Combining apps targeting professionals and senior citizens to improve housing accessibility and influence housing provision policies.

PubMed

Helle, Tina; Iwarsson, Susanne; Lunn, Tine Bieber; Iversen, Mogens Holm; Jonsson, Oskar; Mårtensson, Knut; Svarre, Tanja; Slaug, Björn

2015-01-01

Two separate apps that address the increasingly important issue of accessible housing for senior citizens have been developed in different project settings. One of the apps was developed to facilitate the process for professional raters to assess housing accessibility in the context of individual housing adaptations. The other app was developed for senior citizens to raise their awareness of possible accessibility problems in their current dwelling and in other apartments within the available housing stock. Both apps were developed with a high degree of active user involvement in processes utilizing multiple state of the art methods. The results are two well accepted prototype apps perceived as user-friendly and appropriate for the intended user groups. By combining these two apps, our ambition is for the professional raters to benefit by gaining knowledge of their clients' perceived needs and desires, and for senior citizens to benefit by getting access to a database of professionally rated dwellings. The ultimate goal is the generation of sound knowledge reflecting the needs and desires of senior citizens and professional requirements regarding accessible housing as a means to inform and influence housing provision policies.

A comprehensive dwelling unit choice model accommodating psychological constructs within a search strategy for consideration set formation.

DOT National Transportation Integrated Search

2015-12-01

This study adopts a dwelling unit level of analysis and considers a probabilistic choice set generation approach for residential choice modeling. In doing so, we accommodate the fact that housing choices involve both characteristics of the dwelling u...

Serum disaccharides and osmolality in CCPD patients using icodextrin or glucose as daytime dwell.

PubMed

Posthuma, N; ter Wee, P M; Donker, A J; Oe, P L; van Dorp, W; Peers, E M; Verbrugh, H A

1997-01-01

To evaluate the safety, efficacy, and biocompatibility of icodextrin- and glucose-containing dialysis fluid during continuous cycling peritoneal dialysis (CCPD), patients were treated for 2 years with either icodextrin- or glucose-containing dialysis fluid for their daytime dwell (14-15 hours). Prior to entry into the study, all patients used a standard glucose solution (Dianeal 1.36%, 2.27%, or 3.86%, Baxter, Utrecht, The Netherlands). Open, randomized, prospective, two-center study. University hospital and teaching hospital. Both established and patients new to CCPD were included. A life expectancy of more than 2 years, a stable clinical condition, and written informed consent were necessary before entry. Patients aged under 18, those with peritonitis in the previous month, and women of childbearing potential, unless taking adequate contraceptive precautions, were excluded. Thirty-eight patients entered the study, and 25 (13 glucose, 12 icodextrin) had a follow-up period of 12 months or longer in December 1996. Serum icodextrin metabolites: one to five glucose units (G1-G5), a high molecular weight fraction (G > 10), and total carbohydrate level, as well as a biochemical profile were determined every 3 months in combination with all other study variables. In icodextrin-treated patients, serum disaccharide (maltose) concentrations increased from 0.05 +/- 0.01 (mean +/- SEM) at baseline, to an average concentration in the follow-up visits of 1.14 +/- 0.13 mg/mL (p < 0.001). All icodextrin metabolites increased significantly from baseline, as illustrated by the serum total carbohydrate minus glucose levels: from 0.42 +/- 0.05 mg/mL to an average concentration in the follow-up visits of 5.04 +/- 0.49 mg/mL (p < 0.001). At the same time, serum sodium levels decreased from 138.1 +/- 0.7 mmol/L to an average concentration in the follow-up visits of 135.4 +/- 0.8 mmol/L (p < 0.05). However, after 12 months the serum sodium concentration increased nonsignificantly (NS) from baseline to 136.6 +/- 0.9 mmol/L, after an initial decrease. Serum osmolality increased significantly from baseline in icodextrin users at 9 and 12 months, but did not differ significantly from glucose users in any visit. In icodextrin-treated patients, the calculated serum osmolal gap increased significantly from 4.1 +/- 1.4 mOsm/kg to an average of 11.8 +/- 1.7 mOsm/kg (p < 0.01). The sum of the serum icodextrin metabolites in millimoles/liter equaled the increase in osmolal gap. Body weight increased in icodextrin users (71.9 +/- 2.8 kg to 77.8 +/- 3.0 kg; NS). Clinical adverse effects did not accompany these findings. Residual renal function remained stable during follow-up. The serum icodextrin metabolite levels in the present study increased markedly and were the same as those found previously in continuous ambulatory peritoneal dialysis patients treated with icodextrin, despite the longer dwell time for CCPD patients (14-16 hr versus 8-12 hr). The initial decrease in serum sodium concentration was followed by an increase to a concentration not different from baseline at 12 months. The pathophysiology of this finding is speculated. Calculated osmolal gap in icodextrin patients increased significantly (p < 0.01) at every follow-up visit, and could be explained by the serum icodextrin metabolite increase. We encountered no clinical side effects of the observed levels of icodextrin metabolites.

Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use - a qualitative study.

PubMed

Bell, Hege Therese; Steinsbekk, Aslak; Granas, Anne Gerd

2017-09-01

The aim of the study was to explore how home-dwelling elderly who use fall-risk-increasing drugs (FRIDs) perceive their fall risk and how they relate this to their drug use. A qualitative study with 14 home-dwelling elderly FRID users between 65 and 97 years in Central Norway participating in semi-structured individual interviews. The data were analyzed thematically by using systematic text condensation. The main finding was that the informants did not necessarily perceive the use of FRIDs to be a prominent risk factor for falls. Some informants said they did not reflect upon drug use whatsoever and said they fully trusted their physician's choices. When either experiencing dizziness, fall episodes or by reading the patient information leaflet the informants said to either adjust their drug use or to contact their physician. Some felt rejected due to not getting their point across or their wish to alter the drug was not granted by the physician. Elderly FRID users did not necessarily relate their drug use to fall risk or struggled to present their perceived drug-related problems. Physicians need to regularly inform, monitor and assess the drug treatment when treating elderly with FRIDs.

Stakeholder Perceptions of Threatened Species and Their Management on Urban Beaches

PubMed Central

Maguire, Grainne S.; Rimmer, James M.; Weston, Michael A.

2013-01-01

Simple Summary Coastal urbanisation brings humans into contact with beach-dwelling wildlife. Where wildlife are disturbance prone, active management is required to promote coexistence between beach-goers and endangered wildlife. Coexistence relies on people adopting wildlife-sensitive behaviours. This study examines factors, which influence people’s awareness and perceptions of threatened species management in southern Australia, using Hooded Plover Thinornis rubricollis management as a model. The inconvenience experienced by beach goers in regard to plover management was low. Awareness and support for plover conservation were high. Frequency of beach use, whether a person was a dog walker, and awareness of the species and its plight, influenced perceptions. Abstract We surveyed 579 recreationists regarding management of the threatened, beach-dwelling Hooded Plover Thinornis rubricollis. We postulated that: (1) lower awareness of the species and higher ‘inconvenience’ of management would engender less favourable perceptions of conservation and management; and (2) that frequency of beach use and dog ownership may mediate perceptions and levels of awareness and inconvenience. Overall, inconvenience was low while awareness and support for plover conservation were high. Education and awareness strategies were considered less effective than regulations; exclusion and regulations were considered less desirable than on-ground protective measures. Awareness, frequency of beach use and dog walking did not influence the perceived effectiveness of different managements. More frequent beach users had greater awareness of the species and their plight but reported greater inconvenience associated with management. Respondents with high awareness rated the severity of human-related threats higher; low awareness was associated with more inconvenience associated with on-ground protection, and exclusion and regulations. Dog walkers reported more inconvenience associated with exclusions and regulations than non-dog walkers. Dog walkers who used the beach infrequently rated threats significantly higher than frequent beach users. Conservation and education strategies could usefully be tailored to beach users’ level of use and pet ownership. PMID:26479749

A Mobile Food Record For Integrated Dietary Assessment*

PubMed Central

Ahmad, Ziad; Kerr, Deborah A.; Bosch, Marc; Boushey, Carol J.; Delp, Edward J.; Khanna, Nitin; Zhu, Fengqing

2017-01-01

This paper presents an integrated dietary assessment system based on food image analysis that uses mobile devices or smartphones. We describe two components of our integrated system: a mobile application and an image-based food nutrient database that is connected to the mobile application. An easy-to-use mobile application user interface is described that was designed based on user preferences as well as the requirements of the image analysis methods. The user interface is validated by user feedback collected from several studies. Food nutrient and image databases are also described which facilitates image-based dietary assessment and enable dietitians and other healthcare professionals to monitor patients dietary intake in real-time. The system has been tested and validated in several user studies involving more than 500 users who took more than 60,000 food images under controlled and community-dwelling conditions. PMID:28691119

Comparison of indoor air quality in electrified and un-electrified dwellings in rural South African villages.

PubMed

Röllin, H B; Mathee, A; Bruce, N; Levin, J; von Schirnding, Y E R

2004-06-01

A feasibility study was undertaken to assess the suitability of South African rural villages due to be electrified, for the purposes of undertaking a large-scale study of the impact of reductions in indoor air pollution on acute lower respiratory infections. As part of the feasibility study, quantitative assessments of indoor air pollution in non-electrified and electrified dwellings were performed. Concurrent measurements were made of levels of respirable particulate matter (RSP-stationary), and carbon monoxide (CO) (personal on children <18 months), as well as a stationary co-located with RSP) over a 24-h period in 52 un-electrified and 53 electrified dwellings. The proportion of dwellings with a detectable 24-h concentration of RSP was significantly higher in un-electrified (48.1%) than electrified dwellings (24.5%) (chi(2) = 6.30 on 1 d.f., P = 0.012). In addition a Kruskal-Wallis test (adjusted for ties) showed that the distribution of RSP differed between un-electrified and electrified areas (Kruskal-Wallis chi(2) = 8.20 on 1 d.f., P = 0.014). In those dwellings where some RSP was detected, the amount was on average higher in the un-electrified areas (mean 162 microg/m(3), median 107 microg/m(3)) than in the electrified areas (mean 77 microg/m(3), median 37.5 microg/m(3)). Stationary (kitchen CO) levels in un-electrified dwellings ranged from 0.36 to 20.95 p.p.m. However, in electrified dwellings, kitchen levels ranged from 0 to 11.8 p.p.m. When mean concentrations of CO were compared between electrified and un-electrified dwellings using a two-sample t-test (on log-transformed data), there was overwhelming evidence (P = 0.0004) that the mean level of log (CO) in the kitchen was higher in the un-electrified areas (1.25 vs. 0.69) and also overwhelming evidence (P < 0.0001) that the mean level of log (CO) on the child was higher in the un-electrified areas (0.83 vs. 0.34). Of importance in terms of both policy and for a potential future large-scale study, is that measurable significant differences in indoor pollutants between electrified and un-electrified dwellings during summer were found in spite of only partial transition to electricity use for cooking in electrified villages. It is estimated that at least two-thirds of all households in the developing world are still primary dependent on biomass fuels and coal. This situation applies to 59% of rural households in South Africa. In the last decade a program of providing electricity to three million homes has been underway in South Africa. Among others this intervention aims to reduce exposure to pollutants from burning biomass fuels and reduce detrimental health effects, especially in young children. This study provides scientific evidence that electrified homes in South African villages have lower levels of air pollution (RSP and CO) relative to their non-electrified counterparts.

Concomitant use of analgesics and psychotropics in home-dwelling elderly people – Kuopio 75 + study

PubMed Central

Hartikainen, Sirpa; Mäntyselkä, Pekka; Louhivuori-Laako, Kirsti; Enlund, Hannes; Sulkava, Raimo

2005-01-01

Aims To investigate the extent of concomitant use of analgesic and psychotropic medicines among home-dwelling elderly people aged at least 75 years in Finland. Methods This was a population-based study in Finland, performed as part of Kuopio 75 + study focusing on the clinical epidemiology of diseases, medication and functional capacity. A random sample of 700 persons was drawn from the total population of the city of Kuopio, eastern Finland, aged 75 years on January 1, 1998 (n = 4518). Ninety-nine persons could not be examined and 78 were living in long-term institutions, so that the number of home-dwelling elderly persons amounted to 523. A trained nurse interviewed the participants about their use of medicines, and a geriatrician examined their overall physical and mental status. Dementia and depression were diagnosed according to the DSM IV criteria. Both regular and irregular prescribed and nonprescribed drug use was recorded. Results Every fourth elderly person (27.2%) used analgesics and psychotropics concomitantly, this use becoming twice as common with advancing age (19.6% in the age group 75–79 years, 38.2% among the oldest, aged 85 + years). Concomitant use of psychotropics and opioids also became more common with increasing age (2.8% in age group 75–79 years and 9.6% in the oldest group, aged 85 + years). The use of opioids was nearly twice as common among concomitant users (19.7%) than among those using only analgesics (11.3%). Concomitant users suffered from interfering daily pain and daily pain at rest more commonly than nonusers of analgesics. Depression, sleeping problems and polypharmacy were more common among the concomitant users, who had also had more hip fractures than the rest. Conclusions Concomitant use of analgesics and psychotropics becomes more common with advancing age and is a potential risk factor for adverse drug effects. PMID:16120070

THE EFFECT OF THE GHETTO ON THE DISTRIBUTION AND LEVEL OF NONWHITE EMPLOYMENT IN URBAN AREAS.

DTIC Science & Technology

URBAN AREAS, HOUSING(DWELLINGS)), (*HOUSING(DWELLINGS), URBAN AREAS), (*MANPOWER, URBAN AREAS), (*SOCIOLOGY, URBAN AREAS), POPULATION, URBAN PLANNING, HOUSING PROJECTS, DISTRIBUTION, LABOR , ECONOMICS

THE EFFECT OF THE GHETTO ON THE DISTRIBUTION AND LEVEL OF NONWHITE EMPLOYMENT IN URBAN AREAS,

DTIC Science & Technology

URBAN AREAS, HOUSING(DWELLINGS)), (*HOUSING(DWELLINGS), URBAN AREAS), (*MANPOWER, URBAN AREAS), (*SOCIOLOGY, URBAN AREAS), POPULATION, URBAN PLANNING, HOUSING PROJECTS, DISTRIBUTION, LABOR , ECONOMICS

Investigating Intrinsic and Extrinsic Variables During Simulated Internet Search

NASA Technical Reports Server (NTRS)

Liechty, Molly M.; Madhavan, Poornima

2011-01-01

Using an eye tracker we examined decision-making processes during an internet search task. Twenty experienced homebuyers and twenty-five undergraduates from Old Dominion University viewed homes on a simulated real estate website. Several of the homes included physical properties that had the potential to negatively impact individual perceptions. These negative externalities were either easy to change (Level 1) or impossible to change (Level 2). Eye movements were analyzed to examine the relationship between participants' "stated preferences"[verbalized preferences], "revealed preferences" [actual decisions[, and experience. Dwell times, fixation durations/counts, and saccade counts/amplitudes were analyzed. Results revealed that experienced homebuyers demonstrated a more refined search pattern than novice searchers. Experienced homebuyers were also less impacted by negative externalities. Furthermore, stated preferences were discrepant from revealed preferences; although participants initially stated they liked/disliked a graphic, their eye movement patterns did not reflect this trend. These results have important implications for design of user-friendly web interfaces.

RAETRAD-F: VERSION 1.1 USER'S GUIDE FOR ANALYZING SITE-SPECIFIC MEASUREMENTS OF SOIL RADON POTENTIAL CATEGORY FOR FLORIDA HOUSES

EPA Science Inventory

The document describes RAETRAD-F (RAdon Emanation and TRAnsport into Dwellings--Florida), a computer code that provides a simple way to analyze site-specific soil measurements to estimate upper-limit indoor radon concentrations in a reference house on a site. The code uses data f...

High Throughput Protein Quantitation using MRM Viewer Software and Dynamic MRM on a Triple Quadruple Mass Spectrometer

PubMed Central

Miller, C.; Waddell, K.; Tang, N.

2010-01-01

RP-122 Peptide quantitation using Multiple Reaction Monitoring (MRM) has been established as an important methodology for biomarker verification andvalidation.This requires high throughput combined with high sensitivity to analyze potentially thousands of target peptides in each sample.Dynamic MRM allows the system to only acquire the required MRMs of the peptide during a retention window corresponding to when each peptide is eluting. This reduces the number of concurrent MRM and therefore improves quantitation and sensitivity. MRM Selector allows the user to generate an MRM transition list with retention time information from discovery data obtained on a QTOF MS system.This list can be directly imported into the triple quadrupole acquisition software.However, situations can exist where a) the list of MRMs contain an excess of MRM transitions allowable under the ideal acquisition conditions chosen ( allowing for cycle time and chromatography conditions), or b) too many transitions in a certain retention time region which would result in an unacceptably low dwell time and cycle time.A new tool - MRM viewer has been developed to help users automatically generate multiple dynamic MRM methods from a single MRM list.In this study, a list of 3293 MRM transitions from a human plasma sample was compiled.A single dynamic MRM method with 3293 transitions results in a minimum dwell time of 2.18ms.Using MRM viewer we can generate three dynamic MRM methods with a minimum dwell time of 20ms which can give a better quality MRM quantitation.This tool facilitates both high throughput and high sensitivity for MRM quantitation.

Effects of road traffic noise and the benefit of access to quietness

NASA Astrophysics Data System (ADS)

Öhrström, E.; Skånberg, A.; Svensson, H.; Gidlöf-Gunnarsson, A.

2006-08-01

Socio-acoustic surveys were carried out as part of the Soundscape Support to Health research programme to assess the health effects of various soundscapes in residential areas. The study was designed to test whether having access to a quiet side of one's dwelling enhances opportunities for relaxation and reduces noise annoyance and other adverse health effects related to noise. The dwellings chosen were exposed to sound levels from road traffic ranging from about L=45-68 dB at the most-exposed side. The study involved 956 individuals aged 18-75 years. The results demonstrate that access to quiet indoor and outdoor sections of one's dwelling supports health; it produces a lower degree and extent of annoyance and disturbed daytime relaxation, improves sleep and contributes to physiological and psychological well-being. Having access to a quiet side of one's dwelling reduces disturbances by an average of 30-50% for the various critical effects, and corresponds to a reduction in sound levels of ( LAeq,24h) 5 dB at the most-exposed side. To protect most people (80%) from annoyance and other adverse effects, sound levels from road traffic should not exceed ( LAeq,24h) 60 dB at the most-exposed side, even if there is access to a quiet side of one's dwelling ( LAeq,24h⩽45 dB).

The potential benefit of a home fire safety intervention during emergency medical services calls.

PubMed

Pirrallo, R G; Rubin, J M; Murawsky, G A

1998-03-01

To determine how often house fires occur at 1- and 2-family dwellings visited previously by emergency medical services (EMS) personnel and whether these visits were missed opportunities for a point-of-contact home fire safety intervention. A retrospective, consecutive, case series analysis of all Milwaukee Fire Department alarm responses during 1994 was performed. Measurements included date of service, type of response, property type, dollar loss estimate, number of injuries and fatalities, cause of alarm, and presence of an operational smoke detector. Descriptive, chi2, and relative risk statistics were used to describe the relationship between EMS responses and fire responses at 1- and 2-family dwellings. The Milwaukee Fire Department dispatched 94,378 requests for service to 43,556 addresses. 16,150 addresses generated multiple requests; 7.2% (1,162/16,150) were for an "alarm of fire" response [relative risk 1.83 (95% CI: 1.69-1.99) for addresses with multiple requests vs those with a single request for service]. Most [62% (721/1,162)] of the addresses were visited by EMS personnel prior to the alarm; 28% (205/721) were 1- and 2-family dwellings. A mean of 1.8 (376/205) EMS responses occurred prior to the "alarm of fire" response; 121 addresses received 1 response, 46 received 2, 18 received 3, and 20 received > or = 4 responses. Of 169 addresses with complete data, there was a total fire dollar loss of $1,963,020 (1994) along with 32 injuries and 0 fatalities. While 47% (80/169) of the 1- and 2-family dwellings had a smoke detector present, only 17% (29/169) of the dwellings had an operational smoke detector. A point-of-contact home fire safety intervention appears of potential benefit for frequent users of EMS care. Determination of the presence of an operational smoke detector in 1- and 2-family dwellings may be a useful injury prevention act during such EMS calls.

Passive Measurements of Thoron and its Progeny in some Dwellings in Ireland

NASA Astrophysics Data System (ADS)

Choncubhair, Órlaith Ní; Laughlin, James Mc; Tokonami, Shinji

2008-08-01

In this paper, an account is given of the development, calibration and field use of a passive alpha track detector sensitive to thoron as well as to radon. No database of thoron and thoron progeny concentrations in dwellings in Ireland exists and, as a result, the level of exposure of the Irish population to thoron and its progeny is unknown. As an initial or pilot stage in establishing such a data base measurements of thoron and thoron progeny concentrations (the latter expressed in Equilibrium Equivalent Thoron Concentration (EETC)) were made in 40 randomly chosen Irish dwellings. The EETC measurements were made using a passive thoron progeny deposition rate monitor designed and supplied by NIRS (Japan). In addition standard unmodified SSI passive radon detectors were used to measure radon in these dwellings. The measured thoron concentrations ranged from below the level of detection to 154 Bq/m3 while the radon gas ranged from 15 to 179 Bq/m3. The thoron progeny EETC values for these dwellings ranged from 0.03 to 7.7 Bq/m3. An account is also given of the dosimetric implications of these measurements.

The added value of user involvement during the development of a feedback system regarding physical functioning for community-dwelling elderly people

PubMed Central

Vermeulen, Joan; Neyens, Jacques C. L; Spreeuwenberg, Marieke D; Van Rossum, Erik; Hewson, David; De Witte, Luc P

2012-01-01

Background The number of frail elderly people is increasing. Unfortunately, the number of caregivers is not increasing at the same pace, which affects older people, caregivers and healthcare systems. Because of these developments, self-management is becoming more important in healthcare. To support community-dwelling elderly people in their self-management, a system was developed that monitors their physical functioning. This system provides feedback to elderly people and their caregivers regarding physical indicators of frailty. The feedback is provided to elderly people via the screen of a mobile phone. It is important that elderly people understand the content of the feedback and are able to use the mobile phone properly. If not, it is unlikely that the system can support self-management. Many interactive health technologies that have been developed do not fulfil their promises. An important reason for this is that human and other non-technology issues are not sufficiently taken into consideration during the development process. Objective To collaborate with elderly people during the development and evaluation of a feedback system for community-dwelling elderly people regarding physical functioning. Methods An iterative user-centered design that consists of five phases was used to develop and evaluate the feedback system. These five phases were: 1) Selection of users, 2) Analysis of users and their context, 3) Identification of user needs, 4) Development of a prototype, and 5) Evaluation of the prototype. Three representatives of a target group panel for elderly people were selected in phase 1. They shared their needs and preferences during three expert group meetings that took place during the development process. This resulted in the development of a prototype which was first evaluated in a heuristic evaluation. Once adjustments were made, 11 elderly people evaluated the adjusted prototype using a think aloud procedure. They rated the usability and acceptability of the developed interface on a scale from 1 till 7 using an adapted version of the Post-Study System Usability Questionnaire (PSSUQ). Results A feedback system was developed that provides feedback regarding physical indicators of frailty via a touch screen mobile phone. The interface uses colours, smiley’s, and spoken/written messages to provide feedback that is easy to understand. The heuristic evaluation revealed that there were some problems with consistency and the use of user language. The think aloud evaluation showed that the 11 elderly people were able to navigate through the interface without much difficulty despite some small problems related to the lay-out of the interface. The mean score on an adapted version of the PSSUQ was 5.90 (SD 1.09) which indicates high user satisfaction and good usability. Conclusions The involvement of end-users significantly influenced the lay-out of the interface that was developed. This resulted in an interface that was accepted by the target group. Evaluation of the prototype revealed that the usability of the interface was good. The feedback system will only succeed in supporting self-management when elderly people are able to use the interface and understand the feedback. The input of elderly people during the development process contributed to this.

Antidepressant Use and Recurrent Falls in Community-Dwelling Older Adults: Findings From the Health ABC Study.

PubMed

Marcum, Zachary A; Perera, Subashan; Thorpe, Joshua M; Switzer, Galen E; Castle, Nicholas G; Strotmeyer, Elsa S; Simonsick, Eleanor M; Ayonayon, Hilsa N; Phillips, Caroline L; Rubin, Susan; Zucker-Levin, Audrey R; Bauer, Douglas C; Shorr, Ronald I; Kang, Yihuang; Gray, Shelly L; Hanlon, Joseph T

2016-07-01

Few studies have compared the risk of recurrent falls across various antidepressant agents-using detailed dosage and duration data-among community-dwelling older adults, including those who have a history of a fall/fracture. To examine the association of antidepressant use with recurrent falls, including among those with a history of falls/fractures, in community-dwelling elders. This was a longitudinal analysis of 2948 participants with data collected via interview at year 1 from the Health, Aging and Body Composition study and followed through year 7 (1997-2004). Any antidepressant medication use was self-reported at years 1, 2, 3, 5, and 6 and further categorized as (1) selective serotonin reuptake inhibitors (SSRIs), (2) tricyclic antidepressants, and (3) others. Dosage and duration were examined. The outcome was recurrent falls (≥2) in the ensuing 12-month period following each medication data collection. Using multivariable generalized estimating equations models, we observed a 48% greater likelihood of recurrent falls in antidepressant users compared with nonusers (adjusted odds ratio [AOR] = 1.48; 95% CI = 1.12-1.96). Increased likelihood was also found among those taking SSRIs (AOR = 1.62; 95% CI = 1.15-2.28), with short duration of use (AOR = 1.47; 95% CI = 1.04-2.00), and taking moderate dosages (AOR = 1.59; 95% CI = 1.15-2.18), all compared with no antidepressant use. Stratified analysis revealed an increased likelihood among users with a baseline history of falls/fractures compared with nonusers (AOR = 1.83; 95% CI = 1.28-2.63). Antidepressant use overall, SSRI use, short duration of use, and moderate dosage were associated with recurrent falls. Those with a history of falls/fractures also had an increased likelihood of recurrent falls. © The Author(s) 2016.

Performance assessment of the BEBIG MultiSource® high dose rate brachytherapy treatment unit

NASA Astrophysics Data System (ADS)

Palmer, Antony; Mzenda, Bongile

2009-12-01

A comprehensive system characterisation was performed of the Eckert & Ziegler BEBIG GmbH MultiSource® High Dose Rate (HDR) brachytherapy treatment unit with an 192Ir source. The unit is relatively new to the UK market, with the first installation in the country having been made in the summer of 2009. A detailed commissioning programme was devised and is reported including checks of the fundamental parameters of source positioning, dwell timing, transit doses and absolute dosimetry of the source. Well chamber measurements, autoradiography and video camera analysis techniques were all employed. The absolute dosimetry was verified by the National Physical Laboratory, UK, and compared to a measurement based on a calibration from PTB, Germany, and the supplied source certificate, as well as an independent assessment by a visiting UK centre. The use of the 'Krieger' dosimetry phantom has also been evaluated. Users of the BEBIG HDR system should take care to avoid any significant bend in the transfer tube, as this will lead to positioning errors of the source, of up to 1.0 mm for slight bends, 2.0 mm for moderate bends and 5.0 mm for extreme curvature (depending on applicators and transfer tube used) for the situations reported in this study. The reason for these errors and the potential clinical impact are discussed. Users should also note the methodology employed by the system for correction of transit doses, and that no correction is made for the initial and final transit doses. The results of this investigation found that the uncorrected transit doses lead to small errors in the delivered dose at the first dwell position, of up to 2.5 cGy at 2 cm (5.6 cGy at 1 cm) from a 10 Ci source, but the transit dose correction for other dwells was accurate within 0.2 cGy. The unit has been mechanically reliable, and source positioning accuracy and dwell timing have been reproducible, with overall performance similar to other existing HDR equipment. The unit is capable of high quality brachytherapy treatment delivery, taking the above factors into account.

Educational program for physicians to reduce use of non-steroidal anti-inflammatory drugs among community-dwelling elderly persons: a randomized controlled trial.

PubMed

Ray, W A; Stein, C M; Byrd, V; Shorr, R; Pichert, J W; Gideon, P; Arnold, K; Brandt, K D; Pincus, T; Griffin, M R

2001-05-01

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs for patients 65 years of age or older, primarily for musculoskeletal symptoms of osteoarthritis. Because NSAIDs frequently cause serious gastrointestinal (GI) and other complications among elderly patients, expert guidelines for osteoarthritis recommend acetaminophen-based regimens, which are safer and often as effective as NSAIDs. Evaluate a physician education program that communicated guidelines for management of osteoarthritis in elderly patients that emphasized avoidance of NSAIDs when possible. The program reviewed NSAID risks and benefits and recommended: re-evaluating continuous NSAID users, considering substitution of up to 4 g/d of acetaminophen for the NSAID, and trying topical agents and nonpharmacologic measures. Randomized controlled trial among community-dwelling Tennessee Medicaid enrollees. Study physicians had 5 or more patients who: were community-dwelling Medicaid enrollees 65 years of age or older; had used NSAIDs regularly for at least 180 days; had had no medical care encounters during this period suggesting an indication other than osteoarthritis; and had 1 year of baseline and follow-up data. The study thus included 209 physicians (103 intervention/106 control) with 1,566 qualifying regular NSAID users (768/798). Face-to-face visit to study physicians by another physician, and reminder placements in the charts of patients eligible to have NSAID use reevaluated. Change between baseline and follow-up years in: days of prescribed NSAIDs, acetaminophen, other drugs for musculoskeletal disorders, and GI drugs; outpatient visits and inpatient days of stay; SF36 measures of general health, physical function, and bodily pain (from 40% random patient sample); and over-the-counter NSAIDs (from the sample). Intervention-attributable reduction of 7% (95% CI, 3% to 11%) in days of prescribed NSAIDs use with concomitant increase in acetaminophen use. No significant changes in other study endpoints. The intervention effect was greater among 75 physicians with a completed study visit, whose 564 patients had a 10% (95% CI, 6% to 14%) attributable reduction in NSAID use. The educational program modestly reduced NSAID exposure in community-dwelling elderly patients without undesirable substitution of other medications or detectable worsening of musculoskeletal symptoms.

Characteristics of carbonyls: Concentrations and source strengths for indoor and outdoor residential microenvironments in China

NASA Astrophysics Data System (ADS)

Wang, B.; Lee, S. C.; Ho, K. F.

Indoor and outdoor carbonyl concentrations were measured simultaneously in 12 urban dwellings in Beijing, Shanghai, Guangzhou, and Xi'an, China in summer (from July to September in 2004) and winter (from December 2004 to February 2005). Formaldehyde was the most abundant indoor carbonyls species, while formaldehyde, acetaldehyde and acetone were found to be the most abundant outdoor carbonyls species. The average formaldehyde concentrations in summer indoor air varied widely between cities, ranging from a low of 19.3 μg m -3 in Xi'an to a high of 92.8 μg m -3 in Beijing. The results showed that the dwellings with tobacco smoke, incense burning or poor ventilation had significantly higher indoor concentrations of certain carbonyls. It was noticed that although one half of the dwellings in this study installed with low emission building materials or furniture, the carbonyls levels were still significantly high. It was also noted that in winter both the indoor and outdoor acetone concentrations in two dwellings in Guangzhou were significantly high, which were mainly caused by the usage of acetone as industrial solvent in many paint manufacturing and other industries located around Guangzhou and relatively longer lifetime of acetone for removal by photolysis and OH reaction than other carbonyls species. The indoor carbonyls levels in Chinese dwellings were higher than that in dwellings in the other countries. The levels of indoor and ambient carbonyls showed great seasonal differences. Six carbonyls species were carried out the estimation of indoor source strengths. Formaldehyde had the largest indoor source strength, with an average of 5.25 mg h -1 in summer and 1.98 mg h -1 in winter, respectively. However, propionaldehyde, crotonaldehyde and benzaldehyde had the weakest indoor sources.

Stigma and prejudice: the experience of crack users.

PubMed

Bard, Nathália Duarte; Antunes, Beatriz; Roos, Cristine Moraes; Olschowsky, Agnes; de Pinho, Leandro Barbosa

2016-01-01

to evaluate the stigma and prejudice experienced by crack users in their social context. a qualitative study developed through the Fourth Generation Evaluation, conducted with four interest groups (ten users, eleven families, eight employees, and seven managers), components of the mental health care network. For data collection, we used observation and individual interview. The analysis was performed through the constant comparative method. crack users suffer prejudice and are stigmatized as those who do not fit in the systems established by society (without family links, formal employment and dwelling), and are thus excluded. They exhibit undisciplined behavior and, therefore, are discriminated, marginalized and considered as criminals, losing their uniqueness and living in vulnerable situations. the evaluation process emphasized the need to demystify the social imaginary that demonizes the chemically dependent, being thus important to develop public policies with actions focused on health, prevention, information and combat to stigma.

Concomitant use of acetylcholine esterase inhibitors and urinary antispasmodics among Finnish community-dwelling persons with Alzheimer disease.

PubMed

Torvinen-Kiiskinen, Sanna; Taipale, Heidi; Tanskanen, Antti; Tiihonen, Jari; Hartikainen, Sirpa

2014-12-01

Concomitant use of acetylcholine esterase inhibitors (AChEIs) and anticholinergic drugs, such as urinary antispasmodics (UA), is generally considered as inappropriate because of their opposite pharmacological actions. However, prevalence and the duration or factors associated with concomitant use have not been previously studied among community-dwelling persons with Alzheimer disease (AD). The aim of this study was to examine the prevalence and duration of concomitant use of AChEIs and UAs among community-dwelling persons with AD and factors associated with concomitant use. Register-based data of the MEDALZ-2005 Study included all community-dwelling persons with clinically diagnosed AD at the end of year 2005 in Finland. Persons using AChEI drugs during the 4-year follow-up (2006-2009) were included in the present study (n = 20,442). Among AChEI users, 1576 persons used UA during the follow-up. Prevalence of concomitant use of AChEIs and UAs was 7.3% (n = 1491) during the 4-year follow-up. The median duration of concomitant use was 236 days. Factors associated with concomitant use were age younger than 80 years (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.08-1.34), male sex (OR, 1.16; 95% CI, 1.04-1.30), Parkinson disease (OR, 1.98; 95% CI, 1.55-2.52), diabetes (OR, 1.25; 95% CI, 1.08-1.45), and prostatic cancer (OR, 1.54; 95% CI, 1.13-2.09). Despite their antagonizing action, concomitant use of AChEIs and UAs was quite common among Finnish community-dwelling persons with AD. In addition, duration of concomitant use was comparatively long. It is recommended to consider some other options than UAs to treat urinary incontinence among persons with AD.

Occupant Interactions and Effectiveness of Natural Ventilation Strategies in Contemporary New Housing in Scotland, UK.

PubMed

Sharpe, Tim; Farren, Paul; Howieson, Stirling; Tuohy, Paul; McQuillan, Jonathan

2015-07-21

The need to reduce carbon emissions and fuel poverty has led to increased building envelope air tightness, intended to reduce uncontrolled ventilation heat losses. Ventilation strategies in dwellings still allow the use of trickle ventilators in window frames for background ventilation. The extent to which this results in "healthy" Indoor Air Quality (IAQ) in recently constructed dwellings was a concern of regulators in Scotland. This paper describes research to explore this. First a review of literature was conducted, then data on occupant interactions with ventilation provisions (windows, doors, trickle vents) gathered through an interview-based survey of 200 recently constructed dwellings, and measurements made on a sample of 40 of these. The main measured parameter discussed here is CO2 concentration. It was concluded after the literature review that 1000 ppm absolute was a reasonable threshold to use for "adequate" ventilation. The occupant survey found that there was very little occupant interaction with the trickle ventilators e.g., in bedrooms 63% were always closed, 28% always open, and in only 9% of cases occupants intervened to make occasional adjustments. In the measured dwellings average bedroom CO2 levels of 1520 ppm during occupied (night time) hours were observed. Where windows were open the average bedroom CO2 levels were 972 ppm. With windows closed, the combination of "trickle ventilators open plus doors open" gave an average of 1021 ppm. "Trickle ventilators open" gave an average of 1571 ppm. All other combinations gave averages of 1550 to 2000 ppm. Ventilation rates and air change rates were estimated from measured CO2 levels, for all dwellings calculated ventilation rate was less than 8 L/s/p, in 42% of cases calculated air change rate was less than 0.5 ach. It was concluded that trickle ventilation as installed and used is ineffective in meeting desired ventilation rates, evidenced by high CO2 levels reported across the sampled dwellings. Potential implications of the results are discussed.

The relation between radon in schools and in dwellings: A case study in a rural region of Southern Serbia.

PubMed

Žunić, Z S; Bossew, P; Bochicchio, F; Veselinovic, N; Carpentieri, C; Venoso, G; Antignani, S; Simovic, R; Ćurguz, Z; Udovicic, V; Stojanovska, Z; Tollefsen, T

2017-02-01

Recognized as a significant health hazard, radon (Rn) has been given increasing attention for years. Surveys of different kinds have been performed in many countries to assess the intensity and the geographical extent of possible Rn problems. Common surveys cover mainly dwellings, the indoor place with highest occupancy, and schools, where people spend a large fraction of their lifetime and which can also be considered exemplary for Rn exposure at workplaces; it has however been observed that relating them is difficult. It was unclear whether residential Rn at a location, or in a region, can be predicted by Rn at a school of that location, or vice versa. To current knowledge, no general rule seems applicable, as few models to describe the relationship between Rn in dwellings and in schools have been developed. In Southern Serbia, a Rn survey in a predominantly rural region was based on measurements in primary schools. The question arose whether or to which degree the results can be considered as indicative or even representative for residential Rn concentrations. To answer the question an additional survey of indoor Rn concentrations in dwellings was initiated, designed and performed in Sokobanja district in 2010-2012 in a manner to be able to detect a relationship if it exists. In the study region, 108 dwellings in 12 villages and towns were selected, with one primary school each. In this paper, we investigate how a relation between Rn in schools and dwellings could be identified and quantified, by developing a model and using experimental data from both the above main and additional surveys. The key criterion is the hypothesis that the relation dwellings - schools, if it exists, is stronger for dwellings closer to a school than for those dwellings further away. We propose methods to test the hypothesis. As result, the hypothesis is corroborated at 95% significance level. More specifically, on town level (typical size about 1 km), the Rn concentration ratio dwelling/school is about 0.8 (geometrical mean), with geometrical standard deviation (GSD) about 1.9. For dwelling and school hypothetically in the same location, the ratio is estimated about 0.7 with GSD about 1.5. We think that the methodology can be applied to structurally similar problems. The results could be used to create "conditional maps" of Rn concentration in dwellings, i.e., for example a map of probabilities that indoor Rn concentrations in dwellings exceed 100 Bq/m 3 , as function of Rn concentration in the local school. Copyright © 2016 Elsevier Ltd. All rights reserved.

The relationship between eating-related individual differences and visual attention to foods high in added fat and sugar.

PubMed

Gearhardt, Ashley N; Treat, Teresa A; Hollingworth, Andrew; Corbin, William R

2012-12-01

Attentional biases for food-related stimuli may be associated separately with obesity, disordered eating, and hunger. We tested an integrative model that simultaneously examines the association of body mass index (BMI), disordered eating and hunger with food-related visual attention to processed foods that differ in added fat/sugar level (e.g., sweets, candies, fried foods) relative to minimally processed foods (e.g., fruits, meats/nuts, vegetables) that are lower in fat/sugar content. One-hundred overweight or obese women, ages 18-50, completed a food-related visual search task and measures associated with eating behavior. Height and weight were measured. Higher levels of hunger significantly predicted increased vigilance for sweets and candy and increased vigilance for fried foods at a trend level. Elevated hunger was associated significantly with decreased dwell time on fried foods and, at a trend level, with decreased dwell time on sweets. Higher BMIs emerged as a significant predictor of decreased vigilance for fried foods, but BMI was not related to dwell time. Disordered eating was unrelated to vigilance for or dwell time on unhealthy food types. This pattern of findings suggests that low-level attentional biases may contribute to difficulties making healthier food choices in the current food environment and may point toward useful strategies to reduce excess food consumption. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Relationship between the swallowing function and the health-related QOL among community-dwelling dependent elderly persons].

PubMed

Morisaki, Naoko; Miura, Hiroko; Moriya, Shingo; Hara, Shuichi

2014-01-01

We examined the relationship between the swallowing function and the health-related QOL (quality of life) among community-dwelling dependent elderly persons. The subjects included 191 community-dwelling dependent elderly persons. Data were collected via questionnaires, including information regarding age, gender, the level of care required, post-cerebrovascular disease, the health-related QOL and the swallowing function. We used the SF-8 to measure the health-related QOL and the DRACE (Dysphagia Risk Assessment for the Community-dwelling Elderly) to evaluate the swallowing function. The average DRACE score was 4.29±3.81. In addition, the swallowing risk was found to be related to the SF (social functioning) and MH (mental health) subscales of the SF-8. Our results suggest that the swallowing function is significantly related to the health-related QOL among community-dwelling dependent elderly persons.

A preliminary examination of the translocation of microencapsulated cyfluthrin following applications to the perimeter of residential dwellings.

PubMed

Stout, D M; Leidy, R B

2000-07-01

Methods have been developed to monitor the translocation of microencapsulated cyfluthrin following perimeter applications to residential dwellings. A pilot study was implemented to determine both the potential for application spray to drift away from dwellings and the intrusion of residues into homes following perimeter treatments. Residential monitoring included measuring spray drift using cellulose filter paper and the collection of soil samples from within the spray zone. In addition, interior air was monitored using fiberglass filter paper as a sorbent medium and cotton ball swabs were used to collect surface wipes. Fortification of matrixes resulted in recoveries of > 90%. Spray drift was highest at the point of application and declined to low but measurable levels 9.1 m from the foundations of dwellings. Soil residues declined to low, but measurable levels by 45 days post-application. No cyfluthrin was measured from indoor air; however, some interior surfaces had detectable levels of cyfluthrin until three days post-application. Findings indicate that spray drift resulting from perimeter applications might contaminate non-target surfaces outside the spray zone. Soil borne residues may serve as persistent sources for human exposure and potentially intrude into dwellings through the activities of occupants and pets. Residues do not appreciably translocate through air and consequently inhalation is not a likely route for human exposure. Surface residues detected indoors suggest that the physical movement of residues from the exterior to the interior might be a viable route of movement of residues following this type of application.

New Zealand Health Survey 2012/13: characteristics of medicinal cannabis users.

PubMed

Pledger, Megan; Martin, Greg; Cumming, Jacqueline

2016-04-22

To explore the characteristics of medicinal and non-medicinal cannabis users, and the conditions that were treated with cannabis. The data comes from the New Zealand Health Survey 2012/2013, which sampled 13,009 people, aged 15+ years, living in private or non-private dwellings in New Zealand. Participants self-reported cannabis use and were put into groups: 1) non-users; 2) ex-users; 3) last year users-non-medicinal; 4) last-year users-medicinal. Prevalence was reported for the major demographic subgroups; sex, age and ethnicity. Regression models were then used to find associations between demographic characteristics and cannabis use for groups 3 and 4. About five percent (4.6%, 95% CI 4.1-5.1) of those aged 15+ report using cannabis medicinally. This use was associated with being male, younger, less well-educated and relatively poor. While Māori have the highest prevalence of medicinal use, European NZ/Others make up 67.9% (95% CI 62.7-72.6) of medicinal users. Reported medicinal use was associated with reported conditions that were typically hard to manage: pain, anxiety/nerves and depression. Medicinal users were more likely to report chronic pain and pain interfering, moderately or more, with housework and other work.

Exponential Sum-Fitting of Dwell-Time Distributions without Specifying Starting Parameters

PubMed Central

Landowne, David; Yuan, Bin; Magleby, Karl L.

2013-01-01

Fitting dwell-time distributions with sums of exponentials is widely used to characterize histograms of open- and closed-interval durations recorded from single ion channels, as well as for other physical phenomena. However, it can be difficult to identify the contributing exponential components. Here we extend previous methods of exponential sum-fitting to present a maximum-likelihood approach that consistently detects all significant exponentials without the need for user-specified starting parameters. Instead of searching for exponentials, the fitting starts with a very large number of initial exponentials with logarithmically spaced time constants, so that none are missed. Maximum-likelihood fitting then determines the areas of all the initial exponentials keeping the time constants fixed. In an iterative manner, with refitting after each step, the analysis then removes exponentials with negligible area and combines closely spaced adjacent exponentials, until only those exponentials that make significant contributions to the dwell-time distribution remain. There is no limit on the number of significant exponentials and no starting parameters need be specified. We demonstrate fully automated detection for both experimental and simulated data, as well as for classical exponential-sum-fitting problems. PMID:23746510

Cognitive Decline in Older Persons Initiating Anticholinergic Medications

PubMed Central

Shah, Raj C.; Janos, Alicia L.; Kline, Julia E.; Yu, Lei; Leurgans, Sue E.; Wilson, Robert S.; Wei, Peter; Bennett, David A.; Heilman, Kenneth M.; Tsao, Jack W.

2013-01-01

Background This study examines the effect of initiating medications with anticholinergic activity on the cognitive functions of older persons. Methods Participants were 896 older community-dwelling, Catholic clergy without baseline dementia. Medication data was collected annually. The Anticholinergic Cognitive Burden Scale was utilized to identify use of a medication with probable or definite anticholinergic activity. Participants had at least two annual cognitive evaluations. Results Over a mean follow-up of 10 years, the annual rate of global cognitive function decline for never users, prevalent users, and incident users was −0.062 (SE = 0.005), −0.081(SE = 0.011), and −0.096 (SE = 0.007) z-score units/year, respectively. Compared to never users, incident users had a more rapid decline (difference = −0.034 z-score units/year, SE = 0.008, p<0.001) while prevalent users did not have a significantly more rapid decline (p = 0.1). Conclusions Older persons initiating a medication with anticholinergic activity have a steeper annual decline in cognitive functioning than those who are not taking these medications. PMID:23741303

EFFECTS OF NATURAL AND FORCED BASEMENT VENTILATION ON RADON LEVELS IN SINGLE FAMILY DWELLINGS

EPA Science Inventory

The report gives, for the first time, results of an extensive study of the effect of ventilation on radon concentrations and radon entry rate in a single-family dwelling. Measurements of radon concentrations, building dynamics, and environmental parameters made in Princeton Unive...

Project Parapluie: A User Generated Shelter Design for the Recreation of School-Age Children in a Montreal Housing Project.

ERIC Educational Resources Information Center

Teasdale, Pierre

In many Canadian multi-family residential environments there is often a lack of sheltered space for recreation, other than the dwelling unit, where children can play in inclement weather and engage in those kinds of activities which usually cannot take place in the home. (Such activities include those that are too noisy, too messy, too large to…

Differential effects of power rehabilitation on physical performance and higher-level functional capacity among community-dwelling older adults with a slight degree of frailty.

PubMed

Ota, Atsuhiko; Yasuda, Nobufumi; Horikawa, Shunichi; Fujimura, Takashi; Ohara, Hiroshi

2007-03-01

Evidence is still insufficient regarding the effects of Power Rehabilitation (PR) on physical performance and higher-level functional capacity of community-dwelling frail elderly people. This nonrandomized controlled interventional trial consisted of 46 community-dwelling elderly individuals with light levels of long-term care needs. They were allocated to the intervention (I-group, n = 24) and control (C-group, n = 22) groups. Of them, 32 persons (17 in the I-group; 15 in the C-group) (median age, 77 years; sex, 28% male) completed the study. The I-group subjects underwent PR twice a week for 12 weeks. The outcomes were physical performance (muscle strength, balance, flexibility, and mobility) and higher-level functional capacity as evaluated by the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) and the level of long-term care need as certified by the public long-term care insurance. The I-group demonstrated a significant improvement in the measured value of the timed up-and-go test (median change, a decrease of 4.4 seconds versus a decrease of 0.2 seconds, p = 0.033) and the timed 10-meter walk (a decrease of 3.0 seconds versus an increase of 0.2 seconds, p = 0.007) in comparison with the C-group. No significant change was observed in the TMIG-IC scores or in the level of long-term care need in the I-group. PR improved mobility of community-dwelling frail elderly people; however, such improvement did not translate into higher-level functional capacity. Our findings demonstrate the difficulty in transferring the positive effects associated with PR into an improvement in higher-level functional capacity.

Resilience in Rural Community-Dwelling Older Adults

ERIC Educational Resources Information Center

Wells, Margaret

2009-01-01

Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…

Prevalence of frailty among community dwelling older adults in receipt of low level home support: a cross-sectional analysis of the North Dublin Cohort.

PubMed

Kelly, Sara; O'Brien, Irene; Smuts, Karla; O'Sullivan, Maria; Warters, Austin

2017-06-07

There is increasing demand for formal government funded home help services to support community-dwelling older people in Ireland, yet limited information exists on the health profiles of this group, especially regarding frailty. Our aim was to profile a large cohort of adults in receipt of low level home help and to determine the prevalence of frailty. A total 1312 older adults, (≥ 65 years) in receipt of low level home help (< 5 h per week) were reviewed by community nurses and frailty was assessed using the Clinical Frailty Scale (CFS) in this cross-sectional study. Characteristics of the group were compared between males and females and prevalence of frailty was reported according to gender and principal care. Associations between frailty and a number of variables were explored using bivariate and regression analysis. The cohort of low level home-help users was a mean age of 82.1 (SD 7.3) years, predominantly female (70.6%) and over half (69.2%) lived alone. The prevalence of frailty in this population was 41.5%, with subjects primarily considered mildly (23.2%) or moderately frail (14.5%) by the CFS. A further 38.4% were classed as vulnerable. The degree of frailty did not differ significantly across the younger categories aged 65-84 years. However, in the oldest age groups, namely 90-94 and >95 years, moderate frailty was significantly higher relative to the younger groups (21% and 34%, p < 0.05, p < 0.01 respectively). Home help hours significantly correlated with frailty (rs = 0.371, p < 0.001) and functional dependency (rs = 0.609, p < 0.001), but only weakly with age (rs = 0.101, p = 0.034). Based on regression analysis, determinants of frailty included greater dependency (Barthel score), higher home help hours, non-self-caring and communication difficulty, all of which significantly contributed to the model, with a r squared value of 0.508. A high prevalence of frailty (41.5%) was documented in this population which associated with higher home help utilisation. Frailty was associated with greater functional dependency, but not strongly with chronological age, until after 90 years. These findings highlight opportunities for developing intervention strategies targeted at ageing in place among home help users.

Association of Day Length and Weather Conditions with Physical Activity Levels in Older Community Dwelling People

PubMed Central

Witham, Miles D.; Donnan, Peter T.; Vadiveloo, Thenmalar; Sniehotta, Falko F.; Crombie, Iain K.; Feng, Zhiqiang; McMurdo, Marion E. T.

2014-01-01

Background Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people. Methods We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical Activity Cohort Scotland. We correlated seven day triaxial accelerometry data with daily weather data (temperature, day length, sunshine, snow, rain), and a series of potential effect modifiers were tested in mixed models: environmental variables (urban vs rural dwelling, percentage of green space), psychological variables (anxiety, depression, perceived behavioural control), social variables (number of close contacts) and health status measured using the SF-36 questionnaire. Results 547 participants, mean age 78.5 years, were included in this analysis. Higher minimum daily temperature and longer day length were associated with higher activity levels; these associations remained robust to adjustment for other significant associates of activity: age, perceived behavioural control, number of social contacts and physical function. Of the potential effect modifier variables, only urban vs rural dwelling and the SF-36 measure of social functioning enhanced the association between day length and activity; no variable modified the association between minimum temperature and activity. Conclusions In older community dwelling people, minimum temperature and day length were associated with objectively measured activity. There was little evidence for moderation of these associations through potentially modifiable health, environmental, social or psychological variables. PMID:24497925

Association of day length and weather conditions with physical activity levels in older community dwelling people.

PubMed

Witham, Miles D; Donnan, Peter T; Vadiveloo, Thenmalar; Sniehotta, Falko F; Crombie, Iain K; Feng, Zhiqiang; McMurdo, Marion E T

2014-01-01

Weather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people. We analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical Activity Cohort Scotland. We correlated seven day triaxial accelerometry data with daily weather data (temperature, day length, sunshine, snow, rain), and a series of potential effect modifiers were tested in mixed models: environmental variables (urban vs rural dwelling, percentage of green space), psychological variables (anxiety, depression, perceived behavioural control), social variables (number of close contacts) and health status measured using the SF-36 questionnaire. 547 participants, mean age 78.5 years, were included in this analysis. Higher minimum daily temperature and longer day length were associated with higher activity levels; these associations remained robust to adjustment for other significant associates of activity: age, perceived behavioural control, number of social contacts and physical function. Of the potential effect modifier variables, only urban vs rural dwelling and the SF-36 measure of social functioning enhanced the association between day length and activity; no variable modified the association between minimum temperature and activity. In older community dwelling people, minimum temperature and day length were associated with objectively measured activity. There was little evidence for moderation of these associations through potentially modifiable health, environmental, social or psychological variables.

A Comparative Study on Dwell Fatigue of Ti-6Al-2Sn-4Zr- xMo ( x = 2 to 6) Alloys on a Microstructure-Normalized Basis

NASA Astrophysics Data System (ADS)

Qiu, Jianke; Ma, Yingjie; Lei, Jiafeng; Liu, Yuyin; Huang, Aijun; Rugg, David; Yang, Rui

2014-12-01

The dwell effects of Ti624 x ( x = 2 to 6) alloys, including dwell fatigue life debit, fracture mode and strain accumulation, were characterized and compared. With increasing Mo content, the dwell fatigue life debit decreases quickly, and dwell fatigue fracture exhibits a transition from subsurface to surface initiation. Accompanying these changes, the accumulated strain decreases, and the pattern of secondary cracks loses morphological features typical of dwell cracks. These variations in the fatigue behavior of Ti624 x were attributed on the fundamental level to the dual effects of Mo: It decreases the β transus of titanium and, as a slow diffuser, reduces the rate of phase transformation from β to α. A higher Mo content encourages nucleation of multiple variants of α laths and promotes the transition from aligned colonies to basketweave microstructure during cooling after β forging. As a result both the grain size and microtexture intensity of α grains in the two-phase processed and heat treated microstructure are reduced. Smaller grain size of the alloys with higher Mo content produces smaller slip band spacing and reduces accumulated strain during dwell fatigue, thus reducing propensity for crack initiation. Microtexture was shown to be the direct cause of dwell sensitivity, and their relationship was described with the aid of a two-region redistribution model based on a previous two-element redistribution model proposed by Bache.

Description and Simulation of a Fast Packet Switch Architecture for Communication Satellites

NASA Technical Reports Server (NTRS)

Quintana, Jorge A.; Lizanich, Paul J.

1995-01-01

The NASA Lewis Research Center has been developing the architecture for a multichannel communications signal processing satellite (MCSPS) as part of a flexible, low-cost meshed-VSAT (very small aperture terminal) network. The MCSPS architecture is based on a multifrequency, time-division-multiple-access (MF-TDMA) uplink and a time-division multiplex (TDM) downlink. There are eight uplink MF-TDMA beams, and eight downlink TDM beams, with eight downlink dwells per beam. The information-switching processor, which decodes, stores, and transmits each packet of user data to the appropriate downlink dwell onboard the satellite, has been fully described by using VHSIC (Very High Speed Integrated-Circuit) Hardware Description Language (VHDL). This VHDL code, which was developed in-house to simulate the information switching processor, showed that the architecture is both feasible and viable. This paper describes a shared-memory-per-beam architecture, its VHDL implementation, and the simulation efforts.

Hospitalization Rates of Nursing Home Residents and Community-Dwelling Seniors in British Columbia

ERIC Educational Resources Information Center

Ronald, Lisa A.; McGregor, Margaret J.; McGrail, Kimberlyn M.; Tate, Robert B.; Broemling, Anne-Marie

2008-01-01

The overall use of acute care services by nursing home (NH) residents in Canada has not been well documented. Our objectives were to identify the major causes of hospitalization among NH facility residents and to compare rates to those of community-dwelling seniors. A retrospective cohort was defined using population-level health administrative…

The effect of proximity to major roads on indoor air quality in typical Australian dwellings

NASA Astrophysics Data System (ADS)

Lawson, Sarah J.; Galbally, Ian E.; Powell, Jennifer C.; Keywood, Melita D.; Molloy, Suzie B.; Cheng, Min; Selleck, Paul W.

2011-04-01

An Indoor Air Quality Study of residential dwellings was carried out in Melbourne, Australia, and a subset of the data was analysed to investigate the effect of proximity to major roads on indoor air quality (IAQ). Seven-day measurements of PM 10, NO 2, benzene, toluene, ethylbenzene and xylenes, along with continuous CO and PM 2.5 measurements were utilised. The measurements were made indoors and outdoors in 27 dwellings; 15 Near Road (<50 m from a major road) and 12 Far Road (>300 m from a major road). Dwellings were sampled for one week each in Winter/Spring 2008 and Summer/Autumn 2009, over an eight month period. Analysis of 7-day measurements showed that NO 2 and toluene were elevated at the 5% significance level both indoors and outdoors at Near Road Dwellings compared to Far Road Dwellings. Indoor/Outdoor (I/O) ratios of NO 2 and toluene were not significantly different between Near and Far Road dwellings giving no evidence of any anomalous dominant indoor source for NO 2 and toluene in Near Road dwellings. Indoor NO 2 was significantly correlated to gas stovetop and oven use in both Near and Far Road dwellings. In the absence of gas cooking, indoor NO 2 was elevated in Near Road dwellings relative to Far Road dwellings by approximately 4 ppb and this can be attributed to infiltration of outdoor air. I/O ratios for NO 2 were <1 for Near and Far Road dwellings, indicating that outdoor NO 2, and hence roadway emissions can potentially contribute a significant proportion to the indoor NO 2 concentration. Mean toluene I/O ratios were >2 indicating that indoor sources dominate with minor contribution from outdoors. Hence the relative contribution of roadways to indoor NO 2 is potentially greater than the relative contribution of roadways to indoor toluene. Findings elsewhere suggest that a similar outdoor enhancement of traffic related NO 2 (˜5 ppb) increases risk of lung cancer and childhood asthma ( Brauer et al., 2000; Nyberg et al., 2000). A simple conceptual model indicated spatial and temporal variance in the concentrations was the biggest limitation in detecting roadway influence outside Near Road dwellings for PM 10, PM 2.5 and NO 2 while measurement uncertainty was also important for CO.

Influences of satisfaction with telecare and family trust in older Taiwanese people.

PubMed

Tsai, Chung-Hung; Kuo, Yu-Ming; Uei, Shu-Lin

2014-01-27

The level of trust given towards telecare by the family members of older people using the service is extremely important. Family trust may be an influential factor in deciding whether to use such services. This study focuses on older people's satisfaction with telecare and examines their family's trust in telecare services. Influences on intention to continue using telecare services are also explored. A questionnaire-based survey on 60 communities dwelling older people who had been receiving telecare services in the past two years was employed. This study developed a satisfaction and trust scale based on previous studies. Our results show that older people's satisfaction with telecare services and families' trust were influential in decided whether to continue to use of telecare services. These findings can help medical institutions to better insight into the user experience of telecare to help them provide future services that better comply with clients' desires and requirements.

Health, Personal, and Environmental Predictors of Wheelchair-Use Confidence in Adult Wheelchair Users.

PubMed

Sakakibara, Brodie M; Miller, William C; Eng, Janice J; Routhier, François; Backman, Catherine L

2015-10-01

There are no predictive models of wheelchair-use confidence. Therefore, clinicians and researchers are limited in their ability to screen for and identify wheelchair users who may be more prone to low wheelchair-use confidence and may benefit from clinical intervention. The purpose of this study was to identify health-related, personal, and environmental factors that predict perceived wheelchair-use confidence in community-dwelling adults who use manual wheelchairs. A cross-sectional study was conducted. Community-dwelling manual wheelchair users (N=124) were included in the study if they were ≥50 years of age, had ≥6 months of wheelchair use experience, and had no cognitive impairment. The Wheelchair Use Confidence Scale was used to assess wheelchair-use confidence. The sociodemographic information form, Functional Comorbidity Index, Seating Identification Tool, Interpersonal Support and Evaluation List, and Home and Community Environment Instrument captured the independent variables. Blocks of health, personal, and environmental variables were sequentially entered into the regression model. Five personal variables (age, standardized beta [β]=-0.18; sex, β=-0.26; daily hours of wheelchair occupancy, β=0.20; wheelchair-use training, β=0.20; and wheelchair-use assistance, β=-0.34) and one environmental variable (need for seating intervention, β=-0.18) were statistically significant predictors, explaining 44% of the confidence variance. The sample comprised volunteers and, therefore, may underrepresent or overrepresent particular groups within the population. The study's cross-sectional research design does not allow for conclusions to be made regarding causality. Older women who use wheelchairs and who require assistance with wheelchair use may have low wheelchair-use confidence. The same is true for individuals who have no formal wheelchair-use training, who are in need of a seating intervention, and who report few hours of daily wheelchair use. These wheelchair users may require clinical attention and benefit from intervention. © 2015 American Physical Therapy Association.

Men's and women's perspectives on using a powered mobility device: benefits and societal challenges.

PubMed

Pettersson, Cecilia; Iwarsson, Susanne; Brandt, Ase; Norin, Lizette; Månsson Lexell, Eva

2014-11-01

To describe how men and women experience their use of powered wheelchairs (PW) and powered scooters (PS) in everyday occupations, in the home and in society at large. A qualitative research approach with focus-group methodology was used. Four focus groups were created, with men and women as well as PW and PS users in different groups. Applying a descriptive approach, data were analysed according to the principles described by Krueger. Three categories emerged and revealed that even though use of PW and PS increased independence and enabled everyday occupations, participants struggled to be independent powered mobility device (PMD) users. They experienced many accessibility problems in dwellings and in society, described similarly by users of PW and PS. Men and women experienced their use of (PMD) differently, especially in relation to the service delivery process. The study contributes with new knowledge on accessibility for PW and PS users and related service delivery processes, stating that gender differences regarding provision and training must be taken into account. Occupational therapists can contribute to an enhanced understanding of PMD users' challenges in person-environment-occupation transactions in the home and society, and thereby promote occupational justice for PMD users.

Determining GPS average performance metrics

NASA Technical Reports Server (NTRS)

Moore, G. V.

1995-01-01

Analytic and semi-analytic methods are used to show that users of the GPS constellation can expect performance variations based on their location. Specifically, performance is shown to be a function of both altitude and latitude. These results stem from the fact that the GPS constellation is itself non-uniform. For example, GPS satellites are over four times as likely to be directly over Tierra del Fuego than over Hawaii or Singapore. Inevitable performance variations due to user location occur for ground, sea, air and space GPS users. These performance variations can be studied in an average relative sense. A semi-analytic tool which symmetrically allocates GPS satellite latitude belt dwell times among longitude points is used to compute average performance metrics. These metrics include average number of GPS vehicles visible, relative average accuracies in the radial, intrack and crosstrack (or radial, north/south, east/west) directions, and relative average PDOP or GDOP. The tool can be quickly changed to incorporate various user antenna obscuration models and various GPS constellation designs. Among other applications, tool results can be used in studies to: predict locations and geometries of best/worst case performance, design GPS constellations, determine optimal user antenna location and understand performance trends among various users.

Dynamic Spectrum Access for Internet of Things Service in Cognitive Radio-Enabled LPWANs

PubMed Central

Moon, Bongkyo

2017-01-01

In this paper, we focus on a dynamic spectrum access strategy for Internet of Things (IoT) applications in two types of radio systems: cellular networks and cognitive radio-enabled low power wide area networks (CR-LPWANs). The spectrum channel contention between the licensed cellular networks and the unlicensed CR-LPWANs, which work with them, only takes place within the cellular radio spectrum range. Our aim is to maximize the spectrum capacity for the unlicensed users while ensuring that it never interferes with the licensed network. Therefore, in this paper we propose a dynamic spectrum access strategy for CR-LPWANs operating in both licensed and unlicensed bands. The simulation and the numerical analysis by using a matrix geometric approach for the strategy are presented. Finally, we obtain the blocking probability of the licensed users, the mean dwell time of the unlicensed user, and the total carried traffic and combined service quality for the licensed and unlicensed users. The results show that the proposed strategy can maximize the spectrum capacity for the unlicensed users using IoT applications as well as keep the service quality of the licensed users independent of them. PMID:29206215

Dynamic Spectrum Access for Internet of Things Service in Cognitive Radio-Enabled LPWANs.

PubMed

Moon, Bongkyo

2017-12-05

In this paper, we focus on a dynamic spectrum access strategy for Internet of Things (IoT) applications in two types of radio systems: cellular networks and cognitive radio-enabled low power wide area networks (CR-LPWANs). The spectrum channel contention between the licensed cellular networks and the unlicensed CR-LPWANs, which work with them, only takes place within the cellular radio spectrum range. Our aim is to maximize the spectrum capacity for the unlicensed users while ensuring that it never interferes with the licensed network. Therefore, in this paper we propose a dynamic spectrum access strategy for CR-LPWANs operating in both licensed and unlicensed bands. The simulation and the numerical analysis by using a matrix geometric approach for the strategy are presented. Finally, we obtain the blocking probability of the licensed users, the mean dwell time of the unlicensed user, and the total carried traffic and combined service quality for the licensed and unlicensed users. The results show that the proposed strategy can maximize the spectrum capacity for the unlicensed users using IoT applications as well as keep the service quality of the licensed users independent of them.

Characterization of Indoor Extremely Low Frequency and Low Frequency Electromagnetic Fields in the INMA-Granada Cohort

PubMed Central

Calvente, Irene; Dávila-Arias, Cristina; Ocón-Hernández, Olga; Pérez-Lobato, Rocío; Ramos, Rosa; Artacho-Cordón, Francisco; Olea, Nicolás; Núñez, María Isabel; Fernández, Mariana F.

2014-01-01

Objective To characterize the exposure to electric fields and magnetic fields of non-ionizing radiation in the electromagnetic spectrum (15 Hz to 100 kHz) in the dwellings of children from the Spanish Environment and Childhood-“INMA” population-based birth cohort. Methodology The study sample was drawn from the INMA-Granada cohort. Out of 300 boys participating in the 9–10 year follow-up, 123 families agreed to the exposure assessment at home and completed a specific ad hoc questionnaire gathering information on sources of non-ionizing radiation electric and magnetic fields inside the homes and on patterns of use. Long-term indoor measurements were carried out in the living room and bedroom. Results Survey data showed a low exposure in the children's homes according to reference levels of the International Commission on Non-Ionizing Radiation Protection but with large differences among homes in mean and maximum values. Daytime electrostatic and magnetic fields were below the quantification limit in 78.6% (92 dwellings) and 92.3% (108 dwellings) of houses, with an arithmetic mean value (± standard deviation) of 7.31±9.32 V/m and 162.30±91.16 nT, respectively. Mean magnetic field values were 1.6 lower during the night than the day. Nocturnal electrostatic values were not measured. Exposure levels were influenced by the area of residence (higher values in urban/semi-urban versus rural areas), type of dwelling, age of dwelling, floor of the dwelling, and season. Conclusion Given the greater sensitivity to extremely low-frequency electromagnetic fields of children and following the precautionary principle, preventive measures are warranted to reduce their exposure. PMID:25192253

Characterization of indoor extremely low frequency and low frequency electromagnetic fields in the INMA-Granada cohort.

PubMed

Calvente, Irene; Dávila-Arias, Cristina; Ocón-Hernández, Olga; Pérez-Lobato, Rocío; Ramos, Rosa; Artacho-Cordón, Francisco; Olea, Nicolás; Núñez, María Isabel; Fernández, Mariana F

2014-01-01

To characterize the exposure to electric fields and magnetic fields of non-ionizing radiation in the electromagnetic spectrum (15 Hz to 100 kHz) in the dwellings of children from the Spanish Environment and Childhood-"INMA" population-based birth cohort. The study sample was drawn from the INMA-Granada cohort. Out of 300 boys participating in the 9-10 year follow-up, 123 families agreed to the exposure assessment at home and completed a specific ad hoc questionnaire gathering information on sources of non-ionizing radiation electric and magnetic fields inside the homes and on patterns of use. Long-term indoor measurements were carried out in the living room and bedroom. Survey data showed a low exposure in the children's homes according to reference levels of the International Commission on Non-Ionizing Radiation Protection but with large differences among homes in mean and maximum values. Daytime electrostatic and magnetic fields were below the quantification limit in 78.6% (92 dwellings) and 92.3% (108 dwellings) of houses, with an arithmetic mean value (± standard deviation) of 7.31±9.32 V/m and 162.30±91.16 nT, respectively. Mean magnetic field values were 1.6 lower during the night than the day. Nocturnal electrostatic values were not measured. Exposure levels were influenced by the area of residence (higher values in urban/semi-urban versus rural areas), type of dwelling, age of dwelling, floor of the dwelling, and season. Given the greater sensitivity to extremely low-frequency electromagnetic fields of children and following the precautionary principle, preventive measures are warranted to reduce their exposure.

SU-F-BRA-12: End-User Oriented Tools and Procedures for Testing Brachytherapy TPSs Employing MBDCAs

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

Peppa, V; Pappas, E; Lahanas, V

2015-06-15

Purpose: To develop user-oriented tools for commissioning and dosimetry testing of {sup 192}Ir brachytherapy treatment planning systems (TPSs) employing model based dose calculation algorithms (MBDCAs). Methods: A software tool (BrachyGuide) has been developed for the automatic generation of MCNP6 input files from any CT based plan exported in DICOM RT format from Elekta and Varian TPSs. BrachyGuide also facilitates the evaluation of imported Monte Carlo (MC) and TPS dose distributions in terms of % dose differences and gamma index (CT overlaid colormaps or relative frequency plots) as well as DVHs and related indices. For users not equipped to perform MC,more » a set of computational models was prepared in DICOM format, accompanied by treatment plans and corresponding MCNP6 generated reference data. BrachyGuide can then be used to compare institutional and reference data as per TG186. The model set includes a water sphere with the MBDCA WG {sup 192}Ir source placed centrically and in two eccentric positions, a water sphere with cubic bone and lung inhomogeneities and a five source dwells plan, and a patient equivalent model with an Accelerated Partial Breast Irradiation (APBI) plan. Results: The tools developed were used for the dosimetry testing of the Acuros and ACE MBDCAs implemented in BrachyVision v.13 and Oncentra Brachy v.4.5, respectively. Findings were consistent with previous results in the literature. Besides points close to the source dwells, Acuros was found to agree within type A uncertainties with the reference MC results. Differences greater than MC type A uncertainty were observed for ACE at distances >5cm from the source dwells and in bone. Conclusion: The tools developed are efficient for brachytherapy MBDCA planning commissioning and testing. Since they are appropriate for distribution over the web, they will be put at the AAPM WG MBDCA’s disposal. Research co-financed by the ESF and Greek funds. NSRF operational Program: Education and Lifelong Learning Investing in Knowledge Society-Aristeia. Varian Medical Systems and Nucletron, an Elekta company provided access to TPSs for research purposes. Miss Peppa was supported by IKY-fellowships of excellence for postgraduate studies in Greece,Siemens Program.« less

Involvement of the end user: exploration of older people’s needs and preferences for a wearable fall detection device – a qualitative descriptive study

PubMed Central

Thilo, Friederike JS; Bilger, Selina; Halfens, Ruud JG; Schols, Jos MGA; Hahn, Sabine

2017-01-01

Purpose To explore the needs and preferences of community-dwelling older people, by involving them in the device design and mock-up development stage of a fall detection device, consisting of a body-worn sensor linked to a smartphone application. Patients and methods A total of 22 community-dwelling persons 75 years of age and older were involved in the development of a fall detection device. Three semistructured focus group interviews were conducted. The interview data were analyzed using qualitative descriptive analysis with deductive coding. Results The mock-up of a waterproof, body-worn, automatic and manual alerting device, which served both as a day-time wearable sensor and a night-time wearable sensor, was welcomed. Changes should be considered regarding shape, color and size along with alternate ways of integrating the sensor with items already in use in daily life, such as jewelry and personal watches. The reliability of the sensor is key for the participants. Issues important to the alerting process were discussed, for instance, who should be contacted and why. Several participants were concerned with the mandatory use of the smartphone and assumed that it would be difficult to use. They criticized the limited distance between the sensor and the smartphone for reliable fall detection, as it might restrict activity and negatively influence their degree of independence in daily life. Conclusion This study supports that involving end users in the design and mock-up development stage is welcomed by older people and allows their needs and preferences concerning the fall detection device to be explored. Based on these findings, the development of a “need-driven” prototype is possible. As participants are doubtful regarding smartphone usage, careful training and support of community-dwelling older people during real field testing will be crucial. PMID:28053509

Who Are the High-Cost Users? A Method for Person-Centred Attribution of Health Care Spending.

PubMed

Guilcher, Sara J T; Bronskill, Susan E; Guan, Jun; Wodchis, Walter P

2016-01-01

To develop person-centered episodes of care (PCE) for community-dwelling individuals in the top fifth percentile of Ontario health care expenditures in order to: (1) describe the main clinical groupings for spending; and (2) identify patterns of spending by health sector (e.g. acute care, home care, physician billings) within and across PCE. Data were drawn from population-based administrative databases for all publicly funded health care in Ontario, Canada in 2010/11. This study is a retrospective cohort study. A total of 587,982 community-dwelling individuals were identified among those accounting for the top 5% of provincial health care expenditures between April 1, 2010 and March 31, 2011. PCE were defined as starting with an acute care admission and persisting through subsequent care settings and providers until individuals were without health system contact for 30 days. PCE were classified according to the clinical grouping for the initial admission. PCE and non-PCE costs were calculated and compared to provide a comprehensive measurement of total health system costs for the year. Among this community cohort, 697,059 PCE accounted for nearly 70% ($11,815.3 million (CAD)) of total annual publicly-funded expenditures on high-cost community-dwelling individuals. The most common clinical groupings to start a PCE were Acute Planned Surgical (35.2%), Acute Unplanned Medical (21.0%) and Post-Admission Events (10.8%). Median PCE costs ranged from $3,865 (IQR = $1,712-$10,919) for Acute Planned Surgical to $20,687 ($12,207-$39,579) for Post-Admission Events. Inpatient acute ($8,194.5 million) and inpatient rehabilitation ($434.6 million) health sectors accounted for the largest proportions of allocated PCE spending over the year. Our study provides a novel methodological approach to categorize high-cost health system users into meaningful person-centered episodes. This approach helps to explain how costs are attributable within individuals across sectors and has applications in episode-based payment formulas and quality monitoring.

Predictors of 4-Year Retention among African American and White Community-Dwelling Participants in the UAB Study of Aging

ERIC Educational Resources Information Center

Allman, Richard M.; Sawyer, Patricia; Crowther, Martha; Strothers, Harry S., III; Turner, Timothy; Fouad, Mona N.

2011-01-01

Purpose: To identify racial/ethnic differences in retention of older adults at 3 levels of participation in a prospective observational study: telephone, in-home assessments, and home visits followed by blood draws. Design and Methods: A prospective study of 1,000 community-dwelling Medicare beneficiaries aged 65 years and older included a…

Non-steroidal anti-inflammatory drug (NSAID) use and Alzheimer disease in community-dwelling elderly patients.

PubMed

Landi, Francesco; Cesari, Matteo; Onder, Graziano; Russo, Andrea; Torre, Sergio; Bernabei, Roberto

2003-01-01

Recently, greater attention has been paid to the role of inflammatory processes in the pathophysiology of Alzheimer disease (AD). However, the mechanism by which anti-inflammatory agents (NSAIDs) might slow the progression of AD is not completely known. The aim of the present study was to examine the relationship between NSAIDs use and AD in a large sample of community-dwelling elderly people. In a cross-sectional retrospective study, the authors analyzed data on patients admitted to home care programs. A total of 12 home health agencies participated in the project, with a total of 2,708 patients enrolled in the present study. The main outcome measures were the prevalence of AD and use of NSAIDs treatment. Compared with all non-users, NSAID users had a nearly 50% lower risk of being affected by AD. Separate multivariate analyses of subjects receiving different types of NSAIDs found a significantly decreased risk of cognitive impairment associated with non-aspirin NSAID use, whereas, among subjects taking aspirin, the difference in estimated risk did not reach statistical significance. The results of this population-based cross-sectional study are consistent with the notion that long-term NSAIDs use has a protective effect against AD. However, after possible confounding effects of age and several other variables potentially associated with cognitive impairment were controlled, this association was statistically significant only for non-aspirin NSAIDs use.

Mobility Device Quality Affects Participation Outcomes for People With Disabilities: A Structural Equation Modeling Analysis.

PubMed

Magasi, Susan; Wong, Alex; Miskovic, Ana; Tulsky, David; Heinemann, Allen W

2018-01-01

To test the effect that indicators of mobility device quality have on participation outcomes in community-dwelling adults with spinal cord injury, traumatic brain injury, and stroke by using structural equation modeling. Survey, cross-sectional study, and model testing. Clinical research space at 2 academic medical centers and 1 free-standing rehabilitation hospital. Community-dwelling adults (N=250; mean age, 48±14.3y) with spinal cord injury, traumatic brain injury, and stroke. Not applicable. The Mobility Device Impact Scale, Patient-Reported Outcomes Measurement Information System Social Function (version 2.0) scale, including Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities, and the 2 Community Participation Indicators' enfranchisement scales. Details about device quality (reparability, reliability, ease of maintenance) and device type were also collected. Respondents used ambulation aids (30%), manual (34%), and power wheelchairs (30%). Indicators of device quality had a moderating effect on participation outcomes, with 3 device quality variables (repairability, ease of maintenance, device reliability) accounting for 20% of the variance in participation. Wheelchair users reported lower participation enfranchisement than did ambulation aid users. Mobility device quality plays an important role in participation outcomes. It is critical that people have access to mobility devices and that these devices be reliable. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The nuisance due to the noise of automobile traffic: An investigation in the neighborhoods of freeways

NASA Technical Reports Server (NTRS)

Lamure, C.; Bacelon, M.

1980-01-01

An inquiry was held among 400 people living near freeways in an attempt to determine the characteristics of traffic noise nuisance. A nuisance index was compiled, based on the answers to a questionnaire. Nuisance expressed in these terms was then compared with the noise level measured on the most exposed side of each building. Correlation between the nuisance indexes and the average noise levels is quite good for dwellings with facades parallel to the freeway. At equal noise levels on the most exposed side, the nuisance given for these latter dwellings is lower than for others.

Dissecting delays in trauma care using corporate lean six sigma methodology.

PubMed

Parks, Jennifer K; Klein, Jorie; Frankel, Heidi L; Friese, Randall S; Shafi, Shahid

2008-11-01

The Institute of Medicine has identified trauma center overcrowding as a crisis. We applied corporate Lean Six Sigma methodology to reduce overcrowding by quantifying patient dwell times in trauma resuscitation units (TRU) and to identify opportunities for reducing them. TRU dwell time of all patients treated at a Level I trauma center were measured prospectively during a 3-month period (n = 1,184). Delays were defined as TRU dwell time >6 hours. Using personnel trained in corporate Lean Six Sigma methodology, we created a detailed process map of patient flow through our TRU and measured time spent at each step prospectively during a 24/7 week-long time study (n = 43). Patients with TRU dwell time below the median (3 hours) were compared with those with longer dwell times to identify opportunities for improvement. TRU delays occurred in 183 of 1,184 trauma patients (15%), and peaked on days with >15 patients or with presence of five simultaneous patients. However, 135 delays (74%) occurred on days when

Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men.

PubMed

Kenny, Anne M; Biskup, Bradley; Robbins, Bertha; Marcella, Glenn; Burleson, Joseph A

2003-12-01

To study the effects of vitamin D supplementation in healthier populations of men. : Randomized, controlled trial. General clinical research center. Sixty-five healthy, community-dwelling men (mean age+/-standard deviation=76+/-4, range 65-87). Cholecalciferol (1,000 IU/d) or placebo supplementation for 6 months; all received 500 mg supplemental calcium. Upper and lower extremity muscle strength and power, physical performance and activity, health perception, calcium and vitamin D intake, and biochemical assessment, including 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and ionized calcium levels. The levels of 25OHD increased and PTH decreased in the cholecalciferol group, whereas there were no significant changes in the control group (P<.001). Baseline 25OHD levels correlated with baseline single-leg stance time and physical activity score. Baseline PTH levels correlated with baseline 8-foot walk time and physical activity score. No significant difference in strength, power, physical performance, or health perception was found between groups. The 25OHD or PTH levels correlated with physical activity and physical performance in older, community-dwelling men with normal 25OHD status. Vitamin D supplementation increased 25OHD levels and decreased PTH levels but did not increase muscle strength or improve physical performance or health perception in this group of healthy, older men. Further investigations of the effects of vitamin D supplementation should focus on individuals with low levels of vitamin D.

Do the Preferences of Healthcare Provider Selection Vary among Rural and Urban Patients with Different Income and Cause Different Outcome?

PubMed

Yu, Tsung-Hsien; Chung, Kuo-Piao; Wei, Chung-Jen; Chien, Kuo-Liong; Hou, Yu-Chang

2016-01-01

Equal access to healthcare facilities and high-level quality of care are important strategies to eliminate the disparity in outcome of care. However, the existing literature regarding how urban or rural dwelling patients with different income level select healthcare providers is insufficient. The purposes of this study were to examine whether differences of healthcare provider selection exist among urban and rural coronary artery bypass surgery (CABG) patients with different income level. If so, we further investigated the associated impact on mortality. A retrospective, multilevel study design was conducted using claims data from 2007-2011 Taiwan's Universal Health Insurance Scheme. Healthcare providers' performance and patients' travelling distance to hospitals were used to define the patterns of healthcare provider selection. Baron and Kenny's procedures for mediation effect were conducted. There were 10,108 CABG surgeries included in this study. The results showed that urban dwelling and higher income patients were prone to receive care from better-performance providers. The travelling distances of urban dwelling patients was 15 KM shorter, especially when they received better-performance provider's care. The results also showed that the difference of healthcare provider selection and mortality rate existed between rural and urban dwelling patients with different income levels. After the procedure of mediation effect testing, the results showed that the healthcare provider selection partially mediated the relationships between patients' residential areas with different income levels and 30-day mortality. Preferences of healthcare provider selection vary among rural and urban patients with different income, and such differences partially mediated the outcome of care. Health authorities should pay attention to this issue, and propose appropriate solutions to eliminate the disparity in outcome of CABG care.

Responses of litter-dwelling spiders and carabid beetles to varying levels and patterns of green-tree retention.

Treesearch

Juraj Halaj; Charles B. Halpern; Hoonbok Yi

2008-01-01

We studied effects of timber harvest with green-tree retention on litter-dwelling predatory arthropods (spiders and carabid beetles). Arthropods were sampled with pitfall traps at four experimental blocks in western Oregon and Washington. Within each block, arthropods were collected 5 to 7 years after treatment in five 13-ha harvest units including a control and four...

Effects of extrusion temperature and dwell time on aflatoxin levels in cottonseed.

PubMed

Buser, Michael D; Abbas, Hamed K

2002-04-24

Cottonseed is an economical source of protein and is commonly used in balancing livestock rations; however, its use is typically limited by protein, fat, gossypol, and aflatoxin contents. Whole cottonseed was extruded to determine if the temperature and dwell time (multiple stages of processing) associated with the process affected aflatoxin levels. The extrusion temperature study showed that aflatoxin levels were reduced by an additional 33% when the cottonseed was extruded at 160 degrees C as compared to 104 degrees C. Furthermore, the multiple-pass extrusion study indicated that aflatoxin levels were reduced by an additional 55% when the cottonseed was extruded four times as compared to one time. To estimate the aflatoxin reductions due to extrusion temperature and dwell time, the least mean fits obtained for the individual studies were combined. Total estimated reductions of 55% (three stages of processing at 104 degrees C), 50% (two stages of processing at 132 degrees C), and 47% (one stage of processing at 160 degrees C) were obtained from the combined equations. If the extreme conditions (four stages of processing at 160 degrees C) of the evaluation studies are applied to the combined temperature and processing equation, the resulting aflatoxin reduction would be 76%.

Mobility Device Use Among Older Adults and Incidence of Falls and Worry About Falling: Findings From the 2011–2012 National Health and Aging Trends Study

PubMed Central

Gell, Nancy M.; Wallace, Robert B.; LaCroix, Andrea Z.; Mroz, Tracy M.; Patel, Kushang V.

2015-01-01

OBJECTIVES To examine mobility device use prevalence among community-dwelling older adults in the U.S. and to investigate the incidence of falls and worry about falling by the type and number of mobility devices used. DESIGN Analysis of cross-sectional and longitudinal data from the 2011–2012 National Health and Aging Trends Study SETTING In-person interviews in the homes of study participants PARTICIPANTS Nationally representative sample of Medicare beneficiaries(N=7609). MEASUREMENTS Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, one-year fall history and worry about falling. RESULTS Twenty-four percent of adults age ≥65 reported mobility device use in 2011 and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with non-White race/ethnicity, female sex, lower education level, greater multi-morbidity, and obesity (all P-values < 0.001). Adjusting for demographic, health characteristics, and physical function, the incidence of falls and recurrent falls were not associated with the use of multiple devices or any one particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users, compared with non-users. CONCLUSION The percentage of older adults reporting mobility device use is higher compared to results from previous national surveys and multiple device use is common among those who use any device. Mobility device use is not associated with increased incidence of falls compared to non-device users. Cane-only users may compensate for worry about falling by limiting activity. PMID:25953070

Elevated NT-proBNP Levels are Associated with Poor Cognitive Function in Community-Dwelling Older Adults: Results from the Rancho Bernardo Study

PubMed Central

Daniels, Lori B.; Laughlin, Gail A.; Kritz-Silverstein, Donna; Clopton, Paul; Chen, Wei-Chung; Maisel, Alan S.; Barrett-Connor, Elizabeth

2011-01-01

Background Natriuretic peptides (NP’s) have prognostic value across a wide spectrum of cardiovascular diseases and may predict cognitive dysfunction in patients with cardiovascular disease even in the absence of prior stroke. Little is known about the association of NP’s with cognitive function in community-dwelling adults. We assessed the association between NT-proBNP levels and cognitive function in community-dwelling ambulatory older adults in the Rancho Bernardo Study. Methods We studied 950 men and women, aged 60 years and older, who attended a research clinic visit where a medical history and examination were performed, and blood for cardiovascular disease risk factors and NT-proBNP levels were obtained. Three cognitive function tests were administered: Mini Mental State Exam (MMSE), Trail-Making Test B (Trails B), and Category Fluency. Results Participants with high NT-proBNP levels (≥450 pg/mL, n=198) were older and had a higher prevalence of coronary heart disease (12% vs. 30%), and stroke (5% vs. 11%) (both p’s≤0.001). In unadjusted analyses, all three cognitive function test scores were significantly associated with NT-proBNP levels (p<0.001). After adjusting for age, sex, education, hypertension, body mass index, exercise, alcohol use, smoking, low density lipoprotein cholesterol, creatinine clearance, and prior cardiovascular disease, elevated NT-proBNP levels remained independently associated with poor cognitive performance on MMSE (odds ratio [95% confidence interval] 2.0 [1.1–3.6], p=0.02) and Trails B (1.7 [1.2–2.7], p=0.01), but not Category Fluency (1.4 [0.9–2.2], p=0.19). Results were unchanged after excluding the 6% of participants with a history of stroke. Conclusions NT-proBNP levels were strongly and independently associated with poor cognitive function in community-dwelling older adults. PMID:21683832

Users’ Workshop on Combat Stress (5th) Held at Fort Sam Houston, Texas from 9 to 13 December 1985.

DTIC Science & Technology

1986-07-01

a point that has been implicit throughout this talk, the notion of additive or cumulative aspects of stressful experiences. I have focused primarily... a tendency to dwell on the unpleasant emotion- charged events in the wake of their shooting experience. Officers report reliving and reenacting the...examined in police officers. Existing immediate observation of the link between the occurrence of stress- related symptoms and a shooting event points

Exposure to indoor background radiation and urinary concentrations of 8-hydroxydeoxyguanosine, a marker of oxidative DNA damage.

PubMed Central

Sperati, A; Abeni, D D; Tagesson, C; Forastiere, F; Miceli, M; Axelson, O

1999-01-01

We investigated whether exposure to indoor [gamma]-radiation and radon might be associated with enough free radical formation to increase urinary concentrations of 8-hydroxydeoxyguanosine (8-OHdG), a sensitive marker of DNA damage, due to a hydroxyl radical attack at the C8 of guanine. Indoor radon and [gamma]-radiation levels were measured in 32 dwellings for 6 months by solid-state nuclear track detectors and thermoluminescent dosimeters, respectively. Urine samples for 8-OHdG determinations were obtained from 63 healthy adult subjects living in the measured dwellings. An overall tendency toward increasing levels of 8-OHdG with increasing levels of radon and [gamma]-radiation was seen in the females, presumably due to their estimated longer occupancy in the dwellings measured. Different models were considered for females, with the steepest slopes obtained for [gamma]-radiation with a coefficient of 0.500 (log nmol/l of 8-OHdG for each unit increase of [gamma]-radiation on a log scale) (p<0.01), and increasing to 0.632 (p = 0.035), but with larger variance, when radon was included in the model. In conclusion, there seems to be an effect of indoor radioactivity on the urinary excretion of 8-OHdG for females, who are estimated to have a higher occupancy in the dwellings measured than for males, for whom occupational and other agents may also influence 8-OHdG excretion. ree radicals; [gamma]-radiation; radon. PMID:10064551

Relationships between HMG-CoA reductase inhibitors (statin) use and strength, balance and falls in older people.

PubMed

Haerer, W; Delbaere, K; Bartlett, H; Lord, S R; Rowland, J

2012-12-01

To investigate associations between HMG-CoA reductase inhibitor (statin) use and muscle strength, balance, mobility and falls in older people. Five hundred community-dwelling people aged 70-90 years provided information about their medication use and undertook tests of lower limb strength, postural sway, leaning balance (maximal balance range and coordinated stability tests) and functional mobility. Participants were then followed up for 12 months with respect to falls. After adjusting for general health in analyses of covariance procedures, statin users had poorer maximal balance range than non-statin users (P = 0.017). Statin and non-statin users did not differ with respect to strength, postural sway, mobility or falls experienced in the follow-up year. In a sample of healthy older people, statin use was not associated with muscle weakness, postural sway, reduced mobility or falls. Statin users, however, had poorer leaning balance which may potentially increase fall risk in this group. © 2011 The Authors; Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

Effectiveness of technology use for engaging community dwelling adults with chronic disease in self-care behavior management in health care: a systematic review protocol.

PubMed

Swartwout, Ellen; Deyo, Patsy; El-Zein, Ashley

2016-05-01

The quantitative objective is to identify the effectiveness of technology use for self-care behavior management and the patient engagement levels in health care.More specifically, the objectives are to identify: 1) the effectiveness of technology use (includes mobile health applications, text messages, telemedicine/video conferences between providers and people with chronic disease, remote monitoring and websites) in health care for engaging community-dwelling adults with chronic disease in self-care management, and 2) the patient engagement levels in health care.

Acceptability Among Community Healthcare Nurses of Intelligent Wireless Sensor-system Technology for the Rapid Detection of Health Issues in Home-dwelling Older Adults.

PubMed

Cohen, Christine; Kampel, Thomas; Verloo, Henk

2017-01-01

The effective care and support of community healthcare nurses (CHNs) contribute greatly to the healthy aging of older adults living at home. Integrating innovative technologies into CHNs' daily practice offers new opportunities and perspectives for early detection of health issues and interventions among home-dwelling older adults. To explore the perception of acceptability among CHNs of an intelligent wireless sensor system (IWSS) for use in daily practice for the detection of health issues in home-dwelling older adults receiving home healthcare. Descriptive and qualitative data were sourced from a pilot randomized controlled trial involving 17 CHNs using an IWSS in their daily practice to rapidly detect falls and other health issues in patients' homes. IWSS alerts indicating behavior changes were sent to CHNs. Their perceived usefulness (PU) and perceived ease of use (PEOU) were assessed. The acceptability of IWSS technology was explored using a questionnaire and focus group discussions. The PU and PEOU of the IWSS technology were low to moderate. A majority of the CHNs were dissatisfied with its performance and intrusiveness; they reported multiple obstacles in the usefulness and ease of use of the IWSS technology in daily practice. To improve the IWSS technology's low to moderate acceptability among CHNs, we recommend a more user-centered implementation strategy and an embedded model of nursing care.

Depression, quality of life (QoL) and will to live of community-dwelling postmenopausal women in three Asian countries: Korea, China and Japan.

PubMed

Ina, Koichiro; Hayashi, Toshio; Nomura, Hideki; Ishitsuka, Asako; Hirai, Hisako; Iguchi, Akihisa

2011-01-01

The purpose of this study was to examine the prevalence of screening-detected depression and the association of depression with QoL in community-dwelling postmenopausal women living in three Asian countries. We examined self-reported questionnaires and conducted the study. A total of 698 community-dwelling postmenopausal women living in three Asian countries participated in this study. The mean age was 59.4±6.6 years (±SD) Depressive symptoms were assessed using a 15-item geriatric depression scale (GDS-15). Using the cut-off of 5/6 for the GDS-15, the percentages of subjects with depression were 39.0% of the Korean subjects, 29.2% of the Chinese subjects, and 33.9% of the Japanese subjects. For the assessment of QoL, we used the EQ-5D of the EuroQoL Group. The following five dimensions were assessed: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The proportions of subjects reporting problems for each dimension were examined. Subjects with depression had significantly lower levels of some dimensions of QoL than those without depression in all three countries. In all three countries, 29.2-39.0% of community-dwelling postmenopausal women had screening-detected depression, which was significantly associated with a lower level of some dimensions of QoL. These results suggest that clinicians should pay more attention to depression in community-dwelling postmenopausal women. Copyright © 2010. Published by Elsevier Ireland Ltd.

Factors controlling volatile organic compounds in dwellings in Melbourne, Australia.

PubMed

Cheng, M; Galbally, I E; Molloy, S B; Selleck, P W; Keywood, M D; Lawson, S J; Powell, J C; Gillett, R W; Dunne, E

2016-04-01

This study characterized indoor volatile organic compounds (VOCs) and investigated the effects of the dwelling characteristics, building materials, occupant activities, and environmental conditions on indoor VOC concentrations in 40 dwellings located in Melbourne, Australia, in 2008 and 2009. A total of 97 VOCs were identified. Nine VOCs, n-butane, 2-methylbutane, toluene, formaldehyde, acetaldehyde, d-limonene, ethanol, 2-propanol, and acetic acid, accounted for 68% of the sum of all VOCs. The median indoor concentrations of all VOCs were greater than those measured outdoors. The occupant density was positively associated with indoor VOC concentrations via occupant activities, including respiration and combustion. Terpenes were associated with the use of household cleaning and laundry products. A petroleum-like indoor VOC signature of alkanes and aromatics was associated with the proximity of major roads. The indoor VOC concentrations were negatively correlated (P < 0.05) with ventilation. Levels of VOCs in these Australian dwellings were lower than those from previous studies in North America and Europe, probably due to a combination of an ongoing temporal decrease in indoor VOC concentrations and the leakier nature of Australian dwellings. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

On rate-dependent polycrystal deformation: the temperature sensitivity of cold dwell fatigue

PubMed Central

Zhang, Zhen; Cuddihy, M. A.; Dunne, F. P. E.

2015-01-01

A temperature and rate-dependent crystal plasticity framework has been used to examine the temperature sensitivity of stress relaxation, creep and load shedding in model Ti-6Al polycrystal behaviour under dwell fatigue conditions. A temperature close to 120°C is found to lead to the strongest stress redistribution and load shedding, resulting from the coupling between crystallographic slip rate and slip system dislocation hardening. For temperatures in excess of about 230°C, grain-level load shedding from soft to hard grains diminishes because of the more rapid stress relaxation, leading ultimately to the diminution of the load shedding and hence, it is argued, the elimination of the dwell debit. Under conditions of cyclic stress dwell, at temperatures between 20°C and 230°C for which load shedding occurs, the rate-dependent accumulation of local slip by ratcheting is shown to lead to the progressive cycle-by-cycle redistribution of stress from soft to hard grains. This phenomenon is termed cyclic load shedding since it also depends on the material's creep response, but develops over and above the well-known dwell load shedding, thus providing an additional rationale for the incubation of facet nucleation. PMID:26528078

Indoor noise exposure at home: a field study in the family of urban schoolchildren.

PubMed

Pujol, S; Berthillier, M; Defrance, J; Lardies, J; Levain, J-P; Petit, R; Houot, H; Mauny, F

2014-10-01

This article aims at evaluating indoor noise levels at home and investigating the factors that may influence their variability. An 8-day noise measurement campaign was conducted in the homes of 44 schoolchildren attending the public primary schools of Besançon (France). The presence of the inhabitants in the dwelling and the noisy events occurring indoors and outdoors was daily collected using a time-location-activity diary (TLAD); 902 time periods were analyzed. The indoor noise level increased significantly with the outdoor noise level, along with the duration of the presence or level of activity of the inhabitants at home. However, this effect may vary according to the period of day and the day of the week. Moreover, a significant part of the day and evening indoor noise level variability was explained when considering the TLAD variables: 46% and 45% in the bedroom, 54% and 39% in the main room, respectively. Our results highlight the complexity of the indoor environment in the dwellings of children living in an urban area. Combining the inhabitant presence and indoor noise source descriptors with outdoor noise levels and other dwelling or inhabitant characteristics could improve large-scale epidemiological studies. However, additional efforts are still needed, particularly during the night period. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Falls-Related Drug Use and Risk of Falls Among Older Adults: A Study in a US Medicare Population.

PubMed

Musich, Shirley; Wang, Shaohung S; Ruiz, Joann; Hawkins, Kevin; Wicker, Ellen

2017-07-01

Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls. The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users. A 10% random sample, insured in AARP ® Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users. New users had a 12-month pre-period without FRD use, whereas continuing users had at least one FRD in the pre-period. Both groups had 12-month follow-up after initiating or continuing FRD use. Characteristics associated with the risk of falls for new and continuing users were determined using multivariate logistic regression models. Among insureds, 44% used at least one of the FRD classes. Of these, 29% were new users (N = 35,340) and 71% were continuing users (N = 121,488). Fall rates for the two subgroups were similar at 7 and 8%, respectively. Characteristics associated with the risk of falls were previous injurious fall, use of two or more classes of FRDs, older age, poorer health, and being female. New users were at higher risk than continuing users. New users of FRDs were at highest risk of falls, and continuing users were at increased risk, especially with higher numbers of FRD classes. Both groups could benefit from falls awareness and prevention programs.

Translation, Validation, and Reliability of the Dutch Late-Life Function and Disability Instrument Computer Adaptive Test.

PubMed

Arensman, Remco M; Pisters, Martijn F; de Man-van Ginkel, Janneke M; Schuurmans, Marieke J; Jette, Alan M; de Bie, Rob A

2016-09-01

Adequate and user-friendly instruments for assessing physical function and disability in older adults are vital for estimating and predicting health care needs in clinical practice. The Late-Life Function and Disability Instrument Computer Adaptive Test (LLFDI-CAT) is a promising instrument for assessing physical function and disability in gerontology research and clinical practice. The aims of this study were: (1) to translate the LLFDI-CAT to the Dutch language and (2) to investigate its validity and reliability in a sample of older adults who spoke Dutch and dwelled in the community. For the assessment of validity of the LLFDI-CAT, a cross-sectional design was used. To assess reliability, measurement of the LLFDI-CAT was repeated in the same sample. The item bank of the LLFDI-CAT was translated with a forward-backward procedure. A sample of 54 older adults completed the LLFDI-CAT, World Health Organization Disability Assessment Schedule 2.0, RAND 36-Item Short-Form Health Survey physical functioning scale (10 items), and 10-Meter Walk Test. The LLFDI-CAT was repeated in 2 to 8 days (mean=4.5 days). Pearson's r and the intraclass correlation coefficient (ICC) (2,1) were calculated to assess validity, group-level reliability, and participant-level reliability. A correlation of .74 for the LLFDI-CAT function scale and the RAND 36-Item Short-Form Health Survey physical functioning scale (10 items) was found. The correlations of the LLFDI-CAT disability scale with the World Health Organization Disability Assessment Schedule 2.0 and the 10-Meter Walk Test were -.57 and -.53, respectively. The ICC (2,1) of the LLFDI-CAT function scale was .84, with a group-level reliability score of .85. The ICC (2,1) of the LLFDI-CAT disability scale was .76, with a group-level reliability score of .81. The high percentage of women in the study and the exclusion of older adults with recent joint replacement or hospitalization limit the generalizability of the results. The Dutch LLFDI-CAT showed strong validity and high reliability when used to assess physical function and disability in older adults dwelling in the community. © 2016 American Physical Therapy Association.

Differentially-expressed opsin genes identified in Sinocyclocheilus cavefish endemic to China

PubMed Central

Meng, Fanwei; Zhao, Yahui; Postlethwait, John H.; Zhang, Chunguang

2013-01-01

Eye degeneration is a common troglomorphic character of cave-dwelling organisms. Comparing the morphology and molecular biology of cave species and their close surface relatives is a powerful tool for studying regressive eye evolution and other adaptive phenotypes. We compared two co-occurring and closely-related species of the fish genus Sinocyclocheilus, which is endemic to China and includes both surface- and cave-dwelling species. Sinocyclocheilus tileihornes, a cave species, had smaller eyes than Sinocyclocheilus angustiporus, a surface species. Histological and immunohistochemical analyses revealed that the cavefish had shorter cones and more disorderly rods than did the surface-dwelling species. Using quantitative PCR and in situ hybridization, we found that rhodopsin and a long-wavelength sensitive opsin had significantly lower expression levels in the cavefish. Furthermore, one of two short-wavelength-sensitive opsins was expressed at significantly higher levels in the cavefish. Changes in the expression of opsin genes may have played a role in the degeneration of cavefish eyes PMID:24363664

Antipsychotic doses among community-dwelling persons with Alzheimer disease in Finland.

PubMed

Taipale, Heidi; Koponen, Marjaana; Tanskanen, Antti; Tolppanen, Anna-Maija; Tiihonen, Jari; Hartikainen, Sirpa

2014-08-01

Use of antipsychotics for treatment of behavioral and psychological symptoms of dementia is frequent among persons with Alzheimer disease (AD). Doses used in long-term therapy have not been previously reported. We describe antipsychotic doses used among community-dwelling persons with AD and investigate factors associated with high-dose use. The MEDALZ-2005 (Medication use and Alzheimer disease) cohort is a nationwide sample including all persons with clinically diagnosed AD at the end of year 2005 in Finland (n = 28,093). Data including prescriptions, comorbidities, and hospital discharge diagnoses were collected from nationwide registers. Antipsychotic doses in monotherapy were investigated during 2006 to 2009. Among 8920 antipsychotic users, 4% (n = 336) used antipsychotics with high dose. Typical antipsychotics were more often used with high dose than atypical antipsychotics. High-dose use was associated with younger age (<80 years) (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.36-2.15]), male sex (OR, 1.52; CI, 1.21-1.91), history of psychiatric disorder (OR, 3.25; CI, 2.54-4.15), and inversely associated with Charlson Comorbidity Index score (score 1: OR, 0.74; CI, 0.57-0.97; score ≥2: OR, 0.68; CI, 0.47-0.97). In conclusion, the majority of persons with AD used antipsychotics with low or medium dose. Typical antipsychotics were more often used with high dose than atypical antipsychotics, which indicates a need for precise dosing instructions in the treatment of behavioral and psychological symptoms of dementia. Clinicians should regularly assess dosing levels especially among men and those with history of psychiatric disorder.

Simplified tools for evaluating domestic ventilation systems

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

Maansson, L.G.; Orme, M.

1999-07-01

Within an International Energy Agency (IEA) project, Annex 27, experts from 8 countries (Canada, France, Italy, Japan, The Netherlands, Sweden, UK and USA) have developed simplified tools for evaluating domestic ventilation systems during the heating season. Tools for building and user aspects, thermal comfort, noise, energy, life cycle cost, reliability and indoor air quality (IAQ) have been devised. The results can be used both for dwellings at the design stage and after construction. The tools lead to immediate answers and indications about the consequences of different choices that may arise during discussion with clients. This paper presents an introduction tomore » these tools. Examples applications of the indoor air quality and energy simplified tools are also provided. The IAQ tool accounts for constant emission sources, CO{sub 2}, cooking products, tobacco smoke, condensation risks, humidity levels (i.e., for judging the risk for mould and house dust mites), and pressure difference (for identifying the risk for radon or land fill spillage entering the dwelling or problems with indoor combustion appliances). An elaborated set of design parameters were worked out that resulted in about 17,000 combinations. By using multi-variate analysis it was possible to reduce this to 174 combinations for IAQ. In addition, a sensitivity analysis was made using 990 combinations. The results from all the runs were used to develop a simplified tool, as well as quantifying equations relying on the design parameters. A computerized energy tool has also been developed within this project, which takes into account air tightness, climate, window airing pattern, outdoor air flow rate and heat exchange efficiency.« less

[The hazards of reconstruction: anthropology of dwelling and social health risk in the L'Aquila (Central Italy) post-earthquake].

PubMed

Ciccozzi, Antonello

2016-01-01

Even starting from the purpose of restoring the damage caused by a natural disaster, the post-earthquake reconstructions imply the risk of triggering a set of social disasters that may affect the public health sphere. In the case of the L'Aquila earthquake this risk seems to emerge within the urban planning on two levels of dwelling: at a landscape level, where there has been a change in the shape of the city towards a sprawling-sprinkling process; at an architectural level, on the problematic relationship between the politics and the poetics of cultural heritage protection and the goal to get restoration works capable to ensure the citizens seismic safety.

Separating the Influence of Environment from Stress Relaxation Effects on Dwell Fatigue Crack Growth

NASA Technical Reports Server (NTRS)

Telesman, Jack; Gabb, Tim; Ghosn, Louis J.

2016-01-01

Seven different microstructural variations of LSHR were produced by controlling the cooling rate and the subsequent aging and thermal exposure heat treatments. Through cyclic fatigue crack growth testing performed both in air and vacuum, it was established that four out of the seven LSHR heat treatments evaluated, possessed similar intrinsic environmental resistance to cyclic crack growth. For these four heat treatments, it was further shown that the large differences in dwell crack growth behavior which still persisted, were related to their measured stress relaxation behavior. The apparent differences in their dwell crack growth resistance were attributed to the inability of the standard linear elastic fracture mechanics (LEFM) stress intensity parameter to account for visco-plastic behavior. Crack tip stress relaxation controls the magnitude of the remaining local tensile stresses which are directly related to the measured dwell crack growth rates. It was hypothesized that the environmentally weakened grain boundary crack tip regions fail during the dwells when their strength is exceeded by the remaining local crack tip tensile stresses. It was shown that the classical creep crack growth mechanisms such as grain boundary sliding did not contribute to crack growth, but the local visco-plastic behavior still plays a very significant role by determining the crack tip tensile stress field which controls the dwell crack growth behavior. To account for the influence of the visco-plastic behavior on the crack tip stress field, an empirical modification to the LEFM stress intensity parameter, Kmax, was developed by incorporating into the formulation the remaining stress level concept as measured by simple stress relaxation tests. The newly proposed parameter, Ksrf, did an excellent job in correlating the dwell crack growth rates for the four heat treatments which were shown to have similar intrinsic environmental cyclic fatigue crack growth resistance.

Nest ectoparasites increase physiological stress in breeding birds: an experiment.

PubMed

Martínez-de la Puente, Josué; Merino, Santiago; Tomás, Gustavo; Moreno, Juan; Morales, Judith; Lobato, Elisa; Martínez, Javier

2011-02-01

Parasites are undoubtedly a biotic factor that produces stress. Heat shock proteins (HSPs) are important molecules buffering cellular damage under adverse conditions. During the breeding season, blue tit Cyanistes caeruleus (L.) adults are affected by blood parasites, nest-dwelling parasites and biting flies, potentially affecting their HSP-mediated responses. Here, we treated females with primaquine to reduce blood parasites and fumigated nests with permethrin to reduce nest-dwelling parasites to test whether these treatments affect HSP60 level during the breeding season. Medicated females, but not controls, had a significant reduction of the intensity of infection by Haemoproteus spp. blood parasites. However, final intensity of infection did not differ significantly between groups, and we did not find an effect of medication on change in HSP60 level. Fumigation reduced the abundance of nest-dwelling parasites (mites, fleas and blowfly larvae) and engorged biting midges in nests. Females breeding in non-fumigated nests increased HSP60 levels during the season more than those breeding in fumigated nests. Furthermore, the change in HSP60 level was positively correlated with the abundance of biting midges. These results show how infections by nest ectoparasites during the breeding period can increase the level of HSPs and suggest that biting midges impose physiological costs on breeding female blue tits. Although plausible, the alternative that biting midges prefer to feed on more stressed birds is poorly supported by previous studies.

Focused Study on the Quiet Side Effect in Dwellings Highly Exposed to Road Traffic Noise

PubMed Central

Renterghem, Timothy Van; Botteldooren, Dick

2012-01-01

This study provides additional evidence for the positive effect of the presence of a quiet façade at a dwelling and aims at unraveling potential mechanisms. Locations with dominant road traffic noise and high Lden-levels at the most exposed façade were selected. Dwellings both with and without a quiet façade were deliberately sought out. Face-to-face questionnaires (N = 100) were taken to study the influence of the presence of a quiet side in relation to noise annoyance and sleep disturbance. As a direct effect, the absence of a quiet façade in the dwelling (approached as a front-back façade noise level difference smaller than 10 dBA) leads to an important increase of at least moderately annoyed people (odds-ratio adjusted for noise sensitivity equals 3.3). In an indirect way, a bedroom located at the quiet side leads to an even stronger reduction of the self-reported noise annoyance (odds-ratio equal to 10.6 when adjusted for noise sensitivity and front façade Lden). The quiet side effect seems to be especially applicable for noise sensitive persons. A bedroom located at the quiet side also reduces noise-induced sleep disturbances. On a loud side, bedroom windows are more often closed, however, conflicting with the preference of dwellers. PMID:23330222

Evaluation of temephos and chlorpyrifos-methyl against Culex pipiens (Diptera: Culicidae) larvae in septic tanks in Antalya, Turkey.

PubMed

Cetin, H; Yanikoglu, A; Kocak, O; Cilek, J E

2006-11-01

The larvicidal activity of chlorpyrifos-methyl and temephos was evaluated against Culex pipiens L. (Diptera: Culicidae) in septic tanks in Antalya, Turkey. Chlorpyrifos-methyl (Pyrifos MT 25 emulsifiable concentrate [EC] ) was evaluated at application rates of 0.04, 0.08, and 0.12 mg active ingredient (AI)/liter, and temephos (Temeguard 50 EC) was evaluated at 0.02, 0.04, and 0.06 mg (AI)/liter during a 21-d study. Generally, overall larval reduction in septic tanks from single- and multifamily dwellings treated with either larvicide was significantly greater than pretreatment levels and control tanks for the duration of the study. At 14 d posttreatment, duration of control was greatest in multifamily tanks treated with chlorpyrifos-methyl at the highest application rate with similar levels of control through 21 d for single-family dwellings (range 97-100%). Septic tanks from both types of family dwellings treated at the highest application rate of temephos resulted in >90% reduction through day 21 (range 91-100%). Laboratory bioassays of septic tank water treated at field application rates, without daily dilution, revealed that complete larval mortality was achieved for 21 d at each application rate and formulation. It is thought that daily addition of water and organic matter to the septic tanks in the single and multifamily dwellings influenced the duration of effectiveness of the larvicides.

The average cost of pressure ulcer management in a community dwelling spinal cord injury population.

PubMed

Chan, Brian C; Nanwa, Natasha; Mittmann, Nicole; Bryant, Dianne; Coyte, Peter C; Houghton, Pamela E

2013-08-01

Pressure ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Person-centredness in elder care: A secondary analysis of data from a study among home-dwelling men and women in the Faroe Islands.

PubMed

Róin, Ása

2018-06-01

As individuals in Western societies age, there is increasing demand for home-based care to help older people stay in their homes for as long as possible and provide services that ensure a person's quality of life in old age. Numerous attempts are made to develop a framework to secure quality of care. However, research has shown insufficient quality in care for older people. In this study, the purpose is to study how older people's experiences with home care reflect a person-centred approach to care. Data derived from an earlier study on ageing among home-dwelling men and women who are aged 67-91 and living in the Faroe Islands. Person-centredness as a concept is an often quoted, but ill-defined concept. Most studies concerning person-centred care are conducted within hospital wards or long-term care institutions. Empirical studies concerning home-dwelling older people receiving home care are scarce. The study is a secondary analysis of data from an earlier qualitative study. Latent thematic analysis was used which meant coding issues of potential interest and collecting these codes into themes. Three themes appeared to combine the initial codes: sense of involvement, sense of meaningfulness and contextual conditions. Overall, the analysis showed that the users were seldom involved in planning or scheduling the care they received. What they were offered did not always make sense to them or correspond to their needs or preferences. The number of interviews included was limited. However, findings from this study point at some possible barriers to successful implementation of person-centredness within elder care. Especially, contextual conditions seem to limit the facilitation of person-centred practices. Healthcare providers must take the user's preferences, resources and networks into consideration when coordinating and planning home care and, importantly, be open for negotiating needs. It is important to draw attention to the contrast between political intentions regarding elder care and the limited options for putting the intentions into practice. © 2017 John Wiley & Sons Ltd.

Who Are the High-Cost Users? A Method for Person-Centred Attribution of Health Care Spending

PubMed Central

Guilcher, Sara J. T.; Bronskill, Susan E.; Guan, Jun; Wodchis, Walter P.

2016-01-01

Objective To develop person-centered episodes of care (PCE) for community-dwelling individuals in the top fifth percentile of Ontario health care expenditures in order to: (1) describe the main clinical groupings for spending; and (2) identify patterns of spending by health sector (e.g. acute care, home care, physician billings) within and across PCE. Data sources Data were drawn from population-based administrative databases for all publicly funded health care in Ontario, Canada in 2010/11. Study design This study is a retrospective cohort study. Data collection/extraction methods A total of 587,982 community-dwelling individuals were identified among those accounting for the top 5% of provincial health care expenditures between April 1, 2010 and March 31, 2011. PCE were defined as starting with an acute care admission and persisting through subsequent care settings and providers until individuals were without health system contact for 30 days. PCE were classified according to the clinical grouping for the initial admission. PCE and non-PCE costs were calculated and compared to provide a comprehensive measurement of total health system costs for the year. Principal findings Among this community cohort, 697,059 PCE accounted for nearly 70% ($11,815.3 million (CAD)) of total annual publicly-funded expenditures on high-cost community-dwelling individuals. The most common clinical groupings to start a PCE were Acute Planned Surgical (35.2%), Acute Unplanned Medical (21.0%) and Post-Admission Events (10.8%). Median PCE costs ranged from $3,865 (IQR = $1,712-$10,919) for Acute Planned Surgical to $20,687 ($12,207-$39,579) for Post-Admission Events. Inpatient acute ($8,194.5 million) and inpatient rehabilitation ($434.6 million) health sectors accounted for the largest proportions of allocated PCE spending over the year. Conclusions Our study provides a novel methodological approach to categorize high-cost health system users into meaningful person-centered episodes. This approach helps to explain how costs are attributable within individuals across sectors and has applications in episode-based payment formulas and quality monitoring. PMID:26937955

The severity and associated factors of participation restriction among community-dwelling frail older people: an application of the International Classification of Functioning, Disability and Health (WHO-ICF).

PubMed

Liu, Justina Yat Wa

2017-01-31

The International Classification of Functioning, Disability, and Health (WHO-ICF) describes participation restriction as one aspect of disability. Participation restriction refers to health problems that can hinder people's involvement in different life events. It is rational to believe that the prevalence of participation restriction increases among a frail population. However, information about the level of participation restriction among older people, particularly the pre-frail or frail, remains scant. The aim of this study was to identify the prevalence and underlying risk factors associated with participation restriction among community-dwelling frail and pre-frail older people. A cross-section of 299 community-dwelling frail older people with a mean age of 79.5 participated in this study. They had to have been identified as being either pre-frail or frail based on the five common characteristics of the frailty phenotype. Their level of participation restriction was assessed based on the Chinese Reintegration to Nursing Living Index (C-RNLI). All other independent variables were identified and systematically linked to different components in the WHO-ICF framework. Among all participants, 207 (69.2%) were identified as encountering participation restrictions in at least one aspect of their life, with a mean C-RNLI score of 68.3 (SD 19.43). A multivariate regression analysis showed that the participants' status of frailty, self-perceived social status, level of exhibited depressive mood, sleep quality, mobility, level of fear of falling, and physical activity levels had a significant association with participation restriction. When all of the variables, regardless of significance, were included, the factors together explained 67.1% of the variance in the participants' participation restriction. Participation restriction was prevalent among community-dwelling frail older people and was associated with factors across different components in the WHO-ICF. This finding supports the view that participation restriction is multifactorial in nature.

Association of low serum 25-hydroxyvitamin D levels with the frailty syndrome in Mexican community-dwelling elderly.

PubMed

Gutiérrez-Robledo, Luis Miguel; Ávila-Funes, José Alberto; Amieva, Hélène; Meillon, Céline; Acosta, José Luis; Navarrete-Reyes, Ana Patricia; Torres-Carrillo, Norma; Muñoz-Valle, José Francisco; Torres-Carrillo, Nora Magdalena

2016-01-01

Since vitamin D is an important regulator of muscle function, the effect of vitamin D deficiency on frailty syndrome has been recently studied. This cross-sectional study aimed to determine the association between 25(OH)-vitamin D levels and frailty status in Mexican community-dwelling elderly. Sample of 331 community-dwelling elderly aged 70 or older, a subset of those included in the "Coyoacán cohort" were included. 25(OH)-vitamin D assay and frailty status were measured. Mean age was 79.3 years and 54.1% were women. Those classified as frail were more likely to have lower Mini-Mental State Examination score (p = 0.015), more disability for instrumental activities of daily living (p < 0.001) and for activities of daily living (p < 0.001). Serum 25(OH)-vitamin D levels were lower in the frail subgroup when compared with the non-frail one (p < 0.001). Multivariate logistic regression analyses showed a significant association between intermediate tertile [odds ratios (OR) = 4.13; 95% confidence intervals (CI) 2.00-8.56] or insufficient tertile (OR = 8.95; 95% CI 2.41-33.30) of vitamin D levels and frailty even after adjusting for potential confounders. These results suggest that older adults with low 25(OH)-vitamin D levels are associated with the probability to being frail compared with those with sufficient vitamin D levels.

Physical and leisure activity in older community-dwelling canadians who use wheelchairs: a population study.

PubMed

Best, Krista L; Miller, William C

2011-04-13

Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR = 44.71) and leisure activity (OR = 10.83). Wheelchair use was a risk factor for poor perceived health (OR = 10.56) and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits.

Physical and Leisure Activity in Older Community-Dwelling Canadians Who Use Wheelchairs: A Population Study

PubMed Central

Best, Krista L.; Miller, William C.

2011-01-01

Background. Physical and leisure activities are proven health promotion modalities and have not been examined in older wheelchair users. Main Objectives. Examine physical and leisure activity in older wheelchair users and explore associations between wheelchair use and participation in physical and leisure activity, and wheelchair use, physical and leisure activity, and perceived health. Methods. 8301 Canadians ≥60 years of age were selected from the Canadian Community Health Survey. Sociodemographic, health-related, mobility-related, and physical and leisure activity variables were analysed using logistic regression to determine, the likelihood of participation in physical and leisure activity, and whether participation in physical and leisure activities mediates the relationship between wheelchair use and perceived health. Results. 8.3% and 41.3% older wheelchair users were physically and leisurely active. Wheelchair use was a risk factor for reduced participation in physical (OR = 44.71) and leisure activity (OR = 10.83). Wheelchair use was a risk factor for poor perceived health (OR = 10.56) and physical and leisure activity negatively mediated the relationship between wheelchair user and perceived health. Conclusion. There is a need for the development of suitable physical and leisure activity interventions for older wheelchair users. Participation in such interventions may have associations with health benefits. PMID:21584226

Acceptability Among Community Healthcare Nurses of Intelligent Wireless Sensor-system Technology for the Rapid Detection of Health Issues in Home-dwelling Older Adults

PubMed Central

Cohen, Christine; Kampel, Thomas; Verloo, Henk

2017-01-01

Background: The effective care and support of community healthcare nurses (CHNs) contribute greatly to the healthy aging of older adults living at home. Integrating innovative technologies into CHNs’ daily practice offers new opportunities and perspectives for early detection of health issues and interventions among home-dwelling older adults. Aim: To explore the perception of acceptability among CHNs of an intelligent wireless sensor system (IWSS) for use in daily practice for the detection of health issues in home-dwelling older adults receiving home healthcare. Method: Descriptive and qualitative data were sourced from a pilot randomized controlled trial involving 17 CHNs using an IWSS in their daily practice to rapidly detect falls and other health issues in patients’ homes. IWSS alerts indicating behavior changes were sent to CHNs. Their perceived usefulness (PU) and perceived ease of use (PEOU) were assessed. The acceptability of IWSS technology was explored using a questionnaire and focus group discussions. Results: The PU and PEOU of the IWSS technology were low to moderate. A majority of the CHNs were dissatisfied with its performance and intrusiveness; they reported multiple obstacles in the usefulness and ease of use of the IWSS technology in daily practice. Conclusion: To improve the IWSS technology’s low to moderate acceptability among CHNs, we recommend a more user-centered implementation strategy and an embedded model of nursing care. PMID:28567170

Comparative risk of cerebrovascular adverse events in community-dwelling older adults using risperidone, olanzapine and quetiapine: a multiple propensity score-adjusted retrospective cohort study.

PubMed

Chatterjee, Satabdi; Chen, Hua; Johnson, Michael L; Aparasu, Rajender R

2012-10-01

Atypical antipsychotic agents have been associated with cerebrovascular adverse events, particularly in elderly dementia patients. However, limited evidence exists regarding comparative cerebrovascular profiles of individual atypical agents, particularly in community settings. The objective of this study was to evaluate the risk of cerebrovascular events associated with use of risperidone, olanzapine and quetiapine in community-dwelling older adults in the US. A propensity score-adjusted retrospective cohort design involving the IMS LifeLink™ Health Plan Claims Database was used for the study. The study population included all older adults (aged ≥50 years) who initiated risperidone, olanzapine or quetiapine anytime during 1 July 2000 to 30 June 2008. Patients were followed until hospitalization or an emergency room visit for a cerebrovascular event, or the end of the study period, whichever occurred earlier. The Cox proportional hazard regression model with time-varying covariates was used to evaluate the risk of cerebrovascular events during the follow-up period, using olanzapine as the reference. The covariates adjusted for in the final model included multiple propensity scores and exposure to other medications that could be associated with the risk of cerebrovascular events. A total of 2,458 cerebrovascular events were identified in the study cohort: 1,081 (21.38%) for risperidone users, 816 (18.75%) for olanzapine users and 561 (21.05%) for quetiapine users. After adjusting for propensity scores and other covariates, the Cox proportional hazard model revealed that use of quetiapine [hazard ratio (HR) 0.88; 95% CI 0.78, 0.99] but not risperidone (HR 1.05; 95% CI 0.95, 1.16) was associated with a decrease in the risk of cerebrovascular adverse events compared with olanzapine. The study suggested that quetiapine use may be associated with a moderately lower risk of cerebrovascular events than olanzapine in older adults. Prescribers should closely monitor the patients treated with atypical agents for the incidence of cerebrovascular adverse events.

Physical activity and sedentary behavior measured objectively and subjectively in overweight and obese adults with schizophrenia or schizoaffective disorders.

PubMed

Janney, Carol A; Ganguli, Rohan; Tang, Gong; Cauley, Jane A; Holleman, Robert G; Richardson, Caroline R; Kriska, Andrea M

2015-10-01

Describe objective and subjective physical activity levels and time spent being sedentary in adults with schizophrenia or schizoaffective disorders (SZO/SA). Baseline physical activity and sedentary behaviors were assessed among 46 overweight and obese community-dwelling adults (aged 18-70 years; BMI > 27 kg/m(2)) diagnosed with SZO/SA by DSM-IV-TR, with mild symptom severity (Positive and Negative Syndrome Scale score < 90) who were interested in losing weight and participated in the Weight Assessment and Intervention in Schizophrenia Treatment (WAIST) study from 2004 to 2008. Objective physical activity levels, measured using actigraphs, in WAIST were compared to a nationally representative sample of users (n = 46) and nonusers (n = 46) of mental health service (MHS) from the National Health and Nutrition Examination Survey (NHANES 2003-2004) matched by sex, BMI, and age. On average, adults with SZO/SA wore actigraphs more than 15 h/d for 7 days averaging 151,000 counts/d. The majority of monitoring time (81%) was classified as sedentary (approximately 13 h/d). Moderate/vigorous and light physical activity accounted for only 2% (19 min/d) and 17% (157 min/d) of monitoring time/d, respectively. Primary source of activity was household activities (409 ± 438 min/wk). Fifty-three percent reported walking for transportation or leisure. Adults with SZO/SA were significantly less active (176 min/d) and more sedentary (756 min/d) than NHANES users of MHS (293 and 640 min/d, respectively) and nonusers of MHS (338 and 552 min/d, respectively) (P < .01). Overweight and obese adults with SZO/SA were extremely sedentary; engaged in unstructured, intermittent, low-intensity physical activity; and significantly less active than NHANES users and nonusers of MHS. This sedentary lifestyle is significantly lower than those of other inactive US populations, is costly for the individual and community, and highlights the need for physical activity promotion and interventions in this high risk population. © Copyright 2015 Physicians Postgraduate Press, Inc.

An unusual case of carbon monoxide poisoning.

PubMed Central

Auger, P L; Levesque, B; Martel, R; Prud'homme, H; Bellemare, D; Barbeau, C; Lachance, P; Rhainds, M

1999-01-01

Carbon monoxide, a gas originating from incomplete combustion of carbon-based fuels, is an important cause of human deaths. In this paper, we describe an unusual carbon monoxide poisoning in a dwelling without obvious sources of combustion gases, for which two adults had to be treated in a hyperbaric chamber. Carbon monoxide readings were taken in the house and in the neighboring homes. Methane gas and nitrogen oxide levels were also monitored in the house air. Soil samples were collected around the house and tested for hydrocarbon residues. The investigation revealed the presence of a pocket of carbon monoxide under the foundation of the house. The first readings revealed carbon monoxide levels of 500 ppm in the basement. The contamination lasted for a week. The investigation indicated that the probable source of contamination was the use of explosives at a nearby rain sewer construction site. The use of explosives in a residential area can constitute a major source of carbon monoxide for the neighboring populations. This must be investigated, and public health authorities, primary-care physicians, governmental authorities, and users and manufacturers of explosives must be made aware of this problem. Images Figure 1 Figure 2 PMID:10379009

Fungi in carpeting and furniture dust.

PubMed

Schober, G

1991-11-01

The qualitative and quantitative species composition of fungi in carpets and upholstered furniture dust found in the living-rooms of nine Dutch dwellings was examined in a pilot study. Numbers of spores of xerophilic fungi did not differ in dust removed from carpeting and upholstery. Spores of hydrophilic species were found to be more predominant on floors (P less than 0.05), whereas meso-hygrophilic spores, largely dominated by allergologically relevant Penicillium species, were significantly more abundant in dust taken from regularly used furniture (P less than 0.05). Our results indicate that growth conditions for fungi in the micro-habitats of furniture differ from those in carpeting. No statistically significant differences in number of viable spores have been found in samples taken from ground-floor level compared with those taken from 1st to 3rd floor level of dwellings. From this study, the need for a micro-topographic analysis of the fungal flora in the human environment has become apparent. Efficient allergological home sanitation in dwellings of allergic patients requires detailed data about the colonization of the various micro-habitats by allergenic fungi.

Data compressive paradigm for multispectral sensing using tunable DWELL mid-infrared detectors.

PubMed

Jang, Woo-Yong; Hayat, Majeed M; Godoy, Sebastián E; Bender, Steven C; Zarkesh-Ha, Payman; Krishna, Sanjay

2011-09-26

While quantum dots-in-a-well (DWELL) infrared photodetectors have the feature that their spectral responses can be shifted continuously by varying the applied bias, the width of the spectral response at any applied bias is not sufficiently narrow for use in multispectral sensing without the aid of spectral filters. To achieve higher spectral resolutions without using physical spectral filters, algorithms have been developed for post-processing the DWELL's bias-dependent photocurrents resulting from probing an object of interest repeatedly over a wide range of applied biases. At the heart of these algorithms is the ability to approximate an arbitrary spectral filter, which we desire the DWELL-algorithm combination to mimic, by forming a weighted superposition of the DWELL's non-orthogonal spectral responses over a range of applied biases. However, these algorithms assume availability of abundant DWELL data over a large number of applied biases (>30), leading to large overall acquisition times in proportion with the number of biases. This paper reports a new multispectral sensing algorithm to substantially compress the number of necessary bias values subject to a prescribed performance level across multiple sensing applications. The algorithm identifies a minimal set of biases to be used in sensing only the relevant spectral information for remote-sensing applications of interest. Experimental results on target spectrometry and classification demonstrate a reduction in the number of required biases by a factor of 7 (e.g., from 30 to 4). The tradeoff between performance and bias compression is thoroughly investigated. © 2011 Optical Society of America

Predictors of Older Adults’ Technology Use and Its Relationship to Depressive Symptoms and Well-being

PubMed Central

Mooney, Christopher J.; Douthit, Kathryn Z.; Lynch, Martin F.

2014-01-01

Objective. To extend the empirical evidence regarding the predictors of older adults’ use of information and communications technology (ICT) and to further examine its relationship to depressive symptoms and well-being. Method. This cross-sectional study utilized a sample of community-dwelling older adults from the National Health and Aging Trends Study (N = 6,443). Structural equation modeling was used to estimate the effects of predictor variables on ICT use and the effects of use on depressive symptoms and well-being. Tests of moderation by demographic characteristics and level of ICT use were also performed. Results. Socioeconomic status (SES), age, and cognitive function accounted for approximately 60% of the variance in ICT use. SES was a stronger predictor for Blacks/African Americans, whereas cognitive function was a stronger predictor for Whites. ICT use was unrelated to depressive symptoms or well-being. However, it acted as a moderator, such that limitations in activities of daily living (ADLs) was a stronger predictor of depressive symptoms for high ICT users, whereas ill-health was a stronger predictor for non/limited users. Discussion. Findings do not support the claim that ICT use directly enhances mental health or well-being among older adults although it may protect against depressive symptoms for individuals coping with health conditions other than ADL impairments. PMID:24304556

Are multidose drug dispensing systems initiated for the appropriate patients?

PubMed

Mertens, Bram J; Kwint, H F; van Marum, Rob J; Bouvy, Marcel L

2018-05-16

It is unknown if multidose drug dispensing (MDD) systems are initiated for the appropriate patients. Therefore, the objective of this study was to compare the medication management problems of patients who were about to start with a MDD system (MDD patients) and patients who continued manually dispensed medication (non-MDD users) in order to identify if the appropriate patients receive a MDD system. Patient interviews (semi-structured) were conducted by 44 community pharmacists at the patient's home. Patients over 65 years of age, home dwelling and using at least five chronic drugs, were eligible for the study. An assessment tool was developed including 22 potential medication management problems, covering four domains: functional (7), organizational (7), medication adherence (6), and medication knowledge (2). Median scores were calculated with the interquartile range. Additionally, cognitive function was assessed with the Mini-Cog and frailty using the Groningen Frailty Indicator. One hundred eighty-eight MDD users and 230 non-MDD users were interviewed. MDD users were older, more often female, and using more drugs. Forty-two percent of the MDD users were possibly cognitively impaired and 63% were assessed as frail compared to 20 and 27% respectively of the non-MDD users. MDD users had more potential organizational problems (3 vs. 1; p < 0.01), functional problems (2 vs. 1; p < 0.01), medication adherence problems (1 vs. 0; p < 0.01), and medication knowledge problems (1 vs. 0; p < 0.01) compared to non-MDD users. Seventy percent of the MDD users scored six or more potential medication management problems while this was 22% among non-MDD users. The majority of MDD systems were initiated for patients who experienced multiple potential medication management problems suggesting a decreased medication management capacity.

Dosimetric effects of saline- versus water-filled balloon applicators for IORT using the model S700 electronic brachytherapy source.

PubMed

Redler, Gage; Templeton, Alistair; Zhen, Heming; Turian, Julius; Bernard, Damian; Chu, James C H; Griem, Katherine L; Liao, Yixiang

The Xoft Axxent Electronic Brachytherapy System (Xoft, Inc., San Jose, CA) is a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low-energy (50-kVp) X-ray source simplifies shielding and increases relative biological effectiveness but increases dose distribution sensitivity to medium composition. Treatment planning systems typically assume homogenous water for brachytherapy dose calculations, including precalculated atlas plans for Xoft IORT. However, Xoft recommends saline for balloon applicator filling. This study investigates dosimetric differences due to increased effective atomic number (Z eff ) for saline (Z eff  = 7.56) versus water (Z eff  = 7.42). Balloon applicator diameters range from 3 to 6 cm. Monte Carlo N-Particle software is used to calculate dose at the surface (D s ) of and 1 cm away (D 1cm ) from the water-/saline-filled balloon applicator using a single dwell at the applicator center as a simple estimation of the dosimetry and multiple dwells simulating the clinical dose distributions for the atlas plans. Single-dwell plans show a 4.4-6.1% decrease in D s for the 3- to 6-cm diameter applicators due to the saline. Multidwell plans show similar results: 4.9% and 6.4% D s decrease, for 4-cm and 6-cm diameter applicators, respectively. For the single-dwell plans, D 1cm decreases 3.6-5.2% for the 3- to 6-cm diameter applicators. For the multidwell plans, D 1cm decreases 3.3% and 5.3% for the 4-cm and 6-cm applicators, respectively. The dosimetric effect introduced by saline versus water filling for Xoft balloon applicator-based IORT treatments is ∼5%. Users should be aware of this in the context of both treatment planning and patient outcome studies. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Energy Management in Smart Cities Based on Internet of Things: Peak Demand Reduction and Energy Savings.

PubMed

Mahapatra, Chinmaya; Moharana, Akshaya Kumar; Leung, Victor C M

2017-12-05

Around the globe, innovation with integrating information and communication technologies (ICT) with physical infrastructure is a top priority for governments in pursuing smart, green living to improve energy efficiency, protect the environment, improve the quality of life, and bolster economy competitiveness. Cities today faces multifarious challenges, among which energy efficiency of homes and residential dwellings is a key requirement. Achieving it successfully with the help of intelligent sensors and contextual systems would help build smart cities of the future. In a Smart home environment Home Energy Management plays a critical role in finding a suitable and reliable solution to curtail the peak demand and achieve energy conservation. In this paper, a new method named as Home Energy Management as a Service (HEMaaS) is proposed which is based on neural network based Q -learning algorithm. Although several attempts have been made in the past to address similar problems, the models developed do not cater to maximize the user convenience and robustness of the system. In this paper, authors have proposed an advanced Neural Fitted Q -learning method which is self-learning and adaptive. The proposed method provides an agile, flexible and energy efficient decision making system for home energy management. A typical Canadian residential dwelling model has been used in this paper to test the proposed method. Based on analysis, it was found that the proposed method offers a fast and viable solution to reduce the demand and conserve energy during peak period. It also helps reducing the carbon footprint of residential dwellings. Once adopted, city blocks with significant residential dwellings can significantly reduce the total energy consumption by reducing or shifting their energy demand during peak period. This would definitely help local power distribution companies to optimize their resources and keep the tariff low due to curtailment of peak demand.

Automated construction of an intraoperative high-dose-rate treatment plan library for the Varian brachytherapy treatment planning system.

PubMed

Deufel, Christopher L; Furutani, Keith M; Dahl, Robert A; Haddock, Michael G

2016-01-01

The ability to create treatment plans for intraoperative high-dose-rate (IOHDR) brachytherapy is limited by lack of imaging and time constraints. An automated method for creation of a library of high-dose-rate brachytherapy plans that can be used with standard planar applicators in the intraoperative setting is highly desirable. Nonnegative least squares algebraic methods were used to identify dwell time values for flat, rectangular planar applicators. The planar applicators ranged in length and width from 2 cm to 25 cm. Plans were optimized to deliver an absorbed dose of 10 Gy to three different depths from the patient surface: 0 cm, 0.5 cm, and 1.0 cm. Software was written to calculate the optimized dwell times and insert dwell times and positions into a .XML plan template that can be imported into the Varian brachytherapy treatment planning system. The user may import the .XML template into the treatment planning system in the intraoperative setting to match the patient applicator size and prescribed treatment depth. A total of 1587 library plans were created for IOHDR brachytherapy. Median plan generation time was approximately 1 minute per plan. Plan dose was typically 100% ± 1% (mean, standard deviation) of the prescribed dose over the entire length and width of the applicator. Plan uniformity was best for prescription depths of 0 cm and 0.5 cm from the patient surface. An IOHDR plan library may be created using automated methods. Thousands of plan templates may be optimized and prepared in a few hours to accommodate different applicator sizes and treatment depths and reduce treatment planning time. The automated method also enforces dwell time symmetry for symmetrical applicator geometries, which simplifies quality assurance. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Energy Management in Smart Cities Based on Internet of Things: Peak Demand Reduction and Energy Savings

PubMed Central

Moharana, Akshaya Kumar

2017-01-01

Around the globe, innovation with integrating information and communication technologies (ICT) with physical infrastructure is a top priority for governments in pursuing smart, green living to improve energy efficiency, protect the environment, improve the quality of life, and bolster economy competitiveness. Cities today faces multifarious challenges, among which energy efficiency of homes and residential dwellings is a key requirement. Achieving it successfully with the help of intelligent sensors and contextual systems would help build smart cities of the future. In a Smart home environment Home Energy Management plays a critical role in finding a suitable and reliable solution to curtail the peak demand and achieve energy conservation. In this paper, a new method named as Home Energy Management as a Service (HEMaaS) is proposed which is based on neural network based Q-learning algorithm. Although several attempts have been made in the past to address similar problems, the models developed do not cater to maximize the user convenience and robustness of the system. In this paper, authors have proposed an advanced Neural Fitted Q-learning method which is self-learning and adaptive. The proposed method provides an agile, flexible and energy efficient decision making system for home energy management. A typical Canadian residential dwelling model has been used in this paper to test the proposed method. Based on analysis, it was found that the proposed method offers a fast and viable solution to reduce the demand and conserve energy during peak period. It also helps reducing the carbon footprint of residential dwellings. Once adopted, city blocks with significant residential dwellings can significantly reduce the total energy consumption by reducing or shifting their energy demand during peak period. This would definitely help local power distribution companies to optimize their resources and keep the tariff low due to curtailment of peak demand. PMID:29206159

Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome.

PubMed

Christian, Rose C; Dumesic, Daniel A; Behrenbeck, Thomas; Oberg, Ann L; Sheedy, Patrick F; Fitzpatrick, Lorraine A

2003-06-01

Polycystic ovary syndrome (PCOS), a common endocrine disorder of reproductive-aged women, is associated with multiple risk factors for coronary heart disease (CHD), such as diabetes mellitus, dyslipidemia, visceral obesity, and hypertension. However, premature coronary atherosclerosis has not been demonstrated in PCOS women. Electron beam computed tomography (EBCT) noninvasively measures coronary artery calcium (CAC), a marker for coronary atherosclerosis. We measured CAC by EBCT in 30- to 45-yr-old premenopausal PCOS women and compared the results to CAC in 1) recruited normal ovulatory volunteers matched for age and weight to the PCOS cohort, and 2) community-dwelling women of similar age in an extant coronary calcium database. Healthy, community-dwelling, ovulatory controls (n = 71) were matched by age and body mass index (BMI) to PCOS women (n = 36). Women with diabetes or known CHD were excluded. Subjects underwent EBCT scanning, oral glucose tolerance testing, and CHD risk factor assessment. PCOS women had significantly higher levels of serum total and low density lipoprotein cholesterol and testosterone levels than matched controls. PCOS and control women were obese and had a greater mean BMI than community-dwelling women (33 kg/m(2) for PCOS vs. 31 kg/m(2) for control; P < 0.001). CAC was more prevalent in PCOS women (39%) than in matched controls (21%; odds ratio, 2.4; P = 0.05) or community-dwelling women (9.9%; odds ratio, 5.9; P < 0.001). BMI, waist circumference, and total and low density lipoprotein cholesterol levels predicted CAC prevalence after adjustment for BMI. CAC is more prevalent in PCOS women than in obese or nonobese women of similar age. PCOS women are at increased risk for atherosclerosis and should be targeted for primary prevention of CHD.

Determining residential energy consumption-based CO2 emissions and examining the factors affecting the variation in Ankara, Turkey

NASA Astrophysics Data System (ADS)

Kus, Melike; Akan, Perihan; Aydinalp Koksal, Merih; Gullu, Gulen

2017-11-01

Energy demand of Turkey has been showing a remarkable increase in the last two decades due to rapid increase in population and changes in consumption trends. In parallel to the increase in energy demand, the CO2 emissions in Turkey are also increasing dramatically due to high usage of fossil fuels. CO2 emissions from the residential sector covers almost one fourth of the total sectoral emissions. In this study, CO2 emissions from the residential sector are estimated, and the factors affecting the emission levels are determined for the residential sector in Ankara, Turkey. In this study, detailed surveys are conducted to more than 400 households in Ankara. Using the information gathered from the surveys, the CO2 emissions associated with energy consumption of the households are calculated using the methodology outlined at IPCC. The statistical analyses are carried out using household income, dwelling characteristics, and household economic and demographic data to determine the factors causing the variation in emission levels among the households. The results of the study present that the main factors impacting the amount of total energy consumption and associated CO2 emissions are household income, dwelling construction year, age, education level of the household, and net footage of the dwelling.

Parenting style, resilience, and mental health of community-dwelling elderly adults in China.

PubMed

Zhong, Xue; Wu, Daxing; Nie, Xueqing; Xia, Jie; Li, Mulei; Lei, Feng; Lim, Haikel A; Kua, Ee-Heok; Mahendran, Rathi

2016-07-08

Given the increasing elderly population worldwide, the identification of potential determinants of successful ageing is important. Many studies have shown that parenting style and mental resilience may influence mental health; however, little is known about the psychological mechanisms that underpin this relationship. The current study sought to explore the relationships among mental resilience, perceptions of parents' parenting style, and depression and anxiety among community-dwelling elderly adults in China. In total, 439 community-dwelling elderly Chinese adults aged 60-91 years completed the Personal and Parents' Parenting Style Scale, Connor-Davidson Resilience Scale, Zung Self-Rating Depression Scale, and Zung Self-Rating Anxiety Scale. Elderly adults whose parents preferred positive and authoritative parenting styles had higher levels of mental resilience and lower levels of depression and anxiety. Elderly adults parented in the authoritarian style were found to have higher levels of depression and anxiety, with lower mental resilience. The findings of this study provide evidence related to successful ageing and coping with life pressures, and highlight the important effects of parenting on mental health. The results suggest that examination of the proximal determinants of successful ageing is not sufficient-distal factors may also contribute to the 'success' of ageing by modifying key psychological dispositions that promote adaptation to adversity.

Dampness and Moisture Problems in Norwegian Homes

PubMed Central

Becher, Rune; Høie, Anja Hortemo; Bakke, Jan Vilhelm; Holøs, Sverre Bjørn; Øvrevik, Johan

2017-01-01

The occurrence of dampness and mold in the indoor environment is associated with respiratory-related disease outcomes. Thus, it is pertinent to know the magnitude of such indoor environment problems to be able to estimate the potential health impact in the population. In the present study, the moisture damage in 10,112 Norwegian dwellings was recorded based on building inspection reports. The levels of moisture damage were graded based on a condition class (CC), where CC0 is immaculate and CC1 acceptable (actions not required), while CC2 and CC3 indicate increased levels of damage that requires action. Of the 10,112 dwellings investigated, 3125 had verified moisture or mold damage. This amounts to 31% of the surveyed dwellings. Of these, 27% had CC2 as the worst grade, whereas 4% had CC3 as the worst grade level. The room types and building structures most prone to moisture damage were (in rank order) crawl spaces, basements, un-insulated attics, cooling rooms, and bathrooms. The high proportion of homes with moisture damage indicate a possible risk for respiratory diseases in a relatively large number of individuals, even if only the more extensive moisture damages and those located in rooms where occupants spend the majority of their time would have a significant influence on adverse health effects. PMID:29039816

Indoor air quality in energy-efficient dwellings: Levels and sources of pollutants.

PubMed

Derbez, M; Wyart, G; Le Ponner, E; Ramalho, O; Ribéron, J; Mandin, C

2018-03-01

Worldwide, public policies are promoting energy-efficient buildings and accelerating the thermal renovation of existing buildings. The effects of these changes on the indoor air quality (IAQ) in these buildings remain insufficiently understood. In this context, a field study was conducted in 72 energy-efficient dwellings to describe the pollutants known to be associated with health concerns. Measured parameters included the concentrations of 19 volatile organic compounds and aldehydes, nitrogen dioxide, particulate matter (PM 2.5 ), radon, temperature, and relative humidity. The air stuffiness index and night-time air exchange rate were calculated from the monitored carbon dioxide (CO 2 ) concentrations. Indoor and outdoor measurements were performed at each dwelling during 1 week in each of the two following seasons: heating and non-heating. Moreover, questionnaires were completed by the occupants to characterize the building, equipment, household, and occupants' habits. Perspective on our results was provided by previous measurements made in low-energy European dwellings. Statistical comparisons with the French housing stock and a pilot study showed higher concentrations of terpenes, that is, alpha-pinene and limonene, and hexaldehyde in our study than in previous studies. Alpha-pinene and hexaldehyde are emitted by wood or wood-based products used for the construction, insulation, decoration, and furnishings of the dwellings, whereas limonene is more associated with discontinuous sources related to human activities. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Circulating Estrogen Levels and Self-Reported Health and Mobility Limitation in Community-Dwelling Men of the Framingham Heart Study.

PubMed

Jasuja, Guneet Kaur; Travison, Thomas G; Murabito, Joanne M; Davda, Maithili N; Rose, Adam J; Basaria, Shehzad; Coviello, Andrea; Vasan, Ramachandran S; D'Agostino, Ralph; Bhasin, Shalender

2017-08-01

Self-rated health is a commonly used global indicator of health status. Few studies have examined the association of self-rated health and mobility with estrone and estradiol in men. Accordingly, we determined the cross-sectional, incident, and mediating relations between circulating estrone and estradiol levels with self-rated health, mobility limitation, and physical performance in community-dwelling men. The cross-sectional sample included 1,148 men, who attended Framingham Offspring Study Examinations 7 and 8. Estrone and estradiol levels were measured using liquid chromatography tandem mass spectrometry at Examination 7. Self-reported mobility limitation and self-rated health were assessed at Examinations 7 and 8. Additionally, short physical performance battery, usual walking speed, and grip strength were assessed at Examination 7. In incident analysis, estradiol levels at Examination 7 were associated with increased odds of fair or poor self-rated health at Examination 8, after adjusting for age, body mass index, comorbidities, and testosterone levels; in an individual with 50% greater estradiol than other, the odds of reporting "fair or poor" self-rated health increased by 1.78 (95% confidence interval: 1.25-2.55; p = .001). Neither estrone nor estradiol levels were associated with any physical performance measure at baseline. Higher circulating levels of estradiol are associated with increased risk of incident fair/poor self-rated health in community-dwelling men. The mechanisms by which circulating levels of estradiol are related to self-rated health in men need further investigation. Published by Oxford University Press on behalf of The Gerontological Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Neighborhood Disadvantage and Life-Space Mobility Are Associated with Incident Falls in Community-Dwelling Older Adults.

PubMed

Lo, Alexander X; Rundle, Andrew G; Buys, David; Kennedy, Richard E; Sawyer, Patricia; Allman, Richard M; Brown, Cynthia J

2016-11-01

To determine the relationship between neighborhood-level socioeconomic characteristics, life-space mobility, and incident falls in community-dwelling older adults. Prospective, observational cohort study with a baseline in-home assessment and 6-month telephone follow-up. Central Alabama. Community-dwelling adults aged 65 and older recruited from a random sample of Medicare beneficiaries (N = 1,000). Neighborhood disadvantage was measured using a composite index derived from baseline neighborhood-level residential census tract socioeconomic variables. Data on individual-level socioeconomic characteristics, clinical variables, and life-space collected at baseline were included as covariates in a multivariate model using generalized estimating equations to assess the association with incident falls in the 6 months after baseline. Of the 940 participants who completed baseline and follow-up assessments, 126 (13%) reported one or more new falls in the 6 months after baseline. There was an independent nonlinear association between neighborhood disadvantage (according to increasing quartiles of disadvantage) and incident falls after adjusting for confounders: The lowest quartile served as reference; 2nd quartile odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.2-4.6; 3rd quartile OR = 1.9, 95% CI = 1.0-3.7; 4th quartile OR = 3.2, 95% CI = 1.7-6.0. Each 10-point decrement in life-space (OR = 1.2, 95% CI = 1.0-1.3) was associated with a higher risk of falls. Greater neighborhood disadvantage was associated with greater risk of falls. Life-space also contributes separately to fall risk. Community-dwelling older adults in disadvantaged neighborhoods, particularly those with limited mobility, may benefit from a more-rigorous assessment of their fall risk by healthcare providers. Neighborhood level socioeconomic characteristics should also be an important consideration when identifying vulnerable populations that may benefit the most from fall prevention programs. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Last Mile Asset Monitoring; Low Cost Rapid Deployment Asset Monitoring

NASA Astrophysics Data System (ADS)

Zumr, Zdenek

Installation and utilization of residential distribution transformers has not changed substantially over a long period of time. Utilities typically size their transformers based on a formula that takes into account broadly what types and how many dwellings will be connected. Most new residential dwellings feature 200 Amp service per household with an anticipated energy demand of under 20,000 kWh per year. Average electrical energy consumption varies from state to state but averages to 11,280 kWh per year. Energy demand is expected to fall into a typical residential load curve that shows increased demand early in the morning, then decreasing during the day and another peak early to late evening. Distribution transformers are sized at the limit of the combined evening peak with the assumption that the transformer has enough thermal mass to absorb short overloads that may occur when concurrent loading situations among multiple dwellings arise. The assumption that concurrent loading is of short duration and the transformer can cool off during the night time has been validated over the years and has become standard practice. This has worked well when dwelling loads follow an averaging scheme and low level of coincidence. With the arrival of electric vehicles (EV's) this assumption has to be reevaluated. The acquisition of an electric vehicle in a household can drive up energy demand by over 4000 kWh per year. Potentially problematic is the increased capacity of battery packs and the resulting proliferation of Level 2 chargers. The additional load of a single Level 2 charger concurring with the combined evening peak load will push even conservatively sized distribution transformers over their nameplate rating for a substantial amount of time. Additionally, unlike common household appliances of similar power requirements such as ovens or water heaters, a Level 2 battery charger will run at peak power consumption for several hours, and the current drawn by the EVs has very high levels of harmonic distortion. The excessive loading and harmonic profile can potentially result in damaging heat build-up resulting in asset degradation. In this thesis I present a device and method that monitors pole mounted distribution transformers for overheating, collect and wirelessly upload data and initiate commands to chargers to change output levels from Level 2 to Level 1 or shut down EV charging altogether until the transformer returns into safe operational range.

Benzodiazepine use among adults residing in the urban settlements of Karachi, Pakistan: A cross sectional study

PubMed Central

2011-01-01

Background There are hardly any studies carried out in Pakistan on the usage of benzodiazepines at the level of community. This research was aimed to determine the frequency of benzodiazepine use, along with its associations with socio-demographic and clinical characteristics among community dwelling adults, residing in two urban settlements of Karachi, Pakistan. Methods We performed a cross sectional study from August 2008 to December 2009, in 2 areas of Karachi, namely Garden and Sultanabad. We followed the systematic sampling strategy to randomly select the households, with an adult of either sex and of age 18 years or more. Data collection was carried out through interview, using a pre-tested questionnaire, with items on socio-demographic position, medical history and benzodiazepine use. Student's t-test and χ2 test was employed to determine the associations between socio-demographic and clinical characteristics, and their relationship with benzodiazepine use was determined using applied logistic regression. Results The overall percentage of benzodiazepine consumption was estimated to be 14%. There were significantly more benzodiazepine users in the peri-urban Sultanabad community to the urban community of Garden (p-value = 0.001). The mean age (± SD) for users was 51.3 (± 15.6) years compared to 37.1 (± 14.4) years among non-users. Bromazepam was the most widely used benzodiazepine (29%); followed by diazepam, with a median duration on primary use being 144 weeks (IQR = 48-240). The adjusted logistic regression model revealed that increasing age, location, female sex, unemployment and psychiatric consultation were associated with increased likelihood of benzodiazepine use. Conclusion We believe the unregulated over-the-counter sales of benzodiazepines and social conditions might be playing a role in this high consumption of benzodiazepines in the community. PMID:21801457

Comparison of the adaptive implementation and evaluation of the Meeting Centers Support Program for people with dementia and their family carers in Europe; study protocol of the MEETINGDEM project.

PubMed

Dröes, R M; Meiland, F J M; Evans, S; Brooker, D; Farina, E; Szcześniak, D; Van Mierlo, L D; Orrell, M; Rymaszewska, J; Chattat, R

2017-04-04

The MEETINGDEM study aims to implement and evaluate an innovative, inclusive, approach to supporting community dwelling people with mild to moderate dementia and their family carers, called the Meeting Centers Support Program (MCSP), in three countries in the European Union (EU): Italy, Poland and United Kingdom. Demonstrated benefits of this person-centered approach, developed in The Netherlands, include high user satisfaction, reduced behavioral and mood problems, delayed admission to residential care, lower levels of caregiving-related stress, higher carer competence, and improved collaboration between care and welfare organizations. The project will be carried out over a 36 month period. Project partners in the three countries will utilize, and adapt, strategies and tools developed in the Netherlands. In Phase One (month 1-18) activities will focus on establishing an initiative group of relevant organizations and user representatives in each country, exploring pathways to care and potential facilitators and barriers to implementing the program, and developing country specific implementation plans and materials. In Phase Two (month 19‑36) training will be provided to organizations and staff, after which the meeting centers will be established and evaluated for impact on behavior, mood and quality of life of people with dementia and carers, cost-effectiveness, changes in service use, user satisfaction and implementation process. An overall evaluation will draw together findings from the three countries to develop recommendations for successful implementation of MCSP across the EU. If the Meeting Centers approach can be widely implemented, this could lead to major improvements in dementia care across Europe and beyond. The trial was retrospectively registered in May 2016: trial number: NTR5936 .

24 CFR 35.830 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2013 CFR

2013-04-01

... intervention blood lead level. 35.830 Section 35.830 Housing and Urban Development Office of the Secretary... intervention blood lead level. (a) Risk assessment. Within 15 days after being notified by a public health... an environmental intervention blood lead level, HUD shall complete a risk assessment of the dwelling...

24 CFR 35.830 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2010 CFR

2010-04-01

... intervention blood lead level. 35.830 Section 35.830 Housing and Urban Development Office of the Secretary... intervention blood lead level. (a) Risk assessment. Within 15 days after being notified by a public health... an environmental intervention blood lead level, HUD shall complete a risk assessment of the dwelling...

24 CFR 35.830 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2011 CFR

2011-04-01

... intervention blood lead level. 35.830 Section 35.830 Housing and Urban Development Office of the Secretary... intervention blood lead level. (a) Risk assessment. Within 15 days after being notified by a public health... an environmental intervention blood lead level, HUD shall complete a risk assessment of the dwelling...

24 CFR 35.325 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2012 CFR

2012-04-01

... intervention blood lead level. 35.325 Section 35.325 Housing and Urban Development Office of the Secretary... environmental intervention blood lead level. If a child less than 6 years of age living in a federally assisted dwelling unit has an environmental intervention blood lead level, the owner shall immediately conduct a...

24 CFR 35.325 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2013 CFR

2013-04-01

... intervention blood lead level. 35.325 Section 35.325 Housing and Urban Development Office of the Secretary... environmental intervention blood lead level. If a child less than 6 years of age living in a federally assisted dwelling unit has an environmental intervention blood lead level, the owner shall immediately conduct a...

24 CFR 35.830 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2012 CFR

2012-04-01

... intervention blood lead level. 35.830 Section 35.830 Housing and Urban Development Office of the Secretary... intervention blood lead level. (a) Risk assessment. Within 15 days after being notified by a public health... an environmental intervention blood lead level, HUD shall complete a risk assessment of the dwelling...

24 CFR 35.325 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2011 CFR

2011-04-01

... intervention blood lead level. 35.325 Section 35.325 Housing and Urban Development Office of the Secretary... environmental intervention blood lead level. If a child less than 6 years of age living in a federally assisted dwelling unit has an environmental intervention blood lead level, the owner shall immediately conduct a...

24 CFR 35.325 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2010 CFR

2010-04-01

... intervention blood lead level. 35.325 Section 35.325 Housing and Urban Development Office of the Secretary... environmental intervention blood lead level. If a child less than 6 years of age living in a federally assisted dwelling unit has an environmental intervention blood lead level, the owner shall immediately conduct a...

24 CFR 35.830 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2014 CFR

2014-04-01

... intervention blood lead level. 35.830 Section 35.830 Housing and Urban Development Office of the Secretary... intervention blood lead level. (a) Risk assessment. Within 15 days after being notified by a public health... an environmental intervention blood lead level, HUD shall complete a risk assessment of the dwelling...

24 CFR 35.325 - Child with an environmental intervention blood lead level.

Code of Federal Regulations, 2014 CFR

2014-04-01

... intervention blood lead level. 35.325 Section 35.325 Housing and Urban Development Office of the Secretary... environmental intervention blood lead level. If a child less than 6 years of age living in a federally assisted dwelling unit has an environmental intervention blood lead level, the owner shall immediately conduct a...

A phylogenetic test for adaptive convergence in rock-dwelling lizards.

PubMed

Revell, Liam J; Johnson, Michele A; Schulte, James A; Kolbe, Jason J; Losos, Jonathan B

2007-12-01

Phenotypic similarity of species occupying similar habitats has long been taken as strong evidence of adaptation, but this approach implicitly assumes that similarity is evolutionarily derived. However, even derived similarities may not represent convergent adaptation if the similarities did not evolve as a result of the same selection pressures; an alternative possibility is that the similar features evolved for different reasons, but subsequently allowed the species to occupy the same habitat, in which case the convergent evolution of the same feature by species occupying similar habitats would be the result of exaptation. Many lizard lineages have evolved to occupy vertical rock surfaces, a habitat that places strong functional and ecological demands on lizards. We examined four clades in which species that use vertical rock surfaces exhibit long hindlimbs and flattened bodies. Morphological change on the phylogenetic branches leading to the rock-dwelling species in the four clades differed from change on other branches of the phylogeny; evolutionary transitions to rock-dwelling generally were associated with increases in limb length and decreases in head depth. Examination of particular characters revealed several different patterns of evolutionary change. Rock-dwelling lizards exhibited similarities in head depth as a result of both adaptation and exaptation. Moreover, even though rock-dwelling species generally had longer limbs than their close relatives, clade-level differences in limb length led to an overall lack of difference between rock- and non-rock-dwelling lizards. These results indicate that evolutionary change in the same direction in independent lineages does not necessarily produce convergence, and that the existence of similar advantageous structures among species independently occupying the same environment may not indicate adaptation.

Associations of phthalate concentrations in floor dust and multi-surface dust with the interior materials in Japanese dwellings.

PubMed

Ait Bamai, Yu; Araki, Atsuko; Kawai, Toshio; Tsuboi, Tazuru; Saito, Ikue; Yoshioka, Eiji; Kanazawa, Ayako; Tajima, Shuji; Shi, Cong; Tamakoshi, Akiko; Kishi, Reiko

2014-01-15

Phthalates are widely used as plasticizers in numerous products. However, there has been some concern about the various effects they may have on human health. Thus, household phthalate levels are an important public health issue. While many studies have assessed phthalate levels in house dust, the association of these levels with building characteristics has scarcely been examined. The present study investigated phthalate levels in house dust samples collected from the living areas of homes, and examined associations between these phthalate levels and the interior materials. Dust was collected from two portions of the living area: floor dust from the entire floor surface, and multi-surface dust from objects more than 35 cm above the floor. The levels of seven phthalates were measured using gas chromatography/mass spectrometry in selective ion monitoring mode. Phthalate levels were higher in multi-surface dust than in floor dust. Among floor dust samples, those from dwellings with compressed wooden flooring had significantly higher levels of di-iso-butyl phthalate compared to those with other floor materials, while polyvinyl chloride (PVC) flooring was associated with higher di-2-ethylhexyl phthalate (DEHP) levels. Among multi-surface dust samples, higher levels of DEHP and di-iso-nonyl phthalate (DINP) were found in samples from homes with PVC wallpaper than without. The number of PVC interior materials was significantly positively correlated with the levels of DEHP and DINP in multi-surface dust. The phthalate levels in multi-surface dust were associated with the interior surface materials, and those in floor dust were directly related to the flooring materials. Our findings show that when using house dust as an exposure assessment, it is very important to note where the samples were collected from. The present report provides useful information about the association between phthalates and dust inside dwellings, which will assist with establishing public health provisions. © 2013. Published by Elsevier B.V. All rights reserved.

[The nutritional and dietary intake among community-dwelling elderly female users of mobile vendor vehicles].

PubMed

Yoshimura, Yukio; Ito, Hideki; Yoshimura, Hidenori; Kamada, Chiemi; Okumura, Ryota; Shinno, Yuki; Suzuki, Taro; Horie, Kazumi; Takaya, Koji; Omi, Hideaki

2018-01-01

We compared the nutritional and dietary intakes of users of mobile vendor vehicles and users of stores to clarify the problems in the nutritional intake of users of mobile vendor vehicles. We conducted a questionnaire about the food accessibility among 257 elderly women (age: ≥65 years) who used mobile vendor vehicles and/or stores to shop. The nutritional intake was assessed using the 24-hour recall method. We used an analysis of covariance (ANCOVA) to calculate the age-adjusted mean values for the total nutritional intake. The nutritional intake among users of mobile vendor vehicles included significantly lower intakes of energy (168 kcal), green vegetables, other vegetables, and meats. Furthermore, those who only shopped at mobile vendor vehicles consumed less energy and fewer nutrients than those who shopped at places other than mobile vendor vehicles. The comparison of the shopping frequency and nutritional intake of the subjects who used mobile vendor vehicles alone revealed that the energy and protein intakes of those who shopped once per week was significantly lower in comparison to those who shopped twice per week. Users of mobile vendor vehicles had lower intakes of macronutrients and various minerals and vitamins. Among the food groups, intakes of vegetables, meat, and dairy products were low. These findings suggest that the lack of means of shopping other than mobile vendor vehicles and shopping once per week may be associated with an inadequate dietary intake among users of mobile vendor vehicles. It would be desirable to develop the shopping environment is desirable.

Dwell time considerations for large area cold plasma decontamination

NASA Astrophysics Data System (ADS)

Konesky, Gregory

2009-05-01

Atmospheric discharge cold plasmas have been shown to be effective in the reduction of pathogenic bacteria and spores and in the decontamination of simulated chemical warfare agents, without the generation of toxic or harmful by-products. Cold plasmas may also be useful in assisting cleanup of radiological "dirty bombs." For practical applications in realistic scenarios, the plasma applicator must have both a large area of coverage, and a reasonably short dwell time. However, the literature contains a wide range of reported dwell times, from a few seconds to several minutes, needed to achieve a given level of reduction. This is largely due to different experimental conditions, and especially, different methods of generating the decontaminating plasma. We consider these different approaches and attempt to draw equivalencies among them, and use this to develop requirements for a practical, field-deployable plasma decontamination system. A plasma applicator with 12 square inches area and integral high voltage, high frequency generator is described.

Childhood lead poisoning in Brussels. Prevalence study and etiological factors

NASA Astrophysics Data System (ADS)

Claeys, F.; Sykes, C.; Limbos, C.; Ducoffre, G.

2003-05-01

The objectives of this study were twofold: firstly, to assess the frequency (prevalence) of childhood lead poisoning in some districts of Brussels and second, to identify within the dwellings the major source of lead as well as the risk factors connected with this intoxication. The study population (533 participants) was selected among children who visited childhood health centres in downtown Brussels. The reference group was chosen among children living outside Brussels city center. A casecontrol study was undertaken to meet the second objective of the investigation. The average blood lead level (PbB) was 104 μg/1 in the study population compared with 36 μg/l in the reference group. The 100 μg/l “non effect level" put forward by the Centres for Disease Control (CDC) and by the French legislation, is exceeded by 50% of the children living in this rundown environment. The major cause of intoxication is the presence of old lead-based paints in dwellings (Odd Ratio (OR): 4.4) constructed before 1940. Hand-to-mouth activity, pica activity (OR: 17.1) and a lack of hygiene are factors, which combined, promote intoxication. When the dwellings are undergoing renovation, this risk increases (OR: 7.2).

The Role of Small Woodland Remnants on Ground Dwelling Insect Conservation in Chaco Serrano, Central Argentina

PubMed Central

Moreno, María Laura; Fernández, María Guadalupe; Molina, Silvia Itati; Valladares, Graciela

2013-01-01

Many terrestrial ecosystems are changing due to extensive land use and habitat fragmentation, posing a major threat to biodiversity. In this study, the effects of patch size, isolation, and edge/interior localization on the ground dwelling insect communities in the Chaco Serrano woodland remnants in central Argentina were examined. Sampling was carried out in December 2003 and March 2004 in nine remnants (0.57 to 1000 hectares) using pitfall traps. In total, 7071 individuals representing 12 orders and 79 families were recorded. The taxonomic composition of these communities was linked to remnant size. Insect abundance increased (as did their richness, albeit marginally) as remnant area decreased, with no significant effects of isolation or edge/interior localization on abundance, richness, or diversity. No differential area effects were observed when abundance and richness of predators, scavengers, and herbivores were compared. Thus, ground insect communities in fragmented Chaco Serrano seem to respond mainly to patch level, rather than to within-patch (edge effects) or landscape (isolation) level variables. These results suggest that small Chaco Serrano remnants, by supporting larger ground-dwelling insect assemblages, may play an important role from a conservation viewpoint. PMID:23902409

The role of small woodland remnants on ground dwelling insect conservation in Chaco Serrano, Central Argentina.

PubMed

Moreno, María Laura; Fernández, María Guadalupe; Molina, Silvia Itati; Valladares, Graciela

2013-01-01

Many terrestrial ecosystems are changing due to extensive land use and habitat fragmentation, posing a major threat to biodiversity. In this study, the effects of patch size, isolation, and edge/interior localization on the ground dwelling insect communities in the Chaco Serrano woodland remnants in central Argentina were examined. Sampling was carried out in December 2003 and March 2004 in nine remnants (0.57 to 1000 hectares) using pitfall traps. In total, 7071 individuals representing 12 orders and 79 families were recorded. The taxonomic composition of these communities was linked to remnant size. Insect abundance increased (as did their richness, albeit marginally) as remnant area decreased, with no significant effects of isolation or edge/interior localization on abundance, richness, or diversity. No differential area effects were observed when abundance and richness of predators, scavengers, and herbivores were compared. Thus, ground insect communities in fragmented Chaco Serrano seem to respond mainly to patch level, rather than to within-patch (edge effects) or landscape (isolation) level variables. These results suggest that small Chaco Serrano remnants, by supporting larger ground-dwelling insect assemblages, may play an important role from a conservation viewpoint.

Household emergency preparedness by housing type from a community assessment for public health emergency response (CASPER), Michigan.

PubMed

Murti, Michelle; Bayleyegn, Tesfaye; Stanbury, Martha; Flanders, William Dana; Yard, Ellen; Nyaku, Mawuli; Wolkin, Amy

2014-02-01

We examined the association between housing type and household emergency preparedness among households in Oakland County, Michigan. We used interview data on household emergency preparedness from a cluster design survey in Oakland County, Michigan, in 2012. We compared survey-weighted frequencies of household demographics, medical conditions, and preparedness measures in single-detached homes versus multi-unit dwellings, and determined the unadjusted odds ratios (OR) and the income-level adjusted OR for each preparedness measure. Households had similar demographics and medical conditions between housing types. Unadjusted ORs were statistically significant for single detached homes having a generator (11.1), back-up heat source (10.9), way to cook without utilities (5.8), carbon monoxide (CO) detector (3.8), copies of important documents (3.4), evacuation routes (3.1), and 3-day supply of water (2.5). Income level adjusted ORs remained statistically significant except for owning a CO detector. Households in multi-unit dwellings were less likely to have certain recommended emergency plans and supplies compared to those in single detached homes. Further research is required to explore the feasibility, barriers, and alternatives for households in multi-unit dwellings in terms of complying with these measures.

Assessment of the effectiveness, safety, and biocompatibility of icodextrin in automated peritoneal dialysis. The Dextrin in APD in Amsterdam (DIANA) Group.

PubMed

Posthuma, N; ter Wee, P M; Donker, A J; Oe, P L; Peers, E M; Verbrugh, H A

2000-01-01

Our study assessed the efficacy, safety, and biocompatibility of icodextrin (I) solution compared to glucose (G) solution as the daytime dwell in continuous cycling peritoneal dialysis (CCPD). In a randomized, open, prospective, parallel group study of two year's duration, either I or G was used for the long daytime dwell in CCPD patients. The study was carried out in a university hospital and teaching hospital. Established CCPD patients and patients new to the modality were both included. Clinic visits were made at three-month intervals. In all patients, clinical data were gathered; ultrafiltration (UF) was recorded; and serum, urine, and dialysate samples and effluents were collected. Peritoneal defense characteristics and mesothelial markers were determined. Every six months, peritoneal kinetics studies were performed, and serum samples for icodextrin metabolites were taken. Thirty-eight patients (19 G, 19 I) started the study. The median follow-up was 16 months and 17 months respectively (range: 0.5 - 26 months and 3 - 26 months, respectively). Daytime UF volumes increased significantly (p < 0.001), and 24-hour UF tended to increase from baseline in the I group. Dialysate creatinine clearance increased non significantly in both groups over time. In I patients, serum disaccharides (maltose) concentration increased from 0.05+/-0.01 mg/mL [mean+/- standard error of mean (SEM)] at baseline, to an average concentration in the follow-up visits of 1.15+/- 0.04 mg/mL (p <0.001). At the same time, serum sodium levels decreased from 138.1 +/- 0.7 mmol/L to an average concentration in the follow-up visits of 135.9 +/- 0.8 mmol/L (p < 0.050). At 12 months, the serum sodium concentration increased to a non significant difference from baseline. Serum osmolality increased, but did not differ significantly from G users at any visit. During peritonitis (P), daytime dwell UF decreased significantly compared to non peritonitis (NP) episodes in G patients (p < 0.0 01), but remained stable in I patients. Total 24-hour UF also decreased in G patients (p < 0.001), but not in I patients. In these I patients, serum disaccharides increased from 0.05 +/- 0.01 mg/mL to 1.26 +/- 0.2 mg/mL during follow-up. During peritonitis, serum disaccharides concentration did not increase further (1.47 +/- 0.2 mg/mL, p= 0.56). Thirty P episodes occurred during follow-up: 16 in G patients and 14 in I patients (1 per 17.6 months and 1 per 21.9 months, respectively.) After one year, absolute number and percentage of effluent peritoneal macrophages (PM phi s) were significantly higher in I patients than in G patients. The difference in percentage persisted after two years. The phagocytic capacity of PM phi s decreased over time, resulting in a borderline significant difference for coagulase-negative staphylococci phagocytosis (p=0.005) and a significant difference for E. coli phagocytosis (p <0.05) in favor of I patients. PM phi oxidative metabolism, PM phi cytokine production, and effluent opsonic capacity remained stable over time with no difference between the groups. Mass transfer area coefficients (MTACs) and clearances were stable and appeared unaffected by G or I treatment. Effluent cancer antigen 125 (CA125) was stable in G users and tended to decrease in I users. Effluent interleukin-8 (IL-8), carboxy-terminal propeptide of type I procollagen (PICP ), and amino-terminal propeptide of type III procollagen (PIIINP) did not change over time and did not differ between the groups. The use of I for the long daytime dwell in CCPD led to an increase in total UF of at least 261 mL per day, which was maintained over at least 24 months. During I treatment, serum I metabolites increased significantly and serum sodium concentrations decreased initially. As a result, serum osmolality increased slightly. Clinical adverse effects did not accompany these findings. The UF gain in the I patients was even higher during P, without a

Anthropogenic sources of underwater sound can modify how sediment-dwelling invertebrates mediate ecosystem properties

PubMed Central

Solan, Martin; Hauton, Chris; Godbold, Jasmin A.; Wood, Christina L.; Leighton, Timothy G.; White, Paul

2016-01-01

Coastal and shelf environments support high levels of biodiversity that are vital in mediating ecosystem processes, but they are also subject to noise associated with mounting levels of offshore human activity. This has the potential to alter the way in which species interact with their environment, compromising the mediation of important ecosystem properties. Here, we show that exposure to underwater broadband sound fields that resemble offshore shipping and construction activity can alter sediment-dwelling invertebrate contributions to fluid and particle transport - key processes in mediating benthic nutrient cycling. Despite high levels of intra-specific variability in physiological response, we find that changes in the behaviour of some functionally important species can be dependent on the class of broadband sound (continuous or impulsive). Our study provides evidence that exposing coastal environments to anthropogenic sound fields is likely to have much wider ecosystem consequences than are presently acknowledged. PMID:26847483

Assessment of indoor environment in Paris child day care centers.

PubMed

Roda, Célina; Barral, Sophie; Ravelomanantsoa, Hanitriniala; Dusséaux, Murielle; Tribout, Martin; Le Moullec, Yvon; Momas, Isabelle

2011-11-01

Children are sensitive to indoor environmental pollution. Up until now there has been a lack of data on air quality in child day care centers. The aim of this study is to document the indoor environment quality of Paris child day care centers by repeated measurements, and to compare pollutant levels in child day care centers with levels in Paris dwellings. We selected 28 child day care centers frequented by a random sample of babies who participated in the PARIS birth cohort environmental investigation, and visited the child day care centers for one week twice in one year. Biological contaminants assessed were fungi, endotoxin, dust mite allergens, and chemical pollutants: aldehydes, volatile organic compounds and nitrogen dioxide (NO2). Relative humidity, temperature, and carbon dioxide levels were measured simultaneously. A standardized questionnaire was used to gather information about the buildings and their inhabitants. Airborne endotoxin levels in child day care centers were higher than those found in Paris dwellings. Dust mite allergens in child day care centers were below the threshold level for sensitization in the majority of samples, and in common with dwelling samples. Penicillium and Cladosporium were the most commonly identified genera fungi. The child day care center indoor/outdoor ratio for most chemical pollutants was above unity except for NO2, the levels for NO2 being significantly higher than those measured in homes. Chemical and biological contamination in child day care centers appears to be low, apart from endotoxin and NO2. Failure to take child exposure in child day care centers into account could result in an overestimation of children's exposure to other pollutants. Copyright © 2011 Elsevier Inc. All rights reserved.

Validation of the Oncentra Brachy Advanced Collapsed cone Engine for a commercial (192)Ir source using heterogeneous geometries.

PubMed

Ma, Yunzhi; Lacroix, Fréderic; Lavallée, Marie-Claude; Beaulieu, Luc

2015-01-01

To validate the Advanced Collapsed cone Engine (ACE) dose calculation engine of Oncentra Brachy (OcB) treatment planning system using an (192)Ir source. Two levels of validation were performed, conformant to the model-based dose calculation algorithm commissioning guidelines of American Association of Physicists in Medicine TG-186 report. Level 1 uses all-water phantoms, and the validation is against TG-43 methodology. Level 2 uses real-patient cases, and the validation is against Monte Carlo (MC) simulations. For each case, the ACE and TG-43 calculations were performed in the OcB treatment planning system. ALGEBRA MC system was used to perform MC simulations. In Level 1, the ray effect depends on both accuracy mode and the number of dwell positions. The volume fraction with dose error ≥2% quickly reduces from 23% (13%) for a single dwell to 3% (2%) for eight dwell positions in the standard (high) accuracy mode. In Level 2, the 10% and higher isodose lines were observed overlapping between ACE (both standard and high-resolution modes) and MC. Major clinical indices (V100, V150, V200, D90, D50, and D2cc) were investigated and validated by MC. For example, among the Level 2 cases, the maximum deviation in V100 of ACE from MC is 2.75% but up to ~10% for TG-43. Similarly, the maximum deviation in D90 is 0.14 Gy between ACE and MC but up to 0.24 Gy for TG-43. ACE demonstrated good agreement with MC in most clinically relevant regions in the cases tested. Departure from MC is significant for specific situations but limited to low-dose (<10% isodose) regions. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

The Effect of Functional Hearing and Hearing Aid Usage on Verbal Reasoning in a Large Community-Dwelling Population.

PubMed

Keidser, Gitte; Rudner, Mary; Seeto, Mark; Hygge, Staffan; Rönnberg, Jerker

2016-01-01

Verbal reasoning performance is an indicator of the ability to think constructively in everyday life and relies on both crystallized and fluid intelligence. This study aimed to determine the effect of functional hearing on verbal reasoning when controlling for age, gender, and education. In addition, the study investigated whether hearing aid usage mitigated the effect and examined different routes from hearing to verbal reasoning. Cross-sectional data on 40- to 70-year-old community-dwelling participants from the UK Biobank resource were accessed. Data consisted of behavioral and subjective measures of functional hearing, assessments of numerical and linguistic verbal reasoning, measures of executive function, and demographic and lifestyle information. Data on 119,093 participants who had completed hearing and verbal reasoning tests were submitted to multiple regression analyses, and data on 61,688 of these participants, who had completed additional cognitive tests and provided relevant lifestyle information, were submitted to structural equation modeling. Poorer performance on the behavioral measure of functional hearing was significantly associated with poorer verbal reasoning in both the numerical and linguistic domains (p < 0.001). There was no association between the subjective measure of functional hearing and verbal reasoning. Functional hearing significantly interacted with education (p < 0.002), showing a trend for functional hearing to have a greater impact on verbal reasoning among those with a higher level of formal education. Among those with poor hearing, hearing aid usage had a significant positive, but not necessarily causal, effect on both numerical and linguistic verbal reasoning (p < 0.005). The estimated effect of hearing aid usage was less than the effect of poor functional hearing. Structural equation modeling analyses confirmed that controlling for education reduced the effect of functional hearing on verbal reasoning and showed that controlling for executive function eliminated the effect. However, when computer usage was controlled for, the eliminating effect of executive function was weakened. Poor functional hearing was associated with poor verbal reasoning in a 40- to 70-year-old community-dwelling population after controlling for age, gender, and education. The effect of functional hearing on verbal reasoning was significantly reduced among hearing aid users and completely overcome by good executive function skills, which may be enhanced by playing computer games.

Separating the Influence of Environment from Stress Relaxation Effects on Dwell Fatigue Crack Growth in a Nickel-Base Disk Alloy

NASA Technical Reports Server (NTRS)

Telesman, J.; Gabb, T. P.; Ghosn, L. J.

2016-01-01

Both environmental embrittlement and crack tip visco-plastic stress relaxation play a significant role in determining the dwell fatigue crack growth (DFCG) resistance of nickel-based disk superalloys. In the current study performed on the Low Solvus High Refractory (LSHR) disk alloy, the influence of these two mechanisms were separated so that the effects of each could be quantified and modeled. Seven different microstructural variations of LSHR were produced by controlling the cooling rate and the subsequent aging and thermal exposure heat treatments. Through cyclic fatigue crack growth testing performed both in air and vacuum, it was established that four out of the seven LSHR heat treatments evaluated, possessed similar intrinsic environmental resistance to cyclic crack growth. For these four heat treatments, it was further shown that the large differences in dwell crack growth behavior which still persisted, were related to their measured stress relaxation behavior. The apparent differences in their dwell crack growth resistance were attributed to the inability of the standard linear elastic fracture mechanics (LEFM) stress intensity parameter to account for visco-plastic behavior. Crack tip stress relaxation controls the magnitude of the remaining local tensile stresses which are directly related to the measured dwell crack growth rates. It was hypothesized that the environmentally weakened grain boundary crack tip regions fail during the dwells when their strength is exceeded by the remaining local crack tip tensile stresses. It was shown that the classical creep crack growth mechanisms such as grain boundary sliding did not contribute to crack growth, but the local visco-plastic behavior still plays a very significant role by determining the crack tip tensile stress field which controls the dwell crack growth behavior. To account for the influence of the visco-plastic behavior on the crack tip stress field, an empirical modification to the LEFM stress intensity parameter, Kmax, was developed by incorporating into the formulation the remaining stress level concept as measured by simple stress relaxation tests. The newly proposed parameter, Ksrf, did an excellent job in correlating the dwell crack growth rates for the four heat treatments which were shown to have similar intrinsic environmental cyclic fatigue crack growth resistance.

Visual Acuity’s Association with Levels of Leisure-Time Physical Activity Among Community-Dwelling Older Adults

PubMed Central

Swanson, Mark W; Bodner, Eric; Sawyer, Patricia; Allman, Richard

2013-01-01

Little is known about the affect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations controlling for potential confounders. In multivariate analyses, each lower step in visual acuity category below 20/50 was significantly associated with reduced odds of having a higher level of physical activity OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults. PMID:21945888

Differences in quality of life in home-dwelling persons and nursing home residents with dementia - a cross-sectional study.

PubMed

Olsen, Christine; Pedersen, Ingeborg; Bergland, Astrid; Enders-Slegers, Marie-José; Jøranson, Nina; Calogiuri, Giovanna; Ihlebæk, Camilla

2016-07-11

Dementia often eventually leads to dependency on others and finally to residential care. However, in Norway about half of the dementia population lives at home, due to individual and political wishes. There is scarce and inconclusive knowledge of how living in a nursing home differs from living at home for persons with dementia (PWDs) with regard to their quality of life (QoL). The first aim of the study was therefore to compare QoL, cognitive and physical functions, social contacts, sleep patterns, physical activity levels, exposure to light, and medication of PWDs in nursing homes and home-dwelling PWDs, and whether living in nursing homes was associated with a lower QoL than living at home for PWDs. A second aim was to examine if possible differences between residencies in QoL were consistent over time. The cross-sectional study was based on baseline data from two RCT studies of PWDs. A total of 15 nursing homes with adapted units for PWDs and 23 adapted day care centres for home-dwelling PWDs recruited 78 and 115 participants respectively. Trained nurses scored sociodemographic data, level of dementia (on the Clinical Dementia Rating scale), amount of medication, and QoL (QUALID). Sleep patterns, physical activity levels, and light exposure were measured by actigraphy. A multiple regression analysis was used to test the association between residency and QoL. The association between residency and change in QoL over time was investigated by linear regression analysis of a subsample with follow-up data. Home-dwelling PWDs showed significantly higher QoL than PWDs in nursing homes. This difference was maintained even after stratifying on the severity of dementia. Home-dwelling PWDs with moderate dementia showed significantly less use of walking aids, more social contact, higher levels of activity and exposure to daylight, and less use of psychotropic medications. The regression model explained 28 % of the variance in QoL in persons with moderate dementia. However, only residency contributed significantly in the model. Residency also significantly predicted negative change over time in QoL. The study indicated that living at home as long as possible is not only desirable for economic or health political reasons but also is associated with higher QoL for persons with moderate dementia. More studies are needed to investigate how QoL could be increased for PWDs in nursing homes.

Incremental Housing Development; An Approach In Meeting the Needs Of Low Cost Housing In Indonesia

NASA Astrophysics Data System (ADS)

Wibowo, A. H.; Larasati, D.

2018-05-01

As a country with a rapid population growth, there is a very high shortage of homes and need a quick solution to build houses for the community. The emerging solution is mass housing with industrialization system. As time goes by, this mass housing solution raises a new problem, the mass housing users are not satisfied with the existing home. Incremental development approach is considered as one of the solutions for solving the mass housing problem. Incremental development is a constructive approach that allows the separation of dwellings to be built, altered and dismantled without disturbing others. With this approach, dwelling is not seen as a finished product, but it’s a process where residents can participate in designing their own house according to the needs and economy capabilities. Furthermore, Housing provision is built according to minimal needs and it’s designed as a ‘permanent longlife’ and adaptable base. This paper will discuss the criteria of incremental house for low-income communities provided by the government. Literature studies and case studies are used to find the criteria for incremental house. Some criteria can be used as a reference for incremental house construction as a housing solution in Indonesia.

Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review.

PubMed

Whitehead, Phillip J; Worthington, Esme J; Parry, Ruth H; Walker, Marion F; Drummond, Avril E R

2015-11-01

To identify interventions that aim to reduce dependency in activities of daily living (ADL) in homecare service users. To determine: content; effectiveness in improving ability to perform ADL; and whether delivery by qualified occupational therapists influences effectiveness. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, OTseeker, PEDro, Web of Science, CIRRIE, and ASSIA. We included: randomised controlled trials, non-randomised controlled trials and controlled before and after studies. Two reviewers independently screened studies for inclusion, assessed risk of bias and extracted data. A narrative synthesis of the findings was conducted. Thirteen studies were included, totalling 4975 participants. Ten (77%) were judged to have risk of bias. Interventions were categorised as those termed 're-ablement' or 'restorative homecare' (n=5/13); and those involving separate components which were not described using this terminology (n=8/13). Content of the intervention and level of health professional input varied within and between studies. Effectiveness on ADL: eight studies included an ADL outcome, five favoured the intervention group, only two with statistical significance, both these were controlled before and after studies judged at high risk of bias. ADL outcome was reported using seven different measures. Occupational therapy: there was insufficient evidence to determine whether involvement of qualified occupational therapists influenced effectiveness. There is limited evidence that interventions targeted at personal ADL can reduce homecare service users' dependency with activities, the content of evaluated interventions varies greatly. © The Author(s) 2015.

Generation of TNFalpha and interleukin-6 by peritoneal macrophages after overnight dwells with bicarbonate- or lactate-buffered dialysis fluid.

PubMed

Liberek, Tomasz; Lichodziejewska-Niemierko, Monika; Knopinska-Posluszny, Wanda; Schaub, Thomas P; Kirchgessner, Judith; Passlick-Deetjen, Jutta; Rutkowski, Boleslaw

2002-01-01

In order to evaluate the biocompatibility profile of a newly designed peritoneal dialysis fluid (PDF), we evaluated peritoneal leukocyte (PMphi) cytokine release following overnight in vivo dwells using standard, lactate-buffered, single-chamber bag PDF (Lac-PDF) and purely bicarbonate-buffered, double-chamber bag PDF containing 34 (Bic-PDF) or 39 (Bic Hi-PDF) mmol/L bicarbonate. A randomized, open, crossover clinical trial with single weekly test dwells was performed in stable, long-term continuous ambulatory PD patients (n = 8). During 8-hour overnight dwells, PMphi were exposed to different PDF containing 1.5% glucose. After drainage, peritoneal cells were isolated and incubated with RPMI 1640 medium for 2 or 3 hours, with and without stimulation by lipopolysaccharide (LPS). Ex vivo release of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 was measured by specific ELISA technique. After pre-exposure to Lac-PDF, PMphi generated 242 +/- 279 pg TNFalpha/10(6) cells and 157 +/- 105 pg IL-6/10(6) cells. When pre-exposed to Bic-PDF and Bic Hi-PDF, TNFa and IL-6 production of PMphi was not significantly different from Lac-PDF. After LPS stimulation (100 ng/mL), PMD secretion of TNFalpha and IL-6 pre-exposed to three PDF revealed no significant differences between groups: TNFalpha was 2,864 +/- 1,216, 2,910 +/- 1,202, and 3,291 +/- 558 pg/10(6) cells after overnight dwells with Lac-PDF, Bic-PDF, and Bic Hi-PDF, respectively. Comparably, LPS-stimulated (100 pg/ mL) PMphi showed IL-6 secretion of 891 +/- 335, 1,380 +/- 1,149, and 1,442 +/- 966 pg/10(6) cells for Lac-PDF, Bic-PDF, and Bic Hi-PDF. After long-term overnight dwells, initial pH, the different buffers, and varying glucose degradation product levels of PDF do not strongly affect PMphi function with respect to cytokine release. The lack of significant differences between fluids may result from the complete dialysate equilibration achieved during the overnight intraperitoneal dwell.

The effect of tubing dwell time on insulin adsorption during intravenous insulin infusions.

PubMed

Thompson, Cecilia D; Vital-Carona, Jessica; Faustino, E Vincent S

2012-10-01

Insulin adsorbs to plastic tubing, which decreases the concentration of an insulin solution delivered from an intravenous infusion set. Dwelling insulin within tubing before starting the infusion decreases adsorption but delays treatment initiation and wastes time in infusion preparation. The lack of data on dwell time effects results in wide variability in practice. We aim to determine the effect of dwell time on insulin concentration from intravenous infusion tubing. In this in vitro study, we used insulin solutions with concentrations of 0.1 unit/mL, 1 unit/mL, and 10 units/mL. Each solution dwelled in intravenous infusion sets for 0, 15, 30, or 60 min. After the dwell, we measured insulin concentrations from the solution bags and tubing. We repeated each insulin concentration-dwell time combination five times. Comparisons were performed using analyses of variance. For each of the three insulin concentrations, the mean insulin concentrations from the tubing were not significantly different between dwell times. Duration of dwell time did not affect insulin adsorption in polypropylene intravenous infusion sets. We recommend that following a 20-mL flush, insulin infusions can be started without any dwell time. Removal of dwell times may improve clinical practice by minimizing preparation time and will allow faster initiation of insulin infusion therapy.

Youth tobacco use type and associations with substance use disorders.

PubMed

Cavazos-Rehg, Patricia A; Krauss, Melissa J; Spitznagel, Edward L; Grucza, Richard A; Bierut, Laura Jean

2014-08-01

To examine the associations between youth poly-tobacco use and substance use disorders. Analysis of data from the 2007-11 US National Survey on Drug Use and Health. Randomly selected, household-dwelling adolescents from the non-institutionalized, civilian population of the United States. A total of 91 152 adolescents (aged 12-17 years). Logistic regression models were used to examine the associations between type of tobacco user (non-user, users of alternative tobacco products only, users of cigarettes only and users of cigarettes plus alternative tobacco products) with past year alcohol, marijuana or other illicit drug use disorders, adjusting for demographic and social variables. Compared with non-users of tobacco, the greatest risk for substance use disorders was among users of cigarettes plus alternative tobacco products [alcohol disorder adjusted odds ratio (aOR) = 18.3, 95% confidence interval (CI) = 16.2-20.6; marijuana disorder aOR = 37.2, 95% CI = 32.5-42.7; other drug disorder aOR = 18.4, 95% CI = 15.4-21.8], followed by users of cigarettes only (alcohol disorder aOR = 9.6, 95% CI = 8.8-10.6; marijuana disorder aOR = 20.4, 95% CI = 18.1-23.0; other drug disorder aOR = 9.4, 95% CI = 7.8-11.4), then users of alternative tobacco products only (alcohol disorder aOR = 8.1, 95% CI = 6.7-9.6; marijuana disorder aOR = 9.2, 95% CI = 7.5-11.4; other drug disorder aOR = 3.2, 95% CI = 2.4-4.3). Tobacco use in adolescence is associated with higher rates of substance use disorders across all tobacco users, especially among those who use cigarettes plus other tobacco products. © 2014 Society for the Study of Addiction.

Exposure and effects of sediment-spiked fludioxonil on macroinvertebrates and zooplankton in outdoor aquatic microcosms.

PubMed

Yin, Xiao H; Brock, Theo C M; Barone, Lidia E; Belgers, J Dick M; Boerwinkel, Marie-Claire; Buijse, Laura; van Wijngaarden, René P A; Hamer, Mick; Roessink, Ivo

2018-01-01

Information from effects of pesticides in sediments at an ecosystem level, to validate current and proposed risk assessment procedures, is scarce. A sediment-spiked outdoor freshwater microcosm experiment was conducted with fludioxonil (lipophilic, non-systemic fungicide) to study exposure dynamics and treatment-related responses of benthic and pelagic macroinvertebrates and zooplankton. Besides blank control and solvent control systems the experiment had six different treatment levels (1.7-614mga.s./kg dry sediment) based around the reported 28-d No Observed Effect Concentration (NOEC) for Chironomus riparius (40mga.s./kg dry sediment). Twelve systems were available per treatment of which four were sacrificed on each of days 28, 56 and 84 after microcosm construction. Fludioxonil persisted in the sediment and mean measured concentrations were 53-82% of the initial concentration after 84days. The dissipation rate increased with the treatment level. Also exposure concentrations in overlying water were long-term, with highest concentrations 28days after initiation of the experiment. Sediment-dwelling Oligochaeta and pelagic Rotifera and Cladocera showed the most pronounced treatment-related declines. The most sensitive sediment-dwelling oligochaete was Dero digitata (population NOEC 14.2mga.s./kg dry sediment). The same NOEC was calculated for the sediment-dwelling macroinvertebrate community. The most sensitive zooplankton species was the cladoceran Diaphanosoma brachyurum (NOEC of 1.6μga.s./L in overlying water corresponding to 5.0mga.s./kg dry sediment). At the two highest treatments several rotifer taxa showed a pronounced decrease, while the zooplankton community-level NOEC was 5.6μga.s./L (corresponding to 14.2mga.s./kg dry sediment). Zooplankton taxa calanoid Copepoda and Daphnia gr. longispina showed a pronounced treatment-related increase (indirect effects). Consequently, an assessment factor of 10 to the chronic laboratory NOECs of Chironomus riparius (sediment) and Daphnia magna (water) results in a regulatory acceptable concentration that is sufficiently protective for both the sediment-dwelling and pelagic organisms in the microcosms. Copyright © 2017 Elsevier B.V. All rights reserved.

Patterns of behaviour in dwellings exposed to road traffic noise

NASA Astrophysics Data System (ADS)

Lambert, J.; Simonnet, F.; Vallet, M.

1984-01-01

An inquiry involving a total of 1500 subjects residing in 15 different sites in the conurbations of Lyon and Marseilles was carried out in 1979 with a view to determining the behaviour and attitudes of people with regard to traffic noise. The main purpose of the inquiry was to identify the objective reactions to the traffic noise and to determine how such reactions varied with the noise level, with account taken of the socio-economic characteristics of the subjects (age, income, owner occupier or tenant, etc.). The 08.00-20.00 hour Leq noise level was measured or calculated for each of the dwellings included in the inquiry. The 00.00-05.00 and 20.00-24.00 hour Leq values were also derived for each case and a total of nearly 20 000 different noise levels were involved in the analysis of the data for this inquiry. On considering the completed questionaires it was found that the annoyance experienced during the day was more closely correlated with the noise level ( r = 0·64) than had been the case with the results of previous studies. In addition to showing how traffic noise can interfere with activities and lead, for example, to the closing of windows to shut out the noise, the inquiry yielded information on the way in which activities affected by noise are transferred to quieter rooms, on the extent to which individual dwellings are sound proofed, on the extent to which occupants are likely to move to another dwelling in order to escape from the noise and finally on some aspects of the effects of noise on health and sleep. Thus it appears that a daytime Leq value of more than 65 dB(A) gives rise to what can be regarded as forced behavioural responses to the extent that there are significant changes in the normal way of life of the people concerned and such responses give an indication of the magnitude of the social costs that can be attributed to the undesirable effects of traffic noise.

Comparison of Happiness and Spiritual Well-Being among the Community Dwelling Elderly and those who Lived in Sanitariums.

PubMed

Adib-Hajbaghery, Mohsen; Faraji, Mona

2015-07-01

Several studies are available on the lifestyle, psychological and mental health of the elderly adults. This study aimed to compare the spiritual well-being and happiness in the elderly who lived in sanitariums with those lived in the community. A comparative study was conducted on 384 elderly adults. A census sampling was used in sanitariums and a convenience sampling was performed to select the community dwelling (CD) older adults. A demographic questionnaire, the Pauloutzian and Ellison's spiritual well-being scale and the Oxford happiness questionnaire were used in this study. Descriptive statistics and Kolmogorov-Smirnov, Chi-square and Mann-Whitney U tests and Spearman correlation coefficient were employed for data analysis, using the SPSS software, version 13.0. From the total participants, 56% were CD elderly and 44% were in sanitariums. Among the CD older adults, no one was at a high level of spiritual well-being while in sanitariums 24.4% were at a high level of spiritual well-being. Also, 71.2% of the community dwelling older adults were at a high level of happiness while only 3.6% of those living in sanitariums expressed a high level of happiness. A significant association was found between the level of spiritual well-being and happiness in those who lived in sanitariums (r=0.177, P<0.021). Most of the elderly living in the community and in sanitariums showed moderate spiritual well-being and low happiness. Therefore, nurses and health authorities are responsible not only to inform the community about the importance of spiritual well-being and happiness, but also to establish some strategies in this regard.

Differences in physical fitness and subjectively rated physical health in Vietnamese and German older adults.

PubMed

Nguyen, Hung M; Cihlar, Volker

2013-06-01

This cross-sectional study aims to investigate the differences in physical fitness and subjectively rated physical health of Vietnamese and German older adults in a community dwelling. The Vietnamese sample was a random sample of 96 community-dwelling individuals aged 60 to 80 years; 50 % were women. Education is 0 % less than 5 years, 23.95 % 5 to 9 years, 47.91 % 10 to 12 years, and 28.12 % more than 12 years. The German sample was a random sample of 159 community-dwelling persons aged 59 to 90 years; 79.8 % were women. Education is 1.25 % less than 5 years, 40.25 % 5 to 9 years, 38.84 % 10 to 12 years, and 21.38 % more than 12 years. Senior Fitness Test and Short Form-36 were used as outcome measures. The Vietnamese sample shows significantly higher performance levels in motor abilities, i.e., aerobic fitness, strength, and flexibility. The Vietnamese sample indicates a lower difference in performance levels between age groups than the German sample. No differences in subjectively rated physical health factors were found. The higher performance levels of the Vietnamese sample might reflect a more active lifestyle throughout the life span, especially in socially mediated domains like living arrangements or labor work. Lower performance levels in the studied age groups of the German sample might lead to higher risks of cardiovascular diseases and proneness of falls. A more active lifestyle after retirement could contribute to a healthier, more capable, and more independent individual and collective aging. Subjectively rated health stated is a culturally mitigated domain and therefore might be independent of actual physical fitness levels.

Comparison of body composition and physical and cognitive function between older Japanese adults with no diabetes, prediabetes and diabetes: A cross-sectional study in community-dwelling Japanese older people.

PubMed

Kera, Takeshi; Kawai, Hisashi; Hirano, Hirohiko; Kojima, Motonaga; Watanabe, Yutaka; Fujiwara, Yoshinori; Ihara, Kazushige; Obuchi, Shuichi

2018-03-26

Diabetes is associated with not only cardiovascular and cerebrovascular disease, but also reductions in physical and cognitive function. The purpose of the present study was to determine whether muscle strength, walking ability and balance declined in Japanese community-dwelling older adults with diabetes or prediabetes. We analyzed data from comprehensive health checkups carried out for 1689 individuals (710 men, 979 women; mean age 71.4 ± 5.6 years) between 2011 and 2016. Participants were divided into three groups: no diabetes (non-history of diabetes and glycated hemoglobin level <5.7%), prediabetes (non-history of diabetes, but glycated hemoglobin level was 5.7-6.4%) and diabetes (history of diabetes or glycated hemoglobin level >6.4%). Physical and cognitive function were compared between groups after adjusting for covariates. Participants with diabetes showed higher levels of obesity, comorbidity, gonarthrosis, and body fat, and lower levels of physical function relative to those observed in participants with prediabetes or no diabetes. After adjusting covariates, participants with diabetes showed significantly lower grip strength (P < 0.010), slower walking speed (P < 0.005), longer Timed Up and Go test time (P < 0.007) and less time spent standing on one foot (P < 0.001) relative to those with no diabetes, but not those with prediabetes. Significant functional decline was observed in community-dwelling older adults with diabetes, but not in those with prediabetes. Prevention of the progression of prediabetes to diabetes is important in avoiding reductions in physical function. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in Japan.

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Sugiura, Yumiko; Tsuda, Yuko; Kimura, Motoshi; Hayashida, Itsushi; Kusabiraki, Toshiyuki; Kono, Koichi

2012-01-01

This study aimed to determine the association between sarcopenia, defined by muscle mass, muscle strength, and physical performance, and higher-level functional capacity in community-dwelling Japanese elderly people. Subjects were 1158 elderly, community-dwelling Japanese people aged 65 or older. We used bioelectrical impedance analysis to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance. Sarcopenia was characterized by low muscle mass, plus low muscle strength or low physical performance. Subjects without low muscle mass, low muscle strength, and low physical performance were classified as "normal." Examination of higher-level functional capacity was performed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The TMIG-IC is a 13-item questionnaire completed by the subject; it contains five questions on self-maintenance and four questions each on intellectual activity and social role. Sarcopenia was identified in 11.3% and 10.7% of men and women, respectively. The percentage of disability for instrumental activities of daily living (IADL) was 39.0% in men with sarcopenia and 30.6% in women with sarcopenia. After adjustment for age, in men, sarcopenia was significantly associated with IADL disability compared with intermediate and normal subjects. In women, sarcopenia was significantly associated with every subscale of the TMIG-IC disability compared with intermediate and normal subjects. This study revealed that sarcopenia, defined by muscle mass, muscle strength, and physical performance, had a significant association with disability in higher-level functional capacity in elderly Japanese subjects. Interventions to prevent sarcopenia may prevent higher-level functional disability among elderly people. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[Prevalence and characteristics of urinary incontinence in community-dwelling-elderly as determined by comprehensive health examination and interview for the prevention of geriatric syndrome and bed-ridden state].

PubMed

Yoshida, Yuko; Kim, Hunkyung; Iwasa, Hajime; Kwon, Jinhee; Sugiura, Miho; Furuna, Taketo; Yoshida, Hideyo; Suzuki, Takao

2007-01-01

We examined the prevalence and characteristics of urinary incontinence in community-dwelling elderly individuals. The participants were 1,783 individuals (768 men and 1,015 women) aged over 70 years who participated in a comprehensive health examination involving a medical examination and interview, plus physical performance tests. Differences in characteristics between individuals with and without urinary incontinence were examined, and multivariate logistic regression models were used to describe the characteristics associated with urinary incontinence. The prevalence of urinary incontinence was 13.4% in men and 23.3% in women. Urinary incontinence was significantly associated with a lower level of physical fitness. Multivariate logistic regression showed that urinary incontinence was significantly associated with a slower walking speed (Odds Ratio (OR) = 0.19, 95% Confidence Intervals (CI) 0.08-0.48) and lower serum albumin level (OR = 0.40, 95% CI 0.16-0.99) in men, and with a slower walking speed (OR = 0.29, 95% CI 0.15-0.56), a higher BMI (OR = 1.09, 95% CI 1.04-1.14), depression (OR = 3.06, 95% CI 1.40-6.69), and lack of physical activity (OR = 0.70, 95% CI 0.50-0.98) in women. The characteristics of urinary incontinence in this cohort of community-dwelling elderly individuals were a low level of physical fitness and poor nutritional state in men, and a low level of physical fitness, a tendency to be obese, a poor mental health state, and lack of physical activity in women.

Hierarchy of higher-level physical functions: a longitudinal investigation on a nationally representative population of community-dwelling middle-aged and elderly persons.

PubMed

Yeh, Chih-Jung; Wang, Ching-Yi; Tang, Pei-Fang; Lee, Meng-Chih; Lin, Hui-Sheng; Chen, Hui-Ya

2012-01-01

Understanding the hierarchy of higher-level physical functions to infer disability level (mild, moderate or severe) is essential for the precise targeting of preventive interventions and has been examined previously in a cross-sectional study. Based on longitudinal data, this study evaluated the hierarchy of higher-level physical functions. Data from a cohort of 2729 community-dwelling persons aged over 50 with no initial disability were drawn from the "Survey of Health and Living Status of the Elderly in Taiwan" from 1996 through 2007. The three-level hierarchy of eight chosen activities was examined by the median ages to disability onset with survival analyses and by Cox regressions, which examined the effects of sex and age on the development of this hierarchy. The progression of incident disability was as follows: mild level-running, carrying weight, and squatting; moderate level-climbing stairs, walking, and standing; and severe level-grasping and raising arms up. Women and older persons were at greater risk of developing more severe levels of disability. Another Cox regression with one index activity from each hierarchical level revealed similar results. The three-level hierarchy of higher-level physical functions has been validated longitudinally, suggesting rich research and clinical implications.

Relationship between swallowing functions and health-related quality of life among community-dwelling dependent older individuals.

PubMed

Morisaki, Naoko

2017-10-01

This study analyzed the association between swallowing function levels and health-related quality of life (QOL) among community-dwelling dependent older persons in Japan. A cross-sectional survey of a purposive sample of community-dwelling dependent older individuals in Japan was conducted. Two swallowing functions (tongue pressure and lip-closure force), the risk of dysphagia, and health-related QOL (SF-8) were surveyed. There were 86 (38.2%) men and 139 (61.8%) women, with a mean age of 81.6 ± 7.4 years. The activities of daily living-20 evaluation yielded a total score of 46.39 ± 10.18. The elderly participants had decreased swallowing functions. The risk-of-dysphagia score demonstrated a significant negative correlation with respect to the SF-8 subcategory scores. Moreover, the multiple regression analyses indicated that three variables exhibited significant negative differences: general health perceptions, mental health (SF-8 subarea), and activities of daily living. An increasing risk of dysphagia can lead to a deterioration in the health-related QOL among community-dwelling dependent older individuals. This implies that homecare interventions that address the deterioration of swallowing and the risk of dysphagia could be in high demand in the future. © 2017 Japan Academy of Nursing Science.

Working towards healthy air in dwellings in Europe.

PubMed

Franchi, M; Carrer, P; Kotzias, D; Rameckers, E M A L; Seppänen, O; van Bronswijk, J E M H; Viegi, G; Gilder, J A; Valovirta, E

2006-07-01

Poor indoor air quality has been implicated in the increase in allergic and respiratory diseases seen in industrialized countries in recent decades. Although air pollution in the workplace is well studied, much less is known about the consequences of poor air quality in homes. In an attempt to halt or slow down the increase in allergic and respiratory diseases, the European Federation of Allergy and Airways Diseases Patients Associations (EFA) carried out the EU-funded project entitled 'Towards Healthy Air in Dwellings in Europe' (THADE). The aims were to: compile an overview of evidence-based data about exposure to indoor air pollution and its health effects, particularly in relation to allergies, asthma and other respiratory diseases such as chronic obstructive pulmonary disease; review cost-effective measures and technology to improve indoor air quality; review legislation and guidelines on indoor air pollution; produce maps of pollutants in dwellings; and recommend an integrated strategy that defines appropriate indoor air quality policies for implementation in Europe. This paper summarizes the information about air quality in dwellings and indoor environment-related diseases collected by expert consultants within the framework of THADE and terminates with recommendations for actions aimed at improving air quality in homes. The results of this project confirmed that air pollution in dwellings is a relevant health problem. It is a complex problem that must be addressed at European and international levels, and it involves the medical profession, scientific societies, patients' organizations, lawmakers, architects and the building industry. The complete THADE report is available at http://www.efanet.org/activities/documents/THADEReport.pdf.

Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study.

PubMed

Schnall, Rebecca; Cho, Hwayoung; Liu, Jianfang

2018-01-05

Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness. ©Rebecca Schnall, Hwayoung Cho, Jianfang Liu. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 05.01.2018.

Health Information Technology Usability Evaluation Scale (Health-ITUES) for Usability Assessment of Mobile Health Technology: Validation Study

PubMed Central

Cho, Hwayoung; Liu, Jianfang

2018-01-01

Background Mobile technology has become a ubiquitous technology and can be particularly useful in the delivery of health interventions. This technology can allow us to deliver interventions to scale, cover broad geographic areas, and deliver technologies in highly tailored ways based on the preferences or characteristics of users. The broad use of mobile technologies supports the need for usability assessments of these tools. Although there have been a number of usability assessment instruments developed, none have been validated for use with mobile technologies. Objective The goal of this work was to validate the Health Information Technology Usability Evaluation Scale (Health-ITUES), a customizable usability assessment instrument in a sample of community-dwelling adults who were testing the use of a new mobile health (mHealth) technology. Methods A sample of 92 community-dwelling adults living with HIV used a new mobile app for symptom self-management and completed the Health-ITUES to assess the usability of the app. They also completed the Post-Study System Usability Questionnaire (PSSUQ), a widely used and well-validated usability assessment tool. Correlations between these scales and each of the subscales were assessed. Results The subscales of the Health-ITUES showed high internal consistency reliability (Cronbach alpha=.85-.92). Each of the Health-ITUES subscales and the overall scale was moderately to strongly correlated with the PSSUQ scales (r=.46-.70), demonstrating the criterion validity of the Health-ITUES. Conclusions The Health-ITUES has demonstrated reliability and validity for use in assessing the usability of mHealth technologies in community-dwelling adults living with a chronic illness. PMID:29305343

A Brief Analysis on the Redesign of Traditional Cave Dwellings

NASA Astrophysics Data System (ADS)

Chen, Xuanchen; Feng, Xinqun

2018-05-01

Cave dwelling, the treasure of ancient architecture, is the unique product of Chinese Loess Plateau. However, recently due to the continuous development of social economy and industrial civilization, traditional cave dwelling in our country has represented the backwardness and poverty of the country, and it had been gradually abandoned in the history. In order to effectively avoid this phenomenon and protect the traditional cave dwelling to the greatest extent. This paper makes relevant introduction about traditional cave dwelling, and meanwhile, the redesign of traditional cave dwelling houses has also been studied in detail.

Habitual physical activity levels are associated with performance in measures of physical function and mobility in older men

USDA-ARS?s Scientific Manuscript database

Objectives: To determine whether objectively measured physical activity levels are associated with measures of physical function and mobility in older men. Design: Cross-sectional. Setting: Academic research center. Participants: Eighty-two community-dwelling men >/= 65 years of age with self-report...

Indoor tetrachloroethylene levels and determinants in Paris dwellings.

PubMed

Roda, Célina; Kousignian, Isabelle; Ramond, Anna; Momas, Isabelle

2013-01-01

There is growing public health concern about indoor air quality. Tetrachloroethylene (PERC), a chlorinated volatile organic compound widely used as a solvent in dry cleaning facilities, can be a residential indoor air pollutant. As part of an environmental investigation included in the PARIS (Pollution and asthma Risk: an Infant Study) birth cohort, this study firstly aimed to document domestic PERC levels, and then to identify the factors influencing these levels using standardized questionnaires about housing characteristics and living conditions. Air samples were collected in the child's bedroom over one week using passive devices when infants were 1, 6, 9, and 12 months. PERC was identified and quantified by gas chromatography/mass spectrometry. PERC annual domestic level was calculated by averaging seasonal levels. PERC was omnipresent indoors, annual levels ranged from 0.6 to 124.2 μg/m3. Multivariate linear and logistic regression models showed that proximity to dry cleaning facilities, do-it-yourself activities (e.g.: photographic development, silverware), presence of air vents, and building construction date (<1945) were responsible for higher domestic levels of PERC. This study, conducted in an urban context, provides helpful information on PERC contamination in dwellings, and identifies parameters influencing this contamination. Copyright © 2012 Elsevier Inc. All rights reserved.

The Effect of Tubing Dwell Time on Insulin Adsorption During Intravenous Insulin Infusions

PubMed Central

Vital-Carona, Jessica; Faustino, E. Vincent S.

2012-01-01

Abstract Background Insulin adsorbs to plastic tubing, which decreases the concentration of an insulin solution delivered from an intravenous infusion set. Dwelling insulin within tubing before starting the infusion decreases adsorption but delays treatment initiation and wastes time in infusion preparation. The lack of data on dwell time effects results in wide variability in practice. We aim to determine the effect of dwell time on insulin concentration from intravenous infusion tubing. Materials and Methods In this in vitro study, we used insulin solutions with concentrations of 0.1 unit/mL, 1 unit/mL, and 10 units/mL. Each solution dwelled in intravenous infusion sets for 0, 15, 30, or 60 min. After the dwell, we measured insulin concentrations from the solution bags and tubing. We repeated each insulin concentration–dwell time combination five times. Comparisons were performed using analyses of variance. Results For each of the three insulin concentrations, the mean insulin concentrations from the tubing were not significantly different between dwell times. Duration of dwell time did not affect insulin adsorption in polypropylene intravenous infusion sets. Conclusions We recommend that following a 20-mL flush, insulin infusions can be started without any dwell time. Removal of dwell times may improve clinical practice by minimizing preparation time and will allow faster initiation of insulin infusion therapy. PMID:22746979

Factors Influencing Dwell Fatigue Cracking in Notches of Powder Metallurgy Superalloys

NASA Technical Reports Server (NTRS)

Gabb, T. P.; Telesman, J.; Ghosn, L.; Garg, A.; Gayda, J.

2011-01-01

The influences of heat treatment and cyclic dwells on the notch fatigue resistance of powder metallurgy disk superalloys were investigated for low solvus high refractory (LSHR) and ME3 disk alloys. Disks were processed to produce material conditions with varied microstructures and associated mechanical properties. Notched specimens were first subjected to baseline dwell fatigue cycles having a dwell at maximum load, as well as tensile, stress relaxation, creep rupture, and dwell fatigue crack growth tests at 704 C. Several material heat treatments displayed a bimodal distribution of fatigue life with the lives varying by two orders-of-magnitude, while others had more consistent fatigue lives. This response was compared to other mechanical properties, in search of correlations. The wide scatter in baseline dwell fatigue life was observed only for material conditions resistant to stress relaxation. For selected materials and conditions, additional tests were then performed with the dwells shifted in part or in total to minimum tensile load. The tests performed with dwells at minimum load exhibited lower fatigue lives than max dwell tests, and also exhibited early crack initiation and a substantial increase in the number of initiation sites. These results could be explained in part by modeling evolution of peak stresses in the notch with continued dwell fatigue cycling. Fatigue-environment interactions were determined to limit life for the fatigue cycles with dwells.

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

PubMed

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

2015-01-01

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

Executive function is independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke: implications for falls prevention

PubMed Central

Liu-Ambrose, Teresa; Pang, Marco; Eng, Janice J

2015-01-01

Background Stroke survivors have a high incidence of falls. Impaired executive-controlled processes are frequent in stroke survivors and are associated with falls in this population. Better understanding of the independent association between executive-controlled processes and physiological fall risk (i.e. performances of balance and mobility) could enhance future interventions that aim to prevent falls and to promote an independent lifestyle among stroke survivors. Methods Cross-sectional analysis of 63 adults who suffered a mild stroke >1 year prior to the study, aged > or =50 years. Results Cognitive flexibility was independently associated with performances of balance and mobility in community-dwelling older adults after mild stroke, after accounting for age, quadriceps strength of the paretic side and current physical activity level. Conclusions Clinicians may need to consider cognitive function when assessing and treating impaired balance and mobility in community-dwelling older adults after mild stroke. PMID:17143004

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

[Assertiveness and peripheral intravenous catheters dwell time with ultrasonography-guided insertion in children and adolescents].

PubMed

Avelar, Ariane Ferreira Machado; Peterlini, Maria Angélica Sorgini; da Pedreira, Mavilde Luz Gonçalves

2013-06-01

Randomized controlled trial which aimed to verify whether the use of vascular ultrasound (VUS) increases assertiveness in the use of peripheral venous catheter in children, and the catheter dwell time, when compared to traditional puncture. Data were collected after approval of theethical merit. Children and adolescents undergoing VUS-guided peripheral intravenous (GVUS) or puncture guided by clinical assessment of the venous conditions(CG) were included in the study. Significance level was set at p< or =0.05. The sample was composed of 382 punctures, 188 (49.2%) in VUS Gand 194 (50.8%) in CG, performed in 335 children. Assertiveness was found in 73 (71.6%) GVUS catheters and in 84(71.8%) of the CG (p=0.970), and catheter dwell time presented a median of less than one day in both groups (p=0.121), showing nostatistically significant difference. VUS did not significantly influence the results of the dependent variables investigated. ClinicalTrials.govNCT00930254.

Thyroid Function Variations Within the Reference Range Do Not Affect Quality of Life, Mood, or Cognitive Function in Community-Dwelling Older Men.

PubMed

Samuels, Mary H; Kaimal, Rajani; Waring, Avantika; Fink, Howard A; Yaffe, Kristine; Hoffman, Andrew R; Orwoll, Eric; Bauer, Douglas

2016-09-01

Variations in thyroid function within the laboratory reference range have been associated with a number of clinical outcomes. However, quality of life, mood, and cognitive function have not been extensively studied, and it is not clear whether mild variations in thyroid function have major effects on these neurocognitive outcomes. Data were analyzed from the Osteoporotic Fractures in Men (MrOS) Study, a cohort of community-dwelling men aged 65 years and older in the United States. A total of 539 participants who were not taking thyroid medications and had age-adjusted TSH levels within the reference range underwent detailed testing of quality of life, mood, and cognitive function at baseline. The same quality of life, mood, and cognitive outcomes were measured again in 193 of the men after a mean follow-up of 6 years. Outcomes were analyzed using thyrotropin (TSH) and free thyroxine (FT4) levels as continuous independent variables, adjusting for relevant covariates. At baseline, there were no associations between TSH or FT4 levels and measures of quality of life, mood, or cognition in the 539 euthyroid men. Baseline thyroid function did not predict changes in these outcomes over a mean of 6 years in the 193 men in the longitudinal analysis. Variations in thyroid function within the age-adjusted laboratory reference range are not associated with variations in quality of life, mood, or cognitive function in community-dwelling older men.

Relationships between socioeconomic and lifestyle factors and indoor air quality in French dwellings.

PubMed

Brown, Terry; Dassonville, Claire; Derbez, Mickael; Ramalho, Olivier; Kirchner, Severine; Crump, Derrick; Mandin, Corinne

2015-07-01

To date, few studies have analyzed the relationships between socioeconomic status (SES) and indoor air quality (IAQ). The aim of this study was to examine the relationships between socioeconomic and other factors and indoor air pollutant levels in French homes. The indoor air concentrations of thirty chemical, biological and physical parameters were measured over one week in a sample of 567 dwellings representative of the French housing stock between September 2003 and December 2005. Information on SES (household structure, educational attainment, income, and occupation), building characteristics, and occupants' habits and activities (smoking, cooking, cleaning, etc.) were collected through administered questionnaires. Separate stepwise linear regression models were fitted to log-transformed concentrations on SES and other factors. Logistic regression was performed on fungal contamination data. Households with lower income were more likely to have higher indoor concentrations of formaldehyde, but lower perchloroethylene indoor concentrations. Formaldehyde indoor concentrations were also associated with newly built buildings. Smoking was associated with increasing acetaldehyde and PM2.5 levels and the risk of a positive fungal contamination index. BTEX levels were also associated with occupant density and having an attached garage. The major predictors for fungal contamination were dampness and absolute humidity. These results, obtained from a large sample of dwellings, show for the first time in France the relationships between SES factors and indoor air pollutants, and believe they should be considered alongside occupant activities and building characteristics when study IAQ in homes. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Phenotypic flexibility at the molecular and organismal level allows desert-dwelling rodents to cope with seasonal water availability.

PubMed

Gallardo, Pedro A; Cortes, Arturo; Bozinovic, Francisco

2005-01-01

We examined the phenotypic flexibility of field urine osmolality (Uosm) in response to seasonal rainfall and the experimental expression of renal aquaporins (AQPs) in the leaf-eared mouse Phyllotis darwini, a South American desert-dwelling rodent, through an integrative study at both the cellular and the organismal level. Field Uosm was higher in summer than in winter. Fall and winter Uosm were not significantly different. During a rainy year, winter Uosm was 2,140 +/- 82.3 mOsm kg(-1); the corresponding value in a dry year was 2,569 +/- 61.3 mOsm kg(-1). During the summer, the mean Uosm in a rainy year was 3,321 +/- 71.5 mOsm kg(-1), and in a dry year it was 3,604 +/- 107.2 mOsm kg(-1). The distribution of AQP-2, AQP-3, and AQP-4 was similar to that described for mouse and rat kidneys and confined to principal cells in cortex and inner medullary collecting-duct cells. AQP-4 immunoreactivity was unaltered by the state of water balance. Relative to water loading, dehydration induced an increase in AQP-2 immunoreactivity and protein abundance. Although more discrete, AQP-3 immunolabeling was also increased by dehydration. We now reveal how the integration of flexible renal mechanisms acting at the cellular and organismal level allow a small desert-dwelling mammal to cope with seasonal and yearly (El Nino) water availability in its semiarid habitat.

Rates of bone loss among women initiating antidepressant medication use in midlife.

PubMed

Diem, Susan J; Ruppert, Kristine; Cauley, Jane A; Lian, YinJuan; Bromberger, Joyce T; Finkelstein, Joel S; Greendale, Gail A; Solomon, Daniel H

2013-11-01

Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. We conducted a prospective cohort study at five clinical centers in the United States. The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (<16 vs ≥16). In this cohort of middle-aged women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck.

Cockpit Ocular Recording System (CORS)

NASA Technical Reports Server (NTRS)

Rothenheber, Edward; Stokes, James; Lagrossa, Charles; Arnold, William; Dick, A. O.

1990-01-01

The overall goal was the development of a Cockpit Ocular Recording System (CORS). Four tasks were used: (1) the development of the system; (2) the experimentation and improvement of the system; (3) demonstrations of the working system; and (4) system documentation. Overall, the prototype represents a workable and flexibly designed CORS system. For the most part, the hardware use for the prototype system is off-the-shelf. All of the following software was developed specifically: (1) setup software that the user specifies the cockpit configuration and identifies possible areas in which the pilot will look; (2) sensing software which integrates the 60 Hz data from the oculometer and heat orientation sensing unit; (3) processing software which applies a spatiotemporal filter to the lookpoint data to determine fixation/dwell positions; (4) data recording output routines; and (5) playback software which allows the user to retrieve and analyze the data. Several experiments were performed to verify the system accuracy and quantify system deficiencies. These tests resulted in recommendations for any future system that might be constructed.

On the suitability of ISO 16717-1 reference spectra for rating airborne sound insulation.

PubMed

Mašović, Draško B; Pavlović, Dragana S Šumarac; Mijić, Miomir M

2013-11-01

A standard proposal for rating airborne sound insulation in buildings [ISO 16717-1 (2012)] defines the reference noise spectra. Since their shapes influence the calculated values of single-number descriptors, reference spectra should approximate well typical noise spectra in buildings. There is, however, very little data in the existing literature on a typical noise spectrum in dwellings. A spectral analysis of common noise sources in dwellings is presented in this paper, as a result of an extensive monitoring of various noisy household activities. Apart from music with strong bass content, the proposed "living" reference spectrum overestimates noise levels at low frequencies.

Minimum energy dwelling

NASA Astrophysics Data System (ADS)

1981-07-01

The two detached single family dwellings in the Mission Viejo community in California were monitored for the temperature and flow rate of water and air at some 45 points throughout the domestic hot water, mechanical conditioning, and solar energy systems. On site weather data were collected. Testing of levels of odor and moisture was performed to determine the effect of the tighter than average construction methods used in the MED houses. Electric consumption data for the mechanical system and household consumption were recorded separately. Utility cost records were maintained as a measure of savings between the MED houses and the standard Cordova model. Analyses and results of the data are presented.

Inferring Human Activity in Mobile Devices by Computing Multiple Contexts.

PubMed

Chen, Ruizhi; Chu, Tianxing; Liu, Keqiang; Liu, Jingbin; Chen, Yuwei

2015-08-28

This paper introduces a framework for inferring human activities in mobile devices by computing spatial contexts, temporal contexts, spatiotemporal contexts, and user contexts. A spatial context is a significant location that is defined as a geofence, which can be a node associated with a circle, or a polygon; a temporal context contains time-related information that can be e.g., a local time tag, a time difference between geographical locations, or a timespan; a spatiotemporal context is defined as a dwelling length at a particular spatial context; and a user context includes user-related information that can be the user's mobility contexts, environmental contexts, psychological contexts or social contexts. Using the measurements of the built-in sensors and radio signals in mobile devices, we can snapshot a contextual tuple for every second including aforementioned contexts. Giving a contextual tuple, the framework evaluates the posteriori probability of each candidate activity in real-time using a Naïve Bayes classifier. A large dataset containing 710,436 contextual tuples has been recorded for one week from an experiment carried out at Texas A&M University Corpus Christi with three participants. The test results demonstrate that the multi-context solution significantly outperforms the spatial-context-only solution. A classification accuracy of 61.7% is achieved for the spatial-context-only solution, while 88.8% is achieved for the multi-context solution.

In-depth statistical analysis of the use of a website providing patients' narratives on lifestyle change when living with chronic back pain or coronary heart disease.

PubMed

Schweier, Rebecca; Grande, Gesine; Richter, Cynthia; Riedel-Heller, Steffi G; Romppel, Matthias

2018-07-01

To investigate the use of lebensstil-aendern.de ("lifestyle change"), a website providing peer narratives of experiences with successful lifestyle change, and to analyze whether peer model characteristics, clip content, and media type have an influence on the number of visitors, dwell time, and exit rates. An in-depth statistical analysis of website use with multilevel regression analyses. In two years, lebensstil-aendern.de attracted 12,844 visitors. The in-depth statistical analysis of usage rates demonstrated that audio clips were less popular than video or text-only clips, longer clips attracted more visitors, and clips by younger and female interviewees were preferred. User preferences for clip content categories differed between heart and back pain patients. Clips about stress management drew the smallest numbers of visitors in both indication modules. Patients are interested in the experiences of others. Because the quality of information for user-generated content is generally low, healthcare providers should include quality-assured patient narratives in their interventions. User preferences for content, medium, and peer characteristics need to be taken into account. If healthcare providers decide to include patient experiences in their websites, they should plan their intervention according to the different needs and preferences of users. Copyright © 2018 Elsevier B.V. All rights reserved.

The accuracy of new wheelchair users' predictions about their future wheelchair use.

PubMed

Hoenig, Helen; Griffiths, Patricia; Ganesh, Shanti; Caves, Kevin; Harris, Frances

2012-06-01

This study examined the accuracy of new wheelchair user predictions about their future wheelchair use. This was a prospective cohort study of 84 community-dwelling veterans provided a new manual wheelchair. The association between predicted and actual wheelchair use was strong at 3 mos (ϕ coefficient = 0.56), with 90% of those who anticipated using the wheelchair at 3 mos still using it (i.e., positive predictive value = 0.96) and 60% of those who anticipated not using it indeed no longer using the wheelchair (i.e., negative predictive value = 0.60, overall accuracy = 0.92). Predictive accuracy diminished over time, with overall accuracy declining from 0.92 at 3 mos to 0.66 at 6 mos. At all time points, and for all types of use, patients better predicted use as opposed to disuse, with correspondingly higher positive than negative predictive values. Accuracy of prediction of use in specific indoor and outdoor locations varied according to location. This study demonstrates the importance of better understanding the potential mismatch between the anticipated and actual patterns of wheelchair use. The findings suggest that users can be relied upon to accurately predict their basic wheelchair-related needs in the short-term. Further exploration is needed to identify characteristics that will aid users and their providers in more accurately predicting mobility needs for the long-term.

Radon measurement and mitigation activity in Finland.

PubMed

Valmari, T; Arvela, H; Reisbacka, H; Holmgren, O

2014-07-01

Radon prevention, measurement and mitigation activities have been increasing in Finland during the 2000s. Nowadays, many municipal authorities, especially those located in high-radon areas, require radon prevention measures. This has activated radon measurements. Owners of new houses having radon piping installed under the floor slab are the most active group to measure and reduce the found high-radon values. Their radon awareness is apparently better than on the average, and the existing piping makes it easier and cheaper to reduce the radon levels. Local campaigns involving invitation flyers mailed to the residents have been a cost-effective means to activate measurements of older houses. So far 116,611 dwellings in low-rise residential buildings have been measured. At least 15% of the 16,860 dwellings found to exceed the reference level of 400 Bq m(-3) had their indoor radon level reduced below that. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An overview of the Mediterranean cave-dwelling horny sponges (Porifera, Demospongiae)

PubMed Central

Manconi, Renata; Cadeddu, Barbara; Ledda, Fabio; Pronzato, Roberto

2013-01-01

Abstract The present synthesis focuses on the so called ‘horny sponges’ recorded from marine caves of the Mediterranean Sea. The main aim is to provide a list of all recorded species, diagnostic keys to their identification up to family and genus level, and exhaustive, formally uniform descriptions at the species level contributing to sharing of information on the faunistics and taxonomy of Mediterranean cave-dwelling species, including habitat preferences. The majority of species was recorded in 105 Mediterranean marine caves hosting four orders of horny sponges belonging to 9 families, 19 genera and 40 species. Species endemic to the Mediterranean Sea harboured in marine caves are 14 with an endemicity value of 35%. For each species morphological descriptions are supported by illustrations both original and from the literature, including the diagnostic traits of the skeleton by light and scanning electron microscopy giving further characterization at the specific level. A detailed map together with a list of all caves harbouring horny sponges is also provided with geographic coordinates. PMID:23794833

SU-E-T-758: To Determine the Source Dwell Positions of HDR Brachytherapy Using 2D 729 Ion Chamber Array

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

Kumar, Syam; Sitha

2015-06-15

Purpose: Determination of source dwell positions of HDR brachytherapy using 2D 729 ion chamber array Methods: Nucletron microselectron HDR and PTW 2D array were used for the study. Different dwell positions were assigned in the HDR machine. Rigid interstitial needles and vaginal applicator were positioned on the 2D array. The 2D array was exposed for this programmed dwell positions. The positional accuracy of the source was analyzed after the irradiation of the 2D array. This was repeated for different dwell positions. Different test plans were transferred from the Oncentra planning system and irradiated with the same applicator position on themore » 2D array. The results were analyzed using the in house developed excel program. Results: Assigned dwell positions versus corresponding detector response were analyzed. The results show very good agreement with the film measurements. No significant variation found between the planned and measured dwell positions. Average dose response with 2D array between the planned and nearby dwell positions was found to be 0.0804 Gy for vaginal cylinder applicator and 0.1234 Gy for interstitial rigid needles. Standard deviation between the doses for all the measured dwell positions for interstitial rigid needle for 1 cm spaced positions were found to be 0.33 and 0.37 for 2cm spaced dwell positions. For intracavitory vaginal applicator this was found to be 0.21 for 1 cm spaced dwell positions and 0.06 for 2cm spaced dwell positions. Intracavitory test plans reproduced on the 2D array with the same applicator positions shows the ideal dose distribution with the TPS planned. Conclusion: 2D array is a good tool for determining the dwell position of HDR brachytherapy. With the in-house developed program in excel it is easy and accurate. The traditional way with film analysis can be replaced by this method, as the films will be more costly.« less

49 CFR 24.403 - Additional rules governing replacement housing payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... nearly representative of, and equal to, or better than, the displacement dwelling. (2) If the site of the comparable replacement dwelling lacks a major exterior attribute of the displacement dwelling site, (e.g... shall be subtracted from the acquisition cost of the displacement dwelling for purposes of computing the...

49 CFR 24.403 - Additional rules governing replacement housing payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... nearly representative of, and equal to, or better than, the displacement dwelling. (2) If the site of the comparable replacement dwelling lacks a major exterior attribute of the displacement dwelling site, (e.g... shall be subtracted from the acquisition cost of the displacement dwelling for purposes of computing the...

39 CFR 777.25 - Additional rules for replacement housing payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... displacement dwelling; or (2) The difference between (i) the occupant's share of the acquisition cost of the displacement dwelling and (ii) the purchase price of a decent, safe, and sanitary replacement dwelling actually purchased and occupied by the displaced person. (b) Multiple Occupants of One Displacement Dwelling. If two...

49 CFR 24.403 - Additional rules governing replacement housing payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... nearly representative of, and equal to, or better than, the displacement dwelling. (2) If the site of the comparable replacement dwelling lacks a major exterior attribute of the displacement dwelling site, (e.g... shall be subtracted from the acquisition cost of the displacement dwelling for purposes of computing the...

39 CFR 777.25 - Additional rules for replacement housing payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... displacement dwelling; or (2) The difference between (i) the occupant's share of the acquisition cost of the displacement dwelling and (ii) the purchase price of a decent, safe, and sanitary replacement dwelling actually purchased and occupied by the displaced person. (b) Multiple Occupants of One Displacement Dwelling. If two...

49 CFR 24.403 - Additional rules governing replacement housing payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... nearly representative of, and equal to, or better than, the displacement dwelling. (2) If the site of the comparable replacement dwelling lacks a major exterior attribute of the displacement dwelling site, (e.g... shall be subtracted from the acquisition cost of the displacement dwelling for purposes of computing the...

39 CFR 777.25 - Additional rules for replacement housing payments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... displacement dwelling; or (2) The difference between (i) the occupant's share of the acquisition cost of the displacement dwelling and (ii) the purchase price of a decent, safe, and sanitary replacement dwelling actually purchased and occupied by the displaced person. (b) Multiple Occupants of One Displacement Dwelling. If two...

39 CFR 777.25 - Additional rules for replacement housing payments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... displacement dwelling; or (2) The difference between (i) the occupant's share of the acquisition cost of the displacement dwelling and (ii) the purchase price of a decent, safe, and sanitary replacement dwelling actually purchased and occupied by the displaced person. (b) Multiple Occupants of One Displacement Dwelling. If two...

49 CFR 24.403 - Additional rules governing replacement housing payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... nearly representative of, and equal to, or better than, the displacement dwelling. (2) If the site of the comparable replacement dwelling lacks a major exterior attribute of the displacement dwelling site, (e.g... shall be subtracted from the acquisition cost of the displacement dwelling for purposes of computing the...

39 CFR 777.25 - Additional rules for replacement housing payments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... displacement dwelling; or (2) The difference between (i) the occupant's share of the acquisition cost of the displacement dwelling and (ii) the purchase price of a decent, safe, and sanitary replacement dwelling actually purchased and occupied by the displaced person. (b) Multiple Occupants of One Displacement Dwelling. If two...

Curriculum Making as the Enactment of Dwelling in Places

ERIC Educational Resources Information Center

Ross, Hamish; Mannion, Greg

2012-01-01

This article uses an account of dwelling to interrogate the concept of curriculum making. Tim Ingold's use of dwelling to understand culture is productive here because of his implicit and explicit interest in intergenerational learning. His account of dwelling rests on a foundational ontological claim--that mental construction and representation…

Effects of incomplete residential histories on studies of environmental exposure with application to childhood leukaemia and background radiation.

PubMed

Nikkilä, Atte; Kendall, Gerald; Raitanen, Jani; Spycher, Ben; Lohi, Olli; Auvinen, Anssi

2018-06-22

When evaluating environmental exposures, residential exposures are often most relevant. In most countries, it is impossible to establish full residential histories. In recent publications, childhood leukaemia and background radiation have been studied with and without full residential histories. This paper investigates the consequences of lacking such full data. Data from a nationwide Finnish Case-Control study of Childhood Leukaemia and gamma rays were analysed. This included 1093 children diagnosed with leukaemia in Finland in 1990-2011. Each case was matched by gender and year of birth to three controls. Full residential histories were available. The dose estimates were based on outdoor background radiation measurements. The indoor dose rates were obtained with a dwelling type specific conversion coefficient and the individual time-weighted mean red bone marrow dose rates were calculated using age-specific indoor occupancy and the age and gender of the child. Radiation from Chernobyl fallout was included and a 2-year latency period assumed. The median separation between successive dwellings was 3.4 km and median difference in red bone marrow dose 2.9 nSv/h. The Pearson correlation between the indoor red bone marrow dose rates of successive dwellings was 0.62 (95% CI 0.60, 0.64). The odds ratio for a 10 nSv/h increase in dose rate with full residential histories was 1.01 (95% CI 0.97, 1.05). Similar odds ratios were calculated with dose rates based on only the first dwelling (1.02, 95% CI 0.99, 1.05) and only the last dwelling (1.00, 95% CI 0.98, 1.03) and for subjects who had lived only in a single dwelling (1.05, 95% CI 0.98, 1.10). Knowledge of full residential histories would always be the option of choice. However, due to the strong correlation between exposure estimates in successive dwellings and the uncertainty about the most relevant exposure period, estimation of overall exposure level from a single address is also informative. Error in dose estimation is likely to cause some degree of classical measurement error resulting in bias towards the null. Copyright © 2018 Elsevier Inc. All rights reserved.

Microbiological consequences of indoor composting.

PubMed

Naegele, A; Reboux, G; Vacheyrou, M; Valot, B; Millon, L; Roussel, S

2016-08-01

Recycling of organic waste appeals to more and more people. The aim of this study was to evaluate the microbiological contamination around organic waste bins at three distances over a 12-month period. Contamination near the customary trash of control households was evaluated at the beginning to ensure that there is no recruitment bias. Air samples using the MAS 100 impactor were carried out in 38 dwellings that do household waste composting and in 10 dwellings of controls. Collection of particles by CIP 10 rotating cup sampler and dust samples collected by electrostatic dust collector cloths were acquired in dwellings that do household waste composting. Samples were analyzed by culture and by real-time quantitative PCR. Information about dwelling characteristics and inhabitant practices was obtained by a standardized questionnaire. The genera most often isolated were Penicillium, Aspergillus, Cladosporium and Streptomyces. Near the organic waste bins, bioaerosol samples showed an increase of Acarus siro (P = 0.001). Sedimented dust analyses highlighted an increase of A. siro, Wallemia sebi, Aspergillus versicolor, and Cladosporium sphaerospermum concentrations after a 12-month survey compared to the beginning. Composting favors microorganism development over time, but does not seem to have an effect on the bioaerosol levels and the surface microbiota beyond 0.5 m from the waste bin. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Health inequities in mood disorders based on material and social deprivation in dwelling sectors ].

PubMed

Vanasse, Alain; Courteau, Josiane; Lesage, Alain; Fleury, Marie-Josée; Grégoire, Jean-Pierre; Moisan, Jocelyne; Lauzier, Sophie; Bergeron, Claude

2012-12-01

To compare mood disorder (MD) prevalence in Quebec in 2006, and compare health services and medication use, mortality and morbidity in patients with MD based on sex and the dwelling sector level of material and social deprivation. The objective was also to identify subgroups of individuals using health services in a larger proportion and having a higher risk of morbidity and mortality. We conducted a secondary analysis of the Régie de l’assurance maladie du Québec medico-administrative data. The cohort is composed of adults diagnosed with MD and living in Quebec in 2006. Variables include: physician consultation, medication demand, consultation for substance or alcohol abuse, emergency visit, hospitalization for a mental disorder, and death. Dwelling sector types are defined by crossing Pampalon material and social deprivation quintiles. MD prevalence in 2006 was 3.06% (177 850 patients), with prevalence in women 1.7-fold with respect to men. Findings show a higher MD prevalence as well as a higher mortality and morbidity rate in materially and socially deprived dwelling sectors. Young men also represent a specifically vulnerable subgroup for many study variables. Public policies aimed at improving material conditions (income, education, employment) and breaking out social isolation would have an important impact on the population mental health. Public health program development should pay close attention to young men population.

Predicting the Trajectories of Perceived Pain Intensity in Southern Community-Dwelling Older Adults: The Role of Religiousness.

PubMed

Sun, Fei; Park, Nan Sook; Wardian, Jana; Lee, Beom S; Roff, Lucinda L; Klemmack, David L; Parker, Michael W; Koenig, Harold G; Sawyer, Patricia L; Allman, Richard M

2013-11-01

This study focuses on the identification of multiple latent trajectories of pain intensity, and it examines how religiousness is related to different classes of pain trajectory. Participants were 720 community-dwelling older adults who were interviewed at four time points over a 3-year period. Overall, intensity of pain decreased over 3 years. Analysis using latent growth mixture modeling (GMM) identified three classes of pain: (1) increasing ( n = 47); (2) consistently unchanging ( n = 292); and (3) decreasing ( n = 381). Higher levels of intrinsic religiousness (IR) at baseline were associated with higher levels of pain at baseline, although it attenuated the slope of pain trajectories in the increasing pain group. Higher service attendance at baseline was associated with a higher probability of being in the decreasing pain group. The increasing pain group and the consistently unchanging group reported more negative physical and mental health outcomes than the decreasing pain group.

Modeling of switching regulator power stages with and without zero-inductor-current dwell time

NASA Technical Reports Server (NTRS)

Lee, F. C.; Yu, Y.; Triner, J. E.

1976-01-01

State space techniques are employed to derive accurate models for buck, boost, and buck/boost converter power stages operating with and without zero-inductor-current dwell time. A generalized procedure is developed which treats the continuous-inductor-current mode without the dwell time as a special case of the discontinuous-current mode, when the dwell time vanishes. An abrupt change of system behavior including a reduction of the system order when the dwell time appears is shown both analytically and experimentally.

Effects on centre-based training and home-based training on physical function, quality of life and fall incidence in community dwelling older adults.

PubMed

Kwok, Thomas M K; Tong, C Y

2014-05-01

This was a quasi-experimental study to compare the effects of center-based training with home-based training on physical function, quality of life and fall incidence in older adults. Fifty older adults were recruited to receive exercise training for 6 months. Participants in the center-based group received training under supervision of a physiotherapist at the day training center. Those in the home-based group received training assisted by a care worker at home. The outcome measures were the Elderly Mobility Scale (EMS), Berg Balance Scale (BBS), Numeric Pain Rating Scale (NPRS), Short-form 12 (SF-12) and fall incidence. Assessments were performed on all participants before and after the 6-month intervention period. Center-based training supervised by a physiotherapist was found to have beneficial effects on physical function, quality of life and fall incidence while home-based training assisted by a care worker had no effect on physical condition and self-rated health status in community dwelling older adults. Service agents should provide center-based or home-based training to the ageing population in a user-friendly way with consideration of factors such as rehabilitation potential and accessibility of transportation.

12 CFR 541.25 - Single-family dwelling.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Single-family dwelling. 541.25 Section 541.25... AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.25 Single-family dwelling. The term single-family dwelling means a structure designed for residential use by one family, or a unit so designed, whose owner owns...

Alternative Fuels Data Center: Electric Vehicle Charging for Multi-Unit

Science.gov Websites

Dwellings Electric Vehicle Charging for Multi-Unit Dwellings to someone by E-mail Share Alternative Fuels Data Center: Electric Vehicle Charging for Multi-Unit Dwellings on Facebook Tweet about Alternative Fuels Data Center: Electric Vehicle Charging for Multi-Unit Dwellings on Twitter Bookmark

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

49 CFR 24.401 - Replacement housing payment for 180-day homeowner-occupants.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Has actually owned and occupied the displacement dwelling for not less than 180 days immediately prior... displacement dwelling or, in the case of condemnation, the date the full amount of the estimate of just... homeowner-occupant is paid for the displacement dwelling, or the date a comparable replacement dwelling is...

12 CFR 541.25 - Single-family dwelling.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Single-family dwelling. 541.25 Section 541.25... AFFECTING FEDERAL SAVINGS ASSOCIATIONS § 541.25 Single-family dwelling. The term single-family dwelling means a structure designed for residential use by one family, or a unit so designed, whose owner owns...

Effect of glucose concentration on peritoneal inflammatory cytokines in continuous ambulatory peritoneal dialysis patients.

PubMed Central

Sayarlioglu, Hayriye; Topal, Cevat; Sayarlioglu, Mehmet; Dulger, Haluk; Dogan, Ekrem; Erkoc, Reha

2004-01-01

OBJECTIVE: It is known that glucose concentrations of peritoneal dialysis solutions are detrimental to the peritoneal membrane. In order to determine the effect of glucose concentration on cytokine levels of peritoneal fluid of continuous ambulatory peritoneal dialysis (CAPD) patients, a cross-sectional study was performed. METHODS: Nine non-diabetic CAPD patients participated in two 8-h dwell sessions of overnight exchanges in consecutive days, with 1.36% and 3.86% glucose containing peritoneal dialysis solutions (Baxter-Eczacibas). Peritoneal dialysis fluid tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 levels were measured. RESULTS: TNF-alpha levels after 1.36% and 3.86% glucose used dwells were 23+/-14 pg/ml and 28+/-4 pg/ml, respectively (p=0.78). The IL-6 levels were 106+/-57 pg/ml and 115+/-63 pg/ml (p=0.81), respectively. CONCLUSION: In our in vivo study we found that the glucose concentration of the conventional lactate-based CAPD solution has no effect on basal IL-6 and TNF-alpha levels of peritoneal fluid. Further in vivo studies with non-lactate-based CAPD solutions are needed in order to determine the effect of glucose concentration per se on cytokine release. PMID:15203553

Aromatherapy: does it help to relieve pain, depression, anxiety, and stress in community-dwelling older persons?

PubMed

Tang, Shuk Kwan; Tse, M Y Mimi

2014-01-01

To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (P<0.05). The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults.

Prevalence of Drug Combinations Increasing Bleeding Risk Among Warfarin Users With and Without Alzheimer's Disease.

PubMed

Taipale, Heidi; Vuorikari, Hanna; Tanskanen, Antti; Koponen, Marjaana; Tiihonen, Jari; Kettunen, Raimo; Hartikainen, Sirpa

2015-11-01

The aim of this study was to analyse the prevalence and predictors of drug combinations increasing bleeding risk among warfarin users with and without Alzheimer's disease (AD). This retrospective observational study utilised data from the Finnish MEDALZ-2005 cohort. The MEDALZ-2005 study included all community-dwelling persons with a clinically verified diagnosis of AD at the end of 2005, and one comparison person without AD for each case. Data on drug use was collected from the Prescription Register. We included persons who were warfarin users during the study period 2006-2009. Drug combinations increasing bleeding risk with warfarin included selective serotonin reuptake inhibitors (SSRIs), non-steroidal anti-inflammatory agents (NSAIDs), other antithrombotic drugs and tramadol. Factors associated with combination use were investigated with logistic regression. During the follow-up, 3385 persons with AD and 4830 persons without AD used warfarin. Drug combinations increasing bleeding risk were more common in warfarin users with AD than without AD [35.9 and 30.5%, respectively (p < 0.0001)]. The most common combination was SSRIs and warfarin, which was more common among persons with AD (23.8%) than among persons without AD (10.9%). NSAIDs and warfarin combination was more common among persons without AD. Combination use was associated with AD, female gender, younger age, diabetes mellitus, rheumatoid arthritis and asthma/chronic obstructive pulmonary disease (COPD). Use of drug combinations increasing bleeding risk was more common among warfarin users with AD. Special attention should be paid to minimise the duration of concomitant use and to find safer alternatives without increased bleeding risk.

Cross-cultural adaptation and validation of the Arabic version of the Physical Activity Scale for the Elderly among community-dwelling older adults in Saudi Arabia.

PubMed

Alqarni, Ayidh M; Vennu, Vishal; Alshammari, Sulaiman A; Bindawas, Saad M

2018-01-01

Older adults are the fastest growing population group worldwide. Regular physical activity (PA) is reported to reduce the risk of health conditions and improve personal well-being. Few validated instruments can be used to measure the PA levels among older adults in Saudi Arabia. The Physical Activity Scale for the Elderly (PASE) is used worldwide for evaluating the PA levels of the elderly in epidemiological studies. However, this scale has not been translated into Arabic. This study aimed to cross-culturally adapt the PASE into Arabic language and evaluate its reliability and validity among community-dwelling older adults in Saudi Arabia. This study was a cross-sectional one following Beaton guidelines to translate and perform cultural adaptation, as well as test the reliability and validity of the PASE Arabic version (PASE-A). Elderly (N=74) people from both genders, who lived in a community dwelling in Riyadh city, were selected from several primary health care centers. The study used Cronbach's alpha coefficient to assess the internal consistency reliability, while intraclass correlation coefficient (ICC 2,1 ) was used for test-retest reliability and the Spearman's rank correlation coefficient ( r ) was used to evaluate the correlation among PASE-A and grip strength, Timed Up and Go test, body mass index, and fat percentage. Out of 74 older adults, 59 (79.7%) completed the PASE-A questionnaire twice. The internal consistency of the PASE-A components was good (Cronbach's alpha 0.70-0.75), and the reliability of the components was excellent (ICC 2,1 0.90-0.98). A higher PASE-A score was associated with higher grip strength ( r =0.28, p =0.05) and with shorter Timed Up and Go test times ( r =-0.45, p =0.01). The PASE-A version was easy, understandable, and relevant for Saudi older adults' culture. This scale was a reliable and valid tool for evaluating and assessing the PA level among community-dwelling older adults in Saudi Arabia.

Selection of roosting habitat by forest bats in a diverse forested landscape

Treesearch

Roger W. Perry; Ronald E. Thill; David M. Leslie

2007-01-01

Many studies of roost selection by forest-dwelling bats have concentrated on microhabitat surrounding roosts without providing forest stand level preferences of bats; thus, those studies have provided only part of the information needed by managers. We evaluated diurnal summer roost selection by the bat community at the forest-stand level in a diversely forested...

Cerulean warbler

Treesearch

Scott H. Stoleson; Frederick C. Sechler

2010-01-01

The cerulean warbler (Dendroica cerulea) is a small, canopy-dwelling wood-warbler. In Pennsylvania it is listed as a Species of High-Level Concern. Because of severe population declines, it is currently being considered for listing as Threatened under the United States Endangered Species Act.

The modifying effect of the building envelope on population exposure to PM2.5 from outdoor sources.

PubMed

Taylor, J; Shrubsole, C; Davies, M; Biddulph, P; Das, P; Hamilton, I; Vardoulakis, S; Mavrogianni, A; Jones, B; Oikonomou, E

2014-12-01

A number of studies have estimated population exposure to PM2.5 by examining modeled or measured outdoor PM2.5 levels. However, few have taken into account the mediating effects of building characteristics on the ingress of PM2.5 from outdoor sources and its impact on population exposure in the indoor domestic environment. This study describes how building simulation can be used to determine the indoor concentration of outdoor-sourced pollution for different housing typologies and how the results can be mapped using building stock models and Geographical Information Systems software to demonstrate the modifying effect of dwellings on occupant exposure to PM2.5 across London. Building archetypes broadly representative of those in the Greater London Authority were simulated for pollution infiltration using EnergyPlus. In addition, the influence of occupant behavior on indoor levels of PM2.5 from outdoor sources was examined using a temperature-dependent window-opening scenario. Results demonstrate a range of I/O ratios of PM2.5 , with detached and semi-detached dwellings most vulnerable to high levels of infiltration. When the results are mapped, central London shows lower I/O ratios of PM2.5 compared with outer London, an apparent inversion of exposure most likely caused by the prevalence of flats rather than detached or semi-detached properties. Population exposure to air pollution is typically evaluated using the outdoor concentration of pollutants and does not account for the fact that people in London spend over 80% of their time indoors. In this article, building simulation is used to model the infiltration of outdoor PM2.5 into the domestic indoor environment for dwellings in a London building stock model, and the results mapped. The results show the variation in relative vulnerability of dwellings to pollution infiltration, as well as an estimated absolute indoor concentration across the Greater London Authority (GLA) scaled by local outdoor levels. The practical application of this work is a better understanding of the modifying effect of the building geometry and envelope design on pollution exposure, and how the London building stock may alter exposure. The results will be used to inform population exposure to PM2.5 in future environmental epidemiological studies. © 2014 The Authors. Indoor Air Published by John Wiley & Sons Ltd.

Effects of High Temperature Exposures on Fatigue Life of Disk Superalloys

NASA Technical Reports Server (NTRS)

Gabb, Tim P.; Telesman, Jack; Kantzos, Pete T.; Smith, James W.; Browning, Paul F.

2004-01-01

The effects on fatigue life of high temperature exposures simulating service conditions were considered for two disk superalloys. Powder metallurgy processed, supersolvus heat treated Udimet (trademark) 720 and ME3 fatigue specimens were exposed in air at temperatures of 650 to 704 C, for times of 100 h to over 1000 h. They were then tested using conventional fatigue tests at 650 and 704 C, to determine the effects of exposure on fatigue resistance. Cyclic dwell verification tests were also performed to contrast the effects of intermixed exposures and fatigue cycles. The prior exposures reduced life by up to 70% and increased the scatter in life, compared to unexposed levels. Cyclic dwell tests reduced lives even more. Fractographic evaluations indicated the failure mode was shifted by the exposures and cyclic dwells from predominantly internal to often surface crack initiations. The increased scatter in life was related to the competition between internal crack initiations at inclusions or large grains producing longer lives, and surface crack initiations at an environmentally affected surface layer producing shorter lives.

Efficacy of Biofeedback Therapy in the Treatment of Dyssynergic Defecation in Community-Dwelling Elderly Women.

PubMed

Simón, Miguel A; Bueno, Ana M

The aim of this study was to evaluate the efficacy of biofeedback therapy in the treatment of dyssynergic defecation in chronically constipated community-dwelling elderly women. After an initial assessment phase carried out during 1 month, 20 chronically constipated women with dyssynergic defecation were randomly assigned to either electromyographic biofeedback (EMG-BF) group (n=10) or control group (n=10). Outcome measures used to evaluate the efficacy of treatment were weekly stool frequency, sensation of incomplete evacuation, difficulty evacuation level, mean EMG-activity (μV) of the external anal sphincter during straining to defecate and Anismus index. The results obtained in this randomized controlled trial showed significant differences between the groups in all the dependent variables after 1 month of treatment. Moreover, there was no difference between the groups neither in age nor in the duration of chronic constipation symptoms. At the follow-up, 3 months later, clinical gains were maintained. This study demonstrates that the EMG-BF is an effective behavioral therapy for the treatment of dyssynergic defecation in community-dwelling elderly women.

Infants' indoor and outdoor residential exposure to benzene and respiratory health in a Spanish cohort.

PubMed

Ferrero, Amparo; Esplugues, Ana; Estarlich, Marisa; Llop, Sabrina; Cases, Amparo; Mantilla, Enrique; Ballester, Ferran; Iñiguez, Carmen

2017-03-01

Benzene exposure represents a potential risk for children's health. Apart from being a known carcinogen for humans (group 1 according to IARC), there is scientific evidence suggesting a relationship between benzene exposure and respiratory problems in children. But results are still inconclusive and inconsistent. This study aims to assess the determinants of exposure to indoor and outdoor residential benzene levels and its relationship with respiratory health in infants. Participants were 1-year-old infants (N = 352) from the INMA cohort from Valencia (Spain). Residential benzene exposure levels were measured inside and outside dwellings by means of passive samplers in a 15-day campaign. Persistent cough, low respiratory tract infections and wheezing during the first year of life, and covariates (dwelling traits, lifestyle factors and sociodemographic data) were obtained from parental questionnaires. Multiple Tobit regression and logistic regression models were performed to assess factors associated to residential exposure levels and health associations, respectively. Indoor levels were higher than outdoor ones (1.46 and 0.77 μg/m 3 , respectively; p < 0.01). A considerable percentage of dwellings, 42% and 21% indoors and outdoors respectively, surpassed the WHO guideline of 1.7 μg/m 3 derived from a lifetime risk of leukemia above 1/100 000. Monitoring season, maternal country of birth and parental tobacco consumption were associated with residential benzene exposure (indoor and outdoors). Additionally, indoor levels were associated with mother's age and type of heating, and outdoor levels were linked with zone of residence and distance from industrial areas. After adjustment for confounding factors, no significant associations were found between residential benzene exposure levels and respiratory health in infants. Hence, our study did not support the hypothesis for the benzene exposure effect on respiratory health in children. Even so, it highlights a public health concern related to the personal exposure levels, since a considerable number of children surpassed the abovementioned WHO guideline for benzene exposure. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Sensitivity to Change and Responsiveness of Four Balance Measures for Community-Dwelling Older Adults

PubMed Central

Latham, Nancy K.; Jette, Alan M.; Wagenaar, Robert C.; Ni, Pengsheng; Slavin, Mary D.; Bean, Jonathan F.

2012-01-01

Background Impaired balance has a significant negative impact on mobility, functional independence, and fall risk in older adults. Although several, well-respected balance measures are currently in use, there is limited evidence regarding the most appropriate measure to assess change in community-dwelling older adults. Objective The aim of this study was to compare floor and ceiling effects, sensitivity to change, and responsiveness across the following balance measures in community-dwelling elderly people with functional limitations: Berg Balance Scale (BBS), Performance-Oriented Mobility Assessment total scale (POMA-T), POMA balance subscale (POMA-B), and Dynamic Gait Index (DGI). Design Retrospective data from a 16-week exercise trial were used. Secondary analyses were conducted on the total sample and by subgroups of baseline functional limitation or baseline balance scores. Methods Participants were 111 community-dwelling older adults 65 years of age or older, with functional limitations. Sensitivity to change was assessed using effect size, standardized response mean, and paired t tests. Responsiveness was assessed using minimally important difference (MID) estimates. Results No floor effects were noted. Ceiling effects were observed on all measures, including in people with moderate to severe functional limitations. The POMA-T, POMA-B, and DGI showed significantly larger ceiling effects compared with the BBS. All measures had low sensitivity to change in total sample analyses. Subgroup analyses revealed significantly better sensitivity to change in people with lower compared with higher baseline balance scores. Although both the total sample and lower baseline balance subgroups showed statistically significant improvement from baseline to 16 weeks on all measures, only the lower balance subgroup showed change scores that consistently exceeded corresponding MID estimates. Limitations This study was limited to comparing 4 measures of balance, and anchor-based methods for assessing MID could not be reported. Conclusions Important limitations, including ceiling effects and relatively low sensitivity to change and responsiveness, were noted across all balance measures, highlighting their limited utility across the full spectrum of the community-dwelling elderly population. New, more challenging measures are needed for better discrimination of balance ability in community-dwelling elderly people at higher functional levels. PMID:22114200

Contribution of social relationships to self-rated health among Japanese community-dwelling elderly.

PubMed

Kawasaki, Ryoko; Nakao, Rieko; Ohnishi, Mayumi

2018-05-01

Objective: Participation in social activities is associated with physical and psychological health in the community-dwelling elderly population. We examined the two factors of social relations and community health resources, associated with higher self-rated health levels in the community-dwelling elderly. Methods: A total of 145 community-dwelling elderly people ≥ 65 years old from two neighborhood associations in Nagasaki City were recruited for this study, representing 85% of the officially registered ≥ 65-year-old population in the target area. Face-to-face interviews using a structured questionnaire were conducted by trained interviewers in August 2009, with questions related to sociodemographic characteristics, social relationships, and self-rated health (SRH). Community health resources (type and walking distance from home) were evaluated by one of the authors as a community assessment. Results: Seventy-eight community-dwelling elderly people (25 men and 53 women) participated in the study. Elderly people who reported going out every day were more likely to show higher SRH scores (excellent/good) than those going out less often (OR: 3.7; 95% confidence interval [CI]: 1.0, 14.2; P = 0.056). The numbers of interactions with friends in higher and lower SRH groups were 6.5 ± 8.4 (mean ± standard deviation) and 2.4 ± 1.1 ( P = 0.01, Mann-Whitney U test), respectively. The numbers of relatives talking on the phone in higher and lower SRH groups were 2.9 ± 1.3 and 2.2 ± 1.2 ( P = 0.031, Mann-Whitney U test), respectively. Meeting scores with friends in higher and lower SRH groups were 7.8 ± 5.8 and 4.5 ± 3.6 ( P = 0.068), respectively. The scores of community health resources among higher and lower SRH groups were 21.2 ± 1.5 and 20.9 ± 1.4 ( P = 0.547), respectively. The scores of community association/activities in higher and lower SRH groups were 3.9 ± 1.0 and 3.6 ± 0.9 ( P = 0.227), respectively. Conclusion: This study indicated the importance of interaction with friends and relatives for maintaining higher SRH among community-dwelling elderly people.

Service users' views of the assessment process in stroke rehabilitation.

PubMed

Tyson, Sarah F; Burton, Louisa-Jane; McGovern, Alison; Sharifi, Sudi

2014-08-01

To investigate the service users' (stroke survivors and care-givers) experiences and views of the rehabilitation assessment process. Qualitative data analysis from three focus groups using a content analysis to identify the major themes. Participants were recruited from stroke support groups and community rehabilitation services in a large UK city. Seventeen community-dwelling stroke survivors who had completed their rehabilitation within the previous year and six care-givers. Five themes emerged: understanding the purpose of the assessment; repetition of assessments; feedback about assessments and progress; format of feedback and barriers to feedback. While all participants reported undergoing assessment, some felt their purpose was not always explained and resented unexplained repetitions of tests. Some participants reported a positive experience, but most wanted more information about their progress and predictions of recovery. They wanted regular, consistent, objective information presented in layman's terms; verbally and in writing. Some carers reported difficulty accessing information particularly as a result of confidentiality policies. While some participants accepted these short-comings, others considered them due to staff's disinterest or ineptitude, which undermined their trust in the team. Stroke service users require clear information about the purpose of assessments and regular, consistent, objective feedback about their progress using layman's language both verbally and in writing. © The Author(s) 2014.

Hearing-aid use and long-term health outcomes: Hearing handicap, mental health, social engagement, cognitive function, physical health, and mortality.

PubMed

Dawes, Piers; Cruickshanks, Karen J; Fischer, Mary E; Klein, Barbara E K; Klein, Ronald; Nondahl, David M

2015-01-01

To clarify the impact of hearing aids on mental health, social engagement, cognitive function, and physical health outcomes in older adults with hearing impairment. We assessed hearing handicap (hearing handicap inventory for the elderly; HHIE-S), cognition (mini mental state exam, trail making, auditory verbal learning, digit-symbol substitution, verbal fluency, incidence of cognitive impairment), physical health (SF-12 physical component, basic and instrumental activities of daily living, mortality), social engagement (hours per week spent in solitary activities), and mental health (SF-12 mental component) at baseline, five years prior to baseline, and five and 11 years after baseline. Community-dwelling older adults with hearing impairment (N = 666) from the epidemiology of hearing loss study cohort. There were no significant differences between hearing-aid users and non-users in cognitive, social engagement, or mental health outcomes at any time point. Aided HHIE-S was significantly better than unaided HHIE-S. At 11 years hearing-aid users had significantly better SF-12 physical health scores (46.2 versus 41.2; p = 0.03). There was no difference in incidence of cognitive impairment or mortality. There was no evidence that hearing aids promote cognitive function, mental health, or social engagement. Hearing aids may reduce hearing handicap and promote better physical health.

Relationship between functional capacity and body mass index with plasma coenzyme Q10 and oxidative damage in community-dwelling elderly-people.

PubMed

Del Pozo-Cruz, Jesús; Rodríguez-Bies, Elizabeth; Navas-Enamorado, Ignacio; Del Pozo-Cruz, Borja; Navas, Plácido; López-Lluch, Guillermo

2014-04-01

The impact of aging and physical capacity on coenzyme Q10 (Q10) levels in human blood is unknown. Plasma Q10 is an important factor in cardiovascular diseases. To understand how physical activity in the elderly affects endogenous Q10 levels in blood plasma, we studied a cohort of healthy community-dwelling people. Volunteers were subjected to different tests of the Functional Fitness Test Battery including handgrip strength, six-minute walk, 30 s chair to stand, and time up and go tests. Anthropometric characteristics, plasma Q10 and lipid peroxidation (MDA) levels were determined. Population was divided according to gender and fitness. We found that people showing higher levels of functional capacity presented lower levels of cholesterol and lipid peroxidation accompanied by higher levels of Q10 in plasma. The ratio Q10/cholesterol and Q10/LDL increased in these people. No relationship was found when correlated to muscle strength or agility. On the other hand, obesity was related to lower Q10 and higher MDA levels in plasma affecting women more significantly. Our data demonstrate for the first time that physical activity at advanced age can increase the levels of Q10 and lower the levels of lipid peroxidation in plasma, probably reducing the progression of cardiovascular diseases. Copyright © 2014 Elsevier Inc. All rights reserved.

Exploring user experience and technology acceptance for a fall prevention system: results from a randomized clinical trial and a living lab.

PubMed

Vaziri, Daryoush D; Aal, Konstantin; Ogonowski, Corinna; Von Rekowski, Thomas; Kroll, Michael; Marston, Hannah R; Poveda, Rakel; Gschwind, Yves J; Delbaere, Kim; Wieching, Rainer; Wulf, Volker

2016-01-01

Falls are common in older adults and can result in serious injuries. Due to demographic changes, falls and related healthcare costs are likely to increase over the next years. Participation and motivation of older adults in fall prevention measures remain a challenge. The iStoppFalls project developed an information and communication technology (ICT)-based system for older adults to use at home in order to reduce common fall risk factors such as impaired balance and muscle weakness. The system aims at increasing older adults' motivation to participate in ICT-based fall prevention measures. This article reports on usability, user-experience and user-acceptance aspects affecting the use of the iStoppFalls system by older adults. In the course of a 16-week international multicenter study, 153 community-dwelling older adults aged 65+ participated in the iStoppFalls randomized controlled trial, of which half used the system in their home to exercise and assess their risk of falling. During the study, 60 participants completed questionnaires regarding the usability, user experience and user acceptance of the iStoppFalls system. Usability was measured with the System Usability Scale (SUS). For user experience the Physical Activity Enjoyment Scale (PACES) was applied. User acceptance was assessed with the Dynamic Acceptance Model for the Re-evaluation of Technologies (DART). To collect more detailed data on usability, user experience and user acceptance, additional qualitative interviews and observations were conducted with participants. Participants evaluated the usability of the system with an overall score of 62 (Standard Deviation, SD 15.58) out of 100, which suggests good usability. Most users enjoyed the iStoppFalls games and assessments, as shown by the overall PACES score of 31 (SD 8.03). With a score of 0.87 (SD 0.26), user acceptance results showed that participants accepted the iStoppFalls system for use in their own home. Interview data suggested that certain factors such as motivation, complexity or graphical design were different for gender and age. The results suggest that the iStoppFalls system has good usability, user experience and user acceptance. It will be important to take these along with factors such as motivation, gender and age into consideration when designing and further developing ICT-based fall prevention systems.

Impact of an exercise program on muscular and functional performance and plasma levels of interleukin 6 and soluble receptor tumor necrosis factor in prefrail community-dwelling older women: a randomized controlled trial.

PubMed

Lustosa, Lygia Paccini; Máximo Pereira, Leani Souza; Coelho, Fernanda Matos; Pereira, Daniele Sirineu; Silva, Juscélio Pereira; Parentoni, Adriana Netto; Dias, Rosângela Correa; Domingues Dias, João Marcos

2013-04-01

To examine the impact of a muscle resistance program (MRP) on muscular and functional performance and on interleukin 6 (IL-6) and soluble tumor necrosis factor receptor-1 (sTNFr1) plasma levels in prefrail community-dwelling women. Randomized controlled trial crossover design with a postintervention and short-term follow-up. University hospital. Prefrail community-dwelling women (N=32; ≥65y). The MRP was designed based on the exercise at 75% of each participant's maximum load (10wk, 3 times/wk). Plasma concentrations of IL-6 and sTNFr1 (high-sensitivity enzyme-linked immunosorbent assay kits), muscle strength of the knee extensors (isokinetic), and functional performance (Timed Up & Go [TUG] test and 10-meter walk test [10MWT]). There were significant differences in functional and muscular performance between the pre-MRP, post-MRP, and 10-week follow-up period. After the MRP, both functional (TUG, pre-MRP=11.1s vs post-MRP=10.4s, P=.00; 10MWT, pre-MRP=4.9s vs post-MRP, 4.4s, P=.00) and muscular performances (pre-MRP=77.8% and post-MRP=83.1%, P=.02) improved. After cessation of the MRP (follow-up period), sTNFr1 plasma levels increased by 21.4% at 10-week follow-up (post-MRP, 406.4pg/mL; 10-week follow-up, 517.0pg/mL; P=.03). There were significant differences in sTNFr1 (P=.01). The MRP was effective in improving functional and muscular performances, although alterations in plasma levels of IL-6 and sTNFr1 could not be identified after the MRP. Cessation of the MRP after 10 weeks resulted in increased plasma levels of sTNFr1. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Use of proton pump inhibitors is associated with lower trabecular bone density in older individuals.

PubMed

Maggio, Marcello; Lauretani, Fulvio; Ceda, Gian Paolo; De Vita, Francesca; Bondi, Giuliana; Corsonello, Andrea; Cattabiani, Chiara; Lattanzio, Fabrizia; Ruggiero, Carmelinda; Nouvenne, Antonio; Meschi, Tiziana; Bandinelli, Stefania; Ferrucci, Luigi

2013-12-01

Proton pump inhibitors (PPIs) are highly effective in the treatment of upper gastrointestinal acid-related conditions and are fast becoming one of the most frequently prescribed treatments in adult or older persons. Recent data show that long-term use of PPIs in older subjects is associated with important undesirable effects, including a higher risk of osteoporotic fractures. The mechanisms of this association are unclear and the relationship between the use of PPIs and parameters of bone mass and geometry has never been fully explored. This study investigates the relationship between the chronic use of PPIs and the parameters of bone mass (cortical and trabecular bone mineral density - vBMDc and vBMDt) and bone geometry (cortical and trabecular cross sectional area - tCSA and cCSA) in older individuals. The study population consisted of 1038 subjects (452 men and 586 women) 65years or older, selected from the InCHIANTI study, with complete information on computerized tomography performed at tibial level (pQCT) and on medications. Participants were classified as PPI users and nonusers based on self-report of PPI use over the last 15days, with PPI users (36 subjects, 14 men and 22 women) making up 3.4% of the study population (mean age 75.7±7.4years). The relationship between use of PPIs and pQCT bone parameters was tested by multivariate linear regression analysis adjusted for age, sex and several clinical factors and/or statistically confounding variables identified by partial correlation coefficient and Spearman partial rank order correlation coefficients, as appropriate (age, sex, BMI, caloric intake, IGF-1, IL-6, calcium, estradiol, bioavailable testosterone, vitamin D, parathyroid hormone, cross-sectional muscle area, and level of physical activity). PPI users showed age- and sex-adjusted lower vBMDt than nonusers (180.5±54.8 vs. 207.9±59.4, p=0.001). The inverse association between PPI use and vBMDt remained almost unchanged after adjustment for multiple confounders. There was no statistically significant difference in vBMDc, tCSA and cCSA between PPI users and nonusers. In community dwelling older persons, the use of PPIs is inversely associated with vBMDt, an early marker of the osteoporotic process. These findings suggest that PPI use might increase the risk of fractures in older subjects through its detrimental effects on trabecular bone. © 2013. Published by Elsevier Inc. All rights reserved.

25 CFR 700.53 - Dwelling, replacement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Policies and Instructions Definitions § 700.53 Dwelling, replacement. The term replacement dwelling means a... unreasonable adverse environmental conditions from either natural or man-made sources and in an area not...

Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial.

PubMed

Jorgensen, Martin G; Laessoe, Uffe; Hendriksen, Carsten; Nielsen, Ole Bruno Faurholt; Aagaard, Per

2013-07-01

Older adults show increased risk of falling and major risk factors include impaired lower extremity muscle strength and postural balance. However, the potential positive effect of biofeedback-based Nintendo Wii training on muscle strength and postural balance in older adults is unknown. This randomized controlled trial examined postural balance and muscle strength in community-dwelling older adults (75±6 years) pre- and post-10 weeks of biofeedback-based Nintendo Wii training (WII, n = 28) or daily use of ethylene vinyl acetate copolymer insoles (controls [CON], n = 30). Primary end points were maximal muscle strength (maximal voluntary contraction) and center of pressure velocity moment during bilateral static stance. Intention-to-treat analysis with adjustment for age, sex, and baseline level showed that the WII group had higher maximal voluntary contraction strength (18%) than the control group at follow up (between-group difference = 269 N, 95% CI = 122; 416, and p = .001). In contrast, the center of pressure velocity moment did not differ (1%) between WII and CON at follow-up (between-group difference = 0.23 mm(2)/s, 95% CI = -4.1; 4.6, and p = .92). For secondary end points, pre-to-post changes favoring the WII group were evident in the rate of force development (p = .03), Timed Up and Go test (p = .01), short Falls Efficacy Scale-International (p = .03), and 30-second repeated Chair Stand Test (p = .01). Finally, participants rated the Wii training highly motivating at 5 and 10 weeks into the intervention. Biofeedback-based Wii training led to marked improvements in maximal leg muscle strength (maximal voluntary contraction; rate of force development) and overall functional performance in community-dwelling older adults. Unexpectedly, static bilateral postural balance remained unaltered with Wii training. The high level of participant motivation suggests that biofeedback-based Wii exercise may ensure a high degree of compliance to home- and/or community-based training in community-dwelling older adults.

Medication-related fall incidents in an older, ambulant population: the B-PROOF study.

PubMed

Ham, Annelies C; Swart, Karin M A; Enneman, Anke W; van Dijk, Suzanne C; Oliai Araghi, Sadaf; van Wijngaarden, Janneke P; van der Zwaluw, Nikita L; Brouwer-Brolsma, Elske M; Dhonukshe-Rutten, Rosalie A M; van Schoor, Natasja M; van der Cammen, Tischa J M; Lips, Paul; de Groot, Lisette C P G M; Uitterlinden, André G; Witkamp, Renger F; Stricker, Bruno H; van der Velde, Nathalie

2014-12-01

Medication use is a potentially modifiable risk factor for falling; psychotropic and cardiovascular drugs have been indicated as main drug groups that increase fall risk. However, evidence is mainly based on studies that recorded falls retrospectively and/or did not determine medication use at the time of the fall. Therefore, we investigated the associations indicated in the literature between medication use and falls, using prospectively recorded falls and medication use determined at the time of the fall. Data from the B-PROOF (B-vitamins for the prevention of osteoporotic fractures) study were used, concerning community-dwelling elderly aged ≥65 years. We included 2,407 participants with pharmacy dispensing records. During the 2- to 3-year follow-up, participants recorded falls using a fall calendar. Cox proportional hazard models were applied, adjusting for potential confounders including age, sex, health status variables and concomitant medication use. During follow-up, 1,147 participants experienced at least one fall. Users of anti-arrhythmic medication had an increased fall risk (hazard ratio [HR] 1.61; 95% confidence interval [CI] 1.12-2.32) compared with non-users. Similarly, non-selective beta-blocker use was associated with an increased fall risk (HR 1.41 [95% CI 1.12-1.78]), while statin use was associated with a lower risk (HR 0.81 [95% CI 0.71-0.94]). Benzodiazepine use (HR 1.32 [95% CI 1.02-1.71]), and antidepressant use (HR 1.40 [95% CI 1.07-1.82]) were associated with an increased fall risk. Use of other cardiovascular and psychotropic medication was not associated with fall risk. Our results strengthen the evidence for an increased fall risk in community-dwelling elderly during the use of anti-arrhythmics, non-selective beta-blockers, benzodiazepines, and antidepressant medication. Clinicians should prescribe these drugs cautiously and if possible choose safer alternatives for older patients.

Usability and acceptability of technology for community-dwelling older adults with mild cognitive impairment and dementia: a systematic literature review

PubMed Central

Holthe, Torhild; Halvorsrud, Liv; Karterud, Dag; Hoel, Kari-Anne; Lund, Anne

2018-01-01

Background The objective of this review was to obtain an overview of the technologies that have been explored with older adults with mild cognitive impairment and dementia (MCI/D), current knowledge on the usability and acceptability of such technologies, and how people with MCI/D and their family carers (FCs) were involved in these studies. Materials and methods Primary studies published between 2007 and 2017 that explored the use of technologies for community-dwelling people with MCI/D were identified through five databases: MEDLINE, PsycINFO, Embase, AMED, and CINAHL. Twenty-nine out of 359 papers met the criteria for eligibility. We used the Mixed Methods Appraisal Tool for quality assessment. Results A wide range of technologies was presented in the 29 studies, sorted into four domains: 1) safe walking indoors and outdoors; 2) safe living; 3) independent living; and 4) entertainment and social communication. The current state of knowledge regarding usability and acceptability reveals that even if researchers are aware of these concepts and intend to measure usability and acceptability, they seem difficult to assess. Terms such as “user friendliness” and “acceptance” were used frequently. User participation in the 29 studies was high. Persons with MCI/D, FCs, and staff/other older adults were involved in focus groups, workshops, and interviews as part of the preimplementation process. Conclusion Research regarding technologies to support people with MCI/D seems optimistic, and a wide range of technologies has been evaluated in homes with people with MCI/D and their FCs. A major finding was the importance of including people with MCI/D and their FCs in research, in order to learn about required design features to enhance usability and acceptability. Surprisingly, very few studies reported on the consequences of technology use with regard to quality of life, occupational performance, or human dignity. PMID:29765211

Usability and acceptability of technology for community-dwelling older adults with mild cognitive impairment and dementia: a systematic literature review.

PubMed

Holthe, Torhild; Halvorsrud, Liv; Karterud, Dag; Hoel, Kari-Anne; Lund, Anne

2018-01-01

The objective of this review was to obtain an overview of the technologies that have been explored with older adults with mild cognitive impairment and dementia (MCI/D), current knowledge on the usability and acceptability of such technologies, and how people with MCI/D and their family carers (FCs) were involved in these studies. Primary studies published between 2007 and 2017 that explored the use of technologies for community-dwelling people with MCI/D were identified through five databases: MEDLINE, PsycINFO, Embase, AMED, and CINAHL. Twenty-nine out of 359 papers met the criteria for eligibility. We used the Mixed Methods Appraisal Tool for quality assessment. A wide range of technologies was presented in the 29 studies, sorted into four domains: 1) safe walking indoors and outdoors; 2) safe living; 3) independent living; and 4) entertainment and social communication. The current state of knowledge regarding usability and acceptability reveals that even if researchers are aware of these concepts and intend to measure usability and acceptability, they seem difficult to assess. Terms such as "user friendliness" and "acceptance" were used frequently. User participation in the 29 studies was high. Persons with MCI/D, FCs, and staff/other older adults were involved in focus groups, workshops, and interviews as part of the preimplementation process. Research regarding technologies to support people with MCI/D seems optimistic, and a wide range of technologies has been evaluated in homes with people with MCI/D and their FCs. A major finding was the importance of including people with MCI/D and their FCs in research, in order to learn about required design features to enhance usability and acceptability. Surprisingly, very few studies reported on the consequences of technology use with regard to quality of life, occupational performance, or human dignity.

Assessment of Dioxin-Like Soil Contamination in Mexico by Enzyme-Linked Immunosorbent Assay

PubMed Central

Nichkova, M.; Yáñez, L.; Costilla-Salazar, R.; Torres-Dosal, A.; Gee, S. J.; Hammock, B. D.; Juárez-Santacruz, L.; Díaz-Barriga, F.

2011-01-01

In this work, we describe the results of a preliminary soil assessment program for the detection of dioxins at different sites in Mexico performed by immunoassay. We studied five different sectors considered relevant sources of dioxins: Anaversa and Tekchem industrial areas where organochlorine pesticides were manufactured and released by accidental explosions, secondary smelters, brick kilns, and rural dwellings. In the context of the Agency for Toxic Substances and Disease Registry (ATSDR) guidelines, only the brick kilns sites can be considered as low-risk areas. The dioxin concentrations detected in the vicinity of the Anaversa and Tekchem chemical plants and secondary smelters exceed the screening level of 0.05 ppb set by the ATSDR, and therefore further site-specific studies are needed. The dioxin levels found in all soot samples from indigenous dwellings where wood is used for indoor cooking were above the evaluation level. Considering that the studied areas are representative examples of dioxin sources in less developed countries, our work demonstrates the useful application of dioxin immunoassays as a tool for dioxin screening for environmental assessment programs in developing countries. PMID:20091164

Tooth-related risk factors for periodontal disease in community-dwelling elderly people.

PubMed

Hirotomi, Toshinobu; Yoshihara, Akihiro; Ogawa, Hiroshi; Miyazaki, Hideo

2010-06-01

While most previous epidemiological studies have focused on subject-level risk factors for periodontal destruction, tooth-related factors have not been fully explored. The purpose of this study was to evaluate both tooth-related and subject-related factors affecting periodontal disease progression using a two-level multilevel model. A longitudinal survey over a period of 10 years was carried out on 286 community-dwelling elderly subjects aged 70 years at baseline. Clinical attachment level (CAL) was measured at six sites per tooth on all teeth present and periodontal disease progression was defined as CAL> or =3 mm. Periodontal disease progression was found in 79% of the subjects and most frequently in maxillary molars. Multilevel logistic regressions revealed that subjects wearing removable dentures were significantly at risk for periodontal disease progression. Abutment teeth for removable/fixed dentures were also significantly more likely to suffer periodontal breakdown. Furthermore, the following tooth-related variables were found to be possible risk factors for periodontal disease progression: maxillary and multirooted teeth. Multirooted teeth and abutments for a fixed denture were possible risk factors for periodontal disease progression.

Determinants of participation in colorectal cancer screening among community-dwelling Chinese older people: Testing a comprehensive model using a descriptive correlational study.

PubMed

Leung, Doris Y P; Wong, Eliza M L; Chan, Carmen W H

2016-04-01

The prevalence of colorectal cancer (CRC) among older people is high. Screening for CRC presents a cost-effective secondary prevention and control strategy which results in a significant reduction in mortality. This study aims to describe the prevalence of CRC screening and examine its risk factors among Chinese community-dwelling older people guided by a comprehensive model combining Health Belief Model and Extended Parallel Processing Model. A descriptive correlational study was conducted. A convenience sample of 240 community-dwelling adults aged ≥60 was recruited in May-July in 2012 in Hong Kong. Participants were asked to complete a questionnaire which collected information on demographic variables, CRC-related psychosocial variables and whether they had a CRC screening in the past 10 years. Among the participants, 25.4% reported having a CRC screening test. Results of logistic regression analyses indicated that participants with a higher level in cue to action, and lower perceived knowledge barriers and severity-fear were significantly associated with participation in CRC screening. But there were no significant associations between fatalism and cancer fear with screening. The prevalence of CRC screening was low in Hong Kong Chinese community-dwelling elders. A number of modifiable factors associated with CRC screening were identified which provides specific targets for interventions. This study also adds to the knowledge regarding the associations between fatalism and fear with CRC screening behaviors among Chinese older people. Copyright © 2015 Elsevier Ltd. All rights reserved.

12 CFR 1282.17 - Affordability-Income level definitions-family size and income known (owner-occupied units, actual...

Code of Federal Regulations, 2010 CFR

2010-01-01

... GOALS AND MISSION Housing Goals § 1282.17 Affordability—Income level definitions—family size and income..., for rental housing, family size and income information for the dwelling unit is known to the... sizes: Number of persons in family Percentageof area median income 1 70 2 80 3 90 4 100 5 or more...

Fear of falling and falls self-efficacy and their relationship to higher-level competence among community-dwelling senior men and women in Japan.

PubMed

Katsumata, Yuriko; Arai, Asuna; Tomimori, Masashi; Ishida, Kozo; Lee, Romeo B; Tamashiro, Hiko

2011-07-01

This cross-sectional study examined the relationships of fear of falling and falls self-efficacy with higher-level competence among community-dwelling senior citizens in Japan. Of the 822 registered senior citizens, 731 (89%) community dwellers were requested to participate in the survey using a mailed self-accomplished questionnaire. Data from 648 respondents with duly accomplished questionnaires were analyzed using R(2) , the coefficient of determination, based on a multivariate regression analysis. Fear of falling, low falls self-efficacy and higher-level functional disability were observed among respondents. Of the hypothesized relationships examined by sex, fear of falling was significantly associated with disability among male respondents and low falls self-efficacy among both sexes. Several confounding variables were strongly associated with competence. While the data underscore the strategic importance of promoting higher-level competence among the senior citizens, there is much to suggest that their competence is likely to be maintained if their fear of falling and falls self-efficacy were modified. Programs must also consider a wide array of intervening factors. © 2011 Japan Geriatrics Society.

Dwell Notch Low Cycle Fatigue Behavior of a Powder Metallurgy Nickel Disk Alloy

NASA Technical Reports Server (NTRS)

Telesman, J.; Gabb, T. P.; Yamada, Y.; Ghosn, L. J.; Jayaraman, N.

2012-01-01

A study was conducted to determine the processes which govern dwell notch low cycle fatigue (NLCF) behavior of a powder metallurgy (P/M) ME3 disk superalloy. The emphasis was placed on the environmentally driven mechanisms which may embrittle the highly stressed notch surface regions and reduce NLCF life. In conjunction with the environmentally driven notch surface degradation processes, the visco-plastic driven mechanisms which can significantly change the notch root stresses were also considered. Dwell notch low cycle fatigue testing was performed in air and vacuum on a ME3 P/M disk alloy specimens heat treated using either a fast or a slow cooling rate from the solutioning treatment. It was shown that dwells at the minimum stress typically produced a greater life debit than the dwells applied at the maximum stress, especially for the slow cooled heat treatment. Two different environmentally driven failure mechanisms were identified as the root cause of early crack initiation in the min dwell tests. Both of these failure mechanisms produced mostly a transgranular crack initiation failure mode and yet still resulted in low NLCF fatigue lives. The lack of stress relaxation during the min dwell tests produced higher notch root stresses which caused early crack initiation and premature failure when combined with the environmentally driven surface degradation mechanisms. The importance of environmental degradation mechanisms was further highlighted by vacuum dwell NLCF tests which resulted in considerably longer NLCF lives, especially for the min dwell tests.

Social and Spatial Networks: Kinship Distance and Dwelling Unit Proximity in Rural Thailand

PubMed Central

Verdery, Ashton M.; Entwisle, Barbara; Faust, Katherine; Rindfuss, Ronald R.

2013-01-01

We address a long hypothesized relationship between the proximity of individuals' dwelling units and their kinship association. Better understanding this relationship is important because of its implications for contact and association among members of a society. In this paper, we use a unique dataset from Nang Rong, Thailand which contains dwelling unit locations (GPS) and saturated kinship networks of all individuals living in 51 agricultural villages. After presenting arguments for a relationship between individuals’ dwelling unit locations and their kinship relations as well as the particulars of our case study, we introduce the data and describe our analytic approach. We analyze how kinship - considered as both a system linking collections of individuals in an extended kinship network and as dyadic links between pairs of individuals -patterns the proximity of dwelling units in rural villages. The results show that in general, extended kin live closer to one another than do unrelated individuals. Further, the degree of relatedness between kin correlates with the distance between their dwelling units. Close kin are more likely to co-reside, a fact which drives much of the relationship between kinship relatedness and dwelling unit proximity within villages. There is nevertheless suggestive evidence of a relationship between kinship association and dwelling unit proximity among kin who do not live together. PMID:23956489

Effect of Notches on Creep-Fatigue Behavior of a P/M Nickel-Based Superalloy

NASA Technical Reports Server (NTRS)

Telesman, Jack; Gabb, Timothy P.; Ghosn, Louis J.; Gayda, John, Jr.

2015-01-01

A study was performed to determine and model the effect of high temperature dwells on notched low cycle fatigue (NLCF) and notch stress rupture behavior of a fine grain LSHR powder metallurgy (PM) nickel-based superalloy. It was shown that a 90 second dwell applied at the minimum stress (min dwell) was considerably more detrimental to the NLCF lives than similar dwell applied at the maximum stress (max dwell). The short min dwell NLCF lives were shown to be caused by growth of small oxide blisters which caused preferential cracking when coupled with high concentrated notch root stresses. The cyclic max dwell notch tests failed mostly by a creep accumulation, not by fatigue, with the crack origin shifting internally to a substantial distance away from the notch root. The classical von Mises plastic flow model was unable to match the experimental results while the hydrostatic stress profile generated using the Drucker-Prager plasticity flow model was consistent with the experimental findings. The max dwell NLCF and notch stress rupture tests exhibited substantial creep notch strengthening. The triaxial Bridgman effective stress parameter was able to account for the notch strengthening by collapsing the notched and uniform gage geometry test data into a singular grouping.

Rates of Bone Loss Among Women Initiating Antidepressant Medication Use in Midlife

PubMed Central

Ruppert, Kristine; Cauley, Jane A.; Lian, YinJuan; Bromberger, Joyce T.; Finkelstein, Joel S.; Greendale, Gail A.; Solomon, Daniel H.

2013-01-01

Context: Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. Objective: The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. Design and Setting: We conducted a prospective cohort study at five clinical centers in the United States. Participants: The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). Exposure: The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. Main Outcome Measures: BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. Results: BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (<16 vs ≥16). Conclusions: In this cohort of middle-aged women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck. PMID:24001746

Modeling of switching regulator power stages with and without zero-inductor-current dwell time

NASA Technical Reports Server (NTRS)

Lee, F. C. Y.; Yu, Y.

1979-01-01

State-space techniques are employed to derive accurate models for the three basic switching converter power stages: buck, boost, and buck/boost operating with and without zero-inductor-current dwell time. A generalized procedure is developed which treats the continuous-inductor-current mode without dwell time as a special case of the discontinuous-current mode when the dwell time vanishes. Abrupt changes of system behavior, including a reduction of the system order when the dwell time appears, are shown both analytically and experimentally. Merits resulting from the present modeling technique in comparison with existing modeling techniques are illustrated.

Prevalence of sarcopenia among older community-dwelling people with normal health and nutritional state.

PubMed

Hedayati, Kerstin Khalaj; Dittmar, Manuela

2010-01-01

This study analyzed whether sarcopenia, a risk factor for disability in the aged, also occurs in healthy community-dwelling elders with normal nutritional state. As indicators, body cell mass (BCM) and lean body mass (LBM) were determined in 110 Germans (ages 60-83) using bioimpedance analysis. Nutritional status, muscle function, anthropometry, and physical activity level were investigated. Sarcopenia was already present in well nourished healthy elders. Its prevalence depended on the measure of muscle mass used (BCM percent, 22 percent males, 20 percent females; LBM percent, 4 percent males, 11 percent females). In conclusion, screening for presence of sarcopenia is needed in healthy, well-nourished elderly populations requiring an international standardization. Copyright © Taylor & Francis Group, LLC

Aromatherapy: Does It Help to Relieve Pain, Depression, Anxiety, and Stress in Community-Dwelling Older Persons?

PubMed Central

Tse, M. Y. Mimi

2014-01-01

To examine the effectiveness of an aromatherapy programme for older persons with chronic pain. The community-dwelling elderly people who participated in this study underwent a four-week aromatherapy programme or were assigned to the control group, which did not receive any interventions. Their levels of pain, depression, anxiety, and stress were collected at the baseline and at the postintervention assessment after the conclusion of the four-week programme. Eighty-two participants took part in the study. Forty-four participants (37 females, 7 males) were in the intervention group and 38 participants (30 females, 8 males) were in the control group. The pain scores were 4.75 (SD 2.32) on a 10-point scale for the intervention group and 5.24 (SD 2.14) for the control group before the programme. There was a slight reduction in the pain score of the intervention group. No significant differences were found in the same-group and between-group comparisons for the baseline and postintervention assessments. The depression, anxiety, and stress scores for the intervention group before the programme were 11.18 (SD 6.18), 9.64 (SD 7.05), and 12.91 (SD 7.70), respectively. A significant reduction in negative emotions was found in the intervention group (P < 0.05). The aromatherapy programme can be an effective tool to reduce pain, depression, anxiety, and stress levels among community-dwelling older adults. PMID:25114901

How To Build an Integrated Neighborhood Approach to Support Community-Dwelling Older People?

PubMed Central

Cramm, Jane Murray; Nieboer, Anna Petra

2016-01-01

Background: Although the need for integrated neighborhood approaches (INAs) is widely recognized, we lack insight into strategies like INA. We describe diverse Dutch INA partners’ experiences to provide integrated person- and population-centered support to community-dwelling older people using an adapted version of Valentijn and colleagues’ integrated care model. Our main objective was to explore the experiences with INA participation. We sought to increase our understanding of the challenges facing these partners and identify factors facilitating and inhibiting integration within and among multiple levels. Methods: Twenty-one interviews with INA partners (including local health and social care organizations, older people, municipal officers, and a health insurer) were conducted and subjected to latent content analysis. Results: This study showed that integrated care and support provision through an INA is a complex, dynamic process requiring multilevel alignment of activities. The INA achieved integration at the personal, service, and professional levels only occasionally. Micro-level bottom-up initiatives were not aligned with top-down incentives, forcing community workers to establish integration despite rather than because of meso- and macro-level contexts. Conclusions: Top-down incentives should be better aligned with bottom-up initiatives. This study further demonstrated the importance of community-level engagement in integrated care and support provision. PMID:27616960

Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease.

PubMed

Taipale, Heidi; Tolppanen, Anna-Maija; Koponen, Marjaana; Tanskanen, Antti; Lavikainen, Piia; Sund, Reijo; Tiihonen, Jari; Hartikainen, Sirpa

2017-04-10

Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking. We sought to investigate this association among community-dwelling adults with Alzheimer disease, a condition in which both sedative/hypnotic use and pneumonia are common. We obtained data on all community-dwelling adults with a recent diagnosis of Alzheimer disease in Finland (2005-2011) from the Medication use and Alzheimer disease (MEDALZ) cohort, which incorporates national registry data on prescriptions, reimbursement, hospital discharges and causes of death. Incident users of benzodiazepines and Z-drugs were identified using a 1-year washout period and matched with nonusers using propensity scores. The association with hospital admission or death due to pneumonia was analyzed with the Cox proportional hazards model and adjusted for use of other psychotropic drugs in a time-dependent manner. Among 49 484 eligible participants with Alzheimer disease, 5232 taking benzodiazepines and 3269 taking Z-drugs were matched 1:1 with those not taking these drugs. Collectively, use of benzodiazepines and Z-drugs was associated with an increased risk of pneumonia (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05-1.42). When analyzed separately, benzodiazepine use was significantly associated with an increased risk of pneumonia (adjusted HR 1.28, 95% CI 1.07-1.54), whereas Z-drug use was not (adjusted HR 1.10, 95% CI 0.84-1.44). The risk of pneumonia was greatest within the first 30 days of benzodiazepine use (HR 2.09, 95% CI 1.26-3.48). Benzodiazepine use was associated with an increased risk of pneumonia among patients with Alzheimer disease. Risk of pneumonia should be considered when weighing the benefits and risks of benzodiazepines in this population. © 2017 Canadian Medical Association or its licensors.

Risk of pneumonia associated with incident benzodiazepine use among community-dwelling adults with Alzheimer disease

PubMed Central

Taipale, Heidi; Tolppanen, Anna-Maija; Koponen, Marjaana; Tanskanen, Antti; Lavikainen, Piia; Sund, Reijo; Tiihonen, Jari; Hartikainen, Sirpa

2017-01-01

BACKGROUND: Knowledge regarding whether benzodiazepines and similarly acting non-benzodiazepines (Z-drugs) are associated with an increased risk of pneumonia among older adults is lacking. We sought to investigate this association among community-dwelling adults with Alzheimer disease, a condition in which both sedative/hypnotic use and pneumonia are common. METHODS: We obtained data on all community-dwelling adults with a recent diagnosis of Alzheimer disease in Finland (2005–2011) from the Medication use and Alzheimer disease (MEDALZ) cohort, which incorporates national registry data on prescriptions, reimbursement, hospital discharges and causes of death. Incident users of benzodiazepines and Z-drugs were identified using a 1-year washout period and matched with nonusers using propensity scores. The association with hospital admission or death due to pneumonia was analyzed with the Cox proportional hazards model and adjusted for use of other psychotropic drugs in a time-dependent manner. RESULTS: Among 49 484 eligible participants with Alzheimer disease, 5232 taking benzodiazepines and 3269 taking Z-drugs were matched 1:1 with those not taking these drugs. Collectively, use of benzodiazepines and Z-drugs was associated with an increased risk of pneumonia (adjusted hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.05–1.42). When analyzed separately, benzodiazepine use was significantly associated with an increased risk of pneumonia (adjusted HR 1.28, 95% CI 1.07–1.54), whereas Z-drug use was not (adjusted HR 1.10, 95% CI 0.84–1.44). The risk of pneumonia was greatest within the first 30 days of benzodiazepine use (HR 2.09, 95% CI 1.26–3.48). INTERPRETATION: Benzodiazepine use was associated with an increased risk of pneumonia among patients with Alzheimer disease. Risk of pneumonia should be considered when weighing the benefits and risks of benzodiazepines in this population. PMID:28396328

Reduced opsin gene expression in a cave-dwelling fish

PubMed Central

Tobler, Michael; Coleman, Seth W.; Perkins, Brian D.; Rosenthal, Gil G.

2010-01-01

Regressive evolution of structures associated with vision in cave-dwelling organisms is the focus of intense research. Most work has focused on differences between extreme visual phenotypes: sighted, surface animals and their completely blind, cave-dwelling counterparts. We suggest that troglodytic systems, comprising multiple populations that vary along a gradient of visual function, may prove critical in understanding the mechanisms underlying initial regression in visual pathways. Gene expression assays of natural and laboratory-reared populations of the Atlantic molly (Poecilia mexicana) revealed reduced opsin expression in cave-dwelling populations compared with surface-dwelling conspecifics. Our results suggest that the reduction in opsin expression in cave-dwelling populations is not phenotypically plastic but reflects a hardwired system not rescued by exposure to light during retinal ontogeny. Changes in opsin gene expression may consequently represent a first evolutionary step in the regression of eyes in cave organisms. PMID:19740890

Dwell time-based stabilisation of switched delay systems using free-weighting matrices

NASA Astrophysics Data System (ADS)

Koru, Ahmet Taha; Delibaşı, Akın; Özbay, Hitay

2018-01-01

In this paper, we present a quasi-convex optimisation method to minimise an upper bound of the dwell time for stability of switched delay systems. Piecewise Lyapunov-Krasovskii functionals are introduced and the upper bound for the derivative of Lyapunov functionals is estimated by free-weighting matrices method to investigate non-switching stability of each candidate subsystems. Then, a sufficient condition for the dwell time is derived to guarantee the asymptotic stability of the switched delay system. Once these conditions are represented by a set of linear matrix inequalities , dwell time optimisation problem can be formulated as a standard quasi-convex optimisation problem. Numerical examples are given to illustrate the improvements over previously obtained dwell time bounds. Using the results obtained in the stability case, we present a nonlinear minimisation algorithm to synthesise the dwell time minimiser controllers. The algorithm solves the problem with successive linearisation of nonlinear conditions.

Antidepressant use and cognitive decline in community-dwelling elderly people - The Three-City Cohort.

PubMed

Carrière, Isabelle; Norton, Joanna; Farré, Amandine; Wyart, Marilyn; Tzourio, Christophe; Noize, Pernelle; Pérès, Karine; Fourrier-Réglat, Annie; Ritchie, Karen; Ancelin, Marie Laure

2017-04-19

Cognitive impairment is very common in late-life depression, principally affecting executive skills and information processing speed. The aim of the study was to examine the effect of antidepressant treatment on cognitive performances over a 10-year period. The community-based cohort included 7381 participants aged 65 years and above. Five cognitive domains (verbal fluency, psychomotor speed, executive function, visuospatial skills and global cognition) were assessed up to five times over 10 years of follow-up. Treatment groups included participants under a specific antidepressant class at both baseline and the first follow-up and their follow-up cognitive data were considered until the last consecutive follow-up with a report of antidepressant use of the same class. Linear mixed models were used to compare baseline cognitive performance and cognitive decline over time according to antidepressant treatment. The models were adjusted for multiple confounders including residual depressive symptoms assessed by the Center for Epidemiologic Studies-Depression scale. At baseline, 4.0% of participants were taking antidepressants. Compared to non-users, tricyclic antidepressant users had lower baseline performances in verbal fluency, visual memory and psychomotor speed, and selective serotonin reuptake inhibitor users in verbal fluency and psychomotor speed. For the two other cognitive abilities, executive function and global cognition, no significant differences were found at baseline irrespective of the antidepressant class. Regarding changes over time, no significant differences were observed in comparison with non-users whatever the cognitive domain, except for a slight additional improvement over the follow-up in verbal fluency skills for tricyclic antidepressant users. In this large elderly general population cohort, we found no evidence for an association between antidepressant use and post-treatment cognitive decline over 10 years of follow-up in various cognitive domains.

[Birth and matrimony of foreign citizens in Italy].

PubMed

Manese, G

1986-01-01

A group of 1,030 children of foreign women living in or around Rome, Italy, are classified according to place of birth (public institution or private dwelling) and legitimacy and by parents' educational level, economic and professional status, citizenship, residence, and age at marriage.

MEASUREMENT OF RADON CONCENTRATION IN DWELLINGS IN THE REGION OF HIGHEST LUNG CANCER INCIDENCE IN INDIA.

PubMed

Zoliana, B; Rohmingliana, P C; Sahoo, B K; Mishra, R; Mayya, Y S

2016-10-01

Indoor radon/thoron concentration has been measured in Aizawl district, Mizoram, India, which has the highest lung cancer incidence rates among males and females in India. Simultaneously, radon flux emanated from the surrounding soil of the dwellings was observed in selected places. The annual average value of concentration of radon(thoron) of Aizawl district is 48.8(22.65) Bq m -3 with a geometric standard deviation of 1.25(1.58). Measured radon flux from the soil has an average value of 22.6 mBq m -2 s -1 These results were found to be much below the harmful effect or action level as indicated by the World Health Organisation. On the other hand, food habit and high-level consumption of tobacco and its products in the district have been found to increase the risk of lung cancer incidence in the district. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Real estate market and building energy performance: Data for a mass appraisal approach

PubMed Central

Bonifaci, Pietro; Copiello, Sergio

2015-01-01

Mass appraisal is widely considered an advanced frontier in the real estate valuation field. Performing mass appraisal entails the need to get access to base information conveyed by a large amount of transactions, such as prices and property features. Due to the lack of transparency of many Italian real estate market segments, our survey has been addressed to gather data from residential property advertisements. The dataset specifically focuses on property offer prices and dwelling energy efficiency. The latter refers to the label expressed and exhibited by the energy performance certificate. Moreover, data are georeferenced with the highest possible accuracy: at the neighborhood level for a 76.8% of cases, at street or building number level for the remaining 23.2%. Data are related to the analysis performed in Bonifaci and Copiello [1], about the relationship between house prices and building energy performance, that is to say, the willingness to pay in order to benefit from more efficient dwellings. PMID:26793751

Real estate market and building energy performance: Data for a mass appraisal approach.

PubMed

Bonifaci, Pietro; Copiello, Sergio

2015-12-01

Mass appraisal is widely considered an advanced frontier in the real estate valuation field. Performing mass appraisal entails the need to get access to base information conveyed by a large amount of transactions, such as prices and property features. Due to the lack of transparency of many Italian real estate market segments, our survey has been addressed to gather data from residential property advertisements. The dataset specifically focuses on property offer prices and dwelling energy efficiency. The latter refers to the label expressed and exhibited by the energy performance certificate. Moreover, data are georeferenced with the highest possible accuracy: at the neighborhood level for a 76.8% of cases, at street or building number level for the remaining 23.2%. Data are related to the analysis performed in Bonifaci and Copiello [1], about the relationship between house prices and building energy performance, that is to say, the willingness to pay in order to benefit from more efficient dwellings.

Perceived loneliness and general cognitive status in community-dwelling older adults: the moderating influence of depression.

PubMed

Lam, Charlene L M; Yu, Junhong; Lee, Tatia M C

2017-09-01

The relationship between depression, loneliness, and cognitive functioning among the elderly is not well understood in the literature. In the present study, we tested the moderating influence of depressive symptoms on loneliness and cognitive functioning. We recruited 100 community-dwelling older adults in Hong Kong. Demographic information, perceived loneliness, depressed mood, and general cognitive status were assessed. Results indicated that married participants reported lower levels of perceived loneliness (t (96) = 2.26, p = .03). We found a significant moderating effect of depressive symptoms on the relationship between perceived loneliness and general cognitive status (B = -.05, p = .002). Perceived loneliness correlated negatively with general cognitive status only in participants with higher levels of depressed mood (B = -.16, p = .01). Together, these findings suggest that perceived loneliness combined with depressed mood is related to poorer general cognitive status in older adults. The implications of these findings are discussed.

Outgassing of Out-of-Autoclave Composite Primary Structures for Small Satellites

NASA Astrophysics Data System (ADS)

Komus, Alastair

Out-of-autoclave vacuum-bagged-only (VBO) processing is capable of producing lower cost composite primary structures for small satellites than autoclave processing. However, the outgassing performance of VBO structures in a vacuum environment has not been examined. Panels were manufactured from CYCOM 5320-1 and TC275-1 carbon fiber/epoxy prepreg using VBO processing. The humidity level, pre-cure dwell time, and cure cycle parameters were varied during manufacturing. The degree of cure and glass transition temperature were shown to increase with increasing oven temperature. Processing humidity levels and the length of pre-cure dwell times had no discernable effect on the total mass loss (TML) and collected volatile condensable material (CVCM) that were outgassed under vacuum. Instead the TML was controlled by moisture saturation after manufacturing. Fourier transform infrared spectroscopy showed that epoxy oligomers were the primary CVCM. The study showed the VBO laminates had outgassing values that were comparable to the autoclave-cured laminates.

Predicting the Trajectories of Perceived Pain Intensity in Southern Community-Dwelling Older Adults: The Role of Religiousness

PubMed Central

Sun, Fei; Park, Nan Sook; Wardian, Jana; Lee, Beom S.; Roff, Lucinda L.; Klemmack, David L.; Parker, Michael W.; Koenig, Harold G.; Sawyer, Patricia L.; Allman, Richard M.

2013-01-01

This study focuses on the identification of multiple latent trajectories of pain intensity, and it examines how religiousness is related to different classes of pain trajectory. Participants were 720 community-dwelling older adults who were interviewed at four time points over a 3-year period. Overall, intensity of pain decreased over 3 years. Analysis using latent growth mixture modeling (GMM) identified three classes of pain: (1) increasing (n = 47); (2) consistently unchanging (n = 292); and (3) decreasing (n = 381). Higher levels of intrinsic religiousness (IR) at baseline were associated with higher levels of pain at baseline, although it attenuated the slope of pain trajectories in the increasing pain group. Higher service attendance at baseline was associated with a higher probability of being in the decreasing pain group. The increasing pain group and the consistently unchanging group reported more negative physical and mental health outcomes than the decreasing pain group. PMID:24187410

Interventions to prevent or reduce the level of frailty in community-dwelling older adults: a protocol for a scoping review of the literature and international policies.

PubMed

Puts, Martine T E; Toubasi, Samar; Atkinson, Esther; Ayala, Ana Patricia; Andrew, Melissa; Ashe, Maureen C; Bergman, Howard; Ploeg, Jenny; McGilton, Katherine S

2016-03-02

With ageing comes increased vulnerability such that older adults' ability to recover from acute illnesses, fall-related injuries and other stresses related to the physical ageing processes declines. This increased vulnerability, also known as frailty, is common in older adults and associated with increased healthcare service use and adverse health outcomes. Currently, there is no overview of available interventions to prevent or reduce the level of frailty (as defined by study's authors) which will help healthcare providers in community settings caring for older adults. We will address this gap by reviewing interventions and international policies that are designed to prevent or reduce the level of frailty in community-dwelling older adults. We will conduct a scoping review using the updated guidelines of Arksey and O'Malley to systematically search the peer-reviewed journal articles to identify interventions that aimed to prevent or reduce the level of frailty. We will search grey literature for international policies. The 6-stage scoping review model involves: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; (5) collating, summarising and reporting the results and (6) consulting with key stakeholders. Our scoping review will use robust methodology to search for available interventions focused on preventing or reducing the level of frailty in community-dwelling older adults. We will consult with stakeholders to find out whether they find the frailty interventions/policies useful and to identify the barriers and facilitators to their implementation in Canada. We will disseminate our findings to relevant stakeholders at local, national and international levels by presenting at relevant meetings and publishing the findings. Our review will identify gaps in research and provide healthcare providers and policymakers with an overview of interventions that can be implemented to prevent or postpone frailty. 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/

7 CFR 1924.259 - Handling dwelling construction complaints.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Handling dwelling construction complaints. 1924.259... OF AGRICULTURE PROGRAM REGULATIONS CONSTRUCTION AND REPAIR Complaints and Compensation for Construction Defects § 1924.259 Handling dwelling construction complaints. This section describes the procedure...

Agreement Between Responses From Community-Dwelling Persons With Stroke and Their Proxies on the NIH Neurological Quality of Life (Neuro-QoL) Short Forms.

PubMed

Kozlowski, Allan J; Singh, Ritika; Victorson, David; Miskovic, Ana; Lai, Jin-Shei; Harvey, Richard L; Cella, David; Heinemann, Allen W

2015-11-01

To examine agreement between patient and proxy responses on the Quality of Life in Neurological Disorders (Neuro-QoL) instruments after stroke. Cross-sectional observational substudy of the longitudinal, multisite, multicondition Neuro-QoL validation study. In-person, interview-guided, patient-reported outcomes. Convenience sample of dyads (N=86) of community-dwelling persons with stroke and their proxy respondents. Not applicable. Dyads concurrently completed short forms of 8 or 9 items for the 13 Neuro-QoL adult domains using the patient-proxy perspective. Agreement was examined at the scale-level with difference scores, intraclass correlation coefficients (ICCs), effect size statistics, and Bland-Altman plots, and at the item-level with kappa coefficients. We found no mean differences between patients and proxies on the Applied Cognition-General Concerns, Depression, Satisfaction With Social Roles and Activities, Stigma, and Upper Extremity Function (Fine Motor, activities of daily living) short forms. Patients rated themselves more favorably on the Applied Cognition-Executive Function, Ability to Participate in Social Roles and Activities, Lower Extremity Function (Mobility), Positive Affect and Well-Being, Anxiety, Emotional and Behavioral Dyscontrol, and Fatigue short forms. The largest mean patient-proxy difference observed was 3 T-score points on the Lower Extremity Function (Mobility). ICCs ranged from .34 to .59. However, limits of agreement showed dyad differences exceeding ±20 T-score points, and item-level agreement ranged from not significant to weighted kappa=.34. Proxy responses on Neuro-QoL short forms can complement responses of moderate- to high-functioning community-dwelling persons with stroke and augment group-level analyses, but do not substitute for individual patient ratings. Validation is needed for other stroke populations. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

'Well, if the kids can do it, I can do it': older rehabilitation patients' experiences of telerehabilitation.

PubMed

Shulver, Wendy; Killington, Maggie; Morris, Claire; Crotty, Maria

2017-02-01

Although trials continue to emerge supporting the role of telerehabilitation, implementation has been slow. Key users include older people living with disabilities who are frequent users of hospital rehabilitation services but whose voices are rarely heard. It is unclear whether the use of technologies and reduced face-to-face contact is acceptable to these people. We report on a qualitative study of community dwelling participants who had received a home telerehabilitation programme as an alternative to conventional rehabilitation. Thirteen older participants, three spouses and one carer were interviewed. All had participated in an individualized therapy programme, using a combination of face-to-face and video consults with therapists. The programme used 'off-the-shelf' technologies including iPads for videoconferencing and electronic FitBit R devices. Interviews were recorded, transcribed verbatim and analysed using NVivo software. Thematic analysis resulted in five emergent themes: (i) telerehabilitation is convenient; (ii) telerehabilitation promotes motivation and self-awareness; (iii) telerehabilitation fosters positive therapeutic relationships; (iv) mastering technologies used by younger relatives is a valued aspect of telerehabilitation; and (v) Telerehabilitation does not replace traditional face-to-face rehabilitation therapies. Participants found telerehabilitation convenient and motivating, coped well with the technology and developed positive therapeutic relationships. The learning and practice aspects sat well in the context of a rehabilitation programme. The use of commercially available technologies may have contributed to respondents' high levels of acceptability. The perception of telerehabilitation as complementary to in-person care and the expectation of technological support have implications for the implementation and delivery of telerehabilitation services to older people. © 2016 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Mobility device use in older adults and incidence of falls and worry about falling: findings from the 2011-2012 national health and aging trends study.

PubMed

Gell, Nancy M; Wallace, Robert B; LaCroix, Andrea Z; Mroz, Tracy M; Patel, Kushang V

2015-05-01

To examine the prevalence of mobility device use in community-dwelling older adults in the United States and to investigate the incidence of falls and worry about falling according to type and number of mobility devices used. Analysis of cross-sectional and longitudinal data from the 2011-12 National Health and Aging Trends Study. In-person interviews in the homes of study participants. Nationally representative sample of Medicare beneficiaries (n=7,609). Participants were asked about mobility device use (e.g., canes, walkers, wheelchairs and scooters) in the last month, 1-year fall history and worry about falling. Twenty-four percent of adults aged 65 and older reported mobility device use in 2011, and 9.3% reported using multiple devices within the last month. Mobility device use increased with advancing age and was associated with nonwhite race and ethnicity, female sex, lower education level, greater multimorbidity, and obesity (all P<.001). Adjusting for demographic and health characteristics and physical function, the incidence of falls and recurrent falls was not associated with the use of multiple devices or any particular type of mobility device. Activity-limiting worry about falling was significantly higher in cane-only users than in nonusers. The percentage of older adults reporting mobility device use is higher than results from previous national surveys, and multiple device use is common in those who use any device. Mobility device use is not associated with greater incidence of falls. Cane-only users may compensate for worry about falling by limiting activity. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Anti-depressant medication use and C-reactive protein: results from two population-based studies.

PubMed

Hamer, Mark; Batty, G D; Marmot, Michael G; Singh-Manoux, Archana; Kivimäki, Mika

2011-01-01

The use of anti-depressant medication has been linked to cardiovascular disease (CVD). We examined the association between anti-depressant medication use and a marker of low grade systemic inflammation as a potential pathway linking anti-depressant use and CVD in two population based studies. Data were collected in a representative sample of 8131 community dwelling adults (aged 47.4±15.9 years, 46.7% male) from the Scottish Health Surveys (SHS). The use of anti-depressant medication was coded according to the British National Formulary and blood was drawn for the measurement of C-reactive protein (CRP). In a second study, we attempted to replicate our findings using longitudinal data from the Whitehall II study (n=4584, aged 55.5±5.9 years, mean follow-up 5.5 years). Antidepressants were used in 5.6% of the SHS sample, with selective serotonin reuptake inhibitors (SSRIs) being the most common. There was a higher risk of elevated CRP (>3 mg/L) in users of tricyclic antidepressant (TCA) medication (multivariate adjusted odds ratio (OR)=1.52, 95% CI, 1.07-2.15), but not in SSRI users (multivariate adjusted OR=1.07, 95% CI, 0.81-1.42). A longitudinal association between any antidepressant use and subsequent CRP was confirmed in the Whitehall cohort. In summary, the use of anti-depressants was associated with elevated levels of systemic inflammation independently from the symptoms of mental illness and cardiovascular co-morbidity. This might be a potential mechanism through which antidepressant medication increases CVD risk. Further data are required to explore the effects of dosage and duration of antidepressant treatment. Copyright © 2010 Elsevier Inc. All rights reserved.

Contribution of Water Pollution From Inadequate Sanitation and Housing Quality to Diarrheal Disease in Low-Cost Housing Settlements of Cape Town, South Africa

PubMed Central

Barnes, Jo M.; Pieper, Clarissa H.

2011-01-01

Objectives. We investigated the effects of failing sanitation, poor housing conditions, and fecal pollution in runoff water on the health—particularly the incidence of diarrheal disease—of residents of low-cost housing settlements in Cape Town, South Africa. Methods. In November 2009, we conducted a cross-sectional survey with structured interviews in 4 communities (n = 336 dwellings; 1080 persons). We used Colilert defined-substrate technology to determine Escherichia coli levels in runoff water samples taken from the study communities. Results. Almost 15% of households disposed of soiled products in storm water drains and 6% disposed of soiled products in the street. In only 26% of the dwellings were toilets washed daily. Approximately 59% of dwellings lacked a tap near the toilet for hand washing, and 14% of respondents suffered 1 or more attacks of diarrhea in the 2 weeks preceding their interview. E.coli counts of runoff environmental water samples ranged from 750 to 1 580 000 000 per 100 milliliters. Conclusions. A holistic and integrated approach is needed to improve housing quality and sanitation among Cape Town's low-income citizens. PMID:21566018

Antifungal activity of the pygidial gland secretion of Laemostenus punctatus (Coleoptera: Carabidae) against cave-dwelling micromycetes

NASA Astrophysics Data System (ADS)

Nenadić, Marija; Ljaljević-Grbić, Milica; Stupar, Miloš; Vukojević, Jelena; Ćirić, Ana; Tešević, Vele; Vujisić, Ljubodrag; Todosijević, Marina; Vesović, Nikola; Živković, Nemanja; Ćurčić, Srećko

2017-06-01

The antifungal potential of the pygidial gland secretion of the troglophilic ground beetle Laemostenus punctatus from a cave in Southeastern Serbia against cave-dwelling micromycetes, isolated from the same habitat, has been investigated. Eleven collected samples were analyzed and 32 isolates of cave-dwelling fungi were documented. A total of 14 fungal species were identified as members of the genera Aspergillus, Penicillium, Alternaria, Cladosporium, Rhizopus, Trichoderma, Arthrinium, Aureobasidium, Epicoccum, Talaromyces, and Fusarium. Five isolates were selected for testing the antifungal activity of the pygidial gland secretion: Talaromyces duclauxi, Aspergillus brunneouniseriatus, Penicillium sp., Rhizopus stolonifer, and Trichoderma viride. The microdilution method has been applied to detect minimal inhibitory concentrations (MICs) and minimal fungicidal concentrations (MFCs). The most sensitive isolate was Penicillium sp., while the other isolates demonstrated a high level of resistance to the tested agent. L. punctatus has developed a special mechanism of producing specific compounds that act synergistically within the secretion mixture, which are responsible for the antifungal action against pathogens from the cave. The results open opportunities for further research in the field of ground beetle defense against pathogens, which could have an important application in human medicine, in addition to the environmental impact, primarily.

Cross-linked fibrin degradation products (D-dimer), plasma cytokines, and cognitive decline in community-dwelling elderly persons.

PubMed

Wilson, Craig J; Cohen, Harvey Jay; Pieper, Carl F

2003-10-01

To investigate the effect of coagulation and inflammatory pathway activation on future cognitive decline in older persons. Prospective cohort study. Rural and urban communities in North Carolina. Community-dwelling older people enrolled in the Duke Established Populations for Epidemiologic Studies of the Elderly in 1986. In 1992, blood was drawn for assay of D-dimer (1,723 subjects), Interleukin-6 (1,726 subjects), and other cytokines (1,551 subjects). Cognitive and functional assessments were performed in 1986, 1989, 1992, and 1996. Cognition was measured using the Short Portable Mental Status Questionnaire. Cognitive decline over a 4-year period was significantly correlated (P<.001) with D-dimer, age, race, and physical performance status as measured using the Rosow-Breslau and Nagi instruments. After controlling for demographics, functional status, and comorbidities, D-dimer remained predictive of cognitive decline. Proinflammatory cytokines were not associated with current cognitive status in cross-sectional analyses or with incident cognitive decline in prospective analyses. In a large sample of community-dwelling elders, higher levels of D-dimer were predictive of cognitive decline over a 4-year period. No clinically significant associations were found between age-related peripheral cytokine dysregulation and cognition.

Transformation of dwelling culture based on riverine community in Musi River Palembang

NASA Astrophysics Data System (ADS)

Wicaksono, Bambang; Siswanto, Ari; Kusdiwanggo, Susilo; Anwar, Widya Fransiska Febriati

2017-11-01

Palembang City development since the Palembang Darussalam Sultanate era to the reformation era has impact on the living culture community, less of the raft houses, houses on stilts transformed into a terraced house, and the house became the dominant land. Dwelling Culture oriented on transformation of river become land-oriented. The development has leaving identity, character, and potential of the riverine architecture and dwelling life of river. The goals of study are to describe a case and revealing the meaning of dwelling cultural transformation in Musi River society from the process of cultural acculturation and investigate the architectural aspect from the form of house and modes of dwelling through the structuralism approach. The data collection is conducted qualitatively by using data collection techniques such as observation, interview, literature study, whereas the method of analysis, is a method that is done through Levi-Strauss structuralism approach that identifies all the elements of community thought in a systematic procedure. The results showed the structure behind the orientation, position, shape, and layout of dwelling revealed through the meanings in it. It means, the change and development from cultural acculturation process which oriented in the land dwelling, based on structure thinking of Palembang society.

Level of physical activity in men and women with chronic stroke.

PubMed

Vahlberg, Birgit; Bring, Annika; Hellström, Karin; Zetterberg, Lena

2018-04-16

Community-dwelling stroke survivors generally show low levels of physical activity (PA). An improved understanding of the factors influencing participation in PA after stroke is imperative to improve levels of PA. Furthermore, gender differences in PA have received little attention in stroke research. The objective of this study was to examine gender differences in PA, physical functioning and psychological factors and the association between these factors and PA in men and women 1-3-year post-stroke. A total of 187 community-dwelling individuals with stroke (65-85 years old, 29% women) were included in a secondary analysis based on data from a cross-sectional study. The exclusion criteria were severe cognitive or language dysfunction or dementia. The level of PA was measured by the Physical Activity Scale for the Elderly. Physical function included balance, walking speed and mobility. Psychological factors included depression, health-related quality of life and fall-related self-efficacy. Falls and fear of falling were each measured with a single question. There were no significant differences in PA levels between men and women. In multiple regression analyses, walking speed (p < 0.001) was associated with PA in men, and balance (p = 0.038) was associated with PA in women. The results indicate that strategies to increase PA levels 1-3-year post-stroke could be improved by considering gender-specific factors.

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

24 CFR 883.310 - Property standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., ordinances, and regulations. (c) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors...

7 CFR 1980.318 - Flood or mudslide hazard area precautions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... dwelling location and construction plans and specifications for new buildings or improvements to existing... SERVICE, RURAL BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT... there is no practical alternative. (a) Dwelling location. Dwellings and building improvements located in...

Dwell fatigue in two Ti alloys: An integrated crystal plasticity and discrete dislocation study

NASA Astrophysics Data System (ADS)

Zheng, Zebang; Balint, Daniel S.; Dunne, Fionn P. E.

2016-11-01

It is a well known and important problem in the aircraft engine industry that alloy Ti-6242 shows a significant reduction in fatigue life, termed dwell debit, if a stress dwell is included in the fatigue cycle, whereas Ti-6246 does not; the mechanistic explanation for the differing dwell debit of these alloys has remained elusive for decades. In this work, crystal plasticity modelling has been utilised to extract the thermal activation energies for pinned dislocation escape for both Ti alloys based on independent experimental data. This then allows the markedly different cold creep responses of the two alloys to be captured accurately and demonstrates why the observed near-identical rate sensitivity under non-dwell loading is entirely consistent with the dwell behaviour. The activation energies determined are then utilised within a recently developed thermally-activated discrete dislocation plasticity model to predict the strain rate sensitivities of the two alloys associated with nano-indentation into basal and prism planes. It is shown that Ti-6242 experiences a strong crystallographic orientation-dependent rate sensitivity while Ti-6246 does not which is shown to agree with recently published independent measurements; the dependence of rate sensitivity on indentation slip plane is also well captured. The thermally-activated discrete dislocation plasticity model shows that the incorporation of a stress dwell in fatigue loading leads to remarkable stress redistribution from soft to hard grains in the classical cold dwell fatigue rogue grain combination in alloy Ti-6242, but that no such load shedding occurs in alloy Ti-6246. The key property controlling the behaviour is the time constant of the thermal activation process relative to that of the loading. This work provides the first mechanistic basis to explain why alloy Ti-6242 shows a dwell debit but Ti-6246 does not.

Radon and thoron in cave dwellings (Yan'an, China)

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

Wiegand, J.; Feige, S.; Xie Quingling

2000-04-01

{sup 222}Rn and {sup 220}Rn concentrations were measured in cave dwellings and brick houses in the region of Yan'an (China) during summer 1997. The underground dwellings are built into Quaternary loess, and all investigated houses are founded on it. The median values of indoor {sup 222}Rn and {sup 220}Rn concentrations are 42 (n = 18) and 77Bq m{sup {minus}3} (n = 15) for brick houses and 92 (n = 23) and 215 (n = 17) Bq m{sup {minus}3} for cave dwellings. To classify the dwellings in respect to their cave-character, the fraction of walls having a direct contact to themore » loess is calculated for each dwelling. While the {sup 222}Rn concentrations are increasing with higher fractions, the {sup 220}Rn concentrations are not correlated with this fraction. On the other hand, due to the short half-life of {sup 220}Rn the distance from the measuring point to the walls is negatively correlated with the {sup 220}Rn concentration, while there is no correlation with the {sup 222}Rn concentration. Therefore, concentric isolines of {sup 220}Rn concentrations showing a strong gradient were detected in cave dwellings. An influence of the ventilation rate is distinct for {sup 222}Rn but weak for {sup 220}Rn. The effective dose rates for {sup 222}Rn and {sup 220}Rn and their progenies are calculated for brick houses (2.7 mSv y{sup {minus}1}), cave dwellings (7.1 mSv y{sup {minus}1}), and for traditional cave dwellings with a bed foundation built with loess (16.7 mSv y{sup {minus}1}). These calculations are based on summer measurements only. It is expected that the true effective dose rates will be significantly higher.« less

Impact of Interlayer Dwell Time on Microstructure and Mechanical Properties of Nickel and Titanium Alloys

NASA Astrophysics Data System (ADS)

Foster, B. K.; Beese, A. M.; Keist, J. S.; McHale, E. T.; Palmer, T. A.

2017-09-01

Path planning in additive manufacturing (AM) processes has an impact on the thermal histories experienced at discrete locations in simple and complex AM structures. One component of path planning in directed energy deposition is the time required for the laser or heat source to return to a given location to add another layer of material. As structures become larger and more complex, the length of this interlayer dwell time can significantly impact the resulting thermal histories. The impact of varying dwell times between 0 and 40 seconds on the microstructural and mechanical properties of Inconel® 625 and Ti-6Al-4V builds has been characterized. Even though these materials display different microstructures and solid-state phase transformations, the addition of an interlayer dwell generally led to a finer microstructure in both materials that impacted the resulting mechanical properties. With the addition of interlayer dwell times up to 40 seconds in the Inconel® 625 builds, finer secondary dendrite arm spacing values, produced by changes in the thermal history, correspond to increased yield and tensile strengths. These mechanical properties did not appear to change significantly, however, for dwell times greater than 20 seconds in the Inconel® 625 builds, indicating that longer dwell times have a minimal impact. The addition of interlayer dwell times in Ti-6Al-4V builds resulted in a slight decrease in the measured alpha lath widths and a much more noticeable decrease in the width of prior beta grains. In addition, the yield and tensile values continued to increase, nearly reaching the values observed in the rolled plate substrate material with dwell times up to 40 seconds.

Positive dwell time algorithm with minimum equal extra material removal in deterministic optical surfacing technology.

PubMed

Li, Longxiang; Xue, Donglin; Deng, Weijie; Wang, Xu; Bai, Yang; Zhang, Feng; Zhang, Xuejun

2017-11-10

In deterministic computer-controlled optical surfacing, accurate dwell time execution by computer numeric control machines is crucial in guaranteeing a high-convergence ratio for the optical surface error. It is necessary to consider the machine dynamics limitations in the numerical dwell time algorithms. In this paper, these constraints on dwell time distribution are analyzed, and a model of the equal extra material removal is established. A positive dwell time algorithm with minimum equal extra material removal is developed. Results of simulations based on deterministic magnetorheological finishing demonstrate the necessity of considering machine dynamics performance and illustrate the validity of the proposed algorithm. Indeed, the algorithm effectively facilitates the determinacy of sub-aperture optical surfacing processes.

24 CFR 982.401 - Housing quality standards (HQS).

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Elevators must be working and safe. (h) Interior air quality—(1) Performance requirement. The dwelling unit... environment; (E) Illumination and electricity; (F) Structure and materials; (G) Interior air quality; (H... dwelling unit. (e) Thermal environment—(1) Performance requirement. The dwelling unit must have and be...

Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts

PubMed Central

McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras

2016-01-01

Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time—the time elapsed from when an interruptive alert is generated to when it is dismissed—could be calculated by using historical alert data from log files. Drug–drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1–4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < .001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < .001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. PMID:26499101

Hearing aid use and long-term health outcomes: hearing handicap, mental health, social engagement, cognitive function, physical health and mortality

PubMed Central

Dawes, Piers; Cruickshanks, Karen J.; Fischer, Mary E.; Klein, Barbara E.K.; Klein, Ronald; Nondahl, David M.

2016-01-01

Objective To clarify the impact of hearing aids on mental health, social engagement, cognitive function, and physical health outcomes in older adults with hearing impairment. Design We assessed hearing handicap (Hearing Handicap Inventory for the Elderly; HHIE-S), cognition (Mini Mental State Exam, Trail Making, Auditory Verbal Learning, Digit-Symbol Substitution, Verbal Fluency, incidence of cognitive impairment), physical health (SF-12 physical component, basic and instrumental activities of daily living, mortality), social engagement (hours per week spent in solitary activities) and mental health (SF-12 mental component) at baseline, 5 years prior to baseline, and 5 and 11 years after baseline. Study sample Community-dwelling older adults with hearing impairment (N=666) from the Epidemiology of Hearing Loss Study cohort. Results There were no significant differences between hearing aid users and non-users in cognitive, social engagement or mental health outcomes at any time point. Aided HHIE-S was significantly better than unaided HHIE-S. At 11 years hearing aid users had significantly better SF-12 physical health scores (46.2 versus 41.2; p=0.03). There was no difference in incidence of cognitive impairment or mortality. Conclusion There was no evidence that hearing aids promote cognitive function, mental health, or social engagement. Hearing aids may reduce hearing handicap and promote better physical health. PMID:26140300

Balancing out dwelling and moving: optimal sensorimotor synchronization

PubMed Central

Girard, Benoît; Guigon, Emmanuel

2015-01-01

Sensorimotor synchronization is a fundamental skill involved in the performance of many artistic activities (e.g., music, dance). After a century of research, the manner in which the nervous system produces synchronized movements remains poorly understood. Typical rhythmic movements involve a motion and a motionless phase (dwell). The dwell phase represents a sizable fraction of the rhythm period, and scales with it. The rationale for this organization remains unexplained and is the object of this study. Twelve participants, four drummers (D) and eight nondrummers (ND), performed tapping movements paced at 0.5–2.5 Hz by a metronome. The participants organized their tapping behavior into dwell and movement phases according to two strategies: 1) Eight participants (1 D, 7 ND) maintained an almost constant ratio of movement time (MT) and dwell time (DT) irrespective of the metronome period. 2) Four participants increased the proportion of DT as the period increased. The temporal variabilities of both the dwell and movement phases were consistent with Weber's law, i.e., their variability increased with their durations, and the longest phase always exhibited the smallest variability. We developed an optimal statistical model that formalized the distribution of time into dwell and movement intervals as a function of their temporal variability. The model accurately predicted the participants' dwell and movement durations irrespective of their strategy and musical skill, strongly suggesting that the distribution of DT and MT results from an optimization process, dependent on each participant's skill to predict time during rest and movement. PMID:25878154

High level of cryptic species diversity revealed by sympatric lineages of Southeast Asian forest frogs

PubMed Central

Stuart, Bryan L; Inger, Robert F; Voris, Harold K

2006-01-01

Amphibians tend to exhibit conservative morphological evolution, and the application of molecular and bioacoustic tools in systematic studies have been effective at revealing morphologically ‘cryptic’ species within taxa that were previously considered to be a single species. We report molecular genetic findings on two forest-dwelling ranid frogs from localities across Southeast Asia, and show that sympatric evolutionary lineages of morphologically cryptic frogs are a common pattern. These findings imply that species diversity of Southeast Asian frogs remains significantly underestimated, and taken in concert with other molecular investigations, suggest there may not be any geographically widespread, forest-dwelling frog species in the region. Accurate assessments of diversity and distributions are needed to mitigate extinctions of evolutionary lineages in these threatened vertebrates. PMID:17148433

A Novel Hybrid Mental Spelling Application Based on Eye Tracking and SSVEP-Based BCI

PubMed Central

Stawicki, Piotr; Gembler, Felix; Rezeika, Aya; Volosyak, Ivan

2017-01-01

Steady state visual evoked potentials (SSVEPs)-based Brain-Computer interfaces (BCIs), as well as eyetracking devices, provide a pathway for re-establishing communication for people with severe disabilities. We fused these control techniques into a novel eyetracking/SSVEP hybrid system, which utilizes eye tracking for initial rough selection and the SSVEP technology for fine target activation. Based on our previous studies, only four stimuli were used for the SSVEP aspect, granting sufficient control for most BCI users. As Eye tracking data is not used for activation of letters, false positives due to inappropriate dwell times are avoided. This novel approach combines the high speed of eye tracking systems and the high classification accuracies of low target SSVEP-based BCIs, leading to an optimal combination of both methods. We evaluated accuracy and speed of the proposed hybrid system with a 30-target spelling application implementing all three control approaches (pure eye tracking, SSVEP and the hybrid system) with 32 participants. Although the highest information transfer rates (ITRs) were achieved with pure eye tracking, a considerable amount of subjects was not able to gain sufficient control over the stand-alone eye-tracking device or the pure SSVEP system (78.13% and 75% of the participants reached reliable control, respectively). In this respect, the proposed hybrid was most universal (over 90% of users achieved reliable control), and outperformed the pure SSVEP system in terms of speed and user friendliness. The presented hybrid system might offer communication to a wider range of users in comparison to the standard techniques. PMID:28379187

First-Person Educational Psychology for Teacher Education Majors: A Biofunctional Understanding Intervention

ERIC Educational Resources Information Center

Iran-Nejad, Asghar; Stewart, William; Robinson, Cecil

2015-01-01

This is a semester-long study of the development of first-person biofunctional understanding in educational psychology for teacher education majors. We defined biofunctional understanding as a spontaneous intellectual capacity. To reach its deep biological levels, sculpted by countless evolutionary millennia, students identified and dwelled in…

An Elegant Mind: Learning and Memory in "Caenorhabditis elegans"

ERIC Educational Resources Information Center

Ardiel, Evan L.; Rankin, Catharine H.

2010-01-01

This article reviews the literature on learning and memory in the soil-dwelling nematode "Caenorhabditis elegans." Paradigms include nonassociative learning, associative learning, and imprinting, as worms have been shown to habituate to mechanical and chemical stimuli, as well as learn the smells, tastes, temperatures, and oxygen levels that…

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 881.207 - Property standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... regulations. (g) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an...

24 CFR 884.110 - Types of housing and property standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Smoke detectors—(1) Performance requirement. After October 30, 1992, each dwelling unit must include at least one battery-operated or hard-wired smoke detector, in proper working condition, on each level of the unit. If the unit is occupied by hearing-impaired persons, smoke detectors must have an alarm...

Levels of phthalate esters in settled house dust from urban dwellings with young children in Nanjing, China

NASA Astrophysics Data System (ADS)

Zhang, Qi; Lu, Xiao-Mei; Zhang, Xiao-Ling; Sun, Yong-Gang; Zhu, Dong-Mei; Wang, Bing-Ling; Zhao, Ren-Zheng; Zhang, Zheng-Dong

2013-04-01

To investigate the levels and possible determinants of phthalate esters (PEs) in settled house dust from urban dwellings with young children, dust was collected from 215 urban houses in Nanjing, China, and 145 outdoor settled dust samples were collected nearby. Six PEs were measured by gas chromatography/mass spectrometry. All PEs were detected in the dust from approximately 90% of the houses, with the exception of dioctyl phthalate (DOP), which had only a 59% detection rate. Di-2-ethylhexyl phthalate (DEHP) and di-n-butyl phthalate (DBP) were the most abundant PEs, with geometric means of 110 and 16.4 μg g-1, respectively, and maximal concentrations 9950 and 2150 μg g-1. Factor analysis showed that DBP, DEHP and benzyl butyl phthalate (BBP) might come from the same source and were significantly influenced by the use of solid-wood floor wax. High BBP, DEHP, DOP and total PE levels were associated with indices of dampness, and high DOP was associated with humidifier use. In conclusion, six PEs are ubiquitous in urban settled house dust in Nanjing, China, and both plastic materials and cosmetic and personal care products are important sources. Flooring material, dampness and humidifier use potentially influence house dust PE levels.

Relationship of quadriceps muscle power and optimal shortening velocity with angiotensin-converting enzyme activity in older women.

PubMed

Kostka, Joanna; Sikora, Joanna; Kostka, Tomasz

2017-01-01

The goal of this study was to assess whether angiotensin-converting enzyme (ACE) activity is related to muscle function (strength, power and velocity), as well as to assess if ACE inhibitors (ACEIs) and other angiotensin system blocking medications (ASBMs) influence muscle performance in elderly women. Ninety-five community-dwelling elderly women took part in this study. Anthropometric data, blood ACE activity analysis, maximum power (P max ) and optimal shortening velocity (υ opt ) of the knee extensor muscles, handgrip strength, physical activity (PA) and functional performance were measured. Women taking ACEI were on average almost 2 years older than the women who did not take ACEI. They took more medicines and were also characterized by significantly lower level of ACE, but they did not differ in terms of PA level, results of functional performance and parameters characterizing muscle functions. No correlations of ACE activity with P max and handgrip strength, as well as with PA or functional performance were found. Higher ACE activity was connected with lower υ opt for women who did not take any ASBMs (rho =-0.37; p =0.01). Serum ACE activity was not associated with muscle strength, power and functional performance in both ASBM users and nonusers, but was associated with optimal shortening velocity of quadriceps muscles in older women. Further prospective studies are needed to assess if ACEIs or other ASBMs may slow down the decline in muscle function and performance.

Internet Use Frequency and Patient-Centered Care: Measuring Patient Preferences for Participation Using the Health Information Wants Questionnaire

PubMed Central

Wang, Mo; Feldman, Robert; Zhou, Le

2013-01-01

Background The Internet is bringing fundamental changes to medical practice through improved access to health information and participation in decision making. However, patient preferences for participation in health care vary greatly. Promoting patient-centered health care requires an understanding of the relationship between Internet use and a broader range of preferences for participation than previously measured. Objective To explore (1) whether there is a significant relationship between Internet use frequency and patients’ overall preferences for obtaining health information and decision-making autonomy, and (2) whether the relationships between Internet use frequency and information and decision-making preferences differ with respect to different aspects of health conditions. Methods The Health Information Wants Questionnaire (HIWQ) was administered to gather data about patients’ preferences for the (1) amount of information desired about different aspects of a health condition, and (2) level of decision-making autonomy desired across those same aspects. Results The study sample included 438 individuals: 226 undergraduates (mean age 20; SD 2.15) and 212 community-dwelling older adults (mean age 72; SD 9.00). A significant difference was found between the younger and older age groups’ Internet use frequencies, with the younger age group having significantly more frequent Internet use than the older age group (younger age group mean 5.98, SD 0.33; older age group mean 3.50, SD 2.00; t 436=17.42, P<.01). Internet use frequency was positively related to the overall preference rating (γ=.15, P<.05), suggesting that frequent Internet users preferred significantly more information and decision making than infrequent Internet users. The relationships between Internet use frequency and different types of preferences varied: compared with infrequent Internet users, frequent Internet users preferred more information but less decision making for diagnosis (γ=.57, P<.01); more information and more decision-making autonomy for laboratory test (γ=.15, P<.05), complementary and alternative medicine (γ=.32, P<.01), and self-care (γ=.15, P<.05); and less information but more decision-making autonomy for the psychosocial (γ=-.51, P<.01) and health care provider (γ=-.27, P<.05) aspects. No significant difference was found between frequent and infrequent Internet users in their preferences for treatment information and decision making. Conclusions Internet use frequency has a positive relationship with the overall preferences for obtaining health information and decision-making autonomy, but its relationship with different types of preferences varies. These findings have important implications for medical practice. PMID:23816979

24 CFR 1003.602 - Relocation and real property acquisition.

Code of Federal Regulations, 2010 CFR

2010-04-01

... may occupy a suitable, decent, safe, and sanitary dwelling in the building/complex following... dwelling unit who moves from the building/complex permanently after the submission to HUD of an application... project. (iii) A tenant-occupant of a dwelling who moves from the building/complex permanently, after the...

39 CFR 777.24 - Replacement housing payments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... displaced persons who lawfully and continuously owned and occupied a displacement dwelling for not less than... residential displaced persons who were tenants and lawfully and continuously occupied, a displacement dwelling... the sum of: (i) The amount which must be added to the acquisition cost of the displacement dwelling to...

39 CFR 777.24 - Replacement housing payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... displaced persons who lawfully and continuously owned and occupied a displacement dwelling for not less than... residential displaced persons who were tenants and lawfully and continuously occupied, a displacement dwelling... the sum of: (i) The amount which must be added to the acquisition cost of the displacement dwelling to...

39 CFR 777.24 - Replacement housing payments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... displaced persons who lawfully and continuously owned and occupied a displacement dwelling for not less than... residential displaced persons who were tenants and lawfully and continuously occupied, a displacement dwelling... the sum of: (i) The amount which must be added to the acquisition cost of the displacement dwelling to...

39 CFR 777.24 - Replacement housing payments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... displaced persons who lawfully and continuously owned and occupied a displacement dwelling for not less than... residential displaced persons who were tenants and lawfully and continuously occupied, a displacement dwelling... the sum of: (i) The amount which must be added to the acquisition cost of the displacement dwelling to...

39 CFR 777.24 - Replacement housing payments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... displaced persons who lawfully and continuously owned and occupied a displacement dwelling for not less than... residential displaced persons who were tenants and lawfully and continuously occupied, a displacement dwelling... the sum of: (i) The amount which must be added to the acquisition cost of the displacement dwelling to...

The impact of pinyon mortality on ground-dwelling arthropod communities

Treesearch

Robert J. Delph

2008-01-01

We documented the indirect impact of drought-induced mortality of pinyon pine (Pinus edulis) on ground-dwelling arthropod communities. Tree mortality alters microhabitats utilized by ground-dwelling arthropods through increased solar radiation, dead woody debris, and understory vegetation. Our major objectives were to determine if there were...

24 CFR 203.38 - Location of dwelling.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Location of dwelling. 203.38 Section 203.38 Housing and Urban Development Regulations Relating to Housing and Urban Development... § 203.38 Location of dwelling. At the time a mortgage is insured there must be located on the mortgaged...

Effect of Dissolution Kinetics on Feature Size in Dip-Pen Nanolithography

NASA Astrophysics Data System (ADS)

Weeks, B. L.; Noy, A.; Miller, A. E.; de Yoreo, J. J.

2002-06-01

We have investigated the effects of humidity, tip speed, and dwell time on feature size during dip pen nanolithography. Our results indicate a transition between two distinct deposition regimes occurs at a dwell time independent of humidity. While feature size increases with humidity, the relative increase is independent of dwell time. The results are described by a model that accounts for detachment and reattachment at the tip. The model suggests that, at short dwell times (high speed), the most important parameter controlling the feature size is the activation energy for thiol detachment.

The Application of Downdraught Cooling in Vernacular Skywell Dwellings in China

NASA Astrophysics Data System (ADS)

Xuan, H.; Lv, A. M.

2017-05-01

Traditional skywell dwellings in the hot climate regions of China represent an important cultural heritage. Achieving indoor comfort meeting occupants’ expectations, can contribute to the preservation of this unique traditional architecture. Improvement of ventilation and indoor temperatures through natural, sustainable and low impact solutions is an opportunity in achieving building thermal comfort in these traditional dwellings. The existence of skywells provides a good opportunity for the incorporation of downdraught cooling with minor interventions, and thus by avoiding extensive ductwork, saving energy and improving indoor temperatures, it can contribute to the preservation of traditional dwellings. Applicability of downdraught cooling, the history of traditional ventilation solutions, layout and space features of skywell dwelling are discussed and the way of incorporating downdraught cooling as an alternative to air-conditioning into these buildings is investigated.

I spy with my little eye: cognitive processing of framed physical activity messages.

PubMed

Bassett-Gunter, Rebecca L; Latimer-Cheung, Amy E; Martin Ginis, Kathleen A; Castelhano, Monica

2014-01-01

The primary purpose was to examine the relative cognitive processing of gain-framed versus loss-framed physical activity messages following exposure to health risk information. Guided by the Extended Parallel Process Model, the secondary purpose was to examine the relation between dwell time, message recall, and message-relevant thoughts, as well as perceived risk, personal relevance, and fear arousal. Baseline measures of perceived risk for inactivity-related disease and health problems were administered to 77 undergraduate students. Participants read population-specific health risk information while wearing a head-mounted eye tracker, which measured dwell time on message content. Perceived risk was then reassessed. Next, participants read PA messages while the eye tracker measured dwell time on message content. Immediately following message exposure, recall, thought-listing, fear arousal, and personal relevance were measured. Dwell time on gain-framed messages was significantly greater than loss-framed messages. However, message recall and thought-listing did not differ by message frame. Dwell time was not significantly related to recall or thought-listing. Consistent with the Extended Parallel Process Model, fear arousal was significantly related to recall, thought-listing, and personal relevance. In conclusion, gain-framed messages may evoke greater dwell time than loss-famed messages. However, dwell time alone may be insufficient for evoking further cognitive processing.

Examining the association between late-life leisure activity participation and global cognitive decline in community-dwelling elderly Chinese in Hong Kong.

PubMed

Leung, Grace Tak Yu; Fung, Ada Wai Tung; Tam, Cindy Woon Chi; Lui, Victor Wing Cheong; Chiu, Helen Fung Kum; Chan, Wai Man; Lam, Linda Chiu Wa

2011-01-01

This study examines the association between late-life leisure activity participation and global cognitive decline in community-dwelling elderly Chinese in Hong Kong. Five hundred and five participants, not clinically demented at the baseline, were analysed in the follow-up study of a population-based community survey among Hong Kong Chinese aged 60 and over. Information regarding leisure activity participation, global cognitive function and important sociodemographic variables was collected. Late life leisure activity profiles were classified into intellectual, social, physical and recreational categories, and were measured by total hours per week, total frequency and total number of subtypes. Multivariate logistic regression analyses were used to evaluate the association between leisure activity participation at the baseline and the incidence of global cognitive decline at the 22-month follow-up. The incidence of global cognitive decline was defined as a one-point drop in z-score of the Cantonese version of the mini-mental state examination (CMMSE). At the follow-up, a higher level of participation in intellectual activities was significantly associated with a lower incidence of global cognitive decline as measured by both the total hours per week (multivariate-adjusted OR 0.97 (95% CI 0.94-0.99, p=0.003)), and the total number of subtypes (multivariate-adjusted OR 0.74 (95% CI 0.58-0.95, p=0.018)). A higher level of late-life intellectual activity participation was associated with less global cognitive decline among community-dwelling elderly Chinese in Hong Kong. Copyright © 2010 John Wiley & Sons, Ltd.

An investigation of the psychometric properties of the Chinese (Cantonese) version of Subjective Index of Physical and Social Outcome (SIPSO).

PubMed

Kwong, Patrick Wh; Ng, Shamay Sm; Ng, Gabriel Yf

2017-11-01

The objectives of this study were 1) to translate and make cultural adaptations to the English version of the SIPSO questionnaire to create a Chinese (Cantonese) version, 2) evaluate the internal consistency, test-retest reliability the C-SIPSO questionnaire, and 3) compare the SIPSO-C scores of stroke survivors with different demographic characteristics to establish the discriminant validity of the questionnaire Design: Translation of questionnaire, cross sectional study. University-based clinical research laboratory. Subjects Community-dwelling chronic stroke survivors. Not applicable. Subjective Index of Physical and Social Outcome, Geriatric Depression Scale, 10-metre Walk test. Two bilingual professional translators translated the SIPSO questionnaire independently. An expert panel comprising five registered physiotherapists verified the content validity of the final version (C-SIPSO). C-SIPSO demonstrated good internal consistency (Cronbach's α = 0.83) and excellent test-retest reliability (ICC 3,1 = 0.866) in ninety-two community dwelling chronic stroke survivors. Stroke survivors scored higher than 10 in the Geriatric Depression Scale ( U = 555.0, P < 0.001) and with the comfortable walking speed lower than 0.8ms -1 ( U = 726.5; P = 0.012) scored significantly lower on SIPSO-C. SIPSO-C is a reliable instrument that can be used to measure the level of community integration in community-dwelling stroke survivors in Hong Kong and southern China. Stroke survivors who were at high risk of minor depression and with limited community ambulation ability demonstrated a lower level of community integration as measured with SIPSO-C.

[SCREENING OF NUTRITIONAL STATUS AMONG ELDERLY PEOPLE AT FAMILY MEDICINE].

PubMed

Račić, M; Ivković, N; Kusmuk, S

2015-11-01

The prevalence of malnutrition in elderly is high. Malnutrition or risk of malnutrition can be detected by use of nutritional screening or assessment tools. This systematic review aimed to identify tools that would be reliable, valid, sensitive and specific for nutritional status screening in patients older than 65 at family medicine. The review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were retrieved using MEDLINE (via Ovid), PubMed and Cochrane Library electronic databases and by manual searching of relevant articles listed in reference list of key publications. The electronic databases were searched using defined key words adapted to each database and using MESH terms. Manual revision of reviews and original articles was performed using Electronic Journals Library. Included studies involved development and validation of screening tools in the community-dwelling elderly population. The tools, subjected to validity and reliability testing for use in the community-dwelling elderly population were Mini Nutritional Assessment (MNA), Mini Nutritional Assessment-Short Form (MNA-SF), Nutrition Screening Initiative (NSI), which includes DETERMINE list, Level I and II Screen, Seniors in the Community: Risk Evaluation for Eating, and Nutrition (SCREEN I and SCREEN II), Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), and Malaysian and South African tool. MNA and MNA-SF appear to have highest reliability and validity for screening of community-dwelling elderly, while the reliability and validity of SCREEN II are good. The authors conclude that whilst several tools have been developed, most have not undergone extensive testing to demonstrate their ability to identify nutritional risk. MNA and MNA-SF have the highest reliability and validity for screening of nutritional status in the community-dwelling elderly, and the reliability and validity of SCREEN II are satisfactory. These instruments also contain all three nutritional status indicators and are practical for use in family medicine. However, the gold standard for screening cannot be set because testing of reliability and continuous validation in the study with a higher level of evidence need to be conducted in family medicine.

Pinyon pine mortality alters communities of ground-dwelling arthropods

Treesearch

Robert J. Delph; Michael J. Clifford; Neil S. Cobb; Paulette L. Ford; Sandra L. Brantley

2014-01-01

We documented the effect of drought-induced mortality of pinyon pine (Pinus edulis Engelm.) on communities of ground-dwelling arthropods. Tree mortality alters microhabitats utilized by ground-dwelling arthropods by increasing solar radiation, dead woody debris, and understory vegetation. Our major objectives were to determine (1) whether there were changes in...

A Critical Trilogy of Place: Dwelling in/on an Irritated Place

ERIC Educational Resources Information Center

Hung, Ruyu

2017-01-01

The aim of this paper is to explore the meaning of dwelling in place in terms of the critical trilogy of place. The critical trilogy is a constructively interpretive framework incorporating Greenwood's critical pedagogy of place and Heidegger's philosophical insights of dwelling. The critical trilogy of place, comprising decentralisation,…

Correlation between environmental relative moldiness index (ERMI) values in French dwellings and other measures of fungal contamination

EPA Science Inventory

The Environmental Relative Moldiness Index (ERMI) is a DNA-based metric developed to describe the fungal contamination in US dwellings. Our goal was to determine if the ERMI values in dwellings in north western France were correlated with other measures of fungal contamination. D...

Relationship between Perceived Needs and Assessed Needs for Services in Community-Dwelling Older Persons

ERIC Educational Resources Information Center

Cohen-Mansfield, Jiska; Frank, Julia

2008-01-01

Purpose: We examine the relationship between the perceived needs and assessed needs of community-dwelling seniors. Design and Methods: Trained research assistants administered the Naturally Occurring Retirement Community Baseline Survey to 268 community-dwelling older adults in suburban Maryland. Perceived and assessed needs were measured in the…

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2012 CFR

2012-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2010 CFR

2010-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2014 CFR

2014-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2013 CFR

2013-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

49 CFR 24.402 - Replacement housing payment for 90-day occupants.

Code of Federal Regulations, 2011 CFR

2011-10-01

... occupied the displacement dwelling for at least 90 days immediately prior to the initiation of negotiations... or she moves from the displacement dwelling; or (ii) For an owner-occupant, the later of: (A) The date he or she receives final payment for the displacement dwelling, or in the case of condemnation...

Ownership of dwelling affects the sex ratio at birth in Uganda.

PubMed

Wallner, Bernard; Fieder, Martin; Seidler, Horst

2012-01-01

Socio-economic conditions can affect the secondary sex ratio in humans. Mothers under good environmental conditions are predicted to increase the birth rates of sons according to the Trivers-Willard hypothesis (TWH). This study analyzed the effects of ownership and non-ownership of dwellings on the sex ratio at birth (SRB) on a Ugandan sample. Our investigation included 438,640 mothers aged between 12 and 54 years. The overall average SRB was 0.5008. Mothers who live in owned dwellings gave increased births to sons (0.5019) compared to those who live in non-owned dwellings (0.458). Multivariate statistics revealed the strongest effects of dwelling ownership when controlling for demographic and social variables such as marital status, type of marriage, mothers' age, mothers' education, parity and others. The results are discussed in the framework of recent plausible models dealing with the adjustment of the sex ratio. We conclude that the aspect of dwelling status could represent an important socio-economic parameter in relation to SRB variations in humans if further studies are able to analyze it between different countries in a comparative way.

The cognitive and hedonic costs of dwelling on achievement-related negative experiences: implications for enduring happiness and unhappiness.

PubMed

Lyubomirsky, Sonja; Boehm, Julia K; Kasri, Fazilet; Zehm, Keri

2011-10-01

Increasing evidence suggests that multiple cognitive and motivational processes underlie individual differences in happiness (Lyubomirsky, 2001, 2008). One behavior that is associated with (un)happiness is self-reflection or dwelling. We hypothesized that unhappy individuals would be inclined to dwell about themselves, and that this behavior would have a variety of adverse consequences. Three studies tested the prediction that, unlike their happier peers, unhappy participants would be sensitive to unfavorable achievement feedback, likely to dwell about its implications and, hence, show impaired attention during important academic tasks. The results of Studies 1 and 2 showed that unhappy participants who had "failed" relative to peers subsequently displayed increased interfering thoughts; spent the most time performing a portion of the graduate record examination; and later demonstrated impaired reading comprehension. Study 3 experimentally induced versus inhibiting dwelling and found that the manipulation only impacted unhappy students. Implications of our results for the consequences of dwelling for work and social functioning, as well as for detracting from enduring happiness, are discussed.

Mechanistic basis of temperature-dependent dwell fatigue in titanium alloys

NASA Astrophysics Data System (ADS)

Zheng, Zebang; Balint, Daniel S.; Dunne, Fionn P. E.

2017-10-01

The temperature-dependent dwell sensitivity of Ti-6242 and Ti-6246 alloys has been assessed over a temperature range from - 50∘ C to 390 °C using discrete dislocation plasticity which incorporates both thermal activation of dislocation escape from obstacles and slip transfer across grain boundaries. The worst-case load shedding in Ti-6242 alloy is found to be at or close to 120 °C under dwell fatigue loading, which diminishes and vanishes at temperatures lower than - 50∘ C or higher than 230 °C. Load shedding behaviour is predicted to occur in alloy Ti-6246 also but over a range of higher temperatures which are outside those relevant to in-service conditions. The key controlling dislocation mechanism with respect to load shedding in titanium alloys, and its temperature sensitivity, is shown to be the time constant associated with the thermal activation of dislocation escape from obstacles, with respect to the stress dwell time. The mechanistic basis of load shedding and dwell sensitivity in dwell fatigue loading is presented and discussed in the context of experimental observations.

A Double Dwell High Sensitivity GPS Acquisition Scheme Using Binarized Convolution Neural Network

PubMed Central

Wang, Zhen; Zhuang, Yuan; Yang, Jun; Zhang, Hengfeng; Dong, Wei; Wang, Min; Hua, Luchi; Liu, Bo; Shi, Longxing

2018-01-01

Conventional GPS acquisition methods, such as Max selection and threshold crossing (MAX/TC), estimate GPS code/Doppler by its correlation peak. Different from MAX/TC, a multi-layer binarized convolution neural network (BCNN) is proposed to recognize the GPS acquisition correlation envelope in this article. The proposed method is a double dwell acquisition in which a short integration is adopted in the first dwell and a long integration is applied in the second one. To reduce the search space for parameters, BCNN detects the possible envelope which contains the auto-correlation peak in the first dwell to compress the initial search space to 1/1023. Although there is a long integration in the second dwell, the acquisition computation overhead is still low due to the compressed search space. Comprehensively, the total computation overhead of the proposed method is only 1/5 of conventional ones. Experiments show that the proposed double dwell/correlation envelope identification (DD/CEI) neural network achieves 2 dB improvement when compared with the MAX/TC under the same specification. PMID:29747373

The association between social participation and cognitive function in community-dwelling older populations: Japan Gerontological Evaluation Study at Taisetsu community Hokkaido.

PubMed

Sakamoto, Ai; Ukawa, Shigekazu; Okada, Emiko; Sasaki, Sachiko; Zhao, Wenjing; Kishi, Tomoko; Kondo, Katsunori; Tamakoshi, Akiko

2017-10-01

To study the association between the number of area-level and individual-level social participation items and cognitive function in the community-dwelling older populations of three towns in Hokkaido, Japan. A survey on the frequency of social participation was mailed to those in the Japan Gerontological Evaluation Study 2013 who were aged ≥65 years, were not certified as needing long-term care, and lived in Higashikawa, Higashikagura, or Biei. A subset of participants aged 70-74 years completed the Japanese version of the Montreal Cognitive Assessment in a home visit survey. Both the area-level and individual-level social participation and demographic information were obtained on the self-administered questionnaire. A multilevel analysis using a generalized linear mixed-effects model was used to examine the association between variables in the area-level and individual-level social participation items and cognitive function. Out of 4042 respondents, data from 2576 were used in the area-level analysis. Of those, 180 were aged 70-74 years and completed the home visit survey for the individual-level analysis. A greater number of higher social participation items at the individual level was associated with higher cognitive function scores after adjusting for area-level social participation variables and confounders (regression coefficient: 0.19; 95% confidence interval: 0.03, 0.35). There were no significant associations between area-level social participation item averages and individual-level cognitive function scores. Older populations participating in many kinds of social activities exhibited preserved cognitive function even after adjusting for area-level social participation variables. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A Factorial Data Rate and Dwell Time Experiment in the National Transonic Facility

NASA Technical Reports Server (NTRS)

DeLoach, R.

2000-01-01

This report is an introductory tutorial on the application of formal experiment design methods to wind tunnel testing, for the benefit of aeronautical engineers with little formal experiment design training. It also describes the results of a Study to determine whether increases in the sample rate and dwell time of the National Transonic Facility data system Would result in significant changes in force and moment data. Increases in sample rate from 10 samples per second to 50 samples per second were examined, as were changes in dwell time from one second per data point to two seconds. These changes were examined for a representative aircraft model in a range of tunnel operating conditions defined by angles of attack from 0 deg to 3.8 degrees, total pressure from 15.0 psi to 24.1 psi, and Mach numbers from 0.52 to 0.82. No statistically significant effect was associated with the change in sample rate. The change in dwell time from one second to two seconds affected axial force measurements, and to a lesser degree normal force measurements. This dwell effect comprises a "rectification error" caused by incomplete cancellation of the positive and negative elements of certain low frequency dynamic components that are not rejected by the one-Hz low-pass filters of the data system. These low frequency effects may be due to tunnel circuit phenomena and other sources. The magnitude of the dwell effect depends on dynamic pressure, with angle of attack and Mach number influencing the strength of this dependence. An analysis is presented which suggests that the magnitude of the rectification error depends on the ratio of measurement dwell time to the period of the low-frequency dynamics, as well as the amplitude of the dynamics The essential conclusion of this analysis is that extending the dwell time (or, equivalently, replicating short-dwell data points) reduces the rectification error.

Design and testing of a phantom and instrumented gynecological applicator based on GaN dosimeter for use in high dose rate brachytherapy quality assurance

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

Guiral, P.; Ribouton, J.; Jalade, P.

Purpose: High dose rate brachytherapy (HDR-BT) is widely used to treat gynecologic, anal, prostate, head, neck, and breast cancers. These treatments are typically administered in large dose per fraction (>5 Gy) and with high-gradient-dose-distributions, with serious consequences in case of a treatment delivery error (e.g., on dwell position and dwell time). Thus, quality assurance (QA) or quality control (QC) should be systematically and independently implemented. This paper describes the design and testing of a phantom and an instrumented gynecological applicator for pretreatment QA and in vivo QC, respectively. Methods: The authors have designed a HDR-BT phantom equipped with four GaN-basedmore » dosimeters. The authors have also instrumented a commercial multichannel HDR-BT gynecological applicator by rigid incorporation of four GaN-based dosimeters in four channels. Specific methods based on the four GaN dosimeter responses are proposed for accurate determination of dwell time and dwell position inside phantom or applicator. The phantom and the applicator have been tested for HDR-BT QA in routine over two different periods: 29 and 15 days, respectively. Measurements in dwell position and time are compared to the treatment plan. A modified position–time gamma index is used to monitor the quality of treatment delivery. Results: The HDR-BT phantom and the instrumented applicator have been used to determine more than 900 dwell positions over the different testing periods. The errors between the planned and measured dwell positions are 0.11 ± 0.70 mm (1σ) and 0.01 ± 0.42 mm (1σ), with the phantom and the applicator, respectively. The dwell time errors for these positions do not exhibit significant bias, with a standard deviation of less than 100 ms for both systems. The modified position–time gamma index sets a threshold, determining whether the treatment run passes or fails. The error detectability of their systems has been evaluated through tests on intentionally introduced error protocols. With a detection threshold of 0.7 mm, the error detection rate on dwell position is 22% at 0.5 mm, 96% at 1 mm, and 100% at and beyond 1.5 mm. On dwell time with a dwell time threshold of 0.1 s, it is 90% at 0.2 s and 100% at and beyond 0.3 s. Conclusions: The proposed HDR-BT phantom and instrumented applicator have been tested and their main characteristics have been evaluated. These systems perform unsupervised measurements and analysis without prior treatment plan information. They allow independent verification of dwell position and time with accuracy of measurements comparable with other similar systems reported in the literature.« less

Socio-economic factors associated with maternal health-seeking behaviours among women from poor households in rural Egypt.

PubMed

Benova, Lenka; Campbell, Oona M R; Sholkamy, Hania; Ploubidis, George B

2014-11-25

Socio-economic inequalities in basic maternal health interventions exist in Egypt, yet little is known about health-seeking of poor households. This paper assesses levels of maternal health-seeking behaviours in women living in poor households in rural Upper Egypt, and compares these to national averages. Secondly, we construct innovative measures of socio-economic resourcefulness among the rural poor in order to examine the association between the resulting variables and the four dimensions of maternal health-seeking behaviour. We analysed a cross-sectional survey conducted in Assiut and Sohag governorates in 2010-2011 of 2,242 women in households below the poverty line in 65 poorest villages in Egypt. The associations between four latent socio-economic constructs (socio-cultural resourcefulness, economic resourcefulness, dwelling quality and woman's status) and receipt of any antenatal care (ANC), regular ANC (four or more visits), facility delivery and private sector delivery for women's most recent pregnancy in five years preceding survey were assessed using multivariate logistic regression. In the sample, 58.5% of women reported using any ANC and 51.1% facility delivery, lower than national coverage (74.2% and 72.4%, respectively). The proportion of ANC users receiving regular ANC was lower (67%) than nationally (91%). Among women delivering in facilities, 18% of women in the poor Upper Egypt sample used private providers (63% nationally). In multivariate analysis, higher economic resourcefulness was associated with higher odds of receiving ANC but with lower odds of facility delivery. Socio-cultural resourcefulness was positively associated with receiving any ANC, regular ANC and facility delivery, whereas it was not associated with private delivery care. Dwelling quality was positively associated with private delivery facility use. Woman's status was not independently associated with any of the four behaviours. Coverage of basic maternal health interventions and utilisation of private providers are lower among rural poor women in Upper Egypt than nationally. Variables capturing socio-cultural resourcefulness and economic resourcefulness were useful predictors of ANC and facility delivery. Further understanding of issues surrounding availability, affordability and quality of maternal health services among the poor is crucial to eliminating inequalities in maternal health coverage in Egypt.

Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.

PubMed

Yamada, Minoru; Nishiguchi, Shu; Fukutani, Naoto; Aoyama, Tomoki; Arai, Hidenori

2015-08-01

The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults. A cluster-randomized controlled trial. This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy. Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation). The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25[OH]D), as well as frailty, were assessed by the Cardiovascular Health Study criteria. Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults. These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese adults aged 60 years and older.

PubMed

Hai, Shan; Cao, Li; Wang, Hui; Zhou, Jianghua; Liu, Ping; Yang, Ying; Hao, Qiukui; Dong, Birong

2017-11-01

The aim of the present study was to examine the association between sarcopenia and nutritional status and physical activity among community-dwelling Chinese people aged 60 years and older. This study was carried out on 836 community-dwelling Chinese individuals aged ≥60 years to evaluate sarcopenia using the Asian Working Group for Sarcopenia criteria. Sociodemographic characteristics and lifestyle habits were collected using a general questionnaire. Nutritional status was assessed using the Mini Nutritional Assessment and biochemical parameters, whereas physical activity was assessed using the long form of the International Physical Activity Questionnaire. In addition, univariate and multivariate analysis was used to analyze the association between sarcopenia with nutritional status and physical activity. The total prevalence rate of sarcopenia was 10.5%, 47 (11.3%) men and 41 (9.7%) women who were classified as sarcopenia. The prevalence of sarcopenia was significantly lower among the participants of normal nutrition status. Compared with the participants with sarcopenia, those without sarcopenia had higher levels of prealbumin (P < 0.05) and hemoglobin (P < 0.05) for both sexes. In the multivariate model, after adjustment for all covariates, the Mini Nutritional Assessment score (adjusted OR 0.769, 95% CI 0.689-0.859, P < 0.05) was statistically significantly associated with sarcopenia, but the relationship between physical activity and sarcopenia was not significant. The prevalence of sarcopenia in the Chinese community-dwelling population aged 60 years and older was high. There was a significant association between sarcopenia and nutritional status, but not with physical activity, based on a questionnaire. Further studies should evaluate whether maintaining a good nutritional status might be effective in lowering the risk of sarcopenia. Geriatr Gerontol Int 2017; 17: 1959-1966. © 2017 Japan Geriatrics Society.

Orofacial pain symptoms and associated disability and psychosocial impact in community-dwelling and institutionalized elderly in Hong Kong.

PubMed

Wan, K Y; McMillan, A S; Wong, M C M

2012-03-01

The study investigated the experience of orofacial pain (OFP) symptoms and associated disability and psychosocial impact in community dwelling and institutionalized elderly people in Hong Kong. A community-based cross-sectional survey involving elders aged 60 years and above. Participants were recruited at social centres for the elderly and homes for the aged throughout Hong Kong. Elders who reported OFP symptoms in the previous four weeks took part. Standard questions were asked about OFP conditions in the previous month and the Manchester Orofacial Pain Disability Scale (MOPDS), the Oral Health Impact Profile (OHIP-14) and the General Health Questionnaire (GHQ-12) were administered. The MOPDS was translated and validated for use in Chinese elders. 200 community dwelling and 200 institutionalized elders participated. Toothache was the most common symptom (62.0%) and burning sensation in the tongue was least common (0.5%). The distribution of pain symptoms, pain duration and severity and pain ratings were similar in both groups. The MOPDS (Chinese elders version) had good reliability and construct validity. The MOPDS and OHIP-14 summary scores was significantly higher in the institutionalized elderly (p < 0.001 and p < 0.013, respectively). Psychological distress (GHQ-12 score > or = 4) was more common among the institutionalized elderly (11%) than the community dwelling elderly (4.0%, p = 0.002). Orofacial pain symptoms were associated with significant disability and had a detrimental impact on psychological distress level and quality of life, particularly in the institutionalized elderly. There is a need to improve access to professional care and health-related outreach services generally for elderly people in Hong Kong.

The Impact of Altitude on Sleep-Disordered Breathing in Children Dwelling at High Altitude: A Crossover Study.

PubMed

Hughes, Benjamin H; Brinton, John T; Ingram, David G; Halbower, Ann C

2017-09-01

Sleep-disordered breathing (SDB) is prevalent among children and is associated with adverse health outcomes. Worldwide, approximately 250 million individuals reside at altitudes higher than 2000 meters above sea level (masl). The effect of chronic high-altitude exposure on children with SDB is unknown. This study aims to determine the impact of altitude on sleep study outcomes in children with SDB dwelling at high altitude. A single-center crossover study was performed to compare results of high-altitude home polysomnography (H-PSG) with lower altitude laboratory polysomnography (L-PSG) in school-age children dwelling at high altitude with symptoms consistent with SDB. The primary outcome was apnea-hypopnea index (AHI), with secondary outcomes including obstructive AHI; central AHI; and measures of oxygenation, sleep quality, and pulse rate. Twelve participants were enrolled, with 10 included in the final analysis. Median altitude was 1644 masl on L-PSG and 2531 masl on H-PSG. Median AHI was 2.40 on L-PSG and 10.95 on H-PSG. Both obstructive and central respiratory events accounted for the difference in AHI. Oxygenation and sleep fragmentation were worse and pulse rate higher on H-PSG compared to L-PSG. These findings reveal a clinically substantial impact of altitude on respiratory, sleep, and cardiovascular outcomes in children with SDB who dwell at high altitude. Within this population, L-PSG underestimates obstructive sleep apnea and central sleep apnea compared to H-PSG. Given the shortage of high-altitude pediatric sleep laboratories, these results suggest a role for home sleep apnea testing for children residing at high altitude. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Icodextrin as salvage therapy in peritoneal dialysis patients with refractory fluid overload

PubMed Central

Johnson, David Wayne; Arndt, Mary; O'Shea, Amanda; Watt, Rhonda; Hamilton, Jan; Vincent, Kaia

2001-01-01

Background Icodextrin is a high molecular weight, starch-derived glucose polymer, which is capable of inducing sustained ultrafiltration over prolonged (12–16 hour) peritoneal dialysis (PD) dwells. The aim of this study was to evaluate the ability of icodextrin to alleviate refractory, symptomatic fluid overload and prolong technique survival in PD patients. Methods A prospective, open-label, pre-test/post-test study was conducted in 17 PD patients (8 females/9 males, mean age 56.8 ± 2.9 years) who were on the verge of being transferred to haemodialysis because of symptomatic fluid retention that was refractory to fluid restriction, loop diuretic therapy, hypertonic glucose exchanges and dwell time optimisation. One icodextrin exchange (2.5 L 7.5%, 12-hour dwell) was substituted for a long-dwell glucose exchange each day. Results Icodextrin significantly increased peritoneal ultrafiltration (885 ± 210 ml to 1454 ± 215 ml, p < 0.05) and reduced mean arterial pressure (106 ± 4 to 96 ± 4 mmHg, p < 0.05), but did not affect weight, plasma albumin concentration, haemoglobin levels or dialysate:plasma creatinine ratio. Diabetic patients (n = 12) also experienced improved glycaemic control (haemoglobin Alc decreased from 8.9 ± 0.7% to 7.9 ± 0.7%, p < 0.05). Overall PD technique survival was prolonged by a mean of 11.6 months (95% CI 6.0–17.3 months). On multivariate Cox proportional hazards analysis, extension of technique survival by icodextrin was only significantly predicted by baseline net daily peritoneal ultrafiltration (adjusted HR 2.52, 95% CI 1.13–5.62, p < 0.05). Conclusions Icodextrin significantly improved peritoneal ultrafiltration and extended technique survival in PD patients with symptomatic fluid overload, especially those who had substantially impaired peritoneal ultrafiltration. PMID:11737871

Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors.

PubMed

Singh, Devinder Kaur Ajit; Mohd Nordin, Nor Azlin; Abd Aziz, Noor Azah; Lim, Beng Kooi; Soh, Li Ching

2013-12-13

Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. In this controlled trial, the experimental group received 30 minutes of virtual reality balance games in addition to 90 minutes of standard physiotherapy. The control group continued with their two hours of routine standard physiotherapy. Both groups received 12 therapy sessions: two-hour sessions twice per week for six continuous weeks. Changes in physical function, activities of daily living and balance ability were assessed using the Timed Up and Go test, 30-second Sit to Stand test, Timed Ten-Metre Walk test, Six-Minute Walk test and the Barthel Index, and static balance was assessed using a probalance board. Twenty-eight participants completed post-intervention assessments. The results showed a significant within-subject effect on the Timed Up and Go test: F (1, 26) = 5.83, p = 0.02; and the 30-second Sit to Stand test; F (1, 26) = 13.50, p = 0.001. The between-subject effect was not significant (p > 0.05) for any of the outcome measurements. Substituting a portion of the standard physiotherapy time with virtual reality games was equally effective in maintaining physical function outcomes and activities of daily living among community-dwelling stroke survivors. Australia and New Zealand Clinical Trials Register, ACTRN12613000478718.

An improved automated procedure for informal and temporary dwellings detection and enumeration, using mathematical morphology operators on VHR satellite data

NASA Astrophysics Data System (ADS)

Jenerowicz, Małgorzata; Kemper, Thomas

2016-10-01

Every year thousands of people are displaced by conflicts or natural disasters and often gather in large camps. Knowing how many people have been gathered is crucial for an efficient relief operation. However, it is often difficult to collect exact information on the total number of the population. This paper presents the improved morphological methodology for the estimation of dwellings structures located in several Internally Displaced Persons (IDPs) Camps, based on Very High Resolution (VHR) multispectral satellite imagery with pixel sizes of 1 meter or less including GeoEye-1, WorldView-2, QuickBird-2, Ikonos-2, Pléiades-A and Pléiades-B. The main topic of this paper is the approach enhancement with selection of feature extraction algorithm, the improvement and automation of pre-processing and results verification. For the informal and temporary dwellings extraction purpose the high quality of data has to be ensured. The pre-processing has been extended by including the input data hierarchy level assignment and data fusion method selection and evaluation. The feature extraction algorithm follows the procedure presented in Jenerowicz, M., Kemper, T., 2011. Optical data are analysed in a cyclic approach comprising image segmentation, geometrical, textural and spectral class modeling aiming at camp area identification. The successive steps of morphological processing have been combined in a one stand-alone application for automatic dwellings detection and enumeration. Actively implemented, these approaches can provide a reliable and consistent results, independent of the imaging satellite type and different study sites location, providing decision support in emergency response for the humanitarian community like United Nations, European Union and Non-Governmental relief organizations.

Reconstruct the past thermocline circulation in the Atlantic: calcification depths and Mg/Ca-temperature calibrations for 6 deep-dwelling planktonic foraminifera

NASA Astrophysics Data System (ADS)

Cleroux, C.; deMenocal, P.; Arbuszewski, J.; Linsley, B.

2012-04-01

The subtropical cells are shallow meridional overturning circulations driven by the atmospheric circulation and the deep thermohaline circulation. They connect the mid-latitude and the tropic, release latten heat to the atmosphere and impact climate on decadal to longer time scale. The upper water column temperature and salinity structures of the ocean reflect this circulation. We present proxies to study these past structures. We performed stable oxygen isotope (δ18O) and trace element ratio measurements on one surface-dwelling (G. ruber)1 and six deep-dwelling planktonic foraminifera species (N. dutertrei, G. inflata, G. tumida, G. truncatulinoides, G. hirsuta and G. crassaformis) on 66 coretops spanning from 35°N to 20°S along the Mid-Atlantic ridge. Comparison between measured δ18O and predicted δ18O (using water column temperature and seawater δ18O), shows that N. dutertrei, G. tumida, G. hirsuta and G. crassaformis keep the same apparent calcification depth along the transect (respectively: 125m, 150m, 700m and 800m). Calcification at two depth levels was also tested. For the six deep-dwelling species, we establish Mg/Ca-temperature calibrations with both atlas temperature at the calcification depth and isotopic temperature. We present Mg/Ca-temperature equations for species previously very poorly calibrated. The δ18O and temperature (Mg/Ca derived) on the six planktonic foraminifera species faithfully reproduce the modern water column structure of the upper 800 m depth, establishing promising proxies for past subsurface reconstruction. 1 Arbuszewski, J. J., P. B. deMenocal, A. Kaplan, and C. E. Farmer (2010), On the fidelity of shell-derived δ18Oseawater estimates, Earth and Planetary Science Letters, 300(3-4), 185-196.

High-molecular-weight adiponectin levels in healthy, community-dwelling, elderly Japanese volunteers: a 5-year prospective observational study.

PubMed

Otsuka, Hiromasa; Yanai, Mitsuru; Kobayashi, Hiroki; Haketa, Akira; Hara, Motohiko; Sugama, Kaoru; Kato, Kimitoshi; Soma, Masayoshi

2017-10-19

Serum adiponectin levels are associated with frailty and cardiovascular diseases. Longitudinal changes in adiponectin levels might enhance our understanding of age-related conditions and diseases. This prospective observational study aimed to: (1) elucidate age-related changes in high-molecular-weight (HMW) adiponectin levels; and (2) identify variables predictive of elevated HMW adiponectin levels and the association with well-known adiponectin single-nucleotide polymorphisms (SNPs) in healthy, elderly Japanese participants. Healthy elderly volunteers (n = 196; 55 men and 141 women; median age 72.0 years; range 69.0-75.0 years) underwent anthropometric and physical function measurements, as well as laboratory tests at baseline and the 5-year follow-up. HMW adiponectin levels were significantly higher in women than in men (8.4, 5.3-11.9 vs. 5.7, 3.1-9.0 μg/mL; p < 0.001) at baseline and decreased significantly at follow-up in women (7.7, 4.8-11.2 μg/mL; p < 0.001), but not in men. In the multiple regression analysis, high-density lipoprotein cholesterol levels and body weight were independent predictors of HMW adiponectin levels. The rate of change in HMW adiponectin levels was inversely correlated with the rates of change in body weight, body mass index, and knee leg extension strengths, and positively correlated with rates of change in high-density lipoprotein cholesterol and one-leg standing time. There were no significant differences in HMW adiponectin levels among SNPs. Decreasing HMW adiponectin levels might lead to an increased risk of cardiovascular diseases in elderly women. HMW adiponectin levels significantly decreased over a 5-year period in community-dwelling elderly Japanese women.

Xylella fastidiosa infection of grapevines affects xylem levels of phenolic compounds and pathogenesis-related proteins

USDA-ARS?s Scientific Manuscript database

Pierce’s disease (PD), caused by the xylem-dwelling pathogen Xylella fastidiosa (X.f.), is a serious threat to grape production. The effects of X.f. infection six months post-inoculation on defense-associated proteins and phenolic compounds found in xylem sap and tissue were evaluated. Defense-assoc...

Xylella fastidiosa infection of grapevines affects host secondary metabolite and defense-related protein levels within xylem

USDA-ARS?s Scientific Manuscript database

Pierce’s disease of grapevine is a serious threat to grape production and is caused by the xylem-dwelling bacterial pathogen Xylella fastidiosa. Microscopy studies have documented morphological changes to grapevine xylem due to infection by X. fastidiosa. Comparatively, less is known about the bi...

Soboliphyme baturini infection does not affect the nutritional condition of American marten (Martes americana) in Alaska

Treesearch

J.G. Thomas; J.N. Pauli; E. Donaldio; S.W. Buskirk

2008-01-01

Soboliphyme baturini, a stomach-dwelling nematode of American martens (Martes americana). reaches high levels of infection; however, its effects on the nutritional condition of the host are unknown. To understand the effects of this parasite on American martens, we collected S. baturini and measured abdominal fat...

Local Strain Measurement of Kevlar Strand with Fiber Optic Bragg Grating

NASA Technical Reports Server (NTRS)

Banks, Curtis E.; Grant, Joseph; Russell, Sam; Arnett, Shawn

2008-01-01

1987 DuPont manufactured 4560 denier Kevlar/Epoxy Strands were instrumented with nine and three sensors each. Stress tests were performed at 30,45,60,70 and 80% of ultimate strength with dwell times of 10,000 seconds. FBG showed uneven stress levels which is contrary to conventional observation.

Local strain measurement of Kevlar strand with fiber optic Bragg grating

NASA Astrophysics Data System (ADS)

Banks, Curtis E.; Grant, Joseph; Russell, Sam; Arnett, Shawn

2008-03-01

1987 DuPont manufactured 4560 denier Kevlar/Epoxy Strands were instrumented with nine and three sensors each. Stress tests were performed at 30,45,60,70 and 80% of ultimate strength with dwell times of 10,000 seconds. FBG showed uneven stress levels which is contrary to conventional observation.

Effect of woody debris abundance on daytime refuge use by cotton mice

Treesearch

Travis M. Hinkelman; Susan C. Loeb

2007-01-01

Daytime refuges are important to nocturnal rodents for protection from predators and environmental extremes. Because refuges of forest-dwelling rodents are often associated with woody debris, we examined refuge use by 37 radio-collared Peromyscus gossypinus (cotton mice) in experimental plots with different levels of woody debris. Treatment plots had...

10 CFR 440.22 - Eligible dwelling units.

Code of Federal Regulations, 2010 CFR

2010-01-01

... is occupied by a family unit: (1) Whose income is at or below 200 percent of the poverty level...) Which contains a member who has received cash assistance payments under Title IV or XVI of the Social... his agent; (2) Not less than 66 percent (50 percent for duplexes and four-unit buildings, and certain...

Residential radon in Galicia: a cross-sectional study in a radon-prone area.

PubMed

Lorenzo-González, María; Ruano-Ravina, Alberto; Peón, Joaquín; Piñeiro, María; Barros-Dios, Juan Miguel

2017-09-01

Residential radon exposure is a major public health problem. It is the second greatest cause of lung cancer, after smoking, and the greatest in never-smokers. This study shows the indoor radon exposure distribution in Galicia and estimates the percentage of dwellings exceeding reference levels. It is based on 3245 residential radon measurements obtained from the Galician Radon Map project and from controls of two previous case-control studies on residential radon and lung cancer. Results show a high median residential radon concentration in Galicia (99 Bq m -3 ), with 49.3% of dwellings having a radon concentration above 100 Bq m -3 and 11.1% having a concentration above 300 Bq m -3 . Ourense and Pontevedra, located in South Galicia, are the provinces with the highest median indoor radon concentrations (137 Bq m -3 and 123.5 Bq m -3 , respectively). Results also show lower radon levels in progressively higher building storeys. These high residential radon concentrations confirm Galicia as a radon-prone area. A policy on radon should be developed and implemented in Galicia to minimize the residential radon exposure of the population.

Trophic transfer of metals along freshwater food webs: Evidence of cadmium biomagnification in nature

USGS Publications Warehouse

Croteau, M.-N.; Luoma, S.N.; Stewart, A.R.

2005-01-01

We conducted a study with cadmium (Cd) and copper (Cu) in the delta of San Francisco Bay, using nitrogen and carbon stable isotopes to identify trophic position and food web structure. Cadmium is progressively enriched among trophic levels in discrete epiphyte-based food webs composed of macrophyte-dwelling invertebrates (the first link being epiphytic algae) and fishes (the first link being gobies). Cadmium concentrations were biomagnified 15 times within the scope of two trophic links in both food webs. Trophic enrichment in invertebrates was twice that of fishes. No tendency toward trophic-level enrichment was observed for Cu, regardless of whether organisms were sorted by food web or treated on a taxonomic basis within discrete food webs. The greatest toxic effects of Cd are likely to occur with increasing trophic positions, where animals are ingesting Cd-rich prey (or food). In Franks Tract this occurs within discrete food chains composed of macrophyte-dwelling invertebrates or fishes inhabiting submerged aquatic vegetation. Unraveling ecosystem complexity is necessary before species most exposed and at risk can be identified. ?? 2005, by the American Society of Limnology and Oceanography, Inc.

Relationship between road traffic noisescape and urban form in Hong Kong.

PubMed

Lam, Kin-Che; Ma, Weichun; Chan, Pak Kin; Hui, Wing Chi; Chung, King Lam; Chung, Yi-tak Teresa; Wong, Chun Yin; Lin, Hui

2013-12-01

This paper reports on a study which explored the possible relationship between road traffic noisescape and urban form in Hong Kong. A total of 212 residential complexes from 11 contrasting urban forms were sampled, and their noise levels assessed both at dwelling and neighbourhood scales by noise mapping. Its findings indicate that residential complexes with different urban forms have significantly different noisescape attributes. There is a strong correlation between the noise characteristics and morphological indicators at the dwelling scale. A less obstreperous noisescape is associated with urban forms with lower road and building densities, and with building arrangements which provide self-noise screening. These findings suggest that urban form is an influential determinant of the noisescape in the urban environment, and they point to the need to rethink the conventional approach to managing the urban acoustic environment.

24 CFR 1000.160 - Are non-dwelling structures developed, acquired or assisted under the IHBG program subject to...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Are non-dwelling structures developed, acquired or assisted under the IHBG program subject to limitations on cost or design standards...-dwelling structures developed, acquired or assisted under the IHBG program subject to limitations on cost...

24 CFR 1000.160 - Are non-dwelling structures developed, acquired or assisted under the IHBG program subject to...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Are non-dwelling structures developed, acquired or assisted under the IHBG program subject to limitations on cost or design standards...-dwelling structures developed, acquired or assisted under the IHBG program subject to limitations on cost...

Systematic Literature Review of Randomized Control Trials Assessing the Effectiveness of Nutrition Interventions in Community-Dwelling Older Adults

ERIC Educational Resources Information Center

Bandayrel, Kristofer; Wong, Sharon

2011-01-01

Objective: Nutrition interventions may play an important role in maintaining the health and quality of life in community-dwelling older adults. To the authors' knowledge, no systematic literature review has been conducted on the effectiveness of nutrition interventions in the community-dwelling older adult population. Design: Systematic literature…

24 CFR 203.16 - Certificate and contract regarding use of dwelling for transient or hotel purposes.

Code of Federal Regulations, 2011 CFR

2011-04-01

... use of dwelling for transient or hotel purposes. 203.16 Section 203.16 Housing and Urban Development... use of dwelling for transient or hotel purposes. Every application filed with respect to insurance of... housing or any part thereof covered by the mortgage for transient or hotel purposes, together with the...

Characterizing movement of ground-dwelling arthropods with a novel mark-capture method using fluorescent powder

Treesearch

Kayla I. Perry; Kimberly F. Wallin; John W. Wenzel; Daniel A. Herms

2017-01-01

A major knowledge gap exists in understanding dispersal potential of ground-dwelling arthropods, especially in forest ecosystems. Movement of the ground-dwelling arthropod community was quantified using a novel markcapture technique in which three different colored fluorescent powders in two separate mixtures were applied to the floor of a deciduous forest in...

24 CFR 203.16 - Certificate and contract regarding use of dwelling for transient or hotel purposes.

Code of Federal Regulations, 2010 CFR

2010-04-01

... use of dwelling for transient or hotel purposes. 203.16 Section 203.16 Housing and Urban Development... use of dwelling for transient or hotel purposes. Every application filed with respect to insurance of... housing or any part thereof covered by the mortgage for transient or hotel purposes, together with the...

Environmental constraints and call evolution in torrent-dwelling frogs.

PubMed

Goutte, Sandra; Dubois, Alain; Howard, Samuel D; Marquez, Rafael; Rowley, Jodi J L; Dehling, J Maximilian; Grandcolas, Philippe; Rongchuan, Xiong; Legendre, Frédéric

2016-04-01

Although acoustic signals are important for communication in many taxa, signal propagation is affected by environmental properties. Strong environmental constraints should drive call evolution, favoring signals with greater transmission distance and content integrity in a given calling habitat. Yet, few empirical studies have verified this prediction, possibly due to a shortcoming in habitat characterization, which is often too broad. Here we assess the potential impact of environmental constraints on the evolution of advertisement call in four groups of torrent-dwelling frogs in the family Ranidae. We reconstruct the evolution of calling site preferences, both broadly categorized and at a finer scale, onto a phylogenetic tree for 148 species with five markers (∼3600 bp). We test models of evolution for six call traits for 79 species with regard to the reconstructed history of calling site preferences and estimate their ancestral states. We find that in spite of existing morphological constraints, vocalizations of torrent-dwelling species are most probably constrained by the acoustic specificities of torrent habitats and particularly their high level of ambient noise. We also show that a fine-scale characterization of calling sites allows a better perception of the impact of environmental constraints on call evolution. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

Using standard clinical assessments for home care to identify vulnerable populations before, during, and after disasters.

PubMed

van Solm, Alexandra I T; Hirdes, John P; Eckel, Leslie A; Heckman, George A; Bigelow, Philip L

Several studies have shown the increased vulnerability of and disproportionate mortality rate among frail community-dwelling older adults as a result of emergencies and disasters. This article will discuss the applicability of the Vulnerable Persons at Risk (VPR) and VPR Plus decision support algorithms designed based on the Resident Assessment Instrument-Home Care (RAI-HC) to identify the most vulnerable community-dwelling (older) adults. A sample was taken from the Ontario RAI-HC database by selecting unique home care clients with assessments closest to December 31, 2014 (N = 275,797). Statistical methods used include cross tabulation, bivariate logistic regression as well as Kaplan-Meier survival plotting and Cox proportional hazards ratios calculations. The VPR and VPR Plus algorithms, were highly predictive of mortality, long-term care admission and hospitalization in ordinary circumstances. This provides a good indication of the strength of the algorithms in identifying vulnerable persons at times of emergencies. Access to real-time person-level information of persons with functional care needs is a vital enabler for emergency responders in prioritizing and allocating resources during a disaster, and has great utility for emergency planning and recovery efforts. The development of valid and reliable algorithms supports the rapid identification and response to vulnerable community-dwelling persons for all phases of emergency management.

Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial.

PubMed

Kirby, R Lee; Mitchell, Doug; Sabharwal, Sunil; McCranie, Mark; Nelson, Audrey L

2016-01-01

To test the hypotheses that community-dwelling veterans with spinal cord injury (SCI) who receive the Wheelchair Skills Training Program (WSTP) in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC) group. We carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30-45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST) and Craig Handicap Assessment and Reporting Technique (CHART) scores. Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001) and retained their scores at one year follow-up. The success rates for individual skills were consistent with the total and subtotal WST scores. The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021). Individualized wheelchair skills training in the home environment substantially improves the advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation.

The association between physical activity and social isolation in community-dwelling older adults.

PubMed

Robins, Lauren M; Hill, Keith D; Finch, Caroline F; Clemson, Lindy; Haines, Terry

2018-02-01

Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01-1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R 2 = 0.104). Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial

PubMed Central

Mitchell, Doug; Sabharwal, Sunil; McCranie, Mark; Nelson, Audrey L.

2016-01-01

Objectives To test the hypotheses that community-dwelling veterans with spinal cord injury (SCI) who receive the Wheelchair Skills Training Program (WSTP) in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC) group. Methods We carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30–45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST) and Craig Handicap Assessment and Reporting Technique (CHART) scores. Results Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001) and retained their scores at one year follow-up. The success rates for individual skills were consistent with the total and subtotal WST scores. The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021). Conclusions Individualized wheelchair skills training in the home environment substantially improves the advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation. PMID:28002472

Blocking of Single α-Hemolysin Pore by Rhodamine Derivatives.

PubMed

Rokitskaya, Tatyana I; Nazarov, Pavel A; Golovin, Andrey V; Antonenko, Yuri N

2017-06-06

Measurements of ion conductance through α-hemolysin pore in a bilayer lipid membrane revealed blocking of the ion channel by a series of rhodamine 19 and rhodamine B esters. The longest dwell closed time of the blocking was observed with rhodamine 19 butyl ester (C4R1), whereas the octyl ester (C8R1) was of poor effect. Voltage asymmetry in the binding kinetics indicated that rhodamine derivatives bound to the stem part of the aqueous pore lumen. The binding frequency was proportional to a quadratic function of rhodamine concentrations, thereby showing that the dominant binding species were rhodamine dimers. Two levels of the pore conductance and two dwell closed times of the pore were found. The dwell closed times lengthened as the voltage increased, suggesting impermeability of the channel for the ligands. Molecular docking analysis revealed two distinct binding sites within the lumen of the stem of the α-hemolysin pore for the C4R1 dimer, but only one binding site for the C8R1 dimer. The blocking of the α-hemolysin nanopore by rhodamines could be utilized in DNA sequencing as additional optical sensing owing to bright fluorescence of rhodamines if used for DNA labeling. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Factors related to mental health and hearing in community-dwelling elderly

PubMed Central

Nabeshima, Sumiyo; Yamada, Kiyomi

2018-01-01

ABSTRACT The purpose of this study was to clarify the factors related to mental health and hearing in community-dwelling elderly. Elderly participants in a project to prevent long-term care need were given a self-administered questionnaire and tested by pure-tone audiometry. One hundred fifty were taken as subjects. Forty-one of these subjects (27.3%) were found to have poor mental health. The results of multiple logistic regression analysis with mental health level as the dependent variable indicated that subjects 65–74 years old who did not think their own hearing was bad had better mental health than those who did think their hearing was bad (odds ratio 10.800). Among subjects 75 years and older, those who had not been certified as needing long-term care had better mental health than those who had been certified (odds ratio 3.937). When planning mental health support for community-dwelling elderly in the future, it will be necessary to consider differences in background due to age group. The present results suggest that appropriate support for awareness of hearing and acceptance of decreased hearing ability in people in early old age (65–74 years old) may help to prevent declining mental health in later old age.

Cross-cultural adaptation and construct validity of the Korean version of a physical activity measure for community-dwelling elderly.

PubMed

Choi, Bongsam

2018-01-01

[Purpose] This study aimed to cross-cultural adapt and validate the Korean version of an physical activity measure (K-PAM) for community-dwelling elderly. [Subjects and Methods] One hundred and thirty eight community-dwelling elderlies, 32 males and 106 female, participated in the study. All participants were asked to fill out a fifty-one item questionnaire measuring perceived difficulty in the activities of daily living (ADL) for the elderly. One-parameter model of item response theory (Rasch analysis) was applied to determine the construct validity and to inspect item-level psychometric properties of 51 ADL items of the K-PAM. [Results] Person separation reliability (analogous to Cronbach's alpha) for internal consistency was ranging 0.93 to 0.94. A total of 16 items was misfit to the Rasch model. After misfit item deletion, 35 ADL items of the K-PAM were placed in an empirically meaningful hierarchy from easy to hard. The item-person map analysis delineated that the item difficulty was well matched for the elderlies with moderate and low ability except for high ceilings. [Conclusion] Cross-cultural adapted K-PAM was shown to be sufficient for establishing construct validity and stable psychometric properties confirmed by person separation reliability and fit statistics.

Sleep Disordered Breathing and White Matter Hyperintensities in Community-Dwelling Elders.

PubMed

Rostanski, Sara K; Zimmerman, Molly E; Schupf, Nicole; Manly, Jennifer J; Westwood, Andrew J; Brickman, Adam M; Gu, Yian

2016-04-01

To examine the association between markers of sleep-disordered breathing (SDB) and white matter hyperintensity (WMH) volume in an elderly, multiethnic, community-dwelling cohort. This is a cross-sectional analysis from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a community-based epidemiological study of older adults. Structural magnetic resonance imaging was obtained starting in 2004; the Medical Outcomes Study-Sleep Scale (MOS-SS) was administered to participants starting in 2007. Linear regression models were used to assess the relationship between the two MOS-SS questions that measure respiratory dysfunction during sleep and quantified WMH volume among WHICAP participants with brain imaging. A total of 483 older adults had both structural magnetic resonance imaging and sleep assessment. Self-reported SDB was associated with WMH. After adjusting for demographic and vascular risk factors, WMH volumes were larger in individuals with frequent snoring (β = 2.113, P = 0.004) and among those who reported waking short of breath or with headache (β = 1.862, P = 0.048). In community-dwelling older adults, self-reported measures of SDB are associated with larger WMH volumes. The cognitive effects of SDB that are increasingly being recognized may be mediated at the small vessel level. © 2016 Associated Professional Sleep Societies, LLC.

Ozone disinfection of home nebulizers effectively kills common cystic fibrosis bacterial pathogens.

PubMed

Towle, Dana; Baker, Vanisha; Schramm, Craig; O'Brien, Matthew; Collins, Melanie S; Feinn, Richard; Murray, Thomas S

2018-05-01

The Cystic Fibrosis Foundation (CFF) recommends routine nebulizer disinfection for patients but compliance is challenging due to the heavy burden of home care. SoClean® is a user friendly ozone based home disinfection device currently for home respiratory equipment. The objective of this study was to determine whether SoClean® has potential as a disinfection device for families with CF by killing CF associated bacteria without altering nebulizer output. Ozone based disinfection effectively kills bacterial pathogens inoculated to home nebulizer equipment without gross changes in nebulizer function. Common bacterial pathogens associated with CF were inoculated onto the PariLC® jet nebulizer and bacterial recovery compared with or without varied ozone exposure. In separate experiments, nebulizer output was estimated after repeated ozone exposure by weighing the nebulizer. Ozone disinfection was time dependent with a 5 min infusion time and 120 min dwell time effectively killing >99.99% bacteria tested including Pseudomonas aeruginosa and Staphylococcus aureus. Over 250 h of repeat ozone exposure did not alter nebulizer output. This suggests SoClean® has potential as a user-friendly disinfection technique for home respiratory equipment. © 2018 Wiley Periodicals, Inc.

Asthma, allergy and eczema among adults in multifamily houses in Stockholm (3-HE study)--associations with building characteristics, home environment and energy use for heating.

PubMed

Norbäck, Dan; Lampa, Erik; Engvall, Karin

2014-01-01

Risk factors for asthma, allergy and eczema were studied in a stratified random sample of adults in Stockholm. In 2005, 472 multifamily buildings (10,506 dwellings) were invited (one subject/dwelling) and 7,554 participated (73%). Associations were analyzed by multiple logistic regression, adjusting for gender, age, smoking, country of birth, income and years in the dwelling. In total, 11% had doctor's diagnosed asthma, 22% doctor's diagnosed allergy, 23% pollen allergy and 23% eczema. Doctor's diagnosed asthma was more common in dwellings with humid air (OR = 1.74) and mould odour (OR = 1.79). Doctor's diagnosed allergy was more common in buildings with supply exhaust air ventilation as compared to exhaust air only (OR = 1.45) and was associated with redecoration (OR = 1.48) and mould odour (OR = 2.35). Pollen allergy was less common in buildings using more energy for heating (OR = 0.75) and was associated with humid air (OR = 1.76) and mould odour (OR = 2.36). Eczema was more common in larger buildings (OR 1.07) and less common in buildings using more energy for heating (OR = 0.85) and was associated with water damage (OR = 1.47), humid air (OR = 1.73) and mould odour (OR = 2.01). Doctor's diagnosed allergy was less common in buildings with management accessibility both in the neighbourhood and in larger administrative divisions, as compared to management in the neighbourhood only (OR = 0.49; 95% CI 0.29-0.82). Pollen allergy was less common if the building maintenance was outsourced (OR = 0.67; 95% CI 0.51-0.88). Eczema was more common when management accessibility was only at the division level (OR = 1.49; 95% CI 1.06-2.11). In conclusions, asthma, allergy or eczema were more common in buildings using less energy for heating, in larger buildings and in dwellings with redecorations, mould odour, dampness and humid air. There is a need to reduce indoor chemical emissions and to control dampness. Energy saving may have consequences for allergy and eczema. More epidemiological studies are needed on building management organization.

Late Neolithic Mondsee Culture in Austria: living on lakes and living with flood risk?

NASA Astrophysics Data System (ADS)

Swierczynski, T.; Lauterbach, S.; Dulski, P.; Brauer, A.

2013-07-01

Neolithic and Bronze Age lake dwellings in the European Alps became recently protected under the UNESCO World Heritage. However, only little is known about the cultural history of the related pre-historic communities, their adaptation strategies to environmental changes and particularly about the almost synchronous decline of many of these settlements around the transition from the Late Neolithic to the Early Bronze Age. For example, there is an ongoing debate whether the abandonment of Late Neolithic lake dwellings at Lake Mondsee (Upper Austria) was caused by unfavourable climate conditions or a single catastrophic event. Within the varved sediments of Lake Mondsee, we investigated the occurrence of intercalated detrital layers from major floods and debris flows to unravel extreme surface runoff recurrence during the Neolithic settlement period. A combination of detailed sediment microfacies analysis and μXRF element scanning allows distinguishing debris flow and flood deposits. A total of 60 flood and 12 debris flow event layers was detected between 7000 and 4000 varve years (vyr) BP. Compared to the centennial- to millennial-scale average, a period of increased runoff event frequency can be identified between 5900 and 4450 vyr BP. Enhanced flood frequency is accompanied by predominantly siliciclastic sediment supply between ca. 5500 and 5000 vyr BP and enhanced dolomitic sediment supply between 4900 and 4500 vyr BP. A change in the location and the construction technique of the Neolithic lake dwellings at Lake Mondsee can be observed during the period of higher flood frequency. While lake dwellings of the first settlement period (ca. 5800-5250 cal. yr BP) were constructed directly on the wetlands, later constructions (ca. 5400-4700 cal. yr BP) were built on piles upon the water, possibly indicating an adaptation to either increased flood risk or a general increase of the lake level. However, our results also indicate that other than climatic factors (e.g. socio-economic changes) must have influenced the decline of the Mondsee Culture because flood activity generally decreased since 4450 vyr BP, but no new lake dwellings have been established thereafter.

Food responsiveness regulates episodic behavioral states in Caenorhabditis elegans

PubMed Central

McCloskey, Richard J.; Fouad, Anthony D.; Churgin, Matthew A.

2017-01-01

Animals optimize survival and reproduction in part through control of behavioral states, which depend on an organism’s internal and external environments. In the nematode Caenorhabditis elegans a variety of behavioral states have been described, including roaming, dwelling, quiescence, and episodic swimming. These states have been considered in isolation under varied experimental conditions, making it difficult to establish a unified picture of how they are regulated. Using long-term imaging, we examined C. elegans episodic behavioral states under varied mechanical and nutritional environments. We found that animals alternate between high-activity (active) and low-activity (sedentary) episodes in any mechanical environment, while the incidence of episodes and their behavioral composition depend on food levels. During active episodes, worms primarily roam, as characterized by continuous whole body movement. During sedentary episodes, animals exhibit dwelling (slower movements confined to the anterior half of the body) and quiescence (a complete lack of movement). Roaming, dwelling, and quiescent states are manifest not only through locomotory characteristics but also in pharyngeal pumping (feeding) and in egg-laying behaviors. Next, we analyzed the genetic basis of behavioral states. We found that modulation of behavioral states depends on neuropeptides and insulin-like signaling in the nervous system. Sensory neurons and the Foraging homolog EGL-4 regulate behavior through control of active/sedentary episodes. Optogenetic stimulation of dopaminergic and serotonergic neurons induced dwelling, implicating dopamine as a dwell-promoting neurotransmitter. Our findings provide a more unified description of behavioral states and suggest that perception of nutrition is a conserved mechanism for regulating animal behavior. NEW & NOTEWORTHY One strategy by which animals adapt to their internal states and external environments is by adopting behavioral states. The roundworm Caenorhabditis elegans is an attractive model for investigating how behavioral states are genetically and neuronally controlled. Here we describe the hierarchical organization of behavioral states characterized by locomotory activity, feeding, and egg-laying. We show that decisions to engage in these behaviors are controlled by the nervous system through insulin-like signaling and the perception of food. PMID:28228583

Dwell time algorithm based on the optimization theory for magnetorheological finishing

NASA Astrophysics Data System (ADS)

Zhang, Yunfei; Wang, Yang; Wang, Yajun; He, Jianguo; Ji, Fang; Huang, Wen

2010-10-01

Magnetorheological finishing (MRF) is an advanced polishing technique capable of rapidly converging to the required surface figure. This process can deterministically control the amount of the material removed by varying a time to dwell at each particular position on the workpiece surface. The dwell time algorithm is one of the most important key techniques of the MRF. A dwell time algorithm based on the1 matrix equation and optimization theory was presented in this paper. The conventional mathematical model of the dwell time was transferred to a matrix equation containing initial surface error, removal function and dwell time function. The dwell time to be calculated was just the solution to the large, sparse matrix equation. A new mathematical model of the dwell time based on the optimization theory was established, which aims to minimize the 2-norm or ∞-norm of the residual surface error. The solution meets almost all the requirements of precise computer numerical control (CNC) without any need for extra data processing, because this optimization model has taken some polishing condition as the constraints. Practical approaches to finding a minimal least-squares solution and a minimal maximum solution are also discussed in this paper. Simulations have shown that the proposed algorithm is numerically robust and reliable. With this algorithm an experiment has been performed on the MRF machine developed by ourselves. After 4.7 minutes' polishing, the figure error of a flat workpiece with a 50 mm diameter is improved by PV from 0.191λ(λ = 632.8 nm) to 0.087λ and RMS 0.041λ to 0.010λ. This algorithm can be constructed to polish workpieces of all shapes including flats, spheres, aspheres, and prisms, and it is capable of improving the polishing figures dramatically.

Crystal structures of the ATP-binding and ADP-release dwells of the V1 rotary motor

PubMed Central

Suzuki, Kano; Mizutani, Kenji; Maruyama, Shintaro; Shimono, Kazumi; Imai, Fabiana L.; Muneyuki, Eiro; Kakinuma, Yoshimi; Ishizuka-Katsura, Yoshiko; Shirouzu, Mikako; Yokoyama, Shigeyuki; Yamato, Ichiro; Murata, Takeshi

2016-01-01

V1-ATPases are highly conserved ATP-driven rotary molecular motors found in various membrane systems. We recently reported the crystal structures for the Enterococcus hirae A3B3DF (V1) complex, corresponding to the catalytic dwell state waiting for ATP hydrolysis. Here we present the crystal structures for two other dwell states obtained by soaking nucleotide-free V1 crystals in ADP. In the presence of 20 μM ADP, two ADP molecules bind to two of three binding sites and cooperatively induce conformational changes of the third site to an ATP-binding mode, corresponding to the ATP-binding dwell. In the presence of 2 mM ADP, all nucleotide-binding sites are occupied by ADP to induce conformational changes corresponding to the ADP-release dwell. Based on these and previous findings, we propose a V1-ATPase rotational mechanism model. PMID:27807367

Annealing effect of the InAs dot-in-well structure grown by MBE

NASA Astrophysics Data System (ADS)

Zhao, Xuyi; Wang, Peng; Cao, Chunfang; Yan, Jinyi; Zha, Fangxing; Wang, Hailong; Gong, Qian

2017-12-01

We have demonstrated that in situ annealing effect has to be taken into account in order to realize the 1.31 μm InAs quantum dot (QD) lasers with the dot-in-well (DWELL) structure. The photoluminescence (PL) properties have been investigated for the InAs DWELL samples annealed at different temperatures in situ, simulating the annealing process during the growth of the top cladding AlGaAs layer in the laser structure. The QDs with large size in the DWELL structure are vulnerable to the annealing process at temperatures above 550 °C, revealed by the drastic change in the PL spectra. However, the DWELL structure is stable during the annealing process at 540 °C for three hours. The thermal stability of the QDs in the DWELL structure has to be considered in the growth of QD lasers for long wavelength operation.

Home energy efficiency and radon related risk of lung cancer: modelling study

PubMed Central

Milner, James; Shrubsole, Clive; Das, Payel; Jones, Benjamin; Ridley, Ian; Chalabi, Zaid; Hamilton, Ian; Armstrong, Ben; Davies, Michael

2014-01-01

Objective To investigate the effect of reducing home ventilation as part of household energy efficiency measures on deaths from radon related lung cancer. Design Modelling study. Setting England. Intervention Home energy efficiency interventions, motivated in part by targets for reducing greenhouse gases, which entail reduction in uncontrolled ventilation in keeping with good practice guidance. Main outcome measures Modelled current and future distributions of indoor radon levels for the English housing stock and associated changes in life years due to lung cancer mortality, estimated using life tables. Results Increasing the air tightness of dwellings (without compensatory purpose-provided ventilation) increased mean indoor radon concentrations by an estimated 56.6%, from 21.2 becquerels per cubic metre (Bq/m3) to 33.2 Bq/m3. After the lag in lung cancer onset, this would result in an additional annual burden of 4700 life years lost and (at peak) 278 deaths. The increases in radon levels for the millions of homes that would contribute most of the additional burden are below the threshold at which radon remediation measures are cost effective. Fitting extraction fans and trickle ventilators to restore ventilation will help offset the additional burden but only if the ventilation related energy efficiency gains are lost. Mechanical ventilation systems with heat recovery may lower radon levels and the risk of cancer while maintaining the advantage of energy efficiency for the most airtight dwellings but there is potential for a major adverse impact on health if such systems fail. Conclusion Unless specific remediation is used, reducing the ventilation of dwellings will improve energy efficiency only at the expense of population wide adverse impact on indoor exposure to radon and risk of lung cancer. The implications of this and other consequences of changes to ventilation need to be carefully evaluated to ensure that the desirable health and environmental benefits of home energy efficiency are not compromised by avoidable negative impacts on indoor air quality. PMID:24415631

Association between Sleep Duration and 24-Hour Urine Free Cortisol in the MrOS Sleep Study

PubMed Central

Rao, Madhu N.; Blackwell, Terri; Redline, Susan; Punjabi, Naresh M.; Barrett-Connor, Elizabeth; Neylan, Thomas C.; Stone, Katie L.

2013-01-01

Context Short sleep duration is associated with adverse health outcomes, but the mechanisms involved are unknown. It has been postulated that short sleep duration may elevate cortisol levels, but studies have had conflicting results. It is unclear whether these differing findings may be due to methodological issues, such as assessment of sleep duration. Specifically, objective versus subjective methods of measuring habitual sleep duration may account for the conflicting results found in epidemiological studies. Objective Our goal was to determine whether habitual sleep duration, measured objectively (by actigraphy) and subjectively (by self-report), was associated with 24-hour urine free cortisol (UFC), a measure of integrated cortisol secretion. Our secondary goal was to determine whether slow wave sleep (SWS, determined by polysomnography) was associated with 24-hour UFC. Design/Setting Cross sectional study of community dwelling older men. Patients/Participants 325 men (mean age = 76.6 years, SD = 5.5) from the Portland site of the MrOS Sleep Study, who underwent 24-hour urine collection, polysomnography, actigraphy and sleep questionnaire. Primary Outcome 24-hour UFC. Results In this study of community dwelling older men, self-reported sleep duration was inversely related to 24-hour UFC levels. Participants reporting <5 hours of habitual sleep had an adjusted mean 24-hour UFC of 29.8 ug, compared to 28.0 ug in participants reporting >5 to <8 hours of sleep 25.5 ug in those reporting >8 hours of habitual sleep. However, sleep duration determined by actigraphy was not associated with 24-hour UFC in either univariable or multivariable regression models. SWS was not associated with 24-hour UFC. Conclusion Objectively measured (i.e., actigraphic) sleep duration is not associated with 24-hour UFC in these community dwelling older men. This finding, together with prior studies, suggests that elevated levels of integrated cortisol secretion is not the mechanisms by which short sleep duration leads to adverse health outcomes. PMID:24228086

Development of Composite Indices to Measure the Adoption of Pro-Environmental Behaviours across Canadian Provinces

PubMed Central

Canuel, Magalie; Abdous, Belkacem; Bélanger, Diane; Gosselin, Pierre

2014-01-01

Objective The adoption of pro-environmental behaviours reduces anthropogenic environmental impacts and subsequent human health effects. This study developed composite indices measuring adoption of pro-environmental behaviours at the household level in Canada. Methods The 2007 Households and the Environment Survey conducted by Statistics Canada collected data on Canadian environmental behaviours at households' level. A subset of 55 retained questions from this survey was analyzed by Multiple Correspondence Analysis (MCA) to develop the index. Weights attributed by MCA were used to compute scores for each Canadian province as well as for socio-demographic strata. Scores were classified into four categories reflecting different levels of adoption of pro-environmental behaviours. Results Two indices were finally created: one based on 23 questions related to behaviours done inside the dwelling and a second based on 16 questions measuring behaviours done outside of the dwelling. British Columbia, Quebec, Prince-Edward-Island and Nova-Scotia appeared in one of the two top categories of adoption of pro-environmental behaviours for both indices. Alberta, Saskatchewan, Manitoba and Newfoundland-and-Labrador were classified in one of the two last categories of pro-environmental behaviours adoption for both indices. Households with a higher income, educational attainment, or greater number of persons adopted more indoor pro-environmental behaviours, while on the outdoor index, they adopted fewer such behaviours. Households with low-income fared better on the adoption of outdoors pro-environmental behaviours. Conclusion MCA was successfully applied in creating Indoor and Outdoor composite Indices of pro-environmental behaviours. The Indices cover a good range of environmental themes and the analysis could be applied to similar surveys worldwide (as baseline weights) enabling temporal trend comparison for recurring themes. Much more than voluntary measures, the study shows that existing regulations, dwelling type, households composition and income as well as climate are the major factors determining pro-environmental behaviours. PMID:25013929

Physical Performance and Serum 25(OH)vitamin D Status in Community Dwelling Old Mobility Limited Adults: A Cross-Sectional Study.

PubMed

von Berens, Å; Cederholm, T; Fielding, R A; Gustafsson, T; Kirn, D; Laussen, J; Nydahl, M; Travison, T G; Reid, K; Koochek, A

2018-01-01

To examine the potential association between serum 25(OH) vitamin D and the performance on the Short Physical Performance Battery (SPPB) including the sub-components; five repeated chair stands test, 4 meters walk test and balance in older mobility-limited community-dwelling men and women. A cross sectional study was performed in American and Swedish subjects who were examined for potential participation in a combined exercise and nutrition intervention trial. Logistic regression analysis and linear regression analyses were performed to evaluate the association for 25(OH)D with the overall score on the SBBP, chair stand, gait speed and balance. Community-dwelling (mean age 77.6 ± 5.3 years) mobility limited American (n=494) and Swedish (n=116) females (59%) and males. The SPPB (0-12 points) includes chair stand (s), gait speed (m/s) and a balance test. Mobility limitation i.e., SPPB score ≤ 9 was an inclusion criterion. A blood sample was obtained to measure serum 25(OH)vitamin D concentrations. No clear association of 25(OH)D with SPPB scores was detected either when 25(OH)D was assessed as a continuous variable or when categorized according to serum concentrations of <50, 50-75 or <75 nmol/L. However, when analyzing the relationship between 25(OH)D and seconds to perform the chair stands, a significant quadratic relationship was observed. Thus, at serum levels of 25(OH)D above 74 nmol/L, higher concentrations appeared to be advantageous for the chair stand test, whereas for serum levels below 74 nmol/L this association was not observed. This cross- sectional study lacked clear association between serum 25(OH)D and physical performance in mobility limited adults. A potentially interesting observation was that at higher serum levels of 25(OH)D a better performance on the chair stand test was indicated.

The association between total phthalate concentration and non-communicable diseases and chronic inflammation in South Australian urban dwelling men.

PubMed

Bai, Peter Y; Wittert, Gary; Taylor, Anne W; Martin, Sean A; Milne, Robert W; Jenkins, Alicia J; Januszewski, Andrzej S; Shi, Zumin

2017-10-01

To investigate associations between urinary total phthalate concentration, chronic low-grade inflammation and non-communicable diseases in a cohort of South Australian men. 1504 men aged 39-84 years who provided a urinary sample at the follow-up visit of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study, a randomly-selected group of urban-dwelling, community-based men from Adelaide, Australia (n = 2038; study participation rate: 78.1%). Total phthalate concentration was quantified in fasting morning urine samples. Chronic diseases were assessed through self-report questionnaire or directly measured using standardised clinical and laboratory procedures. Inflammatory biomarkers were assayed by ELISA or spectroscopy. Multivariable linear and logistic regression models were applied to determine associations of log-transformed urinary phthalate concentration with inflammation and chronic disease. Total phthalates were detected in 99.6% of urinary samples; geometric mean (95% CI) was 114.1 (109.5-118.9)µg/g creatinine. Higher total phthalate levels were associated with higher levels of hs-CRP, IL-6 (all p < 0.05) and TNF-α but not MPO. Urinary total phthalate concentrations were positively associated with cardiovascular disease, type-2-diabetes and hypertension. Comparing extreme quartiles of total phthalate, prevalence ratios were 1.78 (95% CI 1.17 - 2.71, p-trend = 0.001) for cardiovascular disease and 1.84 (95%CI 1.34 - 2.51, p-trend = 0.001) for type-2-diabetes and 1.14 (95%CI 1.01 - 1.29, p-trend = 0.013) for hypertension. Total phthalates and asthma and depression were not significantly associated. A positive association between total phthalates and cardiovascular disease, type-2-diabetes, hypertension and increased levels of chronic low-grade inflammatory biomarkers was observed in urban-dwelling Australian men. Copyright © 2017 Elsevier Inc. All rights reserved.

Toward a Phenomenology of Dwelling and Building: Hassan Fathy's "Architecture for the Poor" as an Indication.

ERIC Educational Resources Information Center

Seamon, David

The philosophy of Martin Heidegger has major bearing on work in humanistic geography and related environmental fields. Dwelling, according to Heidegger, is the process through which people make their place of existence a home. For all the seeming rightness of Heidegger's view, there is much about dwelling that confounds and alienates many present…

On the use of multi-dimensional scaling and electromagnetic tracking in high dose rate brachytherapy

NASA Astrophysics Data System (ADS)

Götz, Th I.; Ermer, M.; Salas-González, D.; Kellermeier, M.; Strnad, V.; Bert, Ch; Hensel, B.; Tomé, A. M.; Lang, E. W.

2017-10-01

High dose rate brachytherapy affords a frequent reassurance of the precise dwell positions of the radiation source. The current investigation proposes a multi-dimensional scaling transformation of both data sets to estimate dwell positions without any external reference. Furthermore, the related distributions of dwell positions are characterized by uni—or bi—modal heavy—tailed distributions. The latter are well represented by α—stable distributions. The newly proposed data analysis provides dwell position deviations with high accuracy, and, furthermore, offers a convenient visualization of the actual shapes of the catheters which guide the radiation source during the treatment.

Central line-associated bloodstream infections and catheter dwell-time: A theoretical foundation for a rule of thumb.

PubMed

Voets, Philip J G M

2018-05-14

Many clinicians know from experience and medical epidemiological literature that the risk of central line-associated bloodstream infections (CLABSI) increases rapidly with a prolonged catheter dwell-time, but how this infection risk increases over time remains obscure. In this manuscript, a clinically useful rule of thumb is derived, stating that the risk of CLABSI increases in a quadratic fashion with the increase in catheter dwell-time. The proposed rule of thumb could be considered a quick and effortless clinical tool to rationally predict the pattern of CLABSI risk with an increasing catheter dwell-time. Copyright © 2018. Published by Elsevier Ltd.

Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts.

PubMed

McDaniel, Robert B; Burlison, Jonathan D; Baker, Donald K; Hasan, Murad; Robertson, Jennifer; Hartford, Christine; Howard, Scott C; Sablauer, Andras; Hoffman, James M

2016-04-01

Metrics for evaluating interruptive prescribing alerts have many limitations. Additional methods are needed to identify opportunities to improve alerting systems and prevent alert fatigue. In this study, the authors determined whether alert dwell time-the time elapsed from when an interruptive alert is generated to when it is dismissed-could be calculated by using historical alert data from log files. Drug-drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1-4913 s). Resident physicians had longer median alert dwell times than other prescribers (P < 001). The 10 most frequent DDI alerts (n = 8759 alerts) had shorter median dwell times than alerts that only occurred once (P < 001). This metric can be used in future research to evaluate the effectiveness and efficiency of interruptive prescribing alerts. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparisons of social interaction and activities of daily living between long-term care facility and community-dwelling stroke patients.

PubMed

Yoon, Jeong-Ae; Park, Se-Gwan; Roh, Hyo-Lyun

2015-10-01

[Purpose] This study was conducted to compare the correlation between social interaction and activities of daily living (ADL) between community-dwelling and long-term care facility stroke patients. [Subjects and Methods] The Subjects were 65 chronic stroke patients (32 facility-residing, 33 community-dwelling). The Evaluation Social Interaction (ESI) tool was used to evaluate social interaction and the Assessment of Motor and Process Skills (AMPS) measure was used to evaluate ADL. [Results] Both social interaction and ADL were higher in community-dwelling than facility-residing stroke patients. There was a correlation between ESI and ADL for both motor and process skills among facility-residing patients, while only ADL process skills and ESI correlated among community-dwelling patients. In a partial correlation analysis using ADL motor and process skills as control variables, only process skills correlated with ESI. [Conclusion] For rehabilitation of stroke patients, an extended treatment process that combines ADL and social activities is likely to be required. Furthermore, treatment programs and institutional systems that can improve social interaction and promote health maintenance for community-dwelling and facility-residing chronic stroke patients are needed throughout the rehabilitation process.

Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study.

PubMed

Gray, Christine L; Pence, Brian W; Ostermann, Jan; Whetten, Rachel A; O'Donnell, Karen; Thielman, Nathan M; Whetten, Kathryn

2015-08-25

Policy makers struggling to protect the 153 million orphaned and separated children (OSC) worldwide need evidence-based research on the burden of potentially traumatic events (PTEs) and the relative risk of PTEs across different types of care settings. The Positive Outcomes for Orphans study used a 2-stage, cluster-randomized sampling design to identify 1,357 institution-dwelling and 1,480 family-dwelling orphaned and separated children in 5 low- and middle-income countries (LMICs) in sub-Saharan Africa and Asia. We used the Life Events Checklist developed by the National Center for Posttraumatic Stress Disorder to examine self-reported PTEs among 2,235 OSC ages 10-13 at baseline. We estimated prevalence and incidence during 36-months of follow-up and compared the risk of PTEs across care settings. Data collection began between May 2006 and February 2008, depending on the site. Lifetime prevalence by age 13 of any PTE, excluding loss of a parent, was 91.0% (95% confidence interval (CI) = 85.6, 94.5) in institution-dwelling OSC and 92.4% (95% CI = 90.3, 94.0) in family-dwelling OSC; annual incidence of any PTE was lower in institution-dwelling (23.6% [95% CI = 19.4, 28.7]) than family-dwelling OSC (30.0% [95% CI = 28.1, 32.2]). More than half of children in institutions (50.3% [95% CI = 42.5, 58.0]) and in family-based care (54.0% [95% CI = 50.2, 57.7]) had experienced physical or sexual abuse by age 13. Annual incidence of physical or sexual abuse was lower in institution-dwelling (12.9% [95% CI = 9.6, 17.3]) than family-dwelling OSC (19.4% [95% CI = 17.7, 21.3]), indicating statistically lower risk in institution-dwelling OSC (risk difference = 6.5% [95% CI = 1.4, 11.7]). Prevalence and incidence of PTEs were high among OSC, but contrary to common assumptions, OSC living in institutions did not report more PTEs or more abuse than OSC living with families. Current efforts to reduce the number of institution-dwelling OSC may not reduce incidence of PTEs in this vulnerable population. Protection of children from PTEs should be a primary consideration, regardless of the care setting. © Gray et al.

[Symptoms of sick house syndrome and contributory factors; study of general dwellings in Hokkaido].

PubMed

Saijo, Yasuaki; Reiko, Kishi; Sata, Fumihiro; Katakura, Yoko; Urashima, Yukio; Hatakeyama, Akiko; Mukaihara, Norihiko; Kobayashi, Satoshi; Jin, Kazuo; Iikura, Yoji

2002-11-01

The aim of this study was to clarify the "Sick House Syndrome" which has recently received increasing attention, and to investigate relationships between symptoms and the state of general dwellings in Hokkaido. Questionnaires were sent to residents in 1775 dwellings, mainly solitary houses built or remodeled within the past few years by 24 construction companies in Sapporo and its environs, and answers was received from 564. The questionnaires included queries about building structure and characteristics, the residents' habits in the home, and subjective symptoms. We requested one resident who had the most severe symptoms in the dwelling to answer a questionnaire about symptoms. We classified the symptoms into 11 categories, and selected those that developed or were aggravated after the building or remodeling. We defined dwellings in which inhabitants complained of one or more categories of symptoms as the group with sick-house-related disease (developed or aggravated group: DA group), and those in which the inhabitants complained of two or more symptoms as the group with sick house syndrome (more than one organic symptom group: MO group)". Associations between symptoms and dwellings were then studied. There were 201 dwellings for which residents complained of symptoms (37.2%). Of these, 94 were in the DA group (16.7%), and 57 (10.1%) in the MO group. The symptoms that developed or were aggravated after building or remodeling of the dwellings were throat, 7.1%, dermal, 6.9%, psychoneural, 5.3%, eye, 5.1%, and nasal problems, 4.1%. Unpleasant odors form furniture were significant in both groups (DA: crude odds ratio (OR) 2.66, MO: OR 3.24). Use of aromatics was significant in group DA (OR 1.78). Condensation on windows and mold growth in the dwellings were significant in both groups (condensation on windows; DA: OR 2.98, MO: OR 3.32, mold growth; DA: OR 3.11, MO: OR 3.24). In addition, the percentage of dwellings for which residents complained of symptoms increased with signs of dampness (condensation on windows and mold growth). On logistic regression analysis, condensation on windows and mold growth were significant in both groups, and unpleasant odors from furniture in the MO group. It is suggested that symptoms of sick house syndrome are associated with high humidity such as condensation on windows and mold growth, odors from furniture and use of aromatics.

Plasma TNF-α Is Associated with Inflammation and Nutrition Status in Community-Dwelling Japanese Elderly.

PubMed

Oe, Yukiko; Mochizuki, Kazuki; Miyauchi, Rie; Misaki, Yasumi; Kasezawa, Nobuhiko; Tohyama, Kazushige; Goda, Toshinao

2015-01-01

Inflammation has been suggested to play an important role in age-related chronic diseases and disability, and it is associated with nutritional status including obesity and malnutrition. While numerous studies have examined the validity of inflammatory markers in the population studies in Caucasian elderly people, very little information is available for the factors affecting inflammatory markers in Asian elderly people. Among inflammatory markers frequently used for the studies of aging, tumor necrosis factor α (TNF-α) is produced mainly by macrophages, and contributes to production of interleukin-6 (IL-6) and C-reactive protein (CRP), thus directing a chronic inflammatory process in the body. In the present study, we examined the associations between plasma TNF-α level and several factors related to nutrition status, including BMI, albumin, and energy intake in community-dwelling Japanese elderly. We conducted a cross-sectional study of 390 men and women aged 70-86 y (average 73.5 y), who participated in health check-ups. Associations between plasma TNF-α levels, other clinical parameters, and lifestyle factors were analyzed using Spearman's rank correlation coefficient analysis and multiple linear regression analysis. In elderly men, plasma TNF-α level was positively associated with age, white blood cell count, monocyte count, plasma CRP level, serum creatinine, ureic acid, and triacylglycerol levels, and negatively associated with albumin/globulin ratio, eGFR, and serum HDL-cholesterol level. In elderly women, plasma TNF-α level was positively associated with age, plasma CRP level, and serum triacylglycerol level, and negatively associated with serum albumin and HDL-cholesterol levels. The results of this study suggest that plasma TNF-α is associated with inflammation and insulin resistance in both Japanese elderly men and women, and a prominent association of TNF-α with malnutrition status was observed in elderly women.

Community structure of grassland ground-dwelling arthropods along increasing soil salinities.

PubMed

Pan, Chengchen; Feng, Qi; Liu, Jiliang; Li, Yulin; Li, Yuqiang; Yu, Xiaoya

2018-03-01

Ground-dwelling arthropod communities are influenced by numerous biotic and abiotic factors. Little is known, however, about the relative importance of vegetation structure and abiotic environmental factors on the patterns of ground-dwelling arthropod community across a wide range of soil salinities. Here, a field survey was conducted to assess the driving forces controlling ground-dwelling arthropod community in the salinized grasslands in the Hexi Corridor, Gansu Province, China. The data were analyzed by variance partitioning with canonical correspondence analysis (CCA). We found that vegetation structure and edaphic factors were at least of similar importance to the pattern of the whole ground-dwelling arthropod community. However, when all collected ground-dwelling arthropods were categorized into three trophic guilds (predators, herbivores, and decomposers), as these groups use different food sources, their populations were controlled by different driving forces. Predators and decomposers were mainly determined by biotic factors such as vegetation cover and aboveground plant biomass and herbivores by plant density and vegetation cover. Abiotic factors were also major determinants for the variation occurring in these guilds, with predators strongly affected by soil electrical conductivity (EC) and the content of fine particles (silt + clay, CS), herbivores by soil N:P, EC, and CS, and decomposers by soil EC and organic matter content (SOM). Since plant cover, density, and aboveground biomass can indicate resource availability, which are mainly constrained by soil N:P, EC, CS, and SOM, we consider that the ground-dwelling arthropod community in the salinized grasslands was mainly influenced by resource availability.

Role of physical activity in the occurrence of falls and fall-related injuries in community-dwelling adults over 50 years old.

PubMed

Pereira, Catarina L N; Baptista, Fátima; Infante, Paulo

2014-01-01

This study examined the effect of the type, level and amount of physical activity in falls and fall-related injuries. Participants were 506 community-dwelling adults aged >50 years (390 women: 67.7 ± 6.8 years and 116 men: 69.6 ± 6.6 years). Falls, fall-related injuries (slight and severe), and physical activity (type, level and energy expenditure) were evaluated by questionnaires. Confounders included co-morbidities, fear of falling, environmental hazards and physical fitness. After adjustment for confounders, logistic analysis revealed that the likelihood of falling decreased by 2% for each 100 metabolic expenditure (MET-min/week) of total physical activity and increased by 5% for each 100 MET-min/week of vigorous-intensity physical activity; total physical activity >1125 MET-min/week and vigorous physical activity <500 MET-min/week were identified as cut-off values discriminating non-fallers from fallers. Compared to the low physical activity level, increased physical activity levels diminished the likelihood of the occurrence of severe fall-related injuries by 76% (moderate) and 58% (high; p < 0.05) in fallers. Being active, especially sufficiently active, reduces fall-related injuries by decreasing falls and by safeguarding against severe injuries when falls occur. At least 1125 MET-min/week of total physical activity including >500 MET-min/week of vigorous intensity seems to prevent falls and, therefore, fall-related injuries.

Fecal incontinence knowledge, attitudes, and help-seeking behaviors among community-dwelling adults in Korea.

PubMed

Joh, Hee-Kyung; Seong, Moo-Kyung; Ahn, Hyun-Jun

2018-04-01

Fecal incontinence (FI) is a common debilitating disorder that tends to be underreported. Although low health literacy likely contributes to the underreporting, studies on FI knowledge among the general population remain scarce. We investigated how FI knowledge is associated with attitudes and help-seeking behaviors. We conducted a cross-sectional survey among community-dwelling adults undergoing national health screening in Korea. A structured, self-administered questionnaire was used to assess FI knowledge, attitudes, and help-seeking behaviors. Odds ratios (ORs; 95% confidence intervals, CIs) were estimated using logistic regression with adjustment for covariables. Of the 601 participants completing the survey, only 29.8% were aware of the term FI, and their knowledge levels were insufficient. As for FI-related attitudes, 24.6% considered FI to be very rare, and 22.3% considered it to be moderately or less distressing. Individuals who knew the term FI tended to consider FI more common (OR: 2.45; 95%CI: 1.49-4.02) and distressing (OR: 1.68; 95%CI: 1.07-2.63) than those without knowledge. Assuming future FI occurrence, those considering FI to be distressing were less willing to ignore or self-manage the condition (OR: 0.25; 95%CI: 0.11-0.58). Among patients with FI (n = 83), only 30.1% had sought help and 8.4% had consulted doctors. Knowing the term FI was significantly associated with overall help-seeking behavior (OR: 9.23; 95%CI: 2.09-40.77). FI knowledge levels and help-seeking rates were low among community-dwelling adults. FI knowledge was significantly associated with attitudes and help-seeking behaviors. Future public education programs are warranted to improve FI knowledge, attitudes, and help-seeking behaviors. © 2018 Wiley Periodicals, Inc.

Examining evidence based resistance plus balance training in community-dwelling older adults with complex health care needs: Trial protocol for the Muscling Up Against Disability project.

PubMed

Keogh, Justin W L; Henwood, Tim; Gardiner, Paul; Tuckett, Anthony; Hodgkinson, Brent; Rouse, Kevin

Progressive resistance plus balance training (PRBT) has been demonstrated as effective in reducing later life physical disability, falls risk and poor health, even among those with complex health care needs. However, few studies have examined the influence of PRBT on health service utilisation, cognitive wellbeing and training modality acceptance or undertaken a cost benefit analysis. This project will investigate the broad scope benefits of PRBT participation among community-dwelling older Australians receiving Government supported aged care packages for their complex health care needs. Using a modified stepped-wedge design, 248 community-dwelling adults 65 years and older with some level of government support aged care have been randomised into the study. Those randomised to exercise undertake six months of twice weekly machine-based, moderate to high intensity, supervised PRBT, followed by a six month unsupervised, unsupported follow-up. Controls spend six months undertaking usual activities, before entering the PRBT and follow-up phases. Data are collected at baseline and after each of the six month phases. Measures include level of and change in health and care needs, body composition, muscle capacity, falls, sleep, quality of life, nutritional and mental health status. In addition, acceptance and engagement is determined through telephone and focus group interviews complementing a multi-model health cost benefit evaluation. It is hypothesised this study will demonstrate the feasibility and efficacy of PRBT in improving primary and secondary health outcomes for older adults with aged care needs, and will support the value of this modality of exercise as an integral evidence-based service model of care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly.

PubMed

Shinkov, Alexander; Borissova, Anna-Maria; Dakovska, Lilia; Vlahov, Jordan; Kassabova, Lidia; Svinarov, Dobrin; Krivoshiev, Stefan

2016-02-23

To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.

Indoor airborne endotoxin assessment in homes of Paris newborn babies.

PubMed

Dassonville, C; Demattei, C; Vacquier, B; Bex-Capelle, V; Seta, N; Momas, I

2008-12-01

The aims of this study were first to assess airborne endotoxin levels in the dwellings of 162 newborns living in Paris twice during a 1-year period, and second, to identify predictors for endotoxin concentrations using questionnaire data in relation to housing factors and living conditions. Air samples were collected on a glass fiber filter in polystyrene filter holders, using a pump at a flow rate of 3.5 l/min for 24 h placed in the main room of the home. Endotoxin levels were measured using a chromogenic kinetic Limulus Amoebocyte Lysate test. Geometric means (geometric standard deviation) of airborne endotoxin levels at two different visits were respectively 0.509 (4.289) EU/m3 and 0.557 (3.029) EU/m3. Airborne endotoxin levels were significantly increased: (i) in cold season (P = 0.024), with (ii) the presence of visible cockroaches in the previous 12 months at home (P < 0.001), (iii) increased number of inhabitants per square meter (P = 0.012), (iv) the high frequency of cleaning with the floor cloths (P = 0.0014), and (v) the low frequency of vacuuming (P = 0.0045). This study provided for the first time airborne endotoxin levels issued from repeated measurements in Paris dwellings. PRACTICAL IMPLICATIONS This analysis contributed to identify a few factors that determined indoor airborne endotoxin levels. However, the predictive model including housing factors and living conditions poorly estimated endotoxin levels. Consequently, multiple samples and longer sampling periods might improve the estimate of long-term airborne endotoxin exposure especially its variability, in cohort studies.

Levels of Health Literacy in a Community-Dwelling Population of Chinese Older Adults

PubMed Central

Li, Yu; Dong, XinQi

2014-01-01

Background. Lower levels of health literacy have been associated with adverse health outcomes, especially for older adults. However, limited research has been conducted to understand health literacy levels among Chinese American older adults. Methods. The PINE study is an epidemiological cohort of 3,159 community-dwelling Chinese older adults, 95% of whom do not speak or read English. Chinese older adults’ health literacy levels were examined using the Chinese version of the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test. Kruskal–Wallis test and chi-square statistics were used to identify significant differences by sociodemographic and self-reported health characteristics. Pearson and Spearman correlation coefficients were used to examine correlations between personal characteristics and health literacy level. Results. The mean age among this sample of Chinese older adults was 72.8 years (SD = 8.3, range = 60–105) and the mean REALM-R test score was 6.9 [SD = 2.3, range (0–8)]. Health literacy was positively associated with education, marriage status, and number of people living with. Older age, being female, greater number of children, years in the United States, and preference for speaking Cantonese or Taishanese were negatively associated with health literacy. Health literary was not associated with self-reported health status or quality of life. Conclusions. In this Chicago Chinese population, older adults had reasonable levels of health literacy in Chinese. Future longitudinal research is needed to understand risk/protective factors associated with health literacy level in Chinese older adults. PMID:25378449

Older Adults' Reasons for Using Technology while Aging in Place.

PubMed

Peek, Sebastiaan T M; Luijkx, Katrien G; Rijnaard, Maurice D; Nieboer, Marianne E; van der Voort, Claire S; Aarts, Sil; van Hoof, Joost; Vrijhoef, Hubertus J M; Wouters, Eveline J M

2016-01-01

Most older adults prefer to age in place, and supporting older adults to remain in their own homes and communities is also favored by policy makers. Technology can play a role in staying independent, active and healthy. However, the use of technology varies considerably among older adults. Previous research indicates that current models of technology acceptance are missing essential predictors specific to community-dwelling older adults. Furthermore, in situ research within the specific context of aging in place is scarce, while this type of research is needed to better understand how and why community-dwelling older adults are using technology. To explore which factors influence the level of use of various types of technology by older adults who are aging in place and to describe these factors in a comprehensive model. A qualitative explorative field study was set up, involving home visits to 53 community-dwelling older adults, aged 68-95, living in the Netherlands. Purposive sampling was used to include participants with different health statuses, living arrangements, and levels of technology experience. During each home visit: (1) background information on the participants' chronic conditions, major life events, frailty, cognitive functioning, subjective health, ownership and use of technology was gathered, and (2) a semistructured interview was conducted regarding reasons for the level of use of technology. The study was designed to include various types of technology that could support activities of daily living, personal health or safety, mobility, communication, physical activity, personal development, and leisure activities. Thematic analysis was employed to analyze interview transcripts. The level of technology use in the context of aging in place is influenced by six major themes: challenges in the domain of independent living; behavioral options; personal thoughts on technology use; influence of the social network; influence of organizations, and the role of the physical environment. Older adults' perceptions and use of technology are embedded in their personal, social, and physical context. Awareness of these psychological and contextual factors is needed in order to facilitate aging in place through the use of technology. A conceptual model covering these factors is presented. © 2015 S. Karger AG, Basel.

Long-term low-level arsenic exposure is associated with poorer neuropsychological functioning: a Project FRONTIER study.

PubMed

O'Bryant, Sid E; Edwards, Melissa; Menon, Chloe V; Gong, Gordon; Barber, Robert

2011-03-01

Exposure to elements in groundwater (toxic or beneficial) is commonplace yet, outside of lead and mercury, little research has examined the impact of many commonly occurring environmental exposures on mental abilities during the aging process. Inorganic arsenic is a known neurotoxin that has both neurodevelopmental and neurocognitive consequences. The aim of this study was to examine the potential association between current and long-term arsenic exposure and detailed neuropsychological functioning in a sample of rural-dwelling adults and elders. Data were analyzed from 434 participants (133 men and 301 women) of Project FRONTIER, a community-based participatory research study of the epidemiology of health issues of rural-dwelling adults and elders. The results of the study showed that GIS-based groundwater arsenic exposure (current and long-term) was significantly related to poorer scores in language, visuospatial skills, and executive functioning. Additionally, long-term low-level exposure to arsenic was significantly correlated to poorer scores in global cognition, processing speed and immediate memory. The finding of a correlation between arsenic and the domains of executive functioning and memory is of critical importance as these are cognitive domains that reflect the earliest manifestations of Alzheimer's disease. Additional work is warranted given the population health implications associated with long-term low-level arsenic exposure.

Understanding the Experiences of Rural Community-Dwelling Older Adults in Using a New DVD-Delivered Otago Exercise Program: A Qualitative Study.

PubMed

Agha, Arun; Liu-Ambrose, Teresa Y L; Backman, Catherine L; Leese, Jennifer; Li, Linda C

2015-08-13

The home-based Otago Exercise Program (OEP) has been shown to reduce the occurrence of falls in community-dwelling seniors. A new OEP DVD was recently developed for people living in rural communities to be used with minimal coaching by a physical therapist. This study aimed to understand older adults' experiences using the DVD-delivered OEP and explore barriers and facilitators to implementing the DVD-delivered OEP from the participants' perspectives. Rural community-dwelling older adults (75 years and older) who participated in a six-month DVD-delivered OEP study were invited to participate in this qualitative study. Two small group interviews were initially conducted to explore the breadth of participants' experiences with the program. These were followed by semi-structured individual interviews to gain an in-depth understanding of these experiences. An inductive constant comparison analysis of the transcripts was performed. To ensure methodological rigor, field notes, journaling, and an audit trail were maintained, supplemented by peer-review. Of 32 eligible participants, five participated in group interviews and 16 in individual interviews. Three themes emerged. Theme 1, The OEP DVD-useful training tool but in need of more pep, represented participants' experiences that the DVD provided important guidance at program onset, but was too slow and low-energy for longer-term use. Theme 2, Gaining control over one's exercise regimen, but sometimes life gets in the way of staying active, described participants' appreciation of the program's flexibility, but personal health concerns and everyday lives posed challenges to adhering to the program. Theme 3, Social creatures-wanting greater human connection during exercise, described how some participants desired further social interactions for enhancing motivation and receiving guidance. Individuals should be encouraged to refer to the OEP user manual or DVD as needed and engage friends and family in exercises. The importance of exercise even when living with health problems should be raised at program onset, and participants should be supported in working through challenging issues. Health professionals should work with individuals to integrate the program with their everyday activities.

A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT)

PubMed Central

Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

2016-01-01

Introduction Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. Methods and analysis A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver ‘active’ interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to ‘active’ intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. Ethics and dissemination The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the recommended SPIRIT Checklist. Amendments will be reported to relevant regulatory parties. Trial registration number ISRCTN 71002650; Pre-results. PMID:26781504

A cluster randomised controlled trial of advice, exercise or multifactorial assessment to prevent falls and fractures in community-dwelling older adults: protocol for the prevention of falls injury trial (PreFIT).

PubMed

Bruce, Julie; Lall, Ranjit; Withers, Emma J; Finnegan, Susanne; Underwood, Martin; Hulme, Claire; Sheridan, Ray; Skelton, Dawn A; Martin, Finbarr; Lamb, Sarah E

2016-01-18

Falls are the leading cause of accident-related mortality in older adults. Injurious falls are associated with functional decline, disability, healthcare utilisation and significant National Health Service (NHS)-related costs. The evidence base for multifactorial or exercise interventions reducing fractures in the general population is weak. This protocol describes a large-scale UK trial investigating the clinical and cost-effectiveness of alternative falls prevention interventions targeted at community dwelling older adults. A three-arm, pragmatic, cluster randomised controlled trial, conducted within primary care in England, UK. Sixty-three general practices will be randomised to deliver one of three falls prevention interventions: (1) advice only; (2) advice with exercise; or (3) advice with multifactorial falls prevention (MFFP). We aim to recruit over 9000 community-dwelling adults aged 70 and above. Practices randomised to deliver advice will mail out advice booklets. Practices randomised to deliver 'active' interventions, either exercise or MFFP, send all trial participants the advice booklet and a screening survey to identify participants with a history of falling or balance problems. Onward referral to 'active' intervention will be based on falls risk determined from balance screen. The primary outcome is peripheral fracture; secondary outcomes include number with at least one fracture, falls, mortality, quality of life and health service resource use at 18 months, captured using self-report and routine healthcare activity data. The study protocol has approval from the National Research Ethics Service (REC reference 10/H0401/36; Protocol V.3.1, 21/May/2013). User groups and patient representatives were consulted to inform trial design. Results will be reported at conferences and in peer-reviewed publications. A patient-friendly summary of trial findings will be published on the prevention of falls injury trial (PreFIT) website. This protocol adheres to the recommended SPIRIT Checklist. Amendments will be reported to relevant regulatory parties. ISRCTN 71002650; Pre-results. 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/

Complications pertaining to the detection and characterization of individual and embedded single walled carbon nanotubes by scanning electron microscopy

NASA Astrophysics Data System (ADS)

Orbaek, Alvin W.; Barron, Andrew R.

2013-03-01

Comparison of AFM and SEM images of single walled carbon nanotubes (SWNTs) grown within a dielectric matrix reveal subterranean nanotubes that are present within the matrix, and as such can be charge screened by the dielectric. Under adequate imaging conditions for the SWNT/silica sample the intensity of isolated nanotubes is found to be inversely proportional to the instrument dwell time (i.e., shorter dwell times were found to make SWNT intensities brighter). The threshold dwell time required to enable isolated tubes to be visible was found to be 10 μs moreover, the degree change in intensity was found to be nanotube specific, i.e., different SWNTs respond in a different manner at different dwell times. The results indicate that care should be taken when attempting to quantify number density and length distributions of SWNTs on or within a dielectric matrix.Comparison of AFM and SEM images of single walled carbon nanotubes (SWNTs) grown within a dielectric matrix reveal subterranean nanotubes that are present within the matrix, and as such can be charge screened by the dielectric. Under adequate imaging conditions for the SWNT/silica sample the intensity of isolated nanotubes is found to be inversely proportional to the instrument dwell time (i.e., shorter dwell times were found to make SWNT intensities brighter). The threshold dwell time required to enable isolated tubes to be visible was found to be 10 μs moreover, the degree change in intensity was found to be nanotube specific, i.e., different SWNTs respond in a different manner at different dwell times. The results indicate that care should be taken when attempting to quantify number density and length distributions of SWNTs on or within a dielectric matrix. Electronic supplementary information (ESI) available: Plots of SEM for cross over points, raw SEM images used for Fig. 5, and Fig. 6, SEM image of scattering centre, and SEM images with various scan directions at 10 μs dwell time. See DOI: 10.1039/c3nr00142c

Cohort Comparisons in Resources and Functioning among Centenarians: Findings from the Georgia Centenarian Study

ERIC Educational Resources Information Center

Cho, Jinmyoung; Martin, Peter; Margrett, Jennifer; MacDonald, Maurice; Poon, Leonard W.; Johnson, Mary Ann

2012-01-01

The purpose of this study was to examine cohort comparisons in levels of resources (e.g., mental health, physical functioning, economic and social resources, and cognitive functioning) for 211 community-dwelling centenarians (whose Mini-Mental Status Examination score was 23 or higher) of phases I and III of the Georgia Centenarian Study. The…

12 CFR 1282.19 - Affordability-Rent level definitions-tenant income is not known.

Code of Federal Regulations, 2010 CFR

2010-01-01

... very low-, low-, or moderate-income families where the income of the family in the dwelling unit is not known to the Enterprise, the affordability of the unit is determined based on unit size as follows: (a) For moderate-income, maximum affordable rents to count as housing for moderate-income families shall...

An Exploration of the Relationship between Depressive Symptoms and Cortisol Rhythms in Colorado Ranchers

ERIC Educational Resources Information Center

Schulze, Emily; Laudenslager, Mark; Coussons-Read, Mary

2009-01-01

Context: Although the effects of stress on health have been studied in numerous urban-dwelling populations, fewer studies have addressed these effects in rural populations, such as farmers and ranchers. Purpose: The present study focuses on seasonal levels of depressed affect and perceived stress in Western Colorado ranchers, and how those…

7 CFR 1901.203 - Title VIII of the Civil Rights Act of 1968.

Code of Federal Regulations, 2014 CFR

2014-01-01

... background of the dwelling or landlord such as “White private home,” or “all Black subdivision,” may not be... individuals of similar income levels in the housing market area have housing choices available to them..., including minority publications and other minority outlets available in the housing market area. As part of...

7 CFR 1901.203 - Title VIII of the Civil Rights Act of 1968.

Code of Federal Regulations, 2010 CFR

2010-01-01

... background of the dwelling or landlord such as “White private home,” or “all Black subdivision,” may not be... individuals of similar income levels in the housing market area have housing choices available to them..., including minority publications and other minority outlets available in the housing market area. As part of...

7 CFR 1901.203 - Title VIII of the Civil Rights Act of 1968.

Code of Federal Regulations, 2011 CFR

2011-01-01

... background of the dwelling or landlord such as “White private home,” or “all Black subdivision,” may not be... individuals of similar income levels in the housing market area have housing choices available to them..., including minority publications and other minority outlets available in the housing market area. As part of...

7 CFR 1901.203 - Title VIII of the Civil Rights Act of 1968.

Code of Federal Regulations, 2013 CFR

2013-01-01

... background of the dwelling or landlord such as “White private home,” or “all Black subdivision,” may not be... individuals of similar income levels in the housing market area have housing choices available to them..., including minority publications and other minority outlets available in the housing market area. As part of...

7 CFR 1901.203 - Title VIII of the Civil Rights Act of 1968.

Code of Federal Regulations, 2012 CFR

2012-01-01

... background of the dwelling or landlord such as “White private home,” or “all Black subdivision,” may not be... individuals of similar income levels in the housing market area have housing choices available to them..., including minority publications and other minority outlets available in the housing market area. As part of...

A Magic Dwells in Each Beginning? Contextual Effects of Autonomy Support on Students' Intrinsic Motivation in Unfamiliar Situations

ERIC Educational Resources Information Center

Thomas, Almut E.; Mueller, Florian H.

2017-01-01

In school classes students influence each other at conscious and subconscious levels and therefore, students' shared perceptions are considered meaningful for the development of the individual student. This article identified situations where students' class-average perceptions of autonomy support add to the predictive validity of students'…

Education, Functional Limitations, and Life Satisfaction among Older Adults in South Korea

ERIC Educational Resources Information Center

Lee, Eun-Kyoung Othelia; Lee, Jungui

2013-01-01

This study examined the associations of educational level with functioning and life satisfaction among community-dwelling older adults in South Korea ("n" = 4,152). The sample was drawn from Wave I of the Korean Longitudinal Study on Aging. To examine educational disparities, separate analyses were run to note predictors in less educated…

Albumin, Hemoglobin, and the Trajectory of Cognitive Function in Community-Dwelling Older Japanese: A 13-Year Longitudinal Study.

PubMed

Murayama, H; Shinkai, S; Nishi, M; Taniguchi, Y; Amano, H; Seino, S; Yokoyama, Y; Yoshida, H; Fujiwara, Y; Ito, H

2017-01-01

Cognitive function can substantially decline over a long period, and understanding the trajectory of cognitive function is important. However, little is known about the linkage between nutritional biomarkers and long-term cognitive change. We analyzed 13-year longitudinal data for older Japanese to examine the associations of serum albumin and hemoglobin levels with the trajectory of cognitive function. Longitudinal study. Community-based. A total of 1,744 community-dwelling adults aged 65 years or older who participated in annual health examinations in Kusatsu town, Gunma Prefecture, Japan, from 2002-2014. Cognitive function was assessed annually by the Mini-Mental State Examination (MMSE). Albumin and hemoglobin levels at baseline (the year when a respondent first participated in the health examination) were divided into quartiles. Hierarchical linear modeling was used to analyze intrapersonal and interpersonal differences in cognitive function. Participants' MMSE scores decreased at an accelerated rate over the 13-year period. Participants with the lowest baseline albumin level (below the first quartile line) showed a greater accelerated decline in MMSE scores over time, compared with those with the highest level (above the third quartile line). Moreover, MMSE scores in participants with a lower hemoglobin level and lower MMSE score at baseline tended to decline faster over time at an accelerated rate. These findings yield new insights about the complex and diverse roles of these nutritional biomarkers on the trajectory of cognitive function in old age.

Clinical correlates of vitamin D deficiency in established psychosis.

PubMed

Lally, J; Gardner-Sood, P; Firdosi, M; Iyegbe, C; Stubbs, B; Greenwood, K; Murray, R; Smith, S; Howes, O; Gaughran, F

2016-03-22

Suboptimal vitamin D levels have been identified in populations with psychotic disorders. We sought to explore the relationship between vitamin D deficiency, clinical characteristics and cardiovascular disease risk factors among people with established psychosis. Vitamin D levels were measured in 324 community dwelling individuals in England with established psychotic disorders, along with measures of mental health, cardiovascular risk and lifestyle choices. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25-OHD) levels below 10 ng/ml (equivalent to <25 nmol/L) and "sufficient" Vitamin D as above 30 ng/ml (>50 nmol/L). The mean 25-OHD serum level was 12.4 (SD 7.3) ng/ml, (range 4.0-51.7 ng/ml). Forty nine percent (n = 158) were vitamin D deficient, with only 14 % (n = 45) meeting criteria for sufficiency. Accounting for age, gender, ethnicity and season of sampling, serum 25-OHD levels were negatively correlated with waist circumference (r = -0.220, p < 0.002), triglycerides (r = -0.160, p = 0.024), total cholesterol (r = -0.144, p = 0.043), fasting glucose (r = -0.191, p = 0.007), HbA1c (r = -0.183, p = 0.01), and serum CRP levels (r = -0.211, p = 0.003) and were linked to the presence of metabolic syndrome. This is the largest cross sectional study of serum 25-OHD levels in community dwelling individuals with established psychosis, indicating a high level of vitamin D deficiency. Lower vitamin D levels are associated with increased cardiovascular disease risk factors and in particular metabolic syndrome. Further research is needed to define appropriate protocols for vitamin D testing and supplementation in practice to see if this can improve cardiovascular disease risk. ISRCTN number is ISRCTN58667926 Date of registration: 23/04/2010.

Plasma amyloid β, depression, and dementia in community-dwelling elderly.

PubMed

Direk, Nese; Schrijvers, Elisabeth M C; de Bruijn, Renée F A G; Mirza, Saira; Hofman, Albert; Ikram, M Arfan; Tiemeier, Henning

2013-04-01

Plasma amyloid β (Aβ) levels have been associated with an increased risk of Alzheimer's disease (AD). As depression is common before the onset of AD, a few clinical studies tested the cross-sectional association of Aβ levels with depression in elderly and showed incongruous findings. Hence, we tested the longitudinal association between Aβ levels and depressive symptoms in community-dwelling elderly. The study is embedded in a population-based cohort of 980 participants aged 60 years or older from the Rotterdam Study with Aβ levels. Participants were evaluated for depressive symptoms with the Centre for Epidemiological Studies-Depression scale at baseline and repeatedly over the mean follow-up of 11 years. We first performed cross-sectional analyses. Then, we tested the longitudinal association between Aβ levels and depressive symptoms after excluding participants with dementia during follow-up. In cross-sectional analyses, persons with high Aβ(1-40) levels had more clinically relevant depressive symptoms. However, this association was accounted for by persons with clinically relevant depressive symptoms who developed dementia within the next 11 years. In longitudinal analyses, persons with low levels of Aβ(1-40) and Aβ(1-42) without dementia had a higher risk of clinically relevant depressive symptoms during the follow-up. These findings suggest that the cross-sectional association between high plasma Aβ levels and clinically relevant depressive symptoms in the elderly is due to prodromal dementia. In contrast, the longitudinal association between low plasma Aβ levels and depressive symptoms could not be explained by dementia during follow-up suggesting that Aβ peptides may play a distinct role on depression etiology. Copyright © 2013 Elsevier Ltd. All rights reserved.

Living in a Flexible Space

NASA Astrophysics Data System (ADS)

Canepa, Simona

2017-10-01

How long does a space or an object have to last? If in the past an object or a building manufacturing was designed to last as much as possible, nowadays it is designed to have a life related to the time in which it will be used. Flexibility is what characterizes a space, it’s the ability to be variable and adaptable to changes in the lives of users or in relation to the use which these will make over time. The evolution of the labour market, the difficulty of inserting within it and the need to push more and more frequent move today in the trial of living space models increasingly flexible: people, especially young people, are forced to move on territory outlining a new condition to which the flexible nomadic dwellings offer an adequate response, ensuring high functional performance in confined spaces.

Single-molecule analysis of steroid receptor and cofactor action in living cells

PubMed Central

Paakinaho, Ville; Presman, Diego M.; Ball, David A.; Johnson, Thomas A.; Schiltz, R. Louis; Levitt, Peter; Mazza, Davide; Morisaki, Tatsuya; Karpova, Tatiana S.; Hager, Gordon L.

2017-01-01

Population-based assays have been employed extensively to investigate the interactions of transcription factors (TFs) with chromatin and are often interpreted in terms of static and sequential binding. However, fluorescence microscopy techniques reveal a more dynamic binding behaviour of TFs in live cells. Here we analyse the strengths and limitations of in vivo single-molecule tracking and performed a comprehensive analysis on the intranuclear dwell times of four steroid receptors and a number of known cofactors. While the absolute residence times estimates can depend on imaging acquisition parameters due to sampling bias, our results indicate that only a small proportion of factors are specifically bound to chromatin at any given time. Interestingly, the glucocorticoid receptor and its cofactors affect each other’s dwell times in an asymmetric manner. Overall, our data indicate transient rather than stable TF-cofactors chromatin interactions at response elements at the single-molecule level. PMID:28635963

Factors affecting aging cognitive function among community-dwelling older adults.

PubMed

Kim, Chun-Ja; Park, JeeWon; Kang, Se-Won; Schlenk, Elizabeth A

2017-08-01

The study purpose was to determine factors affecting aging cognitive function of 3,645 community-dwelling older adults in Korea. The Hasegawa Dementia Scale assessed aging cognitive function, blood analyses and anthropometrics assessed cardio-metabolic risk factors, and the Geriatric Depression Scale Short Form Korean Version assessed depressive symptoms. Participants with poor aging cognitive function were more likely to be in the late age group (≥75 y) and currently smoking and have a medical history of stroke, high body mass index, and high level of depressive symptoms; they were also less likely to engage in regular meals and physical activities. Regular meals and physical activities may be primary factors for clinical assessment to identify older adults at risk for aging cognitive function. With aging, depressive symptoms and other unhealthy lifestyle behaviours should be managed to prevent cognitive function disorders. © 2017 John Wiley & Sons Australia, Ltd.

Lung Cancer Mortality and Radon Concentration in a Chronically Exposed Neighborhood in Chihuahua, Mexico: A Geospatial Analysis

PubMed Central

Hinojosa de la Garza, Octavio R.; Sanín, Luz H.; Montero Cabrera, María Elena; Serrano Ramirez, Korina Ivette; Martínez Meyer, Enrique; Reyes Cortés, Manuel

2014-01-01

This study correlated lung cancer (LC) mortality with statistical data obtained from government public databases. In order to asses a relationship between LC deaths and radon accumulation in dwellings, indoor radon concentrations were measured with passive detectors randomly distributed in Chihuahua City. Kriging (K) and Inverse-Distance Weighting (IDW) spatial interpolations were carried out. Deaths were georeferenced and Moran's I correlation coefficients were calculated. The mean values (over n = 171) of the interpolation of radon concentrations of deceased's dwellings were 247.8 and 217.1 Bq/m3, for K and IDW, respectively. Through the Moran's I values obtained, correspondingly equal to 0.56 and 0.61, it was evident that LC mortality was directly associated with locations with high levels of radon, considering a stable population for more than 25 years, suggesting spatial clustering of LC deaths due to indoor radon concentrations. PMID:25165752

Influence of pre-injection control parameters on main-injection fuel quantity for an electronically controlled double-valve fuel injection system of diesel engine

NASA Astrophysics Data System (ADS)

Song, Enzhe; Fan, Liyun; Chen, Chao; Dong, Quan; Ma, Xiuzhen; Bai, Yun

2013-09-01

A simulation model of an electronically controlled two solenoid valve fuel injection system for a diesel engine is established in the AMESim environment. The accuracy of the model is validated through comparison with experimental data. The influence of pre-injection control parameters on main-injection quantity under different control modes is analyzed. In the spill control valve mode, main-injection fuel quantity decreases gradually and then reaches a stable level because of the increase in multi-injection dwell time. In the needle control valve mode, main-injection fuel quantity increases with rising multi-injection dwell time; this effect becomes more obvious at high-speed revolutions and large main-injection pulse widths. Pre-injection pulse width has no obvious influence on main-injection quantity under the two control modes; the variation in main-injection quantity is in the range of 1 mm3.

The personal cost of dementia care in Japan: A comparative analysis of residence types.

PubMed

Nakabe, Takayo; Sasaki, Noriko; Uematsu, Hironori; Kunisawa, Susumu; Wimo, Anders; Imanaka, Yuichi

2018-06-12

We aimed to quantify the personal economic burden of dementia care in Japan according to residence type. A cross-sectional online survey was conducted on 3841 caregivers of people with dementia. An opportunity cost approach was used to calculate informal care costs. All costs and the observed/expected (OE) ratio of costs were adjusted using patient sex, age, and care-needs levels, and compared among the residence types. The mean daily informal care time was 8.2 hours, and the mean monthly informal care costs for community-dwelling people with dementia were US$1559. The OE ratio for informal care costs in community-dwelling patients was higher than in institutionalized patients. The inclusion of informal care costs reduced the differences in total personal costs among the residence types. The economic burden of informal care should be considered when quantifying dementia care costs. Copyright © 2018 John Wiley & Sons, Ltd.

Comparison of Urinary Biomarkers of Exposure in Humans Using Electronic Cigarettes, Combustible Cigarettes, and Smokeless Tobacco.

PubMed

Lorkiewicz, Pawel; Riggs, Daniel W; Keith, Rachel J; Conklin, Daniel J; Xie, Zhengzhi; Sutaria, Saurin; Lynch, Blake; Srivastava, Sanjay; Bhatnagar, Aruni

2018-06-02

Cigarette smoking is associated with an increase in cardiovascular disease risk, attributable in part to reactive volatile organic chemicals (VOCs). However, little is known about the extent of VOC exposure due to the use of other tobacco products. We recruited 48 healthy, tobacco users in four groups: cigarette, smokeless tobacco, occasional users of first generation e-cigarette and e-cigarette menthol and 12 healthy nontobacco users. After abstaining for 48 h, tobacco users used an assigned product. Urine was collected at baseline followed by five collections over a 3-h period to measure urinary metabolites of VOCs, nicotine, and tobacco alkaloids. Urinary levels of nicotine were ≃2-fold lower in occasional e-cigarette and smokeless tobacco users than in the cigarette smokers; cotinine and 3-hydroxycotinine levels were similar in all groups. Compared with nontobacco users, e-cigarette users had higher levels of urinary metabolites of xylene, cyanide, styrene, ethylbenzene, and benzene at baseline and elevated urinary levels of metabolites of xylene, N,N-dimethylformamide, and acrylonitrile after e-cigarette use. Metabolites of acrolein, crotonaldehyde, and 1,3-butadiene were significantly higher in smokers than in users of other products or nontobacco users. VOC metabolite levels in smokeless tobacco group were comparable to those found in nonusers with the exception of xylene metabolite-2-methylhippuric acid (2MHA), which was almost three fold higher than in nontobacco users. Smoking results in exposure to a range of VOCs at concentrations higher than those observed with other products, and first generation e-cigarette use is associated with elevated levels of N,N-dimethylformamide and xylene metabolites. This study shows that occasional users of first generation e-cigarettes have lower levels of nicotine exposure than the users of combustible cigarettes. Compared with combustible cigarettes, e-cigarettes, and smokeless tobacco products deliver lower levels of most VOCs, with the exception of xylene, N,N-dimethylformamide, and acrylonitrile, whose metabolite levels were higher in the urine of e-cigarette users than nontobacco users. Absence of anatabine in the urine of e-cigarette users suggests that measuring urinary levels of this alkaloid may be useful in distinguishing between users of e-cigarettes and combustible cigarettes. However, these results have to be validated in a larger cohortcomprised of users of e-cigarettes of multiple brands.

Stability analysis of switched cellular neural networks: A mode-dependent average dwell time approach.

PubMed

Huang, Chuangxia; Cao, Jie; Cao, Jinde

2016-10-01

This paper addresses the exponential stability of switched cellular neural networks by using the mode-dependent average dwell time (MDADT) approach. This method is quite different from the traditional average dwell time (ADT) method in permitting each subsystem to have its own average dwell time. Detailed investigations have been carried out for two cases. One is that all subsystems are stable and the other is that stable subsystems coexist with unstable subsystems. By employing Lyapunov functionals, linear matrix inequalities (LMIs), Jessen-type inequality, Wirtinger-based inequality, reciprocally convex approach, we derived some novel and less conservative conditions on exponential stability of the networks. Comparing to ADT, the proposed MDADT show that the minimal dwell time of each subsystem is smaller and the switched system stabilizes faster. The obtained results extend and improve some existing ones. Moreover, the validness and effectiveness of these results are demonstrated through numerical simulations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Demonstration of a Bias Tunable Quantum Dots-in-a-Well Focal Plane Array

DTIC Science & Technology

2009-01-01

uniformity and mea- sured noise equivalent temperature difference for the double DWELL devices is computed and compared to the same results from the original...first generation DWELL. Finally, higher temperature operation is explored. Overall, the double DWELL devices had lower noise equivalent temperature...infrared photodetectors ( QWIPs ) with various doping and impurities have produced FPAs capable of detection across much of the infrared spectrum from

Role of step size and max dwell time in anatomy based inverse optimization for prostate implants

PubMed Central

Manikandan, Arjunan; Sarkar, Biplab; Rajendran, Vivek Thirupathur; King, Paul R.; Sresty, N.V. Madhusudhana; Holla, Ragavendra; Kotur, Sachin; Nadendla, Sujatha

2013-01-01

In high dose rate (HDR) brachytherapy, the source dwell times and dwell positions are vital parameters in achieving a desirable implant dose distribution. Inverse treatment planning requires an optimal choice of these parameters to achieve the desired target coverage with the lowest achievable dose to the organs at risk (OAR). This study was designed to evaluate the optimum source step size and maximum source dwell time for prostate brachytherapy implants using an Ir-192 source. In total, one hundred inverse treatment plans were generated for the four patients included in this study. Twenty-five treatment plans were created for each patient by varying the step size and maximum source dwell time during anatomy-based, inverse-planned optimization. Other relevant treatment planning parameters were kept constant, including the dose constraints and source dwell positions. Each plan was evaluated for target coverage, urethral and rectal dose sparing, treatment time, relative target dose homogeneity, and nonuniformity ratio. The plans with 0.5 cm step size were seen to have clinically acceptable tumor coverage, minimal normal structure doses, and minimum treatment time as compared with the other step sizes. The target coverage for this step size is 87% of the prescription dose, while the urethral and maximum rectal doses were 107.3 and 68.7%, respectively. No appreciable difference in plan quality was observed with variation in maximum source dwell time. The step size plays a significant role in plan optimization for prostate implants. Our study supports use of a 0.5 cm step size for prostate implants. PMID:24049323

Serum cytokine levels related to exposure to volatile organic compounds and PM2.5 in dwellings and workplaces in French farmers - a mechanism to explain nonsmoking COPD.

PubMed

Audi, Christelle; Baïz, Nour; Maesano, Cara N; Ramousse, Ollivier; Reboulleau, Damien; Magnan, Antoine; Caillaud, Denis; Annesi-Maesano, Isabella

2017-01-01

Although French farmers smoke less on average than individuals from the general population, they suffer more from COPD. Exposure to biological and chemical air pollutants in the farm may be the cause of these higher COPD rates. This study investigates the role of bio-contaminants, including the relationship of exposure to volatile organic compounds (VOCs) and fine particulate matter (of diameter of 2.5 µm [PM 2.5 ]) objectively measured in the farm settings (dwellings and workplaces) to serum cytokines involved in COPD, in a sample of 72 farmers from 50 farms in the Auvergne region, France. Mean concentrations of VOCs were highest inside the home, while levels of PM 2.5 were highest in workplaces (stables and granaries). After adjusting for confounders, high exposure to PM 2.5 was significantly associated with a decreased level of serum cytokines (among others, IL13: β: -0.94, CI: -1.5 to -0.2, P -value =0.004; IL8: β: -0.82, CI: -1.4 to -0.2, P -value =0.005) and high exposure to VOCs according to a VOC global score with a decreased IL13 level (β: -0.5, CI: -0.9 to -0.1, P -value =0.01). Moreover, respiratory symptoms and diseases, including COPD, were associated with a decreased level of serum cytokines significantly in the case of IL5. An alteration of immune response balance in terms of cytokine levels in relation to indoor chemical air pollution exposure may contribute to respiratory health impairment in farmers.

Receipt of Caregiving and Fall Risk in US Community-dwelling Older Adults.

PubMed

Hoffman, Geoffrey J; Hays, Ron D; Wallace, Steven P; Shapiro, Martin F; Yakusheva, Olga; Ettner, Susan L

2017-04-01

Falls and fall-related injuries (FRI) are common and costly occurrences among older adults living in the community, with increased risk for those with physical and cognitive limitations. Caregivers provide support for older adults with physical functioning limitations, which are associated with fall risk. Using the 2004-2012 waves of the Health and Retirement Study, we examined whether receipt of low (0-13 weekly hours) and high levels (≥14 weekly hours) of informal care or any formal care is associated with lower risk of falls and FRIs among community-dwelling older adults. We additionally tested whether serious physical functioning (≥3 activities of daily living) or cognitive limitations moderated this relationship. Caregiving receipt categories were jointly significant in predicting noninjurious falls (P=0.03) but not FRIs (P=0.30). High levels of informal care category (P=0.001) and formal care (P<0.001) had stronger associations with reduced fall risk relative to low levels of informal care. Among individuals with ≥3 activities of daily living, fall risks were reduced by 21% for those receiving high levels of informal care; additionally, FRIs were reduced by 42% and 58% for those receiving high levels of informal care and any formal care. High levels of informal care receipt were also associated with a 54% FRI risk reduction among the cognitively impaired. Fall risk reductions among older adults occurred predominantly among those with significant physical and cognitive limitations. Accordingly, policy efforts involving fall prevention should target populations with increased physical functioning and cognitive limitations. They should also reduce financial barriers to informal and formal caregiving.

Effects of HUD-supported lead hazard control interventions in housing on children's blood lead.

PubMed

Clark, Scott; Galke, Warren; Succop, Paul; Grote, Joann; McLaine, Pat; Wilson, Jonathan; Dixon, Sherry; Menrath, William; Roda, Sandy; Chen, Mei; Bornschein, Robert; Jacobs, David

2011-02-01

The Evaluation of the US Department of Housing and Urban Development Lead-Based Paint Hazard Control Grant Program studied the effectiveness of the housing intervention performed in reducing the blood lead of children at four post-intervention times (6-months, 1-year, 2-years, and 3-years). A repeat measures analysis showed that blood lead levels declined up to three-years post-intervention. The results at each successive collection time were significantly lower than at the previous post-intervention time except for the difference between the levels at two and three years. At two-years post-intervention, geometric mean blood lead levels were approximately 37% lower than at pre-intervention. Children with pre-intervention blood lead levels as low as 10 μg/dL experienced substantial declines in blood lead levels. Previous studies have found substantial improvements only if a child's pre-intervention blood lead level was above 20 μg/dL. Individual interior lead hazard control treatments as grouped by Interior Strategy were not a significant predictor of post-intervention blood lead levels. However, children living in dwellings where exterior lead hazard control interventions were done had lower blood lead levels at one-year post-intervention than those living in dwellings without the exterior interventions (all other factors being equal), but those differences were only significant when the mean exterior paint lead loading at pre-intervention was about the 90th percentile (7.0mg/cm(2)). This observation suggests that exterior lead hazard control can be an important component of a lead hazard control plan. Children who were six to eleven months of age at pre-intervention had a significant increase in blood lead at one-year post-intervention, probably due to other exposures. Copyright © 2010 Elsevier Inc. All rights reserved.

Elderly Men Have Low Levels of Anti-Müllerian Hormone and Inhibin B, but with High Interpersonal Variation: A Cross-Sectional Study of the Sertoli Cell Hormones in 615 Community-Dwelling Men

PubMed Central

Chong, Yih Harng; Dennis, Nicola A.; Connolly, Martin J.; Teh, Ruth; Jones, Gregory T.; van Rij, Andre M.; Farrand, Stephanie; Campbell, A. John; MLennan, Ian S.

2013-01-01

The Sertoli cells of the testes secrete anti-Müllerian hormone (Müllerian inhibiting Substance, AMH) and inhibin B (InhB). AMH triggers the degeneration of the uterine precursor in male embryos, whereas InhB is part of the gonadal-pituitary axis for the regulation of sperm production in adults. However, both hormones are also putative regulators of homeostasis, and age-related changes in these hormones may therefore be important to the health status of elderly men. The levels of AMH in elderly men are unknown, with limited information being available about age-related changes in InhB. We have therefore used ELISAs to measure Sertoli cell hormone levels in 3 cohorts of community-dwelling men in New Zealand. In total, 615 men were examined, 493 of which were aged 65 or older. Serum AMH and InhB levels inversely correlated with age in men older than 50 years (p<0.001) but not in the younger men. A minority of elderly men had undetectable levels of AMH and InhB. The variation in hormone levels between similarly aged men increased with the age of men. AMH and InhB partially correlated with each other as expected (r = 0.48, p<0.001). However, the ratio of the two Sertoli hormones varied significantly between men, with this variation increasing with age. Elderly men selected for the absence of cardiovascular disease had AMH levels similar to those of young men whereas their InhB levels did not differ from aged-matched controls. These data suggests that Sertoli cell number and function changes with age, but with the extent and nature of the changes varying between men. PMID:23940675

Quantitative comparison of inflammatory infiltrate and linear contraction in human skin treated with 90-microsecond pulsed and 900-microsecond dwell time carbon dioxide lasers.

PubMed

Bucalo, B D; Moy, R L

1998-12-01

Skin resurfacing with 90-microsecond pulse duration carbon dioxide (CO2) resurfacing lasers has been reported to have shorter duration of erythema compared with skin resurfacing with 900-microsecond dwell time lasers. The presence of inflammatory infiltrate following resurfacing may correlate with the persistence of this erythema. Furthermore, skin treated with the 90-microsecond pulse duration laser and the 900-microsecond dwell time lasers both result in equivalent improvement of rhytids in the treated skin. To quantitative the inflammatory cell infiltrate and linear contraction of skin treated with the 90-microsecond pulsed and 900-microsecond dwell time CO2 lasers at intervals of 2 and 4 weeks after treatment. Volunteers were recruited from patients who were planning to undergo full face laser resurfacing under general anesthesia. Informed consent was obtained from all volunteers. In the posterior auricular areas of all volunteers, four separate rectangular areas were marked using a skin marking pen and a template. Two rectangular areas behind the right ear were treated with 6 passes of the 90-microsecond laser and two rectangular areas behind the left ear were treated with the 900-microsecond dwell time laser. The resurfaced areas were wiped with a moist cotton swab and then patted dry with dry gauze between passes. Contraction measurements of the resurfaced areas were taken before and immediately after laser treatment and again at 2 and 4 weeks following treatment. Punch biopsies were also performed at 2 and 4 weeks after treatment in an area of skin different from where contraction measurements were taken. The number of inflammatory cells present in the skin at 2 and 4 weeks after laser resurfacing are greater for skin resurfaced with a 900-microsecond dwell time laser than a 90-microsecond pulse time laser. Linear contraction of skin immediately after treatment was 18% greater with the 900-microsecond dwell time laser than with the 90-microsecond pulsed laser. The difference in the amount of contraction produced by the lasers tended to decrease over time. At 4 weeks there was a 10% difference in mean linear contraction between the two laser types. Increased numbers of inflammatory cells in skin resurfaced with the 900-microsecond dwell time laser may explain the observed persistence of erythema associated with the 900-microsecond dwell time laser. Measurable linear contraction produced by the 900-microsecond dwell time laser was initially 18% greater than the 90-microsecond pulse laser. This difference tends to decrease over time.

Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study

PubMed Central

Pence, Brian W; Ostermann, Jan; Whetten, Rachel A; O’Donnell, Karen; Thielman, Nathan M; Whetten, Kathryn

2015-01-01

Background: Policy makers struggling to protect the 153 million orphaned and separated children (OSC) worldwide need evidence-based research on the burden of potentially traumatic events (PTEs) and the relative risk of PTEs across different types of care settings. Methods: The Positive Outcomes for Orphans study used a 2-stage, cluster-randomized sampling design to identify 1,357 institution-dwelling and 1,480 family-dwelling orphaned and separated children in 5 low- and middle-income countries (LMICs) in sub-Saharan Africa and Asia. We used the Life Events Checklist developed by the National Center for Posttraumatic Stress Disorder to examine self-reported PTEs among 2,235 OSC ages 10–13 at baseline. We estimated prevalence and incidence during 36-months of follow-up and compared the risk of PTEs across care settings. Data collection began between May 2006 and February 2008, depending on the site. Results: Lifetime prevalence by age 13 of any PTE, excluding loss of a parent, was 91.0% (95% confidence interval (CI) = 85.6, 94.5) in institution-dwelling OSC and 92.4% (95% CI = 90.3, 94.0) in family-dwelling OSC; annual incidence of any PTE was lower in institution-dwelling (23.6% [95% CI = 19.4, 28.7]) than family-dwelling OSC (30.0% [95% CI = 28.1, 32.2]). More than half of children in institutions (50.3% [95% CI = 42.5, 58.0]) and in family-based care (54.0% [95% CI = 50.2, 57.7]) had experienced physical or sexual abuse by age 13. Annual incidence of physical or sexual abuse was lower in institution-dwelling (12.9% [95% CI = 9.6, 17.3]) than family-dwelling OSC (19.4% [95% CI = 17.7, 21.3]), indicating statistically lower risk in institution-dwelling OSC (risk difference = 6.5% [95% CI = 1.4, 11.7]). Conclusion: Prevalence and incidence of PTEs were high among OSC, but contrary to common assumptions, OSC living in institutions did not report more PTEs or more abuse than OSC living with families. Current efforts to reduce the number of institution-dwelling OSC may not reduce incidence of PTEs in this vulnerable population. Protection of children from PTEs should be a primary consideration, regardless of the care setting. PMID:26374801

Dementia in developing countries: Does education play the same role in India as in the West?

PubMed

Iyer, Gowri K; Alladi, Suvarna; Bak, Thomas H; Shailaja, Mekala; Mamidipudi, Annapurna; Rajan, Amulya; Gollahalli, Divyaraj; Chaudhuri, Jaydip Ray; Kaul, Subhash

2014-01-01

Evidence suggests that education protects from dementia by enhancing cognitive reserve. However, this may be influenced by several socio-demographic factors. Rising numbers of dementia in India, high levels of illiteracy and heterogeneity in socio-demographic factors provide an opportunity to explore this relationship. To study the association between education and age at dementia onset, in relation to socio-demographic factors. Association between age at dementia onset and literacy was studied in relationship to potential confounding factors such as gender, bilingualism, place of dwelling, occupation, vascular risk factors, stroke, family history of dementia and dementia subtypes. Case records of 648 dementia patients diagnosed in a specialist clinic in a University hospital in Hyderabad, India were examined. All patients were prospectively enrolled as part of an ongoing longitudinal project that aims to evaluate dementia subjects with detailed clinical, etiological, imaging, and follow-up studies. Of the 648 patients, 98 (15.1%) were illiterate. More than half of illiterate skilled workers were engaged in crafts and skilled agriculture unlike literates who were in trade or clerical jobs. Mean age at onset in illiterates was 60.1 years and in literates 64.5 years (p=0.0002). Factors independently associated with age at dementia onset were bilingualism, rural dwelling and stroke, but not education. Our study demonstrates that in India, rural dwelling, bilingualism, stroke and occupation modify the relationship between education and dementia.

Relational coordination between community health nurses and other professionals in delivering care to community-dwelling frail people.

PubMed

Cramm, Jane Murray; Hoeijmakers, Marjan; Nieboer, Anna Petra

2014-03-01

The first aim of this study was to investigate whether relational coordination is higher between primary care professionals and community health nurses than among other professionals. The second aim of this study was to investigate the relationship between different levels of relational coordination and primary care professionals' satisfaction with the care delivery of community health nurses. Community health nursing is based on the notion that all activities should respond to frail people's needs in a coordinated way, together with other professionals. Relational coordination is therefore important for the effective health-care delivery by these nurses. This cross-sectional study was performed among 167 professionals (n = 323, response rate 52%) who regularly worked with community health nurses. The results showed a higher degree of relational coordination with community health nurses than with other primary care professionals. Multilevel analyses revealed that professionals' satisfaction with the care delivered by community health nurses was influenced positively by relational coordination. Enhancing relational coordination between community health nurses and other primary care professionals in the neighborhood may improve the delivery of care to community-dwelling frail people. Comprehensive care delivery to community-dwelling frail people requires strong connections between all health and social care professionals. Community health nurses may be an important factor in strengthening these connections. © 2013 John Wiley & Sons Ltd.

The Ground-Dwelling Arthropod Community of Península Valdés in Patagonia, Argentina

PubMed Central

Cheli, Germán H.; Corley, J. C.; Bruzzone, O.; del Brío, M.; Martínez, F.; Román, N. Martínez; Ríos, I.

2010-01-01

This is the first study based on a planned and intensive sampling effort that describes the community composition and structure of the ground-dwelling arthropod assemblage of Península Valdés (Patagonia). It was carried out using pitfall traps, opened for two weeks during the summers of 2005, 2006 and 2007. A total of 28, 111 individuals were caught. Ants (Hymenoptera: Formicidae) dominated this community, followed by beetles (Coleoptera) and spiders (Araneae). The most abundant species were Pheidole bergi Mayr (Hymenoptera: Formicidae) and Blapstinus punctulatus Solier (Coleoptera: Tenebrionidae). Two new species were very recently described as new based on specimens collected during this study: Valdesiana curiosa Carpintero, Dellapé & Cheli (Hemiptera, Miridae) and Anomaloptera patagonica Dellapé & Cheli (Hemiptera, Oxycarenidae). The order Coleoptera was the most diverse taxa. The distribution of abundance data was best described by the logarithmic series model both at the family and species levels, suggesting that ecological relationships in this community could be controlled by a few factors. The community was dominated by predators from a trophic perspective. This suggests that predation acts as an important factor driving the distribution and abundances of surface-dwelling arthropods in this habitat and as such serves as a key element in understanding desert, above-ground community structure. These findings may also be useful for management and conservation purposes in arid Patagonia. PMID:20572783

Constipation in community-dwelling elders: prevalence and associated factors.

PubMed

Song, Hyo Jeong

2012-01-01

The purpose of this study was to measure the prevalence of constipation in community-dwelling elders and to analyze associated factors. The study sample comprised 186 elders from 5 Senior Citizen Centers in Jeju-si. This community-based cross-sectional study used a structured questionnaire to collect data via interviews with respondents. Interviews were completed by the principal investigator and an assistant. Interviews required approximately 20 minutes and were completed in the senior centers. Respondents were queried about demographic characteristics, body mass index, alcohol consumption, level of exercise, depression, and lower urinary tract symptoms including urinary incontinence. Bowel elimination symptoms were queried, and the presence of constipation was established using Rome II criteria. Multiple logistic regression analysis was used to test for associations between potential risk factors and constipation. The prevalence of constipation in this community-dwelling sample population was 25.8%. The most common symptoms were "hard or lumpy stools" reported by 30.8% and "straining during a bowel movement" reported by 27.1%. Analysis via logistic regression found that constipation is associated with lower urinary tract symptoms (odds ratio = 1.1; 95% confidence interval: 1.03-1.14) and obesity (body mass index ≥ 25 kg/m) (odds ratio = 2.4; 95% confidence interval: 1.01-5.57). Slightly more than one quarter of the elderly reported symptoms of constipation. Associated factors were presence of lower urinary tract symptoms and obesity.

The ground-dwelling arthropod community of Península Valdés in Patagonia, Argentina.

PubMed

Cheli, Germán H; Corley, J C; Bruzzone, O; Brío, M Del; Martínez, F; Román, N Martínez; Ríos, I

2010-01-01

This is the first study based on a planned and intensive sampling effort that describes the community composition and structure of the ground-dwelling arthropod assemblage of Península Valdés (Patagonia). It was carried out using pitfall traps, opened for two weeks during the summers of 2005, 2006 and 2007. A total of 28,111 individuals were caught. Ants(Hymenoptera: Formicidae) dominated this community, followed by beetles (Coleoptera) and spiders (Araneae). The most abundant species were Pheidole bergi Mayr (Hymenoptera:Formicidae) and Blapstinus punctulatus Solier (Coleoptera: Tenebrionidae). Two new species were very recently described as new based on specimens collected during this study: Valdesianacuriosa Carpintero, Dellapé & Cheli (Hemiptera, Miridae) and Anomaloptera patagonica Dellapé& Cheli (Hemiptera, Oxycarenidae). The order Coleoptera was the most diverse taxa. The distribution of abundance data was best described by the logarithmic series model both at the family and species levels, suggesting that ecological relationships in this community could be controlled by a few factors. The community was dominated by predators from a trophic perspective. This suggests that predation acts as an important factor driving the distribution and abundances of surface-dwelling arthropods in this habitat and as such serves as a key element in understanding desert, above-ground community structure. These findings may also be useful for management and conservation purposes in arid Patagonia.

Probing into hybrid organic-molecule and InAs quantum-dots nanosystem with multistacked dots-in-a-well units

NASA Astrophysics Data System (ADS)

Chen, Miaoxiang; Kobashi, Kazufumi

2012-09-01

Hybridizing air-stable organic-molecules with advanced III-V semiconductor quantum-dots (QDs) structures can be utilized to create a new generation of biochemical sensing devices. In order to enhance their optical performances, the active regions in these QDs structures commonly consist of multistacked dots-in-a-well (DWELL) units. The effects of grafted molecules on the performances of the QDs structures with multistacked DWELLs, however, still remain unclear. Here, we show the significant improvements in the optical properties of InAs QDs in a hybrid nanosystem obtained by grafting biocompatible diazonium salt compound (amine donor) atop InAs QDs structure. Since its interface between the QDs structure and molecular monolayer retains an uncontaminated and non-oxidized condition, the nanosystem is an ideal platform to study the intrinsic properties of charge-carrier transport inside the system. Because of the complexity of the energy-levels in the QDs structure due to the existing surface QDs and DWELLs, selective excitation wavelengths (400, 633, and 885 nm, respectively) with different photo-energies are used to exactly analyze the complete charging mechanism in these QDs. A clear view of charge-carrier transfer inside the nanosystem is revealed by employing photoluminescence technique under selective-wavelength excitations. The present work provides new quantitative evidences for exploiting inorganic QDs applications in complex biological systems.

Long-term exposure to wind turbine noise at night and risk for diabetes: A nationwide cohort study.

PubMed

Poulsen, Aslak Harbo; Raaschou-Nielsen, Ole; Peña, Alfredo; Hahmann, Andrea N; Nordsborg, Rikke Baastrup; Ketzel, Matthias; Brandt, Jørgen; Sørensen, Mette

2018-04-14

Focus on renewable energy sources and reduced unit costs has led to increased number of wind turbines (WTs). WT noise (WTN) is reported to be highly annoying at levels from 30 to 35 dB and up, whereas for traffic noise people report to be highly annoyed from 40 to 45 dB and up. This has raised concerns as to whether WTN may increase risk for major diseases, as exposure to traffic noise has consistently been associated with increased risk of cardiovascular disease and diabetes. We identified all Danish dwellings within a radius of 20 WT heights and 25% of all dwellings within 20-40 WT heights from a WT. Using detailed data on WT type and hourly wind data at each WT position and height, we estimated hourly outdoor and low frequency indoor WTN for all dwellings, aggregated as nighttime 1- and 5-year running means. Using nationwide registries, we identified a study population of 614,731 persons living in these dwellings in the period from 1996 to 2012, of whom 25,148 developed diabetes. Data were analysed using Poisson regression with adjustment for individual and area-levels covariates. We found no associations between long-term exposure to WTN during night and diabetes risk, with incidence rate ratios (IRRs) of 0.90 (95% confidence intervals (CI): 0.79-1.02) and 0.92 (95% CI: 0.68-1.24) for 5-year mean nighttime outdoor WTN of 36-42 and ≥ 42 dB, respectively, compared to < 24 dB. For 5-year mean nighttime indoor low frequency WTN of 10-15 and ≥ 15 dB we found IRRs of 0.90 (0.78-1.04) and 0.74 (95% CI: 0.41-1.34), respectively, when compared to and < 5 dB. The lack of association was consistent across strata of sex, distance to major road, validity of noise estimate and WT height. The present study does not support an association between nighttime WTN and higher risk of diabetes. However, there were only few cases in the highest exposure groups and findings need reproduction. Copyright © 2018 Elsevier Inc. All rights reserved.

Factors associated with fluctuations in IgA and IgG levels at the cervix during the menstrual cycle.

PubMed

Safaeian, Mahboobeh; Falk, Roni T; Rodriguez, Ana Cecilia; Hildesheim, Allan; Kemp, Troy; Williams, Marcus; Morera, Lidiana; Barrantes, Manuel; Herrero, Rolando; Porras, Carolina; Pinto, Ligia

2009-02-01

The objective of this analysis was to describe patterns and determinants of cervical immunoglobulin A (IgA) and G (IgG) levels during the menstrual cycle. A total of 154 women who attended 3 visits coinciding with the follicular, periovulatory, and luteal phases of their menstrual cycle were studied. Cervical secretions were collected at each visit for determination of total IgA and IgG levels. Questionnaires administered at each visit inquired about demographic characteristics and behavioral practices. Total IgA and IgG levels were higher among oral contraceptive (OC) users than among naturally cycling women (hereafter, "non-OC users"). IgA and IgG levels decreased at midcycle, particularly among non-OC users. After adjustment for phase of the current cycle, specimen weight, and detection of blood in the sample, report of a recent illness was associated with lower IgA and IgG levels and increased age with higher IgA and IgG levels among OC users and non-OC users. Increased lifetime number of pregnancies was associated with a higher IgA level among non-OC users and a higher IgG level among OC users. Change in immunoglobulin levels between visits was associated with sample weight and the presence of blood for both OC users and non-OC users. Phase of the current menstrual cycle and OC use were significant determinants of cervical IgA and IgG levels. The impacts of endogenous and exogenous hormones on cervical immunoglobulin levels should be further investigated.

General relation between the group delay and dwell time in multicomponent electron systems

NASA Astrophysics Data System (ADS)

Zhai, Feng; Lu, Junqiang

2016-10-01

For multicomponent electron scattering states, we derive a general relation between the Wigner group delay and the Bohmian dwell time. It is found that the definition of group delay should account for the phase of the spinor wave functions of propagating modes. The difference between the group delay and dwell time comes from both the interference delay and the decaying modes. For barrier tunneling of helical electrons on a surface of topological insulators, our calculations including the trigonal-warping term show that the decaying modes can contribute greatly to the group delay. The derived relation between the group delay and the dwell time is helpful to unify the two definitions of tunneling time in a quite general situation.

Designing Playgrounds for Multifamily Dwellings

ERIC Educational Resources Information Center

Corrado, Paul

1978-01-01

Substantive, cost-sensitive guidelines are offered for determining basic playground needs, performance specifications, and site location, as well as construction techniques, for playgrounds servicing multi-family dwellings. (MJB)

Effects of green-tree retention on abundance and guild composition of corticolous arthropods

Treesearch

Juraj Halaj; Charles B. Halpern; Hoonbok Yi

2009-01-01

We studied the effects of varying levels and patterns of green-tree retention on the community composition of bark-dwelling arthropods. Arthropods were sampled with crawl traps installed on 280 live trees and 260 snags (all Douglas-fir) at three locations (experimental blocks) in the western Cascade Range of Oregon and Washington. Sampling coincided with the breeding...

Variable infection of stream salamanders in the southern Appalachians by the trematode Metagonimoides oregonensis (family: Heterophyidae)

Treesearch

Jennie A. Wyderko; Ernest F. Benfield; John C. Maerz; Kristen C. Cecala; Lisa K. Belden

2015-01-01

Many factors contribute to parasites varying in host specificity and distribution among potential hosts. Metagonimoides oregonensis is a digenetic trematode that uses stream-dwelling plethodontid salamanders as second intermediate hosts in the Eastern US. We completed a field survey to identify which stream salamander species, at a regional level, are most...

Use of Contextual Information and Prediction by Struggling Adult Readers: Evidence from Reading Times and Event-Related Potentials

ERIC Educational Resources Information Center

Ng, Shukhan; Payne, Brennan R.; Steen, Allison A.; Stine-Morrow, Elizabeth A. L.; Federmeier, Kara D.

2017-01-01

We employed self-paced reading and event-related potential measures to investigate how adults of varying literacy levels use sentence context information when reading. Community-dwelling participants read strongly and weakly constraining sentences that ended with expected or unexpected target words. Skilled readers showed N400s that were graded by…

Use of Contextual Information and Prediction by Struggling Adult Readers: Evidence from Reading Times and Event-Related Potentials.

ERIC Educational Resources Information Center

Ng, Shukhan; Payne, Brennan R.; Steen, Allison A.; Stine-Morrow, Elizabeth A. L.; Federmeier, Kara D.

2017-01-01

We employed self-paced reading and event-related potential measures to investigate how adults of varying literacy levels use sentence context information when reading. Community-dwelling participants read strongly and weakly constraining sentences that ended with expected or unex- pected target words. Skilled readers showed N400s that were graded…

Mixed effects of geolocators on reproduction and survival of Cerulean Warblers, a canopy-dwelling, long-distance migrant

Treesearch

Douglas W. Raybuck; Jeffrey L. Larkin; Scott H. Stoleson; Than J. Boves

2017-01-01

Light-level geolocators, miniature devices used for tracking avian migration over the full annual cycle, are being widely deployed on small migratory passerines. However, the effects of carrying geolocators on the breeding biology of songbirds are unclear, and variable species- and guild-specific conclusions have been drawn regarding their effects on return rates (...

Response of ground-dwelling spider assemblages to prescribed fire following stand structure manipulation in the southern Cascade Range

Treesearch

Nancy E. Gillette; Richard S. Vetter; Sylvia R. Mori; Carline R. Rudolph; Dessa R. Welty

2008-01-01

We assessed spider (Arachnida: Araneae) responses to prescribed fire following stand s tructure treatments in ponderosa pine (Pinus ponderosa Dougl. ex P. & C. Laws.) stands in the Cascade Range of California. Stands were logged or left untreated to create three levels of structural diversity. We logged one treatment to minimize old-growth...

Potential health effects of indoor radon exposure.

PubMed Central

Radford, E P

1985-01-01

Radon-222 is a ubiquitous noble gas arising from decay of radium-226 normally present in the earth's crust. Alpha radiation from inhaled short-lived daughters of radon readily irradiates human bronchial epithelium, and there is now good evidence of excess risk of lung cancer in underground miners exposed to higher concentrations. In homes, radon levels are highly variable, showing approximately log-normal distributions and often a small fraction of homes with high concentrations of radon and radon daughters. Factors affecting indoor concentrations include type of bedrock under dwellings, house foundation characteristics, radon dissolved in artesian water, and ventilation and degree of air movement in living spaces. Despite much recent work, exposures to radon daughters by the general public are not well defined. From application of risk assessments in miners to home conditions, it appears that about 25% or more of lung cancers among nonsmokers over the age of 60, and about 5% in smokers, may be attributable to exposure to radon daughters at home. It may be necessary to take remedial action to reduce this hazard in those dwellings with elevated levels of radon, and new construction should take account of this problem. PMID:4085431

Item Response Theory Modeling and Categorical Regression Analyses of the Five-Factor Model Rating Form: A Study on Italian Community-Dwelling Adolescent Participants and Adult Participants.

PubMed

Fossati, Andrea; Widiger, Thomas A; Borroni, Serena; Maffei, Cesare; Somma, Antonella

2017-06-01

To extend the evidence on the reliability and construct validity of the Five-Factor Model Rating Form (FFMRF) in its self-report version, two independent samples of Italian participants, which were composed of 510 adolescent high school students and 457 community-dwelling adults, respectively, were administered the FFMRF in its Italian translation. Adolescent participants were also administered the Italian translation of the Borderline Personality Features Scale for Children-11 (BPFSC-11), whereas adult participants were administered the Italian translation of the Triarchic Psychopathy Measure (TriPM). Cronbach α values were consistent with previous findings; in both samples, average interitem r values indicated acceptable internal consistency for all FFMRF scales. A multidimensional graded item response theory model indicated that the majority of FFMRF items had adequate discrimination parameters; information indices supported the reliability of the FFMRF scales. Both categorical (i.e., item-level) and scale-level regression analyses suggested that the FFMRF scores may predict a nonnegligible amount of variance in the BPFSC-11 total score in adolescent participants, and in the TriPM scale scores in adult participants.

Evaluation and equity audit of the domestic radon programme in England.

PubMed

Zhang, Wei; Chow, Yimmy; Meara, Jill; Green, Martyn

2011-09-01

The U.K. has a radon programme to limit the radon risk to health. This involves advice on protective measures in new buildings, technical guidance on their installation, encouragement of radon measurements and remediation in existing dwellings in high radon areas. We have audited the radon programme at the level of individual homes to identify factors that influence the likelihood of remediation. 49% of the householders responded to our survey and 30% of the respondents stated that they had done some remediation to reduce the indoor radon levels. We found that householders with higher incomes and higher socio-economic status are more likely than others to remediate. Householders are less likely to remediate if they have one of the following: living in a property with a high radon concentration, current smokers in the dwelling, being unemployed or an unskilled worker, long length of time living in that property or elderly (65+ years) living by themselves. Householders appeared to be more likely to remediate if they considered the information on radon and its risk to be very clear and useful. This emphasises the importance of communication with householders. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A life cycle assessment of distributed energy production from organic waste: Two case studies in Europe.

PubMed

Evangelisti, Sara; Clift, Roland; Tagliaferri, Carla; Lettieri, Paola

2017-06-01

By means of the life cycle assessment methodology, the purpose of this study is to assess the environmental impact when biomethane from organic waste produced at residential level is used to supply energy to a group of dwellings in the distributed generation paradigm. Three different Combined Heat and Power systems, such as fuel cells, Stirling engine and micro gas turbine, installed at household level are assessed in two different settings: one in Northern Europe (UK) and one in Southern Europe (Italy). Different operating strategies are investigated for each technology. Moreover, marginal electricity production technologies are analysed to assess their influence on the results. This study has demonstrated that the type of bio-methane fed micro-CHP technology employed has a significantly different environmental impact: fuel cells are the most environmentally friendly solution in every category analysed; Stirling engines, although can supply heat to the largest number of dwellings are the least environmentally friendly technology. However, key factors investigated in the model presented in this paper influence the decision making on the type of technology adopted and the operating strategy to be implemented. Copyright © 2017 Elsevier Ltd. All rights reserved.

Age independency of mobility decrease assessed using the Locomotive Syndrome Risk Test in elderly with disability: a cross-sectional study.

PubMed

Yamada, Keiko; Muranaga, Shingo; Shinozaki, Tomohiro; Nakamura, Kozo; Tanaka, Sakae; Ogata, Toru

2018-01-26

Mobility decrease is reportedly age-dependent in community dwelling elderly, and a major factor of disability in the geriatric population. The purpose of this study is to examine whether mobility decrease, as assessed using a set of tests, is similarly age-dependent in elderly adults who already have disability. One hundred thirty-five community-dwelling elderly (54 men, 81 women) with disability and 1469 independent community dwellers (1009 men, 460 women) were analyzed. Disability was defined having a certified need for care under the long-term care insurance system in Japan. Lower extremity mobility decrease was quantified using the Locomotive Syndrome Risk Test, which comprises the two-step test, stand-up test, and 25-Question Geriatric Locomotive Function Scale (GLFS-25). Multivariable regression analyses indicated no age-related decrease in the three test scores among elderly with disability, whereas these scores all decreased with age among independent community dwellers. All the test scores decreased as care level increased. Mobility decrease among elderly adults with disability is unrelated to age. However, the severity of care level is associated with mobility decrease.

Trajectory of Declines in Physical Activity in Community-Dwelling Older Women: Social Cognitive Influences

PubMed Central

Hall, Katherine S.; Motl, Robert W.; White, Siobhan M.; Wójcicki, Thomas R.; Hu, Liang; Doerksen, Shawna E.

2009-01-01

Studies examining physical activity behavior suggest that activity levels decline with age. Such declines are particularly problematic among older adults in light of the research suggesting a protective effect of physical activity on numerous physical health outcomes associated with independent living. Despite a growing recognition of the importance of a physically active lifestyle, little is known about the role of demographic and psychosocial variables on this trajectory of change. In this study, the roles played by outcome expectations, self-efficacy, and functional limitations on changes in physical activity levels over a 2-year period in older women were assessed using latent growth curve modeling. Data were obtained from 249 community-dwelling older women (M age = 68.12, n = 81 Black, and n = 168 White). Demographic, health status, and psychosocial data were collected via self-report upon entry into the study. Self-reported physical activity was assessed at baseline and again at 12 and 24 months. As expected, physical activity declined over the 2-year period. Self-efficacy demonstrated an indirect association with the trajectory of decline in physical activity through functional limitations. Importantly, the pattern of relationships appears independent of demographic factors and chronic health conditions. PMID:19528360

Gender and Age Effects on the Trajectory of Depression in Opioid Users during Methadone Maintenance Treatment.

PubMed

Wang, Peng-Wei; Lin, Huang-Chi; Yang, Yi-Hsin Connie; Hsu, Chih-Yao; Chung, Kuan-Sheng; Wu, Hung-Chi; Yen, Cheng-Fang

2017-01-01

Both heroin use and depression are significant health problems. Methadone maintenance treatment (MMT) can be of great benefit to heroin users. However, changes in the level of depression in heroin users during MMT are not clear. Gender and age are also important factors in the development of depression, and whether gender and age moderate changes in depression in heroin users during MMT warrants further study. This study aimed to explore: (1) the trajectory of depression in opioid users during MMT and (2) the moderating effects of gender and age on the trajectory of depression in opioid users receiving MMT. A total of 294 intravenous heroin users were recruited into this 9-month observational study. The level of depression was measured at the intake interview and at follow-up interviews every 3 months. A latent growth model was used to analyze the trajectory of the level of depression among the participants. Depression improved rapidly during the first 3 months of MMT and slowly after the first 3 months in both the female and male heroin users. There was no gender difference in the level of depression at each follow-up point. The level of depression in the female heroin users decreased faster than that in the male heroin users. In addition, the level of depression in the younger heroin users decreased faster than that in the older subjects. Depression in female and younger heroin users improved more rapidly than in male and older subjects, respectively.

Socioeconomic and Outdoor Meteorological Determinants of Indoor Temperature and Humidity in New York City Dwellings

PubMed Central

Tamerius, JD; Perzanowski, MS; Acosta, LM; Jacobson, JS; Goldstein, IF; Quinn, JW; Rundle, AG; Shaman, J

2013-01-01

Background Numerous mechanisms link outdoor weather and climate conditions to human health. It is likely that many health conditions are more directly affected by indoor rather than outdoor conditions. Yet, the relationship between indoor temperature and humidity conditions to outdoor variability, and the heterogeneity of the relationship among different indoor environments are largely unknown. Methods We use 5–14 day measures of indoor temperature and relative humidity from 327 dwellings in New York City for the years 2008–2011 to investigate the relationship between indoor climate, outdoor meteorological conditions, socioeconomic conditions, and building descriptors. Study households were primarily middle-income and located across the boroughs of Brooklyn, Queens, Bronx, and Manhattan. Results Indoor temperatures are positively associated with outdoor temperature during the warm season and study dwellings in higher socioeconomic status neighborhoods are significantly cooler. During the cool season, outdoor temperatures have little effect on indoor temperatures; however, indoor temperatures can range more than 10 °C between dwellings despite similar outdoor temperatures. Apartment buildings tend to be significantly warmer than houses and dwellings on higher floors are also significantly warmer than dwellings on lower floors. Outdoor specific humidity is positively associated with indoor specific and relative humidity, but there is no consistent relationship between outdoor and indoor relative humidity. Conclusions In New York City, the relationship between indoor and outdoor temperature and humidity conditions vary significantly between dwellings. These results can be used to inform studies of health outcomes for which temperature or humidity is an established factor affecting human health and highlights the need for more research on the determinants of indoor climate. PMID:24077420

Associations between Depressive State and Impaired Higher-Level Functional Capacity in the Elderly with Long-Term Care Requirements.

PubMed

Ogata, Soshiro; Hayashi, Chisato; Sugiura, Keiko; Hayakawa, Kazuo

2015-01-01

Depressive state has been reported to be significantly associated with higher-level functional capacity among community-dwelling elderly. However, few studies have investigated the associations among people with long-term care requirements. We aimed to investigate the associations between depressive state and higher-level functional capacity and obtain marginal odds ratios using propensity score analyses in people with long-term care requirements. We conducted a cross-sectional study based on participants aged ≥ 65 years (n = 545) who were community dwelling and used outpatient care services for long-term preventive care. We measured higher-level functional capacity, depressive state, and possible confounders. Then, we estimated the marginal odds ratios (i.e., the change in odds of impaired higher-level functional capacity if all versus no participants were exposed to depressive state) by logistic models using generalized linear models with the inverse probability of treatment weighting (IPTW) for propensity score and design-based standard errors. Depressive state was used as the exposure variable and higher-level functional capacity as the outcome variable. The all absolute standardized differences after the IPTW using the propensity scores were < 10% which indicated negligible differences in the mean or prevalence of the covariates between non-depressive state and depressive state. The marginal odds ratios were estimated by the logistic models with IPTW using the propensity scores. The marginal odds ratios were 2.17 (95%CI: 1.13-4.19) for men and 2.57 (95%CI: 1.26-5.26) for women. Prevention of depressive state may contribute to not only depressive state but also higher-level functional capacity.

Levels of health literacy in a community-dwelling population of Chinese older adults.

PubMed

Simon, Melissa A; Li, Yu; Dong, XinQi

2014-11-01

Lower levels of health literacy have been associated with adverse health outcomes, especially for older adults. However, limited research has been conducted to understand health literacy levels among Chinese American older adults. The PINE study is an epidemiological cohort of 3,159 community-dwelling Chinese older adults, 95% of whom do not speak or read English. Chinese older adults' health literacy levels were examined using the Chinese version of the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test. Kruskal-Wallis test and chi-square statistics were used to identify significant differences by sociodemographic and self-reported health characteristics. Pearson and Spearman correlation coefficients were used to examine correlations between personal characteristics and health literacy level. The mean age among this sample of Chinese older adults was 72.8 years (SD = 8.3, range = 60-105) and the mean REALM-R test score was 6.9 [SD = 2.3, range (0-8)]. Health literacy was positively associated with education, marriage status, and number of people living with. Older age, being female, greater number of children, years in the United States, and preference for speaking Cantonese or Taishanese were negatively associated with health literacy. Health literary was not associated with self-reported health status or quality of life. In this Chicago Chinese population, older adults had reasonable levels of health literacy in Chinese. Future longitudinal research is needed to understand risk/protective factors associated with health literacy level in Chinese older adults. © The Author 2014. 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.

Chronic Peripheral Inflammation is Associated With Cognitive Impairment in Schizophrenia: Results From the Multicentric FACE-SZ Dataset

PubMed Central

Bulzacka, Ewa; Boyer, Laurent; Schürhoff, Franck; Godin, Ophélia; Berna, Fabrice; Brunel, Lore; Andrianarisoa, Méja; Aouizerate, Bruno; Capdevielle, Delphine; Chéreau-Boudet, Isabelle; Chesnoy-Servanin, Gabrielle; Danion, Jean-Marie; Dubertret, Caroline; Dubreucq, Julien; Faget, Catherine; Gabayet, Franck; Le Gloahec, Tifenn; Llorca, Pierre-Michel; Mallet, Jasmina; Misdrahi, David; Rey, Romain; Richieri, Raphaëlle; Passerieux, Christine; Roux, Paul; Yazbek, Hanan; Leboyer, Marion; Fond, Guillaume

2016-01-01

Objectives: Inflammation, measured by abnormal blood C-reactive protein (CRP) level, has been described in schizophrenia (SZ), being inconsistently related to impaired cognitive functions. The aim of the present study is to investigate cognitive impairment associated with abnormal CRP levels in a large multi-centric sample of community-dwelling SZ patients, using a comprehensive neuropsychological battery. Method: Three hundred sixty-nine community-dwelling stable SZ subjects (76.2% men, mean age 32.7 y) were included and tested with a comprehensive battery of neuropsychological tests. Abnormal CRP level was defined as >3mg/L. Results: Multiple factor analysis revealed that abnormal CRP levels, found in 104 patients (28.2%), were associated with impaired General Intellectual Ability and Abstract Reasoning (aOR = 0.56, 95% CI 0.35–0.90, P = .014), independently of age, sex, education level, psychotic symptomatology, treatments, and addiction comorbidities. Abnormal CRP levels were also associated with the decline of all components of working memory (respectively effect size [ES] = 0.25, P = .033; ES = 0.27, P = .04; ES = 0.33, P = .006; and ES = 0.38, P = .004) and a wide range of other impaired cognitive functions, including memory (ES = 0.26, P = .026), learning abilities (ES = 0.28, P = .035), semantic memory (ES = 0.26, P = .026), mental flexibility (ES = 0.26, P = .044), visual attention (ES = 0.23, P = .004) and speed of processing (ES = 0.23, P = .043). Conclusion: Our results suggest that abnormal CRP level is associated with cognitive impairment in SZ. Evaluating the effectiveness of neuroprotective anti-inflammatory strategies is needed in order to prevent cognitive impairment in SZ. PMID:27143795

Final Report: Multi-Scale Analysis of Deformation and Failure in Polycrystalline Titanium Alloys Under High Strain-Rates

DTIC Science & Technology

2015-12-28

Masoud Anahid, Mahendra K. Samal , and Somnath Ghosh. Dwell fatigue crack nucleation model based on crystal plasticity finite element simulations of...induced crack nucleation in polycrystals. Model. Simul. Mater. Sci. Eng., 17, 064009. 19. Anahid, M., Samal , M. K. & Ghosh, S. (2011). Dwell fatigue...Jour. Plas., 24:428–454, 2008. 4. M. Anahid, M. K. Samal , and S. Ghosh. Dwell fatigue crack nucleation model based on crystal plasticity finite

Indoor environmental quality in French dwellings and building characteristics

NASA Astrophysics Data System (ADS)

Langer, Sarka; Ramalho, Olivier; Derbez, Mickaël; Ribéron, Jacques; Kirchner, Severine; Mandin, Corinne

2016-03-01

A national survey on indoor environmental quality covering 567 residences in mainland France was performed during 2003-2005. The measured parameters were temperature, relative humidity, CO2, and the indoor air pollutants: fourteen individual volatile organic compounds (VOC), four aldehydes and particulate matter PM10 and PM2.5. The measured indoor concentrations were analyzed for correlations with the building characteristics: type of dwelling, period of construction, dwelling location, type of ventilation system, building material, attached garage and retrofitting. The median night time air exchange rate (AER) for all dwellings was 0.44 h-1. The night time AER was higher in apartments (median = 0.49 h-1) than in single-family houses (median = 0.41 h-1). Concentration of formaldehyde was approximately 30% higher in dwellings built after 1990 compared with older ones; it was higher in dwellings with mechanical ventilation and in concrete buildings. The VOC concentrations depended on the building characteristics to various extents. The sampling season influenced the majority of the indoor climate parameters and the concentrations of the air pollutants to a higher degree than the building characteristics. Multivariate linear regression models revealed that the indoor-outdoor difference in specific humidity, a proxy for number of occupants and their indoor activities, remained a significant predictor for most gaseous and particulate air pollutants. The other strong predictors were outdoor concentration, smoking, attached garage and AER (in descending order).

Investigation of force, contact area, and dwell time in finger-tapping tasks on membrane touch interface.

PubMed

Liu, Na; Yu, Ruifeng

2018-06-01

This study aimed to determine the touch characteristics during tapping tasks on membrane touch interface and investigate the effects of posture and gender on touch characteristics variables. One hundred participants tapped digits displayed on a membrane touch interface on sitting and standing positions using all fingers of the dominant hand. Touch characteristics measures included average force, contact area, and dwell time. Across fingers and postures, males exerted larger force and contact area than females, but similar dwell time. Across genders and postures, thumb exerted the largest force and the force of the other four fingers showed no significant difference. The contact area of the thumb was the largest, whereas that of the little finger was the smallest; the dwell time of the thumb was the longest, whereas that of the middle finger was the shortest. Relationships among finger sizes, gender, posture and touch characteristics were proposed. The findings helped direct membrane touch interface design for digital and numerical control products from hardware and software perspectives. Practitioner Summary: This study measured force, contact area, and dwell time in tapping tasks on membrane touch interface and examined effects of gender and posture on force, contact area, and dwell time. The findings will direct membrane touch interface design for digital and numerical control products from hardware and software perspectives.

Asthma, Allergy and Eczema among Adults in Multifamily Houses in Stockholm (3-HE Study) - Associations with Building Characteristics, Home Environment and Energy Use for Heating

PubMed Central

Norbäck, Dan; Lampa, Erik; Engvall, Karin

2014-01-01

Risk factors for asthma, allergy and eczema were studied in a stratified random sample of adults in Stockholm. In 2005, 472 multifamily buildings (10,506 dwellings) were invited (one subject/dwelling) and 7,554 participated (73%). Associations were analyzed by multiple logistic regression, adjusting for gender, age, smoking, country of birth, income and years in the dwelling. In total, 11% had doctor's diagnosed asthma, 22% doctor's diagnosed allergy, 23% pollen allergy and 23% eczema. Doctor's diagnosed asthma was more common in dwellings with humid air (OR = 1.74) and mould odour (OR = 1.79). Doctor's diagnosed allergy was more common in buildings with supply exhaust air ventilation as compared to exhaust air only (OR = 1.45) and was associated with redecoration (OR = 1.48) and mould odour (OR = 2.35). Pollen allergy was less common in buildings using more energy for heating (OR = 0.75) and was associated with humid air (OR = 1.76) and mould odour (OR = 2.36). Eczema was more common in larger buildings (OR 1.07) and less common in buildings using more energy for heating (OR = 0.85) and was associated with water damage (OR = 1.47), humid air (OR = 1.73) and mould odour (OR = 2.01). Doctor's diagnosed allergy was less common in buildings with management accessibility both in the neighbourhood and in larger administrative divisions, as compared to management in the neighbourhood only (OR = 0.49; 95% CI 0.29–0.82). Pollen allergy was less common if the building maintenance was outsourced (OR = 0.67; 95% CI 0.51–0.88). Eczema was more common when management accessibility was only at the division level (OR = 1.49; 95% CI 1.06–2.11). In conclusions, asthma, allergy or eczema were more common in buildings using less energy for heating, in larger buildings and in dwellings with redecorations, mould odour, dampness and humid air. There is a need to reduce indoor chemical emissions and to control dampness. Energy saving may have consequences for allergy and eczema. More epidemiological studies are needed on building management organization. PMID:25479551

Model and algorithm based on accurate realization of dwell time in magnetorheological finishing.

PubMed

Song, Ci; Dai, Yifan; Peng, Xiaoqiang

2010-07-01

Classically, a dwell-time map is created with a method such as deconvolution or numerical optimization, with the input being a surface error map and influence function. This dwell-time map is the numerical optimum for minimizing residual form error, but it takes no account of machine dynamics limitations. The map is then reinterpreted as machine speeds and accelerations or decelerations in a separate operation. In this paper we consider combining the two methods in a single optimization by the use of a constrained nonlinear optimization model, which regards both the two-norm of the surface residual error and the dwell-time gradient as an objective function. This enables machine dynamic limitations to be properly considered within the scope of the optimization, reducing both residual surface error and polishing times. Further simulations are introduced to demonstrate the feasibility of the model, and the velocity map is reinterpreted from the dwell time, meeting the requirement of velocity and the limitations of accelerations or decelerations. Indeed, the model and algorithm can also apply to other computer-controlled subaperture methods.

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

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.

Comparison of public and private care management agencies under public long-term care insurance in Japan: a cross-sectional study.

PubMed

Yoshioka, Yoji; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Okubo, Ichiro

2010-01-01

Long-Term Care Insurance (LTCI), which started in April 2000, allowed private business corporations to provide long-term care services which had been provided by social welfare corporations or public agencies in the previous long-term care scheme. This study compared differences in care management plans for community-dwelling frail elderly people between public care management agencies and private care management agencies. The subjects were 309 community-dwelling frail elderly people living in a suburban city with a population of approximately 55,000 and who had been using community-based long-term care services of the LTCI for 6 months from April 2000. The characteristics of the care management agencies (public/private) were identified using a claims database. After comparing profiles of users and their care mix between those managed by public agencies and by private agencies, the effect of the characteristics of care management agencies on LTCI service use was examined. Public care management agencies favored younger subjects (P = 0.003), male subjects (P = 0.006) and people with a higher need for care (P = 0.02) than private agencies. The number of service items used was significantly larger in public agencies than in their private counterparts. In multivariate regression analysis, the utilization of community-based long-term care service was significantly greater among beneficiaries managed by private agencies than those managed by public agencies (P = 0.02). Private care management agencies play an important role in promoting the use of care services, but their quality of care plans might be questionable.

Prevalence, risk factors and health outcomes associated with polypharmacy among urban community-dwelling older adults in multi-ethnic Malaysia.

PubMed

Lim, Li Min; McStea, Megan; Chung, Wen Wei; Nor Azmi, Nuruljannah; Abdul Aziz, Siti Azdiah; Alwi, Syireen; Kamarulzaman, Adeeba; Kamaruzzaman, Shahrul Bahyah; Chua, Siew Siang; Rajasuriar, Reena

2017-01-01

Polypharmacy has been associated with increased morbidity and mortality in the older population. The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia. This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drug-drug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models. A total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation. A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.

Ground-dwelling ant fauna of sites with high levels of copper.

PubMed

Diehl, E; Sanhudo, C E; Diehl-Fleig, Ed

2004-02-01

Richness and diversity of ant species are related to environmental factors such as vegetation, soil, presence of heavy metals, and insecticides, which allow the use of the assemblage members as terrestrial indicators of environmental conservation status. This study presents the results of ground ants surveyed in Minas do Camaquã in the municipality of Cacapava do Sul (Camaquã Basin), State of Rio Grande do Sul. Collections were performed in four sites, which high levels of copper in the soil, three of which--a mine, a liquid reject, and a solid reject-, had sparse or no plant cover, and one site where Pinus has been used for rehabilitation. Parque das Guaritas was the control site, since it presented normal levels of copper and a dense savanna cover. For each site, three transect lines extending 100 m were draw, and at each 10 m sardine baits were distributed; after two hours the ants present were collected. Hand collections in all five sites were performed during one hour (capture effort). A total of 51 species belonging to 17 genera were collected. The control site was the richest in ant species (r = 45). Sites with high level of copper and poor plant cover presented the lowest richness: mine (r = 14), solid reject (r = 15), and liquid reject (r = 16). In contrast, the site planted with Pinus presented an increment in richness (r = 24) of ground-dwelling ants, suggesting a reahabilitation process.

A structural equation model of the relationship between muscle strength, balance performance, walking endurance and community integration in stroke survivors

PubMed Central

2017-01-01

Purpose To use structural equation modelling (SEM) to determine (1) the direct and indirect associations of strength of paretic lower limb muscles with the level of community integration, and (2) the direct association of walking endurance and balance performance with the level of community integration in community-dwelling stroke survivors. Materials and methods In this cross-sectional study of 105 stroke survivors, the Subjective Index of Physical and Social Outcome (SIPSO) was used to measure the level of community integration. Lower-limb strength measures included isometric paretic ankle strength and isokinetic paretic knee peak torque. The Berg Balance Scale (BBS) and the 6-minute walk test (6MWT) were used to evaluate balance performance and walking endurance, respectively. Results SEM revealed that the distance walked on the 6MWT had the strongest direct association with the SIPSO score (β = 0.41, p <0.001). An increase of one standard deviation in the 6MWT distance resulted in an increase of 0.41 standard deviations in the SIPSO score. Moreover, dorsiflexion strength (β = 0.18, p = 0.044) and the BBS score (β = 0.21, p = 0.021) had direct associations with the SIPSO score. Conclusions The results of the proposed model suggest that rehabilitation training of community-dwelling stroke survivors could focus on walking endurance, balance performance and dorsiflexor muscle strengthening if the aim is to augment the level of community integration. PMID:29049293

Gamma Radiation Doses In Sweden

NASA Astrophysics Data System (ADS)

Almgren, Sara; Barregârd, Lars; Isaksson, Mats

2008-08-01

Gamma dose rate measurements were performed in one urban and one rural area using thermoluminescence dosimeters (TLD) worn by 46 participants and placed in their dwellings. The personal effective dose rates were 0.096±0.019(1 SD) and 0.092±0.016(1 SD)μSv/h in the urban and rural area, respectively. The corresponding dose rates in the dwellings were 0.11±0.042(1 SD) and 0.091±0.026(1 SD)μSv/h. However, the differences between the areas were not significant. The values were higher in buildings made of concrete than of wood and higher in apartments than in detached houses. Also, 222Rn measurements were performed in each dwelling, which showed no correlation with the gamma dose rates in the dwellings.

Parametric study of injection rates with solenoid injectors in an injection quantity and rate measuring device

DOE PAGES

Busch, Stephen; Miles, Paul C.

2015-03-31

A Moehwald HDA (HDA is a German acronym: Hydraulischer Druckanstieg: hydraulic pressure increase) injection quantity and rate measuring unit is used to investigate injection rates obtained with a fast-acting, preproduction diesel solenoid injector. Experimental parametric variations are performed to determine their impact on measured injection rate traces. A pilot–main injection strategy is investigated for various dwell times; these preproduction injectors can operate with very short dwell times with distinct pilot and main injection events. Dwell influences the main injection rate shape. Furthermore, a comparison between a diesel-like fuel and a gasoline-like fuel shows that injection rates are comparable for amore » single injection but dramatically different for multiple injections with short dwells.« less

Experiences of attending day care services designed for people with dementia - a qualitative study with individual interviews.

PubMed

Strandenæs, Margit Gausdal; Lund, Anne; Rokstad, Anne Marie Mork

2018-06-01

Day care is assumed to promote independence in home-dwelling people with dementia, increase well-being and enhance social stimulation. Few studies have directly engaged people with dementia to better understand the benefits and impacts of such services. The aim of this study was to explore attendees' experiences with day care designed for people with dementia. This study had a qualitative descriptive design and included individual interviews with 17 users attending day care. The analysis was undertaken using content analyses. The participants reported that day care had a positive influence on their physical functioning, cognition, well-being, and situation at home because they were provided with social stimulation, meals, and activities. Day care contributed to the maintenance of a rhythm and structure in everyday life. Furthermore, the staff contributed to making the day care a safe place to be and enhanced a sense of belonging. This study reveals the positive impact of day care on the daily lives of people with dementia because this service contributes to the enhancement of activities and social support, prevents isolation, and enhances practical and cognitive functioning as experienced by the users. The staff has a major impact on the experience of the participants in the day care.

Associations between ACE-Inhibitors, Angiotensin Receptor Blockers, and Lean Body Mass in Community Dwelling Older Women.

PubMed

Bea, Jennifer W; Wassertheil-Smoller, Sylvia; Wertheim, Betsy C; Klimentidis, Yann; Chen, Zhao; Zaslavsky, Oleg; Manini, Todd M; Womack, Catherine R; Kroenke, Candyce H; LaCroix, Andrea Z; Thomson, Cynthia A

2018-01-01

Studies suggest that ACE-inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) may preserve skeletal muscle with aging. We evaluated longitudinal differences in lean body mass (LBM) among women diagnosed with hypertension and classified as ACE-I/ARB users and nonusers among Women's Health Initiative participants that received dual energy X-ray absorptiometry scans to estimate body composition ( n =10,635) at baseline and at years 3 and 6 of follow-up. Of those, 2642 were treated for hypertension at baseline. Multivariate linear regression models, adjusted for relevant demographics, behaviors, and medications, assessed ACE-I/ARB use/nonuse and LBM associations at baseline, as well as change in LBM over 3 and 6 years. Although BMI did not differ by ACE-I/ARB use, LBM (%) was significantly higher in ACE-I/ARB users versus nonusers at baseline (52.2% versus 51.3%, resp., p =0.001). There was no association between ACE-I/ARB usage and change in LBM over time. Reasons for higher LBM with ACE-I/ARB use cross sectionally, but not longitundinally, are unclear and may reflect a threshold effect of these medications on LBM that is attenuated over time. Nevertheless, ACE-I/ARB use does not appear to negatively impact LBM in the long term.

The interaction between design and occupier behaviour in the safety of new homes.

PubMed

McDermott, Hilary; Haslam, Roger; Gibb, Alistair

2007-03-01

The design of new homes includes many safety features intended to protect occupiers from injury or ill health within the home, however the effectiveness of these primary intervention measures is likely to be affected by user behaviour. This study examined the interaction between user activity and dwelling design and how this might affect health and safety. It aimed to identify how people use features within new homes and how this may limit the protection afforded by building design, codes and regulations. Forty, home-based, semi-structured, in-depth interviews and home inspections were conducted with individuals recently inhabiting a new home. A range of behaviours were reported in relation to building features including fire doors, pipes and cables, and loft access, which may lead to increased risk of injury or ill-health. For example, occupiers described interfering with the self-closing mechanisms on fire doors and drilling into walls without considering the location of services. They also reported knowingly engaging in unsafe behaviour when accessing the loft, increasing their risk of falls. The accounts suggest that designers and builders need to give greater consideration to how occupier behaviour interacts with building features so that improvements in both design and occupier education can lead to improved health and safety.

Diuretic use is associated with better learning and memory in older adults in the Ginkgo Evaluation of Memory Study.

PubMed

Yasar, Sevil; Lin, Fu-Mei; Fried, Linda P; Kawas, Claudia H; Sink, Kaycee M; DeKosky, Steven T; Carlson, Michelle C

2012-05-01

To investigate the association between diuretics, angiotensin-converting enzyme inhibitors (ACE-I), angiotensin II receptor blockers (AT2RB), and cognitive function. This post hoc analysis of the randomized controlled Ginkgo Evaluation of Memory Study trial focuses on 3069 nondemented community-dwelling participants aged >75 years. At baseline visit, detailed information about medication use was collected and five cognitive domains were assessed. Multivariate linear regression analyses were used to assess cross-sectional associations between medication use and cognitive function. In all, 36% of participants reported history of hypertension and 53% reported antihypertensive medication use, with 17% reporting diuretic, 11% ACE-I, and 2% AT2RB use. Potassium-sparing diuretic use (N = 192) was associated with better verbal learning and memory measured by California Verbal Learning Test as compared with no antihypertensive medication users (β = 0.068, P = .01; β = 0.094, P < .001) and other antihypertensive medication users (β = 0.080, P = .03; β = 0.153, P < .001). Use of ACE-I or AT2RB was not associated with better cognitive function. Results warrant further investigation into possible protective effects of potassium-sparing diuretics and the role of potassium in mitigating cognitive decline. Copyright © 2012 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

The role of social relationships among elderly community-dwelling and nursing-home residents: findings from a quality of life study.

PubMed

Scocco, Paolo; Nassuato, Mario

2017-07-01

In Western countries, older adults' needs are often managed through institutionalization. Based on the assumption that quality of life, particularly social relationships, may be perceived differently according to residential setting, the aims of this study were to compare World Health Organization Quality of Life brief version (WHOQOL-BREF) scores of elderly community-dwelling residents and nursing home residents. A sample of 207 older adults (135 community-dwelling residents, 72 nursing home residents) was evaluated with Mini-Mental State Examination (MMSE), WHOQOL-BREF, and Geriatric Depression Scale (GDS). Nursing home residents achieved lower WHOQOL-BREF scores on the physical health scale only (P = 0.002). In a linear regression model, physical score correlated negatively with GDS score (P = 0.0001) and Mini-Mental State Examination score (P = 0.04), but positively with male gender (P = 0.02) and community-dwelling residence (P = 0.001); psychological score correlated negatively with GDS score (P = 0.0001) and being married (P = 0.03), but positively with male gender (P = 0.009) and being unmarried (P = 0.03). The social relationships score correlated negatively with the GDS score (P = 0.0001) and male gender (P = 0.02), but positively with high education level (P = 0.04). The environment score negatively correlated with GDS score (P = 0.0001). In a logistic regression model, living in a nursing home correlated with female gender (P = 0.001), age (P = 0.0001), a lower physical score (P = 0.0001), and a higher social relationships score (P = 0.02). Depressive symptoms correlated with low scores in all WHOQOL-BREF domains. The variables that correlated with living conditions in a nursing home were older age, male gender, lower physical domain scores, and higher social relationship scores. Opportunities for socialization in nursing homes may thus improve perception of quality of life in this domain. © 2017 Japanese Psychogeriatric Society.

National impacts of the Weatherization Assistance Program in single-family and small multifamily dwellings

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

Brown, M.A.; Berry, L.G.; Balzer, R.A.

1993-05-01

Since 1976, the US Department of Energy (DOE) has operated one of the largest energy conservation programs in the nation -- the low-income Weatherization Assistance Program. The program strives to increase the energy efficiency of dwellings occupied by low-income persons in order to reduce their energy consumption, lower their fuel bills, increase the comfort of their homes, and safeguard their health. It targets vulnerable groups including the elderly, people with disabilities, and families with children. The most recent national evaluation of the impacts of the Program was completed in 1984 based on energy consumption data for households weatherized in 1981.more » DOE Program regulations and operations have changed substantially since then: new funding sources, management principles, diagnostic procedures, and weatherization technologies have been incorporated. Many of these new features have been studied in isolation or at a local level; however, no recent evaluation has assessed their combined, nationwide impacts to date or their potential for the future. In 1990, DOE initiated such an evaluation. This evaluation is comprised of three ``impact`` studies (the Single-Family Study, High-Density Multifamily Study, and Fuel-Oil Study) and two ``policy`` studies. Altogether, these five studies will provide a comprehensive national assessment of the Weatherization Assistance Program as it existed in the 1989 Program Year (PY 1989). This report presents the results of the first phase of the Single-Family Study. It evaluates the energy savings and cost effectiveness of the Program as it has been applied to the largest portion of its client base -- low-income households that occupy single-family dwellings, mobile homes, and small (2- to 4-unit) multifamily dwellings. It is based upon a representative national sample that covers the full range of conditions under which the program was implemented in PY 1989.« less

Nutrient intake in community-dwelling adolescent girls with anorexia nervosa and in healthy adolescents123

PubMed Central

Misra, Madhusmita; Tsai, Patrika; Anderson, Ellen J; Hubbard, Jane L; Gallagher, Katie; Soyka, Leslie A; Miller, Karen K; Herzog, David B; Klibanski, Anne

2011-01-01

Background Adolescence is a common time for the onset of anorexia nervosa (AN), a condition associated with long-term medical and hormonal consequences. Objective The objective was to compare the nutrient intakes of community-dwelling girls with AN with those of healthy adolescents and to describe the associations between specific nutrient intakes and nutritionally dependent hormones. Design Nutrient intakes in 39 community-dwelling girls with AN and 39 healthy adolescents aged 12.1–18.7 y were determined by using 4-d food records. Fasting adiponectin, leptin, ghrelin, insulin, and insulin-like growth factor I (IGF-I) concentrations were measured. Indirect calorimetry was used to assess respiratory quotient and resting energy expenditure. Results In contrast with the control group, the AN group consumed fewer calories from fats (P < 0.0001) and more from carbohydrates (P = 0.0009) and proteins (P < 0.0001). Intake of individual fat components was lower and of dietary fiber higher in the AN group. No significant between-group differences were observed in dietary intakes of calcium, zinc, and iron; however, total intake was greater in the AN group because of greater supplement use (P = 0.006, 0.02, and 0.01, respectively). The AN group had greater intakes of vitamins A, D, and K and of most of the B vitamins, and significantly more girls with AN met the Dietary Reference Intake for calcium (P = 0.01) and vitamin D (P = 0.02) from supplement use. Fat intake predicted ghrelin, insulin, and IGF-I concentrations; carbohydrate intake predicted adiponectin. Resting energy expenditure was lower (P < 0.0001) and leisure activity levels higher in the AN group. Conclusions Despite outpatient follow-up, community-dwelling girls with AN continue to have lower fat and higher fiber intakes than do healthy adolescents, which results in lower calorie intakes. Nutritionally related hormones are associated with specific nutrient intakes. PMID:17023694

Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors

PubMed Central

2013-01-01

Background Evidence indicates that the continuation of therapy among community-dwelling stroke survivors improves physical function. Community rehabilitation programmes often face limitations in terms of resources. It is imperative to include new motivational interventions to encourage some level of non-clinician management. The aim of this study was to determine whether there were any changes in physical function and activities of daily living when substituting a portion of the standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. Methods In this controlled trial, the experimental group received 30 minutes of virtual reality balance games in addition to 90 minutes of standard physiotherapy. The control group continued with their two hours of routine standard physiotherapy. Both groups received 12 therapy sessions: two-hour sessions twice per week for six continuous weeks. Changes in physical function, activities of daily living and balance ability were assessed using the Timed Up and Go test, 30-second Sit to Stand test, Timed Ten-Metre Walk test, Six-Minute Walk test and the Barthel Index, and static balance was assessed using a probalance board. Results Twenty-eight participants completed post-intervention assessments. The results showed a significant within-subject effect on the Timed Up and Go test: F (1, 26) = 5.83, p = 0.02; and the 30-second Sit to Stand test; F (1, 26) = 13.50, p = 0.001. The between-subject effect was not significant (p > 0.05) for any of the outcome measurements. Conclusion Substituting a portion of the standard physiotherapy time with virtual reality games was equally effective in maintaining physical function outcomes and activities of daily living among community-dwelling stroke survivors. Trial Registration Australia and New Zealand Clinical Trials Register, ACTRN12613000478718 PMID:24330250

The impact of exercise and vitamin D supplementation on physical function in community-dwelling elderly individuals: A randomized trial.

PubMed

Aoki, Kana; Sakuma, Mayumi; Endo, Naoto

2018-04-25

We investigated the impact of exercise and vitamin D supplementation on physical function and locomotor dysfunction in community-dwelling elderly individuals. In total, 148 community-dwelling elderly individuals (aged ≥60 years) who were not taking osteoporosis medications participated in a 24-week intervention. The participants were randomly divided into an exercise group, vitamin D group, and exercise and vitamin D group. The participants and outcome-assessing staff were not blinded to group assignment. Exercise comprised three daily sets each of single-leg standing (1 min/leg/set) and squatting (5-6 repetitions/set); vitamin D supplementation was 1000 IU/day. Participants were contacted every 2 weeks to check on their condition and encourage continued participation. The primary outcome was lower limb muscle strength and mass; secondary outcomes were several physical function measurements, serum 25-hydroxyvitamin D levels, and results of a self-assessment questionnaire completed pre- and post-intervention. We analyzed data from 45, 42, and 43 participants in the exercise, vitamin D, and exercise and vitamin D groups, respectively, who completed the intervention. Locomotive syndrome, which involves reduced mobility due to locomotive organ impairment, was diagnosed in 99 participants (76.2%). Many physical function measurements improved in all groups. Lower limb muscle mass increased significantly in all three groups, with no significant differences between the groups in the degree of change. The average serum 25-hydroxyvitamin D of all vitamin D-supplemented participants increased from 28.1 ng/ml to 47.3 ng/ml after vitamin D supplementation. Both exercise and vitamin D supplementation independently improved physical function and increased muscle mass in community-dwelling elderly individuals. Moreover, the combination of exercise and vitamin D supplementation might further enhance these positive effects. UMIN Clinical Trial, UMIN000028229. Copyright © 2018. Published by Elsevier B.V.

Information About Users and Usages: A Literature Review.

ERIC Educational Resources Information Center

Hensley, Susan E.; Nelson, Carnot

Identified in this study are the factors which affect the user's capacity to seek out and utilize information, and the factors which serve as obstacles to information use. Factors relating to both organizational and individual use include level of use, user skills, and user motivation; differentiation of level of use is presented in three levels:…

Exergaming for balance training of elderly: state of the art and future developments

PubMed Central

2013-01-01

Fall injuries are responsible for physical dysfunction, significant disability, and loss of independence among elderly. Poor postural control is one of the major risk factors for falling but can be trained in fall prevention programs. These however suffer from low therapy adherence, particularly if prevention is the goal. To provide a fun and motivating training environment for elderly, exercise games, or exergames, have been studied as balance training tools in the past years. The present paper reviews the effects of exergame training programs on postural control of elderly reported so far. Additionally we aim to provide an in-depth discussion of technologies and outcome measures utilized in exergame studies. Thirteen papers were included in the analysis. Most of the reviewed studies reported positive results with respect to improvements in balance ability after a training period, yet few reached significant levels. Outcome measures for quantification of postural control are under continuous dispute and no gold standard is present. Clinical measures used in the studies reviewed are well validated yet only give a global indication of balance ability. Instrumented measures were unable to detect small changes in balance ability as they are mainly based on calculating summary statistics, thereby ignoring the time-varying structure of the signals. Both methods only allow for measuring balance after the exergame intervention program. Current developments in sensor technology allow for accurate registration of movements and rapid analysis of signals. We propose to quantify the time-varying structure of postural control during gameplay using low-cost sensor systems. Continuous monitoring of balance ability leaves the user unaware of the measurements and allows for generating user-specific exergame training programs and feedback, both during one game and in timeframes of weeks or months. This approach is unique and unlocks the as of yet untapped potential of exergames as balance training tools for community dwelling elderly. PMID:24063521

Exergaming for balance training of elderly: state of the art and future developments.

PubMed

van Diest, Mike; Lamoth, Claudine J C; Stegenga, Jan; Verkerke, Gijsbertus J; Postema, Klaas

2013-09-25

Fall injuries are responsible for physical dysfunction, significant disability, and loss of independence among elderly. Poor postural control is one of the major risk factors for falling but can be trained in fall prevention programs. These however suffer from low therapy adherence, particularly if prevention is the goal. To provide a fun and motivating training environment for elderly, exercise games, or exergames, have been studied as balance training tools in the past years. The present paper reviews the effects of exergame training programs on postural control of elderly reported so far. Additionally we aim to provide an in-depth discussion of technologies and outcome measures utilized in exergame studies. Thirteen papers were included in the analysis. Most of the reviewed studies reported positive results with respect to improvements in balance ability after a training period, yet few reached significant levels. Outcome measures for quantification of postural control are under continuous dispute and no gold standard is present. Clinical measures used in the studies reviewed are well validated yet only give a global indication of balance ability. Instrumented measures were unable to detect small changes in balance ability as they are mainly based on calculating summary statistics, thereby ignoring the time-varying structure of the signals. Both methods only allow for measuring balance after the exergame intervention program. Current developments in sensor technology allow for accurate registration of movements and rapid analysis of signals. We propose to quantify the time-varying structure of postural control during gameplay using low-cost sensor systems. Continuous monitoring of balance ability leaves the user unaware of the measurements and allows for generating user-specific exergame training programs and feedback, both during one game and in timeframes of weeks or months. This approach is unique and unlocks the as of yet untapped potential of exergames as balance training tools for community dwelling elderly.

7 CFR 3550.57 - Dwelling requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... amount required to address the specific need. (b) New dwellings. Construction must meet the requirements..., heating, plumbing, water, and wastewater disposal systems; and be free of termites and other wood damaging...

The modifying effect of the building envelope on population exposure to PM2.5 from outdoor sources

PubMed Central

Taylor, J; Shrubsole, C; Davies, M; Biddulph, P; Das, P; Hamilton, I; Vardoulakis, S; Mavrogianni, A; Jones, B; Oikonomou, E

2014-01-01

A number of studies have estimated population exposure to PM2.5 by examining modeled or measured outdoor PM2.5 levels. However, few have taken into account the mediating effects of building characteristics on the ingress of PM2.5 from outdoor sources and its impact on population exposure in the indoor domestic environment. This study describes how building simulation can be used to determine the indoor concentration of outdoor-sourced pollution for different housing typologies and how the results can be mapped using building stock models and Geographical Information Systems software to demonstrate the modifying effect of dwellings on occupant exposure to PM2.5 across London. Building archetypes broadly representative of those in the Greater London Authority were simulated for pollution infiltration using EnergyPlus. In addition, the influence of occupant behavior on indoor levels of PM2.5 from outdoor sources was examined using a temperature-dependent window-opening scenario. Results demonstrate a range of I/O ratios of PM2.5, with detached and semi-detached dwellings most vulnerable to high levels of infiltration. When the results are mapped, central London shows lower I/O ratios of PM2.5 compared with outer London, an apparent inversion of exposure most likely caused by the prevalence of flats rather than detached or semi-detached properties. PMID:24713025

Evaluation of the level of domestic hygiene in household kitchens.

PubMed

Sanna, A; Carraro, V; Sanna, C; Cabiddu, C; Brandas, V; Coroneo, V

2014-01-01

Each year in industrialized countries, 30-40% or more cases of food poisoning occur in the household. The aims of this study are to describe the aspects related to food safety in households by carrying out a microbiological characterization of the kitchens in residential dwellings and to increase consumers' awareness concerning the importance of good hygienic practices, which are required for preventing foodborne diseases at household level. The collection of data involved taking 760 analytical samples of kitchen-counter tops and food from 80 kitchens of private dwellings; the manner in which food was treated was evaluated from the moment of purchase to its transformation and storage by means of a checklist; the questionnaire enabled us to determine the extent of consumers' knowledge concerning the food sector. Overall, the results showed a good level of hygiene concerning both food and kitchen-counter top food surfaces. The respondents of the questionnaire did not appear to be aware of various health risks especially concerning the management of the temperature and compartments of refrigerators as well as food storage times and the cooking or heating of food. The data indicate that final consumers should take more care when cleaning kitchen-counter tops and washing salad; special training programmes should be included in school curricular in order to increase citizens' awareness and knowledge concerning food risks within the household.

Physical activity levels of older community-dwelling adults are influenced by summer weather variables.

PubMed

Brandon, Caitlin A; Gill, Dawn P; Speechley, Mark; Gilliland, Jason; Jones, Gareth R

2009-04-01

Adequate daily physical activity (PA) is important for maintaining functional capacity and independence in older adults. However, most older adults in Canada do not engage in enough PA to sustain fitness and functional independence. Environmental influences, such as warmer daytime temperatures, may influence PA participation; however, few studies have examined the effect of summertime temperatures on PA levels in older adults. This investigation measured the influence of summertime weather variables on PA in 48 community-dwelling older adults who were randomly recruited from a local seniors' community centre. Each participant wore an accelerometer for a single 7-consecutive-day period (between 30 May and 9 August 2006) during waking hours, and completed a PA logbook to remark on major daily PA events. Local weather variables were collected from a national weather service and compared with PA counts per minute. Regression analysis revealed a curvilinear relationship between log-transformed PA and mean daily temperature (r2 = 0.025; p < 0.05). Linear mixed effects models that accounted for repeated measures nested within individuals were performed for monthly periods, meteorological variables, sex, age, and estimated maximal oxygen consumption, with PA as the dependent variable. Age and Air Quality Index remained significant variables within the model. Higher fitness levels had no effect on allowing individuals to perform more vigorous PA in warmer temperatures.

Association of Plasma Selenium Concentrations with Total IGF-1 Among Older Community-Dwelling Adults: the InCHIANTI Study

PubMed Central

Maggio, Marcello; Ceda, Gian Paolo; Lauretani, Fulvio; Bandinelli, Stefania; Dall'Aglio, Elisabetta; Guralnik, Jack M.; Paolisso, Giuseppe; Semba, Richard D.; Nouvenne, Antonio; Borghi, Loris; Ceresini, Graziano; Ablondi, Fabrizio; Benatti, Mario; Ferrucci, Luigi

2011-01-01

Background and Aims Insulin-like growth factor (IGF-1) stimulates cell proliferation and inhibits cell apoptosis. Recent studies underline its importance as anabolic hormone and nutritional marker in older individuals. IGF-1 synthesis and bioactivity are modulated by nutritional factors including selenium intake. However, whether circulating IGF-1 levels are positively influenced by plasma selenium, one of the most important human antioxidants, is still unknown. Methods Selenium and total IGF-1 were measured in 951 men and women ≥65 years from the InCHIANTI study, Tuscany, Italy. Results Means (SD) of plasma selenium and total IGF-1 were 0.95 (0.15) µmol/L and 113.4 (31.2) ng/mL, respectively. After adjustment for age and sex, selenium levels were positively associated with total IGF-1 (ß ± SE: 43.76±11.2, p=0.0001).After further adjustment for total energy and alcohol intake, serum alanine amino transferase (ALT), congestive heart failure, selenium remained significantly associated with IGF-1 (β ± SE: 36.7 ± 12.2, p=0.003). The association was still significant when IL-6 was introduced in the model (β ± SE: 40.1 ± 12.0, p=0.0008). Conclusions We found an independent, positive and significant association between selenium and IGF-1 serum levels in community dwelling older adults. PMID:20416996

Cellular Telephones Measure Activity and Lifespace in Community-Dwelling Adults: Proof of Principle

PubMed Central

Schenk, Ana Katrin; Witbrodt, Bradley C.; Hoarty, Carrie A.; Carlson, Richard H.; Goulding, Evan H.; Potter, Jane F.; Bonasera, Stephen J.

2011-01-01

OBJECTIVES To describe a system that uses off-the-shelf sensor and telecommunication technologies to continuously measure individual lifespace and activity levels in a novel way. DESIGN Proof of concept involving three field trials of 30, 30, and 21 days. SETTING Omaha, Nebraska, metropolitan and surrounding rural region. PARTICIPANTS Three participants (48-year-old man, 33-year-old woman, and 27-year-old male), none with any functional limitations. MEASUREMENTS Cellular telephones were used to detect in-home position and in-community location and to measure physical activity. Within the home, cellular telephones and Bluetooth transmitters (beacons) were used to locate participants at room-level resolution. Outside the home, the same cellular telephones and global positioning system (GPS) technology were used to locate participants at a community-level resolution. Physical activity was simultaneously measured using the cellular telephone accelerometer. RESULTS This approach had face validity to measure activity and lifespace. More importantly, this system could measure the spatial and temporal organization of these metrics. For example, an individual’s lifespace was automatically calculated across multiple time intervals. Behavioral time budgets showing how people allocate time to specific regions within the home were also automatically generated. CONCLUSION Mobile monitoring shows much promise as an easily deployed system to quantify activity and lifespace, important indicators of function, in community-dwelling adults. PMID:21288235

Activity Monitors as Support for Older Persons' Physical Activity in Daily Life: Qualitative Study of the Users' Experiences.

PubMed

Ehn, Maria; Eriksson, Lennie Carlén; Åkerberg, Nina; Johansson, Ann-Christin

2018-02-01

Falls are a major threat to the health and independence of seniors. Regular physical activity (PA) can prevent 40% of all fall injuries. The challenge is to motivate and support seniors to be physically active. Persuasive systems can constitute valuable support for persons aiming at establishing and maintaining healthy habits. However, these systems need to support effective behavior change techniques (BCTs) for increasing older adults' PA and meet the senior users' requirements and preferences. Therefore, involving users as codesigners of new systems can be fruitful. Prestudies of the user's experience with similar solutions can facilitate future user-centered design of novel persuasive systems. The aim of this study was to investigate how seniors experience using activity monitors (AMs) as support for PA in daily life. The addressed research questions are as follows: (1) What are the overall experiences of senior persons, of different age and balance function, in using wearable AMs in daily life?; (2) Which aspects did the users perceive relevant to make the measurements as meaningful and useful in the long-term perspective?; and (3) What needs and requirements did the users perceive as more relevant for the activity monitors to be useful in a long-term perspective? This qualitative interview study included 8 community-dwelling older adults (median age: 83 years). The participants' experiences in using two commercial AMs together with tablet-based apps for 9 days were investigated. Activity diaries during the usage and interviews after the usage were exploited to gather user experience. Comments in diaries were summarized, and interviews were analyzed by inductive content analysis. The users (n=8) perceived that, by using the AMs, their awareness of own PA had increased. However, the AMs' impact on the users' motivation for PA and activity behavior varied between participants. The diaries showed that self-estimated physical effort varied between participants and varied for each individual over time. Additionally, participants reported different types of accomplished activities; talking walks was most frequently reported. To be meaningful, measurements need to provide the user with a reliable receipt of whether his or her current activity behavior is sufficient for reaching an activity goal. Moreover, praise when reaching a goal was described as motivating feedback. To be useful, the devices must be easy to handle. In this study, the users perceived wearables as easy to handle, whereas tablets were perceived difficult to maneuver. Users reported in the diaries that the devices had been functional 78% (58/74) of the total test days. Activity monitors can be valuable for supporting seniors' PA. However, the potential of the solutions for a broader group of seniors can significantly be increased. Areas of improvement include reliability, usability, and content supporting effective BCTs with respect to increasing older adults' PA. ©Maria Ehn, Lennie Carlén Eriksson, Nina Åkerberg, Ann-Christin Johansson. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 01.02.2018.

Comparative cost-benefit analysis of tele-homecare for community-dwelling elderly in Japan: Non-Government versus Government Supported Funding Models.

PubMed

Akiyama, Miki; Abraham, Chon

2017-08-01

Tele-homecare is gaining prominence as a viable care alternative, as evidenced by the increase in financial support from international governments to fund initiatives in their respective countries. The primary reason for the funding is to support efforts to reduce lags and increase capacity in access to care as well as to promote preventive measures that can avert costly emergent issues from arising. These efforts are especially important to super-aged and aging societies such as in Japan, many European countries, and the United States (US). However, to date and to our knowledge, a direct comparison of non-government vs. government-supported funding models for tele-homecare is particularly lacking in Japan. The aim of this study is to compare these operational models (i.e., non-government vs. government-supported funding) from a cost-benefit perspective. This simulation study applies to a Japanese hypothetical cohort with implications for other super-aged and aging societies abroad. We performed a cost-benefit analysis (CBA) on two operational models for enabling tele-homecare for elderly community-dwelling cohorts based on a decision tree model, which we created with parameters from published literature. The two models examined are (a) Model 1-non-government-supported funding that includes monthly fixed charges paid by users for a portion of the operating costs, and (b) Model 2-government-supported funding that includes startup and installation costs only (i.e., no operating costs) and no monthly user charges. We performed base case cost-benefit analysis and probabilistic cost-benefit analysis with a Monte Carlo simulation. We calculated net benefit and benefit-to-cost ratios (BCRs) from the societal perspective with a five-year time horizon applying a 3% discount rate for both cost and benefit values. The cost of tele-homecare included (a) the startup system expense, averaged over a five-year depreciation period, and (b) operation expenses (i.e., labor and non-labor) per user per year. The benefit of tele-homecare was measured by annual willingness to pay (WTP) for tele-homecare by a user and medical expenditures avoided. Both costs and benefits were inflated using the relevant Japanese consumer price index (CPI) and converted into 2015 US dollars with purchasing power parity (PPP) adjusted. Base case net benefits of Model 1 and Model 2 were $417.00 and $97.30, respectively. Base case BCR of Model 1 tele-homecare was 1.63, while Model 2 was 1.03. The probabilistic analysis estimated mean (95%CI) for BCRs of Model 1 and Model 2 was 1.84 (1.89, 1.88) and 1.46 (1.43, 1.49), respectively. Sensitivity analysis showed robustness of Model 1 in 7 parameters but Model 2 was sensitive in all key parameters such as initial system cost, device cost, number of users, and medical expenditure saved. Break-even analysis showed that the system cost of Model 2 had to be under $187,500. Our results for each model collectively showed that tele-homecare in Japan is cost-saving to some extent. However, the government-funded model (i.e., Model 2), which typically requires use of all startup funding to be spent within the first year on system costs, was inferior to the monthly fee model (i.e., Model 1) that did not use the government funding for installation or continued operations, but rather incorporated a monthly fee from users to support the receipt of services via tele-homecare. While the benefits of Model 1 outweighed the benefits of Model 2, the government-subsidized method employed in Model 2 could be more beneficial in general if some explicit prequalifying estimated metrics are instituted prior to funding. Thus, governments need to require applicants requesting funding to note, at a minimum, (a) estimated costs, (b) the expected number of tele-homecare users, and expected benefits such as (c) WTP by the user, or (d) medical expenditure saved by tele-homecare as a means of financing some of the operational costs. Copyright © 2017 Elsevier B.V. All rights reserved.

47 CFR 76.800 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CABLE TELEVISION SERVICE Cable Inside Wiring § 76.800 Definitions. (a) MDU. A multiple dwelling unit... owns or controls the common areas of a multiple dwelling unit building. (c) MVPD. A multichannel video...

47 CFR 76.800 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CABLE TELEVISION SERVICE Cable Inside Wiring § 76.800 Definitions. (a) MDU. A multiple dwelling unit... owns or controls the common areas of a multiple dwelling unit building. (c) MVPD. A multichannel video...