needed. Recent functional neuroradiological studies utilizing PET and fMRI demonstrated that besides widespread neuronal loss disruption of interconnection between certain cortical networks after the injury may also play the leading role in the development of behaviourally assessed unresponsiveness. Functional and structural connectivity, evaluated by neuroimaging approaches, may correlate with clinical status and may also play prognostic role. Integration of data from various diagnostic modalities is needed for further progress in this area.

Current Status of the Polyamine Research Field

PubMed Central

Pegg, Anthony E.; Casero, Robert A.

2013-01-01

This chapter provides an overview of the polyamine field and introduces the 32 other chapters that make up this volume. These chapters provide a wide range of methods, advice, and background relevant to studies of the function of polyamines, the regulation of their content, their role in disease, and the therapeutic potential of drugs targeting polyamine content and function. The methodology provided in this new volume will enable laboratories already working in this area to expand their experimental techniques and facilitate the entry of additional workers into this rapidly expanding field. PMID:21318864

Quality of Life of Nepalese Women Post Mastectomy

PubMed

Maharjan, Muna; Thapa, Niresh; Adhikari, Raj Devi; Petrini, Marcia A; Amatya, Kapendra Shekhar

2018-04-25

Introduction: Worldwide breast cancer is the common invasive cancer among the females. The quality of life of women after treatment, which is often a mastectomy, is frequently decreased. Objective: To determine the life quality of Nepalese women post mastectomy. Materials and Methods: One hundred seven women after a mastectomy were selected and interviewed by using the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire and its Breast Specific Module to assess women’s quality of life. Result: The study findings revealed a good score on global health status/quality of life. The respondents performed well on functional and symptom scales. In the Breast Specific Module, all respondents performed poor regarding sexual function and sexual enjoyment. Global Health Status was found useful among the women involved in service/business/agriculture and the survivors using breast prosthesis. In Breast Specific Module, systemic therapy side effects showed strong statistical associations with age, marital status, occupation, education, use of breast prosthesis and co-morbidity. Body image was highly significant with age, occupation, education, use of breast prosthesis and co-morbidity. Conclusion: Based on the study findings, counseling, and a structured educational programme is recommended to improve the QOL of women after a mastectomy. Creative Commons Attribution License

Factors predicting work outcome in Japanese patients with schizophrenia: role of multiple functioning levels.

PubMed

Sumiyoshi, Chika; Harvey, Philip D; Takaki, Manabu; Okahisa, Yuko; Sato, Taku; Sora, Ichiro; Nuechterlein, Keith H; Subotnik, Kenneth L; Sumiyoshi, Tomiki

2015-09-01

Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals' version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60-70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.

Knowing who's boss: implicit perceptions of status from the nonverbal expression of pride.

PubMed

Shariff, Azim F; Tracy, Jessica L

2009-10-01

Evolutionary theory suggests that the universal recognition of nonverbal expressions of emotions functions to enhance fitness. Specifically, emotion expressions may send survival-relevant messages to other social group members, who have the capacity to automatically interpret these signals. In the present research, we used 3 different implicit association methodologies to test whether the nonverbal expression of pride sends a functional, automatically perceived signal about a social group member's increased social status. Results suggest that the pride expression strongly signals high status, and this association cannot be accounted for by positive valence or artifacts of the expression such as expanded size due to outstretched arms. These findings suggest that the pride expression may function to uniquely communicate the high status of those who show it. Discussion focuses on the implications of these findings for social functions of emotion expressions and the automatic communication of status.

Socioeconomic Status and Longitudinal Lung Function of Healthy Mexican Children

PubMed Central

Martínez-Briseño, David; Fernández-Plata, Rosario; Gochicoa-Rangel, Laura; Torre-Bouscoulet, Luis; Rojas-Martínez, Rosalba; Mendoza-Alvarado, Laura; García-Sancho, Cecilia; Pérez-Padilla, Rogelio

2015-01-01

Introduction Our aim was to estimate the longitudinal effect of Socioeconomic status (SES) on lung function growth of Mexican children and adolescents. Materials and Methods A cohort of Mexican children in third grade of primary school was followed with spirometry twice a year for 6 years through secondary school. Multilevel mixed-effects lineal models were fitted for the spirometric variables of 2,641 respiratory-healthy Mexican children. Monthly family income (in 2002 U.S. dollars [USD]) and parents’ years completed at school were used as proxies of SES. Results Individuals with higher SES tended to have greater height for age, and smaller sitting height/standing height and crude lung function. For each 1-year increase of parents’ schooling, Forced expiratory volume in 1 sec (FEV1) and Forced vital capacity (FVC) increased 8.5 (0.4%) and 10.6 mL (0.4%), respectively (p <0.05) when models were adjusted for gender. Impact of education on lung function was reduced drastically or abolished on adjusting by anthropometric variables and ozone. Conclusions Higher parental schooling and higher monthly family income were associated with higher lung function in healthy Mexican children, with the majority of the effect likely due to the increase in height-for-age. PMID:26379144

Automation of On-Board Flightpath Management

NASA Technical Reports Server (NTRS)

Erzberger, H.

1981-01-01

The status of concepts and techniques for the design of onboard flight path management systems is reviewed. Such systems are designed to increase flight efficiency and safety by automating the optimization of flight procedures onboard aircraft. After a brief review of the origins and functions of such systems, two complementary methods are described for attacking the key design problem, namely, the synthesis of efficient trajectories. One method optimizes en route, the other optimizes terminal area flight; both methods are rooted in optimal control theory. Simulation and flight test results are reviewed to illustrate the potential of these systems for fuel and cost savings.

Effect of gender and nutritional status on academic achievement and cognitive function among primary school children in a rural district in Malaysia.

PubMed

Hamid, Jan J M; Amal, Mitra K; Hasmiza, H; Pim, C D; Ng, L O; Wan, Manan W M

2011-08-01

The aim of this study was to investigate the relationship between gender, birth weight, nutritional status, and iron status of children with their academic performance and cognitive function. Two hundred and forty-nine children, seven to nine years of age, were recruited by systematic sampling from six primary schools in a rural area in Malaysia. Cognitive function was assessed by using Raven's Coloured Progressive Matrices (R-CPM). Academic performance of the children was recorded from their school final examination results in four subjects including Malay language, English, Mathematics, and Science. Birth weight was recorded from the birth certificate, and nutritional status was determined by weight-for-age z score and height-for-age z score. Girls had a significantly higher score in all the academic tests, but a lower cognitive score compared to boys. Nutritional status was found to be correlated significantly with academic performance. Academic and cognitive function scores were also found to be correlated significantly with birth weight, parents' education, and family income. In a multivariate analysis, gender remained the significant predictor of academic function, and iron status and haemoglobin were the significant predictors of cognitive function, after controlling for other variables. The study showed that girls performed better academically than boys in rural Malaysia. Nutritional status, parents' education and family income could be additional modifiable factors to improve academic performance of the children. More attention is needed to improve academic achievements of boys at their early school years.

Trehalose 6-phosphate: a signal of sucrose status.

PubMed

Paul, Matthew J

2008-05-15

T6P (trehalose 6-phosphate), the precursor of trehalose, has come out of obscurity over 10 years to be appreciated as an important regulator of plant metabolism and development, quite possibly linking the two. This information has been gained from analysis of mutant and transgenic plants, which show strong, diverse and strategically important phenotypes. Plant genes that encode the trehalose pathway are numerous and highly regulated transcriptionally and post-translationally, responding sensitively to the environment in a developmentally programmed and tissue-specific manner further suggestive of a vital function. Yet the precise role of T6P has not been clear. In an article published in the Biochemical Journal in 2006, John Lunn and colleagues addressed a major obstacle to understanding the function of T6P through development of a method capable of resolving femtomolar quantities of T6P from very small amounts of tissue. Using this technology, the authors showed large changes in T6P content that reflect tissue sucrose status. Overall, this elegant work makes an important contribution towards our understanding of the function of T6P in plants.

Varying coefficient function models to explore interactions between maternal nutritional status and prenatal methylmercury toxicity in the Seychelles Child Development Nutrition Study

PubMed Central

Lynch, Miranda L.; Huang, Li-Shan; Cox, Christopher; Strain, J.J.; Myers, Gary J.; Bonham, Maxine P.; Shamlaye, Conrad F.; Stokes-Riner, Abbie; Wallace, Julie M.W.; Duffy, Emeir M.; Clarkson, Thomas W.; Davidson, Philip W.

2010-01-01

Maternal consumption of fish during the gestational period exposes the fetus to both nutrients, especially the long-chain polyunsaturated fatty acids (LCPUFAs), believed to be beneficial for fetal brain development, as well as to the neurotoxicant methylmercury (MeHg). We recently reported that nutrients present in fish may modify MeHg neurotoxicity. Understanding the apparent interaction of MeHg exposure and nutrients present in fish is complicated by the limitations of modeling methods. In this study we fit varying coefficient function models to data from the Seychelles Child Development Nutrition Study (SCDNS) cohort to assess the association of dietary nutrients and children’s development. This cohort of mother-child pairs in the Republic of Seychelles had fish consumption averaging 9 meals per week. Maternal nutritional status was assessed for five different nutritional components known to be present in fish (n-3 LCPUFA, n-6 LCPUFA, iron status, iodine status, and choline) and associated with children’s neurological development. We also included prenatal MeHg exposure (measured in maternal hair). We examined two child neurodevelopmental outcomes (Bayley Scales Infant Development-II (BSID-II) Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI)), each administered at 9 and at 30 months. The varying coefficient models allow the possible interactions between each nutritional component and MeHg to be modeled as a smoothly varying function of MeHg as an effect modifier. Iron, iodine, choline, and n-6 LCPUFA had little or no observable modulation at different MeHg exposures. In contrast the n-3 LCPUFA docosahexaenoic acid (DHA) had beneficial effects on the BSID-II PDI that were reduced or absent at higher MeHg exposures. This study presents a useful modeling method that can be brought to bear on questions involving interactions between covariates, and illustrates the continuing importance of viewing fish consumption during pregnancy as a case of multiple exposures to nutrients and to MeHg. The results encourage more emphasis on a holistic view of the risks and benefits of fish consumption as it relates to infant development. PMID:20961536

Varying coefficient function models to explore interactions between maternal nutritional status and prenatal methylmercury toxicity in the Seychelles Child Development Nutrition Study.

PubMed

Lynch, Miranda L; Huang, Li-Shan; Cox, Christopher; Strain, J J; Myers, Gary J; Bonham, Maxine P; Shamlaye, Conrad F; Stokes-Riner, Abbie; Wallace, Julie M W; Duffy, Emeir M; Clarkson, Thomas W; Davidson, Philip W

2011-01-01

Maternal consumption of fish during the gestational period exposes the fetus to both nutrients, especially the long-chain polyunsaturated fatty acids (LCPUFAs), believed to be beneficial for fetal brain development, as well as to the neurotoxicant methylmercury (MeHg). We recently reported that nutrients present in fish may modify MeHg neurotoxicity. Understanding the apparent interaction of MeHg exposure and nutrients present in fish is complicated by the limitations of modeling methods. In this study we fit varying coefficient function models to data from the Seychelles Child Development Nutrition Study (SCDNS) cohort to assess the association of dietary nutrients and children's development. This cohort of mother-child pairs in the Republic of Seychelles had fish consumption averaging 9 meals per week. Maternal nutritional status was assessed for five different nutritional components known to be present in fish (n-3 LCPUFA, n-6 LCPUFA, iron status, iodine status, and choline) and associated with children's neurological development. We also included prenatal MeHg exposure (measured in maternal hair). We examined two child neurodevelopmental outcomes (Bayley Scales Infant Development-II (BSID-II) Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI)), each administered at 9 and at 30 months. The varying coefficient models allow the possible interactions between each nutritional component and MeHg to be modeled as a smoothly varying function of MeHg as an effect modifier. Iron, iodine, choline, and n-6 LCPUFA had little or no observable modulation at different MeHg exposures. In contrast the n-3 LCPUFA docosahexaenoic acid (DHA) had beneficial effects on the BSID-II PDI that were reduced or absent at higher MeHg exposures. This study presents a useful modeling method that can be brought to bear on questions involving interactions between covariates, and illustrates the continuing importance of viewing fish consumption during pregnancy as a case of multiple exposures to nutrients and to MeHg. The results encourage more emphasis on a holistic view of the risks and benefits of fish consumption as it relates to infant development. Copyright © 2010 Elsevier Inc. All rights reserved.

Biomagnetism using SQUIDs: status and perspectives

NASA Astrophysics Data System (ADS)

Sternickel, Karsten; Braginski, Alex I.

2006-03-01

Biomagnetism involves the measurement and analysis of very weak local magnetic fields of living organisms and various organs in humans. Such fields can be of physiological origin or due to magnetic impurities or markers. This paper reviews existing and prospective applications of biomagnetism in clinical research and medical diagnostics. Currently, such applications require sensitive magnetic SQUID sensors and amplifiers. The practicality of biomagnetic methods depends especially on techniques for suppressing the dominant environmental electromagnetic noise, and on suitable nearly real-time data processing and interpretation methods. Of the many biomagnetic methods and applications, only the functional studies of the human brain (magnetoencephalography) and liver susceptometry are in clinical use, while functional diagnostics of the human heart (magnetocardiography) approaches the threshold of clinical acceptance. Particularly promising for the future is the ongoing research into low-field magnetic resonance anatomical imaging using SQUIDs.

Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation

PubMed Central

Chen, Chang-Hong; Dong, Qi-Rong; Zhou, Rong-Kui; Zhen, Hua-Qing; Jiao, Ya-Jun

2014-01-01

Introduction: Internal fixation with hook plate has been used to treat acromioclavicular joint dislocation. This study aims to evaluate the effect of its use on shoulder function, to further analyze the contributing factors, and provide a basis for selection and design of improved internal fixation treatment of the acromioclavicular joint dislocation in the future. Methods: A retrospective analysis was performed on patients treated with a hook plate for acromioclavicular joint dislocation in our hospital from January 2010 to February 2013. There were 33 cases in total, including 25 males and 8 females, with mean age of 48.27 ± 8.7 years. There were 29 cases of Rockwood type III acromioclavicular dislocation, 4 cases of type V. The Constant-Murley shoulder function scoring system was used to evaluate the shoulder function recovery status after surgery. Anteroposterior shoulder X-ray was used to assess the position of the hook plate, status of acromioclavicular joint reduction and the occurrence of postoperative complications. Results: According to the Constant-Murley shoulder function scoring system, the average scores were 78 ± 6 points 8 to 12 months after the surgery and before the removal of the hook plate, the average scores were 89 ± 5 minutes two months after the removal of hook plate. Postoperative X-ray imaging showed osteolysis in 10 cases (30.3%), osteoarthritis in six cases (18.1%), osteolysis associated with osteoarthritis in four cases(12.1%), and steel hook broken in one case (3%). Conclusion: The use of hook plate on open reduction and internal fixation of the acromioclavicular joint dislocation had little adverse effect on shoulder function and is an effective method for the treatment of acromioclavicular joint dislocation. Osteoarthritis and osteolysis are the two common complications after hook plate use, which are associated with the impairment of shoulder function. Shoulder function will be improved after removal of the hook plate. PMID:25356110

Multiple Types of Memory and Everyday Functional Assessment in Older Adults.

PubMed

Beaver, Jenna; Schmitter-Edgecombe, Maureen

2017-06-01

Current proxy measures for assessing everyday functioning (e.g., questionnaires, performance-based measures, and direct observation) show discrepancies in their rating of functional status. The present study investigated the relationship between multiple proxy measures of functional status and content memory (i.e., memory for information), temporal order memory, and prospective memory in an older adult sample. A total of 197 community-dwelling older adults who did (n = 45) or did not meet (n = 152) criteria for mild cognitive impairment (MCI), completed six different assessments of functional status (two questionnaires, two performance-based tasks, and two direct observation tasks) as well as experimental measures of content memory, prospective memory, and temporal order memory. After controlling for demographics and content memory, the temporal order and prospective memory measures explained a significant amount of variance in all proxy functional status measures. When all variables were entered into the regression analyses, content memory and prospective memory were found to be significant predictors of all measures of functional status, whereas temporal order memory was a significant predictor for the questionnaire and direct observation measures, but not performance-based measures. The results suggest that direct observation and questionnaire measures may be able to capture components of everyday functioning that require context and temporal sequencing abilities, such as multi-tasking, that are not as well captured in many current laboratory performance-based measures of functional status. Future research should aim to inform the development and use of maximally effective and valid proxy measures of functional ability. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Functional status of acute stroke patients in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.

PubMed

Rameezan, B A R; Zaliha, O

2005-12-01

Stroke is a leading cause of death and disability in most developed countries and developing nations. Majority of the stroke survivors are left with significant physical and cognitive impairments. In addition to the improved acute stroke care, they often benefit from rehabilitation in improving their function. This was the first study done to document function for post stroke patients in Malaysia. It was prospective study conducted to document functional status of acute stroke patients upon admission, discharge and at 3 months post stroke. Assessment of functional status for these patients are based on their activities of daily living and ambulation i.e. self-care, sphincter control, mobility, locomotion, communication and social cognition. It is also aimed to describe their demographic and clinical characteristics. Correlation of functional status at 3 months post stroke with the initial severity of stroke was also explored. A total of fifty-one patients with acute stroke in University Malaya Medical Centre (UMMC) were recruited. The patient's age ranged from 38 to 83 years with a mean of 60.2 years. Thirty-six patients (71%) were first stroke sufferers and fifteen patients (29%) had recurrent stroke. At discharge from acute stay, 13% of patients were able to ambulate with aids and 87% needed assistance for ambulation in varying degrees. Eighty-two percent of patients showed improvement in overall function (both motor and cognition) at 3 months post stroke. Sixty percent of patients were independent in ambulation and 40% required assistance. Significant correlation was seen between the initial severity of stroke and functional status at 3 months post stroke. Functional status of patients with stroke has improved at 3 months post stroke. A comprehensive rehabilitation medicine programme should be incorporated into management of stroke patients to expedite functional recovery and improve patient's independence.

Impact of Preoperative Abdominal Visceral Adipose Tissue Area and Nutritional Status on Renal Function After Donor Nephrectomy in Japanese Living Donors for Renal Transplantation.

PubMed

Hori, Shunta; Miyake, Makito; Morizawa, Yosuke; Nakai, Yasushi; Onishi, Kenta; Iida, Kota; Gotoh, Daisuke; Anai, Satoshi; Torimoto, Kazumasa; Aoki, Katsuya; Yoneda, Tatsuo; Tanaka, Nobumichi; Yoshida, Katsunori; Fujimoto, Kiyohide

2018-05-29

BACKGROUND Living kidney donors face the risk of renal dysfunction, resulting in end-stage renal disease, cardiovascular disease, or cerebrovascular disease, after donor nephrectomy. Reducing this risk is important to increasing survival of living donors. In this study, we investigated the effect of preoperative distribution of abdominal adipose tissue and nutritional status on postoperative renal function in living donors. MATERIAL AND METHODS Seventy-five living donors were enrolled in this retrospective study. Preoperative unenhanced computed tomography images were used to measure abdominal adipose tissue parameters. Prognostic nutritional index (PNI) was used to assess preoperative nutritional status. Donors were divided into 2 groups according to abdominal visceral adipose tissue (VAT) area at the level of the fourth and fifth lumbar vertebrae (<80 or ≥80 cm²). Postoperative renal function was compared in the 2 groups, and prognostic factors for development of chronic kidney disease (CKD) G3b were identified using multivariate analysis. RESULTS Donors with a VAT area ≥80 significantly more often had hypertension preoperatively. Although there was no significant difference in preoperative estimated glomerular filtration rate (eGFR) between the 2 groups, postoperative renal function was significantly decreased in donors with a VAT area ≥80 compared to those with a VAT area <80. In multivariate analysis, VAT area ≥80 and PNI <54 were independent factors predicting the development of CKD G3b after 12 months. CONCLUSIONS Our findings suggest that preoperative VAT and PNI affect postoperative renal function. Further research is required to establish appropriate exercise protocols and nutritional interventions during follow-up to improve outcomes in living donors.

Surgery Followed by Radiotherapy Versus Radiotherapy Alone for Metastatic Spinal Cord Compression From Unfavorable Tumors

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

Rades, Dirk, E-mail: Rades.Dirk@gmx.net; Huttenlocher, Stefan; Bajrovic, Amira

Purpose: Despite a previously published randomized trial, controversy exists regarding the benefit of adding surgery to radiotherapy for metastatic spinal cord compression (MSCC). It is thought that patients with MSCC from relatively radioresistant tumors or tumors associated with poor functional outcome after radiotherapy alone may benefit from surgery. This study focuses on these tumors. Methods and Materials: Data from 67 patients receiving surgery plus radiotherapy (S+RT) were matched to 134 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for 10 factors and compared for motor function, ambulatory status, local control, and survival. Additional separate matched-pair analyses were performed formore » patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS) and patients receiving laminectomy (LE). Results: Improvement of motor function occurred in 22% of patients after S+RT and 16% after RT (p = 0.25). Posttreatment ambulatory rates were 67% and 61%, respectively (p = 0.68). Of nonambulatory patients, 29% and 19% (p = 0.53) regained ambulatory status. One-year local control rates were 85% and 89% (p = 0.87). One-year survival rates were 38% and 24% (p = 0.20). The matched-pair analysis of patients receiving LE showed no significant differences between both therapies. In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred more often after DDSS+RT than RT (28% vs. 19%, p = 0.024). Posttreatment ambulatory rates were 86% and 67% (p = 0.30); 45% and 18% of patients regained ambulatory status (p = 0.29). Conclusions: Patients with MSCC from an unfavorable primary tumor appeared to benefit from DDSS but not LE when added to radiotherapy in terms of improved functional outcome.« less

Objective Data Assessment (ODA) Methods as Nutritional Assessment Tools.

PubMed

Hamada, Yasuhiro

2015-01-01

Nutritional screening and assessment should be a standard of care for all patients because nutritional management plays an important role in clinical practice. However, there is no gold standard for the diagnosis of malnutrition or undernutrition, although a large number of nutritional screening and assessment tools have been developed. Nutritional screening and assessment tools are classified into two categories, namely, subjective global assessment (SGA) and objective data assessment (ODA). SGA assesses nutritional status based on the features of medical history and physical examination. On the other hand, ODA consists of objective data provided from various analyses, such as anthropometry, bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), laboratory tests, and functional tests. This review highlights knowledge on the performance of ODA methods for the assessment of nutritional status in clinical practice. J. Med. Invest. 62: 119-122, August, 2015.

Employment status, social function decline and caregiver burden among stroke survivors. A South Indian study.

PubMed

Sreedharan, Sapna Erat; Unnikrishnan, J P; Amal, M G; Shibi, B S; Sarma, Sankara; Sylaja, P N

2013-09-15

Stroke leaves at least 60% of the survivors with moderate to severe disability limiting their employment status and social functioning leading to high levels of caregiver burden. We sought to study the employment status and level of change of social functioning of stroke survivors and their principal caregiver and correlate it with severity of stroke, functional disability, and anxiety and depression scores. One hundred and fifty stroke survivors and principal caregivers (3 months-2 years post-stroke) were recruited for the study. The employment status pre- and post-stroke was assessed. The social function of the patient and caregiver was analyzed using a 6 item social function scale developed for the study, encompassing culturally relevant questions. A 20 point scale adapted from Burden assessment schedule was used to assess the caregiver burden. Mean age of the study group was 54.37±12.072 (range 22-75 years), with 116 males and 34 females. Spouse was the principal caregiver for 142/150 patients (94.6%). In the stroke survivors, compared to the pre-stroke employment status of 62.7%, only 20.7% were employed post-stroke with half having change of job. But the employment status of caregiver was not reduced post-stroke (34.7% vs 33.3%). Employment loss in stroke survivors had a statistically significant association with severity of functional disability, male gender and presence of limb weakness (p values 0.037, 0.0001 and 0.043 respectively). There was an overall decline in social functions among the 6 parameters assessed in both the stroke survivors and caregivers. Of the caregiver burden, financial burden was more among female and older caregivers. The functional status and motor weakness of the stroke survivors did not tend to worsen the overall caregiver burden. Loss of occupation among stroke survivors is high. The decline in social function among stroke survivors and caregivers was significant. Even though functional disability contributed to employment loss and social function decline among stroke survivors, it did not have a significant impact on caregiver burden. © 2013 Elsevier B.V. All rights reserved

Achieving Body Weight Adjustments for Feeding Status and Pregnant or Non-Pregnant Condition in Beef Cows

PubMed Central

Gionbelli, Mateus P.; Duarte, Marcio S.; Valadares Filho, Sebastião C.; Detmann, Edenio; Chizzotti, Mario L.; Rodrigues, Felipe C.; Zanetti, Diego; Gionbelli, Tathyane R. S.; Machado, Marcelo G.

2015-01-01

Background Beef cows herd accounts for 70% of the total energy used in the beef production system. However, there are still limited studies regarding improvement of production efficiency in this category, mainly in developing countries and in tropical areas. One of the limiting factors is the difficulty to obtain reliable estimates of weight variation in mature cows. This occurs due to the interaction of weight of maternal tissues with specific physiological stages such as pregnancy. Moreover, variation in gastrointestinal contents due to feeding status in ruminant animals is a major source of error in body weight measurements. Objectives Develop approaches to estimate the individual proportion of weight from maternal tissues and from gestation in pregnant cows, adjusting for feeding status and stage of gestation. Methods and Findings Dataset of 49 multiparous non-lactating Nellore cows (32 pregnant and 17 non-pregnant) were used. To establish the relationships between the body weight, depending on the feeding status of pregnant and non-pregnant cows as a function of days of pregnancy, a set of general equations was tested, based on theoretical suppositions. We proposed the concept of pregnant compound (PREG), which represents the weight that is genuinely related to pregnancy. The PREG includes the gravid uterus minus the non-pregnant uterus plus the accretion in udder related to pregnancy. There was no accretion in udder weight up to 238 days of pregnancy. By subtracting the PREG from live weight of a pregnant cow, we obtained estimates of the weight of only maternal tissues in pregnant cows. Non-linear functions were adjusted to estimate the relationship between fasted, non-fasted and empty body weight, for pregnant and non-pregnant cows. Conclusions Our results allow for estimating the actual live weight of pregnant cows and their body constituents, and subsequent comparison as a function of days of gestation and feeding status. PMID:25793770

Contrasting Olfaction, Vision, and Audition as Predictors of Cognitive Change and Impairment in Non-Demented Older Adults

PubMed Central

MacDonald, Stuart W.S.; Keller, Connor J.C.; Brewster, Paul W.H.; Dixon, Roger A.

2017-01-01

Objective This study examines the relative utility of a particular class of non-invasive functional biomarkers -- sensory functions -- for detecting those at risk of cognitive decline and impairment. Three central research objectives were examined including whether: (1) olfactory function, vision, and audition exhibited significant longitudinal declines in non-demented older adults, (2) multi-wave change for these sensory function indicators predicted risk of mild cognitive impairment, and (3) change within persons for each sensory measure shared dynamic time-varying associations with within-person change in cognitive functioning. Method A longitudinal sample (n=408) from the Victoria Longitudinal Study was assembled. Three cognitive status subgroups were identified: not impaired cognitively (NIC), single assessment mild cognitive impairment (SA-MCI), and multiple assessment mild cognitive impairment (MA-MCI). Results We tested independent predictive associations, contrasting change in sensory function as predictors of cognitive decline and impairment, utilizing both linear mixed models and logistic regression analysis. Olfaction and, to a lesser extent, vision were identified as the most robust predictors of cognitive status and decline; audition showed little predictive influence. Conclusions These findings underscore the potential utility of deficits in olfactory function, in particular, as an early marker of age- and pathology-related cognitive decline. Functional biomarkers may represent potential candidates for use in the early stages of a multi-step screening approach for detecting those at risk of cognitive impairment, as well as for targeted intervention. PMID:29809033

CAREGIVERS OF THE CHRONICALLY CRITICALLY ILL AFTER DISCHARGE FROM THE INTENSIVE CARE UNIT: SIX MONTHS’ EXPERIENCE

PubMed Central

Choi, JiYeon; Donahoe, Michael P.; Zullo, Thomas G.; Hoffman, Leslie A.

2011-01-01

Background Chronically critically ill patients typically undergo an extended recovery after discharge from the intensive care unit, making involvement of family caregivers essential. Prior studies provide limited detail about specific ways this experience affects caregivers. Objectives To (1) describe lifestyle restrictions and distress among caregivers of chronically critically ill patients 1 and 6 months after discharge and (2) explore how caregivers’ lifestyle restrictions and distress differ according to patients’ and caregivers’ characteristics. Methods Sixty-nine chronically critically ill patients and their family caregivers completed follow-up at 1 and 6 months after discharge from the intensive care unit. Data were collected from medical records and survey via telephone or mail. Results Caregivers’ perceived lifestyle restrictions (Changes in Role Function) decreased from 1 month (mean [SD], 23.0 [8.3]) to 6 months (19.4 [8.6]) after discharge (P = .003), although patients’ problem behaviors and caregivers’ distress (8.9 [9.3] vs 7.9 [9.6], respectively; P = .32) did not change. Change in caregivers’ lifestyle restrictions differed by patients’ disposition (P = .02) and functional status (Health Assessment Questionnaire; P = .007). Caregiver’s lifestyle restrictions remained high when patients never returned home or never recovered their preadmission functional status. Caregivers reported the most restrictions in social life and personal recreation. Patients’ negative emotions and pain caused the most caregiver distress. Conclusions Caregivers of chronically critically ill patients perceived fewer lifestyle restrictions over time but reported no change in patients’ problem behaviors or distress. Lifestyle restrictions and distress remained high when patients never returned home or regained their preadmission functional status. PMID:21196567

Determinants of life expectancy in eastern mediterranean region: a health production function.

PubMed

Bayati, Mohsen; Akbarian, Reza; Kavosi, Zahra

2013-06-01

Determinants of health or health production function in health economics literature constitute noticeable issues in health promotion. This study aimed at estimating a health production function for East Mediterranean Region (EMR) based on the Grossman theoretical model. This ecological study was performed using the econometric methods. The panel data model was used in order to determine the relationship between life expectancy and socioeconomic factors. The data for 21 EMR countries between 1995 and 2007 were used. Fixed-effect-model was employed to estimate the parameters based on Hausman test. In estimating the health production function, factors such as income per capita (β=0.05, P<0.001), education index (β=0.07, P<0.001), food availability (β=0.01, P<0.001), level of urbanisation (β=0.10, P<0.001), and employment ratio (β=0.11, P<0.001) were specified as determinants of health status, proxied by life expectancy at birth. A notable result was the elasticity of life expectancy with respect to the employment rate and its significance level was different between males (β=0.13, P<0.001) and females (β=0.08, P>0.001). In order to improve the health status in EMR countries, health policymakers should focus on the factors which lie outside the healthcare system. These factors are mainly associated with economic growth and development level. Thus, the economic stabilisation policies with the aim of increasing the productivity, economic growth, and reducing unemployment play significant roles in the health status of the people of the region.

Clinical results of primary malignant musculoskeletal tumor treated by wide resection and recycling autograft reconstruction using liquid nitrogen.

PubMed

Paholpak, Permsak; Sirichativapee, Winai; Wisanuyotin, Taweechok; Kosuwon, Weerachai; Jeeravipoolvarn, Polasak

2015-06-01

To evaluate the clinical results of primary malignant musculoskeletal tumors treated with wide resection and recycling autograft reconstruction using liquid nitrogen. We reviewed 12 patients who had a primary malignant bone and soft tissue tumor treated by wide resection and recycling autograft reconstruction using liquid nitrogen between March 2006 and March 2013. The results were judged by recurrence, functional status and complications. Functional status was assessed according to the Musculoskeletal Tumor Society Score (MSTSS). Clinical failure was defined as need for reoperation in order to change the type of reconstruction or to amputate, and the presence of local recurrence. The most common tumor was osteosarcoma (eight cases) followed by Ewing's sarcoma (two cases). The tibia was the most frequently involved skeletal site (six cases) followed by the femur (three cases). The median follow-up period was 32 months. In 12 patients, 7 were still alive without recurrence. There were 3 clinical failures: 1 local recurrence and 2 graft complications at 28, 51 and 20 months after reconstruction, respectively. The main complication was infection (three cases). All osteotomy sites were radiographic unions, and the union time was 8.2 ± 2.7 months. The mean ± SD MSTSS score was 79% ± 11%; excellent functional results were achieved in seven patients. Recycling autograft reconstruction using liquid nitrogen had favorable clinical outcomes in terms of functional status and local recurrence. This reconstruction method, therefore, represents a reasonable alternative for limb salvage surgery. © 2014 Wiley Publishing Asia Pty Ltd.

The effect of Polygonum minus extract on cognitive and psychosocial parameters according to mood status among middle-aged women: a randomized, double-blind, placebo-controlled study

PubMed Central

Shahar, Suzana; Aziz, Ainor Farahin; Ismail, Siti Nur Arina; Yahya, Hanis Mastura; Din, Normah Che; Manaf, Zahara Abdul; Badrasawi, Manal M

2015-01-01

Background Polygonum minus (PM) or locally known in Malaysia, as “kesum” is rich in micronutrients and natural antioxidants. However, its beneficial effect on outcome associates with oxidative stress including cognitive function is yet to be discovered. We assessed the efficacy of PM extract (LineMinus™) on cognitive function and psychosocial status among middle-aged women in Klang Valley of Malaysia. Methods A randomized, double-blind, placebo-controlled trial among 35 healthy middle-aged women was performed, and subjects were randomized to receive either 250 mg PM or placebo of 100 mg maltodextrin each were taken twice daily for 6 weeks. Subjects were assessed for neuropsychological test, psychosocial status, and anthropometric at baseline, week 3, and week 6. Biomarkers were also determined at baseline and week 6. Results The supplementation of PM showed significant intervention effect on Digit Span test (P<0.05) social functioning domain of 36-Item Short Form Health Survey (P<0.05) among subjects with mood disturbance. While, among subjects with good mood, PM supplementation improved Wechsler Abbreviated Scale of Intelligence (WASI) for IQ verbal (P=0.016) and Full Scale IQ of WASI (P=0.004). There were no adverse effects reported for the supplementation as indicated using biomarkers, including liver function and clinical symptoms. Conclusion Supplementation of PM is safe to be consumed for 6 weeks, with potential benefits to attention, short-term memory, improved quality of life, and mood, as well as IQ. PMID:26445532

Sex Differences in Concomitant Trajectories of Self-Reported Disability and Measured Physical Capacity in Older Adults

PubMed Central

Allore, Heather G.; Mendes de Leon, Carlos F.; Gahbauer, Evelyne A.; Gill, Thomas M.

2016-01-01

Background: Despite documented age-related declines in self-reported functional status and measured physical capacity, it is unclear whether these functional indicators follow similar trajectories over time or whether the patterns of change differ by sex. Methods: We used longitudinal data from 687 initially nondisabled adults, aged 70 or older, from the Precipitating Events Project, who were evaluated every 18 months for nearly 14 years. Self-reported disability was assessed with a 12-item disability scale. Physical capacity was measured using grip strength and a modified version of Short Physical Performance Battery. Hierarchical linear models estimated the intra-individual trajectory of each functional indicator and differences in trajectories’ intercept and slope by sex. Results: Self-reported disability, grip strength, and Short Physical Performance Battery score declined over 13.5 years following nonlinear trajectories. Women experienced faster accumulation of self-reported disability, but slower declines in measured physical capacity, compared with men. Trajectory intercepts revealed that women had significantly weaker grip strength and reported higher levels of disability compared with men, with no differences in starting Short Physical Performance Battery scores. These findings were robust to adjustments for differences in sociodemographic characteristics, length-of-survival, health risk factors, and chronic-disease status. Conclusions: Despite the female disadvantage in self-reported disability, older women preserve measured physical capacity better than men over time. Self-reported and measured indicators should be viewed as complementary rather than interchangeable assessments of functional status for both clinical and research purposes, especially for sex-specific comparisons. PMID:27071781

Effect of Low Perceived Social Support on Health Outcomes in Young Patients With Acute Myocardial Infarction: Results From the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients) Study

PubMed Central

Bucholz, Emily M.; Strait, Kelly M.; Dreyer, Rachel P.; Geda, Mary; Spatz, Erica S.; Bueno, Hector; Lichtman, Judith H.; D'Onofrio, Gail; Spertus, John A.; Krumholz, Harlan M.

2014-01-01

Background Social support is an important predictor of health outcomes after acute myocardial infarction (AMI), but social support varies by sex and age. Differences in social support could account for sex differences in outcomes of young patients with AMI. Methods and Results Data from the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study, an observational study of AMI patients aged ≤55 years in the United States and Spain, were used for this study. Patients were categorized as having low versus moderate/high perceived social support using the ENRICHD Social Support Inventory. Outcomes included health status (Short Form‐12 physical and mental component scores), depressive symptoms (Patient Health Questionnaire), and angina‐related quality of life (Seattle Angina Questionnaire) evaluated at baseline and 12 months. Among 3432 patients, 21.2% were classified as having low social support. Men and women had comparable levels of social support at baseline. On average, patients with low social support reported lower functional status and quality of life and more depressive symptoms at baseline and 12 months post‐AMI. After multivariable adjustment, including baseline health status, low social support was associated with lower mental functioning, lower quality of life, and more depressive symptoms at 12 months (all P<0.001). The relationship between low social support and worse physical functioning was nonsignificant after adjustment (P=0.6). No interactions were observed between social support, sex, or country. Conclusion Lower social support is associated with worse health status and more depressive symptoms 12 months after AMI in both young men and women. Sex did not modify the effect of social support. PMID:25271209

Radiotherapy of metastatic spinal cord compression in very elderly patients

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

Rades, Dirk; Hoskin, Peter J.; Karstens, Johann H.

2007-01-01

Purpose: Owing to the aging of the population, the proportion of elderly patients receiving cancer treatment has increased. This study investigated the results of radiotherapy (RT) for metastatic spinal cord compression (MSCC) in the very elderly, because few data are available for these patients. Methods and Materials: The data from 308 patients aged {>=}75 years who received short-course (treatment time 1-5 days) or long-course RT (2-4 weeks) for MSCC were retrospectively analyzed for functional outcome, local control, and survival. Furthermore, nine potential prognostic factors were investigated: gender, performance status, interval from tumor diagnosis to MSCC, tumor type, number of involvedmore » vertebrae, other bone or visceral metastases, ambulatory status, and speed at which motor deficits developed. Results: Improvement of motor deficits occurred in 25% of patients, with no further progression of MSCC in an additional 59%. The 1-year local control and survival rate was 92% and 43%, respectively. Improved functional outcomes were associated with ambulatory status and slower developing motor deficits. Improved local control resulted from long-course RT. Improved survival was associated with a longer interval from tumor diagnosis to MSCC, tumor type (breast/prostate cancer, myeloma/lymphoma), lack of visceral or other bone metastases, ambulatory status, and a slower development of motor deficits. Conclusion: Short- and long-course RT are similarly effective in patients aged {>=}75 years regarding functional outcome and survival. Long-course RT provided better local control. Patients with better expected survival should receive long-course RT and others short-course RT. The criteria for selection of an appropriate regimen for MSCC in very elderly patients should be the same as for younger individuals.« less

What Are the Links between Maternal Social Status, Hippocampal Function, and HPA Axis Function in Children?

ERIC Educational Resources Information Center

Sheridan, Margaret A.; How, Joan; Araujo, Melanie; Schamberg, Michelle A.; Nelson, Charles A.

2013-01-01

The association of parental social status with multiple health and achievement indicators in adulthood has driven researchers to attempt to identify mechanisms by which social experience in childhood could shift developmental trajectories. Some accounts for observed linkages between parental social status in childhood and health have hypothesized…

Language Policy: Status Planning for the Quechua Language in Peru.

ERIC Educational Resources Information Center

Coronel-Molina, Serafin

1997-01-01

The status of Quechua in Peruvian society is discussed, noting specific social and political factors contributing to the dying out of the Quechua language, functional domains the language serves, and possible measures to improve its status. The relationship of those functional domains to Peruvian language policies is also explored. An introductory…

Effect of Dental Status on Changes in Mastication in Patients with Obesity following Bariatric Surgery

PubMed Central

Godlewski, Anne Espérance; Veyrune, Jean Luc; Nicolas, Emmanuel; Ciangura, Cécile A.; Chaussain, Catherine C.; Czernichow, Sébastien; Basdevant, Arnaud; Hennequin, Martine

2011-01-01

Background Patients scheduled for bariatric surgery (BS) are encouraged to chew slowly in order to optimise the digestion process. The influence of dental status on patients' ability to comply with advice on chewing behaviour is poorly documented. This study aims to compare modifications of chewing function before and after BS in three groups of obese patients differing in dental status. Method and Findings A cohort of 46 obese women provided three groups: FD group: fully dentate (7–10 functional dental units [FU]); PD group: partially dentate (4–6 FU) without partial dentures; DW group: partial and complete denture wearers. Chewing time (CT), number of chewing cycles (CC), and chewing frequency (CF) were measured before and after surgery during mastication of standardised samples of raw carrot, peanuts, banana, apple and jelly. The median particle-size distribution (D50) of the pre-swallowed bolus was also evaluated for peanut and carrot. Before surgery, the PD and DW groups exhibited greater mean CCs and CTs than the FD group (SNK p<0.05) and produced a bolus with higher granulometry (SNK, p<0.05) than the FD group. After surgery, CT and CC increased for all groups and for all foods, but not statistically significant for jelly. The resulting changes in bolus granulometry observed depended on both food and dental status. The granulometry of carrot bolus remained as fine or as coarse in FD and DW groups respectively as it was before surgery while it was significantly decreased in the PD group (Student's test, p<0.001). Conclusions After bariatric surgery, all the obese patients, regardless of dental status modified their chewing kinematics. The effects of this chewing behaviour on bolus granulometry depended on dental status and type of food. Further studies are needed to understand better the impact of dental status on feeding behaviour and nutrition in patients with obesity. PMID:21799822

Association of socioeconomic status and cognitive functioning change among elderly Chinese people.

PubMed

Yang, Lei; Martikainen, Pekka; Silventoinen, Karri; Konttinen, Hanna

2016-09-01

the inverse association between high socioeconomic status and impaired cognitive functioning in old age has been widely studied. However, it is still inconclusive whether higher socioeconomic status slows the rate of cognitive decline over ageing, especially in non-Western populations. We examined this association using a large population-based longitudinal survey of older Chinese persons. the sample came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (from the years 2002 to 2011, N = 15,798 at baseline, aged 65-105). The Mini-Mental State Examination (MMSE) based on face-to-face interviews was used to assess cognitive functioning. Socioeconomic status was assessed using educational attainment and household income per capita. Latent growth curve and selection model considering the attrition during the follow-up were utilised to assess the effect of socioeconomic status on the rate of change in cognitive functioning. at baseline, younger elderly people, urban residents and elderly people living alone had better cognitive performance in both genders. Educational attainment was positively associated with cognitive functioning at baseline but did not have a significant effect on the rate of change in cognitive functioning. Higher incomes were associated with better cognitive functioning at baseline, but this difference diminished during the follow-up. higher socioeconomic status was associated with better cognitive performance at baseline but could not protect against the rate of decline in cognitive functioning measured by MMSE in this longitudinal study for elderly Chinese people. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Predicting acceptance and popularity in early adolescence as a function of hearing status, gender, and educational setting.

PubMed

Wolters, Nina; Knoors, Harry E T; Cillessen, Antonius H N; Verhoeven, Ludo

2011-01-01

This study examined associations of communicative skills, social behavior, and personality with acceptance and popularity as a function of hearing status, gender, and educational setting. Participants were 87 deaf and 672 hearing early adolescents of 52 6th grade classrooms in mainstream and special education. Acceptance varied as a function of hearing status by gender; popularity varied as a function of hearing status and educational setting. Deaf boys in mainstream education were less accepted and popular than their hearing classmates and than deaf peers in special education. Deaf girls in mainstream education were also less popular but not less accepted. Communicative skills varied as a function of hearing status, whereas social behavior varied as a function of educational setting. Deaf mainstreamed children showed less developed pragmatic and strategic communicative skills (monitoring, improvisation, initiating/maintaining) than their hearing classmates, but more social adjustment than deaf peers in special education (more prosocial behavior, less antisocial or withdrawn behavior, and more agreeableness). For acceptance, deaf girls in mainstream education compensated the lack of improvisation with higher levels of prosocial behavior, agreeableness, monitoring, and pragmatic skills, and lower levels of antisocial behavior than deaf boys. Monitoring and pragmatic skills negatively affected a deaf mainstream boy's acceptance. In special education, gender differences in prosocial behavior explained deaf boys' lower acceptance. Popularity was explained by pragmatic skills and improvisation as a function of hearing status. Voter population difference and different social behavior norms are considered as an explanation for popularity differences as a function of educational setting. Copyright © 2011 Elsevier Ltd. All rights reserved.

Reliability and validity of functional health status and health-related quality of life questionnaires in children with recurrent acute otitis media

PubMed Central

Brouwer, Carole N. M.; Schilder, Anne G. M.; van Stel, Henk F.; Rovers, Maroeska M.; Veenhoven, Reinier H.; Grobbee, Diederick E.; Sanders, Elisabeth A. M.

2007-01-01

In this study the reliability and validity of generic and disease-specific questionnaires has been assessed focusing on responsiveness. This is part of a study on the effects of recurrent acute otitis media (rAOM) on functional health status (FHS) and health-related quality of life (HRQoL) in 383 children with rAOM participating in a randomized clinical trial. The following generic questionnaires were studied: 1. RAND general health rating index, 2. Functional Status Questionnaire (FSQ Generic and FSQ Specific), 3. TNO-AZL Infant Quality of Life (TAIQOL), and the following disease-specific questionnaires: 1. Otitis Media-6 (OM-6), 2. Numerical rating scales (NRS) for child and caregiver (NRS Child and NRS Caregiver), and 3. a new Family Functioning Questionnaire (FFQ). Reliability was good to excellent (Cronbach’s α range 0.80–0.90, intraclass correlation coefficient range 0.76–0.93). Moderate to strong correlations were found between the questionnaires as well as between questionnaires and relevant clinical indicators (r = 0.29–0.49), demonstrating construct validity. Discriminant validity for children with few versus frequent episodes of acute otitis media per year was good for most questionnaires (P < 0.004) but poor for the otitis media-related subscales of the TAIQOL (P = 0.10–0.97) and both NRS (P = 0.22 and 0.48). Except for the TAIQOL subscales, change scores were significant (P < 0.003) for generic and disease-specific questionnaires. Effect sizes were somewhat higher for disease-specific compared to generic questionnaires (0.55–0.95 versus 0.32–0.60) except for the TAIQOL subscales, which showed very poor sensitivity to change. Anchor-based methods resulted in a somewhat larger range of estimates of MCID than distribution-based methods. Combining distribution-based and anchor-based methods resulted in similar ranges for the minimally clinical important differences for generic and disease-specific questionnaires: 2–15 points on a 0–100 scale. Apart from the generic TAIQOL subscales, both generic and disease-specific questionnaires used in this study showed good psychometric qualities and responsiveness for use in clinical studies on children with rAOM. PMID:17668290

Determinants of self-rated health: could health status explain the association between self-rated health and mortality?

PubMed

Murata, Chiyoe; Kondo, Takaaki; Tamakoshi, Koji; Yatsuya, Hiroshi; Toyoshima, Hideaki

2006-01-01

The purpose of this study was to investigate factors related to self-rated health and to mortality among 2490 community-living elderly. Respondents were followed for 7.3 years for all-cause mortality. To compare the relative impact of each variable, we employed logistic regression analysis for self-rated health and Cox hazard analysis for mortality. Cox analysis stratified by gender, follow-up periods, age group, and functional status was also employed. Series of analysis found that factors associated with self-rated health and with mortality were not identical. Psychological factors such as perceived isolation at home or 'ikigai (one aspect of psychological well-being)' were associated with self-rated health only. Age, functional status, and social relations were associated both with self-rated health and mortality after controlling for possible confounders. Illnesses and functional status accounted for 35-40% of variances in the fair/poor self-rated health. Differences by gender and functional status were observed in the factors related to self-rated health. Overall, self-rated health effect on mortality was stronger for people with no functional impairment, for shorter follow-up period, and for young-old age group. Although, illnesses and functional status were major determinants of self-rated health, economical, psychological, and social factors were also related to self-rated health.

[Healthy life years (HLY) comprehensive indicator of health situation--recommended by European Union].

PubMed

Gromulska, Lucyna; Wysocki, Mirosław J; Goryński, Paweł

2008-01-01

This article presents Healthy Life Years (HLY) indicator of functional health status, its application in the field of public health research and monitoring, method of calculation, idea of its construction and relation of HLY to other health status indicators e.g. life expectancy, quality adjusted life years. Current data on HLY in the EU member states are also presented. HLY indicator is one of structural indicators, recommended by European Council to deliver information on the progress of implementation of the Lisbon Strategy resolutions, which main principle is development of knowledge-based economy characterised by growth, social cohesion and respect for environment. HLY shifts the focus from quantity of years of life to its quality, full-productivity health of the population, thus conveying information not only on health status but also referring to the fields--other than medicine or social sciences--such as: finances, economy, politics, development.

Intimate Partner Violence and Functional Health Status: Associations with Severity, Danger, and Self-Advocacy Behaviors

PubMed Central

Straus, Helen; McNutt, Louise Anne; Rhodes, Karin V.; Conner, Kenneth R.; Kemball, Robin S.; Kaslow, Nadine J.; Houry, Debra

2009-01-01

Abstract Objective To assess physical and mental functional health status as associated with the severity of intimate partner violence (IPV) and perceived danger. Methods Prospective cross-sectional survey of all patients aged 18–55 in an urban emergency department during a convenience sample of shifts. Instruments included the George Washington Universal Violence Prevention Screening protocol, administered by computer during the initial visit, the Short-Form 12 Health Survey (SF-12), the Conflict Tactics Scale (CTS2), and the Revised Danger Assessment (DA), administered by interview at 1 week follow-up. Results In total, 548 (20%) participants screened disclosed IPV victimization. Of those, 216 (40%) completed the follow-up assessment 1 week later. This cohort was 91% African American, 70% single, and 63% female, with a mean age of 35 (SD 10.41). Both physical and mental health functioning scores were lower than normative levels (50) compared with national averages: Physical Component Summary (PCS) scale 43.64 (SD 10.86) and Mental Component Summary (MCS) scale 37.46 (SD 12.29). As physical assault, psychological aggression, and reported injury increased on the CTS2, mental health functioning diminished (p < 0.01). Increased physical assault and psychological aggression were also associated with diminished physical health functioning (p < 0.05). As victim-perceived danger increased on the DA, both physical and mental health functioning decreased (p < 0.01, p < 0.001, respectively). Greater self-advocacy activities were associated with lower mental (but not physical) health functioning as well. Females experienced worsening mental health functioning as both physical assault and psychological aggression increased, whereas male victims experienced worsening mental health functioning only as psychological aggression increased. Conclusions These findings suggest that IPV takes a greater mental than physical toll (for both sexes) and that as IPV severity increases, mental health functioning diminishes and self-advocacy behaviors increase. Additionally, as perceived danger increases, both physical and mental health status worsens. This has important implications for clinicians to assess and consider IPV victims' perceptions of their situations relative to danger, not just the levels of abuse they are experiencing. PMID:19445614

Nutritional status of community-dwelling elderly with newly diagnosed Alzheimer's disease: prevalence of malnutrition and the relation of various factors to nutritional status.

PubMed

Droogsma, E; van Asselt, D Z B; Schölzel-Dorenbos, C J M; van Steijn, J H M; van Walderveen, P E; van der Hooft, C S

2013-07-01

To determine the prevalence of malnutrition and its relation to various factors in community-dwelling elderly with newly diagnosed Alzheimer's disease (AD). Retrospective cross-sectional study. Memory clinic in a rural part of the Netherlands. 312 Community-dwelling AD patients, aged 65 years or older, were included. At the time the diagnosis AD was made, socio-demographic characteristics and data on nutritional status (Mini Nutritional Assessment (MNA)), cognitive function (Mini Mental State Examination (MMSE), Cambridge Cognitive Examination (Camcog)), functional status (Interview for Deterioration in Daily Living Activities in Dementia (IDDD), Barthel Index (BI)) and behaviour (Revised Memory and Behaviour Problems Checklist (RMBPC)) were assessed. Characteristics of well-nourished patients (MNA score >23.5) were compared to characteristics of patients at risk of malnutrition (MNA score 17-23.5). Linear regression analysis was performed to assess the effect of various factors on nutritional status. The prevalence of malnutrition was 0% and 14.1% was at risk of malnutrition. AD patients at risk of malnutrition were more impaired in basic and complex daily functioning than well-nourished AD patients (median IDDD score 41.5 [25th -75th percentile 38.8-48.0] versus median IDDD score 40.0 [25th -75th percentile 37.0-43.0], p = 0.028). The degree of impairment in basic and complex daily functioning (IDDD) was independently related to nutritional status (MNA) (p = 0.001, B = -0.062). One in seven community-dwelling elderly with newly diagnosed AD is at risk of malnutrition. The degree of impairment in daily functioning is independently related to nutritional status. Therefore, assessment of the nutritional status should be included in the comprehensive assessment of AD patients. The relation between daily functioning, nutritional status and AD warrants further investigation.

Functional impairment and mental health functioning among Vietnamese children

PubMed Central

Dang, Hoang-Minh; Weiss, Bahr; Trung, Lam T.

2015-01-01

Purpose Functional impairment is a key indicator of need for mental health services among children and adolescents, often a stronger predictor of service usage than mental health symptoms themselves. Functional impairment may be of particular importance in low and middle income countries (LMIC) because of its potential to focus policy on treatment of child mental health problems which is generally given low priority in LMIC. However, few studies have assessed functional impairment in LMIC. The present study assessed rates of functional impairment among children in Vietnam, as a case example of an LMIC, as well as effects of other risk/protective factors of particular relevance to LMIC (e.g., whether the family lived in an urban or rural area; family structure variables such as grandparents living with the family). Methods 1,314 parents of children 6–16 years old from 10 Vietnamese provinces were interviewed. Results The overall rate of functional impairment among Vietnamese children was 20%, similar to rates in high income countries such as Germany and the United States, suggesting that LMIC status may not be associated with dramatic increases in functional impairment in children. Functional impairment was significantly greater among mental health cases than non-cases, with increases of over 550% associated with mental health caseness. A number of other risk factors (e.g., marital status) had smaller but significant effects. Conclusions Mental health problems are a major but not the sole contributor to functional impairment among Vietnamese children. The pragmatic significance of this research lies in its potential to affect public awareness and policy related to child mental health in LMIC. PMID:26315942

The relationship of body mass index and the functional status of community-dwelling female older people admitting to a geriatric outpatient clinic.

PubMed

Bahat, Gulistan; Tufan, Asli; Aydin, Yucel; Tufan, Fatih; Bahat, Zumrut; Akpinar, Timur Selcuk; Soyluk, Ozlem; Erten, Nilgun; Karan, Mehmet Akif

2015-06-01

The relationship of body mass index (BMI) with functional status differs in diversified geriatric population and various settings. In this study, we aimed to investigate whether BMI is related to functional status independent of age, nutritional status, multimorbidity, and polypharmacy in a group of Turkish community-dwelling female elderly. This study was conducted using a cross-sectional study design. Geriatric outpatient clinic of a university hospital. There were 438 female patients aged 60 years or older included in the analysis. Body mass indexes were calculated from weight (kg) divided by the square of height (m). Functional status was assessed with the evaluation of activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Diseases and drugs were determined after the evaluation of the patients with comprehensive geriatric assessment, physical examination, first-line biochemical tests, and using the patients' self-report and current medication lists. In total, 438 subjects comprised our study cohort. Mean age was 73.3 ± 6.9 years. Mean BMI was 27.8 ± 5.2 kg/m(2). Linear regression analysis revealed significant and independent association of lower BMI with higher ADL and IADL scores (p = 0.02, B = -0.10; p < 0.001, B = -0.17, respectively). ADL and IADL were significantly negatively correlated with BMI in subjects with normal nutrition (p = 0.03, r = -0.122; p = 0.001, r = -0.183) but not in subjects with malnutrition risk or malnutrition. We suggest that lower BMI is associated with better functional status in Turkish community-dwelling female older people. This association is prominent in the subjects with normal nutritional status. Our study recommends the need for further studies accounting for the nutritional status on the relationship between BMI and functionality in different populations and in different settings. It represents an important example for diversity in BMI-functionality relationship.

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.

Importance and globalization status of good manufacturing practice (GMP) requirements for pharmaceutical excipients

PubMed Central

Abdellah, Abubaker; Noordin, Mohamed Ibrahim; Wan Ismail, Wan Azman

2013-01-01

Pharmaceutical excipients are no longer inert materials but it is effective and able to improve the characteristics of the products’ quality, stability, functionality, safety, solubility and acceptance of patients. It can interact with the active ingredients and alter the medicament characteristics. The globalization of medicines’ supply enhances the importance of globalized good manufacturing practice (GMP) requirements for pharmaceutical excipients. This review was intended to assess the globalization status of good manufacturing practice (GMP) requirements for pharmaceutical excipients. The review outcomes demonstrate that there is a lack of accurately defined methods to evaluate and measure excipients’ safety. Furthermore good manufacturing practice requirements for excipients are not effectively globalized. PMID:25685037

Malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement.

PubMed

Suzana, S; Boon, P C; Chan, P P; Normah, C D

2013-04-01

Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor. A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression. Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.

Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review

PubMed Central

2011-01-01

Background Interest in measuring functional status among nondisabled older adults has increased in recent years. This is, in part, due to the notion that adults identified as 'high risk' for functional decline portray a state that is potentially easier to reverse than overt disability. Assessing relatively healthy older adults with traditional self-report measures (activities of daily living) has proven difficult because these instruments were initially developed for institutionalised older adults. Perhaps less evident, are problems associated with change scores and the potential for 'construct under-representation', which reflects the exclusion of important features of the construct (e.g., disability). Furthermore, establishing a formal hierarchy of functional status tells more than the typical simple summation of functional loss, and may have predictive value to the clinician monitoring older adults: if the sequence task difficulty is accelerated or out of order it may indicate the need for interventions. Methods This review identified studies that employed item response theory (IRT) to examine or revise functional status scales. IRT can be used to transform the ordinal nature of functional status scales to interval level data, which serves to increase diagnostic precision and sensitivity to clinical change. Furthermore, IRT can be used to rank items unequivocally along a hierarchy based on difficulty. It should be noted that this review is not concerned with contrasting IRT with more traditional classical test theory methodology. Results A systematic search of four databases (PubMed, Embase, CINAHL, and PsychInfo) resulted in the review of 2,192 manuscripts. Of these manuscripts, twelve met our inclusion/exclusion requirements and thus were targeted for further inspection. Conclusions Manuscripts presented in this review appear to summarise gerontology's best efforts to improve construct validity and content validity (i.e., ceiling effects) for scales measuring the early stages of activity restriction in community-dwelling older adults. Several scales in this review were exceptional at reducing ceiling effects, reducing gaps in coverage along the construct, as well as establishing a formal hierarchy of functional decline. These instrument modifications make it plausible to detect minor changes in difficulty for IADL items positioned at the edge of the disability continuum, which can be used to signal the onset of progressive type disability in older adults. PMID:21846335

Status Report on Speech Research

DTIC Science & Technology

1992-06-01

fronts following pn. -ieme of English). As for phonetic Phonological and A, ticulatomy Characteris tics of Spoken Language coarticulation, Keating proposes...activated tic and antagonistic muscles, and the fixed bound- motoneurons will produce the functionally-specific aries of the vocal tract (the immobile...00121. tative methods will be presented. 45 46 Gracca INTERPRETATION OF MOVEMENT respective acoustic signals, it can be s.~ en that there are marked

Functional health status among rural and urban older adults in Taiwan: the effect of personal control and social control.

PubMed

Chiu, Tzu-I; Spencer, Gale A

2010-09-01

To assess the relationship between perceived social control/personal control and functional health status among older adults in rural and urban Taiwan. The ageing of the population is poised to emerge as a preeminent worldwide phenomenon. It is assumed that even though older adults experience many decades of autonomy and independence, the potential for illness or bodily decline will induce a serious reduction in the level of perceived control in older adult populations. This is a descriptive correlational study using a secondary data base, Social Environment and Biomarkers of Aging Study. Social Environment and Biomarkers of Aging Study is a nationally representative study of health outcomes in the Taiwanese population. Both perceived levels of social control and personal control had a statistically significant relationship with functional health status. Functional health status was significantly higher for urban older adults than their rural counterparts. Personal control and social control were both found to be predictors of functional health status. Major findings are supported by previous studies. Nurses should create programs and plan activities to assist older adults to enhance their perceptions of social control or personal control in order to improve the health status of older adults and minimize associated health care costs. © 2009 Blackwell Publishing Ltd.

Effect of in-home and community-based services on the functional status of elderly in the long-term care insurance system in Japan.

PubMed

Olivares-Tirado, Pedro; Tamiya, Nanako; Kashiwagi, Masayo

2012-08-04

Japan is setting the pace among aging societies of the world. In 2005, Japan became the country with the highest proportion of elderly persons in the world. To deal with the accelerated ageing population and with an increased demand for long-term care services, in April 2000 the Japanese government introduced a mandatory social Long-Term Care Insurance System (LTCI), making long-term care services a universal entitlement for elderly. Overseas literature suggests that the effectiveness of a home visiting program is uncertain in terms of preventing a decline in the functional status of elderly individuals. In Japan, many studies regarding factors associated with LTC service utilization have been conducted, however, limited evidence about the effect of LTC services on the progression of recipient disability is available. Data were obtained from databases of the LTC insurer of City A. To examine the effect of in-home and community-based services on disability status of recipients, a survival analysis in a cohort of moderately disabled elderly people, was conducted. The mean age of participants was 81 years old, and females represented 69% of the participants. A decline or an improvement in functional status, was observed in 43% and 27% of the sample, respectively. After controlling for other variables, women had a significantly greater probability of improving their functional status during all phases of the observation period. The use of "one service" and the amount of services utilized (days/month), were marginally (p = < 0.10) associated with a greater probability of improving their functional status at 12 months into the observation period. The observed effects of in-home and community-based services on disability transition status were considered fairly modest and weak, in terms of their ability to improve or to prevent a decline in functional status. We suggest two mechanisms to explain these findings. First, disability transition as a measure of disability progression may not be specific enough to assess changes in functional status of LTCI recipients. Secondly, in-home and community-based services provided in City A, may be inappropriate in terms of intensity, duration or quality of care.

Functional Domains of the Quechua Language in Peru: Issues of Status Planning.

ERIC Educational Resources Information Center

Coronel-Molina, Serafin M.

1999-01-01

Examines the status of Quechua in Peru and how it has affected language maintenance efforts; discusses the functional domains served by Quechua, relating them to Peruvian language policies; notes the lack of grassroots efforts by indigenous people in Peru; and suggests possible measures to improve its status, noting predictions of the future of…

Health care reform: motivation for discrimination?

PubMed

Navin, J C; Pettit, M A

1995-01-01

One of the major issues in the health care reform debate is the requirement that employers pay a portion of their employees' health insurance premiums. This paper examines the method for calculating the employer share of the health care premiums, as specified in the President's health care reform proposal. The calculation of the firm's cost of providing employee health care benefits is a function of marital status as well as the incidence of two-income earner households. This paper demonstrates that this method provides for lower than average premiums for married employees with no dependents in communities in which there is at least one married couple where both individuals participate in the labor market. This raises the non-wage labor costs of employing single individuals relative to individuals which are identical in every respect except their marital status. This paper explores the economic implications for hiring, as well as profits, for firms located in a perfectly-competitive industry. The results of the theoretical model presented here are clear. Under this proposed version of health care reform, ceteris paribus, firms have a clear preference for two-earner households. This paper also demonstrates that the incentive to discriminate is related to the size of the firm and to the size of the average wage of full-time employees for firms which employ fewer than fifty individuals. While this paper examines the specifics of President Clinton's original proposal, the conclusions reached here would apply to any form of employer-mandated coverage in which the premiums are a function of family status and the incidence of two-earner households.

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

PubMed

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

2013-04-01

Malnutrition and cognitive impairment lead to declines in activities of daily living (ADL). Nutritional status and cognitive ability have been shown to correlate with oral health status and swallowing function. However, the complex relationship among the factors that affect decline in ADL is not understood. We examined direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in Japanese elderly people living at home and receiving home care services because of physical disabilities. Participants were 286 subjects aged 60 years and older (mean age, 84.5±7.9 years) living at home and receiving home care services. Oral health status (the number of teeth and wearing dentures) was assessed, and swallowing function was examined using cervical auscultation. Additionally, ADL, cognitive ability, and nutritional status were assessed using the Barthel Index, the Clinical Dementia Rating Scale, and the Mini Nutritional Assessment-Short Form, respectively. Path analysis was used to test pathways from these factors to ADL. The mean number of teeth present in the participants was 8.6±9.9 (edentates, 40.6%). Dysphagia, malnutrition, and severe cognitive impairment were found in 31.1%, 14.0%, and 21.3% of the participants, respectively. Path analysis indicated that poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition. Malnutrition as well as dysphagia and cognitive impairment directly limited ADL. A lower number of teeth are positively related to swallowing dysfunction, whereas denture wearing contributes to recovery of swallowing function. Dysphagia, cognitive impairment, and malnutrition directly and indirectly decreased ADL in elderly people living at home and receiving home nursing care. The findings suggest that preventing tooth loss and encouraging denture wearing when teeth are lost may indirectly contribute to maintaining or improving ADL, mediated by recovery of swallowing function and nutritional status. © 2012 John Wiley & Sons A/S.

Functional decline after incident wrist fractures—Study of Osteoporotic Fractures: prospective cohort study

PubMed Central

Song, Jing; Dunlop, Dorothy D; Fink, Howard A; Cauley, Jane A

2010-01-01

Objective To study the effect of an incident wrist fracture on functional status in women enrolled in the Study of Osteoporotic Fractures. Design Prospective cohort study. Setting Baltimore, Minneapolis, Portland, and the Monongahela valley in Pennsylvania, USA Participants 6107 women aged 65 years and older without previous wrist or hip fracture recruited from the community between September 1986 and October 1988. Main outcome measure Clinically important functional decline, defined as a functional deterioration of 5 points in five activities of daily living each scored from 0 to 3 (equivalent to one standard deviation decrease in functional ability). Results Over a mean follow-up of 7.6 years, 268 women had an incident wrist fracture and 41 (15%) of these developed clinically important functional decline. Compared with women without wrist fractures, those with incident wrist fractures had greater annual functional decline after adjustment for age, body mass index, and health status. Occurrence of a wrist fracture increased the odds of having a clinically important functional decline by 48% (odds ratio 1.48, 95% confidence interval 1.04 to 2.12), even after adjustment for age, body mass index, health status, baseline functional status, lifestyle factors, comorbidities, and neuromuscular function. Conclusions Wrist fractures contribute to clinically important functional decline in older women. PMID:20616099

Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study

PubMed Central

Carmeli, Cristian; Jokela, Markus; Avendaño, Mauricio; McCrory, Cathal; d’Errico, Angelo; Bochud, Murielle; Barros, Henrique; Costa, Giuseppe; Chadeau-Hyam, Marc; Delpierre, Cyrille; Gandini, Martina; Fraga, Silvia; Goldberg, Marcel; Giles, Graham G; Lassale, Camille; Kenny, Rose Anne; Kelly-Irving, Michelle; Paccaud, Fred; Layte, Richard; Muennig, Peter; Marmot, Michael G; Ribeiro, Ana Isabel; Severi, Gianluca; Steptoe, Andrew; Shipley, Martin J; Zins, Marie; Mackenbach, Johan P; Vineis, Paolo; Kivimäki, Mika

2018-01-01

Abstract Objective To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. Design Multi-cohort population based study. Setting 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. Participants 109 107 men and women aged 45-90 years. Main outcome measure Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. Results According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning lost were greater than years of life lost due to low socioeconomic status and non-communicable disease risk factors. Conclusions The independent association between socioeconomic status and physical functioning in old age is comparable in strength and consistency with those for established non-communicable disease risk factors. The results of this study suggest that tackling all these risk factors might substantially increase life years spent in good physical functioning. PMID:29572376

Morphological, ultrastructural and functional imaging of frozen/thawed and vitrified/warmed human ovarian tissue retrieved from oncological patients.

PubMed

Fabbri, R; Vicenti, R; Macciocca, M; Martino, N A; Dell'Aquila, M E; Pasquinelli, G; Morselli-Labate, A M; Seracchioli, R; Paradisi, R

2016-08-01

Which is the best method for human ovarian tissue cryopreservation: slow freezing/rapid thawing (SF/RT) or vitrification/warming (V/W)? The conventional SF/RT protocol used in this study seems to better preserve the morpho-functional status of human cryopreserved ovarian tissue than the used open carrier V/W protocol. Cryopreservation of human ovarian tissue is generally performed using the SF/RT method. However, reduction in the follicular pool and stroma damage are often observed. An emerging alternative procedure is represented by V/W which seems to allow the maintenance of the morphological integrity of the stroma. This is a retrospective cohort study including six patients affected by oncological diseases and enrolled from January to December 2014. Ovarian tissue was laparoscopically harvested from the right and left ovaries and was cryopreserved using a routinary SF/RT protocol or a V/W method, involving tissue incubation in two solutions (containing propylene glycol, ethylene glycol and sucrose at different concentrations) and vitrification in an open system. For each patient, three pieces from each ovary were collected at the time of laparoscopy (fresh tissue) and after storage (SF/RT or V/W) and processed for light microscopy (LM) and transmission electron microscopy (TEM), to assess the morphological and ultrastructural features of follicles and stroma, and for laser scanning confocal microscopy (LSCM), to determine the functional energetic/redox stroma status. The preservation status of SF/RT and V/W ovarian tissues was compared with that of fresh ones, as well as between them. By LM and TEM, SF/RT and V/W samples showed cryodamage of small entity. Interstitial oedema and increased stromal cell vacuolization and chromatin clumping were observed in SF/RT samples; in contrast, V/W samples showed oocyte nuclei with slightly thickened chromatin and irregular shapes. The functional imaging analysis by LSCM revealed that the mitochondrial activity and intracellular reactive oxygen species levels were reduced both in SF/RT and in V/W samples compared with fresh samples. The study also showed progressive dysfunction of the mitochondrial activity going from the outer to the inner serial section of the ovarian cortex. The reduction of mitochondrial activity of V/W samples compared with fresh samples was significantly higher in the inner section than in the outer section. The results report the bioenergetic and oxidative status assessment of fresh and cryopreserved human ovarian tissue by LSCM, a technique recently applied to tissue samples. The use of LSCM on human ovarian tissues after SF/RT or V/W is a new application that requires validation. The procedures for mitochondrial staining with functional probes and fixing are not yet standardized. Xenografting of the cryopreserved ovarian tissue in severe combined immunodeficient mice and in vitro culture have not yet been performed. The identification of a cryopreservation method able to maintain the morpho-functional integrity of the ovarian tissue and a number of follicles comparable with those observed in fresh tissue might optimize results in clinical practice, in terms of recovery, duration of ovarian function and increased delivery outcomes after replanting. The SF/RT protocol allowed better morpho-functional tissue integrity than the V/W procedure. Funding was provided by Fondazione del Monte di Bologna e Ravenna, Italy. Dr N.A.M. was granted by the project ONEV MIUR PONa3 00134-n.254/R&C 18 5 2011 and the project GR-2011-02351396 (Ministry of Health, Young Researchers Grant 2011/2012). There are no competing interests. Clinical trial 74/2001/0 (approved:13 2 2002): 'Pilot study on cryopreservation of human ovarian tissue: morphological and immunohistochemical analysis before and after cryopreservation'. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The impact of residential status on cognitive decline among older adults in China: Results from a longitudinal study.

PubMed

Xu, Hanzhang; Dupre, Matthew E; Gu, Danan; Wu, Bei

2017-05-15

Residential status has been linked to numerous determinants of health and well-being. However, the influence of residential status on cognitive decline remains unclear. The purpose of this research was to assess the changes of cognitive function among older adults with different residential status (urban residents, rural-to-urban residents, rural residents, and urban-to-rural residents), over a 12-year period. We used five waves of data (2002, 2005, 2008/2009, 2011/2012, and 2014) from the Chinese Longitudinal Healthy Longevity Survey with 17,333 older adults age 65 and over who were interviewed up to five times. Cognitive function was measured by the Mini Mental State Examination (MMSE). Multilevel models were used regarding the effects of residential status after adjusting for demographic characteristics, socioeconomic factors, family support, health behaviors, and health status. After controlling for covariates, significant differences in cognitive function were found across the four groups: rural-to-urban and rural residents had a higher level of cognition than urban residents at baseline. On average, cognitive function decreased over the course of the study period. Rural-to-urban and rural residents demonstrated a faster decline in cognitive function than urban residents. This study suggests that residential status has an impact on the rate of changes in cognition among older adults in China. Results from this study provide directions for future research that addresses health disparities, particularly in countries that are undergoing significant socioeconomic transitions.

Prevalence of sarcopenia and its association with functional and nutritional status among male residents in a nursing home in Turkey.

PubMed

Bahat, Gulistan; Saka, Bulent; Tufan, Fatih; Akin, Sibel; Sivrikaya, Süleyman; Yucel, Nurullah; Erten, Nilgun; Karan, Mehmet A

2010-09-01

The prevalence of sarcopenia differs between different populations, ages, gender and between settings such as the community and nursing homes. Studies on the association of sarcopenia with functional status revealed conflicting results whereas its association with nutritional status is well documented. We aimed at investigating the prevalence of sarcopenia and its association with functional and nutritional status among male residents in a nursing home in Turkey. Fat free mass (FFM) was detected by bioelectric impedance analysis. Functional status was evaluated with Katz activities of daily living (ADL) and Lawton Instrumental activities of daily living (IADL). Nutritional assessment was performed by Mini Nutritional Assessment Test (MNA(R)). One hundred fifty-seven male residents composed the study cohort. Mean age was 73.1 +/- 6.7 years. The prevalence of sarcopenia was 85.4%. No significant correlation was found between sarcopenia and ADL or IADL. There was a weak but significant correlation between IADL score and FFM (r = 0.18; p = 0.02). Sarcopenic residents had lower MNA score than non-sarcopenic residents (18.1 +/- 3.2 vs. 21.8 +/- 0.8, p = 0.02). FFM was significantly lower in the residents with malnutrition compared to well-nourished residents (26.8 +/- 1 kg/body surface area vs. 28.1 +/- 1.8 kg/body surface area, p < 0.05). In conclusion, the prevalence of sarcopenia was very high among male nursing home residents in Turkey. Sarcopenia was associated with low nutritional status but not with functional status.

Development of Matched (migratory Analytical Time Change Easy Detection) Method for Satellite-Tracked Migratory Birds

NASA Astrophysics Data System (ADS)

Doko, Tomoko; Chen, Wenbo; Higuchi, Hiroyoshi

2016-06-01

Satellite tracking technology has been used to reveal the migration patterns and flyways of migratory birds. In general, bird migration can be classified according to migration status. These statuses include the wintering period, spring migration, breeding period, and autumn migration. To determine the migration status, periods of these statuses should be individually determined, but there is no objective method to define 'a threshold date' for when an individual bird changes its status. The research objective is to develop an effective and objective method to determine threshold dates of migration status based on satellite-tracked data. The developed method was named the "MATCHED (Migratory Analytical Time Change Easy Detection) method". In order to demonstrate the method, data acquired from satellite-tracked Tundra Swans were used. MATCHED method is composed by six steps: 1) dataset preparation, 2) time frame creation, 3) automatic identification, 4) visualization of change points, 5) interpretation, and 6) manual correction. Accuracy was tested. In general, MATCHED method was proved powerful to identify the change points between migration status as well as stopovers. Nevertheless, identifying "exact" threshold dates is still challenging. Limitation and application of this method was discussed.

The role of physical activity and diabetes status as a moderator: functional disability among older Mexican Americans.

PubMed

Palmer, Raymond F; Espino, David V; Dergance, Jeannae M; Becho, Johanna; Markides, Kyriakos

2012-11-01

we investigate the temporal association between the rate of change in physical function and the rate of change in disability across four comparison groups: Those with and without diabetes who report >30 min of physical activity per day, and those who report <30 min of physical activity per day. six waves of longitudinal data from the Hispanic Established Population for Epidemiologic Studies of the Elderly were utilised. At baseline, there were a total of 3,050 elder participants aged 65 years old or greater. The longitudinal rates of change in disability and physical function were compared by the diabetes status (ever versus none) and the physical activity status (less than or greater than or equal to 30 min per day). disability and physical function data were analysed using a latent growth curve modelling approach adjusted for relevant demographic/health-related covariates. There were statistically significant longitudinal declines in physical function and disability (P < 0.001) in all groups. Most notable, the physical activity status was an important moderator. Those with >30 min of activity demonstrated better baseline function and less disability as well as better temporal trajectories than those reporting <30 min of physical activity per day. Comparisons between diabetes statuses within the same physical activity groups showed worse disability trajectories among those with diabetes. a longitudinal decline in physical function and disability is moderated most notably by physical activity. The diabetes status further moderates decline in function and disability over time. Increased physical activity appears to be protective of disability in general and may lessen the influence of diabetes-related disability in older Mexican Americans, particularly at the end of life.

Effects of exercise training on pulmonary mechanics and functional status in patients with prolonged mechanical ventilation.

PubMed

Chen, Yen-Huey; Lin, Hui-Ling; Hsiao, Hsiu-Feng; Chou, Lan-Ti; Kao, Kuo-Chin; Huang, Chung-Chi; Tsai, Ying-Huang

2012-05-01

The functional status and outcomes in patients with prolonged mechanical ventilation (PMV) are often limited by poor endurance and pulmonary mechanics, which result from the primary diseases or prolonged time bedridden. We evaluate the impact of exercise training on pulmonary mechanics, physical functional status, and hospitalization outcomes in PMV patients. Twenty-seven subjects with PMV in our respiratory care center (RCC) were divided randomly into an exercise training group (n = 12) and a control group (n = 15). The exercise program comprised 10 sessions of exercise training. The measurement of pulmonary mechanics and physical functional status (Functional Independence Measurement and Barthel index) were performed pre-study and post-study. The hospitalization outcomes included: days of mechanical ventilation, hospitalization days, and weaning and mortality rates during RCC stay. The training group had significant improvement in tidal volume (143.6 mL vs 192.5 mL, P = .02) and rapid shallow breathing index after training (162.2 vs 110.6, P = .009). No significant change was found in the control group except respiratory rate. Both groups had significant improvement in functional status during the study. However, the training group had greater changes in FIM score than the control group (44.6 vs 34.2, P = .024). The training group also had shorter RCC stay and higher weaning and survival rates than the control group, although no statistical difference was found. Subjects with PMV in our RCC demonstrated significant improvement in pulmonary mechanics and functional status after exercise training. The application of exercise training may be helpful for PMV patients to improve hospitalization outcomes.

Functional status predicts acute care readmission in the traumatic spinal cord injury population.

PubMed

Huang, Donna; Slocum, Chloe; Silver, Julie K; Morgan, James W; Goldstein, Richard; Zafonte, Ross; Schneider, Jeffrey C

2018-03-29

Context/objective Acute care readmission has been identified as an important marker of healthcare quality. Most previous models assessing risk prediction of readmission incorporate variables for medical comorbidity. We hypothesized that functional status is a more robust predictor of readmission in the spinal cord injury population than medical comorbidities. Design Retrospective cross-sectional analysis. Setting Inpatient rehabilitation facilities, Uniform Data System for Medical Rehabilitation data from 2002 to 2012 Participants traumatic spinal cord injury patients. Outcome measures A logistic regression model for predicting acute care readmission based on demographic variables and functional status (Functional Model) was compared with models incorporating demographics, functional status, and medical comorbidities (Functional-Plus) or models including demographics and medical comorbidities (Demographic-Comorbidity). The primary outcomes were 3- and 30-day readmission, and the primary measure of model performance was the c-statistic. Results There were a total of 68,395 patients with 1,469 (2.15%) readmitted at 3 days and 7,081 (10.35%) readmitted at 30 days. The c-statistics for the Functional Model were 0.703 and 0.654 for 3 and 30 days. The Functional Model outperformed Demographic-Comorbidity models at 3 days (c-statistic difference: 0.066-0.096) and outperformed two of the three Demographic-Comorbidity models at 30 days (c-statistic difference: 0.029-0.056). The Functional-Plus models exhibited negligible improvements (0.002-0.010) in model performance compared to the Functional models. Conclusion Readmissions are used as a marker of hospital performance. Function-based readmission models in the spinal cord injury population outperform models incorporating medical comorbidities. Readmission risk models for this population would benefit from the inclusion of functional status.

Stimulus electrodiagnosis and motor and functional evaluations during ulnar nerve recovery

PubMed Central

Fernandes, Luciane F. R. M.; Oliveira, Nuno M. L.; Pelet, Danyelle C. S.; Cunha, Agnes F. S.; Grecco, Marco A. S.; Souza, Luciane A. P. S.

2016-01-01

BACKGROUND: Distal ulnar nerve injury leads to impairment of hand function due to motor and sensorial changes. Stimulus electrodiagnosis (SE) is a method of assessing and monitoring the development of this type of injury. OBJECTIVE: To identify the most sensitive electrodiagnostic parameters to evaluate ulnar nerve recovery and to correlate these parameters (Rheobase, Chronaxie, and Accommodation) with motor function evaluations. METHOD: A prospective cohort study of ten patients submitted to ulnar neurorrhaphy and evaluated using electrodiagnosis and motor assessment at two moments of neural recovery. A functional evaluation using the DASH questionnaire (Disability of the Arm, Shoulder, and Hand) was conducted at the end to establish the functional status of the upper limb. RESULTS: There was significant reduction only in the Chronaxie values in relation to time of injury and side (with and without lesion), as well as significant correlation of Chronaxie with the motor domain score. CONCLUSION: Chronaxie was the most sensitive SE parameter for detecting differences in neuromuscular responses during the ulnar nerve recovery process and it was the only parameter correlated with the motor assessment. PMID:26786072

Know thy eHealth user: Development of biopsychosocial personas from a study of older adults with heart failure.

PubMed

Holden, Richard J; Kulanthaivel, Anand; Purkayastha, Saptarshi; Goggins, Kathryn M; Kripalani, Sunil

2017-12-01

Personas are a canonical user-centered design method increasingly used in health informatics research. Personas-empirically-derived user archetypes-can be used by eHealth designers to gain a robust understanding of their target end users such as patients. To develop biopsychosocial personas of older patients with heart failure using quantitative analysis of survey data. Data were collected using standardized surveys and medical record abstraction from 32 older adults with heart failure recently hospitalized for acute heart failure exacerbation. Hierarchical cluster analysis was performed on a final dataset of n=30. Nonparametric analyses were used to identify differences between clusters on 30 clustering variables and seven outcome variables. Six clusters were produced, ranging in size from two to eight patients per cluster. Clusters differed significantly on these biopsychosocial domains and subdomains: demographics (age, sex); medical status (comorbid diabetes); functional status (exhaustion, household work ability, hygiene care ability, physical ability); psychological status (depression, health literacy, numeracy); technology (Internet availability); healthcare system (visit by home healthcare, trust in providers); social context (informal caregiver support, cohabitation, marital status); and economic context (employment status). Tabular and narrative persona descriptions provide an easy reference guide for informatics designers. Personas development using approaches such as clustering of structured survey data is an important tool for health informatics professionals. We describe insights from our study of patients with heart failure, then recommend a generic ten-step personas development process. Methods strengths and limitations of the study and of personas development generally are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

A New Wrist Clinical Evaluation Score.

PubMed

Herzberg, Guillaume; Burnier, Marion; Nakamura, Toshiyasu

2018-04-01

Background  The number of available wrist scoring systems is limited; some of them do not include forearm rotation criteria. Purpose  To describe a new electronic wrist clinical score and to present a new patient's generated wrist evaluation criterion, the subjective wrist value (SWV). Materials and Methods  A new electronic wrist clinical score, the Lyon wrist score (LWS) including wrist VAS pain and function, active range of motion and strength was built into an excel file. VAS flexion-extension pain and function were evaluated independently from pronation-supination pain and function. A new patient's generated wrist evaluation criterion, SWV was described. Results  The LWS is available in two versions, standard and full (the latter including forearm rotation strength). Both standard and full LWS are displayed into an automatically generated diamond-shaped graph providing a comprehensive visual display of the clinical status of most osteoarticular wrist disorders. The graph also includes SWV. The LWS, combined with SWV into a graph that may be directly exported to a PowerPoint presentation, provide a new practical and comprehensive tool for following/comparing wrist osteoarticular clinical status/outcomes. Both standard and full LWS charts are available in colored versions on a related website for free download. Conclusion  A comprehensive updated electronic display of osteoarticular wrist clinical status including forearm rotation criteria is provided and displayed into a graph which may be exported as such into a PowerPoint presentation for clinical analysis/comparisons. Level of Evidence  Level II.

Thought Suppression is Associated with Psychological Distress in Homebound Older Adults

PubMed Central

Petkus, Andrew J.; Gum, Amber; Wetherell, Julie Loebach

2014-01-01

Background Engaging in thought suppression as a coping mechanism has been associated with higher rates of anxiety and depressive disorders in younger adults. Homebound older adults are a population of elders experiencing poor health and high levels of depression and anxiety. It is unclear the extent to which psychological factors, such as thought suppression, are associated with distress, given that their health and disability status may be more salient. The aim of this study was to investigate thought suppression in relation to anxiety and depressive symptoms in homebound older adults. Methods Participants (N = 142) were clients of home-based case management services delivered by aging service agencies in Florida. Participants were administered a research interview that included the White Bear Suppression Inventory, Structured Clinical Interview for DSM-IV Diagnosis (SCID), Brief Symptom Inventory-18 (BSI-18), and Modified Mini-Mental Status Examination (3MS). Case managers provided standard assessments containing functional and health status of the participant. Results After controlling for physical health and cognitive functioning, thought suppression was significantly associated with higher likelihood of clinically significant somatic, depressive, and anxiety symptoms on the BSI-18. Thought suppression was also associated with meeting criteria for a SCID depressive or adjustment disorder. Engaging in thought suppression was associated with worse mental health in this sample of homebound older adults even after taking into account physical health, disability, and cognitive functioning. Conclusions These findings suggest the need to develop and test interventions that may address thought suppression as a coping mechanism. PMID:22170756

Association between gross motor function and nutritional status in children with cerebral palsy: a cross-sectional study from Colombia.

PubMed

Herrera-Anaya, Elizabeth; Angarita-Fonseca, Adriana; Herrera-Galindo, Víctor M; Martínez-Marín, Rocío D P; Rodríguez-Bayona, Cindy N

2016-09-01

To determine the association between gross motor function and nutritional status in children with cerebral palsy (CP) residing in an urban area in a developing country. We conducted a cross-sectional study in 177 children (ages 2-12y, 59.3% male) with a diagnosis of CP who were attending rehabilitation centres in Bucaramanga, Colombia (2012-2013). A physiotherapist evaluated patients using the Gross Motor Function Classification System (GMFCS, levels I to V). Nutritional status was evaluated by nutritionists and classified according to the World Health Organization growth charts. We used linear and multinomial logistic regression methods to determine the associations. There were 39.5%, 6.8%, 5.6%, 16.4%, and 31.6% patients classified in levels I to V respectively. The mean adjusted differences for weight-for-age, height-for-age, BMI-for-age, and height-for-weight z-scores were significantly larger for children classified in levels II to V compared with those in level I. The children classified in levels IV and V were more likely to have malnutrition (adjusted odds ratio [OR] 5.64; 95% confidence interval [CI] 2.27-14.0) and stunting (OR 8.42; 95% CI 2.90-24.4) than those classified in GMFCS levels I to III. Stunting and malnutrition are prevalent conditions among paediatric patients with CP, and both are directly associated with higher levels of gross motor dysfunction. © 2016 Mac Keith Press.

Is Fluid Overload More Important than Diabetes in Renal Progression in Late Chronic Kidney Disease?

PubMed Central

Tsai, Yi-Chun; Tsai, Jer-Chia; Chiu, Yi-Wen; Kuo, Hung-Tien; Chen, Szu-Chia; Hwang, Shang-Jyh; Chen, Tzu-Hui; Kuo, Mei-Chuan; Chen, Hung-Chun

2013-01-01

Fluid overload is one of the major presentations in patients with late stage chronic kidney disease (CKD). Diabetes is the leading cause of renal failure, and progression of diabetic nephropathy has been associated with changes in extracellular fluid volume. The aim of the study was to assess the association of fluid overload and diabetes in commencing dialysis and rapid renal function decline (the slope of estimated glomerular filtration rate (eGFR) less than -3 ml/min per 1.73 m2/y) in 472 patients with stages 4-5 CKD. Fluid status was determined by bioimpedance spectroscopy method, Body Composition Monitor. The study population was further classified into four groups according to the median of relative hydration status (△HS =fluid overload/extracellular water) and the presence or absence of diabetes. The median level of relative hydration status was 7%. Among all patients, 207(43.9 %) were diabetic. 71 (15.0%) subjects had commencing dialysis, and 187 (39.6%) subjects presented rapid renal function decline during a median 17.3-month follow-up. Patients with fluid overload had a significantly increased risk for commencing dialysis and renal function decline independent of the presence or absence of diabetes. No significantly increased risk for renal progression was found between diabetes and non-diabetes in late CKD without fluid overload. In conclusion, fluid overload has a higher predictive value of an elevated risk for renal progression than diabetes in late CKD. PMID:24349311

Design of Intelligent Hydraulic Excavator Control System Based on PID Method

NASA Astrophysics Data System (ADS)

Zhang, Jun; Jiao, Shengjie; Liao, Xiaoming; Yin, Penglong; Wang, Yulin; Si, Kuimao; Zhang, Yi; Gu, Hairong

Most of the domestic designed hydraulic excavators adopt the constant power design method and set 85%~90% of engine power as the hydraulic system adoption power, it causes high energy loss due to mismatching of power between the engine and the pump. While the variation of the rotational speed of engine could sense the power shift of the load, it provides a new method to adjust the power matching between engine and pump through engine speed. Based on negative flux hydraulic system, an intelligent hydraulic excavator control system was designed based on rotational speed sensing method to improve energy efficiency. The control system was consisted of engine control module, pump power adjusted module, engine idle module and system fault diagnosis module. Special PLC with CAN bus was used to acquired the sensors and adjusts the pump absorption power according to load variation. Four energy saving control strategies with constant power method were employed to improve the fuel utilization. Three power modes (H, S and L mode) were designed to meet different working status; Auto idle function was employed to save energy through two work status detected pressure switches, 1300rpm was setting as the idle speed according to the engine consumption fuel curve. Transient overload function was designed for deep digging within short time without spending extra fuel. An increasing PID method was employed to realize power matching between engine and pump, the rotational speed's variation was taken as the PID algorithm's input; the current of proportional valve of variable displacement pump was the PID's output. The result indicated that the auto idle could decrease fuel consumption by 33.33% compared to work in maximum speed of H mode, the PID control method could take full use of maximum engine power at each power mode and keep the engine speed at stable range. Application of rotational speed sensing method provides a reliable method to improve the excavator's energy efficiency and realize power match between pump and engine.

Strength of knee flexors of the paretic limb as an important determinant of functional status in post-stroke rehabilitation.

PubMed

Kostka, Joanna; Czernicki, Jan; Pruszyńska, Magdalena; Miller, Elżbieta

The purpose of the study was to assess the effectiveness of the multi-modal exercise program (MMEP) in patients after stroke, and to identify muscles that are the best predictors of functional performance and changes in functional status in a 3-week rehabilitation program. Thirty-one post-stroke patients (60.6±12.7 years) participating in a 3-week MMEP took part in the study. Measurements of extensor and flexor strength of the knee (F ext , F flex ) were done. Functional performance was measured using Timed Up & Go test (TUG), 6-Minute Walk Test (6-MWT) and Tinetti Test. The rehabilitation program improved all the results of functional tests, as well as the values of strength in the patients. Both baseline and post-rehabilitation functional status was associated with knee flexor and extensor muscle strength of paretic but not of non-paretic limbs. At baseline examination muscle strength difference between both F flex kg -1 and F ext kg -1 had an influence on functional status. After rehabilitation the effect of muscle strength difference on functional status was not evident for F ext kg -1 and, interestingly, even more prominent for F flex kg -1 . MMEP can effectively increase muscle strength and functional capacity in post-stroke patients. Knee flexor muscle strength of the paretic limb and the knee flexor difference between the limbs is the best predictor of functional performance in stroke survivors. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Assessment of Urban Ecosystem Health Based on Matter Element Analysis: A Case Study of 13 Cities in Jiangsu Province, China.

PubMed

Xie, Xuefeng; Pu, Lijie

2017-08-21

Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic hierarchy process (AHP) weighting method were used to assess the UEH of each city in Jiangsu Province during the period of 2000-2014. The results show that the overall ecosystem health status of each city shows continuous improvement. The UEH status of each city gradually transferred from poor, general, and medium condition to good and excellent condition. From the perspective of spatial distribution, the city's UEH showing a steady status after increasing for 10 years, and their spatial variations have gradually reduced. The UEH status in Southern Jiangsu and Central Jiangsu was better than that of Northern Jiangsu Province. From each component point of view, the vigor, resilience, and population health of each city in Jiangsu Province showed a trend of continuous improvement, while the organization and service function first increased and then decreased. The common limiting factors of UEH in Jiangsu Province were Engel's coefficient of urban households, number of beds of hospitals, health centers per 10,000 people, and total investment in the treatment of environmental pollution as percent GDP. These results help decision makers to make suitable decisions to maintain the UEH of each city in Jiangsu Province.

The Association of Health and Income in the Elderly: Experience from a Southern State of Brazil

PubMed Central

Fillenbaum, Gerda G.; Blay, Sergio L.; Pieper, Carl F.; King, Katherine E.; Andreoli, Sergio B.; Gastal, Fábio L.

2013-01-01

Objectives In high income, developed countries, health status tends to improve as income increases, but primarily through the 50th-66th percentile of income. It is unclear whether the same limitation holds in middle income countries, and for both general assessments of health and specific conditions. Methods Data were obtained from Brazil, a middle income country. In-person interviews with a representative sample of community residents age ≥60 (N=6963), in the southern state of Rio Grande do Sul, obtained information on demographic characteristics including household income and number of persons supported, general health status (self-rated health, functional status), depression, and seven physician-diagnosed, self-reported health conditions. Analyses used household income (adjusted for number supported and economies of scale) together with higher order income terms, and controlled for demographics and comorbidities, to ascertain nonlinearity between income and general and specific health measures. Results In fully controlled analyses income was associated with general measures of health (linearly with self-rated health, nonlinearly with functional status). For specific health measures there was a consistent linear association with depression, pulmonary disorders, renal disorders, and sensory impairment. For musculoskeletal, cardiovascular (negative association), and gastrointestinal disorders this association no longer held when comorbidities were controlled. There was no association with diabetes. Conclusion Contrary to findings in high income countries, the association of household-size-adjusted income with health was generally linear, sometimes negative, and sometimes absent when comorbidities were controlled. PMID:24058505

The present state and future directions of PDF methods

NASA Technical Reports Server (NTRS)

Pope, S. B.

1992-01-01

The objectives of the workshop are presented in viewgraph format, as is this entire article. The objectives are to discuss the present status and the future direction of various levels of engineering turbulence modeling related to Computational Fluid Dynamics (CFD) computations for propulsion; to assure that combustion is an essential part of propulsion; and to discuss Probability Density Function (PDF) methods for turbulent combustion. Essential to the integration of turbulent combustion models is the development of turbulent model, chemical kinetics, and numerical method. Some turbulent combustion models typically used in industry are the k-epsilon turbulent model, the equilibrium/mixing limited combustion, and the finite volume codes.

A multiple index integrating different levels of organization.

PubMed

Cortes, Rui; Hughes, Samantha; Coimbra, Ana; Monteiro, Sandra; Pereira, Vítor; Lopes, Marisa; Pereira, Sandra; Pinto, Ana; Sampaio, Ana; Santos, Cátia; Carrola, João; de Jesus, Joaquim; Varandas, Simone

2016-10-01

Many methods in freshwater biomonitoring tend to be restricted to a few levels of biological organization, limiting the potential spectrum of measurable of cause-effect responses to different anthropogenic impacts. We combined distinct organisational levels, covering biological biomarkers (histopathological and biochemical reactions in liver and fish gills), community based bioindicators (fish guilds, invertebrate metrics/traits and chironomid pupal exuviae) and ecosystem functional indicators (decomposition rates) to assess ecological status at designated Water Framework Directive monitoring sites, covering a gradient of human impact across several rivers in northern Portugal. We used Random Forest to rank the variables that contributed more significantly to successfully predict the different classes of ecological status and also to provide specific cut levels to discriminate each WFD class based on reference condition. A total of 59 Biological Quality Elements and functional indicators were determined using this procedure and subsequently applied to develop the integrated Multiple Ecological Level Index (MELI Index), a potentially powerful bioassessment tool. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimizing Insulin Glargine Plus One Injection of Insulin Glulisine in Type 2 Diabetes in the ELEONOR Study

PubMed Central

Nicolucci, Antonio; Del Prato, Stefano; Vespasiani, Giacomo

2011-01-01

OBJECTIVE To determine the functional health status and treatment satisfaction in patients with type 2 diabetes from the Evaluation of Lantus Effect ON Optimization of use of single dose Rapid insulin (ELEONOR) study that investigated whether a telecare program helps optimization of basal insulin glargine with one bolus injection of insulin glulisine. RESEARCH DESIGN AND METHODS Functional health status and treatment satisfaction were investigated using the 36-Item Short-Form (SF-36) Health Survey, the World Health Organization Well-Being Questionnaire (WBQ), and the Diabetes Treatment Satisfaction Questionnaire. RESULTS Of 291 randomized patients, 238 completed the study (telecare: 114; self-monitoring blood glucose: 124). Significant improvements were detected in most SF-36 domains, in WBQ depression and anxiety scores, and in treatment satisfaction, without differences between study groups. CONCLUSIONS An insulin regimen that substantially improves metabolic control, while minimizing the risk of hypoglycemia, can positively affect physical and psychologic well-being and treatment satisfaction irrespective of the educational support system used. PMID:21953799

The Role of Meaning in Life for the Quality of Life of Community-Dwelling Chinese Elders With Low Socioeconomic Status

PubMed Central

2018-01-01

Objectives: There is limited research on the meaning in life among Chinese elders. This study aims to examine the association among functional disabilities, meaning in life, social network, and quality of life in community-dwelling Chinese elders with low socioeconomic status. Methods: A cross-sectional survey was used to collect data from 339 poor community-dwelling Chinese elders aged 60 and above. Results: The results showed that meaning in life and social network were significantly related to quality of life. Moreover, social network was a mediator to the relationship between functional disability and quality of life, and meaning in life was a partial mediator to the relationship between social network and quality of life. Conclusion: Workshops should be organized by the elderly service providers for Chinese elders facing deterioration in health and activity levels to learn to live intentionally and purposefully. A social network among elders should also be fostered in the community. PMID:29780856

Score Reliability and Construct Validity of the Flinn Performance Screening Tool for Adults With Symptoms of Carpal Tunnel Syndrome

PubMed Central

Flinn, Sharon R.; Pease, William S.; Freimer, Miriam L.

2013-01-01

OBJECTIVE We investigated the psychometric properties of the Flinn Performance Screening Tool (FPST) for people referred with symptoms of carpal tunnel syndrome (CTS). METHOD An occupational therapist collected data from 46 participants who completed the Functional Status Scale (FSS) and FPST after the participants’ nerve conduction velocity study to test convergent and contrasted-group validity. RESULTS Seventy-four percent of the participants had abnormal nerve conduction studies. Cronbach’s α coefficients for subscale and total scores of the FPST ranged from .96 to .98. Intrarater reliability for six shared items of the FSS and the FPST was supported by high agreement (71%) and a fair κ statistic (.36). Strong to moderate positive relationships were found between the FSS and FPST scores. Functional status differed significantly among severe, mild, and negative CTS severity groups. CONCLUSION The FPST shows adequate psychometric properties as a client-centered screening tool for occupational performance of people referred for symptoms of CTS. PMID:22549598

NUTRITIONAL STATUS IS ASSOCIATED WITH HEALTH-RELATED QUALITY OF LIFE IN CHILDREN WITH CYSTIC FIBROSIS AGED 9–19 YEARS

PubMed Central

Shoff, Suzanne M.; Tluczek, Audrey; Laxova, Anita; Farrell, Philip M.; Lai, HuiChuan J.

2013-01-01

Background The impact of improved nutritional status on health-related quality of life (HRQOL) is unknown for children with cystic fibrosis (CF). Methods Associations between nutritional status and HRQOL were examined over 2 years in 95 children, aged 9–19 years, who were followed in the Wisconsin Newborn Screening Project. HRQOL was assessed using the Cystic Fibrosis Questionnaire (CFQ). Associations between height z-score (HtZ), BMI z-score (BMIZ) and seven CFQ dimensions were evaluated. Results Mean values of at least 80 were observed for all CFQ dimensions except respiratory symptoms and treatment burden. Treatment burden was significantly worse in patients with meconium ileus (57) compared to pancreatic insufficient (65) and sufficient (78) subjects, p<0.0001. HtZ and BMIZ were positively associated with physical functioning and body image (p<0.05). Conclusions Better nutritional status was associated with increased HRQOL scores. Early diagnosis through newborn screening and improved nutrition provides an opportunity to enhance quality of life and body image perception. PMID:23410621

Influence of cytochrome 2C19 allelic variants on on-treatment platelet reactivity evaluated by five different platelet function tests.

PubMed

Gremmel, Thomas; Kopp, Christoph W; Moertl, Deddo; Seidinger, Daniela; Koppensteiner, Renate; Panzer, Simon; Mannhalter, Christine; Steiner, Sabine

2012-05-01

The antiplatelet effect of clopidogrel has been linked to cytochrome P450 2C19 (CYP2C19) carrier status. The presence of loss of function and gain of function variants were found to have a gene-dose effect on clopidogrel metabolism. However, genotyping is only one aspect of predicting response to clopidogrel and several platelet function tests are available to measure platelet response. Patients and methods We studied the influence of CYP2C19 allelic variants on on-treatment platelet reactivity as assessed by light transmission aggregometry (LTA), the VerifyNow P2Y12 assay, the VASP assay, multiple electrode aggregometry (MEA), and the Impact-R in 288 patients after stenting for cardiovascular disease. Allelic variants of CYP2C19 were determined with the Infiniti® CYP450 2C19+ assay and categorized into four metabolizer states (ultrarapid, extensive, intermediate, poor). Platelet reactivity increased linearly from ultrarapid to poor metabolizers using the VerifyNow P2Y12 assay (P = 0.04), the VASP assay (P = 0.02) and the Impact-R (P = 0.04). The proportion of patients with high on-treatment residual platelet reactivity (HRPR) identified by LTA, the VerifyNow P2Y12 assay and the VASP assay increased when the metabolizer status decreased, while no such relationship could be identified for results of MEA and Impact-R. The presence of loss of function variants (*2/*2, *2-8*/wt, *2/*17) was an independent predictor of HRPR in LTA and the VASP assay while it did not reach statistical significance in the VerifyNow P2Y12 assay, MEA, and the Impact-R. Depending on the type of platelet function test differences in the association of on-treatment platelet reactivity with CYP2C19 carrier status are observed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Validation of Folate-Enriched Eggs as a Functional Food for Improving Folate Intake in Consumers

PubMed Central

Altic, Leslie; McNulty, Helene; Hoey, Leane; McAnena, Liadhan; Pentieva, Kristina

2016-01-01

Functional foods enriched with folate may be beneficial as a means of optimizing folate status in consumers. We recently developed novel eggs enriched with folate through folic acid supplementation of the hen’s feed, but their potential to influence consumer folate status is unknown because the natural folate forms incorporated into the eggs may not necessarily be retained during storage and cooking. This study aimed to determine the stability of natural folates in folate-enriched eggs under typical conditions of storage and cooking. Total folate was determined by microbiological assay following tri-enzyme treatment in folate-enriched eggs and un-enriched (barn and free-range) on the day they were laid, after storage (up to 27 days) and after using four typical cooking methods (boiling, poaching, frying, scrambling) for different durations. On the day of laying, the folate content of enriched eggs was found to be significantly higher than that of un-enriched barn or free-range eggs (mean ± SD; 123.2 ± 12.4 vs. 41.2 ± 2.8 vs. 65.6 ± 18.5 µg/100 g; p < 0.001). Storage at refrigerator and room temperature for periods up to the Best Before date resulted in no significant losses to the folate content of folate-enriched eggs. Furthermore, folate in enriched eggs remained stable when cooked by four typical methods for periods up to the maximum cooking time (e.g., 135 ± 22.5, 133.9 ± 23.0 and 132.5 ± 35.1; p = 0.73, for raw, scrambled for 50 s and scrambled for 2 min, respectively). Thus, natural folates in folate-enriched eggs remain highly stable with little or no losses following storage and cooking. These findings are important because they demonstrate the feasibility of introducing folate-enriched eggs into the diet of consumers as functional foods with enriched folate content. Further studies will confirm their effectiveness in optimizing the biomarker folate status of consumers. PMID:27916895

[Effects of resolving phlegm method on fibrinolytic status in non-alcoholic steatohepatitis patients of phlegm and blood-stasis syndrome].

PubMed

Chen, Li; Jiang, Yang-Kun; Cai, Yan-Bo

2006-12-01

To observe the effect of resolving phlegm method (RPM) on fibrinolytic status in non-alcoholic steatohepatitis (NASH) patients of phlegm blood-stasis (PBS) syndrome type. Sixty-two patients were randomly assigned to 2 groups, namely the treated group (n = 34) treated with Chinese herbs for resolving phlegm and dampness, smoothing liver and gallbladder, promoting blood circulation and removing blood stasis (composition: Indigo Naturalis 10 g, Alumen 3 g, Semen Cassiae 15 g, Fructus Crataegi 15 g, vinegar prepared Radix Bupleuri 10 g, Radix Curcumae 10 g, Radix Salviae Miltiorrhizae 12 g, Herba Lycopi 12 g, talc 12 g and Radix Glycyrrhizae 2 g), one dose twice per day orally, and the control group (n = 28) with ursodeoxycholic acid tablet (UAT) 150 mg three times per day. The treatment course for both groups was 12 weeks. Liver function (ALT, AST, ALP), insulin resistance (IR) index represented by homeostasis model-IR (HOMA-IR) and insulin (Ins), levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1), as well as main symptoms and physical signs were assessed before and after treatment. (1) Compared with those before treatment, levels of ALT, AST, HOMA-IR, t-PA, PAl-1 and main symptoms were all improved in the treated group (P < 0.05 or P < 0.01); (2) There was significant difference in ALP, HOMA-IR, t-PA and PAI-1 between the treated group and the control group (P < 0.05 or P < 0.01); (3) The improvement in liver function related indexes in the control group was mainly the level of ALT, t-PA (P < 0.01), and also shown on HOMA-IR, Ins and PAI-1. RPM could effectively improve liver function and fibrinolytic status. Its effect was better than that of UAT.

Validation of Folate-Enriched Eggs as a Functional Food for Improving Folate Intake in Consumers.

PubMed

Altic, Leslie; McNulty, Helene; Hoey, Leane; McAnena, Liadhan; Pentieva, Kristina

2016-11-30

Functional foods enriched with folate may be beneficial as a means of optimizing folate status in consumers. We recently developed novel eggs enriched with folate through folic acid supplementation of the hen's feed, but their potential to influence consumer folate status is unknown because the natural folate forms incorporated into the eggs may not necessarily be retained during storage and cooking. This study aimed to determine the stability of natural folates in folate-enriched eggs under typical conditions of storage and cooking. Total folate was determined by microbiological assay following tri-enzyme treatment in folate-enriched eggs and un-enriched (barn and free-range) on the day they were laid, after storage (up to 27 days) and after using four typical cooking methods (boiling, poaching, frying, scrambling) for different durations. On the day of laying, the folate content of enriched eggs was found to be significantly higher than that of un-enriched barn or free-range eggs (mean ± SD; 123.2 ± 12.4 vs. 41.2 ± 2.8 vs. 65.6 ± 18.5 µg/100 g; p < 0.001). Storage at refrigerator and room temperature for periods up to the Best Before date resulted in no significant losses to the folate content of folate-enriched eggs. Furthermore, folate in enriched eggs remained stable when cooked by four typical methods for periods up to the maximum cooking time (e.g., 135 ± 22.5, 133.9 ± 23.0 and 132.5 ± 35.1; p = 0.73, for raw, scrambled for 50 s and scrambled for 2 min, respectively). Thus, natural folates in folate-enriched eggs remain highly stable with little or no losses following storage and cooking. These findings are important because they demonstrate the feasibility of introducing folate-enriched eggs into the diet of consumers as functional foods with enriched folate content. Further studies will confirm their effectiveness in optimizing the biomarker folate status of consumers.

Placental dysfunction is associated with altered microRNA expression in pregnant women with low folate status

PubMed Central

Mackie, Fiona L.; Lean, Samantha C.; Greenwood, Susan L.; Heazell, Alexander E. P.; Forbes, Karen; Jones, Rebecca L.

2017-01-01

Scope Low maternal folate status during pregnancy increases the risk of delivering small for gestational age (SGA) infants, but the mechanistic link between maternal folate status, SGA, and placental dysfunction is unknown. microRNAs (miRNAs) are altered in pregnancy pathologies and by folate in other systems. We hypothesized that low maternal folate status causes placental dysfunction, mediated by altered miRNA expression. Methods and results A prospective observational study recruited pregnant adolescents and assessed third trimester folate status and placental function. miRNA array, QPCR, and bioinformatics identified placental miRNAs and target genes. Low maternal folate status is associated with higher incidence of SGA infants (28% versus 13%, p < 0.05) and placental dysfunction, including elevated trophoblast proliferation and apoptosis (p < 0.001), reduced amino acid transport (p < 0.01), and altered placental hormones (pregnancy‐associated plasma protein A, progesterone, and human placental lactogen). miR‐222‐3p, miR‐141‐3p, and miR‐34b‐5p were upregulated by low folate status (p < 0.05). Bioinformatics predicted a gene network regulating cell turnover. Quantitative PCR demonstrated that key genes in this network (zinc finger E‐box binding homeobox 2, v‐myc myelocytomatosis viral oncogene homolog (avian), and cyclin‐dependent kinase 6) were reduced (p < 0.05) in placentas with low maternal folate status. Conclusion This study supports that placental dysfunction contributes to impaired fetal growth in women with low folate status and suggests altered placental expression of folate‐sensitive miRNAs and target genes as a mechanistic link. PMID:28105727

The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients.

PubMed

Paladini, Luciana; Hodder, Rick; Cecchini, Isabella; Bellia, Vincenzo; Incalzi, Raffaele Antonelli

2010-07-01

Dyspnoea is the most common symptom associated with poor quality of life in patients affected by Chronic Obstructive Pulmonary Disease (COPD). While COPD severity is commonly staged by lung function, the Medical Research Council (MRC) dyspnoea scale has been proposed as a more clinically meaningful method of quantifying disease severity in COPD. We wished to assess whether this scale might also be useful during telephone surveys as a simple surrogate marker of perceived health status in elderly patients with COPD. We conducted a comprehensive health status assessment by telephone survey of 200 elderly patients who had a physician diagnosis of COPD. The telephone survey contained 71 items and explored such domains as educational level, financial status, living arrangements and social contacts, co-morbid illness, and the severity and the impact of COPD on health status. Patients were categorized according to the reported MRC score: mild dyspnoea (MRC scale of 1), moderate dyspnoea (MRC scale of 2 and 3), or severe dyspnoea (MRC of 4 and 5). Deterioration in most of the recorded indicators of health status correlated with an increasingly severe MRC score. This was most evident for instrumental activities of daily living (IADL), perceived health and emotional status, pain-related limitations, limitations in social life, hospital admissions in preceding year and prevalence of most co-morbidities. The MRC dyspnoea scale is a reliable index of disease severity and health status in elderly COPD patients which should prove useful for remote monitoring of COPD and for rating health status for epidemiological purposes.

Whole-body cryostimulation (cryotherapy) provides benefits for fatigue and functional status in multiple sclerosis patients. A case-control study.

PubMed

Miller, E; Kostka, J; Włodarczyk, T; Dugué, B

2016-12-01

To study the effects of whole-body cryostimulation (WBC) on fatigue and functional status in multiple sclerosis (MS) patients with different levels of fatigue. Two groups of 24 MS patients with fatigue were studied. At the beginning of the study, the first group presented a Fatigue Severity Scale (FSS) score between 38 and 42 (low-fatigue (LF) group), and the second group had an FSS score between 48 and 52 (high-fatigue (HF) group). Both groups were matched for age and sex. All patients were exposed to 10.3-min session of WBC (one exposure per day at -110°C or lower). Functional status was assessed before and after the series of WBC exposures using the Rivermead Motor Assessment (RMA), the Multiple Sclerosis Impact Scale (MSIS-29), and the Expanded Disability Status Scale (EDSS). The RMA was estimated in three sections: gross function (RMA1), leg and trunk (RMA2), and arm (RMA3). MSIS-29 consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) status. In both groups, the WBC sessions induced a significant improvement in the functional status and in the feeling of fatigue. However, the changes observed in HF patients were significantly greater than those observed in LF patients, especially in the MSIS-29-PHYS, MSIS-29-PSYCH, RMA1, and RMA3. The changes observed in the EDSS, RMA2, and FSS were similar in both groups. WBC appears to be effective in improving functional status and the feeling of fatigue in patients with MS and especially in those who are the most fatigued. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[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.

Mapping the functional assessment of cancer therapy-breast (FACT-B) to the 5-level EuroQoL Group's 5-dimension questionnaire (EQ-5D-5L) utility index in a multi-ethnic Asian population.

PubMed

Cheung, Yin Bun; Luo, Nan; Ng, Raymond; Lee, Chun Fan

2014-12-12

To develop an algorithm for mapping the Functional Assessment of Cancer Therapy-Breast (FACT-B) to the 5-level EuroQoL Group's 5-dimension questionnaire (EQ-5D-5L) utility index. A survey of 238 breast cancer patients in Singapore was conducted. Models using various regression methods with or without recognizing the upper boundary of utility values at 1 were fitted to predict the EQ-5D-5L utility index based on the five subscale scores of the FACT-B. Data from a follow-up survey of these patients were used to validate the results. A model that maps the physical, emotional, functional well-being and the breast cancer concerns subscales of the FACT-B to the EQ-5D-5L utility index was derived. The social well-being subscale was not associated to the utility index. Although theoretical assumptions may not be valid, ordinary least square outperformed other regression methods. The mean predicted utility index within each performance status level at follow-up deviated from the observed mean less than the minimally important difference of EQ-5D for cancer patients. The mapping algorithm converts the FACT-B to the EQ-5D utility index. This enables oncologists, clinical researchers and policy makers to obtain a quantitative utility summary of a patient's health status when only the FACT-B is assessed.

Factors Associated with Performance-based Physical Function of Older Veterans of the PLAAF: A Pilot Study

PubMed Central

Chen, Da-Wei; Jin, Yan-Bin; Liu, Wei; Du, Wen-Jin; Li, Hua-Jun; Chen, Jin-Wen; Xu, Wei

2014-01-01

[Purpose] This study investigated the factors associated with performance-based physical function of older veterans of the People’s Liberation Army Air Force of China (PLAAF). [Subjects and Methods] A cross-sectional survey of 146 older veterans of the PLAAF was carried out. Their physical function was measured using the Chinese Mini-Physical Performance Testing (CM-PPT). The demographics and health status (including physical measures, blood chemical tests, chronic diseases, and number of morbidities) were collected from health examination reports and computer records of case history. Cognition was measured using the Mini-Mental Status Examination (MMSE). [Results] In multiple linear regressions, age, MMSE, Parkinsonism, and chronic obstructive pulmonary disease were independently associated with CM-PPT, while previous stroke and albumin level reached borderline statistical significance. The association between the number of morbidities and CM-PPT was significant after adjustment for MMSE and demographics. The CM-PPT of low (0 or 1), medium (2 to 4) and high count (5 or more) morbidities were 11.3±3.9, 10.2±4.1, 6.1±3.8 respectively, and the difference among these three groups was significant. [Conclusion] Some modified conditions and the number of chronic diseases might be associated with the physical function of older veterans of the PLAAF. PMID:24648625

Evaluation of malnutrition detected with the Nutritional Risk Screening 2002 (NRS-2002) and the quality of life in hospitalized patients with chronic obstructive pulmonary disease.

PubMed

Arslan, M; Soylu, M; Kaner, G; İnanç, N; Başmısırlı, E

2016-01-01

Patients with severe chronic obstructive pulmonary disease (COPD) have impaired quality of life, but the relationship between their nutritional status and quality of life has not been established. The aim of this study was to determine the relationship between quality of life and nutritional status in hospitalized COPD patients. Demographic data, quality of life and nutritional status of 90 inpatients with a mean age of 68.76 ± 10.85 years were enrolled in the study. The Nutritional Risk Screening 2002 (NRS-2002) tool was used to evaluate their nutritional status. The quality of life was assessed using the Short Form-36 (SF-36) questionnaire. The correlation analysis was used for the relationship between SF-36 subscales and nutritional status variables. Of the 90 COPD patients included in the study, 54.4 % were men, and 45.6 % were women. Moderate, severe, and very severe COPD were detected in 37.8 %, 38.9 %, and 23.3 % of the patients, respectively. At risk of malnutrition were 55.6 % of the 90 COPD patients, whereas 44.4 % were not. The scores for physical function, physical role functioning, pain, general health, emotional role functioning, vitality, social function, and mental function subscales were lower in the patients at risk of malnutrition (p <0.001). There was a statistically significant negative correlation between malnutrition score and the subscores of SF-36 related to physical function, physical role functioning, pain, general health, emotional role functioning, vitality, social function, and mental function (p <0.001). COPD patients were found to have a high risk of malnutrition that adversely affects their quality of life. Therefore, the evaluation of the nutritional status of COPD patients should be an integral part of their clinical treatment plans aiming towards improving their quality of life. Hippokratia 2016, 20(2):147-152.

Swallowing Function and Nutritional Status in Japanese Elderly People Receiving Home-care Services: A 1-year Longitudinal Study.

PubMed

Okabe, Y; Furuta, M; Akifusa, S; Takeuchi, K; Adachi, M; Kinoshita, T; Kikutani, T; Nakamura, S; Yamashita, Y

2016-01-01

Malnutrition is a serious health concern for frail elderly people. Poor oral function leading to insufficient food intake can contribute to the development of malnutrition. In the present study, we explored the longitudinal association of malnutrition with oral function, including oral health status and swallowing function, in elderly people receiving home nursing care. Prospective observational cohort study with 1-year follow-up. Two mid-sized cities in Fukuoka, Japan from November 2010 to March 2012. One hundred and ninety-seven individuals, aged ≥ 60 years, living at home and receiving home-care services because of physical disabilities, without malnutrition. Oral health status, swallowing function, taking modified-texture diets such as minced or pureed foods, nutritional status, cognitive function, and activities of daily living were assessed at baseline. The associations between malnutrition at 1-year follow-up and these related factors were analyzed using a logistic regression model. Swallowing disorders [risk ratio (RR): 5.21, 95% confidence interval (95% CI): 1.65-16.43] were associated with malnutrition. On the other hand, oral health status did not have a direct association with malnutrition. Swallowing disorders may be associated with the incidence of malnutrition in elderly people receiving home-care. The findings indicate that maintaining swallowing function may contribute to the prevention of malnutrition in frail elderly people.

Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge: a randomized controlled trial.

PubMed

Beck, Anne Marie; Kjær, Stine; Hansen, Birthe Stenbæk; Storm, Rikke Lunau; Thal-Jantzen, Kirsten; Bitz, Christian

2013-06-01

To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality. Twelve-week single-blind randomized controlled study. Geriatric medical patients (65+ years) at nutritional risk. Participants were randomly allocated to receive a visit in their homes, either three individualized nutritional counselling by a registered dietitian complemented with three follow-up visits by general practitioners or three follow-up visits by general practitioners alone. Primary outcome was risk of re-admissions. Secondary outcomes were functional status (hand grip strength, chair stand, mobility, disability and tiredness in daily activities, rehabilitation capacity), nutritional status (weight, BMI, energy and protein intake), need of social services (home care, home nursing, meals-on-wheels) and mortality. One hundred and fifty-two patients were included; 132 (87%) completed the first and 124 (82%) the second data collection after 12 weeks. Ten per cent of the participants had three contacts with their general practitioner, while compliance with the dietetic intervention was almost 100%. Odds ratio for re-admission and mortality after 26 weeks was 1.62 (95% confidence interval (CI) 0.85 to 3.10) and 0.60 (95% CI 0.17 to 2.13). The intervention had a positive effect on functional status (i.e. mobility, P = 0.029), and nutritional status (i.e. weight, P = 0.035; energy intake, P < 0.001; protein intake, P = 0.001) and the use of meals-on wheels was reduced (P = 0.084). Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge.

Long-term health and work outcomes of renal transplantation and patterns of work status during the end-stage renal disease trajectory.

PubMed

van der Mei, Sijrike F; Kuiper, Daphne; Groothoff, Johan W; van den Heuvel, Wim J A; van Son, Willem J; Brouwer, Sandra

2011-09-01

The aim of this study was to examine the health- and work outcomes of renal transplant recipients long-term after transplantation as well as the pattern of work status, work ability and disability benefits during the end-stage renal disease (ESRD) trajectory that precedes transplantation. 34 transplant recipients completed interviews 3, 13 months and >6 years posttransplantation. Health status (SF-36), work ability (WAI), and fatigue (CIS) were assessed by questionnaires, clinical data were derived from medical charts, and data on functional limitations were extracted from the social security system database. The work status trajectory preceding transplantation was examined retrospectively. Of the 34 third wave transplant recipients, 29% were severely fatigued. Compared with the general working population, recipients experienced worse general health and less vitality. Non-working recipients had worse renal function and general health, and more limitations in physical functioning compared to working recipients. The WAI score indicated moderate work ability for 60% of the employed recipients. Although 67% were employed (45% parttime), 30% of those working still received some disability benefits. Social insurance physicians found variable levels of functional limitations. The mean work status trajectory showed more sickness absence and less work ability during dialysis, but after transplantation, both work status and work ability generally improved. Transplant recipients have a compromised health status which leads to functional limitations and disability. Although work status improved after transplantation, a substantial number of the transplant recipients received disability benefits. The negative health consequences of anti-rejection medications may play an important role in long-term work ability. These results indicate that a 'new' kidney has advantages over dialysis with respect to work, but does not necessarily leads to 'normal' work outcomes.

Associations of Mental Health and Physical Function with Colonoscopy-related Pain.

PubMed

Yamada, Eiji; Watanabe, Seitaro; Nakajima, Atsushi

2017-01-01

Objective To clarify the effects of mental health and physical function in association with colonoscopy-related pain. Methods The mental health and physical function were evaluated using the Japanese version of the SF-8 Health Survey questionnaire. Poor physical status was defined as a physical component summary (PCS) <40 and poor mental status as a mental component summary (MCS) <40. Pain was assessed using a visual analogue scale (VAS), with significant pain defined as VAS ≥70 mm and insignificant pain as VAS <70 mm. The background and colonoscopic findings were compared in patients with significant and insignificant pain. Patients This study evaluated consecutive Japanese patients who were positive on fecal occult blood tests and underwent total colonoscopy. Results Of the 100 patients, 23 had significant and 77 had insignificant colonoscopy-related pain. A multiple logistic regression analysis showed that MCS <40 [odds ratio (OR) 6.03; 95% confidence interval (CI) 1.41-25.9, p=0.0156], PCS <40 (OR 5.96; 95% CI 1.45-24.5, p=0.0133), and ≥300 seconds to reach the cecum (OR 4.13; 95% CI 1.16-14.7, p=0.0281) were independent risk factors for colonoscopy-related pain. Conclusion The mental health and physical function are important determinants of colonoscopy-related pain. Evaluating the mental health and physical function of patients prior to colonoscopy may effectively predict the degree of colonoscopy-related pain.

[The method of tonifying kidneys and activating blood circulation increases testosterone secretion index in late-onset hypogonadism males with kidney deficiency].

PubMed

Zhou, Shao-Hu; Weng, Zhi-Wei; Li, Tang-Lin

2013-07-01

To investigate the effect of the method of tonifying the kidney and activating blood circulation on the testosterone secretion index (TSI) in late-onset hypogonadism (LOH) male patients with kidney deficiency and its possible mechanisms. We screened 60 LOH male patients with kidney deficiency based on the scores on Partial Androgen Deficiency in Aging Males (PADAM), the levels of serum total testosterone (TT) and luteinizing hormone (LH), and TSI (TT/LH). We randomly divided the patients into a Nan Geng Ning (NGN) group (n = 40, aged 55.02 +/- 11.37 years) and a control group (n = 20, aged 54.56 +/- 12.12 years) to be treated orally with NGN decoction and testosterone undecanoate capsules, respectively, both for 12 consecutive weeks. We obtained the scores on psychological status, physical status and sexual function and observed the changes in serum TT, LH and TSI after 4, 8 and 12 weeks of treatment. Compared with the baseline, both the NGN and control groups showed a significant reduction after 12 weeks of medication in the LH level ([5.32 +/- 2.08] vs [4.89 +/- 1.46] IU/L and [5.36 +/- 2.07] vs [4.81 +/- 1.75] IU/L, P < 0.05), psychological status score (5.2 +/- 1.3 vs 2.7 +/- 1.4 and 4.8 +/- 2.2 vs 2.9 +/- 1.2, P < 0.05), physical status score (6.9 +/- 2.5 vs 2.9 +/- 1.6 and 7.1 +/- 2.7 vs 3.1 +/- 1.5, P < 0.05) and sexual function score (10.2 +/- 3.3 vs 4.5 +/- 2.9 and 9.8 +/- 3.1 vs 4.8 +/- 3.0, P < 0.05), but a remarkable increase in the TT level ([11.13 +/- 0.69] vs [14.55 +/- 0.75] nmol/L and [10.99 +/- 0.74] vs [14.74 +/- 0.83] nmol/L, P < 0.05) and TSI ([2.14 +/- 0.65] vs [2.99 +/- 0.72] nmol/IU and ([2.05 +/- 0.73] vs [3.11 +/- 0.65] nmol/IU, P < 0.05). However, no significant differences were found between the NGN and control groups at 12 weeks in LH ([4.89 +/- 1.46] vs [4.81 +/- 1.75] IU/L, P > 0.05), TT ([14.55 +/- 0.75] vs [14.74 +/- 0.83] nmol/L, P > 0.05), TSI ([2.99 +/- 0.72] vs [3.11 +/- 0.65] nmol/IU, P > 0.05), psychological status score (2.7 +/- 1.4 vs 2.9 +/- 1.2, P > 0.05), physi- cal status score (2.9 +/- 1.6 vs 3.1 +/- 1.5, P > 0.05) and sexual function score (4.5 +/- 2.9 vs 4.8 +/- 3.0, P > 0.05). There were no adverse events in either of the two groups throughout the whole experiment. The method of tonifying the kidney and activating blood circulation could significantly improve the clinical symptoms of LOH with kidney deficiency and increase the patient's serum TT level and TSI. NGN decoction works on LOH by acting on the hypothalamic-pituitary-gonad axis.

Comprehensive care improves physical recovery of hip-fractured elderly Taiwanese patients with poor nutritional status.

PubMed

Liu, Hsin-Yun; Tseng, Ming-Yueh; Li, Hsiao-Juan; Wu, Chi-Chuan; Cheng, Huey-Shinn; Yang, Ching-Tzu; Chou, Shih-Wei; Chen, Ching-Yen; Shyu, Yea-Ing L

2014-06-01

The effects of nutritional management among other intervention components have not been examined for hip-fractured elderly persons with poor nutritional status. Accordingly, this study explored the intervention effects of an in-home program using a comprehensive care model that included a nutrition-management component on recovery of hip-fractured older persons with poor nutritional status at hospital discharge. A secondary analysis of data from a randomized controlled trial with 24-month follow-up. A 3000-bed medical center in northern Taiwan. Subjects were included only if they had "poor nutritional status" at hospital discharge, including those at risk for malnutrition or malnourished. The subsample included 80 subjects with poor nutritional status in the comprehensive care group, 87 in the interdisciplinary care group, and 85 in the usual care group. The 3 care models were usual care, interdisciplinary care, and comprehensive care. Usual care provided no in-home care, interdisciplinary care provided 4 months of in-home rehabilitation, and comprehensive care included management of depressive symptoms, falls, and nutrition as well as 1 year of in-home rehabilitation. Data were collected on nutritional status and physical functions, including range of motion, muscle power, proprioception, balance and functional independence, and analyzed using a generalized estimating equation approach. We also compared patients' baseline characteristics: demographic characteristics, type of surgery, comorbidities, length of hospital stay, cognitive function, and depression. Patients with poor nutritional status who received comprehensive care were 1.67 times (95% confidence interval 1.06-2.61) more likely to recover their nutritional status than those who received interdisciplinary and usual care. Furthermore, the comprehensive care model improved the functional independence and balance of patients who recovered their nutritional status over the first year following discharge, but not of those who had not yet recovered. An in-home program using the comprehensive care model with a nutritional component effectively improved the nutritional status of hip-fractured patients with poor nutrition. This comprehensive care intervention more effectively improved recovery of functional independence and balance for patients with recovered nutritional status. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Analysis of the effects of removable dentures on the psychological status, quality of life, and masticatory function of the elderly

NASA Astrophysics Data System (ADS)

Dyas, R.; Nathanael, M.; Indrasari, M.; Masulili, C.; Rahardjo, T. B.; Agustin, D.; Hogervorst, E.; Kusdhany, L.

2017-08-01

Older age is a major risk factor for diseases of the teeth and mouth and dementia. Diseases of the teeth and mouth can lead to tooth loss. The use of removable dentures can help the elderly to replace lost teeth; therefore, dentures are expected to improve the masticatory function, quality of life, and psychological status of the elderly. The aim of this study was to analyze the effects of removable denture usage on the improvement of the psychological status, quality of life, and masticatory function of elderly people. The data was obtained from 30 respondents. The patients answered questionnaires before they used the dentures, 2 weeks after they began using dentures, and 2 months after they started wearing dentures. Four different questionnaires were used: EuroQol Five Dimensions questionnaire (EQ-5D) and Geriatric Depression Scale (GDS), to measure psychological status; a mastication questionnaire to measure masticatory function; and a validated quality of life questionnaire. Based on the results of this study, it is clear that after 2 months of denture usage, removable dentures in the elderly can significantly improve their quality of life, masticatory function, and psychological status(p<0.05).

Patterns of Change in Depression Post Stroke

PubMed Central

Ostir, Glenn V.; Berges, Ivonne-M.; Ottenbacher, Allison; Ottenbacher, Kenneth J.

2011-01-01

Background Little information is available on depressive symptom change in persons with stroke. Objectives Provide estimates of change in depressive symptoms and determine how depressive symptom change influences recovery of functional status. Design Prospective cohort study. Setting Eleven in-patient medical rehabilitation facilities located across the U.S. Participants 544 persons with a first-time stroke. Measurements General linear regression model estimates assessed associations between depressive symptom change and functional status 3 and 12 months post discharge. Results The majority of persons with stroke were aged 75 and older, white, female and married. The most prevalent stroke type was ischemic. Non-depressed patients at discharge who reported fewer symptoms 12-months later had an adjusted functional status score of 108.2. This compared to adjusted functional status scores of 104.6 for those non-depressed at discharge with increasing symptoms over the 12-month follow-up, 100.3 for those depressed at discharge with fewer symptoms over the 12-month follow-up, and 88.0 for those depressed at discharge with more symptoms over the 12-month follow-up. Conclusion Tracking depressive symptom change in hospital and post discharge is clinically relevant and an important component of patient care and recovery of functional status. PMID:21275930

Nutritional status, assessment, requirements and adequacy of traumatic brain injury patients.

PubMed

Daradkeh, Ghazi; Essa, Musthafa Mohamed; Al-Adawi, S Samir; Subash, Selvaraju; Mahmood, Lubna; Kumar, Parvathy R

2014-10-01

Traumatic Brain Injury (TBI) has been considered as a serious public health problem. Each year, traumatic brain injuries are contributing to a substantial number of cases of permanent disability and deaths and it can be classified according to the severity into penetrating and closed head injury. Symptoms, beside to be unconscious can be defined as vomiting, nausea, headache, dizziness, lack of motor coordination, difficulty in balancing, blurred vision and lightheadedness, bad taste in the mouth, ringing in the ears, fatigue and lethargy as well as changes in sleep patterns. The brain is known to be the functional regulator for all the metabolic activities inside the body and TBI patients mostly have a complex metabolic alterations including aberrant cellular metabolism, abnormal metabolic processes, changes in hormones functions and inflammatory cascade. The TBI patient's status needed to be assessed medically and nutritionally since the medical status of the patients can affect the nutrition part. Data from the four assessment tools are needed to be correctly used and interpreted in order to make a proper nutritional diagnosis, clinical assessment, biochemistry as well as anthropometric measurements. Regardless the methods used for assessing TBI patients, having adequate intake and medical care can lead to a reduction in hospital costs, numbers of day hospitalized, numbers of hours of mechanical ventilation and in the overall infection rates.

Fibroblast growth factor 23, iron and inflammation - are they related in early stages of chronic kidney disease?

PubMed

Lukaszyk, Ewelina; Lukaszyk, Mateusz; Koc-Zorawska, Ewa; Bodzenta-Lukaszyk, Anna; Malyszko, Jolanta

2017-06-01

Fibroblast growth factor 23 (FGF-23) levels are elevated in impaired renal function. Inflammation and iron are potential regulators of FGF-23. The aim of the study was to evaluate the association between FGF-23 concentration, novel iron status biomarkers and inflammatory parameters among patients with early stages of chronic kidney disease (CKD). The study population included 84 patients with CKD in the early stage. Serum hemoglobin, fibrinogen, creatinine, iron, transferrin saturation and ferritin levels were measured using standard laboratory methods. Commercially available kits were used to measure: intact FGF-23, hepcidin, soluble transferrin receptor (sTfR), interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP). In patients with CKD no differences in FGF-23 concentration according to iron status were observed. Lower iron concentration was associated with higher concentrations of hsCRP, IL-6 and fibrinogen. In univariate and multivariate analysis FGF-23 correlated with fibrinogen ( r = -0.23, p < 0.05) and eGFR ( r = -0.36, p < 0.05). FGF-23 is affected by kidney function and fibrinogen but not iron status parameters in the early stages of CKD. Our data are paving the way for further studies on the role of FGF-23 in iron metabolism, especially in early stages of CKD.

The Impact of ART on the Economic Outcomes of People Living with HIV/AIDS.

PubMed

Nannungi, Annet; Wagner, Glenn; Ghosh-Dastidar, Bonnie

2013-01-01

Background. Clinical benefits of ART are well documented, but less is known about its effects on economic outcomes such as work status and income in sub-Saharan Africa. Methods. Data were examined from 482 adult clients entering HIV care (257 starting ART; 225 not yet eligible for ART) in Kampala, Uganda. Self-reported data on work status and income were assessed at baseline, months 6 and 12. Multivariate analysis examined the effects of ART over time, controlling for change in physical health functioning and baseline covariates. Results. Fewer ART patients worked at baseline compared to non-ART patients (25.5% versus 34.2%); 48.8% of those not working at baseline were now working at month 6, and 50% at month 12, with similar improvement in both the ART and non-ART groups. However, multivariate analysis revealed that the ART group experienced greater improvement over time. Average weekly income did not differ between the groups at baseline nor change significantly over time, among those who were working; being male gender and having any secondary education were predictive of higher income. Conclusions. ART was associated with greater improvement in work status, even after controlling for change in physical health functioning, suggesting other factors associated with ART may influence work.

Functional measures developed for clinical populations identified impairment among active workers with upper extremity disorders

PubMed Central

Gardner, Bethany T.; Dale, Ann Marie; Buckner-Petty, Skye; Rachford, Robert; Strickland, Jaime; Kaskutas, Vicki; Evanoff, Bradley

2017-01-01

Purpose Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. Methods A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: 1) UE symptoms, 2) UE musculoskeletal disorders (MSD), 3) carpal tunnel syndrome (CTS), and 4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. Results All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. Conclusions Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work. PMID:26091980

Functional assessment of a series of paediatric patients receiving neurointensive treatment: New Functional status scale.

PubMed

Madurga-Revilla, P; López-Pisón, J; Samper-Villagrasa, P; Garcés-Gómez, R; García-Íñiguez, J P; Domínguez-Cajal, M; Gil-Hernández, I; Viscor-Zárate, S

2017-11-01

Functional health, a reliable parameter of the impact of disease, should be used systematically to assess prognosis in paediatric intensive care units (PICU). Developing scales for the assessment of functional health is therefore essential. The Paediatric Overall and Cerebral Performance Category (POPC, PCPC) scales have traditionally been used in paediatric studies. The new Functional Status Scale (FSS) was designed to provide more objective results. This study aims to confirm the validity of the FSS compared to the classic POPC and PCPC scales, and to evaluate whether it may also be superior to the latter in assessing of neurological function. We conducted a retrospective descriptive study of 266 children with neurological diseases admitted to intensive care between 2012 and 2014. Functional health at discharge and at one year after discharge was evaluated using the PCPC and POPC scales and the new FSS. Global FSS scores were found to be well correlated with all POPC scores (P<.001), except in category 5 (coma/vegetative state). Global FSS score dispersion increases with POPC category. The neurological versions of both scales show a similar correlation. Comparison with classic POPC and PCPC categories suggests that the new FSS scale is a useful method for evaluating functional health in our setting. The dispersion of FSS values underlines the poor accuracy of POPC-PCPC compared to the new FSS scale, which is more disaggregated and objective. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Physical Function Assessment in a Community-Dwelling Population of U.S. Chinese Older Adults

PubMed Central

Chang, E-Shien; Simon, Melissa A.

2014-01-01

Background. This report describes the levels of physical function in U.S. Chinese older adults utilizing self-reported and performance-based measures, and examines the association between sociodemographic characteristics and physical function. Methods. The Population Study of Chinese Elderly in Chicago enrolled an epidemiological cohort of 3,159 community-dwelling Chinese older adults aged 60 and older. We collected self-reported physical function using Katz activities of daily living and Lawton instrumental activities of daily living items, the Index of Mobility scale, and the Index of Basic Physical Activities scale. Participants were also asked to perform tasks in chair stand, tandem stand, and timed walk. We computed Pearson and Spearman correlation coefficients to examine the correlation between sociodemographic and physical function variables. Results. A total of 7.8% of study participants experienced activities of daily living impairment, and 50.2% experienced instrumental activities of daily living impairment. With respect to physical performance testing, 11.4% of the participants were not able to complete chair stand for five times, 8.5% of the participants were unable to do chair stands at all. Older age, female gender, lower education level, being unmarried, living with fewer people in the same household, having fewer children, living fewer years in the United States, living fewer years in the community, and worsening health status were significantly correlated with lower levels of physical function. Conclusions. Utilizing self-reported and performance-based measures of physical function in a large population-based study of U.S. Chinese older adults, our findings expand current understanding of minority older adults’ functional status. PMID:25378446

A comparison of functional academic and daily living skills in males with fragile X syndrome with and without autism.

PubMed

Raspa, Melissa; Franco, Vitor; Bishop, Ellen; Wheeler, Anne C; Wylie, Amanda; Bailey, Donald B

2018-05-03

Adaptive behaviors, such as functional academic and daily living skills, are critical for independence in adults with intellectual and developmental disabilities. However, little is known about these skills in fragile X syndrome (FXS), the most common form of inherited intellectual disability. The purposes of this study were to describe the functional academic and daily living skills of males diagnosed with FXS across different age groups and compare skill attainment by autism status and other common co-occurring conditions. We used survey methods to assess parent-reported functional academic and daily living skills in 534 males with FXS. Functional academic skills included time and schedules, money, math, reading, and writing skills. Daily living skills included hygiene, cooking, laundry and housekeeping, transportation, and safety skills. Analyses examined functional academic and daily living skills in a cross-sectional sample of males between ages 5 and 67. Differences in skill attainment were found by child age, co-morbid autism status, total number of co-occurring conditions, and respondent education. Functional academic and daily living skills were predictive of community employment and independent living. These data provide important information on the mastery of both foundational and more complex adaptive skills in males with FXS. Both functional academic and daily living skills were predictive of measures of independence above and beyond other child and family characteristics. These findings point to the need to focus interventions to support the attainment of independence in males with FXS. Copyright © 2018 Elsevier Ltd. All rights reserved.

Multispectral photoacoustic method for the early detection and diagnosis of osteoporosis

NASA Astrophysics Data System (ADS)

Steinberg, Idan; Eyal, Avishay; Gannot, Israel

2013-03-01

Osteoporosis is a major health problem worldwide, with healthcare costs of billions of dollars annually. The risk of fracture depends on the bone mineral density (measured in clinical practice) as well as on the bone microstructure and functional status. Since pure ultrasonic methods can measure bone strength and spectroscopic optical methods can provide valuable functional information, a hybrid multispectral photoacoustic technique can be of great value. We have developed such a system based on a tunable Ti:Sapph laser at 750 - 950 nm, followed by an acousto-optic modulator to generate photoacoustic signals with frequencies of 0.5 - 2.5 MHz. Another system was based on two directly modulated 830nm laser diodes. The systems were used to photoacoustically excite the proximal end of a rat tibia. Spectrum analyzer with tracking generator was used for measuring both the amplitude and the phase at the distal end. Scanning along both the optical wavelength as well as the acoustic frequency enables full mapping of the bone transfer function. Analyzing this function along the wavelength axis allows deducing the gross biochemical composition related to the bone functional and pathological state. Analyzing the amplitude and phase along the acoustic frequency axis yields the speed of sound dispersion and the broadband ultrasonic attenuation - both have shown clinical relevance.

Functional dimorphic enantiostyly in monomorphic enantiostylous species of the subtribe Cassiinae (Fabaceae-Caesalpinioideae).

PubMed

Almeida, N M; Souza, J T; Oliveira, C R S; Bezerra, T T; Novo, R R; Siqueira Filho, J A; Oliveira, P E; Castro, C C

2018-03-23

Monomorphic enantiostylous species produce flowers with a displacement of the style to the left (L) or right (R) on the same individual, and may exhibit different dynamics for the production of these floral types, which may influence levels of selfing. We investigated the production dynamics of L and R floral types in seven species and a variety of monomorphic enantiostylous species of the genera Senna and Chamaecrista. Our hypothesis was that most species present similar proportions of floral morphs each day. Individuals were classified daily over a period of 7 days according to the functional status, i.e. the proportion of floral morphs as functionally L, R or reciprocal (REC, i.e. similar proportions of the two floral morphs), and also according to the number of consecutive days in which they exhibited the same functional status. All species presented low daily flower production. Most species had individuals classified as functionally R, L and REC, and tend to repeat the same functional status over a few days, although they may change functional status during the flowering period. All species exhibited individuals that were classified as functionally reciprocal when both the daily and total number of flowers produced over 7 days was considered. The occurrence of different functional status has not yet been reported in the literature for enantiostylous species. The distinct strategies observed in the dynamics of floral morph production seemed likely to minimise geitonogamy and to favour cross-pollination between individuals (xenogamy). © 2018 German Society for Plant Sciences and The Royal Botanical Society of the Netherlands.

Increased subcortical neural activity among HIV+ individuals during a lexical retrieval task.

PubMed

Thames, April D; Sayegh, Philip; Terashima, Kevin; Foley, Jessica M; Cho, Andrew; Arentoft, Alyssa; Hinkin, Charles H; Bookheimer, Susan Y

2016-08-01

Deficits in lexical retrieval, present in approximately 40% of HIV+ patients, are thought to reflect disruptions to frontal-striatal functions and may worsen with immunosuppression. Coupling frontal-striatal tasks such as lexical retrieval with functional neuroimaging may help delineate the pathophysiologic mechanisms underlying HIV-associated neurological dysfunction. We examined whether HIV infection confers brain functional changes during lexical access and retrieval. It was expected that HIV+ individuals would demonstrate greater brain activity in frontal-subcortical regions despite minimal differences between groups on neuropsychological testing. Within the HIV+ sample, we examined associations between indices of immunosuppression (recent and nadir CD4+ count) and task-related signal change in frontostriatal structures. Method16 HIV+ participants and 12 HIV- controls underwent fMRI while engaged in phonemic/letter and semantic fluency tasks. Participants also completed standardized measures of verbal fluency HIV status groups performed similarly on phonemic and semantic fluency tasks prior to being scanned. fMRI results demonstrated activation differences during the phonemic fluency task as a function of HIV status, with HIV+ individuals demonstrating significantly greater activation in BG structures than HIV- individuals. There were no significant differences in frontal brain activation between HIV status groups during the phonemic fluency task, nor were there significant brain activation differences during the semantic fluency task. Within the HIV+ group, current CD4+ count, though not nadir, was positively correlated with increased activity in the inferior frontal gyrus and basal ganglia. During phonemic fluency performance, HIV+ patients recruit subcortical structures to a greater degree than HIV- controls despite similar task performances suggesting that fMRI may be sensitive to neurocompromise before overt cognitive declines can be detected. Among HIV+ individuals, reduced activity in the frontal-subcortical structures was associated with lower CD4+ count. Copyright © 2015 Elsevier Inc. All rights reserved.

Influence of Occupational Status on the Quality of Life of Chinese Adult Patients with Epilepsy

PubMed Central

Gu, Xiang-Min; Ding, Cheng-Yun; Wang, Ning; Xu, Cheng-Feng; Chen, Ze-Jie; Wang, Qin; Yao, Qin; Wang, Fu-Li

2016-01-01

Background: Epilepsy is one of the most common serious neurological disorders. The present study aimed to investigate the influence of occupational status on the quality of life of Chinese adult patients with epilepsy. Methods: This study surveyed 819 subjects clinically diagnosed with epilepsy for more than 1 year in 11 hospitals in Beijing; 586 were employed (71.55%). All subjects completed the case report form with inquiries on demographic data, social factors, and illness. The patients’ quality of life was assessed using the quality of life in patients with epilepsy-31 items (QOLIE-31) questionnaire. Results: The QOLIE-31 score in the employed group was significantly higher than that in the unemployed group. Furthermore, the scores in all the sections (overall quality of life, energy/fatigue, emotional well-being, seizure worry, cognition, social function, and medication effects) of the employed group were higher than those of the unemployed group. Both the employed and unemployed groups achieved the highest difference in social function. The QOLIE-31 score of students was higher than those of farmers and workers. Both the students and workers scored higher in the quality of life compared with the adult peasants living with epilepsy. The students and farmers showed significant differences in QOLIE-31 score, cognition, emotional well-being, overall quality of life, energy/fatigue, and social function. In contrast, no significant difference was noted in seizure worry and medication effects across the three different kinds of occupation. Conclusion: Occupational status might affect the quality of life of Chinese adult patients with epilepsy, and social function is the most important contributing factor. PMID:27231164

How Socioeconomic Status, Executive Functioning and Verbal Interactions Contribute to Early Academic Achievement in Chinese Children

ERIC Educational Resources Information Center

Chung, Kevin K. H.; Liu, Hongyun; McBride, Catherine; Wong, Anita M. -Y.; Lo, Jason C. M.

2017-01-01

The present study investigated the relative importance of executive functioning, parent-child verbal interactions, phonological awareness and visual skills on reading and mathematics for Chinese children from low-versus middle-socio economic status (SES) backgrounds. A total of 199 kindergarten children were assessed on executive functioning,…

A Structural Analysis of Executive Functions and Socioeconomic Status in School-Age Children: Cognitive Factors as Effect Mediators

ERIC Educational Resources Information Center

Aran-Filippetti, Vanessa; Richaud de Minzi, Maria Cristina

2012-01-01

Socioeconomic status (SES) is a well-known predictor of cognitive achievement and executive functioning, although the underlying cognitive mediating processes remain unclear. The authors analyze the association between different socioeconomic indicators and the executive functions (EF) of schoolchildren and the possible cognitive mediating factors…

[The establishment, development and application of classification approach of freshwater phytoplankton based on the functional group: a review].

PubMed

Yang, Wen; Zhu, Jin-Yong; Lu, Kai-Hong; Wan, Li; Mao, Xiao-Hua

2014-06-01

Appropriate schemes for classification of freshwater phytoplankton are prerequisites and important tools for revealing phytoplanktonic succession and studying freshwater ecosystems. An alternative approach, functional group of freshwater phytoplankton, has been proposed and developed due to the deficiencies of Linnaean and molecular identification in ecological applications. The functional group of phytoplankton is a classification scheme based on autoecology. In this study, the theoretical basis and classification criterion of functional group (FG), morpho-functional group (MFG) and morphology-based functional group (MBFG) were summarized, as well as their merits and demerits. FG was considered as the optimal classification approach for the aquatic ecology research and aquatic environment evaluation. The application status of FG was introduced, with the evaluation standards and problems of two approaches to assess water quality on the basis of FG, index methods of Q and QR, being briefly discussed.

Age and Functional Health Status

DTIC Science & Technology

1989-06-01

age groups. However, decrements in functional health status occurred selectively among older individuals with many of the elderly scoring as well as...Illinois adults (18 and above) were asked to assess their health compared to others their age , only those 61 and older rated their health as better than...and more variable physical functioning, role functioning,, and perceived health in older age groups, particularly those groups aged 50 and

Urinary excretion ratio of xanthurenic acid/kynurenic acid as a functional biomarker of niacin nutritional status.

PubMed

Shibata, Katsumi; Yamazaki, Marika; Matsuyama, Yukiyo

2016-07-18

The present study was conducted to survey functional biomarkers for evaluation of niacin nutritional status. Over 500 enzymes require niacin as a coenzyme. Of these, we chose the tryptophan degradation pathway. To create niacin-deficient animals, quinolinic acid phosphoribosyltransferase-knock out mice were used in the present study because wild type mice can synthesize nicotinamide from tryptophan. When the mice were made niacin-deficient, the urinary excretion of xanthurenic acid (XA) was extremely low compared with control mice; however, it increased according to the recovery of niacin nutritional status. The urinary excretion of kynurenic acid (KA) was the reverse of XA. Kynurenine 3-monooxygenase, which needs NADPH, was thought to be suppressed by niacin deficiency. Thus, we calculated the urinary excretion ratio of XA:KA as a functional biomarker of niacin nutrition. The ratio increased according to recovering niacin nutritional status. Low values equate with low niacin nutritional status.

Pseudo and conditional score approach to joint analysis of current count and current status data.

PubMed

Wen, Chi-Chung; Chen, Yi-Hau

2018-04-17

We develop a joint analysis approach for recurrent and nonrecurrent event processes subject to case I interval censorship, which are also known in literature as current count and current status data, respectively. We use a shared frailty to link the recurrent and nonrecurrent event processes, while leaving the distribution of the frailty fully unspecified. Conditional on the frailty, the recurrent event is assumed to follow a nonhomogeneous Poisson process, and the mean function of the recurrent event and the survival function of the nonrecurrent event are assumed to follow some general form of semiparametric transformation models. Estimation of the models is based on the pseudo-likelihood and the conditional score techniques. The resulting estimators for the regression parameters and the unspecified baseline functions are shown to be consistent with rates of square and cubic roots of the sample size, respectively. Asymptotic normality with closed-form asymptotic variance is derived for the estimator of the regression parameters. We apply the proposed method to a fracture-osteoporosis survey data to identify risk factors jointly for fracture and osteoporosis in elders, while accounting for association between the two events within a subject. © 2018, The International Biometric Society.

A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury

PubMed Central

Kesler, Shelli R.; Lacayo, Norman J.; Jo, Booil

2011-01-01

Primary objectives Children with a history of cancer are at increased risk for cognitive impairments, particularly in executive and memory domains. Traditional, in-person cognitive rehabilitation strategies may be unavailable and/or impractical for many of these children given difficulties related to resources and health status. The feasibility and efficacy of implementing a computerized, home-based cognitive rehabilitation curriculum designed to improve executive function skills was examined in these children. Methods A one-arm open trial pilot study of an original executive function cognitive rehabilitation curriculum was conducted with 23 paediatric cancer survivors aged 7–19. Results Compliance with the cognitive rehabilitation program was 83%, similar to that of many traditional programs. Following the cognitive intervention, participants showed significantly increased processing speed, cognitive flexibility, verbal and visual declarative memory scores as well as significantly increased pre-frontal cortex activation compared to baseline. Conclusions These results suggest that a program of computerized cognitive exercises can be successfully implemented at home in young children with cancer. These exercises may be effective for improving executive and memory skills in this group, with concurrent changes in neurobiologic status. PMID:21142826

Bone age in cerebral palsy

PubMed Central

Miranda, Eduardo Régis de Alencar Bona; Palmieri, Maurício D'arc; de Assumpção, Rodrigo Montezuma César; Yamada, Helder Henzo; Rancan, Daniela Regina; Fucs, Patrícia Maria de Moraes Barros

2013-01-01

Objective To compare the chronological age and bone age among cerebral palsy patients in the outpatient clinic and its correlation with the type of neurological involvement, gender and functional status. Methods 401 patients with spastic cerebral palsy, and ages ranging from three months to 20 years old, submitted to radiological examination for bone age and analyzed by two independent observers according Greulich & Pyle. Results In the topographic distribution, there was a significant delay (p<0.005) in tetraparetic (17.7 months), hemiparetic (10.1 months), and diparetic patients (7.9 months). In the hemiparetic group, the mean bone age in the affected side was 96.88 months and the uncompromised side was 101.13 months (p<0.005). Regarding functional status, the ambulatory group showed a delay of 18.73 months in bone age (p<0.005). Comparing bone age between genders, it was observed a greater delay in males (13.59 months) than in females (9.63 months), but not statistically significant (p = 0.54). Conclusion There is a delay in bone age compared to chronological age influenced by the topography of spasticity, functional level and gender in patients with cerebral palsy. Level of Evidence IV, Case Series. PMID:24453693

[Use of liquid crystal eyeglasses for examination and recovery of binocular vision].

PubMed

Grigorian, A Iu; Avetisov, E S; Kashchenko, T P; Iachmeneva, E I

1999-01-01

A new method for diploptic treatment of strabismus is proposed, based on phase division of visual fields using liquid crystal eyeglasses --computer complex. The method is based on stereovision training (allowing stereothreshold measurements up to 150 ang. sec.). The method was tried in examinations of two groups of children: 10 controls and 74 patients with strabismus. Examinations of normal controls gave new criteria for measuring fusion reserves and stereovisual acuity by the proposed method. The therapeutic method was tried in 2 groups of patients. Time course of visual function improvement was followed up by several criteria: changes in binocular status by the color test and improvement of in-depth and stereoscopic visual acuity. The method is recommended for practice. The authors discuss the problem of small angle strabismus.

The relationship between nutritional status and physical function, admission frequency, length of hospital stay, and mortality in old people living in long-term care facilities.

PubMed

Lin, Sin-Jie; Hwang, Shinn-Jang; Liu, Chieh-Yu; Lin, Hung-Ru

2012-06-01

Nutrition is an important issue for elderly residents of long-term care facilities (LTCFs). About 20% of elderly LTCF residents in Taiwan are malnourished. This study investigated correlations between nutritional status and physical function, admission frequency, hospitalstay duration, and mortality in elderly LTCF residents. Researchers used a retrospective study design and convenient sampling to enroll 174 subjects aged 67 to 105 years (average, 82.5 years) who were living in legally registered LTCFs in Beitou District, Taipei City, Taiwan. A review of LTCF resident files provided data on subjects' demographics, physical examination laboratory results for the most recent 1-year period, anthropometry, physical function, admission frequency, hospital stay duration, and causes of admissions. Subjects had lived in their LTCF for more than 1 year before their enrollment date. Subjects who died during and after the study period were also included in analysis. Results showed significant changes over the study year in subjects' nutritional status, physical function, and calf circumference. Physical function was found significantly correlated with calf circumference, hospitalization status was found correlated with nasal-gastric tube feeding status, and eating pattern was found correlated with calf circumference and levels of both serum albumin and cholesterol. Nutritional status, calf circumference, albumin level, and cholesterol level also correlated significantly with hospitalization status. In this study, the likelihood of hospitalization increased with age and nasal-gastric tube feeding use. Hospital stay duration for subjects receiving nasal-gastric tube feeding was longer than that for those receiving oral feeding. Also, weak nutritional status scores for calf circumference and hemoglobin levels were factors associated with increased mortality risk. Findings recommend that greater attention should be paid to the nutritional status of elderly persons living in LTCFs to reduce hospitalization and death risks, cut medical expenses, and improve quality of care.

Comparing current definitions of return to work: a measurement approach.

PubMed

Steenstra, I A; Lee, H; de Vroome, E M M; Busse, J W; Hogg-Johnson, S J

2012-09-01

Return-to-work (RTW) status is an often used outcome in work and health research. In low back pain, work is regarded as a normal activity a worker should return to in order to fully recover. Comparing outcomes across studies and even jurisdictions using different definitions of RTW can be challenging for readers in general and when performing a systematic review in particular. In this study, the measurement properties of previously defined RTW outcomes were examined with data from two studies from two countries. Data on RTW in low back pain (LBP) from the Canadian Early Claimant Cohort (ECC); a workers' compensation based study, and the Dutch Amsterdam Sherbrooke Evaluation (ASE) study were analyzed. Correlations between outcomes, differences in predictive validity when using different outcomes and construct validity when comparing outcomes to a functional status outcome were analyzed. In the ECC all definitions were highly correlated and performed similarly in predictive validity. When compared to functional status, RTW definitions in the ECC study performed fair to good on all time points. In the ASE study all definitions were highly correlated and performed similarly in predictive validity. The RTW definitions, however, failed to compare or compared poorly with functional status. Only one definition compared fairly on one time point. Differently defined outcomes are highly correlated, give similar results in prediction, but seem to differ in construct validity when compared to functional status depending on societal context or possibly birth cohort. Comparison of studies using different RTW definitions appears valid as long as RTW status is not considered as a measure of functional status.

Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study.

PubMed

Stringhini, Silvia; Carmeli, Cristian; Jokela, Markus; Avendaño, Mauricio; McCrory, Cathal; d'Errico, Angelo; Bochud, Murielle; Barros, Henrique; Costa, Giuseppe; Chadeau-Hyam, Marc; Delpierre, Cyrille; Gandini, Martina; Fraga, Silvia; Goldberg, Marcel; Giles, Graham G; Lassale, Camille; Kenny, Rose Anne; Kelly-Irving, Michelle; Paccaud, Fred; Layte, Richard; Muennig, Peter; Marmot, Michael G; Ribeiro, Ana Isabel; Severi, Gianluca; Steptoe, Andrew; Shipley, Martin J; Zins, Marie; Mackenbach, Johan P; Vineis, Paolo; Kivimäki, Mika

2018-03-23

To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. Multi-cohort population based study. 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. 109 107 men and women aged 45-90 years. Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning lost were greater than years of life lost due to low socioeconomic status and non-communicable disease risk factors. The independent association between socioeconomic status and physical functioning in old age is comparable in strength and consistency with those for established non-communicable disease risk factors. The results of this study suggest that tackling all these risk factors might substantially increase life years spent in good physical functioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Water-salt exchange during bedrest of varying duration

NASA Technical Reports Server (NTRS)

Natochin, Y. V.

1978-01-01

Problems associated with the status of water-sodium metabolism under bedrest programs of varying lengths were studied. The dynamics of electrolyte concentration in blood serum, functional status of kidney osmosis regulating function, and other problems are discussed.

Impact of psychosocial factors on functional improvement in Latino older adults after Tai Chi exercise.

PubMed

Siu, Ka-Chun; Rajaram, Shireen S; Padilla, Carolina

2015-01-01

Increasing evidence underscores the health benefits of Tai Chi (TC), although there is limited evidence of benefits among racial and ethnic minorities. This study investigated the impact of psychosocial status on balance among 23 Latino seniors after a twice-a-week, 12-week TC exercise program. Functional status was measured at baseline, immediately after, and three months following the TC exercise program, using the Timed Up and Go Test and Tinetti Falls Efficacy Scale. Psychosocial status was measured at baseline by the Center for Epidemiologic Studies Depression Scale and Norbeck Social Support Questionnaire. Both measures of functional status improved and were sustained after three months of TC. Greater improvement was significantly related to a higher level of baseline social support. More depressed seniors reported less fear of falling after TC. Depression and social support are important moderators of functional improvement after TC among Latino seniors.

Marital Status as a Moderating Factor in the Process of Disablement.

PubMed

Kail, Ben Lennox

2016-02-01

To test current marital status as a moderator on the influence of depressive symptoms and chronic conditions on subsequent functional limitations. Data come from the Health and Retirement Study (HRS; 1998-2010). Hierarchal linear modeling models tested differences in functional limitations among a sample of 20,215 people. At baseline, married people suffered from fewer subsequent functional limitations than the unmarried. Moreover, limited evidence suggests the influence of depressive symptoms was greater for the married than the unmarried; however, the influence of chronic conditions was consistently attenuated for married people. Accounting for differences in prior health, work, socioeconomic status, and health behaviors did not explain the moderating influence of marital status on the associations between symptoms of depression and chronic conditions with functional limitations. This research highlights the need to identify potential modifiers that may help disrupt the process of disablement among both the married and the unmarried alike. © The Author(s) 2015.

Attained Functional Status Moderates Survival Outcomes of Return to Work After Lung Transplantation.

PubMed

Tumin, Dmitry; Kirkby, Stephen E; Tobias, Joseph D; Hayes, Don

2016-06-01

Returning to work is a desirable outcome of lung transplantation that is selective on attained functional status. Survival implications of post-transplant employment are unclear. The United Network for Organ Sharing registry was queried for first-time lung transplants performed from May 2005 to March 2015 in patients ages 18-64. Attainment of normal functional status post-transplant, defined as a 100 % score on the Karnofsky Performance Scale (KPS), was examined as moderating 5-year survival outcomes of work resumption, using Cox proportional hazards models. Supplemental analysis examined attainment of forced expiratory volume in 1 s (FEV1) ≥80 % predicted as moderating survival implications of post-transplant employment. Of 10,066 patients, 1824 (18 %) returned to work, while 9078 contributed follow-up data on functional status. Multivariable analysis demonstrated a protective effect of work resumption among patients who did not attain normal functional status before returning to work (HR = 0.62; 95 % CI = 0.51, 0.76; p < 0.001). This association was attenuated among transplant recipients who reached 100 % KPS while still unemployed (p < 0.001). Similarly, post-transplant survival was favorably associated with 5-year survival among patients who did not attain at least 80 % predicted FEV1 before returning to work (HR = 0.71; 95 % CI = 0.59, 0.86; p < 0.001). Early return to work after lung transplantation may benefit patients experiencing mild functional limitations. Timing the resumption of employment to coincide with attainment of maximal functional status around 1 year post transplant should be considered.

Association of social support, functional status, and psychological variables with changes in health-related quality of life outcomes in patients with colorectal cancer.

PubMed

Gonzalez-Saenz de Tejada, M; Bilbao, A; Baré, M; Briones, E; Sarasqueta, C; Quintana, J M; Escobar, A

2016-08-01

The aim of this study was to explore the association of social support received, and functional and psychological status of colorectal cancer patients before surgery with changes in health-related quality of life (HRQoL) outcomes measured by EORTC QLQ-C30 at 1-year post-intervention. Consecutive patients that were because of undergo therapeutic surgery for the first time for colon or rectum cancer in nine hospitals in Spain were eligible for the study. Patients completed questionnaires before surgery and 12 months afterwards: one HRQoL instrument, the EORTC QLQ-C30; a social network and social support questionnaire, the Duke-UNC Functional Social Support Questionnaire; the Hospital Anxiety and Depression Scale, to assess anxiety and depression; and the Barthel Index, to assess functional status; as well as questions about sociodemographic information. General linear models were built to explore the association of social support, functional status, and psychological variables with changes in HRQoL 12 months after intervention. A total of 972 patients with colorectal cancer took part in the study. Patients' functional status, social support, and anxiety and depression were associated with changes in at least one HRQoL domain. The higher functional status, and the higher social support, the more they improved in HRQoL domains. Regarding anxiety and depression, the more anxiety and depression patients have at baseline, less they improve in HRQoL domains. Patients with colorectal cancer who have more social support and no psychological distress may have better results in HRQoL domains at 1 year after surgery. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Associations of childhood socioeconomic status and adulthood height with functional limitations among Japanese older people: results from the JAGES 2010 Project.

PubMed

Fujiwara, Takeo; Kondo, Katsunori; Shirai, Kokoro; Suzuki, Kayo; Kawachi, Ichiro

2014-07-01

We examined the associations between childhood socioeconomic status and adulthood height with functional limitations in old age. Data were obtained from the baseline survey of the Japan Gerontological Evaluation Study 2010, a population-based cohort of people aged ≥65 years enrolled from 27 municipalities across Japan (N = 15,499). People aged 65-69, 70-74, 75-79, and ≥80 years experienced the end of World War II when they were aged 0-4, 5-9, 10-14, and ≥15 years, respectively. Subjective socioeconomic status during childhood and current height were obtained by self-report through questionnaire in 2010. Higher-level functional capacity was assessed using a validated questionnaire scale. Poisson regression with robust variance estimator was employed to determine the association between childhood subjective socioeconomic status, height, and functional limitations. Lower childhood subjective socioeconomic status was consistently associated with higher prevalence rate ratio of limitations in higher-level functional capacity, regardless of age cohort. Height was associated with functional limitation only among the group aged 70-74 years: taller (≥170cm for men and ≥160cm for women) people were 16% less likely to report functional limitation in comparison with shorter (<155 cm for men and <145 cm for women) individuals in the fully adjusted model (prevalence rate ratio: 0.84, 95% confidence interval: 0.74-0.96). Low childhood subjective socioeconomic status had a robust association with functional limitation regardless of age cohort. In addition, those who lived through World War II before they reached puberty and attained shorter height were more likely to report functional limitations in old age. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of Marital Status and Shift Work on Family Function among Registered Nurses

PubMed Central

TAI, Shu-Yu; LIN, Pei-Chen; CHEN, Yao-Mei; HUNG, Hsin-Chia; PAN, Chih-Hong; PAN, Shung-Mei; LEE, Chung-Yin; HUANG, Chia-Tsuan; WU, Ming-Tsang

2014-01-01

This study aims to assess the interactive effect of marital status and shift work on family function. A population-based sample of 1,438 nurses between the ages of 20–45 yr was recruited from Taiwan during the period from July 2005 to April 2006 using a mailed questionnaire. The self-administered questionnaire contained information about demographic data, work status, shift work schedule, and the Family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve) Scale, to evaluate family function. Compared to day shift nurses, non-night and rotation shift nurses had 1.53- and 1.38-fold (95% CI=1.09–2.14 and 1.01–1.88) risk to have poor family function after adjusting for other covariates. Married nurses, by contrast, had a 0.44-fold (95% CI=0.29–0.66) risk to have poor family function compared to single nurses. In addition, married nurses who worked non-night or rotation shifts had a significantly higher percent of poor family function than those married nurses working day shifts; however, similar results were not replicated in single nurses. We concluded that shift work and marital status could influence family function. PMID:24909112

Effects of marital status and shift work on family function among registered nurses.

PubMed

Tai, Shu-Yu; Lin, Pei-Chen; Chen, Yao-Mei; Hung, Hsin-Chia; Pan, Chih-Hong; Pan, Shung-Mei; Lee, Chung-Yin; Huang, Chia-Tsuan; Wu, Ming-Tsang

2014-01-01

This study aims to assess the interactive effect of marital status and shift work on family function. A population-based sample of 1,438 nurses between the ages of 20-45 yr was recruited from Taiwan during the period from July 2005 to April 2006 using a mailed questionnaire. The self-administered questionnaire contained information about demographic data, work status, shift work schedule, and the Family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve) Scale, to evaluate family function. Compared to day shift nurses, non-night and rotation shift nurses had 1.53- and 1.38-fold (95% CI=1.09-2.14 and 1.01-1.88) risk to have poor family function after adjusting for other covariates. Married nurses, by contrast, had a 0.44-fold (95% CI=0.29-0.66) risk to have poor family function compared to single nurses. In addition, married nurses who worked non-night or rotation shifts had a significantly higher percent of poor family function than those married nurses working day shifts; however, similar results were not replicated in single nurses. We concluded that shift work and marital status could influence family function.

Effect of whole-body vibration exercise on mobility, balance ability and general health status in frail elderly patients: a pilot randomized controlled trial.

PubMed

Zhang, Li; Weng, Changshui; Liu, Miao; Wang, Qiuhua; Liu, Liming; He, Yao

2014-01-01

To study the effects of whole-body vibration exercises on the mobility function, balance and general health status, and its feasibility as an intervention in frail elderly patients. Pilot randomized controlled trial. Forty-four frail older persons (85.27 ± 3.63 years) meeting the Fried Frailty Criteria. All eligible subjects were randomly assigned to the experimental group, who received a whole-body vibration exercise alone (vibration amplitude: 1-3 mm; frequency: 6-26 Hz; 4-5 bouts × 60 seconds; 3-5 times weekly), or a control group, who received usual care and exercises for eight weeks. The Timed Up and Go Test, 30-second chair stand test, lower extremities muscle strength, balance function, balance confidence and General Health Status were assessed at the beginning of the study, after four weeks and eight weeks of the intervention. Whole-body vibration exercise reduced the time of the Timed Up and Go Test (40.47 ± 15.94 s to 21.34 ± 4.42 s), improved the bilateral knees extensor strength (6.96 ± 1.70 kg to 11.26 ± 2.08 kg), the posture stability (surface area ellipse: 404.58 ± 177.05 to 255.95 ± 107.28) and General Health Status (Short-form Health Survey score: 24.51 ± 10.69 and 49.63 ± 9.85 to 45.03 ± 11.15 and 65.23 ± 9.39, respectively). The repeated-measures ANOVA showed that there were significant differences in the Timed Up and Go Test, 30-second chair stand test, bilateral knees extensor strength, activities-specific balance confidence score and general health status between the two groups (P < 0.05). No side-effects were observed during the training. Whole-body vibration exercise is a safe and effective method that can improve the mobility, knee extensor strength, balance and the general health status in the frail elderly.

Functional Genomics of Attention-Deficit/ Hyperactivity Disorder (ADHD) Risk Alleles on Dopamine Transporter Binding in ADHD and Healthy Control Subjects

PubMed Central

Spencer, Thomas J.; Biederman, Joseph; Faraone, Stephen V.; Madras, Bertha K.; Bonab, Ali A.; Dougherty, Darin D.; Batchelder, Holly; Clarke, Allison; Fischman, Alan J.

2013-01-01

Background The main aim of this study was to examine the relationship between dopamine transporter (DAT) binding in the striatum in individuals with and without attention-deficit/hyperactivity disorder (ADHD), attending to the 3′-untranslated region of the gene (3′-UTR) and intron8 variable number of tandem repeats (VNTR) polymorphisms of the DAT (SLC6A3) gene. Methods Subjects consisted of 68 psychotropic (including stimulant)-naïve and smoking-naïve volunteers between 18 and 55 years of age (ADHD n = 34; control subjects n = 34). Striatal DAT binding was measured with positron emission tomography with 11C altropane. Genotyping of the two DAT (SLC6A3) 3′-UTR and intron8 VNTRs used standard protocols. Results The gene frequencies of each of the gene polymorphisms assessed did not differ between the ADHD and control groups. The ADHD status (t = 2.99; p < .004) and 3′-UTR of SLC6A3 9 repeat carrier status (t = 2.74; p < .008) were independently and additively associated with increased DAT binding in the caudate. The ADHD status was associated with increased striatal (caudate) DAT binding regardless of 3′-UTR genotype, and 3′-UTR genotype was associated with increased striatal (caudate) DAT binding regardless of ADHD status. In contrast, there were no significant associations between polymorphisms of DAT intron8 or the 3′-UTR-intron8 haplotype with DAT binding. Conclusions The 3′-UTR but not intron8 VNTR genotypes were associated with increased DAT binding in both ADHD patients and healthy control subjects. Both ADHD status and the 3′-UTR polymorphism status had an additive effect on DAT binding. Our findings suggest that an ADHD risk polymorphism (3′-UTR) of SLC6A3 has functional consequences on central nervous system DAT binding in humans. PMID:23273726

Does a Higher Income Have Positive Health Effects? Using the Earned Income Tax Credit to Explore the Income-Health Gradient

PubMed Central

Larrimore, Jeff

2011-01-01

Context The existence of a positive relationship between income and morbidity has been well documented in the literature. But it is unclear whether the relationship is positive because increased income allows individuals to purchase more health inputs that improve their health, because healthy individuals are more productive and thus can earn higher wages in the labor market, or because a third factor is improving health and increasing income. This article explores whether increases in income improve the health of the low-income population. Methods Because health status may affect income, this article uses an “instrumental variable” strategy that considers income variations over seventeen years of changes in the generosity of state and federal Earned Income Tax Credits (EITC, a measure that should be exogenous to health status). I measured health status using both the self-reported health status and the functional limitations indicated on the Survey of Income and Program Participation (SIPP), as well as the self-reported health status indicated on the March Current Population Survey (CPS). Findings I found only limited support for the theory that the relationship between income and morbidity is derived from shifts in income. Although I did observe a correlation between income and self-reported health, I found no evidence that increases in income significantly improve self-reported health statuses. In addition, while increases in income appear to reduce the prevalence of hearing limitations when using corrective measures, these increases did not have a significant effect on most of the other functional limitations considered here. Conclusions These findings suggest that the ability to improve short-term health outcomes through public transfer payments may be limited. However, the lifetime effects on the health of people with higher incomes would still be a valuable avenue for future research. PMID:22188352

A spatially filtered multilevel model to account for spatial dependency: application to self-rated health status in South Korea

PubMed Central

2014-01-01

Background This study aims to suggest an approach that integrates multilevel models and eigenvector spatial filtering methods and apply it to a case study of self-rated health status in South Korea. In many previous health-related studies, multilevel models and single-level spatial regression are used separately. However, the two methods should be used in conjunction because the objectives of both approaches are important in health-related analyses. The multilevel model enables the simultaneous analysis of both individual and neighborhood factors influencing health outcomes. However, the results of conventional multilevel models are potentially misleading when spatial dependency across neighborhoods exists. Spatial dependency in health-related data indicates that health outcomes in nearby neighborhoods are more similar to each other than those in distant neighborhoods. Spatial regression models can address this problem by modeling spatial dependency. This study explores the possibility of integrating a multilevel model and eigenvector spatial filtering, an advanced spatial regression for addressing spatial dependency in datasets. Methods In this spatially filtered multilevel model, eigenvectors function as additional explanatory variables accounting for unexplained spatial dependency within the neighborhood-level error. The specification addresses the inability of conventional multilevel models to account for spatial dependency, and thereby, generates more robust outputs. Results The findings show that sex, employment status, monthly household income, and perceived levels of stress are significantly associated with self-rated health status. Residents living in neighborhoods with low deprivation and a high doctor-to-resident ratio tend to report higher health status. The spatially filtered multilevel model provides unbiased estimations and improves the explanatory power of the model compared to conventional multilevel models although there are no changes in the signs of parameters and the significance levels between the two models in this case study. Conclusions The integrated approach proposed in this paper is a useful tool for understanding the geographical distribution of self-rated health status within a multilevel framework. In future research, it would be useful to apply the spatially filtered multilevel model to other datasets in order to clarify the differences between the two models. It is anticipated that this integrated method will also out-perform conventional models when it is used in other contexts. PMID:24571639

Neurocognitive and Functional Correlates of Mobile Phone Use in Middle-Aged and Older Patients with Schizophrenia

PubMed Central

Depp, Colin A; Harmell, Alexandrea L; Vahia, Ipsit V; Mausbach, Brent T

2015-01-01

Objectives Our objective was to examine the association of mobile phone use and ownership with psychopathology, cognitive functioning and functional outcome in 196 outpatients aged 40 and older who were diagnosed with schizophrenia. Methods Participants reported their past and current mobile phone use on a standardized self-report scale and they were administered tests of global cognition, functional capacity and informant-rated functional outcome. Results The great majority of subjects had used a mobile phone (78%) but few currently owned one (27%). After adjusting for age (mean age 51), any past mobile phone use was associated with less severe negative symptoms, and higher global cognitive performance, functional capacity, and functional outcome. A total of 60% of participants reported being comfortable with mobile phones, but comfort was not associated with any cognitive or functional outcomes. Conclusions Most older patients with schizophrenia have used mobile phones and lifetime mobile phone use is a positive indicator of cognitive and functional status. PMID:25768842

Risk Factors for Physical Impairment after Acute Lung Injury in a National, Multicenter Study

PubMed Central

Wozniak, Amy W.; Hough, Catherine L.; Morris, Peter E.; Dinglas, Victor D.; Jackson, James C.; Mendez-Tellez, Pedro A.; Shanholtz, Carl; Ely, E. Wesley; Colantuoni, Elizabeth

2014-01-01

Rationale: Existing studies of risk factors for physical impairments in acute lung injury (ALI) survivors were potentially limited by single-center design or relatively small sample size. Objectives: To evaluate risk factors for three measures of physical impairments commonly experienced by survivors of ALI in the first year after hospitalization. Methods: A prospective, longitudinal study of 6- and 12-month physical outcomes (muscle strength, 6-minute-walk distance, and Short Form [SF]-36 Physical Function score) for 203 survivors of ALI enrolled from 12 hospitals participating in the ARDS Network randomized trials. Multivariable regression analyses evaluated the independent association of critical illness–related variables and intensive care interventions with impairments in each physical outcome measure, after adjusting for patient demographics, comorbidities, and baseline functional status. Measurements and Main Results: At 6 and 12 months, respectively, mean (± SD) values for strength (presented as proportion of maximum strength score evaluated using manual muscle testing) was 92% (± 8%) and 93% (± 9%), 6-minute-walk distance (as percent-predicted) was 64% (± 22%) and 67% (± 26%), and SF-36 Physical Function score (as percent-predicted) was 61% (± 36%) and 67% (± 37%). After accounting for patient baseline status, there was significant association and statistical interaction of mean daily dose of corticosteroids and intensive care unit length of stay with impairments in physical outcomes. Conclusions: Patients had substantial impairments, from predicted values, for 6-minute-walk distance and SF-36 Physical Function outcome measures. Minimizing corticosteroid dose and implementing existing evidence-based methods to reduce duration of intensive care unit stay and associated patient immobilization may be important interventions for improving ALI survivors’ physical outcomes. PMID:24716641

Level of functioning, perceived work ability, and work status among psychiatric patients with major mental disorders.

PubMed

Karpov, B; Joffe, G; Aaltonen, K; Suvisaari, J; Baryshnikov, I; Näätänen, P; Koivisto, M; Melartin, T; Oksanen, J; Suominen, K; Heikkinen, M; Isometsä, E

2017-07-01

Major mental disorders are highly disabling conditions that result in substantial socioeconomic burden. Subjective and objective measures of functioning or ability to work, their concordance, or risk factors for them may differ between disorders. Self-reported level of functioning, perceived work ability, and current work status were evaluated among psychiatric care patients with schizophrenia or schizoaffective disorder (SSA, n=113), bipolar disorder (BD, n=99), or depressive disorder (DD, n=188) within the Helsinki University Psychiatric Consortium Study. Correlates of functional impairment, subjective work disability, and occupational status were investigated using regression analysis. DD patients reported the highest and SSA patients the lowest perceived functional impairment. Depressive symptoms in all diagnostic groups and anxiety in SSA and BD groups were significantly associated with disability. Only 5.3% of SSA patients versus 29.3% or 33.0% of BD or DD patients, respectively, were currently working. About half of all patients reported subjective work disability. Objective work status and perceived disability correlated strongly among BD and DD patients, but not among SSA patients. Work status was associated with number of hospitalizations, and perceived work disability with current depressive symptoms. Psychiatric care patients commonly end up outside the labour force. However, while among patients with mood disorders objective and subjective indicators of ability to work are largely concordant, among those with schizophrenia or schizoaffective disorder they are commonly contradictory. Among all groups, perceived functional impairment and work disability are coloured by current depressive symptoms, but objective work status reflects illness course, particularly preceding psychiatric hospitalizations. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Nutritional status and cognitive function in community-living rural Bangladeshi older adults: data from the poverty and health in ageing project.

PubMed

Ferdous, Tamanna; Cederholm, Tommy; Kabir, Zarina Nahar; Hamadani, Jena Derakhshani; Wahlin, Ake

2010-05-01

To investigate the association between nutritional status and general and specific (fluid and crystallized) cognitive functioning in a group of older people living in a rural area in Bangladesh. Cross-sectional study. Matlab, Bangladesh. Four hundred fifty-seven randomly selected persons aged 60 and older (mean age 69.5 +/- 6.8), 55% female. Nutritional status was evaluated using a modified form of the Mini Nutritional Assessment (MNA). General cognitive function was assessed using the Bangla Adaptation of the Mini-Mental State Examination, and a word synonym test was used to test semantic memory function (a crystallized ability). To assess cognitive processing speed (a fluid ability), "cross balls" and "complete boxes" tests (scores/time unit) were used. Clinical diagnoses were registered. Structured questionnaires were used to assess demographic and socioeconomic status of the participants. Twenty-six percent of the participants were undernourished, and 62% were at risk of malnutrition according to the MNA. The MNA scores were significantly lower in women than in men (P=.01). Women performed worse than men in all three cognitive tasks (P<.001). Poorer cognitive performance was independently associated with older age, female sex, illiteracy, visual impairment, severity of disease, and depressive symptoms. There were significant associations between better nutritional status and better cognitive performance tests of general ability and processing speed, whereas semantic memory appeared to be less affected. The association between nutritional status and cognitive function involves general and specific cognitive abilities, with fluid ability seeming to be affected but crystalized functions being relatively spared.

Nutritional and health status among nursing home residents in Lebanon: comparison across gender in a national cross sectional study

PubMed Central

2014-01-01

Background This study described the differences between elderly men and women living in Lebanese long-term care nursing homes on socio-economic, health and nutritional status. Methods This study used a cross-sectional design. Field researchers obtained data from 221 residents; 148 (67%) women and 73 (33%) men, living in 36 nursing homes. Data on health conditions; nutritional, psychological, and functional status; socio-demographic characteristics, as well as social relations were collected. The analysis used both chi-square and t-test tests. Results The majority of elderly had low socio-economic and poor health status. In comparison to men, women were significantly less educated, had lower occupational status, had no partner, relied financially on their children and relatives, and enjoyed better social relations and health behaviours. Furthermore, the prevalence of both; malnutrition, and at risk of malnutrition, were at 3.2% and 27.6% respectively. There was no statistically significant difference between women and men on Mini Nutritional Assessment, Activities of Daily Living, Geriatric Depression Scale, Body Mass Index, and chronic diseases. While women reported “good” health status compared to men, they continued to have higher prevalence of diseases and chronic pain. Conclusions This study explored the socio-demographic, health, and nutritional status of elderly residing in Lebanese nursing homes and compared these characteristics across gender. The results indicated the need of health support and institutional interventions for elderly women residents. PMID:24950594

Socioeconomic factors' effect on return to work after first stroke.

PubMed

Glader, E-L; Jonsson, B; Norrving, B; Eriksson, M

2017-06-01

The objective of this nationwide study was to analyze how functional status and socioeconomic status affect return to work (RTW) among younger patients with first-time stroke in a Sweden. This register-based cohort study included employed patients aged 25-55 with first-time stroke between 2008 and 2011 and primary outcome was RTW within 1 year after stroke. Data regarding functional status and employment status were retrieved from the Swedish Stroke Register, Riksstroke, and socioeconomic data (income, education, and country of birth) from Statistics Sweden. We included 2539 patients who had answered the question on RTW, and 1880 (74.0%) had RTW within 12 months. Patients with low income (69.9% in lowest income group vs 79.9% in highest group, P<.001), patients born in countries outside the Nordic countries (Sweden 75.5%, Nordic countries 74.3%, European countries 61.7%, other countries 57.3%, P<.001), and the youngest patients (25-34, 63.1%; 35-44, 75.9%; 45-55, 74.3%; P=.008) were less likely to RTW. Pain, low mood, and answering the questionnaire with help were more common in low socioeconomic groups, and when adjusting for these variables, together with age and sex, income and country of birth were no longer independent predictors for RTW. Patients with low socioeconomic status less often RTW 1 year after stroke.Impaired functional status after stroke is more common in patients with lower socioeconomic status and mediates socioeconomic differences in RTW. Improvement of functional status should be targeted to facilitate RTW among stroke patients with low socioeconomic status. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Social hierarchy modulates neural responses of empathy for pain

PubMed Central

Feng, Chunliang; Li, Zhihao; Feng, Xue; Wang, Lili; Tian, Tengxiang

2016-01-01

Recent evidence indicates that empathic responses to others’ pain are modulated by various situational and individual factors. However, few studies have examined how empathy and underlying brain functions are modulated by social hierarchies, which permeate human society with an enormous impact on social behavior and cognition. In this study, social hierarchies were established based on incidental skill in a perceptual task in which all participants were mediumly ranked. Afterwards, participants were scanned with functional magnetic resonance imaging while watching inferior-status or superior-status targets receiving painful or non-painful stimulation. The results revealed that painful stimulation applied to inferior-status targets induced higher activations in the anterior insula (AI) and anterior medial cingulate cortex (aMCC), whereas these empathic brain activations were significantly attenuated in response to superior-status targets’ pain. Further, this neural empathic bias to inferior-status targets was accompanied by stronger functional couplings of AI with brain regions important in emotional processing (i.e. thalamus) and cognitive control (i.e. middle frontal gyrus). Our findings indicate that emotional sharing with others’ pain is shaped by relative positions in a social hierarchy such that underlying empathic neural responses are biased toward inferior-status compared with superior-status individuals. PMID:26516169

Maximizing the Functional Status of Geriatric Patients in an Acute Community Hospital Setting.

ERIC Educational Resources Information Center

Meissner, Paul; And Others

1989-01-01

Compared patients (N=103) admitted to inpatient geriatric care unit focusing on restoration of functional status to control-unit patients (N=75). Found greater improvement in basic functional capabilities of study-unit than control-unit patients. Found mixed picture when length of stay and total charges of study- and control-unit patients were…

Parenting, Family Socioeconomic Status, and Child Executive Functioning: A Longitudinal Study

ERIC Educational Resources Information Center

Rochette, Émilie; Bernier, Annie

2014-01-01

Family socioeconomic status (SES) and the quality of maternal behavior are among the few identified predictors of child executive functioning (EF), and they have often been found to have interactive rather than additive effects on other domains of child functioning. The purpose of this study was to explore their interactive effects in the…

Depression and Functional Status Among African American Stroke Survivors in Inpatient Rehabilitation.

PubMed

Harris, Gabrielle M; Collins-McNeil, Janice; Yang, Qing; Nguyen, Vu Q C; Hirsch, Mark A; Rhoads, Charles F; Guerrier, Tami; Thomas, J George; Pugh, Terrence M; Hamm, Deanna; Pereira, Carol; Prvu Bettger, Janet

2017-01-01

To examine the prevalence of poststroke depression (PSD) among African American stroke survivors and the association of depression with functional status at inpatient rehabilitation facility (IRF) discharge. Secondary data analysis was conducted of a patient cohort who received care at 3 IRFs in the United States from 2009 to 2011. Functional status was measured by the Functional Independence Measure (FIM). Multiple linear regression models were used to examine associations of PSD and FIM motor and cognitive scores. Of 458 African American stroke survivors, 48.5% were female, 84% had an ischemic stroke, and the mean age was 60.8 ± 13.6 years. Only 15.4% (n = 71) had documentation of PSD. Bivariate analyses to identify factors associated with depression identified a higher percentage of patients with depression than without who were retired due to disability (17.1% versus 11.6%) or employed (31.4% versus 19.6%) prestroke (P = .041). Dysphagia, cognitive deficits, and a lower admission motor FIM score were also significantly more common among those with depression. There was no significant relationship between depression and functional status after adjusting for patient characteristics. In this study, 15% of the African Americans who received rehabilitation after a stroke had documentation of PSD but this was not associated with functional status at discharge. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Estimation of iodine nutrition and thyroid function status in late-gestation pregnant women in the United States: Development and application of a population-based pregnancy model.

PubMed

Lumen, A; George, N I

2017-01-01

Previously, a deterministic biologically-based dose-response (BBDR) pregnancy model was developed to evaluate moderate thyroid axis disturbances with and without thyroid-active chemical exposure in a near-term pregnant woman and fetus. In the current study, the existing BBDR model was adapted to include a wider functional range of iodine nutrition, including more severe iodine deficiency conditions, and to incorporate empirically the effects of homeostatic mechanisms. The extended model was further developed into a population-based model and was constructed using a Monte Carlo-based probabilistic framework. In order to characterize total (T4) and free (fT4) thyroxine levels for a given iodine status at the population-level, the distribution of iodine intake for late-gestation pregnant women in the U.S was reconstructed using various reverse dosimetry methods and available biomonitoring data. The range of median (mean) iodine intake values resulting from three different methods of reverse dosimetry tested was 196.5-219.9μg of iodine/day (228.2-392.9μg of iodine/day). There was minimal variation in model-predicted maternal serum T4 and ft4 thyroxine levels from use of the three reconstructed distributions of iodine intake; the range of geometric mean for T4 and fT4, was 138-151.7nmol/L and 7.9-8.7pmol/L, respectively. The average value of the ratio of the 97.5th percentile to the 2.5th percentile equaled 3.1 and agreed well with similar estimates from recent observations in third-trimester pregnant women in the U.S. In addition, the reconstructed distributions of iodine intake allowed us to estimate nutrient inadequacy for late-gestation pregnant women in the U.S. via the probability approach. The prevalence of iodine inadequacy for third-trimester pregnant women in the U.S. was estimated to be between 21% and 44%. Taken together, the current work provides an improved tool for evaluating iodine nutritional status and the corresponding thyroid function status in pregnant women in the U.S. This model enables future assessments of the relevant risk of thyroid hormone level perturbations due to exposure to thyroid-active chemicals at the population-level. Published by Elsevier Inc.

Development of a battery status monitor

NASA Technical Reports Server (NTRS)

Zimmerman, R. I.

1974-01-01

A prototype battery status monitor system has been developed. The functions of the system are: (1) to provide the energy status of the battery, (2) to measure and transmit basic battery parameters, (3) to process these measurements required to determine abnormal functioning of the battery, and (4) to transmit warning signals of the abnormal condition along with a go/no go signal. The system was developed for use with the space shuttle.

Hyperthyroid and Hypothyroid Status Was Strongly Associated with Gout and Weakly Associated with Hyperuricaemia

PubMed Central

See, Lai-Chu; Kuo, Chang-Fu; Yu, Kuang-Hui; Luo, Shue-Fen; Chou, I-Jun; Ko, Yu-Shien; Chiou, Meng-Jiun; Liu, Jia-Rou

2014-01-01

Objectives The aim of this study was to estimate the risk of hyperuricaemia and gout in people with hypothyroid or hyperthyroid status. Methods This study analyzed data from individuals who participated in health screening programs at Chang Gung Memorial Hospital in northern Taiwan (2000–2010). Participants were categorized as having euthyroid, hypothyroid, or hyperthyroid status according to their thyroid-stimulating hormone (TSH) levels. Multinomial logistic regression models were used to calculate the odds ratios (95% CI) for hyperuricaemia and gout in participants with thyroid dysfunction compared to euthyroid participants. Results A total of 87,813 (euthyroid, 83,502; hypothyroid, 1,460; hyperthyroid, 2,851) participants were included. The prevalence of hyperuricaemia was higher in hyperthyroid subjects (19.4%) than in euthyroid subjects (17.8%) but not in hypothyroid subjects (19.3%). The prevalence of gout was significantly higher in both hypothyroid (6.0%) and hyperthyroid (5.3%) subjects than in euthyroid subjects (4.3%). In men, hypothyroid or hyperthyroid status was not associated with hyperuricaemia. However, hypothyroid or hyperthyroid status was associated with ORs (95% CI) of 1.47 (1.10–1.97) and 1.37 (1.10–1.69), respectively, for gout. In women, hypothyroid status was not associated with hyperuricaemia or gout. However, hyperthyroid status was associated with ORs (95% CI) of 1.42 (1.24–1.62) for hyperuricaemia and 2.13 (1.58–2.87) for gout. Conclusions Both hyperthyroid and hypothyroid status were significantly associated with gout and weakly associated with hyperuricaemia. A thyroid function test for gout patients may by warranted. PMID:25486420

An investigation of several numerical procedures for time-asymptotic compressible Navier-Stokes solutions

NASA Technical Reports Server (NTRS)

Rudy, D. H.; Morris, D. J.; Blanchard, D. K.; Cooke, C. H.; Rubin, S. G.

1975-01-01

The status of an investigation of four numerical techniques for the time-dependent compressible Navier-Stokes equations is presented. Results for free shear layer calculations in the Reynolds number range from 1000 to 81000 indicate that a sequential alternating-direction implicit (ADI) finite-difference procedure requires longer computing times to reach steady state than a low-storage hopscotch finite-difference procedure. A finite-element method with cubic approximating functions was found to require excessive computer storage and computation times. A fourth method, an alternating-direction cubic spline technique which is still being tested, is also described.

[The application status of the linear stapler device in the total laryngectomy].

PubMed

Wang, W U; Wei, X L; Su, J P

2017-01-01

Summary It is very obvious that the linear stapler can shorten the operation time, reduce the incidence of pharyngeal fistula, and shorten the oral feeding time in total laryngectomy. However the stapler was used in the total laryngectomy not as widespread as in gastrointestinal surgery. In order to further understanding the function of the linear stapler device in the total laryngectomy, the stapler's composition, working principle, classification，method to use, operation method, and application of advantages and disadvantages will be reviewed. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

A transdiagnostic study of education, employment, and training outcomes in young people with mental illness.

PubMed

Lee, R S C; Hermens, D F; Scott, J; O'Dea, B; Glozier, N; Scott, E M; Hickie, I B

2017-09-01

Optimizing functional recovery in young individuals with severe mental illness constitutes a major healthcare priority. The current study sought to quantify the cognitive and clinical factors underpinning academic and vocational engagement in a transdiagnostic and prospective youth mental health cohort. The primary outcome measure was 'not in education, employment or training' ('NEET') status. A clinical sample of psychiatric out-patients aged 15-25 years (n = 163) was assessed at two time points, on average, 24 months apart. Functional status, and clinical and neuropsychological data were collected. Bayesian structural equation modelling was used to confirm the factor structure of predictors and cross-lagged effects at follow-up. Individually, NEET status, cognitive dysfunction and negative symptoms at baseline were predictive of NEET status at follow-up (p < 0.05). Baseline cognitive functioning was the only predictor of follow-up NEET status in the multivariate Bayesian model, while controlling for baseline NEET status. For every 1 s.d. deficit in cognition, the probability of being disengaged at follow-up increased by 40% (95% credible interval 19-58%). Baseline NEET status predicted poorer negative symptoms at follow-up (β = 0.24, 95% credible interval 0.04-0.43). Disengagement with education, employment or training (i.e. being NEET) was reported in about one in four members of this cohort. The initial level of cognitive functioning was the strongest determinant of future NEET status, whereas being academically or vocationally engaged had an impact on future negative symptomatology. If replicated, these findings support the need to develop early interventions that target cognitive phenotypes transdiagnostically.

Physical activity and physical functioning in Swedish and Iranian 75-year-olds - a comparison.

PubMed

Mosallanezhad, Zahra; Hörder, Helena; Salavati, Mahyar; Nilsson-Wikmar, Lena; Frändin, Kerstin

2012-01-01

The pattern of population aging is highly complex and contextually based. Cross-national comparisons are helpful to explore related factors. Two cross-sectional studies designed to compare physical activity level, physical functioning and certain health related factors in 75-year-old women and men in Sweden and Iran. Cohorts of 637 Swedish and 851 Iranian 75-year-olds were investigated with the same methods regarding physical activity level, physical functioning and health related factors. There were differences in physical activity level (p<0.001), self-reported physical functioning (p<0.001) objective physical functioning (p<0.001), health status (p<0.001) and most socio-demographic aspects between the two countries. Here the Swedish cohort had the advantage. There was no difference between the countries regarding prevalence of vertigo or falls. The only variables where the Iranian cohort had advantage over the Swedes were grip strength and smoking habits. There were larger gender differences in walking habits, self-selected walking speed, timed chair stand, and one-leg stance in Iran, and in grip strength in Sweden, all to the disadvantage of women. Iranian 75-years-olds had a lower physical activity level, a worse lower extremity physical function but a better grip strength, a worse physical health status, but smoked less than their Swedish counterparts. Despite this, there were no differences regarding vertigo or falls. In most aspects, the magnitude of gender differences was about the same and in disadvantage of women, although there were larger differences in Iran in some lower extremity functions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Disclosure of HIV Status and Social Support Among People Living With HIV

PubMed Central

Jorjoran Shushtari, Zahra; Sajjadi, Homeira; Forouzan, Ameneh Setareh; Salimi, Yahya; Dejman, Masoumeh

2014-01-01

Background: Disclosure of HIV is important for improving self-care behaviors, psychological well-being, commitment to the treatment, and reducing risk of transmission. One of the major benefits of disclosure is social support, which is an essential resource for effective coping with HIV infection. However, receiving any social support requires disclosing of HIV status. Objectives: This study aimed to determine the disclosure of HIV status and its related factors such as social support in addition to demographic and disease characteristics among people living with HIV in Iran. Patients and Methods: This cross-sectional study, using simple random sampling, was carried out on 175 people with HIV/AIDS who referred to Behavioral Counseling Centers. The self-administrated, Norbeck Social Support Questionnaire was used to measure social support. Disclosure of HIV status was assessed with an investigator-designed questions. Multiple logistic regression analysis with backward Likelihood Ratio method was applied to identify the adjusted odds ratio between disclosure as dependent variable and demographic variables, social support as independent variables. Results: Participants were often disclosed their HIV status to family members. But there were differences about disclosure of HIV status within the context of the family. Family members were perceived as more supportive. Multiple logistic regression analysis demonstrates that the gender (adjusted OR = 0.181; 95% CI .068-0.479), CD4 cell count (adjusted OR = 0.997; 95% CI 0.994-0.999), route of transmission (injection-drug user [adjusted OR = 9.366; 95% CI 3.358-26.123] and other routes [tattooing, mother to child, dental services, etc.], [adjusted OR = 3.752; 95% CI 1.157-12.167]), and functional support variable (adjusted OR = 1.007; 95% CI 1.001-1.013) remained in the model as significant predictors for disclosure. Conclusions: The results of this study regarding disclosure of HIV status and its relations to social support and some demographic variables can provide an understanding based on the evidence for promotion of knowledge and coping interventions about people living with HIV/AIDS and their perceived social support status. PMID:25389470

Potential markets for application of space medicine achievements

NASA Astrophysics Data System (ADS)

Orlov, Oleg; Belakovskiy, Mark; Kussmaul, Anna

2014-11-01

The Institute of Biomedical Problems (IBMP) is the lead institution of the Russian Federation in the area of space biology and medicine. It has successfully implemented a set of innovation-based activities and projects to develop and introduce promising space products and technologies into the practices of Earth health care. To this end, various investigative methods developed for the medical selection of cosmonauts have been successfully applied in ophthalmology, gastroenterology, and cardiology. Axial loading ;Regent; suits and soil simulators of bearing load have proved their efficiency in rehabilitating patients with motor disorders. Developmental prototypes of versatile training devices and technologies of their application are used for rehabilitation and purposeful development of physical status in people of various age groups. The application of telemedicine technologies allows one to diagnose and treat diseases in people who are in remote locations from medical centers or happen to be in extreme conditions. In cooperation with leading national medical institutions, other developments by the Institute have been also introduced into clinical practice: for example, the method of assessing the human functional state on the basis of computerized analysis of cardiac rhythm indices; methods of diagnosing, treating and preventing osteoporosis and metabolic osteopathias; methods of treating cardiorespiratory diseases using warmed-up heliox mixtures; methods of prophylactic examination and assessing the physical health status of the population; methods of monitoring the functional state and enhancing the physical capacity of athletes; developmental models of devices for simulating the effects of artificial gravity for refining methods of treatment and rehabilitation of patients; and systems of IV anesthesia with an option of a remote control. The effective management of innovation-based activities and the issues of commercialization of promising developments and objects of intellectual property are playing an ever-growing role in an effort to develop a scientific center in particular and a branch on the whole. The range and spectrum of applications of space medicine and biology achievements in sports, extreme, and rehabilitation medicine and preventive maintenance has expanded from year to year.

Lifestyle incongruity, stress and immune function in indigenous Siberians: the health impacts of rapid social and economic change.

PubMed

Sorensen, Mark V; Snodgrass, James J; Leonard, William R; McDade, Thomas W; Tarskaya, Larissa A; Ivanov, Kiundiul I; Krivoshapkin, Vadim G; Alekseev, Vladimir P

2009-01-01

The purpose of this study was to investigate the impact of economic and cultural change on immune function and psychosocial stress in an indigenous Siberian population. We examined Epstein-Barr virus antibodies (EBV), an indirect biomarker of cell-mediated immune function, in venous whole blood samples collected from 143 Yakut (Sakha) herders (45 men and 98 women) in six communities using a cross-sectional study design. We modeled economic change through the analysis of lifestyle incongruity (LI), calculated as the disparity between socioeconomic status and material lifestyle, computed with two orthogonal scales: market and subsistence lifestyle. EBV antibody level was significantly negatively associated with both a market and a subsistence lifestyle, indicating higher cell-mediated immune function associated with higher material lifestyle scores. In contrast, LI was significantly positively associated with EBV antibodies indicating lower immune function, and suggesting higher psychosocial stress, among individuals with economic status in excess of material lifestyle. Individuals with lower incongruity scores (i.e., economic status at parity with material resources, or with material resources in excess of economic status) had significantly lower EBV antibodies. The findings suggest significant health impacts of changes in material well-being and shifting status and prestige markers on health during the transition to a market economy in Siberia. The findings also suggest that relative, as opposed to absolute, level of economic status or material wealth is more strongly related to stress in the Siberian context.

PROSTATE REGULATION: MODELING ENDOGENOUS ...

EPA Pesticide Factsheets

Prostate function is an important indicator of androgen status in toxicological studies making predictive modeling of the relevant pharmacokinetics and pharmacodynamics desirable. Prostate function is an important indicator of androgen status in toxicological studies making predictive modeling of the relevant pharmacokinetics and pharmacodynamics desirable.

Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: a randomized clinical trial.

PubMed

Inani, Sumit B; Selkar, Sohan P

2013-01-01

Low Back Pain (LBP) results in significant level of disability, producing significant restriction on usual activity such as an inability to work. Nearly two third of the adults are affected by non-specific low back pain at some point in their lives. The purpose of the study was to determine the effect of core stabilization exercises in comparison with conventional exercises on pain, functional status in patients with non-specific LBP. Thirty patients diagnosed with non-specific LBP participated with age group between 20-50 years and divided in to 2 groups, one with core stabilization exercises and other conventional exercises, 15 subjects each. Three months study, pre and post treatment outcome measures used were VAS for pain intensity and Modified Oswestry Low Back Pain Disability Index for functional status (disability). Data were analyzed using student 't' test (paired and unpaired). Whereas both groups improved significantly from the initiation of treatment, a between-group comparison revealed significantly greater (p<0.001) improvements regarding pain and functional status for experimental group compared to control group. Core stabilization exercises were found to be more effective in reducing pain and improving functional status by decreasing disability of patients with non-specific low back pain in comparison with conventional exercises.

[Cytogenetic characteristics of the uterine cervical epithelium in inflammatory diseases].

PubMed

Aleksieienko, O I

2011-01-01

Functional status of epithelial cells at inflammatory cervical pathologies has been studied with the use of cytogenetic method of detection of chromosome nucleolar organizer regions. The highest level of rRNA proliferation and synthesis has been detected in cylindrical epithelial cells using the indexes of compact and transitional nucleolonemic types of nucleolar organizer regions, a higher level--in squamous cells of intermediate type, and the lowest one in squamous epithelium of superficial type.

[The value of methods for morphofunctional analysis of cornea in cataract surgery].

PubMed

Borodina, N B; Kobzova, M V; Musaeva, G M

2011-01-01

The characteristics of morphofunctional status of cornea after extracapsular cataract extraction and phakoemulsification with IOL implantation (30 and 58 operations respectively) were analyzed in detail using up-to-date diagnostic techniques. The results of examination using developed algorithm including study of light transmission, refraction and protective function of cornea show advantage of microinvasive ultrasound technique of cataract surgery in terms of minimal impact on corneal structure, optical and biomechanical characteristics.

A Method for Eliminating Beam Steering Error for the Modulated Absorption-Emission Thermometry Technique

DTIC Science & Technology

2015-01-01

emissivity and the radiative intensity of the gas over a spectral band. The temperature is then calculated from the Planck function. The technique does not...pressure budget for cooling channels reduces pump horsepower and turbine inlet temperature DISTRIBUTION STATEMENT A – Approved for public release...distribution unlimited 4 Status of Modeling and Simulation • Existing data set for film cooling effectiveness consists of wall heat flux measurements • CFD

[Magnetotherapy in the combined health resort-based treatment of irritated bowel syndrome].

PubMed

Kaĭsinova, A S; Osipov, Iu S; Litvinova, M A; Prosol'chenko, A V

2011-01-01

The authors describe a combined method for the treatment of irritated bowel syndrome with the use of magnetotherapy, drinking mineral waters, and radon baths. It was shown that prescription of preformed physical factors improves the psycho-emotional status of the patients due to normalization of the motor-evacuative function of the gastrointestinal tract. The overall result of this therapeutic modality is the improvement of the quality of life of the patients.

Functional recovery following critical illness in children: the "wee-cover" pilot study.

PubMed

Choong, Karen; Al-Harbi, Samah; Siu, Katie; Wong, Katie; Cheng, Ji; Baird, Burke; Pogorzelski, David; Timmons, Brian; Gorter, Jan-Willem; Thabane, Lehana; Khetani, Mary

2015-05-01

To determine the feasibility of conducting a longitudinal prospective study to evaluate functional recovery and predictors of impaired functional recovery in critically ill children. Prospective pilot study. Single-center PICU at McMaster Children's Hospital, Hamilton, Canada. Children aged 12 months to 17 years, with at least one organ dysfunction, limited mobility or bed rest during the first 48 hours of PICU admission, and a minimum 48-hour PICU length of stay, were eligible. Patients transferred from a neonatal ICU prior to ever being discharged home, already mobilizing well or at baseline functional status at time of screening, with an English language barrier, and prior enrollment into this study, were excluded. None. The primary outcome was feasibility, as defined by the ability to screen, enroll eligible patients, and execute the study procedures and measurements on participants. Secondary outcomes included functional status at baseline, 3 and 6 months, PICU morbidity, and mortality. Functional status was measured using the Pediatric Evaluation of Disability Inventory and the Participation and Environment Measure for Children and Youth. Thirty-three patients were enrolled between October 2012 and April 2013. Consent rate was 85%, and follow-up rates were 93% at 3 months and 71% at 6 months. We were able to execute the study procedures and measurements, demonstrating feasibility of conducting a future longitudinal study. Functional status deteriorated following critical illness. Recovery appears to be influenced by baseline health or functional status and severity of illness. Longitudinal research is needed to understand how children recover after a critical illness. Our results suggest factors that may influence the recovery trajectory and were used to inform the methodology, outcomes of interest, and appropriate sample size of a larger multicenter study evaluating functional recovery in this population.

Association between social support, functional status, and change in health-related quality of life and changes in anxiety and depression in colorectal cancer patients.

PubMed

Gonzalez-Saenz de Tejada, M; Bilbao, A; Baré, M; Briones, E; Sarasqueta, C; Quintana, J M; Escobar, A

2017-09-01

The aim of this study was to explore the association between baseline social support, functional status, and change in health-related quality of life (HRQoL) in colorectal cancer patients and change in anxiety and depression measured by Hospital Anxiety and Depression Scale (HADS) at 1 year after surgery. Consecutive patients who were due to undergo therapeutic surgery for the first time for colon or rectal cancer in 9 hospitals in Spain were eligible for the study. Patients completed the following questionnaires before surgery and 12 months afterward: 1 HRQoL instrument, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire; a social support questionnaire, the Duke-UNC Functional Social Support Questionnaire; the Barthel Index, to assess functional status; the HADS, to assess anxiety and depression; and questions about sociodemographic information. General linear models were built to explore the association between social support, functional status, and change in HRQoL and changes in anxiety and depression 12 months after surgery. A total of 947 colorectal cancer patients took part in the study. Patients' functional status, social support, and change in HRQoL were associated with changes in anxiety and depression. Greater social support and improvements in physical, cognitive, and social functioning and in insomnia resulted in improvements in anxiety and depression. No functionally independent patients were associated with lesser improvements in anxiety and depression. Colorectal cancer patients who have more social support, are functionally independent and have higher improvements in HRQoL may have better results in anxiety and depression at 1 year after surgery, adjusting for age, gender, location, occupation, and baseline HADS scores. Copyright © 2016 John Wiley & Sons, Ltd.

Environmental drivers of heterogeneity in the trophic-functional structure of protozoan communities during an annual cycle in a coastal ecosystem.

PubMed

Xu, Guangjian; Yang, Eun Jin; Xu, Henglong

2017-08-15

Trophic-functional groupings are an important biological trait to summarize community structure in functional space. The heterogeneity of the tropic-functional pattern of protozoan communities and its environmental drivers were studied in coastal waters of the Yellow Sea during a 1-year cycle. Samples were collected using the glass slide method at four stations within a water pollution gradient. A second-stage matrix-based analysis was used to summarize spatial variation in the annual pattern of the functional structure. A clustering analysis revealed significant variability in the trophic-functional pattern among the four stations during the 1-year cycle. The heterogeneity in the trophic-functional pattern of the communities was significantly related to changes in environmental variables, particularly ammonium-nitrogen and nitrates, alone or in combination with dissolved oxygen. These results suggest that the heterogeneity in annual patterns of protozoan trophic-functional structure may reflect water quality status in coastal ecosystems. Copyright © 2017. Published by Elsevier Ltd.

Weight, Weight Perceptions and Health-Related Quality of Life among a National Sample of US Girls

PubMed Central

Farhat, Tilda; Iannotti, Ronald J.; Summersett-Ringgold, Faith

2015-01-01

Objective To examine associations between three weight indices (weight status, perceived weight, weight status perception accuracy) and HRQOL. Methods Data are for girls in the 2009 Health Behaviors in School-Age Children survey, a nationally representative sample of students in grades 5-10 during the 2009/10 school-year (n=5,018). Controlling for sociodemographics, multivariate linear regressions examined associations between self-reported weight status (Underweight/Normal/Overweight/Obese), perceived weight (how children categorize their weight), weight status perception accuracy (Underestimate/Accurate perception/Overestimate) and dimensions of HRQOL including physical, emotional, social, and school functioning. Results While obesity was only associated with poor physical and emotional HRQOL, perceptions of being overweight were associated with worse physical, emotional, school and social HRQOL. Further, girls who overestimated their weight reported poorer HRQOL than those with accurate weight perceptions. Associations of perceptions of being overweight and weight status overestimation with poor HRQOL despite, in most instances, the absence of associations between weight status and HRQOL, suggest that weight status perceptions may not merely be a mediator of a weight status-HRQOL association, but a significant independent correlate of poor HRQOL. Conclusion These findings raise the issue of whether there is a need to prioritize intervention efforts to promote better HRQOL by re-defining the population of girls most at risk. Parents, teachers and clinicians should be aware that, rather that overweight status, perceptions of being overweight (accurately or not) are associated with a poor HRQOL among girls. Future research should examine the potential negative effect of using specific body image terminologies on adolescents' psychological health. PMID:25961900

MTNR1B rs10830963 is associated with fasting plasma glucose, HbA1C and impaired beta-cell function in Chinese Hans from Shanghai

PubMed Central

2010-01-01

Background Genome-wide association studies (GWAS) in White Europeans have shown that genetic variation rs10830963 in melatonin receptor 1B gene (MTNR1B) is associated with fasting glucose and type 2 diabetes, which has also been replicated in several Asian populations. As a variant in the gene involved in the regulation of circadian rhythms, the effect of the variant on sleep status remains unknown. This study aimed to investigate the effects of MTNR1B rs10830963 on fasting glucose, type 2 diabetes and sleep status in Chinese Hans. Methods MTNR1B rs10830963 was genotyped in a population-based cohort including 3,210 unrelated Chinese Hans from Beijing and Shanghai, and tested for associations with risk of type 2 diabetes, diabetes-related traits and sleep status. Results We confirmed the associations of MTNR1B rs10830963 with fasting glucose (beta = 0.11 mmol/l, 95%CI [0.03, 0.18], P = 0.005), glycated hemoglobin (HbA1c) (beta = 0.07%, 95%CI [0.02,0.12], P = 0.004) and homeostasis model assessment of beta-cell function (HOMA-B) (beta = -5.01%, 95%CI [-8.24,-1.77], P = 0.003) in the Shanghai, but not in the Beijing subpopulation (P ≥ 0.58). The effect size of MTNR1B rs10830963 on fasting glucose in Shanghai Chinese Hans was comparable to that reported from other Asian populations. We found no evidence of associations with type 2 diabetes (OR 1.05 [0.90-1.23], P = 0.54), homeostasis model assessment of insulin sensitivity (HOMA-S) (P = 0.86) or sleep status (P ≥ 0.44). Conclusions A common variant in MTNR1B was associated with fasting glucose, HbA1C and HOMA-B but not with sleep status in Chinese Hans from Shanghai, strengthening the role of MTNR1B rs10830963 in fasting glycemia and impaired beta-cell function. PMID:20398260

Epidemiological correlates of nutritional anemia among children (6-35 months) in rural Wardha, Central India.

PubMed

Sinha, N; Deshmukh, P R; Garg, B S

2008-02-01

Nutritional anemia is associated with impaired performance of a range of mental and physical functions in children, along with increased morbidity. Iron supplementation at a later age may not reverse the adverse effects. National Nutritional Anemia Control Program was launched in India in 1970, but it failed to make any impact. The present study was undertaken to find out prevalence of anemia and its correlates in rural Wardha in children 6-35 months of age. Seven hundred seventy-two children between 6 months and 35 months of age were studied for anemia by cluster-sampling method. The hemoglobin was estimated in the child by 'Filter paper cyanmethemoglobin method.' Pre-designed and pre-tested questionnaire was used to collect data on socio-demographic and other variables. Data was analyzed by SPSS 12.0.1. Mean hemoglobin level was 98.5+/-12.9 gm/L. Prevalence of anemia was 80.3%. Only 1.3% children had severe anemia (hemoglobin<70 gm/L). The univariate analysis showed that anemia is significantly associated with age of the child, education of mother and father, occupation of father, socioeconomic status, birth order and nutritional status as measured by weight for age. The final model suggested that only educational status of the mother, occupation of the father, birth order and nutritional status of the child were significantly associated with anemia. For short-term impact, appropriate nutritional interventions remain the only operational intervention as only the nutritional status (weight for age) is a modifiable factor. But for long-term sustained impact, policy makers need to focus on improving maternal education and reducing family size.

Association of Vitamin K Status Combined With Vitamin D Status and Lower-Extremity Function: A Prospective Analysis of Two Knee Osteoarthritis Cohorts.

PubMed

Shea, M Kyla; Loeser, Richard F; McAlindon, Timothy E; Houston, Denise K; Kritchevsky, Stephen B; Booth, Sarah L

2017-10-17

Vitamins K and D are important for the function of vitamin K-dependent proteins in joint tissues. It is unclear whether these nutrients are mutually important to functional outcomes related to knee osteoarthritis (OA). We evaluated the association of vitamin K and D sufficiency with lower-extremity function in the Health, Aging and Body Composition knee OA substudy (Health ABC) and conducted a replication analysis in an independent cohort, the Osteoarthritis Initiative (OAI). In Health ABC (60% female, mean ± SD age 75 ± 3 years) baseline nutrient status was measured using circulating vitamin K and 25-hydroxyvitamin D (25[OH]D). Lower-extremity function was assessed using the Short Physical Performance Battery (SPPB) and usual 20-meter gait speed. In the OAI (58% female, mean ± SD age 61 ± 9 years), baseline nutrient intake was estimated by food frequency questionnaire. Lower-extremity function was assessed using usual 20-meter gait speed and chair stand completion time. Multivariate mixed models were used to evaluate the association of vitamin K and D status and intake with lower-extremity function over 4-5 years. Health ABC participants with sufficient plasma vitamin K (≥1.0 nmoles/liter) and serum 25(OH)D (≥50 nmoles/liter) generally had better SPPB scores and faster usual gait speed over followup (P ≤ 0.002). In the OAI, sufficient vitamin K and vitamin D intake combined was associated with overall faster usual gait speed and chair stand completion time over followup (P ≤ 0.029). Sufficient vitamin K status combined with sufficient vitamin D status was associated with better lower-extremity function in 2 knee OA cohorts. These findings merit confirmation in vitamin K and D co-supplementation trials. © 2017, American College of Rheumatology.

Quality of Life Perception, Cognitive Function, and Psychological Status in a Real-world Population of Glioblastoma Patients Treated With Radiotherapy and Temozolomide: A Single-center Prospective Study.

PubMed

Lombardi, Giuseppe; Bergo, Eleonora; Del Bianco, Paola; Bellu, Luisa; Pambuku, Ardi; Caccese, Mario; Trentin, Leonardo; Zagonel, Vittorina

2018-05-10

Health-related quality of life (HRQoL), cognitive function, and psychological status represent an important focus during the treatment of glioblastoma patients. Nevertheless, few randomized, prospective clinical trials have analyzed these factors, and very little is known in the real-clinical world. We evaluated these characteristics in glioblastoma patients treated with standard first-line therapy outside clinical trials. In total, 111 newly, histologically diagnosed glioblastoma patients treated at our oncology center with radiotherapy and temozolomide were prospectively enrolled. No patient was enrolled in an experimental clinical trial. We assessed HRQoL, cognitive function, and psychological status before starting treatment, at the end of radiotherapy, and every 3 months until 9 months after the end of radiotherapy using EORTC QLQ-C30, BN20, MMSE, and HADS questionnaires. Global health status, physical, cognitive, and social functioning remained unchanged throughout the study period. A statistically significant change was found in emotional functioning as well as a clinically meaningful amelioration in role functioning between the baseline assessment and 9 months after radiotherapy. Patients older than 65 years reported greater impairment on the bladder control scale than younger patients. When considering tumor location, global health status, communication deficit, and drowsiness, scores were significantly different between the right and left hemispheres. Female patients had a clinically relevant lower score for physical functioning at baseline and 3 months after radiation therapy. Female patients also had a clinically relevant lower depression score at 9 months after radiation therapy. In routine neurooncology practice, HRQoL, cognitive function, and psychological status did not worsen during first-line treatment in glioblastoma patients receiving standard radiotherapy and temozolomide treatment. However, some patient subgroups, such as elderly and female patients, may have different experiences with treatment, and further investigation is required.

Examination of Variables That May Affect the Relationship Between Cognition and Functional Status in Individuals with Mild Cognitive Impairment: A Meta-Analysis

PubMed Central

Mcalister, Courtney; Schmitter-Edgecombe, Maureen; Lamb, Richard

2016-01-01

The objective of this meta-analysis was to improve understanding of the heterogeneity in the relationship between cognition and functional status in individuals with mild cognitive impairment (MCI). Demographic, clinical, and methodological moderators were examined. Cognition explained an average of 23% of the variance in functional outcomes. Executive function measures explained the largest amount of variance (37%), whereas global cognitive status and processing speed measures explained the least (20%). Short- and long-delayed memory measures accounted for more variance (35% and 31%) than immediate memory measures (18%), and the relationship between cognition and functional outcomes was stronger when assessed with informant-report (28%) compared with self-report (21%). Demographics, sample characteristics, and type of everyday functioning measures (i.e., questionnaire, performance-based) explained relatively little variance compared with cognition. Executive functioning, particularly measured by Trails B, was a strong predictor of everyday functioning in individuals with MCI. A large proportion of variance remained unexplained by cognition. PMID:26743326

Serum antioxidant capacity and peroxide level of seven healthy subjects after consumption of different foods.

PubMed

Laus, Maura N; Soccio, Mario; Alfarano, Michela; Pasqualone, Antonella; Lenucci, Marcello S; Di Miceli, Giuseppe; Pastore, Donato

2016-12-01

This article reports experimental data related to the research article entitled "Different effectiveness of two pastas supplemented with either lipophilic or hydrophilic/phenolic antioxidants in affecting serum as evaluated by the novel Antioxidant/Oxidant Balance approach" (M.N. Laus, M. Soccio, M. Alfarano, A. Pasqualone, M.S. Lenucci, G. Di Miceli, D. Pastore, 2016) [1]. Antioxidant status of blood serum of seven healthy subjects was evaluated during four hours after consumption of two functional pastas, supplemented with either bran oleoresin or bran water extract obtained from durum wheat. For comparison, the effect of a non-supplemented reference pasta was also evaluated, as well as the effects of glucose, of the wheat grain dietary supplement Lisosan G, and of the reference pasta consumed together with Lisosan G. Serum antioxidant status was evaluated by measuring both the serum antioxidant capacity, using LOX-FL, ORAC and TEAC methods, and the serum oxidant status, assessed as peroxide level.

Assessing the impact of fishing in shallow rocky reefs: a multivariate approach to ecosystem management.

PubMed

Sangil, Carlos; Martín-García, Laura; Clemente, Sabrina

2013-11-15

In this paper we develop a tool to assess the impact of fishing on ecosystem functioning in shallow rocky reefs. The relationships between biological parameters (fishes, sea urchins, seaweeds), and fishing activities (fish traps, boats, land-based fishing, spearfishing) were tested in La Palma island (Canary Islands). Data from fishing activities and biological parameters were analyzed using principal component analyses. We produced two models using the first component of these analyses. This component was interpreted as a new variable that described the fishing pressure and the conservation status at each studied site. Subsequently the scores on the first axis were mapped using universal kriging methods and the models obtained were extrapolated across the whole island to display the expected fishing pressure and conservation status more widely. The fishing pressure and conservation status models were spatially related; zones where fishing pressure was high coincided with zones in the unhealthiest ecological state. Copyright © 2013 Elsevier Ltd. All rights reserved.

Combining Biomarkers Linearly and Nonlinearly for Classification Using the Area Under the ROC Curve

PubMed Central

Fong, Youyi; Yin, Shuxin; Huang, Ying

2016-01-01

In biomedical studies, it is often of interest to classify/predict a subject’s disease status based on a variety of biomarker measurements. A commonly used classification criterion is based on AUC - Area under the Receiver Operating Characteristic Curve. Many methods have been proposed to optimize approximated empirical AUC criteria, but there are two limitations to the existing methods. First, most methods are only designed to find the best linear combination of biomarkers, which may not perform well when there is strong nonlinearity in the data. Second, many existing linear combination methods use gradient-based algorithms to find the best marker combination, which often result in sub-optimal local solutions. In this paper, we address these two problems by proposing a new kernel-based AUC optimization method called Ramp AUC (RAUC). This method approximates the empirical AUC loss function with a ramp function, and finds the best combination by a difference of convex functions algorithm. We show that as a linear combination method, RAUC leads to a consistent and asymptotically normal estimator of the linear marker combination when the data is generated from a semiparametric generalized linear model, just as the Smoothed AUC method (SAUC). Through simulation studies and real data examples, we demonstrate that RAUC out-performs SAUC in finding the best linear marker combinations, and can successfully capture nonlinear pattern in the data to achieve better classification performance. We illustrate our method with a dataset from a recent HIV vaccine trial. PMID:27058981

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 needs in the acute hospital could be predicted by selected categories of the Acute ICF Core Sets, or by the Barthel Index score. Incorporating ICF Core Set-based data in nursing management decisions, particularly staffing decisions, may be beneficial. PMID:21034438

Fourth-generation spinal instrumentation: experience with adolescent idiopathic scoliosis at a tertiary care hospital in Pakistan

PubMed Central

Fazal, Akil; Lakdawala, Riaz H

2012-01-01

Objective To evaluate the radiological and functional outcome of surgical treatment of adolescent idiopathic scoliosis using fourth-generation posterior spinal instrumentation at The Aga Khan University, Karachi, Pakistan. Design Case series. Place and duration of study The Aga Khan University Hospital after a minimum of 2 years postoperatively. Patients and methods A total of 20 patients with adolescent idiopathic scoliosis were recruited into the study and evaluated for radiological and functional outcome. The study period was from 2000 to 2005. Radiological outcome was assessed using Cobb angle measurement pre and postoperatively, hence assessing percentage correction. The lower instrumented vertebra was taken as the neutral vertebra and the level was recorded. Functional outcome was determined using the Scoliosis Research Society patient administered questionnaire. All patients were called to the clinic and asked to fill in the form. Those patients who were out of the city were mailed the forms and requested via telephone to complete and return. Results Of the 20 patients operated on, twelve were female and eight were male. The average age at operation was 12.7 years. The mean Cobb angle was 69° preoperatively and 20° postoperatively, representing a percentage correction of 71%. The average duration of follow-up was 3.6 years. There was one major complication involving neurological injury post-op and two minor complications involving wound infection. The average Scoliosis Research Society score (on a scale of 1–5, with 5 being best) for pain was 4.5, self-image was 4.2, functional status was 4.1, mental status was 3.8, and satisfaction was 4.4. There was no relationship between the percentage correction of scoliosis and the functional outcome. Those patients with a high preoperative Cobb angle tended to have a better outcome for functional and mental status postoperatively. There was no relation between the lower instrumented vertebra and functional outcome. Conclusion In the correct indications, fourth-generation posterior instrumentation and fusion is a reliable and satisfactory technique to treat adolescent idiopathic scoliosis. PMID:22393301

Predictors of Marriage and Divorce in Adult Survivors of Childhood Cancers: A Report from the Childhood Cancer Survivor Study

PubMed Central

Janson, Christopher; Leisenring, Wendy; Cox, Cheryl; Termuhlen, Amanda M.; Mertens, Ann C.; Whitton, John A.; Goodman, Pamela; Zeltzer, Lonnie; Robison, Leslie L.; Krull, Kevin R.; Kadan-Lottick, Nina S.

2009-01-01

Background/Objective Adult survivors of childhood cancer can have altered social functioning. We sought to identify factors that predict marriage and divorce outcomes in this growing population. Methods Retrospective cohort study of 8,928 ≥ five-year adult survivors of childhood malignancy and 2,879 random sibling controls participating in the Childhood Cancer Survivor Study. Marital status, current health, psychological status, and neurocognitive functioning were determined from surveys and validated instruments. Results Survivors were more likely to be never-married than siblings (relative risk (RR) = 1.21; 95% confidence interval (CI) 1.15–1.26) and the U.S. population (RR=1.25; 95% CI= 1.21 – 1.29), after adjusting for age, gender, and race. Patients with central nervous system (CNS) tumors were at greatest risk for not marrying (RR=1.50; 95% CI= 1.41–1.59). Married survivors divorced at frequencies similar to controls. In multivariable regression analysis, non-marriage was most associated with cranial radiation (RR=1.15; 95% CI=1.02–1.31 for >2400 centigray). In analysis of neurobehavioral functioning, non-marriage was associated with worse task efficiency (RR=1.27; 95% CI=1.20–1.35), but not with emotional distress, or problems with emotional regulation, memory, or organization. Physical conditions predictive of non-marriage included short stature (RR=1.27; 95% CI=1.20–1.34) and poor physical function (RR=1.08; 95% CI=1.00–1.18). Structural equation modeling suggested that cranial radiation influenced marriage status through short stature, cognitive problems, and poor physical function. Conclusions Childhood cancer survivors married at lower frequencies compared to peers. Patients with CNS tumors, cranial radiation, impaired processing efficiency, and short stature were more likely to never marry. Divorce patterns in survivors were similar to peers. PMID:19815636

Peripheral neuropathy in HIV-infected and uninfected patients in Rakai, Uganda

PubMed Central

Nakigozi, Gertrude; Nakasujja, Noeline; Robertson, Kevin; Gray, Ronald H.; Wawer, Maria J.; Sacktor, Ned

2017-01-01

Objective: To determine the prevalence, risk factors, and functional impairment associated with peripheral neuropathy in a prospective cohort of adults in rural Uganda. Methods: Eight hundred participants (400 HIV− and 400 antiretroviral-naive HIV+) in the Rakai Community Cohort Study underwent detailed neurologic evaluations including assessment of neuropathy symptoms, functional measures (Patient Assessment of Own Functioning Inventory and Karnofsky Performance Status scores), and neurologic evaluation by a trained medical officer. Neuropathy was defined as ≥1 subjective symptom and ≥1 sign of neuropathy on examination. Neuropathy risk factors were assessed using log binomial regression. Results: Fifty-three percent of participants were men, with a mean (SD) age of 35 (8) years. Neuropathy was present in 13% of the cohort and was more common in HIV+ vs HIV− participants (19% vs 7%, p < 0.001). Older age (relative risk [RR] 1.04, 95% confidence interval [CI] 1.02–1.06), female sex (RR 1.49, 95% CI 1.04–2.15), HIV infection (RR 2.82, 95% CI 1.86–4.28), tobacco use (RR 1.59, 95% CI 1.02–2.48), and prior neurotoxic medication use (RR 2.08, 95% CI 1.07–4.05) were significant predictors of neuropathy in the overall cohort. Only older age was associated with neuropathy risk in the HIV+ (RR 1.03, 95% CI 1.01–1.05) and HIV− (RR 1.06, 95% CI 1.02–1.10) cohorts. Neuropathy was associated with impaired functional status on multiple measures across all participant groups. Conclusions: Peripheral neuropathy is relatively common and associated with impaired functional status among adults in rural Uganda. Older age, female sex, and HIV infection significantly increase the risk of neuropathy. Neuropathy may be an underrecognized but important condition in rural Uganda and warrants further study. PMID:28679596

Poor preoperative nutritional status is an important predictor of the retardation of rehabilitation after cardiac surgery in elderly cardiac patients.

PubMed

Ogawa, Masato; Izawa, Kazuhiro P; Satomi-Kobayashi, Seimi; Kitamura, Aki; Ono, Rei; Sakai, Yoshitada; Okita, Yutaka

2017-04-01

Preoperative nutritional status and physical function are important predictors of mortality and morbidity after cardiac surgery. However, the influence of nutritional status before cardiac surgery on physical function and the progress of postoperative rehabilitation requires clarification. To determine the effect of preoperative nutritional status on preoperative physical function and progress of rehabilitation after elective cardiac surgery. We enrolled 131 elderly patients with mean age of 73.7 ± 5.8 years undergoing cardiac surgery. We divided them into two groups by nutritional status as measured by the Geriatric Nutritional Risk Index (GNRI): high GNRI group (GNRI ≥ 92, n = 106) and low GNRI group (GNRI < 92, n = 25). Physical function was estimated by handgrip strength, knee extensor muscle strength (KEMS), the Short Physical Performance Battery (SPPB), and 6-minute walk test (6MWT). Progress of postoperative rehabilitation was evaluated by the number of days to independent walking after surgery, length of stay in the ICU, and length of hospital stay. After adjusting for potential confounding factors, preoperative handgrip strength (P = 0.034), KEMS (P = 0.009), SPPB (P < 0.0001), and 6MWT (P = 0.012) were all significantly better in the high GNRI group. Multiple regression analysis revealed that a low GNRI was an independent predictor of the retardation of postoperative rehabilitation. Preoperative nutritional status as assessed by the GNRI could reflect perioperative physical function. Preoperative poor nutritional status may be an independent predictor of the retardation of postoperative rehabilitation in patients undergoing elective cardiac surgery.

Surveillance system and method having parameter estimation and operating mode partitioning

NASA Technical Reports Server (NTRS)

Bickford, Randall L. (Inventor)

2005-01-01

A system and method for monitoring an apparatus or process asset including creating a process model comprised of a plurality of process submodels each correlative to at least one training data subset partitioned from an unpartitioned training data set and each having an operating mode associated thereto; acquiring a set of observed signal data values from the asset; determining an operating mode of the asset for the set of observed signal data values; selecting a process submodel from the process model as a function of the determined operating mode of the asset; calculating a set of estimated signal data values from the selected process submodel for the determined operating mode; and determining asset status as a function of the calculated set of estimated signal data values for providing asset surveillance and/or control.

Respiratory status of stainless steel and mild steel welders.

PubMed

Kalliomäki, P L; Kalliomäki, K; Korhonen, O; Nordman, H; Rahkonen, E; Vaaranen, V

1982-01-01

Eighty-three full-time stainless steel and 29 mild steel welders from one shipyard were examined clinically, and their lung function was measured. The stainless steel welders had used both tungsten inert-gas (low-fume concentration) and manual metal-arc (MMA) (high-fume concentration) welding methods. The individual exposure of the welders was estimated based on the time spent doing MMA welding, the amount of retained contaminants in the lungs (magnetopulmography), and urinary chromium excretion. The results suggest that there is a greater prevalence of small airway disease among shipyard mild steel MMA welders than among stainless steel welders. Among the stainless steel welders the impairment of lung function parameters was associated with the MMA welding method. The type of welding, then, is important when the health hazards of welders are studied, and welders cannot be regarded as a single, homogeneous group.

Methods of Optimizing X-Ray Optical Prescriptions for Wide-Field Applications

NASA Technical Reports Server (NTRS)

Elsner, R. F.; O'Dell, S. L.; Ramsey, B. D.; Weisskopf, M. C.

2010-01-01

We are working on the development of a method for optimizing wide-field x-ray telescope mirror prescriptions, including polynomial coefficients, mirror shell relative displacements, and (assuming 4 focal plane detectors) detector placement and tilt that does not require a search through the multi-dimensional parameter space. Under the assumption that the parameters are small enough that second order expansions are valid, we show that the performance at the detector surface can be expressed as a quadratic function of the parameters with numerical coefficients derived from a ray trace through the underlying Wolter I optic. The best values for the parameters are found by solving the linear system of equations creating by setting derivatives of this function with respect to each parameter to zero. We describe the present status of this development effort.

On 3-D inelastic analysis methods for hot section components. Volume 1: Special finite element models

NASA Technical Reports Server (NTRS)

Nakazawa, S.

1987-01-01

This Annual Status Report presents the results of work performed during the third year of the 3-D Inelastic Analysis Methods for Hot Section Components program (NASA Contract NAS3-23697). The objective of the program is to produce a series of new computer codes that permit more accurate and efficient three-dimensional analysis of selected hot section components, i.e., combustor liners, turbine blades, and turbine vanes. The computer codes embody a progression of mathematical models and are streamlined to take advantage of geometrical features, loading conditions, and forms of material response that distinguish each group of selected components. This report is presented in two volumes. Volume 1 describes effort performed under Task 4B, Special Finite Element Special Function Models, while Volume 2 concentrates on Task 4C, Advanced Special Functions Models.

[Family function and depression in relatives of earthquake victims: a survey conducted one year after China's Wenchuan Earthquake].

PubMed

Hu, Xiao-Lin; Li, Xiao-Lin; Jiang, Xiao-Lian; Li, Rong; Dou, Xin-Man

2012-10-01

The Wenchuan Earthquake that hit Sichuan, China in 2008 not only caused huge losses in terms of human life and economic damage. It also caused psychological trauma in survivors, especially those who had lost relatives and close friends (bereaved). In the aftermath of earthquakes, bereaved individuals require family and spiritual renewal in addition to material assistance. This study investigated the status of and relationship between family function and depression in bereaved individuals living in areas devastated by the Wenchuan Earthquake. Results provide baseline information for post-disaster family reconstruction. This cross-sectional study surveyed 264 qualified bereaved individuals who lived in an area hard hit by the Wenchuan Earthquake. Face-to-face interviews were administered based on the family APGAR(adaptation, partnership, growth, affection, resolve) index and Hamilton depression (HAMD) scale. The mean family function score for participants was 6.52 ± 2.65. Results for half (50.0%) of participants indicated "good" family function. Results indicated marital status, family structure and status of having another baby as factors that significantly influence family function (p < .05). Participants' mean depression score was 40.41 ± 9.35, with all (100%) of participants demonstrating symptoms of depression. The 5 most prevalent depressive symptoms were: depressed mood, decreased interest in work, mental anxiety, diminished capacity and agitation. Results showed marital status, leisure frequency, economic status, and having another baby as factors that significantly influenced family function (p < .05). A Pearson's correlation analysis indicated no significant relationship between level of depression and family function (p >.05). Family functions of the bereaved living in areas hard hit by the Wenchuan Earthquake were all undermined to varying degrees. Although participants all exhibited depressive symptoms, this study found no affect of such symptoms on family functions. Interventions delivered in the months and years after an earthquake should be tailored to address each individual's depression status. Interventions should also help these individuals learn to improve and enhance family functions to effectively reduce negative behaviors and reactions in order to better promote physical and mental health.

Which Frail Older People Are Dehydrated? The UK DRIE Study

PubMed Central

Bunn, Diane K.; Downing, Alice; Jimoh, Florence O.; Groves, Joyce; Free, Carol; Cowap, Vicky; Potter, John F.; Hunter, Paul R.; Shepstone, Lee

2016-01-01

Background: Water-loss dehydration in older people is associated with increased mortality and disability. We aimed to assess the prevalence of dehydration in older people living in UK long-term care and associated cognitive, functional, and health characteristics. Methods: The Dehydration Recognition In our Elders (DRIE) cohort study included people aged 65 or older living in long-term care without heart or renal failure. In a cross-sectional baseline analysis, we assessed serum osmolality, previously suggested dehydration risk factors, general health, markers of continence, cognitive and functional health, nutrition status, and medications. Univariate linear regression was used to assess relationships between participant characteristics and serum osmolality, then associated characteristics entered into stepwise backwards multivariate linear regression. Results: DRIE included 188 residents (mean age 86 years, 66% women) of whom 20% were dehydrated (serum osmolality >300 mOsm/kg). Linear and logistic regression suggested that renal, cognitive, and diabetic status were consistently associated with serum osmolality and odds of dehydration, while potassium-sparing diuretics, sex, number of recent health contacts, and bladder incontinence were sometimes associated. Thirst was not associated with hydration status. Conclusions: DRIE found high prevalence of dehydration in older people living in UK long-term care, reinforcing the proposed association between cognitive and renal function and hydration. Dehydration is associated with increased mortality and disability in older people, but trials to assess effects of interventions to support healthy fluid intakes in older people living in residential care are needed to enable us to formally assess causal direction and any health benefits of increasing fluid intakes. PMID:26553658

[The assessment of the general functional status and of the psychosomatic complaints of workers at hydroelectric power plants].

PubMed

Danev, S; Dapov, E; Pavlov, E; Nikolova, R

1992-01-01

Evaluation of the general functional status and psychosomatic complaints of 61 workers from the hydroelectric power stations is made. The following methods are used: 1. Assessment of the general functional state, by means of computer analysis of the cardiac variability, analysing the changes in the values of the following indices: average value of the cardiac intervals (X), their standard deviation (SD), coefficient of variation (CV), amplitude of the mode (AMO), index of stress (IS), index of the vegetative balance (IVB), homeostatic index (HI). The last 3 indices serve for determination of the complex evaluation of chronic fatigue and work adaptation (ChFWA). 2. Evaluation of the psychosomatic complaints, by the use of a questionnaire for the subjective psychosomatic complaints. 3. Studying the systolic and diastolic blood pressure. The average values received in workers from HPS were compared with the average values of the population of the country and with the average values of a similar working activity of a group of operators from the thermal power station HPS. In conclusion it could be noted that concerning ChFWA the received values in workers from HPS are not more unfavourable generalized values from that measured in workers, occupied with similar type of work in other industrial branches of the country. However, they are with more unfavourable data in comparison with the workers from HPS. The subjective evaluation of the operators concerning their psychic and body health status is moderately worse, both in comparison with the values of the index for the country, and in comparison with those of the operators from HPS.

Medicare capitation model, functional status, and multiple comorbidities: model accuracy

PubMed Central

Noyes, Katia; Liu, Hangsheng; Temkin-Greener, Helena

2012-01-01

Objective This study examined financial implications of CMS-Hierarchical Condition Categories (HCC) risk-adjustment model on Medicare payments for individuals with comorbid chronic conditions. Study Design The study used 1992-2000 data from the Medicare Current Beneficiary Survey and corresponding Medicare claims. The pairs of comorbidities were formed based on the prior evidence about possible synergy between these conditions and activities of daily living (ADL) deficiencies and included heart disease and cancer, lung disease and cancer, stroke and hypertension, stroke and arthritis, congestive heart failure (CHF) and osteoporosis, diabetes and coronary artery disease, CHF and dementia. Methods For each beneficiary, we calculated the actual Medicare cost ratio as the ratio of the individual’s annualized costs to the mean annual Medicare cost of all people in the study. The actual Medicare cost ratios, by ADLs, were compared to the HCC ratios under the CMS-HCC payment model. Using multivariate regression models, we tested whether having the identified pairs of comorbidities affects the accuracy of CMS-HCC model predictions. Results The CMS-HCC model underpredicted Medicare capitation payments for patients with hypertension, lung disease, congestive heart failure and dementia. The difference between the actual costs and predicted payments was partially explained by beneficiary functional status and less than optimal adjustment for these chronic conditions. Conclusions Information about beneficiary functional status should be incorporated in reimbursement models since underpaying providers for caring for population with multiple comorbidities may provide severe disincentives for managed care plans to enroll such individuals and to appropriately manage their complex and costly conditions. PMID:18837646

Health-related quality of life in end-stage renal disease patients: the effects of renal rehabilitation.

PubMed

Kouidi, E

2004-05-01

Health-related quality of life (HRQoL) consists of a number of components like functional status, psychological and social functioning, cognition and disease and treatment-related symptoms. End-stage renal disease (ESRD) patients display emotional disturbances, as well as non-adherence to treatment and fluid and food intake, depression, anxiety, social withdrawal and cardiovascular and other co-existing disease morbidity. They have very low functional capacity and physical limitations in their daily activities that affect their mortality and morbidity. Exercise training in ESRD patients is effective in increasing work related activities and important components of their daily life and improving physical functioning. A physical rehabilitation program also leads to a reduction in depression and improvement in family and social interactions. Therefore, renal rehabilitation should be considered as an important therapeutic method for improving physical fitness, social function, well-being and thus health-adjusted quality of life in ESRD patients.

Neuropharmacological Specificity of Brain Structures Involved in Soman-Induced Seizures

DTIC Science & Technology

2012-01-01

Bernabé Burckhart M-F, Lallement G. Efficacy of the ketamine-atropine combination in the delayed treatment of soman- induced status epilepticus ...The functional anatomy of limbic status epilepticus in the rat. I. Patterns of 14C-2-deoxyglucose uptake and fos immunochemistry. Journal of...Neuroscience 1993a;13(11):4787–801. White LE, Price JL. The functional anatomy of limbic status epilepticus in the rat. II. The effects of focal deactivation

Functional Status Outperforms Comorbidities as a Predictor of 30-Day Acute Care Readmissions in the Inpatient Rehabilitation Population.

PubMed

Shih, Shirley L; Zafonte, Ross; Bates, David W; Gerrard, Paul; Goldstein, Richard; Mix, Jacqueline; Niewczyk, Paulette; Greysen, S Ryan; Kazis, Lewis; Ryan, Colleen M; Schneider, Jeffrey C

2016-10-01

Functional status is associated with patient outcomes, but is rarely included in hospital readmission risk models. The objective of this study was to determine whether functional status is a better predictor of 30-day acute care readmission than traditionally investigated variables including demographics and comorbidities. Retrospective database analysis between 2002 and 2011. 1158 US inpatient rehabilitation facilities. 4,199,002 inpatient rehabilitation facility admissions comprising patients from 16 impairment groups within the Uniform Data System for Medical Rehabilitation database. Logistic regression models predicting 30-day readmission were developed based on age, gender, comorbidities (Elixhauser comorbidity index, Deyo-Charlson comorbidity index, and Medicare comorbidity tier system), and functional status [Functional Independence Measure (FIM)]. We hypothesized that (1) function-based models would outperform demographic- and comorbidity-based models and (2) the addition of demographic and comorbidity data would not significantly enhance function-based models. For each impairment group, Function Only Models were compared against Demographic-Comorbidity Models and Function Plus Models (Function-Demographic-Comorbidity Models). The primary outcome was 30-day readmission, and the primary measure of model performance was the c-statistic. All-cause 30-day readmission rate from inpatient rehabilitation facilities to acute care hospitals was 9.87%. C-statistics for the Function Only Models were 0.64 to 0.70. For all 16 impairment groups, the Function Only Model demonstrated better c-statistics than the Demographic-Comorbidity Models (c-statistic difference: 0.03-0.12). The best-performing Function Plus Models exhibited negligible improvements in model performance compared to Function Only Models, with c-statistic improvements of only 0.01 to 0.05. Readmissions are currently used as a marker of hospital performance, with recent financial penalties to hospitals for excessive readmissions. Function-based readmission models outperform models based only on demographics and comorbidities. Readmission risk models would benefit from the inclusion of functional status as a primary predictor. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Can We Spin Straw Into Gold? An Evaluation of Immigrant Legal Status Imputation Approaches

PubMed Central

Van Hook, Jennifer; Bachmeier, James D.; Coffman, Donna; Harel, Ofer

2014-01-01

Researchers have developed logical, demographic, and statistical strategies for imputing immigrants’ legal status, but these methods have never been empirically assessed. We used Monte Carlo simulations to test whether, and under what conditions, legal status imputation approaches yield unbiased estimates of the association of unauthorized status with health insurance coverage. We tested five methods under a range of missing data scenarios. Logical and demographic imputation methods yielded biased estimates across all missing data scenarios. Statistical imputation approaches yielded unbiased estimates only when unauthorized status was jointly observed with insurance coverage; when this condition was not met, these methods overestimated insurance coverage for unauthorized relative to legal immigrants. We next showed how bias can be reduced by incorporating prior information about unauthorized immigrants. Finally, we demonstrated the utility of the best-performing statistical method for increasing power. We used it to produce state/regional estimates of insurance coverage among unauthorized immigrants in the Current Population Survey, a data source that contains no direct measures of immigrants’ legal status. We conclude that commonly employed legal status imputation approaches are likely to produce biased estimates, but data and statistical methods exist that could substantially reduce these biases. PMID:25511332

Study of limitations and attributes of microprocessor testing techniques

NASA Technical Reports Server (NTRS)

Mccaskill, R.; Sohl, W. E.

1977-01-01

All microprocessor units have a similar architecture from which a basic test philosophy can be adopted and used to develop an approach to test each module separately in order to verify the functionality of each module within the device using the input/output pins of the device and its instruction set; test for destructive interaction between functional modules; and verify all timing, status information, and interrupt operations of the device. Block and test flow diagrams are given for the 8080, 8008, 2901, 6800, and 1802 microprocessors. Manufacturers are listed and problems encountered in testing the modules are discussed. Test equipment and methods are described.

Predicting Acceptance and Popularity in Early Adolescence as a Function of Hearing Status, Gender, and Educational Setting

ERIC Educational Resources Information Center

Wolters, Nina; Knoors, Harry E. T.; Cillessen, Antonius H. N.; Verhoeven, Ludo

2011-01-01

This study examined associations of communicative skills, social behavior, and personality with acceptance and popularity as a function of hearing status, gender, and educational setting. Participants were 87 deaf and 672 hearing early adolescents of 52 6th grade classrooms in mainstream and special education. Acceptance varied as a function of…

Air Force Handbook. 109th Congress

DTIC Science & Technology

2009-01-01

FY06 Combat Survivor Evader Locator (CSEL) Acquisition Status Capabilities/Profile Functions /Performance Parameters 38 • Air Force’s primary source for...Broadcast Service (GBS) Capabilities/Profile Acquisition Status Functions /Performance Parameters • Purchase Requirements (Phase 2): • 3 primary ...Operations (AF CONOPS) that support the CSAF and joint vision of combat operations. • AF CONOPS describe key Air Force mission and/or functional areas

Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment.

PubMed

Krappinger, Dietmar; Irenberger, Alexander; Zegg, Michael; Huber, Burkhart

2013-06-01

The treatment of large posttraumatic tibial bone defects using the Ilizarov method was shown to be successful in several studies. These studies, however, typically focus on the radiological and functional outcome using objective parameters only. The aim of the present study was therefore to assess the objective and subjective outcome of a consecutive series of patients with large posttraumatic tibial bone defects using the Ilizarov method. Additionally, it was our goal to assess the physical and mental stress for the patients and their relatives during the long treatment period and the general health status at final follow-up. A consecutive series of 15 patients with posttraumatic tibial bone defects of >30 mm after sustaining open tibial fractures and failure of internal fixation was included. The objective outcome was assessed at final follow-up using Paley's criteria. For the assessment of the subjective outcome, all patients were asked to evaluate their satisfaction with the function of the lower leg, the cosmetic appearance and overall outcome as well. The physical and mental stress of the treatment for the patients and the nearest relative of patients were assessed at the time of frame removal using a custom-made questionnaire. The SF-36 was used to evaluate the general health status at final follow-up. Solid bone union with stable soft tissue coverage and eradication of infection was achieved in all patients despite a high complication rate. The functional outcome at final follow-up was excellent or good in all patients. The patients' satisfaction with the overall outcome and the function of the lower extremity was high as well. The fear of amputation and complications was the major subjective burden for both the patients and their relatives. The long external fixation time is another relevant issue. The Ilizarov method is a safe option for the treatment of large posttraumatic tibial bone defects after failure of internal fixation despite the high complication rate. It is essential to comment this to the patients and their relatives prior to the application of the frame increase their compliance with the long and emotionally draining treatment. The Ilizarov method is worth the effort only in patients, who will presumably comply with this treatment option and all of its drawbacks.

Changes in Nutritional and Functional Status in Longer Stay Patients Admitted to a Geriatric Evaluation and Management Unit.

PubMed

Whitley, A; Skliros, E; Graven, C; McIntosh, R; Lasry, C; Newsome, C; Bowie, A

2017-01-01

Malnutrition and functional decline are common in older inpatients admitted to subacute care settings. However the association between changes in nutritional status and relevant functional outcomes remains under-researched. This study examined changes in nutritional status, function and mobility in patients admitted to a Geriatric Evaluation and Management (GEM) unit who had a length of stay (LOS) longer than 21 days. A prospective, observational study. Two GEM units at St Vincent's Hospital Melbourne, Australia. Patients admitted to the GEM units who stayed longer than 21 days were included in the study. Patients were assessed on admission and prior to discharge using the Subjective Global Assessment (SGA), Functional Independence Measure (FIM) motor domain and the Modified Elderly Mobility Scale (MEMS). Fifty-nine patients (Mean age 84.0 ± 7 years) met the required length of stay and were included in the study. Fifty-four per cent (n=32) were malnourished on admission (SGA B/C) and 44% (n=26) were malnourished on discharge. Twenty-two per cent (n=13) improved SGA category, 75% remained stable (n=44) and 3% deteriorated (n=2) from admission to discharge. Total Motor FIM scores significantly increased from admission to discharge in both the improved (p<0.001) and stable or deteriorated (p<0.001) nutritional status groups. Subjects who improved in nutritional status had a significantly higher MEMS score at discharge (p<0.001). On admission to the GEM unit, just over half the included patients were rated as malnourished defined by SGA category. Nearly one quarter of the sample had improved their nutritional status at the time of discharge. Improvement in nutritional status was associated with greater improvement in mobility scores. Further studies are required to investigate the effectiveness of nutrition interventions, which will inform models of care aiming to optimise nutritional, functional, and associated clinical outcomes in patients admitted to GEM units.

The FOUR score and GCS as predictors of outcome after traumatic brain injury.

PubMed

McNett, Molly; Amato, Shelly; Gianakis, Anastasia; Grimm, Dawn; Philippbar, Sue Ann; Belle, Josie; Moran, Cristina

2014-08-01

The Glasgow Coma Scale (GCS) is a routine component of a neurological exam for critically ill traumatic brain injury (TBI) patients, yet has been criticized for not accurately depicting verbal status among intubated patients or including brain stem reflexes. Preliminary research on the Full Outline of UnResponsiveness (FOUR) Scale suggests it overcomes these limitations. Research is needed to determine correlations with patient outcomes. The aims of this study were to: (1) examine correlations between 24 and 72 h FOUR and GCS scores and functional/cognitive outcomes; (2) determine relationship between 24 and 72 h FOUR scores and mortality. Prospective cohort study. Data gathered on adult TBI patients at a Level I trauma center. FOUR scores assigned at 24, 72 h. Functional outcome measured by functional independence measure scores at rehabilitation discharge; cognitive status measured by Weschler Memory Scale scores 3 months post-injury. n = 136. Mean age 53.1. 72 h FOUR and GCS scores correlated with functional outcome (r s = 0.34, p = 0.05; r s = 0.39, p = 0.02), but not cognitive status. Receiver operating characteristic curves were comparable for FOUR and GCS at 24 and 72 h for functional status (24 h FOUR, GCS = 0.625, 0.602, respectively; 72 h FOUR, GCS = 0.640, 0.688), cognitive status (24 h FOUR, GCS = 0.703, 0.731; 72 h FOUR, GCS = 0.837, 0.674), and mortality (24 h FOUR, GCS = 0.913, 0.935; 72 h FOUR, GCS = 0.837, 0.884). FOUR is comparable to GCS in terms of predictive ability for functional status, cognitive outcome 3 months post-injury, and in-hospital mortality.

Association between Functional Capacity Decline and Nutritional Status Based on the Nutrition Screening Initiative Checklist: A 2-Year Cohort Study of Japanese Community-Dwelling Elderly.

PubMed

Sugiura, Yumiko; Tanimoto, Yoshimi; Imbe, Ayumi; Inaba, Yuiko; Sakai, Satoshi; Shishikura, Kanako; Tanimoto, Keiji; Hanafusa, Toshiaki

2016-01-01

To assess whether nutritional status based on the Nutrition Screening Initiative Checklist is useful for predicting functional capacity decline in community-dwelling Japanese elderly. This two-year observational cohort study included 536 community-dwelling Japanese (65 years and older at baseline) who were independent in both activities and instrumental activities of daily living. Demographic attributes, chronic illness, lifestyle-related habits, nutritional status, functional capacity, and anthropometric measurements were assessed, with decline in functional capacity used as the outcome measure. Subjects were classified into three groups as follows based on the Nutrition Screening Initiative Checklist: low (59.5%), moderate (23.7%), and high (16.8%) nutritional risk. Significant differences were found between nutritional status and the following four baseline variables: age, hypertension, cerebrovascular diseases, and current smoking. However, no significant differences were evident between nutritional status and sex, body mass index, diabetes, drinking habit, or exercise habit. Logistic regression analysis adjusted for age, sex, body mass index, hypertension, cerebrovascular diseases and smoking habit showed that the high nutritional risk group was significantly associated with a decline in both activities of daily living (odds ratio: 4.96; 95% confidence interval (CI): 1.59-15.50) and instrumental activities of daily living (OR: 2.58; 95% CI: 1.31-5.06) compared with the low nutritional risk group. Poor nutritional status based on the Nutrition Screening Initiative Checklist was associated with a decline in functional capacity over a 2-year period in community-dwelling Japanese elderly. These results suggest that the Nutrition Screening Initiative Checklist is a suitable tool for predicting functional capacity decline in community-dwelling elderly.

Nutrition Status Parameters and Hydration Status by Bioelectrical Impedance Vector Analysis Were Associated With Lung Function Impairment in Children and Adolescents With Cystic Fibrosis.

PubMed

Hauschild, Daniela Barbieri; Barbosa, Eliana; Moreira, Emilia Addison Machado; Ludwig Neto, Norberto; Platt, Vanessa Borges; Piacentini Filho, Eduardo; Wazlawik, Elisabeth; Moreno, Yara Maria Franco

2016-06-01

(1) To compare nutrition and hydration status between a group of children/adolescents with cystic fibrosis (CFG; n = 46; median age, 8.5 years) and a control group without cystic fibrosis (CG). (2) To examine the association of nutrition and hydration status with lung function in the CFG. A cross-sectional study. Nutrition screening, anthropometric parameters, and bioelectrical impedance analysis (BIA) were assessed. The z scores for body mass index for age, height for age, mid upper arm circumference, triceps and subscapular skinfold thickness, mid upper arm muscle area, resistance/height, and reactance/height were calculated. Bioelectrical impedance vector analysis was conducted. Forced expiratory volume in 1 second <80% was considered lung function impairment. An adjusted logistic regression was applied (P < .05). In the CFG, lung function impairment was observed in 51.1%. All anthropometric parameters were lower, and the mean z-resistance/height and z-reactance/height were higher in the CFG (P < .05) compared with the CG. In the CFG, 43% were severely/mildly dehydrated, while none were in the CG (P = .007). In the CFG, there was an association between high nutrition risk-via nutrition screening (odds ratio [OR], 22.28; P < .05), lower values of anthropometric parameters, higher z-resistance/height (OR, 2.23; P < .05) and z-reactance/height (OR, 1.81; P < .05), and dehydration (OR, 4.94; P < .05)-and lung function impairment. The CFG exhibited a compromised nutrition status assessed by anthropometric and BIA parameters. Nutrition screening, anthropometric and BIA parameters, and hydration status were associated with lung function. © 2016 American Society for Parenteral and Enteral Nutrition.

Long-term total sleep deprivation decreases the default spontaneous activity and connectivity pattern in healthy male subjects: a resting-state fMRI study

PubMed Central

Dai, Xi-Jian; Liu, Chun-Lei; Zhou, Ren-Lai; Gong, Hong-Han; Wu, Bin; Gao, Lei; Wang, Yi-Xiang J

2015-01-01

Objective The aim of this study is to use resting-state functional connectivity (rsFC) and amplitude of low-frequency fluctuation (ALFF) methods to explore intrinsic default-mode network (DMN) impairment after sleep deprivation (SD) and its relationships with clinical features. Methods Twelve healthy male subjects underwent resting-state functional magnetic resonance imaging twice: once following rested wakefulness (RW) and the other following 72 hours of total SD. Before the scans, all subjects underwent the attention network test (ANT). The independent component analysis (ICA), rsFC, and ALFF methods were used to examine intrinsic DMN impairment. Receiver operating characteristic (ROC) curve was used to distinguish SD status from RW status. Results Compared with RW subjects, SD subjects showed a lower accuracy rate (RW =96.83%, SD =77.67%; P<0.001), a slower reaction time (RW =695.92 ms; SD =799.18 ms; P=0.003), a higher lapse rate (RW =0.69%, SD =19.29%; P<0.001), and a higher intraindividual coefficient of variability in reaction time (RW =0.26, SD =0.33; P=0.021). The ICA method showed that, compared with RW subjects, SD subjects had decreased rsFC in the right inferior parietal lobule (IPL, BA40) and in the left precuneus (PrC)/posterior cingulate cortex (PCC) (BA30, 31). The two different areas were selected as regions of interest (ROIs) for future rsFC analysis. Compared with the same in RW subjects, in SD subjects, the right IPL showed decreased rsFC with the left PrC (BA7) and increased rsFC with the left fusiform gyrus (BA37) and the left cluster of middle temporal gyrus and inferior temporal gyrus (BA37). However, the left PrC/PCC did not show any connectivity differences. Compared with RW subjects, SD subjects showed lower ALFF area in the left IPL (BA39, 40). The left IPL, as an ROI, showed decreased rsFC with the right cluster of IPL and superior temporal gyrus (BA39, 40). ROC curve analysis showed that the area under the curve (AUC) value of the left IPL was 0.75, with a cutoff point of 0.834 (mean ALFF signal value). Further diagnostic analysis exhibited that the AUC alone discriminated SD status from RW status, with 75% sensitivity and 91.7% specificity. Conclusion Long-term SD disturbed the spontaneous activity and connectivity pattern of DMN. PMID:25834451

Towards Tunable Consensus Clustering for Studying Functional Brain Connectivity During Affective Processing.

PubMed

Liu, Chao; Abu-Jamous, Basel; Brattico, Elvira; Nandi, Asoke K

2017-03-01

In the past decades, neuroimaging of humans has gained a position of status within neuroscience, and data-driven approaches and functional connectivity analyses of functional magnetic resonance imaging (fMRI) data are increasingly favored to depict the complex architecture of human brains. However, the reliability of these findings is jeopardized by too many analysis methods and sometimes too few samples used, which leads to discord among researchers. We propose a tunable consensus clustering paradigm that aims at overcoming the clustering methods selection problem as well as reliability issues in neuroimaging by means of first applying several analysis methods (three in this study) on multiple datasets and then integrating the clustering results. To validate the method, we applied it to a complex fMRI experiment involving affective processing of hundreds of music clips. We found that brain structures related to visual, reward, and auditory processing have intrinsic spatial patterns of coherent neuroactivity during affective processing. The comparisons between the results obtained from our method and those from each individual clustering algorithm demonstrate that our paradigm has notable advantages over traditional single clustering algorithms in being able to evidence robust connectivity patterns even with complex neuroimaging data involving a variety of stimuli and affective evaluations of them. The consensus clustering method is implemented in the R package "UNCLES" available on http://cran.r-project.org/web/packages/UNCLES/index.html .

Characterization of task-free and task-performance brain states via functional connectome patterns.

PubMed

Zhang, Xin; Guo, Lei; Li, Xiang; Zhang, Tuo; Zhu, Dajiang; Li, Kaiming; Chen, Hanbo; Lv, Jinglei; Jin, Changfeng; Zhao, Qun; Li, Lingjiang; Liu, Tianming

2013-12-01

Both resting state fMRI (R-fMRI) and task-based fMRI (T-fMRI) have been widely used to study the functional activities of the human brain during task-free and task-performance periods, respectively. However, due to the difficulty in strictly controlling the participating subject's mental status and their cognitive behaviors during R-fMRI/T-fMRI scans, it has been challenging to ascertain whether or not an R-fMRI/T-fMRI scan truly reflects the participant's functional brain states during task-free/task-performance periods. This paper presents a novel computational approach to characterizing and differentiating the brain's functional status into task-free or task-performance states, by which the functional brain activities can be effectively understood and differentiated. Briefly, the brain's functional state is represented by a whole-brain quasi-stable connectome pattern (WQCP) of R-fMRI or T-fMRI data based on 358 consistent cortical landmarks across individuals, and then an effective sparse representation method was applied to learn the atomic connectome patterns (ACPs) of both task-free and task-performance states. Experimental results demonstrated that the learned ACPs for R-fMRI and T-fMRI datasets are substantially different, as expected. A certain portion of ACPs from R-fMRI and T-fMRI data were overlapped, suggesting some subjects with overlapping ACPs were not in the expected task-free/task-performance brain states. Besides, potential outliers in the T-fMRI dataset were further investigated via functional activation detections in different groups, and our results revealed unexpected task-performances of some subjects. This work offers novel insights into the functional architectures of the brain. Copyright © 2013 Elsevier B.V. All rights reserved.

Characterization of Task-free and Task-performance Brain States via Functional Connectome Patterns

PubMed Central

Zhang, Xin; Guo, Lei; Li, Xiang; Zhang, Tuo; Zhu, Dajiang; Li, Kaiming; Chen, Hanbo; Lv, Jinglei; Jin, Changfeng; Zhao, Qun; Li, Lingjiang; Liu, Tianming

2014-01-01

Both resting state fMRI (R-fMRI) and task-based fMRI (T-fMRI) have been widely used to study the functional activities of the human brain during task-free and task-performance periods, respectively. However, due to the difficulty in strictly controlling the participating subject's mental status and their cognitive behaviors during R-fMRI/T-fMRI scans, it has been challenging to ascertain whether or not an R-fMRI/T-fMRI scan truly reflects the participant's functional brain states during task-free/task-performance periods. This paper presents a novel computational approach to characterizing and differentiating the brain's functional status into task-free or task-performance states, by which the functional brain activities can be effectively understood and differentiated. Briefly, the brain's functional state is represented by a whole-brain quasi-stable connectome pattern (WQCP) of R-fMRI or T-fMRI data based on 358 consistent cortical landmarks across individuals, and then an effective sparse representation method was applied to learn the atomic connectome patterns (ACP) of both task-free and task-performance states. Experimental results demonstrated that the learned ACPs for R-fMRI and T-fMRI datasets are substantially different, as expected. A certain portion of ACPs from R-fMRI and T-fMRI data were overlapped, suggesting some subjects with overlapping ACPs were not in the expected task-free/task-performance brain states. Besides, potential outliers in the T-fMRI dataset were further investigated via functional activation detections in different groups, and our results revealed unexpected task-performances of some subjects. This work offers novel insights into the functional architectures of the brain. PMID:23938590

Family Functioning: Associations with Weight Status, Eating Behaviors, and Physical Activity in Adolescents

PubMed Central

Berge, Jerica M.; Wall, Melanie; Larson, Nicole; Loth, Katie A.; Neumark-Sztainer, Dianne

2012-01-01

Purpose This paper examines the relationship between family functioning (e.g. communication, closeness, problem solving, behavioral control) and adolescent weight status and relevant eating and physical activity behaviors. Methods Data are from EAT 2010 (Eating and Activity in Teens), a population-based study that assessed eating and activity among socioeconomically and racially/ethnically diverse youth (n = 2,793). Adolescents (46.8% boys, 53.2% girls) completed anthropometric assessments and surveys at school in 2009–2010. Multiple linear regression was used to test the relationship between family functioning and adolescent weight, dietary intake, family meal patterns, and physical activity. Additional regression models were fit to test for interactions by race/ethnicity. Results For adolescent girls, higher family functioning was associated with lower body mass index z-score and percent overweight, less sedentary behavior, higher intake of fruits and vegetables, and more frequent family meals and breakfast consumption. For adolescent boys, higher family functioning was associated with more physical activity, less sedentary behavior, less fast food consumption, and more frequent family meals and breakfast consumption. There was one significant interaction by race/ethnicity for family meals; the association between higher family functioning and more frequent family meals was stronger for non-white boys compared to white boys. Overall, strengths of associations tended to be small with effect sizes ranging from - 0.07 to 0.31 for statistically significant associations. Conclusions Findings suggest that family functioning may be protective for adolescent weight and weight-related health behaviors across all race/ethnicities, although assumptions regarding family functioning in the homes of overweight children should be avoided given small effect sizes. PMID:23299010

Assessment of Diastolic Function in Single Ventricle Patients Following the Fontan Procedure

PubMed Central

Margossian, Renee; Sleeper, Lynn A.; Pearson, Gail D.; Barker, Piers C.; Mertens, Luc; Quartermain, Michael D.; Su, Jason T.; Shirali, Girish; Chen, Shan; Colan, Steven D.

2016-01-01

Objectives Patients with functional single ventricles (FSV) following the Fontan procedure have abnormal cardiac mechanics. We sought to determine factors that influence diastolic function and to describe associations of diastolic function with current clinical status. Methods Echocardiograms were obtained as part of the Pediatric Heart Network Fontan Cross-Sectional Study. Diastolic function grade (DFG) was assessed as normal (grade 0), impaired relaxation (grade 1), pseudonormalization (grade 2), restrictive (grade 3). Studies were also classified dichotomously (restrictive pattern present or absent). Relationships between DFG and pre-Fontan variables (e.g., ventricular morphology, age at Fontan, history of volume-unloading surgery), and current status (e.g., systolic function, valvar regurgitation, exercise performance) were explored. Results DFG was calculable in 326/546 subjects (60%); mean age = 11.7±3.3 years. Overall, 32% of patients had grade 0, 9% grade 1, 37% grade 2, and 22% grade 3. Although there was no association between ventricular morphology and DFG, there was an association between ventricular morphology and E’, which was lowest in those with right ventricular morphology (p<.001); this association remained significant when using z-scores adjusted for age (p=<.001). DFG was associated with achieving maximal effort on exercise testing (p=.004); the majority (64%) of those not achieving maximal effort had DFG 2 or 3.No additional significant associations of DFG with laboratory or clinical measures were identified. Conclusion Assessment of diastolic function by current algorithms results in a high percentage of patients with abnormal DFG, but we found few clinically or statistically significant associations. This may imply a lack of impact of abnormal diastolic function upon clinical outcome in this cohort, or may indicate that the methodology may not be applicable to pediatric FSV patients. PMID:27624592

Absolute and Functional Iron Deficiency Is a Common Finding in Patients With Heart Failure and After Heart Transplantation.

PubMed

Przybylowski, P; Wasilewski, G; Golabek, K; Bachorzewska-Gajewska, H; Dobrzycki, S; Koc-Zorawska, E; Malyszko, J

2016-01-01

Anemia is relatively common in patients with heart failure and heart transplant recipients. Both absolute and functional iron deficiency may contribute to the anemia in these populations. Functional iron deficiency (defined as ferritin greater than 200 ng/mL with TSAT (Transferrin saturation) less than 20%) is characterized by the presence of adequate iron stores as defined by conventional criteria, but with insufficient iron mobilization to adequately support. The aim of this study was to determine prevalence of absolute and functional iron deficiency in patients with heart failure (n = 269) and after heart transplantation (n = 130) and their relation to parameters of iron status and inflammation. Iron status, complete blood count, and creatinine levels were assessed using standard laboratory methods. C-reactive protein, hepcidin and hemojuvelin were measured using commercially available kits. Absolute iron deficiency was present in 15% of patients with heart failure and 30% in heart transplant recipients, whereas functional iron deficiency was present in 18% of patients with heart failure and 17% in heart transplant recipients. Functional iron deficiency was associated with significantly higher C-reactive protein and hepcidin levels in heart failure patients, and higher hepcidin and lower estimate glomerular filtration rates in heart transplant recipients. Prevalence of anemia (according to the World Health Organization) was significantly higher in heart transplant recipients (40% vs 22%, P < .001), they were also younger, but with worse kidney function than patients with heart failure. Both absolute and functional iron deficiency were present in a considerable group of patients. This population should be carefully screened for possible reversible causes of inflammation. Copyright © 2016 Elsevier Inc. All rights reserved.

Nursing interventions for improving nutritional status and outcomes of stroke patients: descriptive reviews of processes and outcomes.

PubMed

Perry, Lin; Hamilton, Sharon; Williams, Jane; Jones, Susan

2013-02-01

Stroke produces many effects that impact eating. Nutrition is fundamental for recovery and rehabilitation, but the nursing nutritional role and associated outcomes have not been delineated. (1) To identify nursing interventions intended to improve nutritional status and related outcomes of stroke survivors, and (2) To examine the outcomes of identified nursing interventions on nutrition-related outcomes, including dietary intake, functional status, complications, activities of daily living, mortality, and quality of life for stroke survivors. A modified version of Cochrane literature searching and review methods was used to identify studies that described and evaluated nursing nutritional interventions for adult stroke patients in hospital and community settings. A minimum of 10 years content of seven databases and nine journals was searched to March 2011. Findings were presented descriptively. In total 27 papers from 26 studies were included: 5 randomized controlled trials, 5 clinical trials, 6 quasi-experiments, 4 case studies, and 6 qualitative/observational studies. Stroke nursing nutritional care encompassed screening of nutritional status and swallowing function; assessment of nutritional characteristics and preferences; referral; mealtime organization, supervision and monitoring; mealtime assistance and feeding skills. Nurses individualized care, coordinated or managed meal delivery and enteral feeding systems, were responsible for the dining environment and conduct of mealtimes; they taught staff, patients, and carers. There was little indication of integrated or psychosocial nursing nutritional care, or concepts, theories or models of nursing nutritional care. Many interventions were described but not evaluated. Little high quality evidence was of available. This review indicated the parameters of nursing nutritional care, and provided a framework for future research. A functional, supportive, and educational nursing nutritional role was described but little evidence was of sufficient quality to support policy and practice development or inform education. Nutritional care was revealed as an essential but under-recognized element of stroke nursing. © 2012 The authors. World Views on Evidence-Based Nursing © Sigma Theta Tau International.

Urgency Urinary Incontinence in Women ≥ 50 years: Incidence, Remission and Predictors of Change

PubMed Central

Komesu, YM; Schrader, RM; Rogers, RG; Ketai, LH

2011-01-01

Objectives To estimate 2 year incidence, remission and predictors of urgency urinary incontinence (UUI) in a community based population of women ≥50. Methods We analyzed 2004–2006 data in the Health and Retirement Study. Subjects were women ≥ 50 with baseline and follow-up UUI information. UUI incidence and remission were calculated. Predictors of UUI progression and improvement were estimated controlling for age, ethnicity, body mass index (BMI), parity, psychiatric illness, medical co-morbidities, functional limitations and stress urinary incontinence (SUI). We evaluated whether baseline UUI status predicted follow-up status and used multivariable logistic regression to identify predictor variables. Results 8,581 women reported UUI status at baseline and follow-up. Of 7,244 women continent at baseline, 268 affirmed UUI at follow-up for a 2 year incidence of 3.7%. Of 581 women with UUI at baseline, 150 were continent at follow-up for a 2 year remission of 25.8%. Predictors of UUI development included increased age (7th and 10th decade compared to 6th decade; OR 1.5 and 7.2, CI 1.1–2.1 and 4.2–12.5, respectively), obesity (OR 1.6, CI 1.2–2.1), history of psychiatric illness (OR 1.6, CI 1.3–2.0), functional limitations (OR 6.2, CI 4.2–9.2) and SUI (OR 5.0, CI 3.0–8.3). Women who denied UUI at baseline were also likely to deny UUI at follow-up (OR 47.4, CI 22.9–98.1). Conclusions In this community based population of women ≥ 50 UUI incidence was low and remission was high. Predictors of UUI included increased age, severe obesity, functional limitations, a positive psychiatric history and incontinence status at baseline. PMID:22453668

Different effect of handle region peptide on β-cell function in different sexes of rats neonatally treated with sodium L-glutamate.

PubMed

Wu, Yi-xi; Sun, Ru-qiong; Yin, Guo-shu; Xu, Dong-chuan; Wang, Ping; Lin, Kun; Lin, Chu-jia; Lin, Shao-da

2015-03-17

BACKGROUND The (pro)renin receptor ((P)RR) was reported to be expressed in various tissues including the pancreas, and handle region peptide (HRP) is believed to block the function of (P)RR. This study aimed to investigate the effect of HRP on the glucose tolerance status and β-cell function of female rats, neonatally treated with sodium L-glutamate (MSG) and to compare with the previously reported HRP effect on male rats. MATERIAL AND METHODS Female MSG rats aged 8 weeks were divided into MSG control group and HRP treated group and the normal SD rats served as control. The MSG rats were treated with HRP by osmotic minipumps with dose of 1 mg/kg per day for total 28 days. Glucose tolerance status was evaluated at the end of the study. Islets α-cell and β-cell were marked with insulin antibody and glucagon antibody respectively. The proliferation of islet cells and expression of subunit of NADPH oxidase P22phox were marked by PCNA and P22phox antibody. Picrosirius red staining was performed for evaluating fibrosis of islets. RESULTS HRP improved the glucose status tolerance with decreasing α-cell mass, islets PCNA-positive cells, expression of P22phox and picrosirius red stained areas, and increasing β-cell mass in female MSG rats. The indexes with obviously interacted effect of sexes and HRP for the MSG rats were the AUC of blood glucose concentration (P<0.01), α-cell mass (P<0.05), proliferation of islet cells (P<0.01) and area of picrosirius red staining (P<0.01). CONCLUSIONS HRP improved the glucose tolerance status in the females although it was previously reported to worsen the glucose tolerance in male MSG rats. Different levels of sex hormones may partly account for the disparate effects observed for HRP in different sexes.

Different Effect of Handle Region Peptide on β-Cell Function in Different Sexes of Rats Neonatally Treated with Sodium L-Glutamate

PubMed Central

Wu, Yi-xi; Sun, Ru-qiong; Yin, Guo-shu; Xu, Dong-chuan; Wang, Ping; Lin, Kun; Lin, Chu-jia; Lin, Shao-da

2015-01-01

Background The (pro)renin receptor ((P)RR) was reported to be expressed in various tissues including the pancreas, and handle region peptide (HRP) is believed to block the function of (P)RR. This study aimed to investigate the effect of HRP on the glucose tolerance status and β-cell function of female rats, neonatally treated with sodium L-glutamate (MSG) and to compare with the previously reported HRP effect on male rats. Material/Methods Female MSG rats aged 8 weeks were divided into MSG control group and HRP treated group and the normal SD rats served as control. The MSG rats were treated with HRP by osmotic minipumps with dose of 1 mg/kg per day for total 28 days. Glucose tolerance status was evaluated at the end of the study. Islets α-cell and β-cell were marked with insulin antibody and glucagon antibody respectively. The proliferation of islet cells and expression of subunit of NADPH oxidase P22phox were marked by PCNA and P22phox antibody. Picrosirius red staining was performed for evaluating fibrosis of islets. Results HRP improved the glucose status tolerance with decreasing α-cell mass, islets PCNA-positive cells, expression of P22phox and picrosirius red stained areas, and increasing β-cell mass in female MSG rats. The indexes with obviously interacted effect of sexes and HRP for the MSG rats were the AUC of blood glucose concentration (P<0.01), α-cell mass (P<0.05), proliferation of islet cells (P<0.01) and area of picrosirius red staining (P<0.01). Conclusions HRP improved the glucose tolerance status in the females although it was previously reported to worsen the glucose tolerance in male MSG rats. Different levels of sex hormones may partly account for the disparate effects observed for HRP in different sexes. PMID:25783768

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 equation; HTN = hypertension; MI = myocardial infarction; MMSE = Mini-Mental State Examination; NIHSS = NIH Stroke Scale; NOMAS = Northern Manhattan Study; QOL = quality of life; QLI = quality of life index. PMID:20574034

Depression, disability and functional status among community-dwelling older adults in South Africa: evidence from the first South African National Income Dynamics Study.

PubMed

Tomita, Andrew; Burns, Jonathan K

2013-12-01

This study examined the relationship between depression and functional status among a community-dwelling older population of 65 years and older in South Africa. Data from the first wave of the South African National Income Dynamics Study were used, this being the first longitudinal panel survey of a nationally representative sample of households. The study focused on the data for resident adults 65 years and older (n = 1,429). Depression was assessed using the 10-item version of the Center for Epidemiologic Studies Depression Scale. Functional status, pertaining to both difficulty and dependence in activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning and mobility (PFM), were assessed using 11 items. Functional challenges were generally higher in the older age group. There was a significant association between depression and functional dependence in ADL (adjusted OR = 2.57 [CI: 1.03-6.41]), IADL (adjusted OR = 2.76 [CI: 1.89-4.04]), and PFM (adjusted OR = 1.66 [CI: 1.18-2.33]), but the relationship between depression and functional status, particularly PFM, appeared weaker in older age. The relationship between depression symptoms and function is complex. Functional characteristics between older and younger old populations are diverse, and caution is indicated against overgeneralizing the challenges related to depression and function among this target population. Copyright © 2013 John Wiley & Sons, Ltd.

Social isolation and loneliness: Prospective associations with functional status in older adults.

PubMed

Shankar, Aparna; McMunn, Anne; Demakakos, Panayotes; Hamer, Mark; Steptoe, Andrew

2017-02-01

The present analysis aimed to examine the associations of isolation and loneliness, individually as well as simultaneously, with 2 measures of functional status (gait speed and difficulties in activities of daily living) in older adults over a 6-year period using data from the English Longitudinal Study of Ageing, and to assess if these associations differ by SES. Loneliness was measured using the short form of the Revised UCLA scale, and an index of social isolation was computed incorporating marital status; frequency of contact with friends, family, and children; and participation in social activities. Measures of functional status were assessed identically at baseline and 6 years later for 3070 participants (mean age 69 years). Wealth was used as an indicator of SES. In fully and mutually adjusted models, social isolation and loneliness were found to be associated with a decrease in gait speed at follow-up, with stronger effects among more disadvantaged individuals. Loneliness was associated with an increase in difficulties with activities of daily living. Isolation and loneliness were adversely associated with different aspects of functional status. Interventions to reduce isolation and loneliness may be particularly beneficial for individuals in disadvantaged groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Mental resilience, perceived immune functioning, and health.

PubMed

Van Schrojenstein Lantman, Marith; Mackus, Marlou; Otten, Leila S; de Kruijff, Deborah; van de Loo, Aurora Jae; Kraneveld, Aletta D; Garssen, Johan; Verster, Joris C

2017-01-01

Mental resilience can be seen as a trait that enables an individual to recover from stress and to face the next stressor with optimism. People with resilient traits are considered to have a better mental and physical health. However, there are limited data available assessing the relationship between resilient individuals and their perspective of their health and immune status. Therefore, this study was conducted to examine the relationship between mental resilience, perceived health, and perceived immune status. A total of 779 participants recruited at Utrecht University completed a questionnaire consisting of demographic characteristics, the brief resilience scale for the assessment of mental resilience, the immune function questionnaire (IFQ), and questions regarding their perceived health and immune status. When correcting for gender, age, height, weight, smoker status, amount of cigarettes smoked per week, alcohol consumption status, amount of drinks consumed per week, drug use, and frequency of past year drug use, mental resilience was significantly correlated with perceived health ( r =0.233, p =0.0001), perceived immune functioning ( r =0.124, p =0.002), and IFQ score ( r =-0.185, p =0.0001). A significant, albeit modest, relationship was found between mental resilience and perceived immune functioning and health.

Associations of Mental Health and Physical Function with Colonoscopy-related Pain

PubMed Central

Yamada, Eiji; Watanabe, Seitaro; Nakajima, Atsushi

2017-01-01

Objective To clarify the effects of mental health and physical function in association with colonoscopy-related pain. Methods The mental health and physical function were evaluated using the Japanese version of the SF-8 Health Survey questionnaire. Poor physical status was defined as a physical component summary (PCS) <40 and poor mental status as a mental component summary (MCS) <40. Pain was assessed using a visual analogue scale (VAS), with significant pain defined as VAS ≥70 mm and insignificant pain as VAS <70 mm. The background and colonoscopic findings were compared in patients with significant and insignificant pain. Patients This study evaluated consecutive Japanese patients who were positive on fecal occult blood tests and underwent total colonoscopy. Results Of the 100 patients, 23 had significant and 77 had insignificant colonoscopy-related pain. A multiple logistic regression analysis showed that MCS <40 [odds ratio (OR) 6.03; 95% confidence interval (CI) 1.41-25.9, p=0.0156], PCS <40 (OR 5.96; 95% CI 1.45-24.5, p=0.0133), and ≥300 seconds to reach the cecum (OR 4.13; 95% CI 1.16-14.7, p=0.0281) were independent risk factors for colonoscopy-related pain. Conclusion The mental health and physical function are important determinants of colonoscopy-related pain. Evaluating the mental health and physical function of patients prior to colonoscopy may effectively predict the degree of colonoscopy-related pain. PMID:28202858

Rehabilitation in multiple sclerosis.

PubMed

Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta

2017-07-01

The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

12 CFR 48.14 - Supervision.

Code of Federal Regulations, 2014 CFR

2014-01-01

....14 Supervision. (a) Supervision by the national bank. A national bank engaging in retail forex... occupying a similar status or performing a similar function) of all retail forex accounts carried, operated... persons occupying a similar status or performing a similar function) relating to its retail forex business...

12 CFR 48.14 - Supervision.

Code of Federal Regulations, 2012 CFR

2012-01-01

....14 Supervision. (a) Supervision by the national bank. A national bank engaging in retail forex... occupying a similar status or performing a similar function) of all retail forex accounts carried, operated... persons occupying a similar status or performing a similar function) relating to its retail forex business...

12 CFR 48.14 - Supervision.

Code of Federal Regulations, 2013 CFR

2013-01-01

....14 Supervision. (a) Supervision by the national bank. A national bank engaging in retail forex... occupying a similar status or performing a similar function) of all retail forex accounts carried, operated... persons occupying a similar status or performing a similar function) relating to its retail forex business...

Evaluation of nutritional status and energy expenditure in athletes.

PubMed

Mielgo-Ayuso, Juan; Maroto-Sánchez, Beatriz; Luzardo-Socorro, Raquel; Palacios, Gonzalo; Palacios Gil-Antuñano, Nieves; González-Gross, Marcela

2015-02-26

Continuous physical exercise leads the athlete to maintain an unstable balance between dietary intake, energy expenditure and the additional demands of a high amount of physical activity. Thus, an accurate assessment of nutritional status is essential to optimize the performance, since it affects health, body composition, and the recovery of the athlete. Specific aspects like the type of sport, specialty or playing position, training schedule and competition calendar, category, specific objectives, which differ from the general population, must be considered. A biochemical assessment can give us a general idea of the nutritional status, lipid profile, liver or kidney function, if diet is too high in proteins or fats, as well as possible nutritional deficiencies and the need for supplementation. Sport kinanthropometry has great utility that enables the assessment of body mass, height, length, diameter, perimeter and skinfolds, where information is processed by applying different equations, obtaining information on somatotype, body composition, and the proportionality of different parts of the body. To give proper nutritional counselling, energy needs of the athlete must be known. If objective measurement is not possible, there are tables including theoretically established energy requirements of different sports. Dietary assessment should include information about food consumption and nutrient intake to establish the relationship between diet, health status and athlete's performance. On the other hand, an adequate hydration status in athletes is essential to maintain adequate performance. Hence, the knowledge of fluid intake by the athlete is a matter of the utmost importance. Dehydration can cause harmful effects on athletes' health. As there is no gold standard, urine gravidity and urine colour are the most extended methods for analyzing hydration status. There is consensus that due to complexity, the combination of different methods assures an effective data collection which will be useful to proceed in dietary and nutritional intervention.. Copyright AULA MEDICA EDICIONES 2015. Published by AULA MEDICA. All rights reserved.

Does Competence Mediate the Associations between Puberty and Internalizing or Externalizing Problems in Adolescent Girls

PubMed Central

Negriff, Sonya; Hillman, Jennifer, B.; Dorn, Lorah D.

2011-01-01

Purpose To examine separate mediational models linking a) menarcheal status or b) pubertal timing to internalizing and externalizing problems through competence. Method Cross-sectional analyses of 262 adolescent girls (11–17 years; M=14.93, SD=2.17) enrolled in a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health. Measures of menarcheal status (pre/post), pubertal timing (early, on-time, or late), internalizing and externalizing behavior, and perceived competence (parent and adolescent report) were obtained. Structural Equation Modeling was used for analyses. Results Perceived competence was found to fully mediate the association between menarcheal status and parent report of internalizing and externalizing problems. For adolescent report, there was a full mediation effect for internalizing problems but a partial mediation effect for externalizing problems. Being menarcheal was related to lower competence which was related to higher internalizing and externalizing problems. Models including pubertal timing were not significant. Conclusions Perceived competence is important in understanding the associations between menarcheal status and internalizing and externalizing problems. Interventions targeting competence, particularly in post-menarcheal girls, may reduce or prevent problem behaviors. PMID:21939864

Loss of olfactory function and nutritional status in vital older adults and geriatric patients.

PubMed

Toussaint, Nicole; de Roon, Margot; van Campen, Jos P C M; Kremer, Stefanie; Boesveldt, Sanne

2015-03-01

The aim of this cross-sectional study was to assess the association of olfactory function and nutritional status in vital older adults and geriatric patients. Three hundred forty-five vital (mean age 67.1 years) and 138 geriatric older adults (mean age 80.9 years) were included. Nutritional status was assessed using the mini nutritional assessment-short form. The Sniffin' Sticks was used to measure olfactory function. Eleven percentage of the vital older adults were at risk of malnutrition, whereas 60% of the geriatric participants were malnourished or at risk. Only 2% of the vital older adults were anosmic, compared with 46% of the geriatric participants. Linear regression demonstrated a significant association (P = 0.015) between olfactory function and nutritional status in the geriatric subjects. However, this association became insignificant after adjustment for confounders. Both crude and adjusted analysis in the vital older adults did not show a significant association. The results indicate that, in both groups of elderly, there is no direct relation between olfactory function and nutritional status. We suggest that a decline in olfactory function may still be considered as one of the risk-factors for malnutrition in geriatric patients-once co-occurring with other mental and/or physical problems that are more likely to occur in those patients experience. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Preconception Maternal Iodine Status Is Positively Associated with IQ but Not with Measures of Executive Function in Childhood.

PubMed

Robinson, Sian M; Crozier, Sarah R; Miles, Elizabeth A; Gale, Catharine R; Calder, Philip C; Cooper, Cyrus; Inskip, Hazel M; Godfrey, Keith M

2018-05-15

Adverse effects of severe maternal iodine deficiency in pregnancy on fetal brain development are well-established, but the effects of milder deficiency are uncertain. Most studies examine iodine status in pregnancy; less is known about iodine nutrition before conception. We examined relations between maternal preconception iodine status and offspring cognitive function, within a prospective mother-offspring cohort. Maternal iodine status was assessed through the use of the ratio of iodine:creatinine concentrations (I/Cr) in spot urine samples [median (IQR) period before conception 3.3 y (2.2-4.7 y)]. Childhood cognitive function was assessed at age 6-7 y. Full-scale IQ was assessed via the Wechsler Abbreviated Scale of Intelligence, and executive function through the use of tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Analyses (n = 654 mother-child dyads) were adjusted for potential confounders including maternal intelligence, education, and breastfeeding duration. The median (IQR) urinary iodine concentration was 108.4 µg/L (62.2-167.8 µg/L) and the I/Cr ratio 114 µg/g (76-164 µg/g). The preconception I/Cr ratio was positively associated with child IQ, before and after adjustment for potential confounding influences [β = 0.13 (95% CI: 0.04, 0.21)/SD, P = 0.003]. 8.9% of women had a preconception urinary I/Cr ratio <50 µg/g; compared with those with an I/Cr ratio ≥150 µg/g, the IQ of their offspring was 0.49 (95% CI: 0.79, 0.18) SD lower. There were no associations with the executive function outcomes assessed via CANTAB, before or after adjustment for confounders. The positive association between iodine status before conception and child IQ provides some support for demonstrated links between low maternal iodine status in pregnancy and poorer cognitive function reported in other studies. However, given the negative effects on school performance previously observed in children born to iodine-deficient mothers, the lack of associations with measures of executive function in the present study was unexpected. Further data are needed to establish the public health importance of low preconception iodine status.

Association of presence/absence and on/off patterns of Helicobacter pylori oipA gene with peptic ulcer disease and gastric cancer risks: a meta-analysis.

PubMed

Liu, Jingwei; He, Caiyun; Chen, Moye; Wang, Zhenning; Xing, Chengzhong; Yuan, Yuan

2013-11-20

There are increasing studies examining the relationship between the status of H. pylori oipA gene and peptic ulcer disease (PUD) and gastric cancer (GC) but the results turn out to be controversial. We attempted to clarify whether oipA gene status is linked with PUD and/or GC risks. A systematically literature search was performed through four electronic databases. According to the specific inclusion and exclusion criteria, seven articles were ultimately available for the meta-analysis of oipA presence/absence with PUD and GC, and eleven articles were included for the meta-analysis of oipA on/off status with PUD and GC. For the on/off functional status analysis of oipA gene, the "on" status showed significant associations with increased risks of PUD (OR = 3.97, 95% CI: 2.89, 5.45; P < 0.001) and GC (OR = 2.43, 95% CI: 1.45, 4.07; P = 0.001) compared with gastritis and functional dyspepsia controls. Results of the homogeneity test indicated different effects of oipA "on" status on PUD risk between children and adult subgroups and on GC risk between PCR-sequencing and immunoblot subgroups. For the presence/absence analysis of oipA gene, we found null association of the presence of oipA gene with the risks of PUD (OR = 1.93, 95% CI: 0.60, 6.25; P = 0.278) and GC (OR = 2.09, 95% CI: 0.51, 8.66; P = 0.308) compared with gastritis and functional dyspepsia controls. To be concluded, when oipA exists, the functional "on" status of this gene showed association with increased risks for PUD and GC compared with gastritis and FD controls. However, merely investigating the presence/absence of oipA would overlook the importance of its functional on/off status and would not be reliable to predict risks of PUD and GC. Further large-scale and well-designed studies concerning on/off status of oipA are required to confirm our meta-analysis results.

Disorders of nutritional status in sepsis – facts and myths

PubMed Central

Wachowska, Ewelina; Słotwiński, Robert

2017-01-01

The problem of diagnosing nutritional status disorders in septic patients remains unresolved. This is associated with the necessity of the introduction of newer and newer methods of assessing nutritional status, often requiring precise and expensive equipment as well as employment of professionals in this field in hospital wards, primarily including intensive care units (ICU). Methods that have been applied thus far for assessing nutritional status, also used in severely ill septic patients, have little impact on improving treatment results. This is due to the high dynamics of changes in nutritional status in these patients, healing process variability in individual patients, and the “mismatch” of methods for assessing nutritional status in relation to the patient’s clinical status. The diagnostic value of the traditional methods of assessing nutritional status, i.e. anthropometric analysis and selected laboratory tests, as markers of nutritional status disorders in septic patients, is still debatable. There is still no precise method that could become the “gold standard” allowing for early identification of malnutrition in these group of patients. Phase angle, bioelectrical impedance vector analysis (BIVA), and the “illness marker”, obtained directly from the resistance, reactance, and impedance, can be used as prognostic or nutritional indices in severely ill septic patients, but the intensity of research on this subject needs to be increased. Detailed assessment of nutritional status should include tests of selected inflammation markers (including TLC, HMGB1, IL-6, IL-10, IL-1ra, sTNFRI). PMID:28702094

Disorders of nutritional status in sepsis - facts and myths.

PubMed

Kosałka, Katarzyna; Wachowska, Ewelina; Słotwiński, Robert

2017-01-01

The problem of diagnosing nutritional status disorders in septic patients remains unresolved. This is associated with the necessity of the introduction of newer and newer methods of assessing nutritional status, often requiring precise and expensive equipment as well as employment of professionals in this field in hospital wards, primarily including intensive care units (ICU). Methods that have been applied thus far for assessing nutritional status, also used in severely ill septic patients, have little impact on improving treatment results. This is due to the high dynamics of changes in nutritional status in these patients, healing process variability in individual patients, and the "mismatch" of methods for assessing nutritional status in relation to the patient's clinical status. The diagnostic value of the traditional methods of assessing nutritional status, i.e. anthropometric analysis and selected laboratory tests, as markers of nutritional status disorders in septic patients, is still debatable. There is still no precise method that could become the "gold standard" allowing for early identification of malnutrition in these group of patients. Phase angle, bioelectrical impedance vector analysis (BIVA), and the "illness marker", obtained directly from the resistance, reactance, and impedance, can be used as prognostic or nutritional indices in severely ill septic patients, but the intensity of research on this subject needs to be increased. Detailed assessment of nutritional status should include tests of selected inflammation markers (including TLC, HMGB1, IL-6, IL-10, IL-1ra, sTNFRI).

Fluorometric assessments of viability and mitochondrial status of boar spermatozoa following liquid storage.

PubMed

Fraser, L; Lecewicz, M; Strzezek, J

2002-01-01

A study was conducted to assess viability and mitochondrial status of boar spermatozoa stored at 5 degrees C and 16 degrees C. Gel-free ejaculates, collected from 3 mature boars, were extended in a standard diluent (K3) supplemented with a low-density lipoprotein fraction (LDF) isolated from egg yolk, and stored for 96 h at 5 degrees C and 16 degrees C. Motility analysis was conducted after semen dilution (D0) and on D1-D4 of storage. A double staining method, rhodamine 123 (R123) and propidium iodide (PI), was used to assess sperm viability and mitochondrial status. Sperm viability was also assessed using Hoechst 33,258 (H33258) stain. In fresh semen samples, the percentage of motility was significantly correlated with the percentage of viable spermatozoa with functional mitochondria (R123-PI), viable spermatozoa determined by H33258 staining and ATP content (r = 0.88, p < or = 0.01; r = 0.69, p < or = 0.05; r = 0.77, p < or = 0.01, respectively). The ATP content was also positively correlated with the percentage of viable spermatozoa with functional mitochondria (r = 0.76, p < or = 0.01). Sperm cells progressively lost motility, viability and mitochondrial capacity when stored in the supportive media at 5 degrees C and 16 degrees C. Motility estimates were lower (p < or = 0.05) than the percentage of viable spermatozoa with functional mitochondria during storage in K3 and LDF-based diluents on D4 and D3-D4, respectively. Deterioration in motility and membrane integrity was less marked in spermatozoa stored in LDF-based diluents. Spermatozoa doubly-stained with R123-PI appeared to possess some functional mitochondria, particularly in LDF-based diluent semen. Estimates of sperm viability, as determined by R123-PI staining, were equivalent (p > or = 0.05) to estimates made using H33258 staining. A decrease in mitochondrial activity, as measured by R123 uptake, was accompanied by lower ATP content in spermatozoa stored in K3 and LDF-based diluents after 48 h and 72 h of storage, respectively. Fluorometric measurements of viability and mitochondrial status of boar spermatozoa during liquid storage seem to provide reliable information about the sperm functional membranes.

Social hierarchy modulates neural responses of empathy for pain.

PubMed

Feng, Chunliang; Li, Zhihao; Feng, Xue; Wang, Lili; Tian, Tengxiang; Luo, Yue-Jia

2016-03-01

Recent evidence indicates that empathic responses to others' pain are modulated by various situational and individual factors. However, few studies have examined how empathy and underlying brain functions are modulated by social hierarchies, which permeate human society with an enormous impact on social behavior and cognition. In this study, social hierarchies were established based on incidental skill in a perceptual task in which all participants were mediumly ranked. Afterwards, participants were scanned with functional magnetic resonance imaging while watching inferior-status or superior-status targets receiving painful or non-painful stimulation. The results revealed that painful stimulation applied to inferior-status targets induced higher activations in the anterior insula (AI) and anterior medial cingulate cortex (aMCC), whereas these empathic brain activations were significantly attenuated in response to superior-status targets' pain. Further, this neural empathic bias to inferior-status targets was accompanied by stronger functional couplings of AI with brain regions important in emotional processing (i.e. thalamus) and cognitive control (i.e. middle frontal gyrus). Our findings indicate that emotional sharing with others' pain is shaped by relative positions in a social hierarchy such that underlying empathic neural responses are biased toward inferior-status compared with superior-status individuals. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Functional limitations as potential mediators of the effects of self-reported vision status on fall risk of older adults.

PubMed

Steinman, Bernard A; Allen, Susan M; Chen, Jie; Pynoos, Jon

2015-02-01

To test whether limitations in mobility and large-muscle functioning mediate self-reported vision status to increase fall risk among respondents age 65 and above. This study used two waves from the Health and Retirement Study. We conducted binary logistic and negative binomial regression analyses to test indirect paths leading from self-reported vision status to falls, via indices of mobility and large-muscle functioning. Limited evidence was found for a mediating effect among women; however, large-muscle groups were implicated as partially mediating risk factors for falls among men with fair self-reported vision status. Implications of these findings are discussed including the need for prioritizing improved muscle strength of older men and women with poor vision as a preventive measure against falls. © The Author(s) 2014.

The relations of majority-minority group status and having an other-religion friend to Indonesian youths' socioemotional functioning.

PubMed

Eisenberg, Nancy; Sallquist, Julie; French, Doran C; Purwono, Urip; Suryanti, Telie Ari; Pidada, Sri

2009-01-01

In this study, the authors examined the relations of Indonesian adolescents' socioemotional functioning to their majority-minority status and the presence of cross-religion friendships and whether sex moderated these relations. At Time 1, 1,254 7th graders and their peers in Bandung, Indonesia, reported on their friendships, prosocial behavior, and peer likability; months later, a selected sample of 250 youths and their teachers and parents rated the youths' social functioning and (mal)adjustment. When controlling for socioeconomic status and initial sociometric status, girls were generally higher in measures of adjustment, whereas majority children were lower in externalizing problems and, for boys, loneliness. For minority children's social competence and prosocial behavior at school, there was evidence of a buffering effect of having a cross-religion friend.

A Comparison between Older Persons with Down Syndrome and a Control Group: Clinical Characteristics, Functional Status and Sensori-Motor Function

ERIC Educational Resources Information Center

Carmeli, Eli; Kessel, Shlomo; Merrick, Joav; Bar-Chad, Shmuel

2004-01-01

The increase in life expectancy within the general population has resulted in an increasing number of elderly adults with intellectual disability, and this is reflected in the increased life expectancy in persons with Down syndrome, currently about 56 years. The aim of this study was to study the clinical characteristics, the functional status and…

Effects of Exercise Intervention on Pain, Shoulder Movement, and Functional Status in Women after Breast Cancer Surgery: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Mohammed, Salwa A.

2016-01-01

Background: Breast cancer is one of the most important types of cancer among women worldwide and is a significant stressor in women's life that may affect functional health status. The present study was aimed to determine the effect of selected exercises program on pain, shoulder disability, and functional outcomes in women after breast cancer…

Malnutrition According to Mini Nutritional Assessment Is Associated With Severe Functional Impairment in Geriatric Patients Before and up to 6 Months After Hip Fracture.

PubMed

Goisser, Sabine; Schrader, Eva; Singler, Katrin; Bertsch, Thomas; Gefeller, Olaf; Biber, Roland; Bail, Hermann Josef; Sieber, Cornel C; Volkert, Dorothee

2015-08-01

Hip fractures (HFs) in old age frequently cause severe functional impairment and deteriorating autonomy in everyday life. Many older patients with HFs are malnourished or at risk of malnutrition. In this study, we examined the relationship between nutritional status of geriatric patients before HF and their functional and clinical course up to 6 months after hospital discharge. Observational study with follow-up after 6 months. Four wards of the department of trauma and orthopedic surgery of a large urban maximum care hospital (Klinikum Nürnberg, Nuremberg, Germany). Geriatric patients aged ≥75 years with surgically repaired proximal femoral fracture. Prefracture nutritional status was determined by Mini Nutritional Assessment (MNA). Comorbidities and complications during hospital stay were obtained from medical documentation. Functional status before HF, postoperatively, at hospital discharge, and 6 months later was assessed by Barthel Index for activities of daily living (ADL) and patients' mobility level and related to MNA categories. Associations were evaluated using χ(2), Fisher exact, Kruskal-Wallis, Mann-Whitney-U, Jonckheere-Terpstra, and Cochrane-Armitage tests as appropriate, as well as analysis of covariance with repeated measures. Of 97 included patients, 17% were malnourished and 38% at risk of malnutrition before HF. Participants with (risk of) malnutrition were equally mobile but more dependent in ADL prior to HF than well-nourished patients (P < .001). Independent of nutritional status, after 6 months 68% of participants had not regained their prefracture level of independence in ADL. According to analysis of covariance, the ADL development over time until follow-up 6 months after hospital discharge did not depend on nutritional status. However, at follow-up malnourished patients more often suffered from remaining losses in ADL ≥25% of initial Barthel Index points (P = .033) and less often had regained their prefracture mobility level (P = .020) than well-nourished patients. Clinical course did not differ significantly between the groups with different nutritional status. In this study with geriatric HF patients from all functional and cognitive levels, worse prefracture nutritional status was associated with worse functional status and more frequent remaining functional loss, whereas the trajectory of ADL recovery and clinical course did not differ significantly. Further studies with sufficient statistical power are needed to substantiate these inconclusive results. In order to clarify the association of nutritional status with functional and clinical course in geriatric patients after HF, they should preferably focus on the role of nutritional management during the hospital stay. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Effect of music intervention on the cognitive and depression status of senior apartment residents in Taiwan

PubMed Central

Tai, Shu-Yu; Wang, Ling-Chun; Yang, Yuan-Han

2015-01-01

Objective To identify the effect of music intervention on cognitive function and depression status of residents in senior citizen apartments based on the existing evidence regarding music therapy. Methods An experimental study was conducted from November 2008 to December 2009. Sixty healthy senior apartment residents over 65 years of age were recruited and separated into two groups. According to their opinion, 41 took part in the music intervention group and 19 in the comparison group. The music intervention involved Buddhist hymns. The short-term effects were evaluated based on the measurement of cognitive function and depression level using the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale-short form (GDS-SF) at the baseline, 1 month, and 4 months. Results The means of the initial and the 1-month MMSE and GDS-SF scores did not differ between the two groups. The 4-month MMSE score significantly declined compared with the initial level in the comparison group, whereas no significant change was observed in the experimental group. Moreover, the 4-month GDS-SF score significantly improved in both groups compared with the initial level. Conclusion Music intervention may postpone cognitive decline in healthy residents preferring Buddhist hymns in the senior citizen apartments in 4 months follow-up, and intense contact with participants may improve their mood status. PMID:26109859

The effect of automated monitoring and real-time prompting on nurses' hand hygiene performance.

PubMed

Levchenko, Alexander I; Boscart, Veronique M; Fernie, Geoff R

2013-10-01

Adequate hand hygiene compliance by healthcare staff is considered an effective method to reduce hospital-acquired infections. The electronic system developed at Toronto Rehabilitation Institute automatically detects hand hygiene opportunities and records hand hygiene actions. It includes an optional visual hand hygiene status indication, generates real-time hand hygiene prompting signals, and enables automated monitoring of individual and aggregated hand hygiene performance. The system was installed on a complex continuous care unit at the entrance to 17 patient rooms and a utility room. A total of 93 alcohol gel and soap dispensers were instrumented and 14 nurses were provided with the personal wearable electronic monitors. The study included three phases with the system operating in three different modes: (1) an inactive mode during the first phase when hand hygiene opportunities and hand hygiene actions were recorded but prompting and visual indication functions were disabled, (2) only hand hygiene status indicators were enabled during the second phase, and (3) both hand hygiene status and real-time hand hygiene prompting signals were enabled during the third phase. Data collection was performed automatically during all of the three phases. The system indicated significantly higher hand hygiene activity rates and compliance during the third phase, with both hand hygiene indication and real-time prompting functions enabled. To increase the efficacy of the technology, its use was supplemented with individual performance reviews of the automatically collected data.

[Nutritional status and the relationship regarding functional status after stroke].

PubMed

López Espuela, Fidel; Portilla Cuenca, Juan Carlos; Holguín Mohedas, Marta; Párraga Sánchez, José Manuel; Cordovilla-Guardia, Sergio; Casado Naranjo, Ignacio

2017-09-14

To assess the nutritional status (NS) of patients at three months of suffering a stroke, and to establish the relationship between functional recovery and complications in this period. A cross-sectional observational study evaluating the NS of patients older than 65 years at three months of having a stroke. The NS was assessed using the Mini Nutritional Assessment (MNA). Sociodemographic and anthropometric data, cardiovascular risk factors, as well as functional status (through the Barthel index and the modified Rankin scale) and the presented complications were collected. One hundred and three patients were included, with a medium age of 75.81 (± 6.73). The MNA score was 23.13 points (± 4.47); 8.2% had malnutrition and 38.1% had risk of malnutrition. There were no differences in the NS between women and men (p = 0.076) neither relation of the NS with age. NS deficiency was associated with poorer function (r = 0.608; p < 0.001), the development of complications (urinary tract infection and fever) (p = 0.044) and dysphagia (p = 0.014). In addition, those patients with better nutritional status had a better quality of life (r = 0.506; p < 0.001). It was also associated with poorer socioeconomic status (p = 0.020) and institutionalization (p = 0.004). The risk of malnutrition is common in stroke survivors at the short-term. This NS is associated with a worse functional situation and self-perceived quality of life and with a higher rate of complications. Early detection of the risk of malnutrition is essential in patients who have suffered a stroke.

Associations between positive emotion and recovery of functional status following stroke.

PubMed

Ostir, Glenn V; Berges, Ivonne-Marie; Ottenbacher, Margaret E; Clow, Angela; Ottenbacher, Kenneth J

2008-05-01

Accumulating evidence indicates the beneficial effects of positive emotion on health and general well-being in older age. Less evidence is available on whether positive emotion supports improvement in functional status after an acute medical event such as stroke. This study examined the association between positive emotion at discharge from inpatient medical rehabilitation and functional status 3 months later in persons with stroke. A longitudinal study using information from the Stroke Recovery in Underserved Patients database. The study included 823 persons aged 55 years or older with stroke and admitted to an inpatient medical rehabilitation facility. Information was collected during inpatient medical rehabilitation stay and approximately 3 months after discharge. The mean age of the sample was 72.8 years (SD = 9.5), 51.5% were women and 53.8% were married. The sample was mostly non-Hispanic white (79.2%), followed by non-Hispanic black (15.0%) and Hispanic (5.8%). The average length of stay was 20.1 day (SD = 10.1). In multivariate regression analyses, discharge positive emotion score was significantly associated with higher overall functional status (b = 0.70, SE = 0.21, p = .001) as well as with higher motor (b = 0.37, SE = 0.17, p = .003) and cognitive (b = 0.30, SE = 0.05, p = .0001) status at 3-month follow-up after adjustment for relevant risk factors. Our results indicate positive emotion is associated with gains in functional status after stroke. Findings have implications for stroke recovery programs and suggest the need to include measures of positive emotion inpatient assessments.

Vitamin B12 intake and status and cognitive function in elderly people.

PubMed

Doets, Esmée L; van Wijngaarden, Janneke P; Szczecińska, Anna; Dullemeijer, Carla; Souverein, Olga W; Dhonukshe-Rutten, Rosalie A M; Cavelaars, Adrienne E J M; van 't Veer, Pieter; Brzozowska, Anna; de Groot, Lisette C P G M

2013-01-01

Current recommendations on vitamin B12 intake vary from 1.4 to 3.0 μg per day and are based on the amount needed for maintenance of hematologic status or on the amount needed to compensate obligatory losses. This systematic review evaluates whether the relation between vitamin B12 intake and cognitive function should be considered for underpinning vitamin B12 recommendations in the future. The authors summarized dose-response evidence from randomized controlled trials and prospective cohort studies on the relation of vitamin B12 intake and status with cognitive function in adults and elderly people. Two randomized controlled trials and 6 cohort studies showed no association or inconsistent associations between vitamin B12 intake and cognitive function. Random-effects meta-analysis showed that serum/plasma vitamin B12 (50 pmol/L) was not associated with risk of dementia (4 cohort studies), global cognition z scores (4 cohort studies), or memory z scores (4 cohort studies). Although dose-response evidence on sensitive markers of vitamin B12 status (methylmalonic acid and holotranscobalamin) was scarce, 4 of 5 cohort studies reported significant associations with risk of dementia, Alzheimer's disease, or global cognition. Current evidence on the relation between vitamin B12 intake or status and cognitive function is not sufficient for consideration in the development of vitamin B12 recommendations. Further studies should consider the selection of sensitive markers of vitamin B12 status. © The Author 2012. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Current status of potential applications of repurposed Cas9 for structural and functional genomics of plants.

PubMed

Seth, Kunal; Harish

2016-11-25

Redesigned Cas9 has emerged as a tool with various applications like gene editing, gene regulation, epigenetic modification and chromosomal imaging. Target specific single guide RNA (sgRNA) can be used with Cas9 for precise gene editing with high efficiency than previously known methods. Further, nuclease-deactivated Cas9 (dCas9) can be fused with activator or repressor for activation (CRISPRa) and repression (CRISPRi) of gene expression, respectively. dCas9 fused with epigenetic modifier like methylase or acetylase further expand the scope of this technique. Fluorescent probes can be tagged to dCas9 to visualize the chromosome. Due to its wide-spread application, simplicity, accessibility, efficacy and universality, this technique is expanding the structural and functional genomic studies of plant and developing CRISPR crops. The present review focuses on current status of using repurposed Cas9 system in these various areas, with major focus on application in plants. Major challenges, concerns and future directions of using this technique are discussed in brief. Copyright © 2016 Elsevier Inc. All rights reserved.

Fall prevention in postmenopausal women: the role of Pilates exercise training.

PubMed

Hita-Contreras, F; Martínez-Amat, A; Cruz-Díaz, D; Pérez-López, F R

2016-06-01

Falls and fall-related injuries are a major public health concern for postmenopausal women. Fear of falling, impairments in gait and postural control, and changes in body composition have been identified as important risk factors for falling. Physical exercise is an important tool in fall prevention and management. The Pilates method is a non-impact activity that can be adapted to different physical conditions and health status and is recommended for various populations. In postmenopausal women, it has been deemed an effective way to improve some fall-related physical and psychological aspects, such as postural and dynamic balance. In addition, some physical capacities, such as flexibility, personal autonomy, mobility, and functional ability have also shown to benefit from Pilates interventions involving women in their second half of life, as well as certain psychological aspects including fear of falling, depressive status, and quality of life. Pilates exercise has shown effectively to prevent falls in postmenopausal women by improving their balance, physical and psychological functioning, and independence. Nevertheless, further studies are needed to demonstrate its validity in different clinical situations.

Alternative splicing and the progesterone receptor in breast cancer

PubMed Central

Cork, David MW; Lennard, Thomas WJ; Tyson-Capper, Alison J

2008-01-01

Progesterone receptor status is a marker for hormone responsiveness and disease prognosis in breast cancer. Progesterone receptor negative tumours have generally been shown to have a poorer prognosis than progesterone receptor positive tumours. The observed loss of progesterone receptor could be through a range of mechanisms, including the generation of alternatively spliced progesterone receptor variants that are not detectable by current screening methods. Many progesterone receptor mRNA variants have been described with deletions of various whole, multiple or partial exons that encode differing protein functional domains. These variants may alter the progestin responsiveness of a tissue and contribute to the abnormal growth associated with breast cancer. Absence of specific functional domains from these spliced variants may also make them undetectable or indistinguishable from full length progesterone receptor by conventional antibodies. A comprehensive investigation into the expression profile and activity of progesterone receptor spliced variants in breast cancer is required to advance our understanding of tumour hormone receptor status. This, in turn, may aid the development of new biomarkers of disease prognosis and improve adjuvant treatment decisions. PMID:18557990

Functional vitamin B-6 status and long-term mortality in renal transplant recipients.

PubMed

Minović, Isidor; van der Veen, Anna; van Faassen, Martijn; Riphagen, Ineke J; van den Berg, Else; van der Ley, Claude; Gomes-Neto, António W; Geleijnse, Johanna M; Eggersdorfer, Manfred; Navis, Gerjan J; Kema, Ido P; Bakker, Stephan Jl

2017-12-01

Background: Low plasma concentrations of pyridoxal 5'-phosphate (PLP) are common in renal transplant recipients (RTRs) and confer increased risk of long-term mortality. To our knowledge, it is not known whether low plasma PLP concentrations have functional (i.e., intracellular) consequences and, if so, whether such consequences are associated with increased risk of mortality. Objectives: We assessed the association of plasma PLP with functional vitamin B-6 status and explored the potential association of functional vitamin B-6 status with long-term mortality in RTRs. Design: In a longitudinal cohort of 678 stable RTRs with a median follow-up of 5.3 y (IQR: 4.8-6.1 y) and 297 healthy controls, PLP, plasma 3-hydroxykynurenine (3-HK), and xanthurenic acid (XA) were analyzed via validated assays. PLP was used as direct biomarker for vitamin B-6 status, and the 3-HK:XA ratio was used as functional biomarker of vitamin B-6 status with a higher ratio reflecting worse functional vitamin B-6 status. Results: Median PLP, 3-HK, and XA concentrations were 41 nmol/L (IQR: 29-60 nmol/L), 40.1 nmol/L (IQR: 33.0-48.0 nmol/L), and 19.1 nmol/L (IQR: 14.5-24.9 nmol/L), respectively, in healthy controls compared with 29 nmol/L (IQR: 17-50 nmol/L), 61.5 nmol/L (IQR: 45.6-86.5 nmol/L), and 25.5 nmol/L (IQR: 17.2-40.0 nmol/L), respectively, in RTRs (all P < 0.001). RTRs had a higher median 3-HK:XA ratio (2.38; IQR: 1.68-3.49) than did healthy controls (2.13; IQR: 1.63-2.71) ( P < 0.05). In RTRs, the 3-HK:XA ratio was inversely associated with plasma PLP (β = -0.21, P < 0.001). Moreover, a higher 3-HK:XA ratio was independently associated with increased risk of all-cause mortality (HR per SD increment: 1.30; 95% CI: 1.13, 1.49), cancer mortality (HR per SD increment: 1.47; 95% CI: 1.12, 1.95), and infectious disease mortality (HR per SD increment: 1.50; 95% CI: 1.21, 1.86) in RTRs. Conclusions: Vitamin B-6-deficient RTRs have a worse functional vitamin B-6 status than do healthy controls and vitamin B-6-sufficient RTRs. Worse functional vitamin B-6 status in RTRs is independently associated with an increased risk of mortality particularly because of cancer and infectious disease. This trial was registered at clinicaltrials.gov as NCT02811835. © 2017 American Society for Nutrition.

The association of menopause status with physical function: the Study of Women's Health Across the Nation.

PubMed

Tseng, Lisa A; El Khoudary, Samar R; Young, Elizabeth A; Farhat, Ghada N; Sowers, MaryFran; Sutton-Tyrrell, Kim; Newman, Anne B

2012-11-01

The aim of this study was to determine whether postmenopause status is associated with self-reported limitations in physical function. The Study of Women's Health Across the Nation is a multisite, multiethnic, longitudinal study of midlife women. Women aged 45 to 57 years (N = 2,566) completed the physical function scale of the Medical Outcomes Study Short-Form 36 on visit 4 (2000-2001). Scores created a three-category variable of physical function limitations: none (86-100), moderate (51-85), and substantial (0-50). In the Study of Women's Health Across the Nation, menopause status is a five-category list variable based on menstrual bleeding patterns and gynecological surgery. Premenopausal and perimenopausal women using hormones (n = 284) or missing physical function scores (n = 46) were excluded. Multinomial logistic regression was used to relate physical function and menopause status after adjustment for age, ethnicity, site, education, body mass index (BMI), and self-reported diabetes, hypertension, arthritis, depressive symptoms, smoking, and hormone use among postmenopausal women. Of 2,236 women, 8% were premenopausal, 51% were early perimenopausal, 12% were late perimenopausal, 24% were naturally postmenopausal, and 5% were surgically postmenopausal. In the full model, substantial limitations in physical function were higher in postmenopausal women, whether naturally postmenopausal (odds ratio, 3.82; 95% CI, 1.46-10.0) or surgically postmenopausal (odds ratio, 3.54; 95% CI, 1.15-10.84), than in premenopausal women. These associations were attenuated by higher BMI and depressive symptoms but remained significant. Moderate limitations in physical function were not significantly related to menopause status. Women experiencing surgical or naturally occurring postmenopause report greater limitations in physical function compared with premenopausal women, independent of age and only partly explained by higher BMI and depressive symptoms. This suggests that physiological changes in menopause could contribute directly to limitations in physical function.

Early exercise in critically ill patients enhances short-term functional recovery.

PubMed

Burtin, Chris; Clerckx, Beatrix; Robbeets, Christophe; Ferdinande, Patrick; Langer, Daniel; Troosters, Thierry; Hermans, Greet; Decramer, Marc; Gosselink, Rik

2009-09-01

: To investigate whether a daily exercise session, using a bedside cycle ergometer, is a safe and effective intervention in preventing or attenuating the decrease in functional exercise capacity, functional status, and quadriceps force that is associated with prolonged intensive care unit stay. A prolonged stay in the intensive care unit is associated with muscle dysfunction, which may contribute to an impaired functional status up to 1 yr after hospital discharge. No evidence is available concerning the effectiveness of an early exercise training intervention to prevent these detrimental complications. : Randomized controlled trial. : Medical and surgical intensive care unit at University Hospital Gasthuisberg. : Ninety critically ill patients were included as soon as their cardiorespiratory condition allowed bedside cycling exercise (starting from day 5), given they still had an expected prolonged intensive care unit stay of at least 7 more days. : Both groups received respiratory physiotherapy and a daily standardized passive or active motion session of upper and lower limbs. In addition, the treatment group performed a passive or active exercise training session for 20 mins/day, using a bedside ergometer. : All outcome data are reflective for survivors. Quadriceps force and functional status were assessed at intensive care unit discharge and hospital discharge. Six-minute walking distance was measured at hospital discharge. No adverse events were identified during and immediately after the exercise training. At intensive care unit discharge, quadriceps force and functional status were not different between groups. At hospital discharge, 6-min walking distance, isometric quadriceps force, and the subjective feeling of functional well-being (as measured with "Physical Functioning" item of the Short Form 36 Health Survey questionnaire) were significantly higher in the treatment group (p < .05). : Early exercise training in critically ill intensive care unit survivors enhanced recovery of functional exercise capacity, self-perceived functional status, and muscle force at hospital discharge.

Study of the relationship between quality of life and socioeconomic status in Isfahan at 2011.

PubMed

Keyvanara, Mahmoud; Khasti, Behjat Yazd; Zadeh, Marzie Rezaei; Modaber, Fatemeh

2015-01-01

Quality of life (QOL) is one of the health indexes for which many efforts have been made to define and measure during the last four decades of the 20(th) century in many countries. This paper is aimed at studying the QOL in relation to socioeconomic status of the general population of Isfahan in 1390. We applied a descriptive-analytical and sectional method. In this research, 385 women and men over 15 years of age from 14 regions of Isfahan's municipality were studied using multi-stage quota sampling. We examined QOL using the SF-36 standard questionnaire, along with two domains of mental and physical health and eight subscales within the validity domain of 65-90%. Social (81%) and economical (70%) status was also measured by the questionnaire instrument in both objective and subjective domains after confirming the validity and reliability of the instruments. The given data were analyzed by SPSS 17 software and using descriptive and statistical tests. The indicators of QOL showed that a score deviation of the SF-36 questionnaire in physical health (SD = 2.31) and mental health (SD = 3.22) domains was obtained from the population. Of the eight subscales, bodily pains and limitations on functioning as physical and mental had an inverse relationship with socioeconomic status. However, physical health, mental health, social activities, public health, and vitality had a significant positive relationship, including different strengths and weaknesses, with socioeconomic status. Also, sexuality and housing status had no relationship with QOL. There is a direct and significant relationship between quality of life and socioeconomic status variables in Isfahan.

Impact of Preoperative Radiotherapy on General and Disease-Specific Health Status of Rectal Cancer Survivors: A Population-Based Study

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

Thong, Melissa S.Y., E-mail: M.Thong@uvt.nl; Comprehensive Cancer Centre South, Eindhoven; Mols, Floortje

Purpose: To date, few studies have evaluated the impact of preoperative radiotherapy (pRT) on long-term health status of rectal cancer survivors. Using a population-based sample, we assessed the impact of pRT on general and disease-specific health status of rectal cancer survivors up to 10 years postdiagnosis. The health status of older ({>=}75 years old at diagnosis) pRT survivors was also compared with that of younger survivors. Methods and Materials: Survivors identified from the Eindhoven Cancer Registry treated with surgery only (SU) or with pRT between 1998 and 2007 were included. Survivors completed the Short Form-36 (SF-36) health survey questionnaire andmore » the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal 38 (EORTC QLQ-CR38) questionnaire. The SF-36 and EORTC QLQ-CR38 (sexuality subscale) scores of the survivors were compared to an age- and sex-matched Dutch normal population. Results: A total of 340 survivors (response, 85%; pRT survivors, 71%) were analyzed. Overall, survivors had similar general health status. Both short-term (<5 years) and long-term ({>=}5 years) pRT survivors had significantly poorer body image and more problems with gastrointestinal function, male sexual dysfunction, and defecation than SU survivors. Survivors had comparable general health status but greater sexual dysfunction than the normal population. Older pRT survivors had general and disease-specific health status comparable to that of younger pRT survivors. Conclusions: For better survivorship care, rectal cancer survivors could benefit from increased clinical and psychological focus on the possible long-term morbidity of treatment and its effects on health status.« less

Primary status, complementary status, and organizational survival in the U.S. venture capital industry.

PubMed

Bothner, Matthew S; Kim, Young-Kyu; Lee, Wonjae

2015-07-01

We introduce a distinction between two kinds of status and examine their effects on the exit rates of organizations investing in the U.S. venture capital industry. Extending past work on status-based competition, we start with a simple baseline: we describe primary status as a network-related signal of an organization's quality in a leadership role, that is, as a function of the degree to which an organization leads others that are themselves well regarded as lead organizations in the context of investment syndicates. Combining Harary's (1959) image of the elite consultant with Goffman's (1956) concept of "capacity-esteem," we then discuss complementary status as an affiliation-based signal of an organization's quality in a supporting role. We measure complementary status as a function of the extent to which an organization is invited into syndicates by well-regarded lead organizations-that is, by those possessing high levels of primary status. Findings show that, conditioning on primary status, complementary status reduces the rate at which venture capital organizations exit the industry. Consistent with the premise that these kinds of status correspond to different roles and market identities, we also find that complementary status attenuates (and ultimately reverses) the otherwise favorable effect of primary status on an organization's life chances. Theoretically and methodologically oriented scope conditions, as well as implications for future research, are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.