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Sample records for multidimensional home-based exercise

  1. Home-Based Exercise

    MedlinePlus

    ... a Vestibular Disorder Family Support Network Desorden Vestibular/Vértigo - En Español הפרעות ... What is a Home VRT program? During vestibular rehabilitation therapy (VRT), home exercises ...

  2. Exercise therapy for claudication: Should home-based exercise therapy be prescribed in clinical practice?

    PubMed

    Lindo, Fae A

    2015-12-01

    Peripheral artery disease is a cause of morbidity and mortality in the United States. The literature suggests evidence that an exercise program can be beneficial in the treatment of patients with claudication. Supervised exercise therapy is well documented in the literature, and national guidelines recommend it as an initial conservative management. When a supervised exercise program is unavailable or not covered by insurance, an alternative to supervised exercise is vital. The purpose of this review is to examine the evidence regarding the efficacy of a home-based exercise program. Four studies were included in this review, and although the evidence supporting a home-based exercise program is limited in the literature, the findings indicate that a home-based exercise program increases claudication onset time, resulting in greater mobility and improvement in the patient's quality of life.

  3. A Controlled Trial of Hospital versus Home-Based Exercise in Cardiac Patients.

    ERIC Educational Resources Information Center

    Arthur, Heather M.; Smith, Kelly M.; Kodis, Jennifer; McKelvie, Robert

    2002-01-01

    Examined the effect of 6-month hospital-based exercise training versus 6-month monitored home-based training in cardiac rehabilitation patients following surgery, investigating which conferred the greatest physical, quality of life, and social support benefits. Home-based training resulted in improvements in exercise performance as great as those…

  4. Effectiveness of a home-based exercise program on anthropometric and metabolic changes among school cooks.

    PubMed

    Mediano, Mauro Felippe Felix; de Souza, Rita Adriana Gomes; Souza, Amanda Moura; Sichieri, Rosely

    2015-12-01

    The scope of this study was to evaluate the anthropometric and metabolic changes after low intensity home-based exercise. In the school year of 2007, 95 school cooks in the city of Niteroi (State of Rio de Janeiro, Brazil) were randomly assigned to one of the following groups: home-based exercise (n = 47) or control group (n = 48). The home-based exercise program was performed three times a week, during 40 minutes at moderate intensity. Anthropometric variables were collected at the baseline and after 4 and 8 months, whereas biochemical and individual food intake were measured at the baseline and after 8 months. Energy expenditure was evaluated only at the baseline. The home-based exercise group exhibited a greater weight loss (-0.9 vs. -0.2; p = 0.05) in comparison with controls during the follow-up and the same pattern was found for BMI (-0.1 vs. +0.1; p = 0.07), although without statistical significance. Exercise showed no effects on waist circumference, lipid profile and glucose. In conclusion, greater weight loss was observed in the group that performed low intensity home-based exercise and this strategy can assist in body weight control even without alterations in terms of lipids and glucose.

  5. The effectiveness of home-based exercise programs for low back pain patients

    PubMed Central

    Anar, Sevgi Özdinç

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effectiveness of home-based exercise programs for low back pain (LBP) patients. [Subjects and Methods] The study subjects were 49 volunteer chronic LBP patients. Home-based exercises that had been specifically modified for the individual patients were prescribed for a period of four weeks, and the volunteers were asked to return for a control evaluation at the end of this period. Exercise adherence and correct performance, pain intensity, disability, endurance, and flexibility were compared between pre- and post intervention, and correlations between exercise adherence and correct performance with, pain intensity score, endurance, disability, and flexibility were investigated. [Results] Twenty-eight patients (57.14%) did not return for the control evaluation. The mean age of the patients who participated in this control test was 43.24 ± 10.89 years. The adherence rate of the home exercise program was 54.10 ± 26.01%, and the correctly performed execises score was 2.7 ± 1.9. All of the parameters had improved at the final evaluation; however, there was no correlation among the parameters. [Conclusion] Clinicians should be aware of the patient’s adherence level when recommending home-based exercises, and should also realize that exercises might be performed inaccurately in an unsupervised environment. PMID:27821923

  6. Older Adult Perceptions of Participation in Group- and Home-Based Falls Prevention Exercise.

    PubMed

    Robins, Lauren M; Hill, K D; Day, Lesley; Clemson, Lindy; Finch, Caroline; Haines, Terry

    2016-07-01

    This paper describes why older adults begin, continue, and discontinue group- and home-based falls prevention exercise and benefits and barriers to participation. Telephone surveys were used to collect data for 394 respondents. Most respondents reported not participating in group- (66%) or home-based (78%) falls prevention exercise recently. Reasons for starting group-based falls prevention exercise include health benefits (23-39%), health professional recommendation (13-19%), and social interaction (4-16%). They discontinued because the program finished (44%) or due to poor health (20%). Commonly reported benefits were social interaction (41-67%) and health (15-31%). Disliking groups was the main barrier (2-14%). Home-based falls prevention exercise was started for rehabilitation (46-63%) or upon health professional recommendation (22-48%) and stopped due to recovery (30%). Improvement in health (18-46%) was the main benefit. These findings could assist health professionals in prescribing group-based falls prevention exercise by considering characteristics of older adults who perceive social interaction to be beneficial.

  7. Efficacy of home-based exercise programmes for people with chronic heart failure: a meta-analysis.

    PubMed

    Hwang, Rita; Marwick, Thomas

    2009-10-01

    Home-based programmes may offer an alternative to conventional programmes or as a means of maintaining physical fitness after graduating from centre-based programmes. We sought to examine the effectiveness of home-based exercise programmes on exercise capacity in patients with heart failure compared with usual medical care. Electronic databases were searched to identify randomized controlled trials. Protocols included an initial period of centre-based exercise followed by exercise at home, home-based exercise only and concurrent centre and home-based exercise. Outcome measures included peak oxygen consumption, exercise duration and the six-minute walk test. Nineteen relevant studies were identified for review. The mean improvement in peak oxygen consumption was 2.86 ml/kg per min [95% confidence interval (CI): 1.43-4.29]. Exercise duration increased by 1.94 min (95% CI: 0.89-2.98) and distance on the six-minute walk test was increased by 30.41 m (95% CI: 6.13-54.68). Other reported benefits of home-based programmes include increased quality of life and lowered hospital admission rates. In conclusion, home-based exercise programmes have been shown to benefit people with heart failure in the short term. Further research is required to investigate the long-term effects of home exercise and to determine the optimal strategies for improving exercise adherence in patients with heart failure.

  8. A computerized recognition system for the home-based physiotherapy exercises using an RGBD camera.

    PubMed

    Ar, Ilktan; Akgul, Yusuf Sinan

    2014-11-01

    Computerized recognition of the home based physiotherapy exercises has many benefits and it has attracted considerable interest among the computer vision community. However, most methods in the literature view this task as a special case of motion recognition. In contrast, we propose to employ the three main components of a physiotherapy exercise (the motion patterns, the stance knowledge, and the exercise object) as different recognition tasks and embed them separately into the recognition system. The low level information about each component is gathered using machine learning methods. Then, we use a generative Bayesian network to recognize the exercise types by combining the information from these sources at an abstract level, which takes the advantage of domain knowledge for a more robust system. Finally, a novel postprocessing step is employed to estimate the exercise repetitions counts. The performance evaluation of the system is conducted with a new dataset which contains RGB (red, green, and blue) and depth videos of home-based exercise sessions for commonly applied shoulder and knee exercises. The proposed system works without any body-part segmentation, bodypart tracking, joint detection, and temporal segmentation methods. In the end, favorable exercise recognition rates and encouraging results on the estimation of repetition counts are obtained.

  9. Exercise rehabilitation for peripheral artery disease: An exercise physiology perspective with special emphasis on the emerging trend of home-based exercise.

    PubMed

    Gardner, Andrew W

    2015-11-01

    Peripheral artery disease (PAD) is a significant medical concern that is highly prevalent, costly, and deadly. Additionally, patients with PAD have significant impairments in functional independence and health-related quality of life due to leg symptoms and ambulatory dysfunction. Exercise therapy is a primary treatment for patients with PAD, as ambulatory outcome measures improve following a program of exercise rehabilitation. This review describes the outcomes that improve with exercise, the potential mechanisms for improved leg symptoms, key exercise program considerations for training patients with PAD with walking-based exercise, other exercise modalities that have been utilised, the use of on-site supervised exercise programs, and a major focus on historical and contemporary trials on conducting home-based, minimally supervised exercise program to treat PAD. The review concludes with recommendations for future exercise trials, with particular emphasis on reported greater details of the exercise prescription to more accurately quantify the total exercise dose of the program.

  10. Efficacy of home-based kinesthesia, balance & agility exercise training among persons with symptomatic knee osteoarthritis.

    PubMed

    Rogers, Matthew W; Tamulevicius, Nauris; Semple, Stuart J; Krkeljas, Zarko

    2012-01-01

    The purpose of this study was to determine the efficacy of a home-based kinesthesia, balance and agility (KBA) exercise program to improve symptoms among persons age ≥ 50 years with knee osteoarthritis (OA). Forty-four persons were randomly assigned to 8-weeks, 3 times per week KBA, resistance training (RT), KBA + RT, or Control. KBA utilized walking agility exercises and single-leg static and dynamic balancing. RT used elastic resistance bands for open chain lower extremity exercises. KBA + RT performed selected exercises from each technique. Control applied inert lotion daily. Outcomes included the OA specific WOMAC Index of Pain, Stiffness, and Physical Function (PF), community activity level, exercise self-efficacy, self-report knee stability, and 15m get up & go walk (GUG). Thirty-three participants [70.7 (SD 8.5) years] completed the trial. Analysis of variance comparing baseline, mid-point, and follow-up measures revealed significant (p < 0.05) improvements in WOMAC scores among KBA, RT, KBA + RT, and Control, with no differences between groups. However, Control WOMAC improvements peaked at mid-point, whereas improvement in the exercise conditions continued at 8-weeks. There were no significant changes in community activity level. Only Control improved exercise self-efficacy. Knee stability was improved in RT and Control. GUG improved in RT and KBA+RT. These results indicate that KBA, RT, or a combination of the two administered as home exercise programs are effective in improving symptoms and quality of life among persons with knee OA. Control results indicate a strong placebo effect in the short term. A combination of KBA and RT should be considered as part of the rehabilitation program, but KBA or RT alone may be appropriate for some patients. Studies with more statistical power are needed to confirm or refute these results. Patient presentation, preferences, costs, and convenience should be considered when choosing an exercise rehabilitation approach

  11. Quality of Life Improves with Individualized Home-based Exercises in Critical Care Survivors

    PubMed Central

    Shelly, Aayushi G.; Prabhu, Nivedita S.; Jirange, Priyanka; Kamath, Asha; Vaishali, K.

    2017-01-01

    The Aim of the Study: This study aims to determine the effect of individualized home-based exercise on the quality of life post-Intensive Care Unit (ICU) discharge. Subjects: Adult patients invasively mechanically ventilated for more than 48 h in medical ICU. Methodology: Thirty-five patients were enrolled prospectively in this study. They were interviewed to complete short form 36 (SF-36) version 2 questionnaire and were randomly allocated to control and experimental group by block randomization. The experimental group received individualized exercise information sheet and control group was asked to continue routine exercises done during their hospital stay. The experimental group also received a log book and weekly telephonic reminders. Patients were interviewed to complete the SF-36 through the telephone 4 weeks after hospital discharge. Results: Physical and mental components of the quality of life as measured by the SF-36 at the end of 4 weeks after hospital discharge showed a statistically significant difference (P < 0.05) in the experimental group. Conclusion: A well-structured individualized exercise program improves the quality of life of critically ill patients after discharge. PMID:28250604

  12. Comparison of group-based exercise versus home-based exercise in patients with ankylosing spondylitis: effects on Bath Ankylosing Spondylitis Indices, quality of life and depression.

    PubMed

    Karapolat, Hale; Akkoc, Yeşim; Sari, Ismail; Eyigor, Sibel; Akar, Servet; Kirazli, Yeşim; Akkoc, Nurullah

    2008-06-01

    The objective of this non-randomised controlled trial was to evaluate the impact of group-based exercise programme and a home-based exercise programme on Bath Ankylosing Spondylitis Indices, depression and quality of life in patients with ankylosing spondylitis (AS). Approximately 41 patients in a rehabilitation unit were divided into two groups, either group- or home-based exercise programme. Exercise sessions were performed three times a week for a period of 6 weeks. The patients were compared before and after the rehabilitation programme, with respect to Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Disease Assessment Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Beck Depression Inventory (BDI) and The Nottingham Health Profile (NHP). A statistically significant improvement was observed on BASDAI, BASMI and energy, pain, reaction of emotional and sleep subscores of NHP in both exercise groups after the exercise programme (p < 0.05). No statistically significant changes were detected in BASFI, BDI and social and mobility subscores of NHP in both exercise groups (p > 0.05). No statistically significant differences were found between the two exercise programmes (p > 0.05). Group and home-based exercise programmes are efficient in improving symptoms and mobility and had an important effect on quality of life in patients with AS. Home-based exercise programme, as it is cheaper, more easily performed and efficient, may be preferable for the management programme in AS.

  13. Parent and Child Perceptions of a Self-Regulated, Home-Based Exercise Program for Children with Cystic Fibrosis

    PubMed Central

    Happ, Mary Beth; Hoffman, Leslie A.; Higgins, Linda W.; DiVirgilio, Dana; Orenstein, David M.

    2014-01-01

    Background Despite recognized benefits, many children with cystic fibrosis (CF) do not consistently participate in physical activities. There is little empirical literature regarding the feelings and attitudes of children with CF toward exercise programs, parental roles in exercise, or factors influencing exercise experiences during research participation. Objectives To describe the exercise experiences of children with CF and their parents during participation in a six-month program of self-regulated, home-based exercise. Methods This qualitative descriptive study nested within a randomized controlled trial of a self-regulated, home-based exercise program used serial semi-structured interviews conducted individually at two and six months with 11 purposively selected children with CF and their parent(s). Results Six boys and five girls, ages 10–16, and parents (nine mothers, four fathers) participated in a total of 44 interviews. Five major thematic categories describing child and parent perceptions and experience of the bicycle exercise program were identified in the transcripts: (a) motivators; (b) barriers; (c) effort/work; (d) exercise routine; (e) sustaining exercise. Research participation, parent-family participation, health benefits, and the child’s personality traits were primary motivators. Competing activities, priorities and responsibilities were the major barriers to implementing the exercise program as prescribed. Motivation waned and the novelty wore off for several (approximately half) parent-child dyads, who planned to decrease or stop the exercise program after the study ended. Discussion We identified motivators and barriers to a self-regulated, home-based exercise program for children with CF that can be addressed in planning future exercise interventions to maximize the health benefits for children with CF and the feasibility and acceptability to the children and their families. PMID:23995464

  14. Adherence to a home-based exercise program and incidence of cardiovascular disease in type 2 diabetes patients.

    PubMed

    Shinji, S; Shigeru, M; Ryusei, U; Mitsuru, M; Shigehiro, K

    2007-10-01

    The aim of this study was to examine the association between adherence to a home-based exercise program and the incidence of cardiovascular disease (CVD) in patients with type 2 diabetes. We investigated 102 patients with type 2 diabetes aged 35 to 75 years, and followed them prospectively for 17.2 months. Before enrollment, all patients received a traditional exercise prescription. The exercise program consisted of a daily walking exercise at home for 20 - 30 minutes. Self-reported adherence to the exercise program and the incidence of CVD were confirmed by information obtained from telephone interviews. There were 38 dropouts among the patients in the exercise program. Dropouts were significantly younger than completers. The rate of obesity was significantly higher among the dropouts than among the completers. No differences were observed between the two groups for gender, history of CVD and other clinical characteristics. During the follow-up, we documented 8 new cases of CVD. The incidence of CVD during the follow-up was 1.56 percent among the program completers and 18.4 percent among the dropouts. Adherence to the home-based exercise was inversely related to the incidence of CVD (p < 0.01). These associations persisted after adjustment for age and other covariates. In conclusion, adherence to an exercise program is associated with a reduced incidence of CVD among patients with type 2 diabetes.

  15. Effects on balance, falls, and bone mineral density of a home-based exercise program without home visits in community-dwelling elderly women: a randomized controlled trial.

    PubMed

    Kamide, Naoto; Shiba, Yoshitaka; Shibata, Hiroshi

    2009-01-01

    The aim of the present study was to investigate the effects of home-based exercise without home visits on physical function, falls, and bone mineral density in community-dwelling elderly women. Sixty community-dwelling, elderly (> or =65 years of age) women were recruited from a Japanese community. Subjects were randomly assigned to a home-based exercise group or a control group. The subjects assigned to the home-based exercise group performed home-based exercise without home visits 3 times per week for 6 months in their homes. Assessments of physical function and bone mineral density were carried out before and after intervention in both groups. Muscle strength, gait velocity, the timed up and go test (TUGT), single leg stance time, the bend reach performance test, and reaction time were measured to assess physical function. The patients' history of falls was also assessed before and after the 12-month follow-up. To determine bone mineral density, the speed of sound (SOS) at the right calcaneus was measured using a quantitative ultrasound device. There were no significant differences between the two groups in baseline characteristics. 82.6% of subjects completed the prescribed exercise program in the home-based exercise group. Compared to the control group, TUGT improved significantly (p<0.05) in the home-based exercise group. Home-based exercise without home visits can be adopted for community-dwelling elderly women, particularly since no specific place or instructor is needed.

  16. Comparison of Veteran experiences of low-cost, home-based diet and exercise interventions.

    PubMed

    Holtz, Bree; Krein, Sarah L; Bentley, Douglas R; Hughes, Maria E; Giardino, Nicholas D; Richardson, Caroline R

    2014-01-01

    Obesity is a significant health problem among Veterans who receive care from the Department of Veterans Affairs, as it is for so many other Americans. Veterans from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) experience a myriad of chronic conditions, which can make it difficult to maintain a physically active lifestyle. This pilot study tested the feasibility and user satisfaction with three low-cost, home-based diet and exercise programs, as well as point-of-decision prompts among these Veterans. The three programs target mechanisms that have been shown to improve healthy behavior change, including (1) online mediated social support, (2) objective monitoring of physical activity, and (3) structured high-intensity workouts. This was a randomized crossover trial; each participant used two of the three programs, and all used the point-of-decision prompts. Our qualitative results identified five overall themes related to social support, objective monitoring, structured activity, awareness and understanding, and the point-of-decision prompts. In general, participants were satisfied with and lost weight with each of the interventions. This study demonstrated that these low-cost interventions could be successful with the OIF/OEF Veteran population. A larger and longer study is planned to further investigate the effectiveness of these interventions.

  17. Home-based neuromuscular electrical stimulation improves exercise tolerance and health-related quality of life in patients with COPD

    PubMed Central

    Coquart, Jérémy B; Grosbois, Jean-Marie; Olivier, Cecile; Bart, Frederic; Castres, Ingrid; Wallaert, Benoit

    2016-01-01

    Background This retrospective, observational study of a routine clinical practice reports the feasibility and efficiency of home-based pulmonary rehabilitation (PR), including transcutaneous neuromuscular electrical stimulation (NMES) or usual endurance physical exercise (UEPE), on exercise tolerance, anxiety/depression, and health-related quality of life (HRQoL) in patients with COPD. Methods Seventy-one patients with COPD participated in home-based PR with NMES (Group NMES [GNMES]), while 117 patients participated in home-based PR with the UEPEs (Group UEPE [GUEPE]). NMES was applied for 30 minutes twice a day, every day. The endurance exercises in GUEPE began with a minimum 10-minute session at least 5 days a week, with the goal being 30–45 minutes per session. Three upper and lower limb muscle strengthening exercises lasting 10–15 minutes were also proposed to both the groups for daily practice. Moreover, PR in both the groups included a weekly 90-minute session based on an educational needs assessment. The sessions comprised endurance physical exercise for GUEPE, NMES for GNMES, resumption of physical daily living activities, therapeutic patient education, and psychosocial support to facilitate health behavior changes. Before and after PR, functional mobility and physical exercise capacity, anxiety, depression, and HRQoL were evaluated at home. Results The study revealed that NMES significantly improved functional mobility (−18.8% in GNMES and −20.6% in GUEPE), exercise capacity (+20.8% in GNMES and +21.8% in GUEPE), depression (−15.8% in GNMES and −30.1% in GUEPE), and overall HRQoL (−7.0% in GNMES and −18.5% in GUEPE) in the patients with COPD, regardless of the group (GNMES or GUEPE) or severity of airflow obstruction. Moreover, no significant difference was observed between the groups with respect to these data (P>0.05). Conclusion Home-based PR including self-monitored NMES seems feasible and effective for severely disabled COPD patients

  18. The effect of a home-based exercise intervention on postnatal depression and fatigue: A randomized controlled trial.

    PubMed

    Mohammadi, Fatemeh; Malakooti, Jamileh; Babapoor, Jalil; Mohammad-Alizadeh-Charandabi, Sakineh

    2015-10-01

    This study aims to determine the effectiveness of home-based low-intensity stretching and breathing exercises on the reduction of 1 and 2 month post-partum depression (primary outcome) and fatigue (secondary outcome) scores. In this randomized controlled trial, 127 women at 26-32 weeks' gestation with Edinburgh score less than 15, who attended 14 selected health centres in Tabriz, Iran, were randomly allocated into one of the following three groups: no intervention group, group receiving training for exercise during pregnancy, and group receiving training for exercise during pregnancy and post-partum period until 2 months after delivery. Depression and fatigue scores were measured using the Edinburgh Postnatal Depression Scale and Fatigue Identification Form, respectively, at baseline, 1 month and 2 months after delivery. The data were analysed with SPSS-ver. 13.0 (SPSS Inc, Chicago, IL, USA) using chi-square, Fisher's exact and Kruskal-Wallis tests. Mean rank of the difference scores of depression and fatigue were not significantly different among the groups, both at 1 and 2 months post-partum (P > 0.05). Therefore, this study did not provide evidence to show that training women to do the home-based exercises during pregnancy or during pregnancy and post-partum period have a preventive effect on post-partum depression and fatigue. However, more studies are needed for making precise judgment.

  19. Personalized Home-based Interval Exercise Training May Improve Cardiorespiratory Fitness in Cancer Patients Preparing to Undergo Hematopoietic Cell Transplantation

    PubMed Central

    Wood, William A; Phillips, Brett; Smith-Ryan, Abbie E; Wilson, Doug; Deal, Allison M; Bailey, Charlotte; Meeneghan, Mathew; Reeve, Bryce B; Basch, Ethan M; Bennett, Antonia V; Shea, Thomas C; Battaglini, Claudio L

    2016-01-01

    Impaired cardiorespiratory fitness is associated with inferior survival in patients preparing to undergo hematopoietic cell transplantation (HCT). Exercise training based on short, higher-intensity intervals has the potential to efficiently improve cardiorespiratory fitness. We studied home-based interval exercise training (IET) in 40 patients prior to autologous (N=20) or allogeneic (N=20) HCT. Each session consisted of 5, three-minute intervals of walking, jogging, or cycling at 65-95% maximal heart rate (MHR) with 3 minutes of low intensity exercise (<65% MHR) between intervals. Participants were asked to perform sessions at least 3 times weekly. The duration of the intervention was at least 6 weeks, depending on each patient’s scheduled transplantation date. Cardiorespiratory fitness was assessed from a peak oxygen consumption test (VO2peak) and a 6 minute walk (6MWD) before and after the intervention period. For the autologous HCT cohort, improvements in VO2peak (p=0.12) and 6MWD (p=0.19) were not statistically significant. For the allogeneic cohort, the median VO2peak improvement was 3.7ml/kg*min (p=0.005) and the median 6MWD improvement was 34 meters (p=0.006). Home-based, interval exercise training can be performed prior to HCT and has the potential to improve cardiorespiratory fitness. PMID:26999467

  20. Effects of home-based exercise on postural control and sensory organization in individuals with Parkinson disease.

    PubMed

    Nocera, Joe; Horvat, Michael; Ray, Christopher T

    2009-12-01

    Loss of function and postural instability occur in Parkinson disease (PD). Dynamic exercise interventions are successful in improving motor control and physical function. However, most programs are based in a health facility or physical therapy setting and involve travel. With the limitations associated with PD (e.g. health care and medication cost as well as travel limitations) these therapies may be inaccessible and exclude some individuals from maintaining or increasing their function. The purpose of this study was to evaluate the effectiveness of a home-based exercise intervention on postural control in individuals with PD. Multivariate analysis of covariance was performed on individuals with PD (N = 10) and healthy aged-matched controls (N = 10). Participants were assessed utilizing computerized dynamic posturography (CDP) before and after a 10-week exercise intervention. Participants were instructed on proper technique prior to the intervention, were given an illustrated home program, and were monitored weekly concerning their progress. Pre-intervention assessment demonstrated that individuals with PD had statically lower scores on a Sensory Organization Test (p < .05). Following the intervention, results indicated no statistical difference between individuals with PD and aged match controls (p > .05). This initial study indicates that a home exercise intervention is an effective method of improving postural control in individuals with PD. Results from this investigation support further study to determine the extent to which both preventative and restorative home-based programs can improve postural control.

  1. Sex-specific predictors of improved walking with step-monitored, home-based exercise in peripheral artery disease.

    PubMed

    Gardner, Andrew W; Parker, Donald E; Montgomery, Polly S

    2015-10-01

    The aim of this study was to determine whether baseline clinical characteristics and the duration and intensity of ambulation during our step-monitored home-based exercise program were predictive of changes in ambulatory outcomes at completion of the program in symptomatic patients with peripheral artery disease (PAD). Twenty-two men (ankle-brachial index (ABI) = 0.71 ± 0.19) and 24 women (ABI = 0.66 ± 0.23) completed the home exercise program, consisting of intermittent walking to mild-to-moderate claudication pain for 3 months. Ambulatory outcome measures were peak walking time (PWT) and claudication onset time (COT) during a treadmill test, and the distance recorded during a 6-minute walk distance test (6MWD). Men experienced significant increases (p<0.01) in COT, PWT, and 6MWD following the home exercise program, and women had significant increases in 6MWD (p<0.01) and PWT (p<0.05). In women, average exercise cadence during the home exercise sessions was the only predictor that entered the model for change in COT (p=0.082), and was the first predictor in the model for change in PWT (p=0.029) and 6MWD (p=0.006). In men, the ABI was the only predictor that entered the model for change in 6MWD (p=0.002), and ABI was a predictor along with metabolic syndrome in the model for change in COT (p=0.003). No variables entered the model for change in PWT. Faster ambulatory cadence during the step-monitored home-based exercise program may predict greater improvements in ambulatory function in women, whereas having less severe PAD and comorbid burden at baseline may predict greater improvements in ambulatory function in men. ClinicalTrials.gov Identifier: NCT00618670.

  2. Safety and efficacy of a 6-month home-based exercise program in patients with facioscapulohumeral muscular dystrophy

    PubMed Central

    Bankolé, Landry-Cyrille; Millet, Guillaume Y.; Temesi, John; Bachasson, Damien; Ravelojaona, Marion; Wuyam, Bernard; Verges, Samuel; Ponsot, Elodie; Antoine, Jean-Christophe; Kadi, Fawzi; Féasson, Léonard

    2016-01-01

    Abstract Background: Previous randomized controlled trials investigating exercise training programs in facioscapulohumeral muscular dystrophy (FSHD) patients are scarce and of short duration only. This study assessed the safety and efficacy of a 6-month home-based exercise training program on fitness, muscle, and motor function in FSHD patients. Methods: Sixteen FSHD patients were randomly assigned to training (TG) and control (CG) groups (both n = 8) in a home-based exercise intervention. Training consisted of cycling 3 times weekly for 35 minutes (combination of strength, high-intensity interval, and low-intensity aerobic) at home for 24 weeks. Patients in CG also performed an identical training program (CTG) after 24 weeks. The primary outcome was change in peak oxygen uptake (VO2 peak) measured every 6 weeks. The principal secondary outcomes were maximal quadriceps strength (MVC) and local quadriceps endurance every 12 weeks. Other outcome measures included maximal aerobic power (MAP) and experienced fatigue every 6 weeks, 6-minute walking distance every 12 weeks, and muscle characteristics from vastus lateralis biopsies taken pre- and postintervention. Results: The compliance rate was 91% in TG. Significant improvements with training were observed in the VO2 peak (+19%, P = 0.002) and MAP by week 6 and further to week 24. Muscle endurance, MVC, and 6-minute walking distance increased and experienced fatigue decreased. Muscle fiber cross-sectional area and citrate synthase activity increased by 34% (P = 0.008) and 46% (P = 0.003), respectively. Dystrophic pathophysiologic patterns were not exacerbated. Similar improvements were experienced by TG and CTG. Conclusions: A combined strength and interval cycling exercise-training program compatible with patients’ daily professional and social activities leads to significant functional benefits without compromising muscle tissue. PMID:27495097

  3. Effect of home-based Kegel exercises on quality of life in women with stress and mixed urinary incontinence.

    PubMed

    Cavkaytar, S; Kokanali, M K; Topcu, H O; Aksakal, O S; Doğanay, M

    2015-05-01

    The aim of this study was to assess the effects of home-based Kegel exercises in women with stress and mixed urinary incontinence. A total of 90 women with urodynamically proven urinary stress (SUI) and mixed (MUI) incontinence awaiting anti-incontinence surgery were recruited in the urogynaecology clinic of Ankara Zekai Tahir Burak Women's Health Research and Education Hospital. Of these, 18 women were excluded due to low compliance and the remaining 72 were divided into two groups according to urodynamic diagnosis (SUI group, n = 38; MUI group, n = 34). Age, BMI, menopausal status and medical history of the women were recorded. The women took Kegel exercise, consisting of 10 sets of contractions/day; each set included 10 repetitions, for at least 8 weeks. To evaluate the pelvic floor muscle strength, the modified Oxford grading system was used before and after Kegel exercising. The Incontinence Impact Questionnaire (IIQ-7); Urogenital Distress Inventory (UDI-6) and the Patient Global Impression of Improvement (PGI-I) questions were compared before and after 8 weeks of Kegel exercising. The age, BMI, gravidity, menopausal status, macrosomic fetus history, hypertension and asthma were similar between the groups. There were statistically significant lower scores in both IIQ-7 and UDI-6 before and after Kegel exercises within each group (p < 0.001). The mean change of the IIQ-7 and UDI-6 score was statistically significantly higher in the SUI group than in the MUI group (p = 0.023 and p = 0.003, respectively). Results of the Oxford scale were also statistically significantly higher after Kegel exercises within each group (p = < 0.001). In total, 68.4% of the women in the SUI group and 41.2% of the women in the MUI group reported improvements which were statistically significant (p = 0.02). We conclude that home-based Kegel exercises, with no supervision, have been found effective in women with SUI and MUI. The improvement was more prominent in women with SUI.

  4. Embedded assessment algorithms within home-based cognitive computer game exercises for elders.

    PubMed

    Jimison, Holly; Pavel, Misha

    2006-01-01

    With the recent consumer interest in computer-based activities designed to improve cognitive performance, there is a growing need for scientific assessment algorithms to validate the potential contributions of cognitive exercises. In this paper, we present a novel methodology for incorporating dynamic cognitive assessment algorithms within computer games designed to enhance cognitive performance. We describe how this approach works for variety of computer applications and describe cognitive monitoring results for one of the computer game exercises. The real-time cognitive assessments also provide a control signal for adapting the difficulty of the game exercises and providing tailored help for elders of varying abilities.

  5. Effects of home-based exercise intervention on health-related quality of life for patients with ankylosing spondylitis: a meta-analysis.

    PubMed

    Liang, Hui; Zhang, Hua; Ji, Haiyan; Wang, Chunmei

    2015-10-01

    The objective of this paper was to objectively evaluate the effectiveness of home-based exercise interventions for improving health-related quality of life in patients with ankylosing spondylitis (AS). Databases including PubMed, Web of Science, EMBASE, Ovid-Medline, and The Cochrane Library were electronically searched published from inception through October 2014 involving home-based exercise intervention in AS patients. Studies that measured the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), depression and pain as outcomes were included. Studies involving patients with multiple diseases or received combinations of other interventions were excluded. Two independent investigators screened the identified articles, extracted the data, and assessed the methodological quality of the included studies. Qualitative descriptions were conducted, and quantitative analysis was performed with RevMan software (version 5.2). A total of six studies comprising 1098 participants were included in the study. Meta-analyses showed that home-based exercise interventions significantly reduced the BASFI scores (MD = -0.39, 95 % CI -0.57, -0.20, p = 0.001), BASDAI scores (MD = -0.50, 95 % CI -0.99, -0.02, p = 0.04), depression scores (MD = -2.31, 95 % CI -3.33, -1.30, p = 0.001), and for pain scores because of different evaluation methods among these studies; therefore, a subgroup analysis should be conducted for comparison. The results show that home-based exercise interventions can effectively improve the health-related quality of life in patients with AS. The benefit and clinical performance of home-based exercise care requires further investigation by a series of multicenter, large-sample size randomized controlled trails.

  6. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study

    PubMed Central

    2014-01-01

    Background With the number of older adults in society rising, frailty becomes an increasingly prevalent health condition. Regular physical activity can prevent functional decline and reduce frailty symptoms. In particular, home-based exercise programs can be beneficial in reducing frailty of older adults and fall risk, and in improving associated physiological parameters. However, adherence to home-based exercise programs is generally low among older adults. Current developments in technology can assist in enlarging adherence to home-based exercise programs. This paper presents the rationale and design of a study evaluating the adherence to and effectiveness of an individually tailored, home-based physical activity program for frail older adults driven by mobility monitoring through a necklace-worn physical activity sensor and remote feedback using a tablet PC. Methods/design Fifty transitionally frail community-dwelling older adults will join a 6-month home-based physical activity program in which exercises are provided in the form of exercise videos on a tablet PC and daily activity is monitored by means of a necklace-worn motion sensor. Participants exercise 5 times a week. Exercises are built up in levels and are individually tailored in consultation with a coach through weekly telephone contact. Discussion The physical activity program driven by mobility monitoring through a necklace-worn sensor and remote feedback using a tablet PC is an innovative method for physical activity stimulation in frail older adults. We hypothesize that, if participants are sufficiently adherent, the program will result in higher daily physical activity and higher strength and balance assessed by physical tests compared to baseline. If adherence to and effectiveness of the program is considered sufficient, the next step would be to evaluate the effectiveness with a randomised controlled trial. The knowledge gained in this study can be used to develop and fine-tune the application

  7. A Randomized Controlled Trial of Home-Based Exercise for Cancer-Related Fatigue in Women during and after Chemotherapy with or without Radiation Therapy

    PubMed Central

    Dodd, Marylin J.; Cho, Maria H.; Miaskowski, Christine; Painter, Patricia L.; Paul, Steven M.; Cooper, Bruce A.; Duda, John; Krasnoff, Joanne; Bank, Kayee A.

    2010-01-01

    Background Few studies have evaluated an individualized home-based exercise prescription during and after cancer treatment. Objective The purpose was to evaluate the effectiveness of a home-based exercise training intervention, the PRO-SELF FATIGUE CONTROL PROGRAM on the management of cancer related fatigue. Interventions/Methods Participants (N=119) were randomized into one of three groups: Group 1 (EE) received the exercise prescription throughout the study; Group 2 (CE) received their exercise prescription after completing cancer treatment; Group 3 (CC) received usual care. Patients completed the Piper Fatigue Scale, General Sleep Disturbance Scale, Center for Epidemiological Studies-Depression scale, and Worst Pain Intensity Scale. Results All groups reported mild fatigue levels, sleep disturbance and mild pain, but not depression. Using multilevel regression analysis significant linear and quadratic trends were found for change in fatigue and pain (i.e., scores increased, then decreased over time). No group differences were found in the changing scores over time. A significant quadratic effect for the trajectory of sleep disturbance was found, but no group differences were detected over time. No significant time or group effects were found for depression. Conclusions Our home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment. The optimal timing of exercise remains to be determined. Implications for practice Clinicians need to be aware that some physical activity is better than none, and there is no harm in exercise as tolerated during cancer treatment. Further analysis is needed to examine the adherence to exercise. More frequent assessments of fatigue, sleep disturbance, depression, and pain may capture the effect of exercise. PMID:20467301

  8. Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial

    PubMed Central

    2014-01-01

    Background The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers. Methods/Design This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls) for 5 × 10 minutes per week and up to 5 group-based coaching sessions, or 2) home based physical exercise performed during leisure time (using elastic bands and body weight exercises) for 5 × 10 minutes per week. Both intervention groups will also receive ergonomic instructions on patient handling and use of lifting aides etc. Inclusion criteria are female healthcare workers working at a hospital. Average pain intensity (VAS scale 0-10) of the back, neck and shoulder

  9. Associations between psychological factors and the effect of home-based physical exercise in women with chronic neck and shoulder pain

    PubMed Central

    Karlsson, Linn; Gerdle, Björn; Takala, Esa-Pekka; Andersson, Gerhard; Larsson, Britt

    2016-01-01

    Background: Exercise is often used in the treatment of chronic neck and shoulder muscle pain. It is likely that psychological aspects have an impact on the results of exercise-based treatments. Objectives: (1) To examine the associations between psychological factors and the effect of a home-based physical exercise intervention. (2) To examine differences in psychological factors at baseline between (a) subjects who continued in the trial and those who did not and (b) subjects who completed the intervention and those who did not. Method: A total of 57 women with chronic neck and shoulder pain were included in a home-based exercise intervention trial. Pain intensity, disability, and psychological factors (anxiety and depression symptoms, catastrophizing, fear-avoidance beliefs, self-efficacy, and pain acceptance) were measured at baseline, after 4–6 months, and after 1 year of exercise. Associations between the psychological factors and changes in pain intensity and disability were analysed, as well as differences in psychological factors at baseline between subjects who continued in and completed the intervention, and those who did not. Results: Associations between positive changes in pain intensity and disability were found for low fear-avoidance beliefs and low-pain self-efficacy at baseline. In addition, fear-avoidance beliefs at baseline were higher in the subjects who dropped out of the intervention than in those who continued. Pain acceptance at baseline was higher in the subjects who completed the intervention at the end of the trial. Conclusion: Particularly, fear-avoidance beliefs and pain self-efficacy should be taken into consideration when implementing home-based physical exercise as treatment for chronic neck pain. In addition, high pain acceptance might improve the adherence to prescribed exercise. PMID:27688880

  10. Effect of a Home-Based Exercise Program on Functional Recovery Following Rehabilitation After Hip Fracture A Randomized Clinical Trial

    PubMed Central

    Latham, Nancy K.; Harris, Bette Ann; Bean, Jonathan F.; Heeren, Timothy; Goodyear, Christine; Zawacki, Stacey; Heislein, Diane M.; Mustafa, Jabed; Pardasaney, Poonam; Giorgetti, Marie; Holt, Nicole; Goehring, Lori; Jette, Alan M.

    2015-01-01

    .1 [SD, 7.9] at 6 months; control group: 56 [SD, 7.1] at baseline, 56.6 [SD, 8.1] at 6 months; and between-group difference, 1.3 [95% CI, 0.2 to 2.4], P = .03; and mean AM-PAC daily activity scores for intervention group: 57.4 [SD, 13.7] at baseline, 61.3 [SD, 15.7] at 6 months; control group: 58.2 [SD, 15.2] at baseline, 58.6 [SD, 15.3] at 6 months; and between-group difference, 3.5 [95% CI, 0.9 to 6.0], P = .03). In multiple imputation analyses, between-group differences remained significant for SPPB and AM-PAC daily activity, but not for mobility. Significant between-group differences persisted at 9 months for all functional measures with and without imputation. CONCLUSIONS AND RELEVANCE Among patients who had completed standard rehabilitation after hip fracture, the use of a home-based functionally oriented exercise program resulted in modest improvement in physical function at 6 months after randomization. The clinical importance of these findings remains to be determined. PMID:24549550

  11. Longer-term effects of home-based exercise interventions on exercise capacity and physical activity in coronary artery disease patients: A systematic review and meta-analysis.

    PubMed

    Claes, Jomme; Buys, Roselien; Budts, Werner; Smart, Neil; Cornelissen, Véronique A

    2017-02-01

    Background Exercise-based cardiovascular rehabilitation (CR) improves exercise capacity (EC), lowers cardiovascular risk profile and increases physical functioning in the short term. However, uptake of and adherence to a physically active lifestyle in the long run remain problematic. Home-based (HB) exercise programmes have been introduced in an attempt to enhance long-term adherence to recommended levels of physical activity (PA). The current systematic review and meta-analysis aimed to compare the longer-term effects of HB exercise programmes with usual care (UC) or centre-based (CB) CR in patients referred for CR. Design Systematic review and meta-analysis. Methods Non-randomised controlled trials (RCTs) or randomised trials comparing the effects of HB exercise programmes with UC or CB rehabilitation on EC and/or PA, with a follow-up period of ≥12 months and performed in coronary artery disease patients, were searched in four databases (PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Cochrane Central Register of Controlled trials (CENTRAL)) from their inception until September 7, 2016. Standardised mean differences (SMDs) were calculated and pooled by means of random effects models. Risk of bias, publication bias and heterogeneity among trials were also assessed. Results Seven studies could be included in the meta-analysis on EC, but only two studies could be included in the meta-analysis on PA (total number of 1440 patients). The results showed no significant differences in EC between HB rehabilitation and UC (SMD 0.10, 95% confidence interval (CI) -0.13 to 0.33). There was a small but significant difference in EC in favour of HB compared to CB rehabilitation (SMD 0.25, 95% CI 0.02-0.48). No differences were found for PA (SMD 0.37, 95% CI -0.18 to 0.92). Conclusions HB exercise is slightly more effective than CB rehabilitation in terms of maintaining EC. The small number of studies warrants the need for more

  12. Benefits of a novel concept of home-based exercise with the aim of preventing aspiration pneumonia and falls in frail older women: a pragmatic controlled trial

    PubMed Central

    Takatori, Katsuhiko; Matsumoto, Daisuke; Nishida, Munenori; Matsushita, Shinnichiro; Noda, Tatsuya; Imamura, Tomoaki

    2016-01-01

    Aim To investigate whether home-based exercise with the aim of preventing aspiration pneumonia and accidental falls improves swallowing-related and physical functions in community-dwelling frail older women. Methods Participants were 266 community-dwelling frail older women in a long-term care prevention class (mean (SD): age 75 (5) years). Participants were allocated to either an intervention group or a control group. In the intervention group, participants were asked to perform, at least three times a week for 6 months, a home-based exercise programme that was specifically developed to prevent aspiration pneumonia and accidental falls. Control group participants were instructed to perform general stretching exercises only. Voluntary peak cough flow and lip closure force were measured as swallowing-related functions. Static and dynamic balance function, lower limb strength and flexibility were measured as secondary outcomes. Intervention effects were determined using t tests; effect sizes were calculated using Cohen's d. Results Voluntary peak cough flow in the intervention group was significantly greater than in the control group (p<0.01, d=0.5). However, lip closure force did not differ between groups. Regarding physical function, results of the Timed Up and Go Test (p<0.05, d=0.4), Chair Stand Test (p<0.01, d=0.4), maximal knee extension strength (p<0.05, d=0.4), and Sit and Reach Test (p<0.05, d=0.3) showed greater improvement in the intervention group. Conclusions Specifically developed home-based exercise as described in this study is simple and can be performed briefly. Improvements in voluntary peak cough flow and physical function indicate the possible usefulness of such exercise in preventing falls and aspiration pneumonia in community-dwelling frail older adults. Trial registration number UMIN Clinical Trials Registry (UMIN-CTR): UMIN000014880. PMID:27900185

  13. The process associated with motivation of a home-based Wii Fit exercise program among sedentary African American women with systemic lupus erythematosus

    PubMed Central

    Yuen, Hon K.; Breland, Hazel L.; Vogtle, Laura K.; Holthaus, Katy; Kamen, Diane L.; Sword, David

    2012-01-01

    Objective To explore the process associated with the motivation for playing Wii Fit among patients with systemic lupus erythematosus (SLE). Methods Individual in-depth semi-structured telephone interviews were conducted with 14 sedentary African American women with SLE to explore their experiences and reflect on their motivation for playing Wii Fit after completing a 10-week home-based Wii Fit exercise program. Interviews were audio-recorded, transcribed verbatim, and analyzed using the constant comparative method to identify categories related to participants’ motivation. Three authors independently sorted, organized and coded transcript text into categories, then combined the categories into themes and subthemes. Results In addition to the two themes (Ethical principal of keeping a commitment, and Don’t want to let anyone down) generic to home-based exercise trials, we identified five themes (Enjoyment, Health Benefits, Sense of Accomplishment, Convenience, and Personalized) that revealed why the participants were motivated to play the Wii Fit. Enjoyment had three subthemes: Interactive, Challenging, and Competitive with an embedded social element. However, several participants commented they were not able to do many activities, master certain games, or figure out how to play some; as a result, they were bored with the limited selection of activities that they could do. Conclusions The motivational elements of the Wii Fit may contribute to improved exercise motivation and adherence in select sedentary African American women with SLE. Results provide a better understanding on the important elements to incorporate in the development of sustainable home-based exercise programs with interactive health video games for this population. PMID:23260612

  14. Prophylactic exercises among head and neck cancer patients during and after swallowing sparing intensity modulated radiation: adherence and exercise performance levels of a 12-week guided home-based program.

    PubMed

    Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Witte, Birgit I; Aalders, Yke J; de Goede, Cees J T; de Bree, Remco; Doornaert, Patricia; Rietveld, Derek H F; Buter, Jan; Langendijk, Johannes A; Leemans, C René; Verdonck-de Leeuw, Irma M

    2017-02-01

    The background and purpose of this paper is to investigate adherence, exercise performance levels and associated factors in head and neck cancer (HNC) patients participating in a guided home-based prophylactic exercise program during and after treatment [swallowing sparing intensity modulated radiation therapy (SW-IMRT)]. Fifty patients were included in the study. Adherence was defined as the percentage of patients who kept up exercising; exercise performance level was categorized as low: ≤1, moderate: 1-2, and high: ≥2 time(s) per day, on average. Associations between 6- and 12-week exercise performance levels and age, gender, tumour site and stage, treatment, intervention format (online or booklet), number of coaching sessions, and baseline HNC symptoms (EORTC-QLQ-H&N35) were investigated. Adherence rate at 6 weeks was 70% and decreased to 38% at 12 weeks. In addition, exercise performance levels decreased over time (during 6 weeks: 34% moderate and 26% high; during 12 weeks: 28% moderate and 18% high). The addition of chemotherapy to SW-IMRT [(C)SW-IMRT] significantly deteriorated exercise performance level. Adherence to a guided home-based prophylactic exercise program was high during (C)SW-IMRT, but dropped afterwards. Exercise performance level was negatively affected by chemotherapy in combination with SW-IMRT.

  15. Predictors of compliance with a home-based exercise program added to usual medical care in preventing postmenopausal osteoporosis: an 18-month prospective study.

    PubMed

    Mayoux-Benhamou, M A; Roux, C; Perraud, A; Fermanian, J; Rahali-Kachlouf, H; Revel, M

    2005-03-01

    This prospective 18-month study was designed to assess long-term compliance with a program of exercise aimed to prevent osteoporosis after an educational intervention and to uncover determinants of compliance. A total of 135 postmenopausal women were recruited by flyers or instructed by their physicians to participate in an educational session added to usual medical care. After a baseline visit and dual-energy X-ray absorptiometry, volunteers participated in a 1-day educational session consisting of a lecture and discussion on guidelines for appropriate physical activity and training in a home-based exercise program taught by a physical therapist. Scheduled follow-up visits were 1, 6, and 18 months after the educational session. Compliance with the exercise program was defined as an exercise practice rate 50% or greater than the prescribed training. The 18-month compliance rate was 17.8% (24/135). The main reason for withdrawal from the program was lack of motivation. Two variables predicted compliance: contraindication for hormone replacement therapy (odds ratio [OR] = 0.13; 95% confidence interval [95% CI], 0.04 to 0.46) and general physical function scores from an SF-36 questionnaire (OR=1.26; 95% CI, 1.03 to 1.5). To a lesser extent, osteoporosis risk, defined as a femoral T-score < or =-2.5, predicted compliance (OR=0.34; 95% CI, 0.10 to 1.16). Despite the addition of an educational session to usual medical care to inform participants about the benefits of exercise, only a minority of postmenopausal women adhered to a home-based exercise program after 18 months.

  16. A Home-Based Exercise Program Driven by Tablet Application and Mobility Monitoring for Frail Older Adults: Feasibility and Practical Implications

    PubMed Central

    Zijlstra, Wiebren; Zhang, Wei; Spoorenberg, Sophie L.W.; Báez, Marcos; Far, Iman Khaghani; Baldus, Heribert; Stevens, Martin

    2017-01-01

    Introduction Stimulation of a physically active lifestyle among older adults is essential to health and well-being. The objective of this study was to evaluate the feasibility and user opinion of a home-based exercise program supported by a sensor and tablet application for frail older adults. Methods Community-dwelling older adults (aged ≥70 y) living in The Netherlands were recruited in 2014. Participants exercised 3 months with and 3 months without supervision from a remote coach. Feasibility was operationalized as adherence to exercise (percentage of 5 exercise bouts per week completed) and to wearing the sensor (with 70% defined as sufficient adherence) and the number of problems reported. User opinion was measured with a questionnaire addressing ease of use of the technology and opinion on the program. Results Twenty-one of 40 enrolled participants completed the trial. Adherence overall was 60.9% (average of 3 bouts per week). Adherence among completers (69.2%) was significantly higher than adherence among dropouts (49.9%). Adherence was sufficient among completers during the 3 months of supervision (75.8%). Adherence to wearing the sensor was 66.7% and was significantly higher among completers than among dropouts (75.7% vs 54.2%). The rate of incidents was significantly lower among completers than among dropouts (0.4 vs 1.2 incidents per participant per week). Connectivity-related incidents were prominent. On a scale of 1 to 5, completers gave ratings of 4.3 (after 3 months) and 4.2 (after 6 months). Conclusion A home-based exercise program using novel technology seems feasible when participants are given a stable internet connection. This program shows promise for stimulating physical activity among older frail adults, especially if it offers regular coaching. PMID:28152361

  17. Individualized home-based exercise programs for older people to reduce falls and improve physical performance: A systematic review and meta-analysis.

    PubMed

    Hill, Keith D; Hunter, Susan W; Batchelor, Frances A; Cavalheri, Vinicius; Burton, Elissa

    2015-09-01

    There is considerable diversity in the types of exercise programs investigated to reduce falls in older people. The purpose of this paper was to review the effectiveness of individualized (tailored) home-based exercise programs in reducing falls and improving physical performance among older people living in the community. A systematic review and meta-analysis was conducted of randomized or quasi-randomized trials that utilized an individualized home-based exercise program with at least one falls outcome measure reported. Single intervention exercise studies, and multifactorial interventions where results for an exercise intervention were reported independently were included. Two researchers independently rated the quality of each included study. Of 16,871 papers identified from six databases, 12 met all inclusion criteria (11 randomized trials and a pragmatic trial). Study quality overall was high. Sample sizes ranged from 40 to 981, participants had an average age 80.1 years, and although the majority of studies targeted the general older population, several studies included clinical groups as their target (Parkinson's disease, Alzheimer's disease, and hip fracture). The meta-analysis results for the five studies reporting number of fallers found no significant effect of the intervention (RR [95% CI]=0.93 [0.72-1.21]), although when a sensitivity analysis was performed with one study of participants recently discharged from hospital removed, this result was significant (RR [95% CI] = 0.84 [0.72-0.99]). The meta-analysis also found that intervention led to significant improvements in physical activity, balance, mobility and muscle strength. There were no significant differences for measures of injurious falls or fractures.

  18. A home-based exercise intervention to increase physical activity among people living with HIV: study design of a randomized clinical trial

    PubMed Central

    2013-01-01

    Background While combination antiretroviral therapy has extended the life expectancy of those infected with human immunodeficiency virus (HIV), there is a high prevalence of comorbidities that increase the risk of cardiovascular morbidity and mortality among people living with HIV/AIDS (PLWHA). The side effects associated with antiretroviral therapy (ART) lead to multiple metabolic disorders, making the management of these metabolic issues and risk of cardiovascular disease (CVD) in those treated with ART a critical issue. Clinical research trials, primarily clinical exercise, rarely include this population due to unique challenges in research methods with underserved minority populations living with a life threatening illness like HIV/AIDS. This paper describes the rationale and design of a randomized clinical trial evaluating the feasibility of a home-based exercise program designed to increase physical activity (PA) and reduce the risk of CVD in PLWHA. Methods/design PLWHA being treated with ART will be randomly assigned to one of two groups: a home-based PA intervention or standard care. All participants will receive an educational weight loss workbook and pedometer for self-monitoring of PA. Only those in the intervention group will receive additional elastic Thera-bands® for strength training and behavioral telephone based coaching. Discussion This study will evaluate the feasibility of a home-based program designed to increase PA among PLWHA. Further, it will evaluate the effectiveness of such a program to decrease modifiable risk factors for CVD as a secondary outcome. This study was funded by the NIH/NINR R21 Grant 1R21NRO11281. Trial registration Clinical Trial Identifier NCT01377064 PMID:23706094

  19. Changes in derived measures from six-minute walk distance following home-based exercise training in congestive heart failure: A preliminary report.

    PubMed

    Babu, Abraham Samuel; Desai, Charmie V; Maiya, Arun G; Guddattu, Vasudeva; Padmakumar, Ramachandran

    2016-01-01

    The response of derived parameters from six-minute walk distance (6MWD), like 6MW work (6MWW), to exercise training and its correlation with quality of life (QoL) in congestive heart failure (CHF) is not known. A secondary analysis from a randomized controlled trial on 30 patients (23 males; mean age 57.7±10.4 years; mean ejection fraction 31±10%) with CHF in NYHA class I-IV who completed an eight-week home-based exercise training program found a significant improvement in 6MWW (p<0.05), with similar correlations between 6MWD and 6MWW with QoL. 6MWW does not appear to provide additional benefit to 6MWD in cardiac rehabilitation for CHF.

  20. RH-02A PILOT RCT ON THE EFFICACY OF HOME-BASED EXERCISE TO IMPROVE COGNITIVE FUNCTIONING IN GRADE II AND III GLIOMA PATIENTS

    PubMed Central

    Gehring, Karin; Stuiver, Martijn; Rutten, Geert-Jan; Taphoorn, Martin; Aaronson, Neil; Sitskoorn, Margriet

    2014-01-01

    Many patients with gliomas suffer from cognitive deficits. Recent findings indicate that physical exercise is effective in ameliorating cognitive decline, in particular in older adults and select neurological patient populations. Studies of exercise interventions in patients with cancer demonstrated to have beneficial effects on various measures of physical and mental well-being. This pilot randomized controlled trial investigates the efficacy of home-based exercise in improving cognitive functioning and self-reported mental well-being in glioma patients. Clinically stable patients with grade II and III glioma will undergo baseline neuropsychological testing, including questionnaires on cognitive symptoms, fatigue, sleep, mood and quality of life; and cardiorespiratory exercise testing (CPET) to determine room for improvement of physical fitness. Sixty patients will be randomized in a 2:1 ratio to the intervention group or active control group. Patients in the intervention group exercise 3 times per week for 6 months, during 20 to 45 minutes at an increasing intensity of 55 to 85% of their maximum heart rate. CPET-outcome (VO2peak) is used to tailor an individual, home-based exercise program. Participants wear heart rate monitors and are supervised by a physical therapist via internet and telephone. Patients in the active control group are advised to walk regularly. Neuropsychological test performance, physical fitness, and mental well-being are assessed again after 6 months. In November 2014, 30 patients are expected to be accrued. Six-month follow-up data on neuropsychological performance, physical fitness and self-reported mental well-being of the currently included 15 patients (12 intervention; 3 control group) will be available. Mean age of this group is 48.1 (±9.8) years; median time since surgery is 4.1 (0.7-14.7) years. Most of these participants are female (n = 11), and have a grade II glioma (n = 10). To our knowledge, this is the first study that

  1. Structured Home-Based Exercise Versus Invasive Treatment: A Mission Impossible? A Pilot Randomized Study in Elderly Patients With Intermittent Claudication.

    PubMed

    Lamberti, Nicola; Malagoni, Anna Maria; Ficarra, Valentina; Basaglia, Nino; Manfredini, Roberto; Zamboni, Paolo; Mascoli, Francesco; Manfredini, Fabio

    2016-09-01

    We compared the effects of an original structured home-based exercise program and revascularization in elderly patients with peripheral arterial disease over a 4-month period. Twenty-seven participants (n = 21; age = 68 ± 7 years) with moderate to severe claudication were randomized into (1) a test in-train out group (Ti-To; n = 18) that performed a home-based walking program prescribed and controlled at the hospital or (2) a revascularization group (Rev; n = 9) that underwent an endovascular and/or surgical procedure. The primary end point was quality of life as evaluated by the physical component summary (PCS) score of the Medical Outcomes Study Short Form 36 questionnaire. Secondary outcome measures included initial claudication distance (ICD) and absolute claudication distance (ACD), 6-minute walk distance (6MWD) and pain-free walk distance (PFWD), ankle-brachial index (ABI), and cost per walking meter gained. The PCS score significantly increased for both treatments at follow-up without a significant intergroup difference, as did ICD, ACD, and PFWD. The 6MWD and ABI significantly improved in the Rev group, and the Ti-To group exhibited a markedly lower cost per meter gained. The comparable effects of the 2 treatments need to be confirmed in a larger, randomized controlled trial.

  2. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.

    PubMed Central

    Campbell, A. J.; Robertson, M. C.; Gardner, M. M.; Norton, R. N.; Tilyard, M. W.; Buchner, D. M.

    1997-01-01

    OBJECTIVE: To assess the effectiveness of a home exercise programme of strength and balance retraining exercises in reducing falls and injuries in elderly women. DESIGN: Randomised controlled trial of an individually tailored programme of physical therapy in the home (exercise group, n = 116) compared with the usual care and an equal number of social visits (control group, n = 117). SETTING: 17 general practices in Dunedin, New Zealand. SUBJECTS: Women aged 80 years and older living in the community and registered with a general practice in Dunedin. MAIN OUTCOME MEASURES: Number of falls and injuries related to falls and time between falls during one year of follow up; changes in muscle strength and balance measures after six months. RESULTS: After one year there were 152 falls in the control group and 88 falls in the exercise group. The mean (SD) rate of falls was lower in the exercise than the control group (0.87 (1.29) v 1.34 (1.93) falls per year respectively; difference 0.47; 95% confidence interval 0.04 to 0.90). The relative hazard for the first four falls in the exercise group compared with the control group was 0.68 (0.52 to 0.90). The relative hazard for a first fall with injury in the exercise group compared with the control group was 0.61 (0.39 to 0.97). After six months, balance had improved in the exercise group (difference between groups in change in balance score 0.43 (0.21 to 0.65). CONCLUSIONS: An individual programme of strength and balance retraining exercises improved physical function and was effective in reducing falls and injuries in women 80 years and older. PMID:9366737

  3. Home-based exercise and support programme for people with dementia and their caregivers: study protocol of a randomised controlled trial

    PubMed Central

    2011-01-01

    Background Dementia affects the mood of people with dementia but also of their caregivers. In the coming years, the number of people with dementia will increase worldwide and most of them will continue to live in the community as long as possible. Home-based psychosocial interventions reducing the depressive symptoms of both people with dementia and their caregivers in their own home are highly needed. Methods/Design This manuscript describes the design of a Randomised Controlled Trial (RCT) of the effects of a home-based exercise and support programme for people with dementia and their caregivers. The aim is to randomly assign 156 dyads (caregiver and dementia diagnosed person) to an intervention group or a comparison group. The experimental group receives a home programme in which exercise and support for the people with dementia and their caregivers are combined and integrated. The comparison group receives a minimal intervention. Primary outcomes are physical health (people with dementia) and mood (people with dementia and caregivers). In addition, to get more insight in the working components of the intervention and the impact of the intervention on the relationship of the dyads a qualitative sub-study is carried out. Discussion This study aims to contribute to an evidence-based treatment to reduce depressive symptoms among people with dementia and their caregivers independently living in the community. Trial Registration The study has been registered at the Netherlands National Trial Register (NTR), which is connected to the International Clinical Trials Registry Platform of the WHO. Trial number: NTR1802. PMID:22117691

  4. Effect of Workplace- versus Home-Based Physical Exercise on Muscle Response to Sudden Trunk Perturbation among Healthcare Workers: A Cluster Randomized Controlled Trial

    PubMed Central

    Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel; Jay, Kenneth; Aagaard, Per; Andersen, Lars L.

    2015-01-01

    Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2.2] on a scale of 0–10) from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or (2) home-based physical exercise (HOME) performed during leisure time for 5 × 10 minutes per week. Mechanical and neuromuscular (EMG) response to randomly assigned unloading and loading trunk perturbations and questions of fear avoidance were assessed at baseline and 10-week follow-up. Results. No group by time interaction for the mechanical trunk response and EMG latency time was seen following the ten weeks (P = 0.17–0.75). However, both groups demonstrated within-group changes (P < 0.05) in stopping time during the loading and unloading perturbation and in stopping distance during the loading perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI −2.7–−0.7 (P < 0.05) and −0.14 (−0.30 to 0.02) (P = 0.09)), respectively. WORK and HOME performed 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions per week, respectively. Conclusions. Although training adherence was higher following WORK compared to HOME this additional training volume did not lead to significant between-group differences in the responses to sudden trunk perturbations. However, WORK led to reduced fear avoidance and reduced muscle preactivity prior to the perturbation onset, compared with HOME. This trial is registered with Clinicaltrials.gov (NCT01921764). PMID:26583145

  5. Effects of Home-Based Diet and Exercise on Functional Outcomes Among Older, Overweight Long-Term Cancer Survivors: The RENEW: Randomized Clinical Trial

    PubMed Central

    Morey, Miriam C.; Snyder, Denise C.; Sloane, Richard; Jay Cohen, Harvey; Peterson, Bercedis; Hartman, Terryl J; Miller, Paige; Mitchell, Diane C.; Demark-Wahnefried, Wendy

    2009-01-01

    Context Five-year survival rates for early-stage colorectal, breast and prostate cancer currently exceed 90% and are increasing. Cancer survivors are at greater risk for second malignancies, other co-morbidities, and accelerated functional decline. Lifestyle interventions may provide benefit, but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status. Objective To determine whether a telephone counseling and mailed material-based diet-exercise intervention is effective in reorienting functional decline in older, overweight cancer survivors. Design Randomized controlled trial in which survivors were randomly assigned to intervention (Intervention, n=319) or delayed-intervention control arms (Control, n=322). Setting Home-based from Canada, United Kingdom and 21 United States Participants 641 overweight (body mass index [BMI] ≥ 25), long-term (≥ 5 years) survivors (ages 65–91) of colorectal, breast and prostate cancer recruited July 2005-May 2007. Intervention 12-month home-based tailored program of telephone counseling and mailed materials promoting exercise, improved diet quality, and modest weight loss. Control group wait-listed for 12 months. Main Outcome Measures Change in self-reported physical function (SF-36 physical function subscale: 0–100, high score indicates better function) from baseline to 12 months was the primary endpoint. Secondary outcomes included changes in basic and advanced lower extremity function (0–100), physical activity, BMI, and overall health quality-of-life. Results From an average baseline score of 75.7 to 12-month follow-up, SF-36 function scores declined less rapidly in Intervention [−2.15(95% CI-0.36,−3.93)] versus Control [−4.84(−3.04,−6.63)] arms (p=0.03). Likewise, changes in basic lower extremity function were +0.34(−0.84,1.52) versus −1.89(−0.70,−3.09) from an average baseline score of 78.2, p=0.005. Physical activity, dietary

  6. Multidimensional exercise for people with Parkinson's disease: a case report.

    PubMed

    Kluding, Patricia; McGinnis, Patricia Quinn

    2006-06-01

    The primary impairments associated with Parkinson's disease occur in combination with the secondary, preventable effects of immobility. A community-based fitness program may help increase activity and maintain function in people in the early or middle stages of the disease. This article describes a unique program designed to reduce fall risk and promote independent exercise for people with Parkinson's disease. Two 66-year-old males, both community ambulators and in early or middle stages of Parkinson's disease, participated in 3 months of various physical activities. Group balance classes were held twice weekly during the first month, participants joined a fitness center and self-directed their exercise program during the second month, and group Tai Chi classes were held twice weekly during the third month. At conclusion of the program, participants were given suggestions for continued physical fitness activities. After the 3-month program, improvements were noted for both individuals in functional reach, Timed Up and Go, and Berg Balance scores. Both participants continued to exercise regularly for at least 8 months following the program. Two individuals with Parkinson's disease demonstrated improvement in their balance test performance over a 3-month period. Perhaps most importantly, these participants independently continued exercising after completing this program.

  7. Home-Based Resistance Training: Predictors of Participation and Adherence.

    ERIC Educational Resources Information Center

    Jette, Alan M.; Rooks, Dan; Lachman, Margie; Lin, Ting H.; Levenson, Claudia; Heislein, Diane; Giorgetti, Marie M.; Harris, B. A.

    1998-01-01

    Identifies factors associated with exercise participation and adherence in a sample of sedentary, functionally limited, community-dwelling adults ages 60 to 94 who participated in a home-based resistance training program (N=102). Results show that psychological factors were most important to adherence to the home-based program. (Author/MKA)

  8. Evaluating the effectiveness of a home-based exercise programme delivered through a tablet computer for preventing falls in older community-dwelling people over 2 years: study protocol for the Standing Tall randomised controlled trial

    PubMed Central

    Delbaere, K; Valenzuela, T; Woodbury, A; Davies, T; Yeong, J; Steffens, D; Miles, L; Pickett, L; Zijlstra, G A R; Clemson, L; Close, J C T; Howard, K; Lord, S R

    2015-01-01

    Introduction In order to prevent falls, older people should exercise for at least 2 h per week for 6 months, with a strong focus on balance exercises. This article describes the design of a randomised controlled trial to evaluate the effectiveness of a home-based exercise programme delivered through a tablet computer to prevent falls in older people. Methods and analysis Participants aged 70 years or older, living in the community in Sydney will be recruited and randomly allocated to an intervention or control group. The intervention consists of a tailored, home-based balance training delivered through a tablet computer. Intervention participants will be asked to complete 2 h of exercises per week for 2 years. Both groups will receive an education programme focused on health-related information relevant to older adults, delivered through the tablet computer via weekly fact sheets. Primary outcome measures include number of fallers and falls rate recorded in weekly fall diaries at 12 months. A sample size of 500 will be necessary to see an effect on falls rate. Secondary outcome measures include concern about falling, depressive symptoms, health-related quality of life and physical activity levels (in all 500 participants); and physiological fall risk, balance, functional mobility, gait, stepping and cognitive performance (in a subsample of 200 participants). Adherence, acceptability, usability and enjoyment will be recorded in intervention group participants over 2 years. Data will be analysed using the intention-to-treat principle. Secondary analyses are planned in people with greater adherence. Economic analyses will be assessed from a health and community care provider perspective. Ethics and dissemination Ethical approval was obtained from UNSW Ethics Committee in December 2014 (ref number HC#14/266). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conferences. Trial registration number

  9. Effects of Aerobic Exercise on Female Body Esteem: A Multidimensional Approach.

    ERIC Educational Resources Information Center

    Franzoi, Stephen L.

    Although research has shown that regularly engaging in vigorous activity has both physical and mental benefits, including a more positive evaluation of one's own body, the multidimensional nature of people's body attitudes has not been considered. The Body Esteem Scale (BES) was developed to identify and assess different body esteem dimensions.…

  10. Reach Out to Enhance Wellness in Older Cancer Survivors (RENEW): Design, Methods and Recruitment Challenges of a Home-based Exercise and Diet Intervention to Improve Physical Function among Long-term Survivors of Breast, Prostate, and Colorectal Cancer

    PubMed Central

    Snyder, Denise Clutter; Morey, Miriam C.; Sloane, Richard; Stull, Valeda; Cohen, Harvey Jay; Peterson, Bercedis; Pieper, Carl; Hartman, Terryl J.; Miller, Paige E.; Mitchell, Diane C.; Demark-Wahnefried, Wendy

    2009-01-01

    Objective Cure rates for cancer are increasing, especially for breast, prostate, and colorectal cancer. Despite positive trends in survivorship, a cancer diagnosis can trigger accelerated functional decline that can threaten independence, reduce quality-of-life and increase health care costs, especially among the elderly who comprise the majority of survivors. Lifestyle interventions may hold promise in reorienting functional decline in older cancer survivors, but few studies have been conducted. Method We describe the design and methods of a randomized controlled trial, RENEW (Reach out to ENhancE Wellness), that tests whether a home-based multi-behavior intervention focused on exercise, and including a low-saturated fat, plant-based diet, would improve physical functioning among 641 older, long-term (≥5 years post-diagnosis) survivors of breast, prostate, or colorectal cancer. Challenges to recruitment are examined. Results 20,015 cases were approached, and screened using a two-step screening process to assure eligibility. This population of long-term, elderly cancer survivors had lower rates of response (∼11%) and higher rates of ineligibility (∼70%) than our previous intervention studies conducted on adults with newly diagnosed cancer. Significantly higher response rates were noted among survivors who were white, younger, and more proximal to diagnosis and breast cancer survivors (p-values < 0.001). Conclusions Older cancer survivors represent a vulnerable population for whom lifestyle interventions may hold promise. RENEW may provide guidance in allocating limited resources in order to maximize recruitment efforts aimed at this needy, but hard-to-reach population. PMID:19117329

  11. Physiologic Determinants of Exercise Capacity in Pulmonary Langerhans Cell Histiocytosis: A Multidimensional Analysis

    PubMed Central

    Fry, Stephanie; Giovannelli, Jonathan; Langlois, Carole; Bricout, Nicolas; Aguilaniu, Bernard; Bellocq, Agnes; Le Rouzic, Olivier; Dominique, Stephane; Delobbe, Alain; François, Geraldine; Tazi, Abdellatif; Wallaert, Benoit; Chenivesse, Cecile

    2017-01-01

    Background Reduced exercise capacity severely impacts quality of life in pulmonary Langerhans cell histiocytosis. Ascertaining mechanisms that impair exercise capacity is necessary to identify targets for symptomatic treatments. Methods Dyspnea, pulmonary function tests and cardiopulmonary exercise test were analysed in 62 study participants. Data were compared between subjects with impaired and normal aerobic capacity (V’O2 peak less than 84% versus 84% predicted or more). Data were reduced using a principal component analysis. Multivariate analysis included V’O2 peak as the dependent variable and principal components as covariates. Results V’O2 peak was reduced in 44 subjects (71%). Subjects with impaired aerobic capacity presented: (i) decreased FEV1, FVC, FEV1/FVC, DLCO and DLCO/VA and increased AaDO2, (ii) increased ventilatory equivalents at ventilatory threshold, VD/VT peak, AaDO2 peak and PaCO2 peak and decreased ventilatory reserve and PaO2 peak. There was no difference between groups in dyspnea scores. Principal component analysis extracted 4 principal components interpreted as follows: PC1: gas exchange; PC2: “pseudorestriction”; PC3: exercise-induced hyperpnea; PC4: air trapping. Multivariate analysis explained 65% of V’O2 peak. The 4 principal components were independently associated with V’O2 peak (βcoefficients: PC1: 9.3 [4.6; 14], PC2: 7.5 [3; 11.9], PC3: -5.3 [-9.6;-1.], PC4: -9.8 [-14,9;-4.7]). Conclusion Impaired exercise capacity is frequent in pulmonary Langerhans cell histiocytosis. It is mainly caused by pulmonary changes but is not associated with increased dyspnea intensity. Therefore, treating the lung represents a relevant approach for improving exercise capacity, even in patients experiencing mild dyspnea. PMID:28072848

  12. Head Start Home-Based Resource Directory.

    ERIC Educational Resources Information Center

    Trans-Management Systems, Inc.

    A revision of the 1989 publication, this directory was compiled in order to help parents and professionals involved with Head Start home-based programming in meeting the needs of young children and families. The directory lists a broad range of guides and resources on topics related to Head Start home-based programs. Each listing provides the…

  13. A tool for home-based rehabilitation allowing for clinical evaluation in a visual markerless scenario.

    PubMed

    Capecci, M; Ceravolo, M G; D'Orazio, F; Ferracuti, F; Iarlori, S; Lazzaro, G; Longhi, S; Romeo, L; Verdini, F

    2015-08-01

    This work deals with the design of an interactive monitoring tool for home-based physical rehabilitation. The software platform includes a video processing stage and the exercise performance evaluation. Image features are extracted by a Kinect v2 sensor and elaborated to return the exercises score. Furthermore the tool provides to physiotherapists a quantitative exercise evaluation of subject's performances. The proposed tool for home rehabilitation has been tested on 5 subjects and 5 different exercises and results are presented. In particular both exercises and relative evaluation indexes were selected by specialists in neurorehabilitation.

  14. Multidimensional spectrometer

    DOEpatents

    Zanni, Martin Thomas; Damrauer, Niels H.

    2010-07-20

    A multidimensional spectrometer for the infrared, visible, and ultraviolet regions of the electromagnetic spectrum, and a method for making multidimensional spectroscopic measurements in the infrared, visible, and ultraviolet regions of the electromagnetic spectrum. The multidimensional spectrometer facilitates measurements of inter- and intra-molecular interactions.

  15. Reach Out to Enhance Wellness Home-Based Diet-Exercise Intervention Promotes Reproducible and Sustainable Long-Term Improvements in Health Behaviors, Body Weight, and Physical Functioning in Older, Overweight/Obese Cancer Survivors

    PubMed Central

    Demark-Wahnefried, Wendy; Morey, Miriam C.; Sloane, Richard; Snyder, Denise C.; Miller, Paige E.; Hartman, Terryl J.; Cohen, Harvey J.

    2012-01-01

    Purpose Diet and exercise interventions have been tested in cancer survivors as a means to reduce late effects and comorbidity, but few have assessed adherence and health outcomes long term. Methods Between July 2005 and May 2007, the Reach Out to Enhance Wellness (RENEW) trial accrued 641 locoregionally staged, long-term (≥ 5 years from diagnosis) colorectal, breast, and prostate cancer survivors in the United States (21 states), Canada, and the United Kingdom. All participants were sedentary (< 150 minutes of physical activity [PA] a week), overweight or obese (body mass index, 25 to 40 kg/m2), and over age 65 years. The trial tested a diet-exercise intervention delivered via mailed print materials and telephone counseling. RENEW used a wait-list control, cross-over design (ie, participants received the year-long intervention immediately or after a 1-year delay), which allowed the opportunity to assess program efficacy (previously reported primary outcome), durability, and reproducibility (reported herein). Measures included diet quality (DQ), PA, BMI, and physical function (PF). Results No significant relapse was observed in the immediate-intervention arm for DQ, PA, and BMI; however, rates of functional decline increased when the intervention ceased. From year 1 to year 2, significant improvements were observed in the delayed-intervention arm; mean change scores in behaviors and BMI and PF slopes were as follows: DQ score, 5.2 (95% CI, 3.4 to 7.0); PA, 45.8 min/wk (95% CI, 26.9 to 64.6 min/wk); BMI, −0.56 (95% CI, −0.75 to −0.36); and Short Form-36 PF, −1.02 versus −5.52 (P < .001 for all measures). Overall, both arms experienced significant improvements in DQ, PA, and BMI from baseline to 2-year follow-up (P < .001). Conclusion Older cancer survivors respond favorably to lifestyle interventions and make durable changes in DQ and PA that contribute to sustained weight loss. These changes positively reorient functional decline trajectories during

  16. Effects of home-based pulmonary rehabilitation with a metronome-guided walking pace in chronic obstructive pulmonary disease.

    PubMed

    Lee, Sung-soon; Kim, Changhwan; Jin, Young-Soo; Oh, Yeon-Mok; Lee, Sang-Do; Yang, Yun Jun; Park, Yong Bum

    2013-05-01

    Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P < 0.001) over the six-month follow-up period after rehabilitation. There were no significant differences in pulmonary function and peak exercise parameters. We developed an effective home-based PR program with a metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.

  17. Home-based versus centre-based cardiac rehabilitation

    PubMed Central

    Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

    2014-01-01

    Background The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Traditionally centre-based cardiac rehabilitation (CR) programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. Objectives To determine the effectiveness of home-based cardiac rehabilitation programmes compared with supervised centre-based cardiac rehabilitation on mortality and morbidity, health-related quality of life and modifiable cardiac risk factors in patients with coronary heart disease. Search methods We updated the search of a previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2007, Issue 4), MEDLINE, EMBASE and CINAHL from 2001 to January 2008. We checked reference lists and sought advice from experts. No language restrictions were applied. Selection criteria Randomised controlled trials (RCTs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes, in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Data collection and analysis Studies were selected independently by two reviewers, and data extracted by a single reviewer and checked by a second one. Authors were contacted where possible to obtain missing information. Main results Twelve studies (1,938 participants) met the inclusion criteria. The majority of studies recruited a lower risk patient following an acute myocardial infarction (MI) and revascularisation. There was no difference in outcomes of home- versus centre-based cardiac rehabilitation in mortality risk ratio (RR) was 1.31 (95% confidence interval (C) 0.65 to 2.66), cardiac events, exercise capacity standardised mean difference (SMD) −0.11 (95% CI −0.35 to 0.13), as well

  18. Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD

    PubMed Central

    Grosbois, Jean Marie; Gicquello, Alice; Langlois, Carole; Le Rouzic, Olivier; Bart, Frédéric; Wallaert, Benoit; Chenivesse, Cécile

    2015-01-01

    Introduction Personalized, global pulmonary rehabilitation (PR) management of patients with COPD is effective, regardless of the place in which this rehabilitation is provided. The objective of this retrospective observational study was to study the long-term outcome of exercise capacity and quality of life during management of patients with COPD treated by home-based PR. Methods Home-based PR was administered to 211 patients with COPD (mean age, 62.3±11.1 years; mean forced expiratory volume in 1 second, 41.5%±17.7%). Home-based PR was chosen because of the distance of the patient’s home from the PR center and the patient’s preference. Each patient was individually managed by a team member once a week for 8 weeks with unsupervised continuation of physical exercises on the other days of the week according to an individual action plan. Exercise conditioning, therapeutic patient education, and self-management were included in the PR program. The home assessment comprised evaluation of the patient’s exercise capacity by a 6-minute stepper test, Timed Up and Go test, ten times sit-to-stand test, Hospital Anxiety and Depression score, and quality of life (Visual Simplified Respiratory Questionnaire, VQ11, Maugeri Respiratory Failure 28). Results No incidents or accidents were observed during the course of home-based PR. The 6-minute stepper test was significantly improved after completion of the program, at 6 months and 12 months, whereas the Timed Up and Go and ten times sit-to-stand test were improved after PR and at 6 months but not at 12 months. Hospital Anxiety and Depression and quality of life scores improved after PR, and this improvement persisted at 6 months and 12 months. Conclusion Home-based PR for unselected patients with COPD is effective in the short term, and this effectiveness is maintained in the medium term (6 months) and long term (12 months). Home-based PR is an alternative to outpatient management provided all activities, such as exercise

  19. [Home-based telerehabilitation after stroke].

    PubMed

    Keidel, M; Vauth, F; Richter, J; Hoffmann, B; Soda, H; Griewing, B; Scibor, M

    2017-02-01

    The use of modern information and telecommunication technologies enables telerehabilitation of neurological deficits in the domestic environment. The current state of studies on rehabilitative teletherapy for improvement of motor function and mobility deficits due to stroke is reviewed. Two neurolinguistic proof of concept studies investigating the efficacy of online interactive telespeech therapy are reported, which compared virtual screen to screen interactive telerehabilitation of aphasia after stroke and dysarthrophonia in Parkinson's disease to conventional face to face rehabilitation. The results of the studies indicate that the neurological rehabilitation of motor and communicative deficits in the domestic environment of patients by means of teletherapy is just as efficient as conventional rehabilitation. Under home-based telerehabilitation patient transfer becomes unnecessary. Rehabilitative Teletherapy is a posthospital component of a cross-sector supply chain for patients with handicaps or impairments due to stroke and other neurological diseases.

  20. An easy to use and affordable home-based personal eHealth system for chronic disease management based on free open source software.

    PubMed

    Burkow, Tatjana M; Vognild, Lars K; Krogstad, Trine; Borch, Njål; Ostengen, Geir; Bratvold, Astrid; Risberg, Marijke Jongsma

    2008-01-01

    This paper describes an easy to use home-based eHealth system for chronic disease management. We present the design and implementation of a prototype for home based education, exercises, treatment and following-up, with the TV and a remote control as user interface. We also briefly describe field trials of the system for patients with COPD and diabetes, and their experience with the technology.

  1. Kinect system in home-based cardiovascular rehabilitation.

    PubMed

    Vieira, Ágata; Gabriel, Joaquim; Melo, Cristina; Machado, Jorge

    2017-01-01

    Cardiovascular diseases lead to a high consumption of financial resources. An important part of the recovery process is the cardiovascular rehabilitation. This study aimed to present a new cardiovascular rehabilitation system to 11 outpatients with coronary artery disease from a Hospital in Porto, Portugal, later collecting their opinions. This system is based on a virtual reality game system, using the Kinect sensor while performing an exercise protocol which is integrated in a home-based cardiovascular rehabilitation programme, with a duration of 6 months and at the maintenance phase. The participants responded to a questionnaire asking for their opinion about the system. The results demonstrated that 91% of the participants (n = 10) enjoyed the artwork, while 100% (n = 11) agreed on the importance and usefulness of the automatic counting of the number of repetitions, moreover 64% (n = 7) reported motivation to continue performing the programme after the end of the study, and 100% (n = 11) recognized Kinect as an instrument with potential to be an asset in cardiovascular rehabilitation. Criticisms included limitations in motion capture and gesture recognition, 91% (n = 10), and the lack of home space, 27% (n = 3). According to the participants' opinions, the Kinect has the potential to be used in cardiovascular rehabilitation; however, several technical details require improvement, particularly regarding the motion capture and gesture recognition.

  2. Experiences in home-based growth monitoring.

    PubMed

    Suelan, F; Briones, H

    1992-01-01

    A growth monitoring project (GMP) of child weighing was implemented by the Philippines' Department of Health (DOH) through the Integrated Provincial Health Office to monitor either children's nutritional progress or their faltering of growth. Weaknesses, however, were found in the GMP. For example, only 31% of preschoolers included in the Nutrition Center of the Philippines (NCP) survey had growth charts. An 1990 UNICEF-DOH survey also found that the growth chart was used primarily by mothers and service providers to record infant immunization. Mothers brought their children to well-baby clinics in barangay health centers only when their children were sick. Conducted only once per year, weighing was not perceived as a tool in detecting and preventing sickness, and ensuring normal growth. Asked to help improve the GMP, the NCP consulted intended beneficiaries and cooperators to develop a plan to pilot an intensive monitoring project in four towns of Negros Occidental, starting in January 1991 and ending in December 1992. The resultant Home-Based Growth Monitoring (HBGM) project would place emphasis upon enabling rural mothers to become self-sustaining agents for child growth monitoring. A key feature was the establishment of a weighing post in a strategic place for every 2-3 family clusters. The HBGM project was piloted in 1991 in Calatrava, Toboso, Cauayan, and Sipalay. This paper describes project implementation, problems and solutions, and results.

  3. Exercises

    MedlinePlus

    ... Living with Chronic Lung Disease Common Feelings Anxiety Depression Sleep Intimacy Importance of Being Together Body Changes with Age Communicating with Your Partner Exercise and Sexual Activity Less Strenuous Positions for Sexual ...

  4. A Home-Based Palliative Care Consult Service for Veterans.

    PubMed

    Golden, Adam G; Antoni, Charles; Gammonley, Denise

    2016-11-01

    We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians.

  5. Rationing home-based nursing care: professional ethical implications.

    PubMed

    Tønnessen, Siri; Nortvedt, Per; Førde, Reidun

    2011-05-01

    The purpose of this study was to investigate nurses' decisions about priorities in home-based nursing care. Qualitative research interviews were conducted with 17 nurses in home-based care. The interviews were analyzed and interpreted according to a hermeneutic methodology. Nurses describe clinical priorities in home-based care as rationing care to mind the gap between an extensive workload and staff shortages. By organizing home-based care according to tight time schedules, the nurses' are able to provide care for as many patients as possible. Furthermore, legal norms set boundaries for clinical priority decisions, resulting in marginalized care. Hence, rationing care jeopardizes important values in the nurse-patient relationship, in particular the value of individualized and inclusive nursing care. The findings are highly relevant for clinical practice, since they have major implications for provision of nursing care. They revive debates about the protection of values and standards of care, and nurses' role and responsibility when resources are limited.

  6. Home Based Early Intervention: Dimensions of Current Practice.

    ERIC Educational Resources Information Center

    Halpern, Robert

    1986-01-01

    Questions whether home-based early intervention is an invasion of the family that inadvertently undermines its self-confidence or is a life-saving service to families whose children are at risk of abuse and neglect. (HOD)

  7. Analyzing the Interprofessional Working of a Home-Based Primary Care Team.

    PubMed

    Smith-Carrier, Tracy; Neysmith, Sheila

    2014-09-01

    Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients' homes), as well the negotiation of external relationships in the HBPC field, require further investigation.

  8. Assessment of Haptic Interaction for Home-Based Physical Tele-Therapy using Wearable Devices and Depth Sensors.

    PubMed

    Barmpoutis, Angelos; Alzate, Jose; Beekhuizen, Samantha; Delgado, Horacio; Donaldson, Preston; Hall, Andrew; Lago, Charlie; Vidal, Kevin; Fox, Emily J

    2016-01-01

    In this paper a prototype system is presented for home-based physical tele-therapy using a wearable device for haptic feedback. The haptic feedback is generated as a sequence of vibratory cues from 8 vibrator motors equally spaced along an elastic wearable band. The motors guide the patients' movement as they perform a prescribed exercise routine in a way that replaces the physical therapists' haptic guidance in an unsupervised or remotely supervised home-based therapy session. A pilot study of 25 human subjects was performed that focused on: a) testing the capability of the system to guide the users in arbitrary motion paths in the space and b) comparing the motion of the users during typical physical therapy exercises with and without haptic-based guidance. The results demonstrate the efficacy of the proposed system.

  9. Multidimensional scaling

    PubMed Central

    Papesh, Megan H.; Goldinger, Stephen D.

    2012-01-01

    The concept of similarity, or a sense of "sameness" among things, is pivotal to theories in the cognitive sciences and beyond. Similarity, however, is a difficult thing to measure. Multidimensional scaling (MDS) is a tool by which researchers can obtain quantitative estimates of similarity among groups of items. More formally, MDS refers to a set of statistical techniques that are used to reduce the complexity of a data set, permitting visual appreciation of the underlying relational structures contained therein. The current paper provides an overview of MDS. We discuss key aspects of performing this technique, such as methods that can be used to collect similarity estimates, analytic techniques for treating proximity data, and various concerns regarding interpretation of the MDS output. MDS analyses of two novel data sets are also included, highlighting in step-by-step fashion how MDS is performed, and key issues that may arise during analysis. PMID:23359318

  10. Impact of a home-based walking intervention on outcomes of sleep quality, emotional distress, and fatigue in patients undergoing treatment for solid tumors.

    PubMed

    Wenzel, Jennifer A; Griffith, Kathleen A; Shang, Jingjing; Thompson, Carol B; Hedlin, Haley; Stewart, Kerry J; DeWeese, Theodore; Mock, Victoria

    2013-01-01

    Exercise use among patients with cancer has been shown to have many benefits and few notable risks. The purpose of this study was to evaluate the impact of a home-based walking intervention during cancer treatment on sleep quality, emotional distress, and fatigue. Methods. A total of 138 patients with prostate (55.6%), breast (32.5%), and other solid tumors (11.9%) were randomized to a home-based walking intervention or usual care. Exercise dose was assessed using a five-item subscale of the Cooper Aerobics Center Longitudinal Study Physical Activity Questionnaire. Primary outcomes of sleep quality, distress, and fatigue were compared between the two study arms. Results. The exercise group (n = 68) reported more vigor (p = .03) than control group participants (n = 58). In dose response models, greater participation in aerobic exercise was associated with 11% less fatigue (p < .001), 7.5% more vigor (p = .001), and 3% less emotional distress (p = .03), after controlling for intervention group assignment, age, and baseline exercise and fatigue levels. Conclusion. Patients who exercised during cancer treatment experienced less emotional distress than those who were less active. Increasing exercise was also associated with less fatigue and more vigor. Home-based walking is a simple, sustainable strategy that may be helpful in improving a number of symptoms encountered by patients undergoing active treatment for cancer.

  11. A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD

    PubMed Central

    Cameron-Tucker, Helen Laura; Wood-Baker, Richard; Joseph, Lyn; Walters, Julia A; Schüz, Natalie; Walters, E Haydn

    2016-01-01

    Purpose With the limited reach of pulmonary rehabilitation (PR) and low levels of daily physical activity in chronic obstructive pulmonary disease (COPD), a need exists to increase daily exercise. This study evaluated telephone health-mentoring targeting home-based walking (tele-rehab) compared to usual waiting time (usual care) followed by group PR. Patients and methods People with COPD were randomized to tele-rehab (intervention) or usual care (controls). Tele-rehab delivered by trained nurse health-mentors supported participants’ home-based walking over 8–12 weeks. PR, delivered to both groups simultaneously, included 8 weeks of once-weekly education and self-management skills, with separate supervised exercise. Data were collected at three time-points: baseline (TP1), before (TP2), and after (TP3) PR. The primary outcome was change in physical capacity measured by 6-minute walk distance (6MWD) with two tests performed at each time-point. Secondary outcomes included changes in self-reported home-based walking, health-related quality of life, and health behaviors. Results Of 65 recruits, 25 withdrew before completing PR. Forty attended a median of 6 (4) education sessions. Seventeen attended supervised exercise (5±2 sessions). Between TP1 and TP2, there was a statistically significant increase in the median 6MWD of 12 (39.1) m in controls, but no change in the tele-rehab group. There were no significant changes in 6MWD between other time-points or groups, or significant change in any secondary outcomes. Participants attending supervised exercise showed a nonsignificant improvement in 6MWD, 12.3 (71) m, while others showed no change, 0 (33) m. The mean 6MWD was significantly greater, but not clinically meaningful, for the second test compared to the first at all time-points. Conclusion Telephone-mentoring for home-based walking demonstrated no benefit to exercise capacity. Two 6-minute walking tests at each time-point may not be necessary. Supervised exercise

  12. Encounters in Home-Based Nursing Care - Registered Nurses’ Experiences

    PubMed Central

    Wälivaara, Britt-Marie; Sävenstedt, Stefan; Axelsson, Karin

    2013-01-01

    The encounter between registered nurses and persons in need of healthcare has been described as fundamental in nursing care. This encounter can take place face-to-face in physical meetings and through meetings via distance-spanning technology. A strong view expressed in the literature is that the face-to-face encounter is important and cannot entirely be replaced by remote encounters. The encounter has been studied in various healthcare contexts but there is a lack of studies with specific focus on the encounter in home-based nursing care. The aim of this study was to explore the encounter in home-based nursing care based on registered nurses’ experiences. Individual interviews were performed with 24 nurses working in home-based nursing care. The transcribed interviews were analyzed using thematic content analysis and six themes were identified: Follows special rules, Needs some doing, Provides unique information and understanding, Facilitates by being known, Brings energy and relieves anxiety, and Can reach a spirit of community. The encounter includes dimensions of being private, being personal and being professional. A good encounter contains dimensions of being personal and being professional and that there is a good balance between these. This is an encounter between two human beings, where the nurse faces the person with herself and the profession steadily and securely in the back. Being personal and professional at the same time could encourage nurses to focus on doing and being during the encounter in home-based nursing care. PMID:23847697

  13. Washington State's Laws Regulating Home-Based Instruction. Revised.

    ERIC Educational Resources Information Center

    Bergeson, Terry; Kelly, Thomas J.; Riggers, Marcia L.; Dyer, Melinda

    This publication was put together by the Washington State Office of Superintendent of Public Instruction in response to questions about laws concerning home-based instruction passed in 1985. Part 1 contains responses to questions relating to Chapter 28A.225 RCW and Chapter 28A.200 RCW; topics covered include regulations governing compulsory school…

  14. Home-Based Crisis Therapy: A Comparative Outcome Study.

    ERIC Educational Resources Information Center

    Rowland, Charity; And Others

    Substitute care for a child at risk has been been associated with psychological distress in the child and his family and a drain on public finances. To investigate the cost effectiveness and ultimate influence on family intactness of home-based family crisis intervention, 77 low income, inner city families with an adolescent child at risk of…

  15. Status of the Home-Based Effort Within Head Start.

    ERIC Educational Resources Information Center

    Children First, Inc., Washington, DC.

    This status report is an attempt to provide a comprehensive picture of Head Start home-based programs which aimed at helping parents provide children with the same kinds of activities and support in their own homes that children would receive in any quality child development center. Data was collected through: (1) Children (1st) First, Inc.'s…

  16. Home Based Early Intervention: The Story of Susan.

    ERIC Educational Resources Information Center

    Gray, Davon

    1980-01-01

    Case of a severely handicapped preschooler illustrates advantages of home-based infant stimulation program. Initial goals were: work toward physical separation of mother and child, shape and reinforce child's behavior to extinguish crying, shape and reinforce mother's behavior to enrich home environment, and stimulate and reinforce a developmental…

  17. Home Based Care: Direction for the 80s.

    ERIC Educational Resources Information Center

    Bryce, Marvin E.

    Home based family centered (HBFC) service programs have been developed as alternatives to out-of-home placement. These programs have reported relatively high service success rates at costs signficantly lower than foster home and institutional care while, at the same time, avoiding the social and psychological risks of out-of-home placement.…

  18. Longitudinal comparison of a physiotherapist-led, home-based and group-based program for increasing physical activity in community-dwelling middle-aged adults.

    PubMed

    Freene, Nicole; Waddington, Gordon; Davey, Rachel; Cochrane, Tom

    2015-01-01

    Few studies have compared the longer-term effects of physical activity interventions. Here we compare a 6-month physiotherapist-led, home-based physical activity program to a community group exercise program over 2 years. Healthy, sedentary community-dwelling 50-65 year olds were recruited to a non-randomised community group exercise program (G, n = 93) or a physiotherapist-led, home-based physical activity program (HB, n = 65). Outcomes included 'sufficient' physical activity (Active Australia Survey), minutes of moderate-vigorous physical activity (ActiGraph GT1M), aerobic capacity (2-min step-test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Outcome measures were collected at baseline, 6, 12, 18 and 24 months. Using intention-to-treat analysis, both interventions resulted in significant and sustainable increases in the number of participants achieving 'sufficient' physical activity (HB 22 v. 41%, G 22 v. 47%, P ≤ 0.001) and decreases in waist circumference (HB 90 v. 89 cm, G 93 v. 91 cm, P < 0.001) over 2 years. The home-based program was less costly (HB A$47 v. G $84 per participant) but less effective in achieving the benefits at 2 years. The physiotherapist-led, home-based physical activity program may be a low-cost alternative to increase physical activity levels for those not interested in, or unable to attend, a group exercise program.

  19. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    PubMed Central

    López-Liria, Remedios; Padilla-Góngora, David; Catalan-Matamoros, Daniel; Rocamora-Pérez, Patricia; Pérez-de la Cruz, Sagrario; Fernández-Sánchez, Manuel

    2015-01-01

    Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients' functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The groups did not significantly differ in the leg side (right/left) or clinical characteristics (P > 0.05). After the intervention, both groups showed significant improvements (P < 0.001) from the baseline values in the level of pain (visual analogue scale), the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices), balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective. PMID:25961017

  20. Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis

    PubMed Central

    Zawada, Anna; Jolly, Kate; Moxham, Tiffany; Taylor, Rod S

    2010-01-01

    Objective To compare the effect of home based and supervised centre based cardiac rehabilitation on mortality and morbidity, health related quality of life, and modifiable cardiac risk factors in patients with coronary heart disease. Design Systematic review. Data sources Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, Medline, Embase, CINAHL, and PsycINFO, without language restriction, searched from 2001 to January 2008. Review methods Reference lists checked and advice sought from authors. Included randomised controlled trials that compared centre based cardiac rehabilitation with home based programmes in adults with acute myocardial infarction, angina, or heart failure or who had undergone coronary revascularisation. Two reviewers independently assessed the eligibility of the identified trials and extracted data independently. Authors were contacted when possible to obtain missing information. Results 12 studies (1938 participants) were included. Most studies recruited patients with a low risk of further events after myocardial infarction or revascularisation. No difference was seen between home based and centre based cardiac rehabilitation in terms of mortality (relative risk 1.31, 95% confidence interval 0.65 to 2.66), cardiac events, exercise capacity (standardised mean difference −0.11, −0.35 to 0.13), modifiable risk factors (weighted mean difference systolic blood pressure (0.58 mm Hg, −3.29 mm Hg to 4.44 mm Hg), total cholesterol (−0.13 mmol/l, −0.31 mmol/l to 0.05 mmol/l), low density lipoprotein cholesterol (−0.15 mmol/l, −0.31 mmol/l to 0.01 mmol/l), or relative risk for proportion of smokers at follow-up (0.98, 0.73 to 1.31)), or health related quality of life, with the exception of high density lipoprotein cholesterol (−0.06, −0.11 to −0.02) mmol/l). In the home based participants, there was evidence of superior adherence. No consistent difference was seen in the healthcare costs of the two forms

  1. Developing Initiatives for Home-Based Child Care: Current Research and Future Directions

    ERIC Educational Resources Information Center

    Porter, Toni; Paulsell, Diane

    2011-01-01

    Home-based child care accounts for a significant share of the child care supply in the United States, especially for infants and toddlers. A synthesis of the home-based care research literature and information about recent home-based care quality initiatives points to a critical need for more systematic efforts to develop and test quality…

  2. Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial

    PubMed Central

    Dias, Fernanda Dultra; Sampaio, Luciana Maria Malosá; da Silva, Graziela Alves; Gomes, Évelim LF Dantas; do Nascimento, Eloisa Sanches Pereira; Alves, Vera Lucia Santos; Stirbulov, Roberto; Costa, Dirceu

    2013-01-01

    Introduction Pulmonary rehabilitation (PR) is a multidisciplinary program of care for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving the functional capacity and quality of life, as well as maintaining the clinical stability of COPD sufferers. However, not all patients are available for such a program despite discomfort with their condition. The aim of this study was to evaluate the effects of a home-based PR (HBPR) program on functional ability, quality of life, and respiratory muscle strength and endurance. Patients and methods Patients with COPD according to the Global Initiative of Chronic Obstructive Lung Disease were randomized (double-blind) into two groups. One group performed a protocol at home with aerobic and muscle strength exercises and was called the intervention group; the other group received only instructions to perform breathing and stretching exercises, characterizing it as the control group (CG). We assessed the following variables at baseline and 2 months: exercise tolerance (incremental shuttle walk test and upper limb test), respiratory muscle (strength and endurance test), and health-related quality of life (Airways Questionnaire 20). Results There were no significant changes after the intervention in either of the two groups in exercise tolerance and quality of life. However, the intervention group had improved respiratory endurance compared with the CG, while the CG presented a decrease in the load sustained by the respiratory muscles after the HBPR. Conclusion A program of HBPR with biweekly supervision (although not enough to provide significant improvements in physical capacity or quality of life) played an important role in maintaining the stability of the clinical features of patients with COPD; the patients had no worsening of symptoms during the intervention period according to the daily log. PMID:24235824

  3. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD)

    PubMed Central

    Neder, J; Sword, D; Ward, S; Mackay, E; Cochrane, L; Clark, C

    2002-01-01

    Background: Passive training of specific locomotor muscle groups by means of neuromuscular electrical stimulation (NMES) might be better tolerated than whole body exercise in patients with severe chronic obstructive pulmonary disease (COPD). It was hypothesised that this novel strategy would be particularly effective in improving functional impairment and the consequent disability which characterises patients with end stage COPD. Methods: Fifteen patients with advanced COPD (nine men) were randomly assigned to either a home based 6 week quadriceps femoris NMES training programme (group 1, n=9, FEV1=38.0 (9.6)% of predicted) or a 6 week control period before receiving NMES (group 2, n=6, FEV1=39.5 (13.3)% of predicted). Knee extensor strength and endurance, whole body exercise capacity, and health related quality of life (Chronic Respiratory Disease Questionnaire, CRDQ) were assessed. Results: All patients were able to complete the NMES training programme successfully, even in the presence of exacerbations (n=4). Training was associated with significant improvements in muscle function, maximal and endurance exercise tolerance, and the dyspnoea domain of the CRDQ (p<0.05). Improvements in muscle performance and exercise capacity after NMES correlated well with a reduction in perception of leg effort corrected for exercise intensity (p<0.01). Conclusions: For severely disabled COPD patients with incapacitating dyspnoea, short term electrical stimulation of selected lower limb muscles involved in ambulation can improve muscle strength and endurance, whole body exercise tolerance, and breathlessness during activities of daily living. PMID:11923552

  4. Exploring pharmacy and home-based sexually transmissible infection testing

    PubMed Central

    Habel, Melissa A.; Scheinmann, Roberta; Verdesoto, Elizabeth; Gaydos, Charlotte; Bertisch, Maggie; Chiasson, Mary Ann

    2015-01-01

    Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. Methods The study included two phases in February 2011–July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. Results Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45 000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. Conclusions This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases. PMID:26409484

  5. Home-based versus centre-based cardiac rehabilitation: abridged Cochrane systematic review and meta-analysis

    PubMed Central

    Buckingham, S A; Taylor, R S; Jolly, K; Zawada, A; Dean, S G; Cowie, A; Norton, R J; Dalal, H M

    2016-01-01

    Objective To update the Cochrane review comparing the effects of home-based and supervised centre-based cardiac rehabilitation (CR) on mortality and morbidity, quality of life, and modifiable cardiac risk factors in patients with heart disease. Methods Systematic review and meta-analysis. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and CINAHL were searched up to October 2014, without language restriction. Randomised trials comparing home-based and centre-based CR programmes in adults with myocardial infarction, angina, heart failure or who had undergone coronary revascularisation were included. Results 17 studies with 2172 patients were included. No difference was seen between home-based and centre-based CR in terms of: mortality (relative risk (RR) 0.79, 95% CI 0.43 to 1.47); cardiac events; exercise capacity (mean difference (MD) −0.10, −0.29 to 0.08); total cholesterol (MD 0.07 mmol/L, −0.24 to 0.11); low-density lipoprotein cholesterol (MD −0.06 mmol/L, −0.27 to 0.15); triglycerides (MD −0.16 mmol/L, −0.38 to 0.07); systolic blood pressure (MD 0.2 mm Hg, −3.4 to 3.8); smoking (RR 0.98, 0.79 to 1.21); health-related quality of life and healthcare costs. Lower high-density lipoprotein cholesterol (MD −0.07 mmol/L, −0.11 to −0.03, p=0.001) and lower diastolic blood pressure (MD −1.9 mm Hg, −0.8 to −3.0, p=0.009) were observed in centre-based participants. Home-based CR was associated with slightly higher adherence (RR 1.04, 95% CI 1.01 to 1.07). Conclusions Home-based and centre-based CR provide similar benefits in terms of clinical and health-related quality of life outcomes at equivalent cost for those with heart failure and following myocardial infarction and revascularisation. PMID:27738516

  6. Between ideals and reality in home-based rehabilitation

    PubMed Central

    Steihaug, Sissel; Lippestad, Jan-W.; Werner, Anne

    2016-01-01

    Setting and objective The growing elderly population and the rising number of people with chronic diseases indicate an increasing need for rehabilitation. Norwegian municipalities are required by law to offer rehabilitation. The aim of this study was to investigate how rehabilitation work is perceived and carried out by first-line service providers compared with the guidelines issued by Norway’s health authorities. Design and subjects In this action research project, qualitative data were collected through 24 individual interviews and seven group interviews with employees – service providers and managers – in the home-based service of two boroughs in Oslo, Norway. The data were analysed using a systematic text-condensation method. Results The results show that rehabilitation receives little attention in the boroughs and that patients are seldom rehabilitated at home. There is disagreement among professional staff as to what rehabilitation is and should be. The purchaser–provider organization, high speed of service delivery, and scarcity of resources are reported to hamper rehabilitation work. Conclusion and implications A discrepancy exists between the high level of ambitious goals of Norwegian health authorities and the possibilities that practitioners have to achieve them. This situation results in healthcare staff being squeezed by the increasing expectations and demands of the population and the promises and statutory rights coming from politicians and administrators. For the employees in the municipalities to place rehabilitation on the agenda, it is a requirement that authorities understand the clinical aspect of rehabilitation and provide the municipalities with adequate framework conditions for successful rehabilitation work. Key pointsHome-based rehabilitation is documented to be effective, and access to rehabilitation has been established in Norwegian law.The purchaser–provider organization, high rate of speed, and a scarcity of resources in

  7. User Interaction Design for a Home-Based Telecare System

    NASA Astrophysics Data System (ADS)

    Raptis, Spyros; Tsiakoulis, Pirros; Chalamandaris, Aimilios; Karabetsos, Sotiris

    This paper presents the design of the user-interaction component of a home-based telecare system for congestive heart failure patients. It provides a short overview of the overall system and offers details on the different interaction types supported by the system. Interacting with the user occurs either as part of a scheduled procedure or as a consequence of identifying or predicting a potentially hazardous deterioration of the patients' health state. The overall logic of the interaction is structured around event-scenario associations, where a scenario consists of concrete actions to be performed, some of which may involve the patient. A key objective in this type of interaction that it is very simple, intuitive and short, involving common everyday objects and familiar media such as speech.

  8. Information needs in home based healthcare in South Africa.

    PubMed

    de la Harpe, Retha; Barnes, Jay; Korpela, Mikko

    2010-01-01

    Home based health care (HBHC) is advocated by the WHO "to ensure better accessibility to effective and efficient health care in community and home-settings to improve health and well-being, and contribute to morbidity and mortality reduction". In South Africa the government and many other role players see an increasingly important role for HBHC. Many researchers believe that the evolution of HBHC will follow the socio-technical network evolution. There can be no doubt that the focus is on using information and communication technologies (ICT) to implement HBHC solutions. The objective of this paper is to provide a rich picture of the current situation and needs for improvement in HBHC in South Africa today through descriptive research in one specific case. The longer-term purpose is to identify pain-points that require socio-technical solutions, including but not exclusively ICT-supported solutions.

  9. Home- and Hospital-Based Cardiac Rehabilitation Exercise: The Important Role of Physician Recommendation.

    PubMed

    Dunn, Susan L; Dunn, L Maureen; Buursma, Madison P; Clark, Jacob A; Vander Berg, Lucas; DeVon, Holli A; Tintle, Nathan L

    2016-09-02

    Exercise reduces morbidity and mortality for patients with heart disease. Despite clear guidelines and known benefits, most cardiac patients do not meet current exercise recommendations. Physician endorsement positively affects patient participation in hospital-based Phase II cardiac rehabilitation programs, yet the importance of physician recommendation for home-based cardiac rehabilitation exercise is unknown. A prospective observational design was used to examine predictors of both home-based and Phase II rehabilitation exercise in a sample of 251 patients with coronary heart disease. Regression analyses were done to examine demographic and clinical characteristics, physical functioning, and patient's report of physician recommendation for exercise. Patients with a strong physician referral, who were married and older, were more likely to participate in Phase II exercise. Increased strength of physician recommendation was the unique predictor of home-based exercise. Further research is needed to examine how health professionals can motivate cardiac patients to exercise in home and outpatient settings.

  10. Smart Home-Based Health Platform for Behavioral Monitoring and Alteration of Diabetes Patients

    PubMed Central

    Helal, Abdelsalam; Cook, Diane J.; Schmalz, Mark

    2009-01-01

    Background Researchers and medical practitioners have long sought the ability to continuously and automatically monitor patients beyond the confines of a doctor's office. We describe a smart home monitoring and analysis platform that facilitates the automatic gathering of rich databases of behavioral information in a manner that is transparent to the patient. Collected information will be automatically or manually analyzed and reported to the caregivers and may be interpreted for behavioral modification in the patient. Method Our health platform consists of five technology layers. The architecture is designed to be flexible, extensible, and transparent, to support plug-and-play operation of new devices and components, and to provide remote monitoring and programming opportunities. Results The smart home-based health platform technologies have been tested in two physical smart environments. Data that are collected in these implemented physical layers are processed and analyzed by our activity recognition and chewing classification algorithms. All of these components have yielded accurate analyses for subjects in the smart environment test beds. Conclusions This work represents an important first step in the field of smart environment-based health monitoring and assistance. The architecture can be used to monitor the activity, diet, and exercise compliance of diabetes patients and evaluate the effects of alternative medicine and behavior regimens. We believe these technologies are essential for providing accessible, low-cost health assistance in an individual's own home and for providing the best possible quality of life for individuals with diabetes. PMID:20046657

  11. Multidimensional Risk Analysis: MRISK

    NASA Technical Reports Server (NTRS)

    McCollum, Raymond; Brown, Douglas; O'Shea, Sarah Beth; Reith, William; Rabulan, Jennifer; Melrose, Graeme

    2015-01-01

    Multidimensional Risk (MRISK) calculates the combined multidimensional score using Mahalanobis distance. MRISK accounts for covariance between consequence dimensions, which de-conflicts the interdependencies of consequence dimensions, providing a clearer depiction of risks. Additionally, in the event the dimensions are not correlated, Mahalanobis distance reduces to Euclidean distance normalized by the variance and, therefore, represents the most flexible and optimal method to combine dimensions. MRISK is currently being used in NASA's Environmentally Responsible Aviation (ERA) project o assess risk and prioritize scarce resources.

  12. Family Members Providing Home-Based Palliative Care to Older Adults: The Enactment of Multiple Roles

    ERIC Educational Resources Information Center

    Clemmer, Sarah J.; Ward-Griffin, Catherine; Forbes, Dorothy

    2008-01-01

    Canadians are experiencing increased life expectancy and chronic illness requiring end-of-life care. There is limited research on the multiple roles for family members providing home-based palliative care. Based on a larger ethnographic study of client-family-provider relationships in home-based palliative care, this qualitative secondary analysis…

  13. Pilot Study of a Home-based Asthma Health Education Program.

    ERIC Educational Resources Information Center

    Dolinar, Rose-Marie; Kumar, Vijay; Rowe, Brian H.; Coutu-Wakulczyk, Ginette

    2000-01-01

    Examines the influence of a home-based asthma health education program on parental coping and quality of life. Families (N=40) with children under 11 received either health education sessions or a booklet representing the traditional approach to care. Results suggest the use of a one-time, home-based intervention to assist families caring for…

  14. Entrepreneurial Checklist Tool for Beginning Farm and Home-Based Businesses

    ERIC Educational Resources Information Center

    Rafie, A. R.; Nartea, Theresa

    2012-01-01

    Extension educators entertain frequent questions on beginning a farm or starting a home-based business. Retired, unemployed, and displaced workers consider starting a small farm or home-based business. Determining educational needs or individual business aptitude is time consuming. Lengthy and comprehensive skill-based checklists exist for…

  15. Latino Parent Home-Based Practices that Bolster Student Academic Persistence

    ERIC Educational Resources Information Center

    Mena, Jasmine A.

    2011-01-01

    Home-based parental involvement practices (i.e., educational encouragement, monitoring, and support) and their impact on students' academic persistence were investigated with a sample of 137, ninth-grade Latino students in a northeast high school. Structural Equation Modeling results indicate that the relationship between home-based parental…

  16. Effects and costs of home-based training with telemonitoring guidance in low to moderate risk patients entering cardiac rehabilitation: The FIT@Home study

    PubMed Central

    2013-01-01

    Background Physical training has beneficial effects on exercise capacity, quality of life and mortality in patients after a cardiac event or intervention and is therefore a core component of cardiac rehabilitation. However, cardiac rehabilitation uptake is low and effects tend to decrease after the initial rehabilitation period. Home-based training has the potential to increase cardiac rehabilitation uptake, and was shown to be safe and effective in improving short-term exercise capacity. Long-term effects on physical fitness and activity, however, are disappointing. Therefore, we propose a novel strategy using telemonitoring guidance based on objective training data acquired during exercise at home. In this way, we aim to improve self-management skills like self-efficacy and action planning for independent exercise and, consequently, improve long-term effectiveness with respect to physical fitness and physical activity. In addition, we aim to compare costs of this strategy with centre-based cardiac rehabilitation. Methods/design This randomized controlled trial compares a 12-week telemonitoring guided home-based training program with a regular, 12-week centre-based training program of equal duration and training intensity in low to moderate risk patients entering cardiac rehabilitation after an acute coronary syndrome or cardiac intervention. The home-based group receives three supervised training sessions before they commence training with a heart rate monitor in their home environment. Participants are instructed to train at 70-85% of their maximal heart rate for 45–60 minutes, twice a week. Patients receive individual coaching by telephone once a week, based on measured heart rate data that are shared through the internet. Primary endpoints are physical fitness and physical activity, assessed at baseline, after 12 weeks and after one year. Physical fitness is expressed as peak oxygen uptake, assessed by symptom limited exercise testing with gas exchange

  17. HOME-BASED BLOOD PRESSURE INTERVENTIONS FOR AFRICAN AMERICANS

    PubMed Central

    Feldman, Penny H.; McDonald, Margaret V.; Mongoven, Jennifer M.; Peng, Timothy R.; Gerber, Linda M.; Pezzin, Liliana E.

    2009-01-01

    Background Efforts to increase blood pressure (BP) control rates in African Americans, a traditionally underserved, high risk population must address both provider practice and patient adherence issues. The Home-Based BP Intervention for African Americans study is a three-arm randomized controlled trial designed to test two strategies to improve HTN management and outcomes in a decentralized service setting serving a vulnerable and complex home care population. The primary study outcomes are systolic BP, diastolic BP, and BP control; secondary outcomes are nurse adherence to HTN management recommendations, and patient adherence to medication, healthy diet and other self-management strategies. Methods and Results Nurses (N=312) in a nonprofit Medicare-certified home health agency are randomized along with their eligible hypertensive patients (N=845). The two interventions being tested are: (i) a “basic” intervention delivering key evidence-based reminders to home care nurses and patients while the patient is receiving traditional post-acute home health care; and (ii) an “augmented” intervention that includes that same as the basic intervention, plus transition to an ongoing HTN Home Support Program that extends support for 12 months. Outcomes are measured at 3 and 12 months post baseline interview. The interventions will be assessed relative to usual care and to each other. Conclusions Systems change to improve BP management and outcomes in home health will not easily occur without new intervention models and rigorous evaluation of their impact. Results from this trial will provide important information on potential strategies to improve BP control in a low income, chronically ill patient population. PMID:20031844

  18. A New Measure of Home Exercise Benefits and Barriers

    ERIC Educational Resources Information Center

    Thind, Herpreet; Fava, Joseph; Traficante, Regina; Bock, Beth C.

    2016-01-01

    Background: To increase physical activity among college students, new approaches are needed including the exploration of home-based exercise. However, research related to potential facilitators and barriers to exercising at home is limited. Purpose: The goal of this study was to develop a reliable and valid measure that can assess predictors of…

  19. Multidimensional spectral load balancing

    SciTech Connect

    Hendrickson, B.; Leland, R.

    1993-01-01

    We describe an algorithm for the static load balancing of scientific computations that generalizes and improves upon spectral bisection. Through a novel use of multiple eigenvectors, our new spectral algorithm can divide a computation into 4 or 8 pieces at once. These multidimensional spectral partitioning algorithms generate balanced partitions that have lower communication overhead and are less expensive to compute than those produced by spectral bisection. In addition, they automatically work to minimize message contention on a hypercube or mesh architecture. These spectral partitions are further improved by a multidimensional generalization of the Kernighan-Lin graph partitioning algorithm. Results on several computational grids are given and compared with other popular methods.

  20. Flexibility and Strength Measures in Children Participating in a Cardiac Rehabilitation Exercise Program.

    ERIC Educational Resources Information Center

    Koch, Barbara M.; And Others

    1988-01-01

    A 12-week structured rehabilitation program featuring warm-up exercises, increased aerobic exercise, cool down, and home-based continuation of exercise helped 12 children with surgically corrected congenital heart disease improve lower extremity strength and flexibility. (Author/CB)

  1. The Incidence and Wage Consequences of Home-Based Work in the United States, 1980-2000

    ERIC Educational Resources Information Center

    Oettinger, Gerald S.

    2011-01-01

    This study documents the rapid growth in home-based wage and salary employment and the sharp decline in the home-based wage penalty in the United States between 1980 and 2000. These twin patterns, observed for both men and women in most occupation groups, suggest that employer costs of providing home-based work arrangements have decreased.…

  2. Service and business model for technology enabled and home-based cardiac rehabilitation programs.

    PubMed

    Sarela, Antti; Whittaker, Frank; Korhonen, Ilkka

    2009-01-01

    Cardiac rehabilitation programs are comprehensive life-style programs aimed at preventing recurrence of a cardiac event. However, the current programs have globally significantly low levels of uptake. Home-based model can be a viable alternative to hospital-based programs. We developed and analysed a service and business model for home based cardiac rehabilitation based on personal mentoring using mobile phones and web services. We analysed the different organizational and economical aspects of setting up and running the home based program and propose a potential business model for a sustainable and viable service. The model can be extended to management of other chronic conditions to enable transition from hospital and care centre based treatments to sustainable home-based care.

  3. Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients.

    PubMed

    do Nascimento, Eloisa Sanches Pereira; Sampaio, Luciana Maria Malosá; Peixoto-Souza, Fabiana Sobral; Dias, Fernanda Dultra; Gomes, Evelim Leal Freitas Dantas; Greiffo, Flavia Regina; Ligeiro de Oliveira, Ana Paula; Stirbulov, Roberto; Vieira, Rodolfo Paula; Costa, Dirceu

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR) program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8). At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal inspiratory pressure, improvements on two components from the health-related quality-of-life questionnaire, and a decrease in plasma IL-8 levels after the intervention. The HBPR is an important and viable alternative to pulmonary rehabilitation for the treatment of patients with COPD; it improves exercise tolerance, inspiratory muscle strength, quality of life, and systemic inflammation in COPD patients.

  4. Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients

    PubMed Central

    do Nascimento, Eloisa Sanches Pereira; Sampaio, Luciana Maria Malosá; Peixoto-Souza, Fabiana Sobral; Dias, Fernanda Dultra; Gomes, Evelim Leal Freitas Dantas; Greiffo, Flavia Regina; Ligeiro de Oliveira, Ana Paula; Stirbulov, Roberto; Vieira, Rodolfo Paula; Costa, Dirceu

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR) program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8). At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal inspiratory pressure, improvements on two components from the health-related quality-of-life questionnaire, and a decrease in plasma IL-8 levels after the intervention. The HBPR is an important and viable alternative to pulmonary rehabilitation for the treatment of patients with COPD; it improves exercise tolerance, inspiratory muscle strength, quality of life, and systemic inflammation in COPD patients. PMID:25848241

  5. Multidimensional stochastic approximation Monte Carlo

    NASA Astrophysics Data System (ADS)

    Zablotskiy, Sergey V.; Ivanov, Victor A.; Paul, Wolfgang

    2016-06-01

    Stochastic Approximation Monte Carlo (SAMC) has been established as a mathematically founded powerful flat-histogram Monte Carlo method, used to determine the density of states, g (E ) , of a model system. We show here how it can be generalized for the determination of multidimensional probability distributions (or equivalently densities of states) of macroscopic or mesoscopic variables defined on the space of microstates of a statistical mechanical system. This establishes this method as a systematic way for coarse graining a model system, or, in other words, for performing a renormalization group step on a model. We discuss the formulation of the Kadanoff block spin transformation and the coarse-graining procedure for polymer models in this language. We also apply it to a standard case in the literature of two-dimensional densities of states, where two competing energetic effects are present g (E1,E2) . We show when and why care has to be exercised when obtaining the microcanonical density of states g (E1+E2) from g (E1,E2) .

  6. Home based management in multiple sclerosis: results of a randomised controlled trial

    PubMed Central

    Pozzilli, C; Brunetti, M; Amicosante, A; Gasperini, C; Ristori, G; Palmisano, L; Battaglia, M

    2002-01-01

    Background: Home based medical care is a popular alternative to standard hospital care but there is uncertainty about its cost-effectiveness. Objectives: To compare the effectiveness and the costs of multidisciplinary home based care in multiple sclerosis with hospital care in a prospective randomised controlled trial with a one year follow up. Methods: 201 patients with clinically definite multiple sclerosis were studied. They were randomised in a ratio 2:1 to an intervention group (133) or a control group (68). They were assessed at baseline and one year after randomisation with validated measures of physical and psychological impairment and quality of life (SF-36 health survey). The costs to the National Health Service over the one year follow up were calculated by a cost minimisation analysis. Results: There were no differences in functional status between the home based care group and the hospital group. There was a significant difference between the two groups favouring home based management in four SF-36 health dimensions—general health, bodily pain, role-emotional, and social functioning (all p ≤ 0.001). The cost of home based care was slightly less (822 euros/patient/year) than hospital care, mainly as a result of a reduction in hospital admissions. Conclusions: Comprehensive planning of home based intervention implemented by an interdisciplinary team and designed specifically for people with multiple sclerosis may provide a cost-effective approach to management and improve the quality of life. PMID:12185154

  7. Multidimensional capillary electrophoresis.

    PubMed

    Grochocki, Wojciech; Markuszewski, Michał J; Quirino, Joselito P

    2015-01-01

    Multidimensional separation where two or more orthogonal displacement mechanisms are combined is a promising approach to increase peak capacity in CE. The combinations allow dramatic improvement of analytical performance since the total peak capacity is given by a product of the peak capacities of all methods. The initial reports were concentrated on the construction of effective connections between capillaries for 2D analysis. Today, 2D and 3D CE systems are now able to separate real complex biological or environmental mixtures with good repeatability, improved resolution with minimal loss of sample. This review will present the developments in the field of multidimensional CE during the last 15 years. The endeavors in this specific field were on the development of interfaces, interface-free techniques including integrated separations, microdevices, and on-line sample concentration techniques to improve detection sensitivity.

  8. Lifestyle-oriented non-pharmacological treatments for fibromyalgia: a clinical overview and applications with home-based technologies

    PubMed Central

    Friedberg, Fred; Williams, David A; Collinge, William

    2012-01-01

    Fibromyalgia (FM) is a persistent and disabling widespread pain condition often accompanied by chronic fatigue, cognitive problems, sleep disturbance, depression, anxiety, and headache. To date, the most thoroughly studied non-pharmacological approaches to managing FM are those with a focus on changing patient activities and beliefs that affect the illness. These interventions are intended to facilitate enduring improvement in pain and functional status. Lifestyle-oriented treatments include patient education, aerobic or other physical exercise, and cognitive-behavioral therapy (CBT). These interventions in FM can be delivered in medical or behavioral health care settings by trained professionals, through patient-oriented treatment manuals, or via remote-access technologies. Non-pharmacological treatments, in particular exercise and CBT, have yielded effect sizes and cost–benefit ratios comparable to medications. This paper describes lifestyle-oriented non-pharmacological treatments for FM and highlights selected literature reviews of these interventions. In addition, behavioral and practical issues are addressed that may affect these non-pharmacological treatments, including patient expectations, participant burden, and treatment availability. Recommendations are made to facilitate these interventions and potentially improve outcomes. In particular, the increasing availability of convenient home-based mobile technologies to deliver these non-pharmacological treatments is described. PMID:23166446

  9. Multidimensional diffusion MRI

    NASA Astrophysics Data System (ADS)

    Topgaard, Daniel

    2017-02-01

    Principles from multidimensional NMR spectroscopy, and in particular solid-state NMR, have recently been transferred to the field of diffusion MRI, offering non-invasive characterization of heterogeneous anisotropic materials, such as the human brain, at an unprecedented level of detail. Here we revisit the basic physics of solid-state NMR and diffusion MRI to pinpoint the origin of the somewhat unexpected analogy between the two fields, and provide an overview of current diffusion MRI acquisition protocols and data analysis methods to quantify the composition of heterogeneous materials in terms of diffusion tensor distributions with size, shape, and orientation dimensions. While the most advanced methods allow estimation of the complete multidimensional distributions, simpler methods focus on various projections onto lower-dimensional spaces as well as determination of means and variances rather than actual distributions. Even the less advanced methods provide simple and intuitive scalar parameters that are directly related to microstructural features that can be observed in optical microscopy images, e.g. average cell eccentricity, variance of cell density, and orientational order - properties that are inextricably entangled in conventional diffusion MRI. Key to disentangling all these microstructural features is MRI signal acquisition combining isotropic and directional dimensions, just as in the field of multidimensional solid-state NMR from which most of the ideas for the new methods are derived.

  10. Efficacy of home-based lymphoedema management in reducing acute attacks in subjects with lymphatic filariasis in Burkina Faso.

    PubMed

    Jullien, Patrick; Somé, Jeanne d'Arc; Brantus, Pierre; Bougma, Roland W; Bamba, Issouf; Kyelem, Dominique

    2011-09-01

    One of the two main goals of the Global Programme to Eliminate Lymphatic Filariasis (LF) is to provide care for those suffering from the devastating clinical manifestations of this filarial infection. Among the 120 million infected people worldwide, up to 16 million have lymphoedema. The WHO strategy for managing lymphoedema is based on rigorous skin hygiene, exercise, antibiotics and antifungals when indicated. The aim is to reduce acute attacks of adenolymphangitis and cellulitis responsible for lymphoedema progression and disability. The objective of our study was to assess the effectiveness of home-based lymphoedema management implemented by the national health system of Burkina Faso. Any patient was eligible to participate in the study if suffering from LF-related lymphoedema of a lower limb at any stage, and receiving care as part of the health education and washing project between April 2005 and December 2007. The primary readout was the occurrence of an acute attack in the month preceding the consultation reported by the patient or observed by the care-giver. In all, 1089 patients were enrolled in the study. Before lymphoedema management intervention, 78.1% (95%CI: 75.5-80.5) of the patients had an acute attack in the month preceding the consultation; after four and half months of lymphoedema management, this was reduced to 39.1% (95%CI: 36.2-42.1). A reduction of acute attacks related to the number of consultations or related to the patients' age and gender was not observed. Our results suggest that the home-based lymphoedema management programme in the primary health care system of Burkina Faso is effective in reducing morbidity due to LF in the short-term (4.5 months). The lymphoedema management requires no additional human resources, but whether its effect can be sustained remains to be seen.

  11. Attitudes towards acceptance of an innovative home-based and remote sensing rehabilitation protocol among cardiovascular patients in Shantou, China

    PubMed Central

    Fang, Jia-Ying; Li, Ji-Lin; Li, Zhong-Han; Xu, Duan-Min; Chen, Chang; Xie, Bin; Chen, Helen; Au, William W

    2016-01-01

    Background Cardiac rehabilitation (CR) protocols have diversified to include home-based cardiac tele-rehabilitation (HBCTR) as an alternative to hospital-based or center-based CR. To adopt the use of home-based cardiac tele-rehabilitation, it is necessary to assess cardiac patients' attitudes towards acceptance of such e-health technology, especially in China where knowledge of such technology is deficient. Methods Interviews were conducted in the First Affiliated Hospital of Shantou University Medical College, Shantou, China. After percutaneous coronary interventional (PCI) surgery, patients completed the survey. Results Among the 150 patients, only 13% had ever heard of HBCTR. After an introduction of our HBCTR program, 60% of patients were willing to participate in the program. From our multivariate analysis of questionnaire data, age (OR: 0.92, 95% CI: 0.86–0.98; P = 0.007), average family monthly income (OR: 0.13, 95% CI: 0.05–0.34; P < 0.001), education level (OR: 0.24, 95% CI: 0.10–0.59; P = 0.002) and physical exercise time (OR: 0.19, 95% CI: 0.06–0.56; P = 0.003) were independent predictors for acceptance of HBCTR. From the reasons for participation, patients selected: enhanced safety and independence (28.3%), ability to self-monitor physical conditions daily (25.4%), and having automatic and emergency alert (23.1%). Reasons for refusal were: too cumbersome operation (34.3%) and unnecessary protocol (19.4%). Conclusions Most patients lacked knowledge about HBCTR but volunteered to participate after they have learned about the program. Several personal and life-style factors influenced their acceptance of the program. These indicate that both improvement of technology and better understanding of the program will enhance active participation. PMID:27403142

  12. Effects of macronutrient intake on thigh muscle mass during home-based walking training in middle-aged and older women.

    PubMed

    Okazaki, K; Yazawa, D; Goto, M; Kamijo, Y-I; Furihata, M; Gen-no, H; Hamada, K; Nose, H

    2013-10-01

    We examined whether post-exercise macronutrient supplementation during a 5-month home-based interval walking training (IWT) accelerated exercise-induced increases in skeletal muscle mass and strength in healthy middle-aged and older women. Thirty-five women (41-78 years) were randomly divided into two groups: IWT alone (CNT, n = 18) or IWT plus post-exercise macronutrient (7.6 g protein, 32.5 g carbohydrate, and 4.4 g fat) supplementation (NUT, n = 17). For IWT, all subjects were instructed to repeat five or more sets of 3-min low-intensity walking at 40% peak aerobic capacity (Vo2 peak ), followed by a 3-min high-intensity walking above 70% Vo2 peak per day for 4 or more days per week. We determined Vo2 peak , thigh muscle tissue area by computer tomography, and thigh muscle strength in all subjects before and after IWT. We found that an increase in hamstring muscle tissue area was 2.8 ± 1.2% in NUT vs -1.0 ± 0.7% in CNT and that in isometric knee flexion force was 16.3 ± 3.7% in NUT vs 6.5 ± 3.0% in CNT; both were significantly higher in NUT than in CNT (both, P < 0.001). Thus, post-exercise macronutrient supplementation enhanced the increases in thigh muscle mass and strength, although partially, in home-based IWT in middle-aged and older women.

  13. Economic Evidence for US Asthma Self-Management Education and Home-Based Interventions.

    PubMed

    Hsu, Joy; Wilhelm, Natalie; Lewis, Lillianne; Herman, Elizabeth

    The health and economic burden of asthma in the United States is substantial. Asthma self-management education (AS-ME) and home-based interventions for asthma can improve asthma control and prevent asthma exacerbations, and interest in health care-public health collaboration regarding asthma is increasing. However, outpatient AS-ME and home-based asthma intervention programs are not widely available; economic sustainability is a common concern. Thus, we conducted a narrative review of existing literature regarding economic outcomes of outpatient AS-ME and home-based intervention programs for asthma in the United States. We identified 9 outpatient AS-ME programs and 17 home-based intervention programs with return on investment (ROI) data. Most programs were associated with a positive ROI; a few programs observed positive ROIs only among selected populations (eg, higher health care utilization). Interpretation of existing data is limited by heterogeneous ROI calculations. Nevertheless, the literature suggests promise for sustainable opportunities to expand access to outpatient AS-ME and home-based asthma intervention programs in the United States. More definitive knowledge about how to maximize program benefit and sustainability could be gained through more controlled studies of specific populations and increased uniformity in economic assessments.

  14. Risk management and clinical governance for complex home-based health care.

    PubMed

    Lewis, Mary; Noyes, Jane

    2007-07-01

    Healthcare professionals have an obligation to enable children with complex needs to lead 'ordinary lives' at home but the views of professionals and family members often diverge in relation to the management of risks. Nurses are increasingly taking on the clinical responsibility for children with complex needs within a multidisciplinary, multi-agency team, yet have little training or experience in adapting risk management and clinical governance frameworks to home-based settings. Risk management frameworks for home-based care for children with complex health and social care needs are introduced in this article. Best practice guidance and resources for adapting risk management frameworks are presented to meet this identified gap in knowledge and experience. Children, young people and their parents have increasing expectations relating to the type and quality of home-based support they receive. Developing and applying clinical governance and risk management frameworks are part of improving outcomes for children with complex needs and their families.

  15. RAPID HOME-BASED HIV TESTING TO REDUCE COSTS IN A LARGE TUBERCULOSIS COHORT STUDY.

    PubMed

    Galea, Jerome T; Contreras, Carmen; Lecca, Leonid; Shin, Sonya; Lobatón, Raúl; Zhang, Zibiao; Calderón, Roger; Murray, Megan; Becerra, Mercedes C

    2013-06-21

    To reduce costs in a large tuberculosis household contact cohort study in Lima, Peru, we replaced laboratory-based HIV testing with home-based rapid testing. We developed a protocol and training course to prepare staff for the new strategy; these included role playing for home-based deployment of the Determine® HIV 1/2 Ag/Ac Combo HIV test. Though the rapid HIV test produced more false-positives, the overall cost per participant tested, refusal rate and time to confirmatory HIV testing were lower with the home-based rapid testing strategy compared to the original approach. Rapid testing could be used in similar research or routine care settings.

  16. Multidimensional sexual perfectionism.

    PubMed

    Stoeber, Joachim; Harvey, Laura N; Almeida, Isabel; Lyons, Emma

    2013-11-01

    Perfectionism is a multidimensional personality characteristic that can affect all areas of life. This article presents the first systematic investigation of multidimensional perfectionism in the domain of sexuality exploring the unique relationships that different forms of sexual perfectionism show with positive and negative aspects of sexuality. A sample of 272 university students (52 male, 220 female) completed measures of four forms of sexual perfectionism: self-oriented, partner-oriented, partner-prescribed, and socially prescribed. In addition, they completed measures of sexual esteem, sexual self-efficacy, sexual optimism, sex life satisfaction (capturing positive aspects of sexuality) and sexual problem self-blame, sexual anxiety, sexual depression, and negative sexual perfectionism cognitions during sex (capturing negative aspects). Results showed unique patterns of relationships for the four forms of sexual perfectionism, suggesting that partner-prescribed and socially prescribed sexual perfectionism are maladaptive forms of sexual perfectionism associated with negative aspects of sexuality whereas self-oriented and partner-oriented sexual perfectionism emerged as ambivalent forms associated with positive and negative aspects.

  17. Multidimensional Potential Burgers Turbulence

    NASA Astrophysics Data System (ADS)

    Boritchev, Alexandre

    2016-03-01

    We consider the multidimensional generalised stochastic Burgers equation in the space-periodic setting: partial {u}/partial t+(nabla f({u}) \\cdot nabla) {u}-ν Δ {u}= nabla η, quad t ≥ 0, {x} in{T}^d=({R}/ {Z})^d, under the assumption that u is a gradient. Here f is strongly convex and satisfies a growth condition, ν is small and positive, while η is a random forcing term, smooth in space and white in time. For solutions u of this equation, we study Sobolev norms of u averaged in time and in ensemble: each of these norms behaves as a given negative power of ν. These results yield sharp upper and lower bounds for natural analogues of quantities characterising the hydrodynamical turbulence, namely the averages of the increments and of the energy spectrum. These quantities behave as a power of the norm of the relevant parameter, which is respectively the separation ℓ in the physical space and the wavenumber k in the Fourier space. Our bounds do not depend on the initial condition and hold uniformly in {ν}. We generalise the results obtained for the one-dimensional case in [10], confirming the physical predictions in [4, 30]. Note that the form of the estimates does not depend on the dimension: the powers of {ν, |{{k}}|, ℓ} are the same in the one- and the multi-dimensional setting.

  18. Multidimensional Perfectionism and the Self

    ERIC Educational Resources Information Center

    Ward, Andrew M.; Ashby, Jeffrey S.

    2008-01-01

    This study examined multidimensional perfectionism and self-development. Two hundred seventy-one undergraduates completed a measure of multidimensional perfectionism and two Kohutian measures designed to measure aspects of self-development including social connectedness, social assurance, goal instability (idealization), and grandiosity. The…

  19. Theta vocabulary II. Multidimensional case

    NASA Astrophysics Data System (ADS)

    Kharchev, S.; Zabrodin, A.

    2016-06-01

    It is shown that the Jacobi and Riemann identities of degree four for the multidimensional theta functions as well as the Weierstrass identities emerge as algebraic consequences of the fundamental multidimensional binary identities connecting the theta functions with Riemann matrices τ and 2 τ.

  20. Profile Analysis: Multidimensional Scaling Approach.

    ERIC Educational Resources Information Center

    Ding, Cody S.

    2001-01-01

    Outlines an exploratory multidimensional scaling-based approach to profile analysis called Profile Analysis via Multidimensional Scaling (PAMS) (M. Davison, 1994). The PAMS model has the advantages of being applied to samples of any size easily, classifying persons on a continuum, and using person profile index for further hypothesis studies, but…

  1. Suicide: a multidimensional malaise.

    PubMed

    Leenaars, A A

    1996-01-01

    No one really knows why human beings commit suicide. The goal of this paper is to provide a psychological point of view on the topic, among the many other perspectives that are needed. It addresses the question by providing a theory of suicide, arguing that it is theory that allows us to sort out the booming buzzing mess of experience (Wm. James). Suicide is a multi-dimensional malaise. Metaphorically speaking, it is an intrapsychic drama on an interpersonal stage. As sound theory must be empirically observable, the theory is next applied to research of suicide notes, studying such factors as age, sex, and method of suicide, cross-culture and cross-time. Next, because all theory must have clinical applicability, a clinical case study of Goethe's Werther is provided. Overall, it is concluded that we need to continue to develop models to understand the suicidal mind.

  2. THE VALUE OF HOME-BASED COLLECTION OF BIOSPECIMENS IN REPRODUCTIVE EPIDEMIOLOGY

    EPA Science Inventory

    The Value of Home-Based Collection of Biospecimens in Reproductive Epidemiology
    John C. Rockett1, Germaine M. Buck2, Courtney D. Johnson2 and Sally D. Perreault1
    1Reproductive Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Rese...

  3. A Pilot Study on the Impact of a Home-Based Parenting Intervention: Parents Plus

    ERIC Educational Resources Information Center

    Byrne, Ellie; Holland, Sally; Jerzembek, Gabi

    2010-01-01

    This article reports on a pilot study undertaken in order to explore the impact of a home-based parenting intervention (Parents Plus), on parents and families. Parents Plus is part of a Welsh Early Years strategy called Flying Start and aims to promote positive parent-child interactions. This article explores the medium-term to long-term impact of…

  4. Developing Student Knowledge and Skills for Home-Based Social Work Practice

    ERIC Educational Resources Information Center

    Allen, Susan F.; Tracy, Elizabeth M.

    2008-01-01

    Providing social work services for clients in their homes is often a distinguishing feature of social work practice. The home environment affects the intervention process at each stage of contact with a family. Home-based practice requires specific skills to deal with clients' presenting concerns as well as safety, boundary, confidentiality, and…

  5. Dutch Home-Based Pre-Reading Intervention with Children at Familial Risk of Dyslexia

    ERIC Educational Resources Information Center

    van Otterloo, Sandra G.; van der Leij, Aryan

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small…

  6. An Evaluation of Migrant Head Start Programs. Appendices. Preliminary Report on Home Base Findings.

    ERIC Educational Resources Information Center

    Reyes (J.A.) Associates, Inc., Washington, DC.

    Utilizing specially designed interview schedules to evaluate the kinds of services children and families receive from various Migrant Head Start programs throughout the country, this preliminary report on home base findings consists of questions asked of the staff at every Migrant Head Start site across the country and questions asked of parents…

  7. Parent Perspective on the Home-Based Interim Alternative Educational Setting: A Phenomenological Study

    ERIC Educational Resources Information Center

    Jones, Gregory L.

    2011-01-01

    The purpose of this study was to explore and describe the perspectives of parents of expelled disabled students placed in home-based interim alternative educational settings (IAES). The study consisted of three parent participants whose disabled children, by virtue of their violations of the school district's discipline policy, were…

  8. Predictors of Home-Based Child Care Providers' Participation in Professional Development Workshops and Coaching

    ERIC Educational Resources Information Center

    Rusby, Julie C.; Jones, Laura B.; Crowley, Ryann; Smolkowski, Keith; Arthun, Chris

    2013-01-01

    Background: Little is known about factors that influence home-based child care providers' participation in professional development. Factors that predict participation in activities that are designed to promote the utilization and maintenance of skills taught are of particular interest. Objective: Our aim was to examine factors in the home-based…

  9. Impact of Home-Based Family Therapy on Maternal and Child Outcomes in Disadvantaged Adolescent Mothers.

    ERIC Educational Resources Information Center

    Cherniss, Cary; Herzog, Elaine

    1996-01-01

    Evaluates the effects of home-based family therapy on 116 high- risk teenage mothers and their children. Subjects received case management, supportive counseling and some received family therapy. Twelve-month follow-up indicated family therapy subjects improved parenting and became less welfare dependent. No significant difference was found at 24…

  10. Home-Based Comprehensive Assessment of Rural Elderly Persons: The CARE Project

    ERIC Educational Resources Information Center

    Cravens, David D.; Mehr, David R.; Campbell, James D.; Armer, Jane; Kruse, Robin L.; Rubenstein, Laurence Z.

    2005-01-01

    Context: Home-based comprehensive geriatric assessment (CGA) has been effective in urban areas but has had little study in rural areas. CGA involves medical history taking, a physical exam, and evaluation of functional status, mental status, cognitive status, gait and balance, medications, vision, extent of social supports, and home safety. We…

  11. Brief Report: Relative Effectiveness of Different Home-Based Behavioral Approaches to Early Teaching Intervention

    ERIC Educational Resources Information Center

    Reed, Phil; Osborne, Lisa A.; Corness, Mark

    2007-01-01

    The effectiveness of home-based early behavioral interventions for children (2:6-4:0 years old) with autistic spectrum disorders was studied over 9-10 months. Measures of autistic severity, intellectual, educational, and adaptive behavioral functioning were taken. There was no evidence of recovery from autism. High-intensity behavioral approaches…

  12. Latino Parents Utilizing Home-Based Activities to Support Algebra-Readiness Skills

    ERIC Educational Resources Information Center

    Molinar, Soledad Marie

    2010-01-01

    This dissertation involved a series of training sessions where parents from a Title I middle school participated in the learning and practice of Algebra Readiness skills. The project was based on a series of six weekly trainings for parents to learn home-based activities to increase their child's Algebra Readiness. I administered an initial…

  13. Perceptions of Personal Well-Being among Youth Accessing Residential or Intensive Home-Based Treatment

    ERIC Educational Resources Information Center

    Preyde, Michele; Watkins, Hanna; Ashbourne, Graham; Lazure, Kelly; Carter, Jeff; Penney, Randy; White, Sara; Frensch, Karen; Cameron, Gary

    2013-01-01

    The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental…

  14. Home-based therapy for severe acute malnutrition with ready-to-use food

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Severe acute malnutrition is a devastating condition afflicting children under 5 years in many developing countries, but concentrated in sub-Saharan Africa. This paper examines the development of home-based lipid-nutrient therapeutic foods for the treatment of acute malnutrition in sub-Saharan Afric...

  15. School- And Home-Based Drug Prevention: Environmental, Parent, and Child Risk Reduction

    ERIC Educational Resources Information Center

    Hahn, Ellen J.; Hall, Lynne A.; Rayens, Mary Kay; Myers, April V.; Bonnel, Galadriel

    2007-01-01

    The study purpose was to test the effect of a school- and home-based alcohol, tobacco, and other drug (ATOD) prevention program on reducing environmental, parent, and child risk factors for ATOD use. The design was a three-group pretest-posttest with interviews at baseline and 1 and 6 months post-intervention. The sample was 126 parents and their…

  16. Quality Improvement in Home-Based Child Care Settings: Research Resources to Inform Policy

    ERIC Educational Resources Information Center

    Lawrence, Sharmila; Stephens, Samuel A.

    2016-01-01

    This "Topic of Interest" provides a comprehensive list of research in the Research Connections collection that was published in 2005 or later addressing issues related to quality improvement specifically in home-based child care. The resources are grouped under the following headings: Overviews, Summaries, and Reviews of Quality…

  17. Recurrent Vascular Headache: Home-Based Behavioral Treatment versus Abortive Pharmacological Treatment.

    ERIC Educational Resources Information Center

    Holroyd, Kenneth A.; And Others

    1988-01-01

    Compared the effectiveness of a home-based behavioral intervention (relaxation and thermal biofeedback training) with an abortive pharmacological intervention (with compliance training) for treating recurrent migraine and migraine/tension headaches. Both interventions yielded reductions in headache activity, psychosomatic symptoms, and daily life…

  18. Suggested Structure for Meetings of Home-Based ESL Classes for Native Speakers of Spanish.

    ERIC Educational Resources Information Center

    Spener, David

    This guide for volunteer teachers of English as a Second Language to Spanish speakers in a home-based program outlines a suggested format for class time and activities. The guide describes how teachers can organize their class periods to promote learner-centeredness and participation in the English learning process. The structure, designed to help…

  19. A Home-Based Ecobehavioral Parent-Training and Generalization Package with a Neglectful Mother.

    ERIC Educational Resources Information Center

    Dachman, Ronald S.; And Others

    1984-01-01

    A home-based ecobehavioral parent-training package with a low-income single-parent referred for child neglect, and her seven-year-old son was effective in increasing the mother's frequency of descriptive praise and in producing demonstrable changes in the untreated corollary behaviors. Maintenance probes conducted two and six months following the…

  20. Multidimensional Multiphysics Simulation of TRISO Particle Fuel

    SciTech Connect

    J. D. Hales; R. L. Williamson; S. R. Novascone; D. M. Perez; B. W. Spencer; G. Pastore

    2013-11-01

    Multidimensional multiphysics analysis of TRISO-coated particle fuel using the BISON finite-element based nuclear fuels code is described. The governing equations and material models applicable to particle fuel and implemented in BISON are outlined. Code verification based on a recent IAEA benchmarking exercise is described, and excellant comparisons are reported. Multiple TRISO-coated particles of increasing geometric complexity are considered. It is shown that the code's ability to perform large-scale parallel computations permits application to complex 3D phenomena while very efficient solutions for either 1D spherically symmetric or 2D axisymmetric geometries are straightforward. Additionally, the flexibility to easily include new physical and material models and uncomplicated ability to couple to lower length scale simulations makes BISON a powerful tool for simulation of coated-particle fuel. Future code development activities and potential applications are identified.

  1. Multidimensional multiphysics simulation of TRISO particle fuel

    NASA Astrophysics Data System (ADS)

    Hales, J. D.; Williamson, R. L.; Novascone, S. R.; Perez, D. M.; Spencer, B. W.; Pastore, G.

    2013-11-01

    Multidimensional multiphysics analysis of TRISO-coated particle fuel using the BISON finite element nuclear fuels code is described. The governing equations and material models applicable to particle fuel and implemented in BISON are outlined. Code verification based on a recent IAEA benchmarking exercise is described, and excellent comparisons are reported. Multiple TRISO-coated particles of increasing geometric complexity are considered. The code's ability to use the same algorithms and models to solve problems of varying dimensionality from 1D through 3D is demonstrated. The code provides rapid solutions of 1D spherically symmetric and 2D axially symmetric models, and its scalable parallel processing capability allows for solutions of large, complex 3D models. Additionally, the flexibility to easily include new physical and material models and straightforward ability to couple to lower length scale simulations makes BISON a powerful tool for simulation of coated-particle fuel. Future code development activities and potential applications are identified.

  2. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial

    PubMed Central

    Mahal, Ajay; Hill, Catherine J; Lee, Annemarie L; Burge, Angela T; Cox, Narelle S; Moore, Rosemary; Nicolson, Caroline; O'Halloran, Paul; Lahham, Aroub; Gillies, Rebecca; McDonald, Christine F

    2017-01-01

    Background Pulmonary rehabilitation is a cornerstone of care for COPD but uptake of traditional centre-based programmes is poor. We assessed whether home-based pulmonary rehabilitation, delivered using minimal resources, had equivalent outcomes to centre-based pulmonary rehabilitation. Methods A randomised controlled equivalence trial with 12 months follow-up. Participants with stable COPD were randomly assigned to receive 8 weeks of pulmonary rehabilitation by either the standard outpatient centre-based model, or a new home-based model including one home visit and seven once-weekly telephone calls from a physiotherapist. The primary outcome was change in 6 min walk distance (6MWD). Results We enrolled 166 participants to receive centre-based rehabilitation (n=86) or home-based rehabilitation (n=80). Intention-to-treat analysis confirmed non-inferiority of home-based rehabilitation for 6MWD at end-rehabilitation and the confidence interval (CI) did not rule out superiority (mean difference favouring home group 18.6 m, 95% CI −3.3 to 40.7). At 12 months the CI did not exclude inferiority (−5.1 m, −29.2 to 18.9). Between-group differences for dyspnoea-related quality of life did not rule out superiority of home-based rehabilitation at programme completion (1.6 points, −0.3 to 3.5) and groups were equivalent at 12 months (0.05 points, −2.0 to 2.1). The per-protocol analysis showed the same pattern of findings. Neither group maintained postrehabilitation gains at 12 months. Conclusions This home-based pulmonary rehabilitation model, delivered with minimal resources, produced short-term clinical outcomes that were equivalent to centre-based pulmonary rehabilitation. Neither model was effective in maintaining gains at 12 months. Home-based pulmonary rehabilitation could be considered for people with COPD who cannot access centre-based pulmonary rehabilitation. Trial registration number NCT01423227, clinicaltrials.gov. PMID:27672116

  3. Increasing Access to Cost Effective Home-Based Rehabilitation for Rural Veteran Stroke Survivors

    PubMed Central

    Housley, SN; Garlow, AR; Ducote, K; Howard, A; Thomas, T; Wu, D; Richards, K; Butler, AJ

    2016-01-01

    Introduction An estimated 750,000 Americans experience a stroke annually. Most stroke survivors require rehabilitation. Limited access to rehabilitation facilities has a pronounced burden on functional outcomes and quality of life. Robotic devices deliver reproducible therapy without the need for real-time human oversight. This study examined the efficacy of using home-based, telerobotic-assisted devices (Hand and Foot Mentor: HM and FM) to improve functional ability and reduce depression symptoms, while improving access and cost savings associated with rehabilitation. Methods Twenty stroke survivors performed three months of home-based rehabilitation using a robotic device, while a therapist remotely monitored progress. Baseline and end of treatment function and depression symptoms were assessed. Satisfaction with the device and access to therapy were determined using qualitative surveys. Cost analysis was performed to compare home-based, robotic-assisted therapy to clinic-based physical therapy. Results Compared to baseline, significant improvement in upper extremity function (30.06%, p= 0.046), clinically significant benefits in gait speed (29.03%), moderate improvement in depressive symptoms (28.44%) and modest improvement in distance walked (30.2%) were observed. Participants indicated satisfaction with the device. Home-based robot therapy expanded access to post-stroke rehabilitation for 35% of the people no longer receiving formal services and increased daily access for the remaining 65%, with a cost savings of $2,352 (64.97%) compared to clinic-based therapy. Conclusion Stroke survivors made significant clinically meaningful improvements in the use of their impaired extremities using a robotic device in the home. Home-based, robotic therapy reduced costs, while expanding access to a rehabilitation modality for people who would not otherwise have received care. PMID:28018979

  4. Prospective study on cost-effectiveness of home-based motor assessment in Parkinson's disease.

    PubMed

    Cubo, E; Mariscal, N; Solano, B; Becerra, V; Armesto, D; Calvo, S; Arribas, J; Seco, J; Martinez, A; Zorrilla, L; Heldman, D

    2017-02-01

    Introduction Treatment adjustments in Parkinson's disease (PD) are in part dependent on motor assessments. The aim of this study was to evaluate the cost-effectiveness of home-based motor monitoring plus standard in-office visits versus in-office visits alone in patients with advanced PD. Methods The procedures consisted of a prospective, one-year follow-up, randomized, case-control study. A total of 40 patients with advanced PD were randomized into two groups: 20 patients underwent home-based motor monitoring by using wireless motion sensor technology, while the other 20 patients had in-office visits. Motor and non-motor symptom severities, quality of life, neuropsychiatric symptoms, and comorbidities were assessed every four months. Direct costs were assessed using a standardized questionnaire. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER). Results Both groups of PD patients were largely comparable in their clinical and demographic variables at baseline; however, there were more participants using levodopa-carbidopa intestinal gel in the home-based motor monitoring group. There was a trend for lower Unified Parkinson's Disease Rating Scale functional status (UPDRS II) scores in the patients monitored at home compared to the standard clinical follow-up ( p = 0.06). However, UPDRS parts I, III, IV and quality-adjusted life-years scores were similar between both groups. Home-based motor monitoring was cost-effective in terms of improvement of functional status, motor severity, and motor complications (UPDRS II, III; IV subscales), with an ICER/UPDRS ranging from €126.72 to €701.31, respectively. Discussion Home-based motor monitoring is a tool which collects cost-effective clinical information and helps augment health care for patients with advanced PD.

  5. Behaviour change techniques in home-based cardiac rehabilitation: a systematic review

    PubMed Central

    Heron, Neil; Kee, Frank; Donnelly, Michael; Cardwell, Christopher; Tully, Mark A; Cupples, Margaret E

    2016-01-01

    Background Cardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice. Aim To identify and describe the use of BCTs in home-based CR programmes. Design and setting Randomised controlled trials of home-based CR between 2005 and 2015 were identified by searching MEDLINE®, Embase, PsycINFO, Web of Science, and Cochrane Database. Method Reviewers independently screened titles and abstracts for eligibility. Relevant data, including BCTs, were extracted from included studies. A meta-analysis studied risk factor change in home-based and comparator programmes. Results From 2448 studies identified, 11 of good methodological quality (10 on post-myocardial infarction, one on heart failure, 1907 patients) were included. These reported the use of 20 different BCTs. Social support (unspecified) was used in all studies and goal setting (behaviour) in 10. Of the 11 studies, 10 reported effectiveness in reducing CVD risk factors, but one study showed no improvement compared to usual care. This study differed from effective programmes in that it didn’t include BCTs that had instructions on how to perform the behaviour and monitoring, or a credible source. Conclusion Social support and goal setting were frequently used BCTs in home-based CR programmes, with the BCTs related to monitoring, instruction on how to perform the behaviour, and credible source being included in effective programmes. Further robust trials are needed to determine the relative value of different BCTs within CR programmes. PMID:27481858

  6. Associations of Caregiver Stress with Working Conditions, Caregiving Practices, and Child Behaviour in Home-Based Child Care

    ERIC Educational Resources Information Center

    Rusby, Julie C.; Jones, Laura Backen; Crowley, Ryann; Smolkowski, Keith

    2013-01-01

    Home-based child caregivers face unique stressors related to the nature of their work. One hundred and fifty-five home-based child care providers in Oregon, USA, participated in this cross-sectional correlational study. We investigated associations between indicators of caregiver stress and child care working conditions, the quality of caregiver…

  7. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    ERIC Educational Resources Information Center

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  8. Spectral multidimensional scaling

    PubMed Central

    Aflalo, Yonathan; Kimmel, Ron

    2013-01-01

    An important tool in information analysis is dimensionality reduction. There are various approaches for large data simplification by scaling its dimensions down that play a significant role in recognition and classification tasks. The efficiency of dimension reduction tools is measured in terms of memory and computational complexity, which are usually a function of the number of the given data points. Sparse local operators that involve substantially less than quadratic complexity at one end, and faithful multiscale models with quadratic cost at the other end, make the design of dimension reduction procedure a delicate balance between modeling accuracy and efficiency. Here, we combine the benefits of both and propose a low-dimensional multiscale modeling of the data, at a modest computational cost. The idea is to project the classical multidimensional scaling problem into the data spectral domain extracted from its Laplace–Beltrami operator. There, embedding into a small dimensional Euclidean space is accomplished while optimizing for a small number of coefficients. We provide a theoretical support and demonstrate that working in the natural eigenspace of the data, one could reduce the process complexity while maintaining the model fidelity. As examples, we efficiently canonize nonrigid shapes by embedding their intrinsic metric into , a method often used for matching and classifying almost isometric articulated objects. Finally, we demonstrate the method by exposing the style in which handwritten digits appear in a large collection of images. We also visualize clustering of digits by treating images as feature points that we map to a plane. PMID:24108352

  9. Multidimensional persistence in biomolecular data

    PubMed Central

    Xia, Kelin; Wei, Guo-Wei

    2015-01-01

    Persistent homology has emerged as a popular technique for the topological simplification of big data, including biomolecular data. Multidimensional persistence bears considerable promise to bridge the gap between geometry and topology. However, its practical and robust construction has been a challenge. We introduce two families of multidimensional persistence, namely pseudo-multidimensional persistence and multiscale multidimensional persistence. The former is generated via the repeated applications of persistent homology filtration to high dimensional data, such as results from molecular dynamics or partial differential equations. The latter is constructed via isotropic and anisotropic scales that create new simiplicial complexes and associated topological spaces. The utility, robustness and efficiency of the proposed topological methods are demonstrated via protein folding, protein flexibility analysis, the topological denoising of cryo-electron microscopy data, and the scale dependence of nano particles. Topological transition between partial folded and unfolded proteins has been observed in multidimensional persistence. The separation between noise topological signatures and molecular topological fingerprints is achieved by the Laplace-Beltrami flow. The multiscale multidimensional persistent homology reveals relative local features in Betti-0 invariants and the relatively global characteristics of Betti-1 and Betti-2 invariants. PMID:26032339

  10. Home-based telemental healthcare safety planning: what you need to know.

    PubMed

    Luxton, David D; O'Brien, Karen; McCann, Russell A; Mishkind, Matthew C

    2012-10-01

    Telemental health (TMH) care provided directly to the home is an emerging area of care delivery. TMH care involves awareness of safety issues and adequate safety planning, although detailed practical recommendations for home-based TMH safety planning are absent in the literature. With this article we aim to increase awareness of safety issues associated with home-based synchronous TMH treatment and to discuss recommendations for consistent safety planning that can inform the development of standard operating procedures, emergency protocols, and overall good TMH practice. Specific areas discussed include consideration of state and local requirements, appropriateness of TMH care, technology and infrastructure, and emergency management and monitoring procedures. The topic of safety, as it relates to TMH policy, as well as the need for additional TMH research are also discussed.

  11. Evaluating the benefits of home-based management of atrial fibrillation: current perspectives

    PubMed Central

    Sheikh, Azfar B; Felzer, Jamie R; Munir, Abdullah Bin; Morin, Daniel P; Lavie, Carl J

    2016-01-01

    Atrial fibrillation (AF) is the most common arrhythmia worldwide, leading to an extensive public health and economic burden. The increasing incidence and prevalence of AF is due to the advancing age of the population, structural heart disease, hypertension, diabetes, and thyroid disease. The majority of costs associated with AF have been attributed to the cost of hospitalization. In order to minimize costs and decrease hospitalizations, counseling on modifiable risk factors contributing to AF has been strongly emphasized. With the release of novel oral anticoagulants bypassing the need for anticoagulant bridging or laboratory monitoring, post-discharge nurse-led home intervention, and novel methods of heart rate monitoring, home-based AF management has reached a new level of ease and sophistication. In this review, we aimed to review modifiable risk factors for AF and various methods of home-based management of AF, along with their benefits. PMID:27799843

  12. Investment in home-based maternal, newborn and child health records improves immunization coverage in Indonesia.

    PubMed

    Osaki, K; Hattori, T; Kosen, Soewarta; Singgih, Budihardja

    2009-08-01

    Indonesia Demographic and Health Surveys show that the ownership of home-based immunization records among children aged 12-23 months increased from 30.8% in 1997 and 30.7% in 2002-3 to 37% in 2007. In 2002-3, 70.9% of children who owned records had received all vaccines by the time of the survey, whereas 42.9% of children who did not own records had been fully immunized. An Indonesian ministerial decree of 2004 stated that the Maternal and Child Health Handbook (MCH handbook) was to be the only home-based record of maternal, newborn and child health. The increased immunization coverage seen would be a reflection of MCH handbook implementation, through raising awareness of immunization among community and health personnel and children's parents or guardians and allowing more accurate measurement of immunization coverage.

  13. Creating an Ethnodrama to Catalyze Dialogue in Home-Based Dementia Care.

    PubMed

    Speechley, Mark; DeForge, Ryan T; Ward-Griffin, Catherine; Marlatt, Nicole M; Gutmanis, Iris

    2015-11-01

    This article describes the development of a theater script derived from a critical ethnographic study that followed people living with dementia--and their family and professional caregivers--over an 18-month period. Analysis of the ethnographic data yielded four themes that characterized home-based dementia care relationships: managing care resources, making care decisions, evaluating care practices, and reifying care norms. The research team expanded to include a colleague with playwright experience, who used these themes to write a script. A theater director was included to cast and direct the play, and finally, a videography company filmed the actors on a realistic set. To contribute to the qualitative health research and the research-based theater knowledge translation literatures, this article describes and explains the creative decisions taken as part of our effort to disseminate research focused on home-based dementia care in a way that catalyzes and fosters critical (actionable) dialogue.

  14. Muscle Strength Enhancement Following Home-Based Virtual Cycling Training in Ambulatory Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Chen, Chia-Ling; Hong, Wei-Hsien; Cheng, Hsin-Yi Kathy; Liaw, Mei-Yun; Chung, Chia-Ying; Chen, Chung-Yao

    2012-01-01

    This study is the first well-designed randomized controlled trial to assess the effects of a novel home-based virtual cycling training (hVCT) program for improving muscle strength in children with spastic cerebral palsy (CP). Twenty-eight ambulatory children with spastic CP aged 6-12 years were randomly assigned to an hVCT group (n = 13) or a…

  15. Using Child-Parent Psychotherapy in a Home-Based Program Model

    ERIC Educational Resources Information Center

    Ball, Jennifer; Smith, Mae

    2015-01-01

    This article tells the story of a single mother, Maria, who has a history of trauma, and her 2-year-old daughter, Lina, as they learn, play, and heal together through the use of Child-Parent Psychotherapy, an evidenced-based, trauma-informed therapeutic intervention in a home-based program model. Through the power of play, Maria and Lina are able…

  16. Efficacy of an early home-based cardiac rehabilitation program for patients after acute myocardial infarction

    PubMed Central

    Xu, Lin; Cai, Zekun; Xiong, Meihua; Li, Yekuo; Li, Guoying; Deng, Yu; Hau, William Kongto; Li, Shuo; Huang, Wenhua; Qiu, Jian

    2016-01-01

    Abstract Background: The effect of an early short-term home-based cardiac rehabilitation (CR) program on ventricular function in acute myocardial infarction (AMI) patients is not yet clear. The purpose of this study was to evaluate the efficacy of our CR program on the improvement of myocardial function using three-dimensional speckle tracking echocardiography (3D-STE) in AMI patients. Methods: Fifty-two AMI patients were randomly assigned to 2 groups after discharge: the rehabilitation group, which participated in an early, home-based CR program, and the control group, which received only usual care. All subjects in both groups underwent 3D-STE examinations of the left ventricle within 48 hours of percutaneous coronary intervention and again 4 weeks after discharge. Global longitudinal strain (GLS), global radial strain (GRS), global area strain (GAS), global circumferential strain (GCS), left ventricular ejection fraction (LVEF), and segmental strains were computed. The CR program was initially conducted with supervised inpatient training, followed by an unsupervised home-based training program during a 4-week follow-up. Results: We obtained segmental strains from 832 segments, of which 319 were defined as interventional segments, 179 as ischemic segments, and the remaining segments as normal segments. At the 4-week follow-up, when controlling for baseline values, the rehabilitation group showed significant improvements in GLS, GRS, GCS, GAS, LVEF, and in all of the segmental strains of the 3 subgroups compared with the control group (P <0.05). Conclusion: Our study suggests that an early, home-based CR program can greatly improve the ventricular function of AMI patients in a short period of time. PMID:28033254

  17. Knowledge regarding HIV/AIDS among home-based caregivers in Namibia

    PubMed Central

    Niikondo, Hileni; Hoque, Muhammad; Ntuli-Ngcobo, Busi

    2011-01-01

    Lack of practical knowledge among home-based caregivers on human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), anti-retroviral therapy (ART) and poor individual adherence to treatment are among the root causes of ineffective ART service delivery in Namibia. The purpose of our study was to investigate the knowledge among home-based caregivers in Namibia regarding HIV/AIDS. The study was a descriptive, cross-sectional one in which 89 participants completed a self-administered questionnaire to assess their knowledge of HIV/AIDS. Almost all (93%) of the respondents gave a correct definition of HIV. Over a tenth (11.3%) did not know that HIV decreases the body's ability to fight disease and 33.7% could not define AIDS. Almost all (98%) the home-based caregivers knew that HIV can be diagnosed only through a blood test and 91% mentioned that consistent and correct use of condoms during sexual intercourse protects one from HIV infection. Fewer than half (44%) of the respondents could indicate on-and-off fever as a symptom of AIDS and 16% mentioned that increased body weight is a sign of AIDS, which is incorrect. Although the knowledge of the caregivers on HIV/AIDS was above average in some aspects, there was still lack of knowledge on isolated issues such as AIDS definitions and signs and how HIV works. Training organisations in home-based care settings should emphasise the knowledge of AIDS definition and signs as well as of post-test counselling, consequence of poor adherence and facilities that issue anti-retroviral treatment.

  18. Home-Based Hospice Care Reduces End-of-Life Expenditure in Taiwan: A Population-Based Study.

    PubMed

    Chen, Li-Fu; Chang, Chun-Ming; Huang, Chih-Yuan

    2015-09-01

    Inpatient hospice care can reduce futile treatment and medical costs. However, the cost trimming effect of home-based hospice care in hospital has yet not been explored. This study evaluates the impact of home-based hospice care on end-of-life expenditure in hospitals with different spending intensity. This is a population-based retrospective study in Taiwan. Cancer decedents were identified in the National Health Insurance Research Database (NHIRD) from 2009 to 2011. They are categorized by hospital spending intensity. A hierarchical linear regression model with a random-intercept model was used to analyze the relationship between end-of-life expenditure (dependent variable) with and without home-based hospice, and both patient-level and hospital-level characteristics. A total of 78,613 cancer decedents were identified in the NHIRD from 2009 to 2011. Of these decedents, 17,638, 43,286, and 17,689 were categorized by hospital spending intensity as high, moderate, and low, respectively. Decedents with home-based hospice care were associated with US$2452 less in expenditure per patient compared with those without home-based hospice care. The majority of savings occurred in the last 3 months of life. These savings with home-based hospice care were consistent in hospitals with different levels of spending intensity. Home-based hospice reduced one-fifth expenditure at the end of life of cancer decedents treated in hospitals with different spending intensity.

  19. Self-reported impact of caregiving on voluntary home-based caregivers in Mutale Municipality, South Africa

    PubMed Central

    Netshandama, Vhonani O.; Mudau, Makondelela J.

    2016-01-01

    Background The establishment of home-based care (HBC) programmes in developing countries has resulted in a shift of burden from hospitals to communities where palliative care is provided by voluntary home-based caregivers. Aim The study investigated the impact of caregiving on voluntary home-based caregivers. Setting The study was conducted at HBC organisations located in Mutale Municipality of Limpopo Province, South Africa. Methods A quantitative cross-sectional descriptive survey design was applied to investigate the impact of caregiving on voluntary home-based caregivers. The sample was comprised of (N = 190) home-based caregivers. Home-based caregivers provide care to people in need of care in their homes, such as orphans, the elderly and those suffering from chronic illnesses such as tuberculosis, HIV and/or AIDS, cancer and stroke. Self-administered questionnaires were used to collect data which were analysed descriptively using the Statistical Package for the Social Sciences software, Version 20. Results The results showed that 101 (53.2%) participants were worried about their financial security because they were not registered as workers, whilst 74 (39.0%) participants were always worried about getting infection from their clients because they often do not have protective equipment. Conclusion Voluntary home-based caregivers have an important role in the provision of palliative care to people in their own homes, and therefore, the negative caregiving impact on the lives of caregivers may compromise the provision of quality palliative care. PMID:27380854

  20. [Sociability networks: approaches based on home-based therapeutic care services].

    PubMed

    Argiles, Carmen Terezinha Leal; Kantorski, Luciane Prado; Willrich, Janaína Quinzen; Antonacci, Milena Hohmann; Coimbra, Valéria Cristina Christello

    2013-07-01

    Home-based therapeutic services emerge in the context of psychiatric reform in Brazil, as a step forward in the policy of de-institutionalization, as well as being essential services to overcome custody practices, typical of the asylum model. These services provide spaces for care, welcome and decent housing for people whose family and social ties have been affected by internment in psychiatric hospitals. The article seeks to evaluate the sociability network of users of home-based therapeutic services in Alegrete in the State of Rio Grande do Sul, based on a case report. This study is part of the research on 'Networks that Rehabilitate'--evaluating innovative experiments in the composition of psychosocial care networks. Data from semi-structured interviews with the six workers of the service were used. It was observed that the service provides unique and innovative experience to find solutions that bring people with long periods of psychiatric hospitalization back together with their family, the community and city life, thereby eliminating the segregation to which they were subjected. Coaching residents and workers in the creation of home-based therapeutic care services reveals the potential to reintegrate mentally handicapped patients into society.

  1. Peer tutoring with or without home-based reinforcement, for reading remediation.

    PubMed Central

    Trovato, J; Bucher, B

    1980-01-01

    An operant-based corrective reading program was established to study effectiveness of peer tutoring in the school, for reading deficient children. Sixty-nine second to fourth grade students were matched on measures of initial reading ability and level of reading retardation, and randomly assigned to three groups: Peer Tutoring Only, Peer Tutoring with Home Based Reinforcement, and Control. SRA materials were used in training for the experimental groups, supplemented with additional reading materials. The program continued for 15 weeks, in seven public schools. Changes in oral reading accuracy and comprehansion were assessed. Both reading and comprehension were significantly increased by peer tutoring, relative to the control group. The addition of home-based reinforcement doubled this increase. The measured gain in oral reading, based upon standardized testing, was 0.19 years for the controls and 1.27 years for peer tutoring with home-based reinforcement. Internal measures of gain showed similar results, and comprehension gains were also comparable. A high rate of compliance with the tutoring program was maintained by the tutors. High ratings of satisfaction were obtained for the program, from all groups of participants. The feasibility of the program for application in the school system is discussed. PMID:7364691

  2. Enhancing the capacity to facilitate physical activity in home-based child care settings.

    PubMed

    Naylor, Patti-Jean; Temple, Viviene A

    2013-01-01

    Healthy Opportunities for Preschoolers (HOP) is a physical activity and movement skill intervention that was developed to address the unique needs of home-based child care providers. The authors used a train-the-trainer approach to enhance local uptake and implementation of HOP and examined the impact on the trainers' (workshop leaders') perceived knowledge, confidence, and intention to implement community workshops and subsequently on the knowledge, confidence, and intentions of workshop participants. This study also assessed feasibility: reach, satisfaction, and facilitators and barriers to workshop implementation. Overall, 92% and 89.5% of the leaders were very or extremely satisfied with the workshop content and delivery, respectively. Training significantly increased their self-reported knowledge (p < .001) and confidence (p < .001). Subsequently, 73% of workshop participants (48 workshops, n = 321) took part in the evaluation; intention to use what they learned after the workshop was high (86%) and perceived knowledge, confidence, and attitude all increased significantly (p < .001). The HOP train-the-trainer approach was feasible and enhanced knowledge, confidence, and readiness to change among home-based child care providers. This approach should be considered as a component of an overall strategy to enhance the promotion of physical activity and movement skills in home-based child care settings.

  3. Effects of a Combined Exercise Program Using an iPad for Older Adults

    PubMed Central

    Lee, Juhee; Byun, Jinyee; Lee, Minkyung

    2016-01-01

    Objectives The purpose of this study was to examine the function, health status, and efficacy effects of a combined exercise program using an iPad among older women in Korea, a tech-savvy country. Methods The study employed a pretest and posttest experimental design with a control group. The experimental group of subjects comprised 16 female older adults and the control group comprised 10 who were aged 65 years or older. The experimental group participated in a supervised group-based exercise program and an individualized home-based exercise program that involved the use of an iPad. The combined group and home-based exercise program consisted of group exercise, which took place in a senior center for 30 minutes weekly, and a home-based iPad exercise program, which the subjects followed at least 3 times a week. The collected data were analyzed using the Statistical Analysis System (SAS ver. 9.3 TS Level 1M0) program, which utilized a chi-square test, a Fisher exact test, a t-test, and a repeated-measures ANOVA. Results The results showed that cognitive status changed significantly over time, and there was an interaction between group and time. Further, self-efficacy for exercise and outcome expectations for exercise changed significantly over time. Conclusions Exercise programs using iPad interventions may be useful for the management of cognitive functioning and the integration of functional physical abilities in older adults. PMID:27200215

  4. Multidimensional peptide separations in proteomics.

    PubMed

    Link, Andrew J

    2002-12-01

    Multidimensional peptide separation will play an increasingly important role in the drive to identify and quantitate the proteome. By increasing the peak and load capacity, multidimensional approaches increase the number and dynamic range of peptides that can be analyzed in a complex biological organism. Separation methods using different physical properties of peptides have been combined with varying degrees of success. The ultimate goal is a rapid separation strategy that can be coupled with analytical methods, such as mass spectrometry, to provide comprehensive monitoring of the changing concentration, interactions, and structures of proteins in the proteome.

  5. On the Need for Multidimensional Stirling Simulations

    NASA Technical Reports Server (NTRS)

    Dyson, Rodger W.; Wilson, Scott D.; Tew, Roy C.; Demko, Rikako

    2005-01-01

    Given the cost and complication of simulating Stirling convertors, do we really need multidimensional modeling when one-dimensional capabilities exist? This paper provides a comprehensive description of when and why multidimensional simulation is needed.

  6. Multidimensional Perfectionism and Ego Defenses

    ERIC Educational Resources Information Center

    Dickinson, Wendy L.; Ashby, Jeffrey S.

    2005-01-01

    This study examined the relationship between multidimensional perfectionism and ego defense style among 130 college students. Cluster analysis results facilitated the identification of groups of adaptive perfectionists, maladaptive perfectionists, and non-perfectionists. The researchers found that identified maladaptive perfectionists used…

  7. Multidimensional Scaling of Video Surrogates.

    ERIC Educational Resources Information Center

    Goodrum, Abby A.

    2001-01-01

    Four types of video surrogates were compared under two tasks. Multidimensional scaling was used to map dimensional dispersions of users' judgments of similarity between videos and surrogates. Congruence between these maps was used to evaluate representativeness of each surrogate type. Congruence was greater for image-based than for text-based…

  8. A Multidimensional Software Engineering Course

    ERIC Educational Resources Information Center

    Barzilay, O.; Hazzan, O.; Yehudai, A.

    2009-01-01

    Software engineering (SE) is a multidimensional field that involves activities in various areas and disciplines, such as computer science, project management, and system engineering. Though modern SE curricula include designated courses that address these various subjects, an advanced summary course that synthesizes them is still missing. Such a…

  9. Recycling Behavior: A Multidimensional Approach

    ERIC Educational Resources Information Center

    Meneses, Gonzalo Diaz; Palacio, Asuncion Beerli

    2005-01-01

    This work centers on the study of consumer recycling roles to examine the sociodemographic and psychographic profile of the distribution of recycling tasks and roles within the household. With this aim in mind, an empirical work was carried out, the results of which suggest that recycling behavior is multidimensional and comprises the undertaking…

  10. Home-based voluntary HIV counselling and testing found highly acceptable and to reduce inequalities

    PubMed Central

    2010-01-01

    Background Low uptake of voluntary HIV counselling and testing (VCT) in sub-Saharan Africa is raising acceptability concerns which might be associated with ways by which it is offered. We investigated the acceptability of home-based delivery of counselling and HIV testing in urban and rural populations in Zambia where VCT has been offered mostly from local clinics. Methods A population-based HIV survey was conducted in selected communities in 2003 (n = 5035). All participants stating willingness to be HIV tested were offered VCT at home and all counselling was conducted in the participants' homes. In the urban area post-test counselling and giving of results were done the following day whereas in rural areas this could take 1-3 weeks. Results Of those who indicated willingness to be HIV tested, 76.1% (95%CI 74.9-77.2) were counselled and received the test result. Overall, there was an increase in the proportion ever HIV tested from 18% before provision of home-based VCT to 38% after. The highest increase was in rural areas; among young rural men aged 15-24 years up from 14% to 42% vs. for urban men from 17% to 37%. Test rates by educational attainment changed from being positively associated to be evenly distributed after home-based VCT. Conclusions A high uptake was achieved by delivering HIV counselling and testing at home. The highest uptakes were seen in rural areas, in young people and groups with low educational attainment, resulting in substantial reductions in existing inequalities in accessing VCT services. PMID:20553631

  11. Effects of home-based respiratory muscle training in children and adolescents with chronic lung disease* **

    PubMed Central

    Rodríguez, Iván; Zenteno, Daniel; Manterola, Carlos

    2014-01-01

    OBJECTIVE: Respiratory muscle weakness is a functional repercussion of chronic lung disease (CLD). The objective of this study was to assess the effects of home-based respiratory muscle training (RMT) in children and adolescents with CLD or neuromuscular disease (NMD). METHODS: This was a quasi-experimental study involving children and adolescents with CLD or NMD. Before and after 6 months of home-based RMT, we measured respiratory muscle strength (MIP and MEP), PEF, and peak cough flow (PCF). We made statistical comparisons between the pre-RMT and post-RMT values, as well as evaluating the correlation between the duration and effect of RMT. RESULTS: The study included 29 patients, with a mean age of 12 years (range, 5-17 years), of whom 18 (62.1%) were male. The CLD group comprised 11 patients (37.9%), and the NMD group comprised 18 (62.1%). The mean duration of the RMT was 60 weeks (range, 46-90 weeks) in the CLD group and 39 weeks (range, 24-89 weeks) in the NMD group. In comparison with the pre-RMT values, the post-RMT values for MIP and MEP were significantly higher in both groups, whereas those for PEF and PCF were significantly higher only in the NMD group. We found no correlation between the duration and the effect of RMT. CONCLUSIONS: Home-based RMT appears to be an effective strategy for increasing respiratory muscle strength in children and adolescents with CLD or NMD, although it increased the ability to cough effectively only in those with NMD. PMID:25610503

  12. The Home-Based Occupational Therapy Intervention in the Alzheimer's Disease Multiple Intervention Trial (ADMIT).

    PubMed

    Schmid, Arlene A; Spangler-Morris, Carrie; Beauchamp, Rachel C; Wellington, Miranda C; Hayden, Whitney M; Porterfield, Hannah S; Ferguson, Denisha; Callahan, Christopher M

    2015-01-01

    There is no way to prevent functional declines related to Alzheimer's Disease (AD). The use of occupational therapy (OT) has been shown to be successful in managing some aspects of AD. We added home-based OT to evidence-based best practice for AD with the aim of delaying functional decline in people with AD. OT was delivered in the home to a caregiver dyad including the person with AD and her/his caregiver. This paper describes the OT intervention for the AD Multiple Intervention Trial, a parallel randomized controlled trial. We include baseline data on the 180 caregiver dyads.

  13. Questionable Exercises.

    ERIC Educational Resources Information Center

    Liemohn, Wendell; Haydu, Traci; Phillips, Dawn

    1999-01-01

    This publication presents general guidelines for exercise prescription that have an anatomical basis but also consider the exerciser's ability to do the exercise correctly. It reviews various common questionable exercises, explaining how some exercises, especially those designed for flexibility and muscle fitness, can cause harm. Safer…

  14. Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage—a feasibility study protocol

    PubMed Central

    Street, Alexander J.; Magee, Wendy L.; Odell-Miller, Helen; Bateman, Andrew; Fachner, Jorg C.

    2015-01-01

    Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3–60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes. PMID:26441586

  15. Clinic- and Home-Based Contingency Management Plus Parent Training for Adolescent Cannabis Use Disorders

    PubMed Central

    Stanger, Catherine; Ryan, Stacy R.; Scherer, Emily A.; Norton, Gray E.; Budney, Alan J.

    2015-01-01

    Objective To conduct a randomized test comparing two multicomponent, contingency management interventions, one with and one without a full parent training curriculum, and an individual treatment for adolescent cannabis use disorders. Method 153 adolescents who met DSM-IV criteria for cannabis abuse or dependence were randomized to motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT), MET/CBT+abstinence-based contingency management (CM), or MET/CBT+CM+Parent Training (PT). Results Overall, during treatment, abstinence was greater for youth receiving clinic- and home-based CM without PT compared to those who received individual MET/CBT. There was no additional benefit of the full parent training curriculum on marijuana use, youth externalizing problems, or parenting. Conclusion These results suggest that clinic- plus home-based CM for cannabis use disorders can increase rates of abstinence during treatment over and above an evidence-based treatment (individual MET/CBT), but the addition of a comprehensive parenting training curriculum did not further enhance efficacy. PMID:26004659

  16. Predictors of client engagement and attrition in home-based child maltreatment prevention services.

    PubMed

    Damashek, Amy; Doughty, Debby; Ware, Lisa; Silovsky, Jane

    2011-02-01

    High rates of program attrition in home-based family support and child maltreatment prevention services are common. Researchexamining factors related to family engagement (i.e., enrollment and completion rates) may help program developers increase theimpact of child abuse prevention services by reducing attrition. The present study examined the relative influence of provider,program, and individual factors from the Integrated Theory of Parent Involvement (ITPI) as well as maternal and family demo-graphic and risk variables in predicting service enrollment and completion in a home-based child maltreatment prevention service(SafeCareþ) and a standard community care program (Services as Usual [SAU]). Participants were 398 female caregivers ofchildren ages 5 and below. Support was found for the primary role of program and provider factors in client enrollment andcompletion of services. Specifically, participants in SafeCareþ were 4 times more likely to enroll in services and 8.5 times morelikely to complete services than those in SAU. Family risk variables including intimate partner psychological aggression, substanceabuse, and depression were also significant predictors. Recommended next steps include integration of risk-related factors in theITPI framework and disentangling specific provider and program factors related to service engagement.

  17. eFurniture for home-based frailty detection using artificial neural networks and wireless sensors.

    PubMed

    Chang, Yu-Chuan; Lin, Chung-Chih; Lin, Pei-Hsin; Chen, Chun-Chang; Lee, Ren-Guey; Huang, Jing-Siang; Tsai, Tsai-Hsuan

    2013-02-01

    The purpose of this study is to integrate wireless sensor technologies and artificial neural networks to develop a system to manage personal frailty information automatically. The system consists of five parts: (1) an eScale to measure the subject's reaction time; (2) an eChair to detect slowness in movement, weakness and weight loss; (3) an ePad to measure the subject's balancing ability; (4) an eReach to measure body extension; and (5) a Home-based Information Gateway, which collects all the data and predicts the subject's frailty. Using a furniture-based measuring device to provide home-based measurement means that health checks are not confined to health institutions. We designed two experiments to obtain optimum frailty prediction model and test overall system performance: (1) We developed a three-step process to adjust different parameters to obtain an optimized neural identification network whose parameters include initialization, L.R. dec and L.R. inc. The post-process identification rate increased from 77.85% to 83.22%. (2) We used 149 cases to evaluate the sensitivity and specificity of our frailty prediction algorithm. The sensitivity and specificity of this system are 79.71% and 86.25% respectively. These results show that our system is a high specificity prediction tool that can be used to assess frailty.

  18. Home-based reinforcement and the modification of pre-delinquents' classroom behavior1

    PubMed Central

    Bailey, Jon S.; Wolf, Montrose M.; Phillips, Elery L.

    1970-01-01

    In Exp. I, five pre-delinquents from Achievement Place attended a special summer school math class where study behavior and rule violations were measured daily for each boy. The boys were required to take a “report card” for the teacher to mark. The teacher simply marked yes or no whether a boy had “studied the whole period” and “obeyed the class rules.” All yeses earned privileges in the home that day but a no lost all the privileges. Using a reversal design, it was shown that privileges dispensed remotely could significantly improve classroom performance. In Exp. II and III, home-based reinforcement was also shown to be effective in improving the study behavior of two youths in public school classrooms. In addition, data from Exp. III suggest that the daily feedback and reinforcement may be faded without much loss in study behavior. Home-based reinforcement was demonstrated to be a very effective and practical classroom behavior modification technique. PMID:16795262

  19. Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects

    PubMed Central

    Davoodi, Somayeh; Mohammadzadeh, Zeinab; Safdari, Reza

    2016-01-01

    Objective: Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient’s lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. Methods: In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Results: Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemotherapy management have positive results and led to patients and clinicians satisfactions. Conclusion: This study shows that the mobile phone system for home-based monitoring chemotherapy side effects works well. In result, knowledge of cancer self-management and the rate of patient’s effective participation in care process improved. PMID:27482134

  20. Systematic review of family and home-based interventions targeting paediatric overweight and obesity.

    PubMed

    Knowlden, A P; Sharma, M

    2012-06-01

    The family and home environment is a highly influential psychosocial antecedent of paediatric obesity. The purpose of this investigation was to systematically analyze family and home-based randomized control trials aimed at treating overweight and obesity in children ages 2-7 years. In gathering materials for this review, a search of Cumulative Index to Nursing and Allied Health, MEDLINE, Education Resources Information Center, Psychology and Behavioural Sciences Collection and CENTRAL databases was conducted for the time frame of January 2001 to August 2011. The data extraction spanned three phases resulting in a total of nine interventions that met the specified inclusion criteria. Among the identified studies, eight produced significant outcomes. The majority of the programmes incorporated educational sessions targeting parents as the primary modality for intervention delivery. Less than one-quarter of the interventions included home visitations; however, all of the interventions included home-based activities to reinforce behaviour modification. Only three of the interventions applied social and behavioural theory, and only two interventions employed process evaluation. Additional research is needed to gauge the efficacy of the home and family milieu for treating paediatric obesity.

  1. Lessons learned from the usability assessment of home-based telemedicine systems.

    PubMed

    Agnisarman, Sruthy Orozhiyathumana; Chalil Madathil, Kapil; Smith, Kevin; Ashok, Aparna; Welch, Brandon; McElligott, James T

    2017-01-01

    At-home telemedicine visits are quickly becoming an acceptable alternative for in-person patient visits. However, little work has been done to understand the usability of these home-based telemedicine solutions. It is critical for user acceptance and real-world applicability to evaluate available telemedicine solutions within the context-specific needs of the users of this technology. To address this need, this study evaluated the usability of four home-based telemedicine software platforms: Doxy.me, Vidyo, VSee, and Polycom. Using a within-subjects experimental design, twenty participants were asked to complete a telemedicine session involving several tasks using the four platforms. Upon completion of these tasks for each platform, participants completed the IBM computer system usability questionnaire (CSUQ) and the NASA Task Load Index test. Upon completing the tasks on all four platforms, the participants completed a final post-test subjective questionnaire ranking the platforms based on their preference. Of the twenty participants, 19 completed the study. Statistically significant differences among the telemedicine software platforms were found for task completion time, total workload, mental demand, effort, frustration, preference ranking and computer system usability scores. Usability problems with installation and account creation led to high mental demand and task completion time, suggesting the participants preferred a system without such requirements. Majority of the usability issues were identified at the telemedicine initiation phase. The findings from this study can be used by software developers to develop user-friendly telemedicine systems.

  2. Reliability of home-based, motor function measure in hereditary neuromuscular diseases.

    PubMed

    Ruiz-Cortes, Xiomara; Ortiz-Corredor, Fernando; Mendoza-Pulido, Camilo

    2017-02-01

    Objective To evaluate the reliability of the motor function measure (MFM) scale in the assessment of disease severity and progression when administered at home and clinic and assess its correlation with the Paediatric Outcomes Data Collection Instrument (PODCI). Methods In this prospective study, two assessors rated children with hereditary neuromuscular diseases (HNMDs) using the MFM at the clinic and then 2 weeks later at the patients' home. Intraclass correlation coefficient (ICC) was calculated for the reliability of the MFM and its domains. The reliability of each item was assessed and the correlation between MFM and three domains of PODCI was evaluated. Results A total of 48 children (5-17 years of age) were assessed in both locations and the MFM scale demonstrated excellent inter-rater reliability (ICC, 0.98). Weighted kappa ranged from excellent to poor. Correlation of the home-based MFM with the PODCI domain 'basic mobility and transfers' was excellent, with the 'upper extremity' domain was moderate, but there was no correlation with the 'happiness' domain. Conclusion The MFM is a reliable tool for assessing patients with HNMD when used in a home-based setting.

  3. Daily home-based spirometry during withdrawal of inhaled corticosteroid in severe to very severe chronic obstructive pulmonary disease

    PubMed Central

    Rodriguez-Roisin, Roberto; Tetzlaff, Kay; Watz, Henrik; Wouters, Emiel FM; Disse, Bernd; Finnigan, Helen; Magnussen, Helgo; Calverley, Peter MA

    2016-01-01

    The WISDOM study (NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland–Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume in 1 second values recorded at home and in the clinic (mean difference of −0.05 L), which may be due to suboptimal patient effort in performing unsupervised recordings. However, this difference remained consistent over time. Overall, these data demonstrate that home-based and in-clinic spirometric measurements were equally valid and reliable for assessing lung function in patients with COPD, and suggest that home-based spirometry may be a useful tool to facilitate analysis of changes in lung function on a day-to-day basis. PMID:27578972

  4. Cuba: Multidimensional numerical integration library

    NASA Astrophysics Data System (ADS)

    Hahn, Thomas

    2016-08-01

    The Cuba library offers four independent routines for multidimensional numerical integration: Vegas, Suave, Divonne, and Cuhre. The four algorithms work by very different methods, and can integrate vector integrands and have very similar Fortran, C/C++, and Mathematica interfaces. Their invocation is very similar, making it easy to cross-check by substituting one method by another. For further safeguarding, the output is supplemented by a chi-square probability which quantifies the reliability of the error estimate.

  5. Multidimensional bioseparation with modular microfluidics

    DOEpatents

    Chirica, Gabriela S.; Renzi, Ronald F.

    2013-08-27

    A multidimensional chemical separation and analysis system is described including a prototyping platform and modular microfluidic components capable of rapid and convenient assembly, alteration and disassembly of numerous candidate separation systems. Partial or total computer control of the separation system is possible. Single or multiple alternative processing trains can be tested, optimized and/or run in parallel. Examples related to the separation and analysis of human bodily fluids are given.

  6. Exercise Prescription.

    ERIC Educational Resources Information Center

    Ribisl, Paul M.

    If exercise programs are to become effective in producing the desired results, then the correct exercise prescription must be applied. Four variables should be controlled in the prescription of exercise: (a) type of activity, (b) intensity, (c) duration, and (d) frequency. The long-term prescription of exercise involves the use of a (a) starter…

  7. "Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

    PubMed

    Young, Rachel; Willis, Erin; Cameron, Glen; Geana, Mugur

    2014-06-01

    While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.

  8. Rapid home-based human immunodeficiency virus testing to reduce costs in a large tuberculosis cohort study

    PubMed Central

    Contreras, C.; Lecca, L.; Shin, S.; Lobatón, R.; Zhang, Z.; Calderón, R.; Murray, M.; Becerra, M. C.

    2013-01-01

    To reduce costs in a large tuberculosis household contact cohort study in Lima, Peru, we replaced laboratory-based human immunodeficiency virus (HIV) testing with home-based rapid HIV testing. We developed a protocol and training course to prepare staff for the new strategy; these included role-playing for home-based deployment of the Determine® HIV 1/2 Ag/Ac Combo HIV test. Although the rapid HIV test produced more false-positives, the overall cost per participant tested, refusal rate and time to confirmatory HIV testing were lower with the home-based rapid testing strategy compared to the original approach. Rapid testing could be used in similar research or routine care settings. PMID:25580381

  9. Follow-up of an Exercise-Based Treatment for Children with Reading Difficulties

    ERIC Educational Resources Information Center

    Reynolds, David; Nicolson, Roderick I.

    2007-01-01

    This study reports the results of a long-term follow-up of an exercise-based approach to dyslexia-related disorders (Reynolds, Nicolson, & Hambly, "Dyslexia," 2003; 9(1): 48-71). In the initial study, children at risk of dyslexia were identified in 3 years of a junior school. One half then undertook a 6 month, home-based exercise…

  10. Home based telemedicine intervention for patients with uncontrolled hypertension: - a real life - non-randomized study

    PubMed Central

    2014-01-01

    Background Control of blood pressure is frequently inadequate in spite of availability of several classes of well tolerated and effective antihypertensive drugs. Several factors, including the use of suboptimal doses of drugs, inadequate or ineffective treatments and poor drug compliance may be the reason for this phenomenon. The aim of the current non- randomized study was to evaluate the effectiveness of a Home-Based Telemedicine service in patients with uncontrolled hypertension. Methods 74 patients were enrolled in a Home Based Telemedicine group and 94 patients in the Usual Care group. At baseline and at the end of the study, patients in both groups were seen in a cardiology office. Patients in Home Based Telemedicine group additionally were followed by a physician-nurse, through scheduled and unscheduled telephone appointments. These patients also received a blood pressure measuring device that could transmit the readings to a central data monitor via secure data connection. Results During the study period (80 ± 25 days), a total of 17401 blood pressure measurements were taken in the Home Based Telemedicine group corresponding to 236 ± 136 readings per patient and a mean daily measurement of 3 ± 1.7. The scheduled telephone contacts (initiated by the nurse) equaled to 5.2 ± 4.3/patient (370 in total) and the unscheduled telephone contacts (initiated by the patients) were 0.4 ± 0.9/patient (30 in total). The mean systolic blood pressure values decreased from 153 ± 19 mmHg to 130 ± 15 mmHg (p < 0.0001) at the end of the study and diastolic blood pressure values decreased from 89 ± 10 mmHg to 76 ± 11 mmHg (p < 0.0001). In the Usual Care group, the mean systolic blood pressure values decreased from 156 ± 16 mmHg to 149 ± 17 mmHg (p < 0.05) at the end of the study and diastolic blood pressure values decreased from 90 ± 8 mmHg to 86 ± 9 mmHg (p < 0.05). The changes in drug

  11. Home-based chronic care. An expanded integrative model for home health professionals.

    PubMed

    Suter, Paula; Hennessey, Beth; Harrison, Gregory; Fagan, Martha; Norman, Barbara; Suter, W Newton

    2008-04-01

    The Chronic Care Model (CCM) developed by is an influential and accepted guide for the care of patients with chronic disease. Wagner acknowledges a current healthcare focus on acute care needs that often circumvents chronic care coordination. He identifies the need for a "division of labor" to assist the primary care physician with this neglected function. This article posits that the role of chronic care coordination assistance and disease management fits within the purview of home healthcare and should be central to home health chronic care delivery. An expanded Home-Based Chronic Care Model (HBCCM) is described that builds on Wagner's model and integrates salient theories from fields beyond medicine. The expanded model maximizes the potential for disease self-management success and is intended to provide a foundation for home health's integral role in chronic disease management.

  12. Home-based caregivers' knowledge regarding anti-retroviral therapy in Namibia.

    PubMed

    Niikondo, H N; Hoque, M E; Ntuli-Ngcobo, B

    2011-03-01

    Lack of practical knowledge among home-based caregivers (HBCs) on HIV/AIDS, anti-retroviral treatment (ART) and poor individual adherence to treatment are among the root causes of ineffective ART service delivery in Namibia. The purpose of the study was to investigate the knowledge of HBCs in Namibia regarding ART. The study was a descriptive, cross-sectional study in which 89 participants completed self-administered questionnaires to assess their knowledge regarding ART. Knowledge of HBCs on ART was above average in some aspects, there was still lack of knowledge on necessity of post-test counseling. Training organizations should put emphasis on the necessity of post-test counseling, consequence of poor adherence and type of facilities that issue ART.

  13. Challenges and Strategies in Providing Home Based Primary Care for Refugees in the US.

    PubMed

    Febles, C; Nies, M A; Fanning, K; Tavernier, S S

    2016-08-18

    The recent crisis in the Middle East has prompted the exodus of millions of refugees from the region who are at present seeking shelter across Europe and in the United States. Among the most immediate needs of refugees upon arrival in a host country is health care, and it is one of the most sustained interactions they experience. Home visits are a common form of primary care for refugees. The authors review the literature to identify themes related to challenges and strategies for providing home based primary care to refugees. The literature review was performed by searching cross-disciplinary databases utilizing Onesearch, but focusing primarily on results produced through CINAHL, EBSCOHOST, and Pub Med databases. To maximize the number of studies included, there was no time frame placed upon publication dates of articles within the search. A total of 55 articles were included in this paper.

  14. The use of computer vision techniques to augment home based sensorised environments.

    PubMed

    Uhríková, Zdenka; Nugent, Chris D; Hlavác, Václav

    2008-01-01

    Technology within the home environment is becoming widely accepted as a means to facilitate independent living. Nevertheless, practical issues of detecting different tasks between multiple persons within the same environment along with managing instances of uncertainty associated with recorded sensor data are two key challenges yet to be fully solved. This work presents details of how computer vision techniques can be used as both alternative and complementary means in the assessment of behaviour in home based sensorised environments. Within our work we assessed the ability of vision processing techniques in conjunction with sensor based data to deal with instances of multiple occupancy. Our Results indicate that the inclusion of the video data improved the overall process of task identification by detecting and recognizing multiple people in the environment using color based tracking algorithm.

  15. Evaluation of A Novel Information-Sharing Instrument for Home-Based Palliative Care

    PubMed Central

    Sawada, Koichiro; Shimada, Masanari; Kadoya, Shinichi; Endo, Naoki; Ishiguro, Kaname; Takashima, Rumi; Amemiya, Yoko; Fujikawa, Yasunaga; Ikezaki, Tomoaki; Takeuchi, Miyako; Kitazawa, Hidenori; Iida, Hiroyuki; Koseki, Shiro; Morita, Tatsuya; Sasaki, Koji; Kashii, Tatsuhiko; Murakami, Nozomu

    2015-01-01

    Aim: To examine the feasibility and usefulness of a novel region-based pathway: the Regional Referral Clinical Pathway for Home-Based Palliative Care. Method: This was a feasibility study to evaluate the frequency of variances and the perceived usefulness of pathway using in-depth interviews. All patients with cancer referred to the palliative care team between 2011 and 2013 and received home care services were enrolled. Result: A total of 44 patients were analyzed, and pathway was completed in all the patients. The target outcome was achieved in 61.4% while some variances occurred in 54.5%. Nine categories were identified as the usefulness of the pathway, such as reviewing and sharing information and promoting communication, education, motivation, and relationships. Conclusion: This novel pathway is feasible and seems to be useful. PMID:24814723

  16. Parents' experiences of home-based applied behavior analysis programs for young children with autism.

    PubMed

    Grindle, Corinna F; Kovshoff, Hanna; Hastings, Richard P; Remington, Bob

    2009-01-01

    Although much research has documented the benefits to children with autism of early intensive behavioral intervention (EIBI), little has focused on the impact of EIBI on families. Using a semi-structured format, we interviewed 53 parents whose children had received 2 years of EIBI to obtain detailed first person accounts of the perceived benefits and pitfalls of running a home program, and the impact of EIBI on family life and support systems. In general, parents were positive about EIBI, its benefits for them, their child, and the broader family. Interviews also, however, revealed some of the more challenging aspects of managing home-based EIBI. The implications of these findings for more supportive interventions for families on home programs are discussed.

  17. Teaching math skills to at-risk students using home-based peer tutoring.

    PubMed

    Mayfield, Kristin H; Vollmer, Timothy R

    2007-01-01

    Home-based peer tutoring was used to teach math skills to 4 girls with deficits in mathematics and histories of abuse or neglect. Girls living in the same home formed tutoring dyads, and each participant served as both the peer tutor and the tutee during the course of the study. At the initiation of the tutoring intervention, an expert tutor provided multiple 3-min tutoring sessions to the designated peer tutor on three or four mathematics skills. The peer tutor concurrently provided 3-min tutoring sessions on the same skills to the tutee using a multiple baseline design. Results showed that participants improved their performance on all target skills. Additional interventions were implemented for some skills to improve accuracy further. Maintenance tests were also administered after 3 to 5 months of no practice on the skills. Results showed that tutors and tutees maintained their accuracy on 7 of the 12 skills assessed.

  18. Treatment Engagement: Building Therapeutic Alliance in Home-Based Treatment with Adolescents and their Families

    PubMed Central

    Thompson, Sanna J.; Bender, Kimberly; Lantry, Janet; Flynn, Patrick M.

    2010-01-01

    Client engagement is an essential yet challenging ingredient in effective therapy. Engaged clients are more likely to bond with therapists and counselors, endorse treatment goals, participate to a greater degree, remain in treatment longer, and report higher levels of satisfaction. This study explored the process of engaging high-risk youth and their parents in a unique home-based family therapy intervention. Qualitative interviews were conducted with 19 families who completed family therapy sessions that included a core component aimed at increasing treatment engagement. Parents’ and youths’ perceptions of engagement suggest the importance of developing therapeutic alliance with therapists, who facilitated building a shared alliance among family members. Implications for improving client engagement are discussed within the context of alliance building with the therapist and among family members. PMID:20556209

  19. Job Enlargement: A Multidimensional Process

    ERIC Educational Resources Information Center

    Donaldson, Lex

    1975-01-01

    An evaluation study into the effects of a job enlargement exercise indicates that the expected increases in satisfaction associated with greater work variety, novelty, and felt use of abilities were achieved. (Author/MLF)

  20. Home-based Diagnosis of Obstructive Sleep Apnea in an Urban Population

    PubMed Central

    Garg, Natasha; Rolle, Andrew J.; Lee, Todd A.; Prasad, Bharati

    2014-01-01

    Study Objectives: Home-based diagnosis of obstructive sleep apnea (OSA) with portable monitoring (PM) is increasingly utilized, but remains understudied in underserved and minority populations. We tested the feasibility of home PM in an urban population at risk for OSA compared to in-laboratory polysomnography (PSG) and examined patient preference with respect to home PM versus PSG. Methods: Randomized crossover study of home PM (WatchPAT200) and in-laboratory simultaneous PSG and PM in 75 urban African Americans with high pre-test probability of OSA, identified with the Berlin questionnaire. Results: Fifty-seven of 75 participants were women, average age 45 ± 11 years (mean ± SD), 35% with ≤ high school education, and 76% with annual household income < $50,000. Technical failure rates were 5.3% for home vs. 3.1% for in-laboratory PM. There was good agreement between apnea hypopnea index on PSG; AHIPSG and AHI on home PM (mean ± 2 SD of the differences = 0.64 ± 46.5 and intraclass correlation coefficient; ICC = 0.73). The areas under the curve for the receiver-operator characteristic curves for home PM were 0.90 for AHIPSG ≥ 5, 0.95 for AHIPSG ≥ 10, and 0.92 for AHIPSG ≥ 15. 62/75 (82%) participants preferred home over in-laboratory testing. Conclusions: Home PM for diagnosis of OSA in a high risk urban population is feasible, accurate, and preferred by patients. As home PM may improve access to care, the cost-effectiveness of this diagnostic strategy for OSA should be examined in underserved urban and rural populations. Clinical Trials Registration: ClinicalTrials.gov, identifier: NCT01997723 Citation: Garg N, Rolle AJ, Lee TA, Prasad B. Home-based diagnosis of obstructive sleep apnea in an urban population. J Clin Sleep Med 2014;10(8):879-885. PMID:25126034

  1. Bayesian Spatial NBDA for Diffusion Data with Home-Base Coordinates.

    PubMed

    Nightingale, Glenna F; Laland, Kevin N; Hoppitt, William; Nightingale, Peter

    2015-01-01

    Network-based diffusion analysis (NBDA) is a statistical method that allows the researcher to identify and quantify a social influence on the spread of behaviour through a population. Hitherto, NBDA analyses have not directly modelled spatial population structure. Here we present a spatial extension of NBDA, applicable to diffusion data where the spatial locations of individuals in the population, or of their home bases or nest sites, are available. The method is based on the estimation of inter-individual associations (for association matrix construction) from the mean inter-point distances as represented on a spatial point pattern of individuals, nests or home bases. We illustrate the method using a simulated dataset, and show how environmental covariates (such as that obtained from a satellite image, or from direct observations in the study area) can also be included in the analysis. The analysis is conducted in a Bayesian framework, which has the advantage that prior knowledge of the rate at which the individuals acquire a given task can be incorporated into the analysis. This method is especially valuable for studies for which detailed spatially structured data, but no other association data, is available. Technological advances are making the collection of such data in the wild more feasible: for example, bio-logging facilitates the collection of a wide range of variables from animal populations in the wild. We provide an R package, spatialnbda, which is hosted on the Comprehensive R Archive Network (CRAN). This package facilitates the construction of association matrices with the spatial x and y coordinates as the input arguments, and spatial NBDA analyses.

  2. Predictors of caregiver burden across the home-based palliative care trajectory in Ontario, Canada.

    PubMed

    Guerriere, Denise; Husain, Amna; Zagorski, Brandon; Marshall, Denise; Seow, Hsien; Brazil, Kevin; Kennedy, Julia; Burns, Sheri; Brooks, Heather; Coyte, Peter C

    2016-07-01

    Family caregivers of patients enrolled in home-based palliative care programmes provide unpaid care and assistance with daily activities to terminally ill family members. Caregivers often experience caregiver burden, which is an important predictor of anxiety and depression that can extend into bereavement. We conducted a longitudinal, prospective cohort study to comprehensively assess modifiable and non-modifiable patient and caregiver factors that account for caregiver burden over the palliative care trajectory. Caregivers (n = 327) of patients with malignant neoplasm were recruited from two dedicated home-based palliative care programmes in Southern Ontario, Canada from 1 July 2010 to 31 August 2012. Data were obtained from bi-weekly telephone interviews with caregivers from study admission until death, and from palliative care programme and home-care agency databases. Information collected comprised patient and caregiver demographics, utilisation of privately and publicly financed resources, patient clinical status and caregiver burden. The average age of the caregivers was 59.0 years (SD: 13.2), and almost 70% were female. Caregiver burden increased over time in a non-linear fashion from study admission to patient death. Increased monthly unpaid care-giving time costs, monthly public personal support worker costs, emergency department visits and low patient functional status were associated with higher caregiver burden. Greater use of hospice care was associated with lower burden. Female caregivers tended to report more burden compared to men as death approached, and burden was higher when patients were male. Low patient functional status was the strongest predictor of burden. Understanding the influence of modifiable and non-modifiable factors on the experience of burden over the palliative trajectory is essential for the development and targeting of programmes and policies to support family caregivers and reduce burden. Supporting caregivers can have

  3. Home-based functional walking program for advanced cancer patients receiving palliative care: a case series

    PubMed Central

    2013-01-01

    Background Although meta-analyses have demonstrated that physical activity can positively impact quality of life outcomes in early stage cancer patients, it is not yet known whether these benefits can be extended to patients with advanced cancer. In a previous pilot survey of patients with advanced cancer with a median survival of 104 days, participants felt willing and able to participate in a physical activity intervention, and reported a strong preference for walking and home-based programming. Here, we report on the initial development and feasibility of a home-based functional walking program in patients with advanced cancer receiving palliative care. Methods Nine adult patients were recruited from outpatient palliative care clinics and palliative home care. A pilot intervention trial was conducted over a 6-week period. The McGill Quality of Life Questionnaire (MQOL), Late Life Function and Disability Instrument (LLFDI), Edmonton Symptom Assessment System (ESAS), Seniors Fitness Test, four-test balance scale, and grip strength, were performed pre- and post-intervention. Participants wore activPAL™ accelerometers to monitor ambulatory activity levels. Results Of the nine recruited participants, three participants dropped out prior to baseline testing due to hospital admission and feeling overwhelmed, and three participants dropped out during the intervention due to severe symptoms. Only three participants completed the intervention program, pre- and post-intervention assessments: two reported improvements in total MQOL scores, yet all three shared an overall trend towards worsening symptom and total fatigue scores post-intervention. Two participants passed away within 90 days of completing the intervention. Conclusions This case series demonstrates the challenges of a physical activity intervention in patients with advanced cancer receiving palliative care. Further feasibility research is required in this patient population. Trial registration This study is

  4. Home based therapy for severe malnutrition with ready-to-use food

    PubMed Central

    Manary, M; Ndkeha, M; Ashorn, P; Maleta, K; Briend, A

    2004-01-01

    Background: The standard treatment of severe malnutrition in Malawi often utilises prolonged inpatient care, and after discharge results in high rates of relapse. Aims: To test the hypothesis that the recovery rate, defined as catch-up growth such that weight-for-height z score >0 (WHZ, based on initial height) for ready-to-use food (RTUF) is greater than two other home based dietary regimens in the treatment of malnutrition. Methods: HIV negative children >1 year old discharged from the nutrition unit in Blantyre, Malawi were systematically allocated to one of three dietary regimens: RTUF, RTUF supplement, or blended maize/soy flour. RTUF and maize/soy flour provided 730 kJ/kg/day, while the RTUF supplement provided a fixed amount of energy, 2100 kJ/day. Children were followed fortnightly. Children completed the study when they reached WHZ >0, relapsed, or died. Outcomes were compared using a time-event model. Results: A total of 282 children were enrolled. Children receiving RTUF were more likely to reach WHZ >0 than those receiving RTUF supplement or maize/soy flour (95% v 78%, RR 1.2, 95% CI 1.1 to 1.3). The average weight gain was 5.2 g/kg/day in the RTUF group compared to 3.1 g/kg/day for the maize/soy and RTUF supplement groups. Six months later, 96% of all children that reached WHZ >0 were not wasted. Conclusions: Home based therapy of malnutrition with RTUF was successful; further operational work is needed to implement this promising therapy. PMID:15155403

  5. First-time parents' experiences of home-based postnatal care in Sweden

    PubMed Central

    Aarts, Clara; Darj, Elisabeth

    2010-01-01

    Aim To gain a deeper understanding of first-time parents' experiences of early discharge from hospital after delivery and home-based postnatal care. Material and methods The study was comprised of focus group interviews, interviews with couples and with fathers. Twenty-one parents participated. Inclusion criteria: healthy women who have given birth to their first child after a normal pregnancy and delivery, the women's partners, healthy and full term babies, Swedish-speaking, discharge from the delivery ward within 24 hours, resident in the Uppsala community, the parents cohabited at the time of the delivery. The material was analysed by qualitative content analysis. Results Three themes emerged: The family's strategy, which describes the family's expectations of postnatal care and their experiences of the real situation. Some are flexible concerning going home early, and others have decided in advance. Self-reliance and strength, which explores the parents' feelings of security and uncertainty, freedom and independence, and shared responsibility. Breast-feeding is described as the ‘main thing’, an interactive learning process. Professional support in the home summarizes the parents' experience of the midwife's support at home. While conflicting feelings may be revealed during the first days, the midwife confirms their new roles as parents. The midwife is seen as a support and adviser to the parents. Conclusion This study shows that parents welcome home-based postnatal care with professional support from midwives. We conclude that this care suits healthy families. We think it will be more important in the future to discriminate between healthy families and those in need of hospital care, than to focus on the moment when they leave the hospital, early or late. PMID:20074000

  6. Home-based rehabilitation interventions for adults living with HIV: a scoping review.

    PubMed

    Cobbing, Saul; Hanass-Hancock, Jill; Myezwa, Hellen

    2016-01-01

    Home-based rehabilitation (HBR) has been shown to improve the lives of people living with a wide range of chronic diseases in resource-rich settings. This may also be a particularly effective strategy in resource-poor settings, where access to institution-based rehabilitation is limited. This review aimed to summarise and discuss the evidence related to the effectiveness of home-based rehabilitation (HBR) interventions designed specifically for adults living with HIV. A scoping review methodology was employed, involving systematic search techniques and appraisal of appropriate evidence. English-language journal articles that assessed the quality of life or functional ability outcomes of HBR interventions for adults living with HIV were considered for this review. Out of an initial 1 135 publications retrieved from the search of databases, six articles met this review's inclusion criteria. While this review highlights the scarcity of empirical evidence related to HBR interventions for adults living with HIV, the findings of these six articles are that HBR is a safe management option that may confer a number of physical and psychological benefits for this population. Future research on HBR interventions should include a wider range of assessment measures, including cost-benefit analyses and specific tools designed to assess the functional ability and participation in activities of daily living of participants involved in these programmes. In particular, more research on HBR is required in resource-poor environments, such as sub-Saharan Africa where HIV is endemic, to assess whether this is a feasible strategy that is both effective and practical in the areas that may need it most.

  7. Quality of life in Chinese home-based advanced cancer patients: does awareness of cancer diagnosis matter?

    PubMed

    Fan, Xiaoping; Huang, Hua; Luo, Qiong; Zhou, Jiying; Tan, Ge; Yong, Na

    2011-10-01

    The aim of this study was to assess the quality of life (QOL) of Chinese home-based advanced-stage cancer patients and to evaluate the association between the disclosure of cancer diagnosis and QOL. An interview-based survey was conducted from December 2009 to June 2010 in the home-based hospice of the First Affiliated Hospital of Chongqing Medical University, China. The principal finding of this study demonstrated that patients who did not have knowledge of their diagnosis exhibited better physical and emotional QOL compared with those who had knowledge of their diagnosis.

  8. Assessment of home-based behavior modification programs for autistic children: reliability and validity of the behavioral summarized evaluation.

    PubMed

    Oneal, Brent J; Reeb, Roger N; Korte, John R; Butter, Eliot J

    2006-01-01

    Since the publication of Lovaas' (1987) impressive findings, there has been a proliferation of home-based behavior modification programs for autistic children. Parents and other paraprofessionals often play key roles in the implementation and monitoring of these programs. The Behavioral Summarized Evaluation (BSE) was developed for professionals and paraprofessionals to use in assessing the severity of autistic symptoms over the course of treatment. This paper examined the psychometric properties of the BSE (inter-item consistency, factorial composition, convergent validity, and sensitivity to parents' perceptions of symptom change over time) when used by parents of autistic youngsters undergoing home-based intervention. Recommendations for future research are presented.

  9. Measures for a multidimensional multiverse

    NASA Astrophysics Data System (ADS)

    Chung, Hyeyoun

    2015-04-01

    We explore the phenomenological implications of generalizing the causal patch and fat geodesic measures to a multidimensional multiverse, where the vacua can have differing numbers of large dimensions. We consider a simple model in which the vacua are nucleated from a D -dimensional parent spacetime through dynamical compactification of the extra dimensions, and compute the geometric contribution to the probability distribution of observations within the multiverse for each measure. We then study how the shape of this probability distribution depends on the time scales for the existence of observers, for vacuum domination, and for curvature domination (tobs,tΛ , and tc, respectively.) In this work we restrict ourselves to bubbles with positive cosmological constant, Λ . We find that in the case of the causal patch cutoff, when the bubble universes have p +1 large spatial dimensions with p ≥2 , the shape of the probability distribution is such that we obtain the coincidence of time scales tobs˜tΛ˜tc . Moreover, the size of the cosmological constant is related to the size of the landscape. However, the exact shape of the probability distribution is different in the case p =2 , compared to p ≥3 . In the case of the fat geodesic measure, the result is even more robust: the shape of the probability distribution is the same for all p ≥2 , and we once again obtain the coincidence tobs˜tΛ˜tc . These results require only very mild conditions on the prior probability of the distribution of vacua in the landscape. Our work shows that the observed double coincidence of time scales is a robust prediction even when the multiverse is generalized to be multidimensional; that this coincidence is not a consequence of our particular Universe being (3 +1 )-dimensional; and that this observable cannot be used to preferentially select one measure over another in a multidimensional multiverse.

  10. Resistance Strength Training Exercise in Children with Spinal Muscular Atrophy

    PubMed Central

    Lewelt, Aga; Krosschell, Kristin J.; Stoddard, Gregory J.; Weng, Cindy; Xue, Mei; Marcus, Robin L.; Gappmaier, Eduard; Viollet, Louis; Johnson, Barbara A.; White, Andrea T.; Viazzo-Trussell, Donata; Lopes, Philippe; Lane, Robert H.; Carey, John C.; Swoboda, Kathryn J.

    2015-01-01

    Introduction Preliminary evidence in adults with spinal muscular atrophy (SMA) and in SMA animal models suggests exercise has potential benefits in improving or stabilizing muscle strength and motor function. Methods We evaluated feasibility, safety, and effects on strength and motor function of a home-based, supervised progressive resistance strength training exercise program in children with SMA types II and III. Up to 14 bilateral proximal muscles were exercised 3 times weekly for 12 weeks. Results Nine children with SMA, aged 10.4±3.8 years, completed the resistance training exercise program. Ninety percent of visits occurred per protocol. Training sessions were pain-free (99.8%), and no study-related adverse events occurred. Trends in improved strength and motor function were observed. Conclusions A 12-week supervised, home-based, 3 days/week progressive resistance training exercise program is feasible, safe, and well tolerated in children with SMA. These findings can inform future studies of exercise in SMA. PMID:25597614

  11. "Not easy at all but I am trying": barriers and facilitators to physical activity in a South African cohort of people living with HIV participating in a home-based pedometer walking programme.

    PubMed

    Roos, Ronel; Myezwa, Hellen; van Aswegen, Helena

    2015-01-01

    The promotion of physical activity is encouraged in people living with HIV and AIDS (PLWHA) as a means of promoting wellness and health. Adherence to programmes that promote exercise is often reduced, and home-based programmes are suggested to improve adherence. This study investigated the personal and environmental factors that cause barriers and facilitators of physical activity in a home-based pedometer walking programme as a means of highlighting adherence challenges. An observational study nested in a randomised controlled trial was conducted in a cohort of South African PLWHA on antiretroviral therapy over a six-month period. Descriptive analysis and qualitative content analysis of 42 participants who underwent physical activity modification assisted with data review. The mean age of the sample was 38.7 (±8.9) years, consisted mostly of women (n = 35; 83.3%) who were employed (n = 19; 45.2%) but earning very little (less than R500 per month) and often single or widowed (n = 23; 54.8%). Barriers to physical activity identified included physical complaints, e.g., low-energy levels; psychological complaints, e.g., stress levels; family responsibility, e.g., being primary caregivers; the physical environment, e.g., adverse weather conditions; social environment, e.g., domestic abuse and crime; and workplace, e.g., being in a sedentary job. Facilitators of physical activity included support and encouragement from friends and family, religious practices during worship and community environment, e.g., having access to parks and sport fields. The study is of benefit as it highlights personal and environmental factors that need to be considered when developing or implementing a home-based walking programme in PLWHA.

  12. Effect of home-based training using a slant board with dorsiflexed ankles on walking function in post-stroke hemiparetic patients

    PubMed Central

    Nakayama, Yasuhide; Iijima, Setsu; Kakuda, Wataru; Abo, Masahiro

    2016-01-01

    [Purpose] To investigate the effects of a 30-day rehabilitation program using a slant board on walking function in post-stroke hemiparetic patients. [Subjects and Methods] Six hemiparetic patients with gait disturbance were studied. The patients were instructed to perform a home-based rehabilitation program using a slant board, thrice daily for 30 days, the exercise included standing on the slant board for 3 minutes, with both ankles dorsiflexed without backrest. For all patients, the Brunnstrom Recovery Stage, Barthel Index, range of motion of the ankle joint, modified Ashworth scale scole for calf muscle, sensory impairments with Numeral Rating Scale, maximum walking speed, number of steps, and Timed “Up and Go” test were serially evaluated at the beginning and end of the 30-day program. [Results] The program significantly increased walking velocity, decreased the number of steps in the 10-m walking test, and decreased Timed “Up and Go” test performance time. [Conclusion] This rehabilitation program using the slant board was safe and improved walking function in patients. The improvement in walking function could be due to a forward shift of the center of gravity, which can be an important part of motor learning for gait improvement. PMID:27630431

  13. SKI*HI Home-Based Programming for Children Who Are Deaf or Hard of Hearing: Recent Research Findings.

    ERIC Educational Resources Information Center

    Strong, Carol J.; And Others

    1994-01-01

    Data relating to 2,768 children served by the SKI*HI model of early, home-based programming for children with hearing impairments revealed that SKI*HI children, on average, were identified by 18 months of age, had higher rates of language development during intervention than prior to intervention, and had greater language gains than expected based…

  14. Evaluation of the routine use of amoxicillin as part of the home-based treatment of severe acute malnutrition

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To determine whether the inclusion of amoxicillin correlates with better recovery rates in the home-based treatment of severe acute malnutrition with ready-to-use therapeutic food. This retrospective cohort study compared data from the treatment of two groups of children in Malawi aged 6-59 months w...

  15. A Case for Increasing Empirical Attention to Head Start's Home-Based Program: An Exploration of Routine Collaborative Goal Setting

    ERIC Educational Resources Information Center

    Manz, Patricia H.; Lehtinen, Jaana; Bracaliello, Catherine

    2013-01-01

    Collaborative goal setting among home visitors and family members is a mandate for Head Start's home-based program. Yet, a dearth of research is available for advancing evidence-based practices for setting and monitoring home visiting goals or for understanding how family characteristics or program features are associated with them. With the…

  16. Science and Pre-School Children with Special Educational Needs: Aspects of Home-Based Teaching Sessions

    ERIC Educational Resources Information Center

    Bennington, Andrea

    2004-01-01

    This article focuses upon the role of the peripatetic pre-school teacher for children who have special educational needs. It explores the key issues involved in home-based teaching; the importance of developing meaningful partnerships with parents; early intervention; and the significance of play in promoting learning for young children. The…

  17. Home-Based Child Development Interventions for Preschool Children from Socially Disadvantaged Families. Campbell Systematic Reviews. 2012:1

    ERIC Educational Resources Information Center

    Miller, Sarah; Maguire, Lisa K.; Macdonald, Geraldine

    2011-01-01

    The purpose of this research is to determine the effects of home-based programmes aimed specifically at improving developmental outcomes for preschool children from socially disadvantaged families. The authors searched the following databases between 7 October and 12 October 2010: Cochrane Central Register of Controlled Trials (CENTRAL) (2010,…

  18. A Correlational Study of Telework Frequency, Information Communication Technology, and Job Satisfaction of Home-Based Teleworkers

    ERIC Educational Resources Information Center

    Webster-Trotman, Shana P.

    2010-01-01

    In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction…

  19. Mobile and home-based vendors' contributions to the retail food environment in rural South Texas Mexican-origin settlements.

    PubMed

    Valdez, Zulema; Dean, Wesley R; Sharkey, Joseph R

    2012-10-01

    A growing concern with high rates of obesity and overweight among immigrant minority populations in the US has focused attention on the availability and accessibility to healthy foods in such communities. Small-scale vending in rural, impoverished and underserved areas, however, is generally overlooked; yet, this type of informal activity and source for food is particularly important in such environs, or "food desserts," where traditional forms of work and mainstream food outlets are limited or even absent. This exploratory study investigates two types of small-scale food vending that take place in rural colonias, or Mexican-origin settlements along the South Texas border with Mexico: mobile and home-based. Using a convenience sample of 23 vendors who live and work in Texas colonias, this study identifies the characteristics associated with mobile and home-based food vendors and their businesses and its contributions to the rural food environment. Findings reveal that mobile and home-based vending provides a variety of food and beverage options to colonia residents, and suggests that home-based vendors contribute a greater assortment of food options, including some healthier food items, than mobile food vendors, which offer and sell a limited range of products. Findings may contribute to the development of innovative policy solutions and interventions aimed at increasing healthy food options or reducing health disparities in immigrant communities.

  20. Visually Impaired Older Adults and Home-Based Leisure Activities: The Effects of Person-Environment Congruence

    ERIC Educational Resources Information Center

    Stevens-Ratchford, Regina; Krause, Airi

    2004-01-01

    This qualitative study explored the effect of person-environment congruence on participation in homebased leisure activities by two legally blind older adults who lived independently in the community. The results indicated that visual impairment increased the time spent in home-based leisure activities and that the participants used various…

  1. A Randomized Controlled Trial of Child FIRST: A Comprehensive Home-Based Intervention Translating Research into Early Childhood Practice

    ERIC Educational Resources Information Center

    Lowell, Darcy I.; Carter, Alice S.; Godoy, Leandra; Paulicin, Belinda; Briggs-Gowan, Margaret J.

    2011-01-01

    This randomized, controlled trial was designed to document the effectiveness of Child FIRST (Child and Family Interagency, Resource, Support, and Training), a home-based, psychotherapeutic, parent-child intervention embedded in a system of care. Multirisk urban mothers and children, ages 6-36 months (N = 157) participated. At the 12-month…

  2. The Impact of Perceived Stress, Social Support, and Home-Based Physical Activity on Mental Health among Older Adults

    ERIC Educational Resources Information Center

    Kwag, Kyung Hwa; Martin, Peter; Russell, Daniel; Franke, Warren; Kohut, Marian

    2011-01-01

    This study investigated how perceived stress, social support, and home-based physical activity affected older adults' fatigue, loneliness, and depression. We also explored whether social support and physical activity mediated the relationships between stress and mental health problems. The data of 163 older participants were analyzed in this…

  3. Parent Training: An Investigation of a Home-Based Teaching Program for a Mentally Retarded Infant by a Parent.

    ERIC Educational Resources Information Center

    Shimizu, Naoji

    1987-01-01

    The paper reports on a parent training program based on behavior analysis and home-based teaching by the parent of a 2-year-old Japanese boy tentatively diagnosed as autistic. Parent training was divided into three modules: understanding the fundamental principles of teaching by using the knowledge of behavioral principles as applied to children;…

  4. Home-Based Preventive Parenting Intervention for at-Risk Infants and Their Families: An Open Trial

    PubMed Central

    Bagner, Daniel M.; Rodríguez, Gabriela M.; Blake, Clair A.; Rosa-Olivares, Jose

    2014-01-01

    The purpose of this study was to examine the feasibility, acceptability, and initial outcome of a home-based adaptation of Parent-Child Interaction Therapy for at-risk infants with externalizing behavior problems. Seven 12- to 15-month-old infants and their families were recruited at a large pediatric primary care clinic to participate in a home-based parenting intervention to prevent subsequent externalizing behavior problems. Home-based assessments were conducted at baseline, postintervention, and a 4- to 6-month follow-up. Six of the 7 (86%) families completed the intervention, and all completers reported high satisfaction with the intervention. All of the mothers demonstrated significant improvements and statistically reliable changes in their interactions with their infant, and most reported clinically significant and statistically reliable changes in infant behavior problems. The current study provides preliminary support for the use of this brief, home-based parenting intervention in addressing behavior problems as early as possible to improve access to an intervention for at-risk infants and their families. Successes and challenges with the development and implementation of this intervention are discussed along with directions for future research and clinical practice. PMID:25414568

  5. Effects of Pharmacist-Led Patient Education on Diabetes-Related Knowledge and Medication Adherence: A Home-Based Study

    ERIC Educational Resources Information Center

    Chow, Ee Pin; Hassali, Mohamed Azmi; Saleem, Fahad; Aljadhey, Hisham

    2016-01-01

    Objective: Patient education is key to the management of acute and chronic conditions. However, the majority of such educational interventions have been reported from health-care settings. In contrast, this study aims to evaluate whether a home-based intervention can result in better understanding about type 2 diabetes mellitus and can increase…

  6. On Compensation in Multidimensional Response Modeling

    ERIC Educational Resources Information Center

    van der Linden, Wim J.

    2012-01-01

    The issue of compensation in multidimensional response modeling is addressed. We show that multidimensional response models are compensatory in their ability parameters if and only if they are monotone. In addition, a minimal set of assumptions is presented under which the MLEs of the ability parameters are also compensatory. In a recent series of…

  7. Robustness of Adaptive Testing to Multidimensionality.

    ERIC Educational Resources Information Center

    Weiss, David J.; Suhadolnik, Debra

    The present monte carlo simulation study was designed to examine the effects of multidimensionality during the administration of computerized adaptive testing (CAT). It was assumed that multidimensionality existed in the individuals to whom test items were being administered, i.e., that the correct or incorrect responses given by an individual…

  8. A Mobile Cloud-Based Parkinson’s Disease Assessment System for Home-Based Monitoring

    PubMed Central

    Petitti, Diana B

    2015-01-01

    Background Parkinson’s disease (PD) is the most prevalent movement disorder of the central nervous system, and affects more than 6.3 million people in the world. The characteristic motor features include tremor, bradykinesia, rigidity, and impaired postural stability. Current therapy based on augmentation or replacement of dopamine is designed to improve patients’ motor performance but often leads to levodopa-induced adverse effects, such as dyskinesia and motor fluctuation. Clinicians must regularly monitor patients in order to identify these effects and other declines in motor function as soon as possible. Current clinical assessment for Parkinson’s is subjective and mostly conducted by brief observations made during patient visits. Changes in patients’ motor function between visits are hard to track and clinicians are not able to make the most informed decisions about the course of therapy without frequent visits. Frequent clinic visits increase the physical and economic burden on patients and their families. Objective In this project, we sought to design, develop, and evaluate a prototype mobile cloud-based mHealth app, “PD Dr”, which collects quantitative and objective information about PD and would enable home-based assessment and monitoring of major PD symptoms. Methods We designed and developed a mobile app on the Android platform to collect PD-related motion data using the smartphone 3D accelerometer and to send the data to a cloud service for storage, data processing, and PD symptoms severity estimation. To evaluate this system, data from the system were collected from 40 patients with PD and compared with experts’ rating on standardized rating scales. Results The evaluation showed that PD Dr could effectively capture important motion features that differentiate PD severity and identify critical symptoms. For hand resting tremor detection, the sensitivity was .77 and accuracy was .82. For gait difficulty detection, the sensitivity was .89

  9. Exercise & Sleep

    MedlinePlus

    ... on. Feature: Back to School, the Healthy Way Exercise & Sleep Past Issues / Fall 2012 Table of Contents ... helps kids. Photo: iStock 6 "Bests" About Kids' Exercise At least one hour of physical activity a ...

  10. Compulsive Exercise

    MedlinePlus

    ... overdoing it for almost anyone. Much like with eating disorders, many people who engage in compulsive exercise do ... compulsive exercising doesn't have to accompany an eating disorder, the two often go hand in hand. In ...

  11. Kegel Exercises

    MedlinePlus

    ... To do Kegel exercises, you just squeeze your pelvic floor muscles. The part of your body including your ... bone. Kegel exercises are designed to make your pelvic floor muscles stronger. These are the muscles that hold ...

  12. Exercise Headaches

    MedlinePlus

    ... also can help prevent exercise headaches. References Cutrer FM, et al. Cough, exercise, and sex headaches. Neurology ... aspx?bookid=690. Accessed Jan. 19, 2015. Cutrer FM. Exertional headaches. http://www.uptodate.com/home. Accessed ...

  13. An Introduction to Coherent Multidimensional Spectroscopy.

    PubMed

    Chen, Peter C

    2016-12-01

    Coherent multidimensional spectroscopy is a field that has drawn much attention as an optical analogue to multidimensional nuclear magnetic resonance imaging. Coherent multidimensional spectroscopic techniques produce spectra that show the magnitude of an optical signal as a function of two or more pulsed laser frequencies. Spectra can be collected in either the frequency or the time domain. In addition to improving resolution and overcoming spectral congestion, coherent multidimensional spectroscopy provides the ability to investigate and conduct studies based upon the relationship between different peaks. The purpose of this paper is to provide a general introduction to the area of coherent multidimensional spectroscopy, to provide a brief overview of current experimental approaches, and to discuss some emerging developments in this relatively young field.

  14. The Role of Clinical and Geographic Factors in the Use of Hospital versus Home-Based Cardiac Rehabilitation

    PubMed Central

    Brual, Janette; Gravely, Shannon; Suskin, Neville; Stewart, Donna E.; Grace, Sherry L.

    2015-01-01

    Objective Cardiac rehabilitation (CR) is most often provided in a hospital setting. Home-based models of care have been developed to overcome geographic, among other, barriers in patients at lower-risk. This study assessed whether clinical and geographic factors were related to use of either a hospital- or home-based program. Methods Secondary analysis was undertaken within a study of 1268 cardiac outpatients recruited from 97 cardiologist practices where clinical data were extracted. Participants completed a survey including the Duke Activity Status Index. They reported CR utilization in a second survey mailed 9 months later, including CR site and program model. Geographic information systems was used to determine distances and drive times to the CR site attended from patients’ homes. Results Overall, 469 (37.0%) participants attended CR at one of 41 programs. Of the 373 (79.5%) participants with complete geographic data, 43 (11.5%) reported attending home-based CR. The sole clinical difference was in activity status, where patients attending hospital-based program had lower activity status (p<.01). There were no differences in model attended based on geographic parameters including urban vs. rural dwelling or drive times (p>.05). Conclusions Only one-tenth of outpatients participated in a home-based program, and this allocation was unrelated geographic considerations. While patients should continue to be appropriately-triaged based on clinical risk to ensure safety, more targeted allocation of patients to home-based services may be warranted. This may optimize degree of participation, and potentially patient outcomes. PMID:22561240

  15. The magnitude, share and determinants of unpaid care costs for home-based palliative care service provision in Toronto, Canada.

    PubMed

    Chai, Huamin; Guerriere, Denise N; Zagorski, Brandon; Coyte, Peter C

    2014-01-01

    With increasing emphasis on the provision of home-based palliative care in Canada, economic evaluation is warranted, given its tremendous demands on family caregivers. Despite this, very little is known about the economic outcomes associated with home-based unpaid care-giving at the end of life. The aims of this study were to (i) assess the magnitude and share of unpaid care costs in total healthcare costs for home-based palliative care patients, from a societal perspective and (ii) examine the sociodemographic and clinical factors that account for variations in this share. One hundred and sixty-nine caregivers of patients with a malignant neoplasm were interviewed from time of referral to a home-based palliative care programme provided by the Temmy Latner Centre for Palliative Care at Mount Sinai Hospital, Toronto, Canada, until death. Information regarding palliative care resource utilisation and costs, time devoted to care-giving and sociodemographic and clinical characteristics was collected between July 2005 and September 2007. Over the last 12 months of life, the average monthly cost was $14 924 (2011 CDN$) per patient. Unpaid care-giving costs were the largest component - $11 334, accounting for 77% of total palliative care expenses, followed by public costs ($3211; 21%) and out-of-pocket expenditures ($379; 2%). In all cost categories, monthly costs increased exponentially with proximity to death. Seemingly unrelated regression estimation suggested that the share of unpaid care costs of total costs was driven by patients' and caregivers' sociodemographic characteristics. Results suggest that overwhelming the proportion of palliative care costs is unpaid care-giving. This share of costs requires urgent attention to identify interventions aimed at alleviating the heavy financial burden and to ultimately ensure the viability of home-based palliative care in future.

  16. Employing the International Classification of Functioning, Disability and Health framework to capture user feedback in the design and testing stage of development of home-based arm rehabilitation technology.

    PubMed

    Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andrew; O'Connor, Rory; Levesley, Martin

    2016-01-01

    The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health (ICF) as a framework to ensure that key aspects of user feedback are identified in the design and testing stages of development of a home-based upper limb rehabilitation system. Seventeen stroke survivors with residual upper limb weakness, and seven healthcare professionals with expertise in stroke rehabilitation, were enrolled in the user-centered design process. Through semi-structured interviews, they provided feedback on the hardware, software and impact of a home-based rehabilitation device to facilitate self-managed arm exercise. Members of the multidisciplinary clinical and engineering research team, based on previous experience and existing literature in user-centred design, developed the topic list for the interviews. Meaningful concepts were extracted from participants' interviews based on existing ICF linking rules and matched to categories within the ICF Comprehensive Core Set for stroke. Most of the interview concepts (except personal factors) matched the existing ICF Comprehensive Core Set categories. Personal factors that emerged from interviews e.g. gender, age, interest, compliance, motivation, choice and convenience that might determine device usability are yet to be categorised within the ICF framework and hence could not be matched to a specific Core Set category.

  17. Exercise Habit

    MedlinePlus

    ... minutes at a time throughout your day. Remember: exercise has so many health benefits that any amount is better than none.How ... The cost might give you an incentive to exercise on a regular basis.Benefits of regular exerciseReduces your risk of heart disease, ...

  18. Morning Exercise

    ERIC Educational Resources Information Center

    Schmitt, Natalie Crohn

    2006-01-01

    In this article, Natalie Schmitt recalls her teaching experiences with morning exercise programs, beginning with her first teaching job as assistant Morning Exercise teacher at the Francis W. Parker School in Chicago. In the Morning Exercises, students were encouraged to employ all means of expression: speaking, drawing, dancing, singing, acting.…

  19. A large-scale operational study of home-based therapy with ready-to-use therapeutic food in childhood malnutriton in Malawi

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Home-based therapy with ready-to-use therapeutic food (RUTF) for the treatment of malnutrition has better outcomes in the research setting than standard therapy. This study examined outcomes of malnourished children aged 6-60 months enrolled in operational home-based therapy with RUTF. Children enro...

  20. Effects of Home-Based Constraint-Induced Therapy versus Dose-Matched Control Intervention on Functional Outcomes and Caregiver Well-Being in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Lin, Keh-chung; Wang, Tien-ni; Wu, Ching-yi; Chen, Chia-ling; Chang, Kai-chieh; Lin, Yu-chan; Chen, Yi-ju

    2011-01-01

    This study compared home-based constraint-induced therapy (CIT) with a dose-matched home-based control intervention for children with cerebral palsy (CP). The differences in unilateral and bilateral motor performance, daily functions, and quality of parental well-being (i.e., the stress level of their parents) were evaluated. The study included 21…

  1. Linking Home-Based Child Care and State-Funded Preschool: The Community Connections Preschool Program (Illinois Action for Children). Evaluation Phase 1-Implementation Study

    ERIC Educational Resources Information Center

    Forry, Nicole; Anderson, Rachel; Zaslow, Martha; Chrisler, Alison; Banghart, Patti; Kreader, J. Lee

    2011-01-01

    The Community Connections preschool program (herein referred to as Community Connections) was developed to help prepare children in home-based child care for success in school and in life. It has three goals: (1) to make state prekindergarten classroom experiences available to children in home-based care, (2) to extend classroom learning…

  2. Fractionating dead reckoning: role of the compass, odometer, logbook, and home base establishment in spatial orientation

    PubMed Central

    Martin, Megan M.; Winter, Shawn S.

    2008-01-01

    Rats use multiple sources of information to maintain spatial orientation. Although previous work has focused on rats' use of environmental cues, a growing number of studies have demonstrated that rats also use self-movement cues to organize navigation. This review examines the extent that kinematic analysis of naturally occurring behavior has provided insight into processes that mediate dead-reckoning-based navigation. This work supports a role for separate systems in processing self-movement cues that converge on the hippocampus. The compass system is involved in deriving directional information from self-movement cues; whereas, the odometer system is involved in deriving distance information from self-movement cues. The hippocampus functions similar to a logbook in that outward path unique information from the compass and odometer is used to derive the direction and distance of a path to the point at which movement was initiated. Finally, home base establishment may function to reset this system after each excursion and anchor environmental cues to self-movement cues. The combination of natural behaviors and kinematic analysis has proven to be a robust paradigm to investigate the neural basis of spatial orientation. PMID:18553065

  3. Evaluation of the home-based maternal record: a WHO collaborative study.

    PubMed Central

    Shah, P. M.; Selwyn, B. J.; Shah, K.; Kumar, V.

    1993-01-01

    Thirteen centres in eight countries (Egypt, India, Pakistan, Philippines, Senegal, Sri Lanka, Democratic Yemen and Zambia) participated in the WHO collaborative study to evaluate the home-based maternal record (HBMR). The evaluation showed that use of the HBMR had a favourable impact on utilization of health care services and continuity of the health care of women during their reproductive period. When adapted to local risk conditions, their cut-off points and the available resources, the HBMR succeeded in promoting self-care by mothers and their families and in enhancing the timely identification of at-risk cases that needed referral and special care. The introduction of the HBMR increased the diagnosis and referral of at-risk pregnant women and newborn infants, improved family planning and health education, led to an increase in tetanus toxoid immunization, and provided a means of collecting health information in the community. The HBMR was liked by mothers, community health workers and other health care personnel because, by using it, the mothers became more involved in looking after their own health and that of their babies. Apart from local adaptation of the HBMR, the training and involvement of health personnel (including those at the second and tertiary levels) from the start of the HBMR scheme influenced its success in promoting maternal and child health care. It also improved the collection of community-based data and the linking of referral networks. PMID:8261557

  4. Induction of oral tolerance to peanut: a successful home-based protocol.

    PubMed

    Ojeda, P; Ojeda, I; Pineda, F; Alfaya, T; Ojeda, J A

    2010-01-01

    In Spain, peanut allergy is increasingly prevalent. Successful protocols for the induction of oral tolerance (LOT) with several foods have been reported. We aimed to induce clinical tolerance to peanut in a child with severe peanut allergy (age 4 years, facial urticaria and lip angioedema upon licking a peanut; peanut skin prick test, 13 x 10 mm; specific immunoglobulin (Ig) E > 100 kUA/L). At age 6, the threshold oral challenge dose was 62.5 mg. Several peanut solutions were prepared and sequentially administered at the patient's home. Over 138 days, the dose was increased from 0.625 to 5500 mg. There were 43 mild-to-moderate reactions (28% of the doses administered). Pre-LOT and post-LOT peanut IgE and IgG4 values were 265 vs 487 kUA/L, and 6.11 vs 14.8 mg/L. This is the first report of successful LOT to peanut in Spain. This home-based regimen is safe under permanent and close medical supervision by an allergist.

  5. Automated Cognitive Health Assessment From Smart Home-Based Behavior Data.

    PubMed

    Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

    2016-07-01

    Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis.

  6. A feasibility study of home-based contingency management with adolescent smokers of rural Appalachia.

    PubMed

    Reynolds, Brady; Harris, Millie; Slone, Stacey A; Shelton, Brent J; Dallery, Jesse; Stoops, William; Lewis, Russell

    2015-12-01

    Cigarette smoking among adolescents remains a significant public health concern. This problem is compounded in regions such as rural Appalachia where rates of smoking are consistently higher than national averages and access to treatments is limited. The current research evaluated a home-based contingency management program completed over the Internet with adolescent smokers recruited from rural Appalachia. Participants (N = 62) submitted 3 video recordings per day showing their breath carbon monoxide (CO) levels using a handheld CO monitor. Participants were assigned to either an active treatment condition (AT; n = 31) in which reductions in breath CO were reinforced or a control treatment condition (CT; n = 31) in which providing timely video recordings were reinforced with no requirement to reduce breath CO. Results revealed that participants in the AT condition reduced their breath CO levels significantly more so during treatment than participants in the CT condition. Within-group comparisons revealed that participants in both conditions significantly reduced their breath CO, self-reported smoking, and nicotine dependence ratings during treatment. However, only participants in the AT condition significantly reduced urinary cotinine levels during treatment, and only participants in this condition maintained all reductions until 6-week post treatment. Participants in the CT condition only maintained self-reported smoking reductions until posttreatment assessments. These results support the feasibility and initial efficacy of this incentive-based approach to smoking cessation with adolescent smokers living in rural locations.

  7. The web-rhetoric of companies offering home-based personal health monitoring.

    PubMed

    Nordgren, Anders

    2012-06-01

    In this paper I investigate the web-rhetoric of companies offering home-based personal health monitoring to patients and elderly people. Two main rhetorical methods are found, namely a reference to practical benefits and a use of prestige words like "quality of life" and "independence". I interpret the practical benefits in terms of instrumental values and the prestige words in terms of final values. I also reconstruct the arguments on the websites in terms of six different types of argument. Finally, I articulate a general critique of the arguments, namely that the websites neglect the context of use of personal health monitoring technologies. Whether or not a technology is good depends on the use of the technology by a particular individual in a particular context. The technology is not good-or bad-in itself. I support this critique with a number of more specific arguments such as the risk for reduced personal contact. For some elderly people social contact with care providers is more valuable than the independent living made possible by remote monitoring, for others independence is more important.

  8. Engaging military parents in a home-based reintegration program: a consideration of strategies.

    PubMed

    Ross, Abigail M; DeVoe, Ellen R

    2014-02-01

    For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.

  9. Community health workers and home-based care programs for HIV clients.

    PubMed Central

    Johnson, Becky A.; Khanna, Sunil K.

    2004-01-01

    In Nyanza Province, Kenya, estimated HIV prevalence is 22%. Given that more than 80% of the population resides in rural areas, the majority of individuals in Nyanza Province do not have access to medical facilities on a regular basis. In response to the growing demands the HIV epidemic has placed on the people and communities in this region, hundreds of lay individuals have been trained as community health workers to provide home-based care to sick or dying HIV/AIDS clients in rural areas. This paper discusses the role and impact of these community health workers in Nyanza Province, Kenya. It outlines the collaborative relationship between community health workers and the Ministry of Health, examining community health workers' use of extant biomedical structures at the district level to provide services that government-run health facilities lack the monetary resources or personnel to provide. Finally, it explores the role played by community health workers in providing HIV/AIDS education to individuals in an attempt to prevent further infections. PMID:15101670

  10. A novel BCI-controlled pneumatic glove system for home-based neurorehabilitation.

    PubMed

    Coffey, Aodhán L; Leamy, Darren J; Ward, Tomás E

    2014-01-01

    Commercially available devices for Brain-Computer Interface (BCI)-controlled robotic stroke rehabilitation are prohibitively expensive for many researchers who are interested in the topic and physicians who would utilize such a device. Additionally, they are cumbersome and require a technician to operate, increasing the inaccessibility of such devices for home-based robotic stroke rehabilitation therapy. Presented here is the design, implementation and test of an inexpensive, portable and adaptable BCI-controlled hand therapy device. The system utilizes a soft, flexible, pneumatic glove which can be used to deflect the subject's wrist and fingers. Operation is provided by a custom-designed pneumatic circuit. Air flow is controlled by an embedded system, which receives serial port instruction from a PC running real-time BCI software. System tests demonstrate that glove control can be successfully driven by a real-time BCI. A system such as the one described here may be used to explore closed loop neurofeedback rehabilitation in stroke relatively inexpensively and potentially in home environments.

  11. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    PubMed

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions.

  12. Multidimensional Adaptation in MAS Organizations.

    PubMed

    Alberola, Juan M; Julian, Vicente; Garcia-Fornes, Ana

    2013-04-01

    Organization adaptation requires determining the consequences of applying changes not only in terms of the benefits provided but also measuring the adaptation costs as well as the impact that these changes have on all of the components of the organization. In this paper, we provide an approach for adaptation in multiagent systems based on a multidimensional transition deliberation mechanism (MTDM). This approach considers transitions in multiple dimensions and is aimed at obtaining the adaptation with the highest potential for improvement in utility based on the costs of adaptation. The approach provides an accurate measurement of the impact of the adaptation since it determines the organization that is to be transitioned to as well as the changes required to carry out this transition. We show an example of adaptation in a service provider network environment in order to demonstrate that the measurement of the adaptation consequences taken by the MTDM improves the organization performance more than the other approaches.

  13. Minimal Models of Multidimensional Computations

    PubMed Central

    Fitzgerald, Jeffrey D.; Sincich, Lawrence C.; Sharpee, Tatyana O.

    2011-01-01

    The multidimensional computations performed by many biological systems are often characterized with limited information about the correlations between inputs and outputs. Given this limitation, our approach is to construct the maximum noise entropy response function of the system, leading to a closed-form and minimally biased model consistent with a given set of constraints on the input/output moments; the result is equivalent to conditional random field models from machine learning. For systems with binary outputs, such as neurons encoding sensory stimuli, the maximum noise entropy models are logistic functions whose arguments depend on the constraints. A constraint on the average output turns the binary maximum noise entropy models into minimum mutual information models, allowing for the calculation of the information content of the constraints and an information theoretic characterization of the system's computations. We use this approach to analyze the nonlinear input/output functions in macaque retina and thalamus; although these systems have been previously shown to be responsive to two input dimensions, the functional form of the response function in this reduced space had not been unambiguously identified. A second order model based on the logistic function is found to be both necessary and sufficient to accurately describe the neural responses to naturalistic stimuli, accounting for an average of 93% of the mutual information with a small number of parameters. Thus, despite the fact that the stimulus is highly non-Gaussian, the vast majority of the information in the neural responses is related to first and second order correlations. Our results suggest a principled and unbiased way to model multidimensional computations and determine the statistics of the inputs that are being encoded in the outputs. PMID:21455284

  14. Discovering Multidimensional Motifs in Physiological Signals for Personalized Healthcare.

    PubMed

    Balasubramanian, Arvind; Wang, Jun; Prabhakaran, Balakrishnan

    2016-08-01

    Personalized diagnosis and therapy requires monitoring patient activity using various body sensors. Sensor data generated during personalized exercises or tasks may be too specific or inadequate to be evaluated using supervised methods such as classification. We propose multidimensional motif (MDM) discovery as a means for patient activity monitoring, since such motifs can capture repeating patterns across multiple dimensions of the data, and can serve as conformance indicators. Previous studies pertaining to mining MDMs have proposed approaches that lack the capability of concurrently processing multiple dimensions, thus limiting their utility in online scenarios. In this paper, we propose an efficient real-time approach to MDM discovery in body sensor generated time series data for monitoring performance of patients during therapy. We present two alternative models for MDMs based on motif co-occurrences and temporal ordering among motifs across multiple dimensions, with detailed formulation of the concepts proposed. The proposed method uses an efficient hashing based record to enable speedy update and retrieval of motif sets, and identification of MDMs. Performance evaluation using synthetic and real body sensor data in unsupervised motif discovery tasks shows that the approach is effective for (a) concurrent processing of multidimensional time series information suitable for real-time applications, (b) finding unknown naturally occurring patterns with minimal delay, and

  15. Evaluation and Management of Fatigue in Oncology: A Multidimensional Approach

    PubMed Central

    Tazi, El Mehdi; Errihani, Hassan

    2011-01-01

    Fatigue, one of the most common symptoms experienced by cancer patients, is multidimensional and is associated with significant impairment in functioning and overall quality of life. Although the precise pathophysiology of cancer-related fatigue (CRF) is not well understood, a number of metabolic, cytokine, neurophysiologic, and endocrine changes have been described in these patients. A better understanding of these abnormalities is likely to lead to novel therapeutic interventions. Clinically, all patients presenting with significant fatigue should be evaluated for treatable conditions that might contribute to this symptom. Exercise and treatment of anemia are the two most established interventions for CRF. Psychostimulants seem promising based on early studies. Several complementary medicine treatments that showed efficacy in preliminary studies merit further testing. PMID:21976847

  16. Multidimensional text classification for drug information.

    PubMed

    Lertnattee, Verayuth; Theeramunkong, Thanaruk

    2004-09-01

    This paper proposes a multidimensional model for classifying drug information text documents. The concept of multidimensional category model is introduced for representing classes. In contrast with traditional flat and hierarchical category models, the multidimensional category model classifies each document using multiple predefined sets of categories, where each set corresponds to a dimension. Since a multidimensional model can be converted to flat and hierarchical models, three classification approaches are possible, i.e., classifying directly based on the multidimensional model and classifying with the equivalent flat or hierarchical models. The efficiency of these three approaches is investigated using drug information collection with two different dimensions: 1) drug topics and 2) primary therapeutic classes. In the experiments, k-nearest neighbor, naive Bayes, and two centroid-based methods are selected as classifiers. The comparisons among three approaches of classification are done using two-way analysis of variance, followed by the Scheffé's test for post hoc comparison. The experimental results show that multidimensional-based classification performs better than the others, especially in the presence of a relatively small training set. As one application, a category-based search engine using the multidimensional category concept was developed to help users retrieve drug information.

  17. Exercise and age

    MedlinePlus

    ... It is never too late to start exercising. Exercise has benefits at any age. Don't worry if you ... to tie your shoes Alternative Names Age and exercise Images Benefit of regular exercise Flexibility exercise Exercise and age ...

  18. Analytical chemistry, multidimensional spectral signatures, and the future of coherent multidimensional spectroscopy

    NASA Astrophysics Data System (ADS)

    Wright, John C.

    2016-10-01

    Spectroscopy is a dominant measurement methodology because it resolves molecular level details over a wide concentration range. Its limitations, however, become challenged when applied to complex materials. Coherent multidimensional spectroscopy (CMDS) is the optical analogue of multidimensional NMR and like NMR, its multidimensionality promises to increase the spectral selectivity of vibrational and electronic spectroscopy. This article explores whether this promise can make CMDS a dominant spectroscopic method throughout the sciences. In order for CMDS to become a dominant methodology, it must create multidimensional spectral fingerprints that provide the selectivity required for probing complex samples. Pump-CMDS probe methods separate the pump's measurement of dynamics from a multidimensional and selective probe. Fully coherent CMDS methods are ideal multidimensional probes because they avoid relaxation effects, spectrally isolate the output signals, and provide unique and invariant spectral signatures using any combination of vibrational and electronic quantum states.

  19. Muscle strength enhancement following home-based virtual cycling training in ambulatory children with cerebral palsy.

    PubMed

    Chen, Chia-Ling; Hong, Wei-Hsien; Cheng, Hsin-Yi Kathy; Liaw, Mei-Yun; Chung, Chia-Ying; Chen, Chung-Yao

    2012-01-01

    This study is the first well-designed randomized controlled trial to assess the effects of a novel home-based virtual cycling training (hVCT) program for improving muscle strength in children with spastic cerebral palsy (CP). Twenty-eight ambulatory children with spastic CP aged 6-12 years were randomly assigned to an hVCT group (n=13) or a control group (n=15). Outcome measures, including gross motor function of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) and muscle strength (isokinetic torque of knee extensor and flexor muscle), were administered before and immediately after the 12-week intervention. Analysis of covariance (ANCOVA) at post-treatment showed that, compared to the control group, the hVCT group had significantly higher isokinetic torque in the knee extensor and flexor muscles at 60°/s and 120°/s angular velocities (p<0.05). At post-treatment, the hVCT group also showed greater isokinetic strength improvement in the knee flexor than in the knee extensor at 60°/s (knee flexor: 41%; knee extensor: 19%) and at 120°/s (knee flexor: 36%; knee extensor: 30%). However, the BOTMP scores at post-treatment did not differ between the two groups. Although the proposed 12-week hVCT protocol does not improve gross motor function, it enhances knee muscle strength in children with CP. The protocol obtains larger gains in the knee flexor than in the knee extensor at different angular velocities. The study findings will help clinicians to provide more effective and efficient strategies for muscle strength training in children with CP.

  20. Seasonal influenza vaccination among homebound elderly receiving home-based primary care in New York City.

    PubMed

    Banach, David B; Ornstein, Katherine; Factor, Stephanie H; Soriano, Theresa A

    2012-02-01

    Seasonal influenza vaccination is recommended for all persons aged ≥50 years to reduce influenza related morbidity and mortality, but vaccination coverage among community-dwelling elderly remains low. Homebound elderly receiving home-based primary care (HBPC) have fewer barriers to vaccination than other community-dwelling elderly. The Mount Sinai Visiting Doctors (MSVD) program provides HBPC to homebound elderly in New York City. This study assessed seasonal influenza vaccination coverage within an urban HBPC program and identified factors associated with vaccine refusal. A cross-sectional analysis of data from the 2008-2009 influenza season was completed and influenza vaccination coverage was assessed. The association between social, demographic and health-related characteristics and vaccine refusal was evaluated using bivariate analysis and multivariable logistic regression. Of 689 people aged >65 eligible for influenza vaccination, 578 (84%) accepted and 111 (16%) refused vaccination. In multivariable analysis, vaccine refusal was positively associated with female gender (adjusted odds ratio [AOR] = 1.85, 95% confidence interval [CI] 1.02, 3.35), black race (AOR = 2.04, 95% CI 1.28, 3.25), and living alone (AOR = 1.71, 95% CI 1.10, 2.67), and negatively associated with dementia (AOR = 0.59, 95% CI 0.37, 0.91). Seasonal influenza vaccine coverage in the MSVD program was high compared to nursing home and community-dwelling elderly. Offering patients vaccination at home without additional expense will likely improve vaccine coverage among urban homebound elderly. Understanding why vaccine refusal rates are higher among females, black patients, and those living alone should guide interventions to increase vaccine acceptance among this population.

  1. Home-based HIV counseling and testing: Client experiences and perceptions in Eastern Uganda

    PubMed Central

    2012-01-01

    Background Though prevention and treatment depend on individuals knowing their HIV status, the uptake of testing remains low in Sub-Saharan Africa. One initiative to encourage HIV testing involves delivering services at home. However, doubts have been cast about the ability of Home-Based HIV Counseling and Testing (HBHCT) to adhere to ethical practices including consent, confidentiality, and access to HIV care post-test. This study explored client experiences in relation these ethical issues. Methods We conducted 395 individual interviews in Kumi district, Uganda, where teams providing HBHCT had visited 6–12 months prior to the interviews. Semi-structured questionnaires elicited information on clients’ experiences, from initial community mobilization up to receipt of results and access to HIV services post-test. Results We found that 95% of our respondents had ever tested (average for Uganda was 38%). Among those who were approached by HBHCT providers, 98% were informed of their right to decline HIV testing. Most respondents were counseled individually, but 69% of the married/cohabiting were counseled as couples. The majority of respondents (94%) were satisfied with the information given to them and the interaction with the HBHCT providers. Most respondents considered their own homes as more private than health facilities. Twelve respondents reported that they tested positive, 11 were referred for follow-up care, seven actually went for care, and only 5 knew their CD4 counts. All HIV infected individuals who were married or cohabiting had disclosed their status to their partners. Conclusion These findings show a very high uptake of HIV testing and satisfaction with HBHCT, a large proportion of married respondents tested as couples, and high disclosure rates. HBHCT can play a major role in expanding access to testing and overcoming disclosure challenges. However, access to HIV services post-test may require attention. PMID:23146071

  2. The Effect of Home-based Daily Journal Writing in Korean Adolescents with Smartphone Addiction.

    PubMed

    Lee, Hyuk; Seo, Min Jae; Choi, Tae Young

    2016-05-01

    Despite the benefits of smartphones, many adverse effects have emerged. However, to date, there was no particular approach to treat or prevent smartphone addiction. The aim of this study was to evaluate the therapeutic effectiveness of a home-based daily journal of smartphone use (HDJ-S) in Korean adolescents. Three hundred thirty five middle school students participated in this study. The severity of smartphone addiction was measured using the Korean Smartphone Addiction Proneness Scale. The ability to control smartphone use was evaluated with the Motive Scale for Smartphone Regulation. We used the Parents' Concerns for Children's Smartphone Activities Scale to measure parental monitoring and supervision of adolescents' smartphone activities. The Korean Smartphone Addiction Proneness Scale classified subjects into high risk and non-high risk for smartphone addiction, according to total scores. Forty six participants (14%) were high risk for smartphone addiction. The high risk group performed the HDJ-S for two weeks, and the same scales were subsequently assessed. After performing the HDJ-S, the total scores of the Korean Smartphone Addiction Proneness Scale decreased significantly in the high risk group (P < 0.001). There was a significant increase in the total scores of the Parents' Concerns for Children's Smartphone Activities Scale in the high risk group between baseline and following two weeks of treatment (P < 0.05). The HDJ-S was effective for adolescents with smartphone addiction and increased the parents' concerns for their children's smartphone activities. We suggested that HDJ-S would be considered as a treatment and prevention for smartphone addiction.

  3. The Effect of Home-based Daily Journal Writing in Korean Adolescents with Smartphone Addiction

    PubMed Central

    2016-01-01

    Despite the benefits of smartphones, many adverse effects have emerged. However, to date, there was no particular approach to treat or prevent smartphone addiction. The aim of this study was to evaluate the therapeutic effectiveness of a home-based daily journal of smartphone use (HDJ-S) in Korean adolescents. Three hundred thirty five middle school students participated in this study. The severity of smartphone addiction was measured using the Korean Smartphone Addiction Proneness Scale. The ability to control smartphone use was evaluated with the Motive Scale for Smartphone Regulation. We used the Parents’ Concerns for Children’s Smartphone Activities Scale to measure parental monitoring and supervision of adolescents’ smartphone activities. The Korean Smartphone Addiction Proneness Scale classified subjects into high risk and non-high risk for smartphone addiction, according to total scores. Forty six participants (14%) were high risk for smartphone addiction. The high risk group performed the HDJ-S for two weeks, and the same scales were subsequently assessed. After performing the HDJ-S, the total scores of the Korean Smartphone Addiction Proneness Scale decreased significantly in the high risk group (P < 0.001). There was a significant increase in the total scores of the Parents’ Concerns for Children’s Smartphone Activities Scale in the high risk group between baseline and following two weeks of treatment (P < 0.05). The HDJ-S was effective for adolescents with smartphone addiction and increased the parents’ concerns for their children’s smartphone activities. We suggested that HDJ-S would be considered as a treatment and prevention for smartphone addiction. PMID:27134499

  4. Characterisation methods for the hyperspectral sensor HySpex at DLR's calibration home base

    NASA Astrophysics Data System (ADS)

    Baumgartner, Andreas; Gege, Peter; Köhler, Claas; Lenhard, Karim; Schwarzmaier, Thomas

    2012-09-01

    The German Aerospace Center's (DLR) Remote Sensing Technology Institute (IMF) operates a laboratory for the characterisation of imaging spectrometers. Originally designed as Calibration Home Base (CHB) for the imaging spectrometer APEX, the laboratory can be used to characterise nearly every airborne hyperspectral system. Characterisation methods will be demonstrated exemplarily with HySpex, an airborne imaging spectrometer system from Norsk Elektro Optikks A/S (NEO). Consisting of two separate devices (VNIR-1600 and SWIR-320me) the setup covers the spectral range from 400 nm to 2500 nm. Both airborne sensors have been characterised at NEO. This includes measurement of spectral and spatial resolution and misregistration, polarisation sensitivity, signal to noise ratios and the radiometric response. The same parameters have been examined at the CHB and were used to validate the NEO measurements. Additionally, the line spread functions (LSF) in across and along track direction and the spectral response functions (SRF) for certain detector pixels were measured. The high degree of lab automation allows the determination of the SRFs and LSFs for a large amount of sampling points. Despite this, the measurement of these functions for every detector element would be too time-consuming as typical detectors have 105 elements. But with enough sampling points it is possible to interpolate the attributes of the remaining pixels. The knowledge of these properties for every detector element allows the quantification of spectral and spatial misregistration (smile and keystone) and a better calibration of airborne data. Further laboratory measurements are used to validate the models for the spectral and spatial properties of the imaging spectrometers. Compared to the future German spaceborne hyperspectral Imager EnMAP, the HySpex sensors have the same or higher spectral and spatial resolution. Therefore, airborne data will be used to prepare for and validate the spaceborne system

  5. Cost-Effectiveness of a Community-Integrated Home Based Depression Intervention in Older African Americans

    PubMed Central

    Pizzi, Laura T.; Jutkowitz, Eric; Frick, Kevin D.; Suh, Dong-Churl; Prioli, Katherine M.; Gitlin, Laura N.

    2014-01-01

    Objectives To test the cost-effectiveness of a home-based depression program, Beat the Blues (BTB). Design We conducted a cost-effectiveness analysis as part of a previously reported randomized controlled trial that tested BTB versus a wait-list control group. Setting Community-dwelling older African American adults. Participants African Americans who were ≥55 years of age, English speaking, cognitively intact (MMSE ≥24), and had depressive symptoms (PHQ-9 score ≥5) (N=129). Intervention Participants randomly assigned to BTB received up to 10 home visits over a period of 4 months by licensed social workers who provided care management, referral/linkage, stress reduction, depression education, and behavioral activation to help participants achieve self-identified goals. Measurements Incremental cost effectiveness ratios (ICERs) of BTB versus wait-list controls during the 4-month study period. The primary ICER was defined as cost/quality-adjusted life year using the EQ-5D and secondarily using the HUI-3. Additional ICERs were calculated using clinical measures (cost per depression improvement, cost per depression remission). Costs included BTB intervention, depression-related healthcare visits and medications, caregiver time, and social services. Results BTB cost per participant per month was $146. Base case ICERs were $64,896 per QALY (EQ-5D) and $36,875 per QALY (HUI-3). Incremental cost per depression improvement was $2,906 and per remission was $3,507. Univariate and probabilistic sensitivity analyses yielded cost/QALY range of $20,500-$76,500. Conclusion Based on the range of cost effectiveness values resulting from this study, BTB is a cost-effective treatment for managing depressive symptoms in older African Americans that compares favorably with the cost effectiveness of previously tested approaches. PMID:25516025

  6. Processes of user participation among formal and family caregivers in home-based care for persons with dementia.

    PubMed

    Larsen, Lill Sverresdatter; Normann, Hans Ketil; Hamran, Torunn

    2017-02-01

    Scandinavian health policy supports prolonged home-based care for people with dementia. User participation is expected to reduce family burden. The aim of this study was to explore how formal and family caregivers experience collaboration while providing home-based dementia care, with a focus on user participation. Seventeen qualitative in-depth interviews were conducted among formal and family caregivers in rural municipalities. The theme identified during this process was 'negotiating participation in decisions'. This theme was analysed using positioning theory. Concepts such as user participation are ambiguous, and caregivers negotiate positions during decision-making processes. Such negotiations are caused by the problematic relationships among patients' legal consent, undefined spokespersons and pragmatic care practices. These constant negotiations enable or obstruct collaboration in several situations. User participation as a concept might contribute to conflicts during collaborations. Dialogues about user participation that focus on consent and spokespersons could reduce the burden created by negotiations in practice.

  7. The role of home-based information and communications technology interventions in chronic disease management: a systematic literature review.

    PubMed

    Gaikwad, Rekha; Warren, Jim

    2009-06-01

    This article presents a systematic literature review done to evaluate the feasibility and benefits of home-based information and communications technology enabled interventions for chronic disease management, with emphasis on their impact on health outcomes and costs. Relevant articles were retrieved from PubMed and evaluated using quality worksheets with pre-identified inclusion and exclusion criteria. Of the 256 articles retrieved, 27 were found to concord with the study criteria. Evaluation of the identified articles was conducted irrespective of study design, type of home-based intervention or chronic disease involved. The review demonstrates that HBIs applied to chronic disease management improve functional and cognitive patient outcomes and reduce healthcare spending. However, further research is needed to assess benefit in terms of evidence-based outcome indicators (that can provide a basis for meta-analysis), to confirm sustainable cost benefits, and to systematically collect data on physician satisfaction with patient management.

  8. Service Desk Calls in a Home-based Clinical Informatics Study: Supporting End Users in the Field

    PubMed Central

    Valdez, RS; Burke, LJ; Casper, GR; Sturgeon, BA; Rosmait, C; Palzkill, D; Hamann, D; Murphy, J; Brennan, PF

    2012-01-01

    Home-based clinical informatics technologies are being developed to facilitate health care provision and management. Given the novelty of these technologies, end users such as patients and their formal and informal caregivers may require support during use. This paper presents a case study within the United States of the service desk calls generated over a 31-month period by patients enrolled in a large randomized field experiment, HeartCare II. This case study provides future deployers of home-based clinical information technologies with an understanding of the types of support that may be required during use. Our analysis reveals that calls to the service desk originated as a result of user problems, hardware problems, software problems, and internal communication problems among individuals involved in the delivery and use of the technology. Implications of these needs for support during use are also discussed. PMID:24199135

  9. A framework for prescription in exercise-oncology research.

    PubMed

    Sasso, John P; Eves, Neil D; Christensen, Jesper F; Koelwyn, Graeme J; Scott, Jessica; Jones, Lee W

    2015-06-01

    The field of exercise-oncology has increased dramatically over the past two decades, with close to 100 published studies investigating the efficacy of structured exercise training interventions in patients with cancer. Of interest, despite considerable differences in study population and primary study end point, the vast majority of studies have tested the efficacy of an exercise prescription that adhered to traditional guidelines consisting of either supervised or home-based endurance (aerobic) training or endurance training combined with resistance training, prescribed at a moderate intensity (50-75% of a predetermined physiological parameter, typically age-predicted heart rate maximum or reserve), for two to three sessions per week, for 10 to 60 min per exercise session, for 12 to 15 weeks. The use of generic exercise prescriptions may, however, be masking the full therapeutic potential of exercise treatment in the oncology setting. Against this background, this opinion paper provides an overview of the fundamental tenets of human exercise physiology known as the principles of training, with specific application of these principles in the design and conduct of clinical trials in exercise-oncology research. We contend that the application of these guidelines will ensure continued progress in the field while optimizing the safety and efficacy of exercise treatment following a cancer diagnosis.

  10. A framework for prescription in exercise-oncology research†

    PubMed Central

    Sasso, John P; Eves, Neil D; Christensen, Jesper F; Koelwyn, Graeme J; Scott, Jessica; Jones, Lee W

    2015-01-01

    The field of exercise-oncology has increased dramatically over the past two decades, with close to 100 published studies investigating the efficacy of structured exercise training interventions in patients with cancer. Of interest, despite considerable differences in study population and primary study end point, the vast majority of studies have tested the efficacy of an exercise prescription that adhered to traditional guidelines consisting of either supervised or home-based endurance (aerobic) training or endurance training combined with resistance training, prescribed at a moderate intensity (50–75% of a predetermined physiological parameter, typically age-predicted heart rate maximum or reserve), for two to three sessions per week, for 10 to 60 min per exercise session, for 12 to 15 weeks. The use of generic exercise prescriptions may, however, be masking the full therapeutic potential of exercise treatment in the oncology setting. Against this background, this opinion paper provides an overview of the fundamental tenets of human exercise physiology known as the principles of training, with specific application of these principles in the design and conduct of clinical trials in exercise-oncology research. We contend that the application of these guidelines will ensure continued progress in the field while optimizing the safety and efficacy of exercise treatment following a cancer diagnosis. PMID:26136187

  11. Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease

    PubMed Central

    Byrnes, Joshua; Carrington, Melinda; Chan, Yih-Kai; Pollicino, Christine; Dubrowin, Natalie; Stewart, Simon; Scuffham, Paul A.

    2015-01-01

    The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI) in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95%CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95%CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95%CI: -$22,843, $14,863]). This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most. PMID:26657844

  12. Using Multidimensional Scaling for Curricular Goal Analysis.

    ERIC Educational Resources Information Center

    Leitzman, David F.; And Others

    1980-01-01

    Reports research that utilized multidimensional scaling and related analytic procedures to validate the curricular goals of a graduate therapeutic recreation program. Data analysis includes the use of the two-dimensional KYST and PREFMAP spaces. (Author/JD)

  13. Multi-dimensional edge detection operators

    NASA Astrophysics Data System (ADS)

    Youn, Sungwook; Lee, Chulhee

    2014-05-01

    In remote sensing, modern sensors produce multi-dimensional images. For example, hyperspectral images contain hundreds of spectral images. In many image processing applications, segmentation is an important step. Traditionally, most image segmentation and edge detection methods have been developed for one-dimensional images. For multidimensional images, the output images of spectral band images are typically combined under certain rules or using decision fusions. In this paper, we proposed a new edge detection algorithm for multi-dimensional images using secondorder statistics. First, we reduce the dimension of input images using the principal component analysis. Then we applied multi-dimensional edge detection operators that utilize second-order statistics. Experimental results show promising results compared to conventional one-dimensional edge detectors such as Sobel filter.

  14. Home-Based Life Saving Skills in Ethiopia: an update on the second phase of field testing.

    PubMed

    Sibley, Lynn; Buffington, Sandra Tebben; Tedessa, Lelisse; McNatt, Kathryn

    2006-01-01

    Home-Based Life Saving Skills (HBLSS) was integrated over 3 years into a district-level child survival project coordinated through the Ministry of Health and Save the Children Foundation/US in Liben Woreda, Guji Zone, Oromia Region, southern Ethiopia. During late 2004, the second phase of the program was reviewed for performance, home-based management, learning transfer, and program coverage. The immediate posttraining performance score for HBLSS guides for "First Actions" was 87% (a 78% increase over the pretraining baseline) and 79% at 1 year (a 9% decrease from the immediate posttraining score). The home-based management score of women attended by HBLSS guides for "First Actions" was 89%, compared to 32% for women assisted by other unskilled attendants. HBLSS guides teach women and families in the community as they were taught, by using pictorial Take Action Cards, role-play and demonstration, and a variety of venues. Estimates of HBLSS coverage suggest that HBLSS guides attended 24% to 26% of births, and 54% of women giving birth were exposed to HBLSS training. The HBLSS field tests demonstrate a promising program that increases access to basic care for poor, underserved, rural populations who carry the greatest burden of maternal and neonatal mortality.

  15. Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

    PubMed

    Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

    2015-01-01

    This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability.

  16. Multidimensional Data Modeling for Business Process Analysis

    NASA Astrophysics Data System (ADS)

    Mansmann, Svetlana; Neumuth, Thomas; Scholl, Marc H.

    The emerging area of business process intelligence attempts to enhance the analytical capabilities of business process management systems by employing data warehousing and mining technologies. This paper presents an approach to re-engineering the business process modeling in conformity with the multidimensional data model. Since the business process and the multidimensional model are driven by rather different objectives and assumptions, there is no straightforward solution to converging these models.

  17. Multidimensional imaging using compressive Fresnel holography.

    PubMed

    Horisaki, Ryoichi; Tanida, Jun; Stern, Adrian; Javidi, Bahram

    2012-06-01

    We propose a generalized framework for single-shot acquisition of multidimensional objects using compressive Fresnel holography. A multidimensional object with spatial, spectral, and polarimetric information is propagated with the Fresnel diffraction, and the propagated signal of each channel is observed by an image sensor with randomly arranged optical elements for filtering. The object data are reconstructed using a compressive sensing algorithm. This scheme is verified with numerical experiments. The proposed framework can be applied to imageries for spectrum, polarization, and so on.

  18. [Home-based versus ambulatory hospital-based training in COPD].

    PubMed

    Jolly, Enrique; Sívori, Martín; Villarreal, Sara; Almeida, Marta; Sáenz, César

    2014-01-01

    There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.George's), submaximal (6 minutes' walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79 %, p = 0.0197 in rD group) and in 6 minutes' test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD vs. 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.

  19. Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial.

    PubMed

    Dundar, U; Solak, O; Toktas, H; Demirdal, U S; Subasi, V; Kavuncu, V; Evcik, D

    2014-11-01

    Ankylosing spondylitis (AS) is a chronic systemic inflammatory disease that affects mainly the axial skeleton and causes significant pain and disability. Aquatic (water-based) exercise may have a beneficial effect in various musculoskeletal conditions. The aim of this study was to compare the effectiveness of aquatic exercise interventions with land-based exercises (home-based exercise) in the treatment of AS. Patients with AS were randomly assigned to receive either home-based exercise or aquatic exercise treatment protocol. Home-based exercise program was demonstrated by a physiotherapist on one occasion and then, exercise manual booklet was given to all patients in this group. Aquatic exercise program consisted of 20 sessions, 5× per week for 4 weeks in a swimming pool at 32-33 °C. All the patients in both groups were assessed for pain, spinal mobility, disease activity, disability, and quality of life. Evaluations were performed before treatment (week 0) and after treatment (week 4 and week 12). The baseline and mean values of the percentage changes calculated for both groups were compared using independent sample t test. Paired t test was used for comparison of pre- and posttreatment values within groups. A total of 69 patients with AS were included in this study. We observed significant improvements for all parameters [pain score (VAS) visual analog scale, lumbar flexion/extension, modified Schober test, chest expansion, bath AS functional index, bath AS metrology index, bath AS disease activity index, and short form-36 (SF-36)] in both groups after treatment at week 4 and week 12 (p < 0.05). Comparison of the percentage changes of parameters both at week 4 and week 12 relative to pretreatment values showed that improvement in VAS (p < 0.001) and bodily pain (p < 0.001), general health (p < 0.001), vitality (p < 0.001), social functioning (p < 0.001), role limitations due to emotional problems (p < 0.001), and general mental health (p < 0.001) subparts of

  20. Multidimensionally encoded magnetic resonance imaging.

    PubMed

    Lin, Fa-Hsuan

    2013-07-01

    Magnetic resonance imaging (MRI) typically achieves spatial encoding by measuring the projection of a q-dimensional object over q-dimensional spatial bases created by linear spatial encoding magnetic fields (SEMs). Recently, imaging strategies using nonlinear SEMs have demonstrated potential advantages for reconstructing images with higher spatiotemporal resolution and reducing peripheral nerve stimulation. In practice, nonlinear SEMs and linear SEMs can be used jointly to further improve the image reconstruction performance. Here, we propose the multidimensionally encoded (MDE) MRI to map a q-dimensional object onto a p-dimensional encoding space where p > q. MDE MRI is a theoretical framework linking imaging strategies using linear and nonlinear SEMs. Using a system of eight surface SEM coils with an eight-channel radiofrequency coil array, we demonstrate the five-dimensional MDE MRI for a two-dimensional object as a further generalization of PatLoc imaging and O-space imaging. We also present a method of optimizing spatial bases in MDE MRI. Results show that MDE MRI with a higher dimensional encoding space can reconstruct images more efficiently and with a smaller reconstruction error when the k-space sampling distribution and the number of samples are controlled.

  1. Vector fields in multidimensional cosmology

    NASA Astrophysics Data System (ADS)

    Meierovich, Boris E.

    2011-09-01

    Vector fields in the expanding Universe are considered within the multidimensional theory of general relativity. Vector fields in general relativity form a three-parametric variety. Our consideration includes the fields with a nonzero covariant divergence. Depending on the relations between the particular parameters and the symmetry of a problem, the vector fields can be longitudinal and/or transverse, ultrarelativistic (i.e. massless) or nonrelativistic (massive), and so on. The longitudinal and transverse vector fields are considered separately in detail in the background of the de Sitter cosmological metric. In most cases the field equations reduce to Bessel equations, and their temporal evolution is analyzed analytically. The energy-momentum tensor of the most simple zero-mass longitudinal vector fields enters the Einstein equations as an additive to the cosmological constant. In this case the de Sitter metric is the exact solution of the Einstein equations. Hence, the most simple zero-mass longitudinal vector field pretends to be an adequate tool for macroscopic description of dark energy as a source of the expansion of the Universe at a constant rate. The zero-mass vector field does not vanish in the process of expansion. On the contrary, massive fields vanish with time. Though their amplitude is falling down, the massive fields make the expansion accelerated.

  2. Exercise Physiologists

    MedlinePlus

    ... CAAHEP). High school students interested in postsecondary exercise physiology programs should take courses in anatomy, physiology, and physics. Licenses, Certifications, and Registrations Louisiana is ...

  3. Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

    PubMed Central

    2010-01-01

    Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from

  4. GOLIAH: A Gaming Platform for Home-Based Intervention in Autism - Principles and Design.

    PubMed

    Bono, Valentina; Narzisi, Antonio; Jouen, Anne-Lise; Tilmont, Elodie; Hommel, Stephane; Jamal, Wasifa; Xavier, Jean; Billeci, Lucia; Maharatna, Koushik; Wald, Mike; Chetouani, Mohamed; Cohen, David; Muratori, Filippo

    2016-01-01

    -child relationship. This pilot study shows the feasibility of using the developed gaming platform for home-based intensive intervention. However, the overall capability of the platform in delivering intervention needs to be assessed in a bigger open trial.

  5. The Impact of a Home-Based Palliative Care Program in an Accountable Care Organization

    PubMed Central

    Mudra, Mitchell; Romano, Carole; Lukoski, Ed; Chang, Andy; Mittelberger, James; Scherr, Terry; Cooper, David

    2017-01-01

    Abstract Background: People with advanced illness usually want their healthcare where they live—at home—not in the hospital. Innovative models of palliative care that better meet the needs of seriously ill people at lower cost should be explored. Objectives: We evaluated the impact of a home-based palliative care (HBPC) program implemented within an Accountable Care Organization (ACO) on cost and resource utilization. Methods: This was a retrospective analysis to quantify cost savings associated with a HBPC program in a Medicare Shared Savings Program ACO where total cost of care is available. We studied 651 decedents; 82 enrolled in a HBPC program compared to 569 receiving usual care in three New York counties who died between October 1, 2014, and March 31, 2016. We also compared hospital admissions, ER visits, and hospice utilization rates in the final months of life. Results: The cost per patient during the final three months of life was $12,000 lower with HBPC than with usual care ($20,420 vs. $32,420; p = 0.0002); largely driven by a 35% reduction in Medicare Part A ($16,892 vs. $26,171; p = 0.0037). HBPC also resulted in a 37% reduction in Medicare Part B in the final three months of life compared to usual care ($3,114 vs. $4,913; p = 0.0008). Hospital admissions were reduced by 34% in the final month of life for patients enrolled in HBPC. The number of admissions per 1000 beneficiaries per year was 3073 with HBPC and 4640 with usual care (p = 0.0221). HBPC resulted in a 35% increased hospice enrollment rate (p = 0.0005) and a 240% increased median hospice length of stay compared to usual care (34 days vs. 10 days; p < 0.0001). Conclusion: HBPC within an ACO was associated with significant cost savings, fewer hospitalizations, and increased hospice use in the final months of life. PMID:27574868

  6. GOLIAH: A Gaming Platform for Home-Based Intervention in Autism – Principles and Design

    PubMed Central

    Bono, Valentina; Narzisi, Antonio; Jouen, Anne-Lise; Tilmont, Elodie; Hommel, Stephane; Jamal, Wasifa; Xavier, Jean; Billeci, Lucia; Maharatna, Koushik; Wald, Mike; Chetouani, Mohamed; Cohen, David; Muratori, Filippo

    2016-01-01

    parents–child relationship. This pilot study shows the feasibility of using the developed gaming platform for home-based intensive intervention. However, the overall capability of the platform in delivering intervention needs to be assessed in a bigger open trial. PMID:27199777

  7. Results of a feasibility randomised controlled study of the guidelines for exercise in multiple sclerosis project.

    PubMed

    Learmonth, Yvonne C; Adamson, Brynn C; Kinnett-Hopkins, Dominique; Bohri, Maria; Motl, Robert W

    2017-03-01

    There is increasing recognition that exercise is an efficacious strategy for managing many consequences of multiple sclerosis (MS), yet persons with MS are not engaging in sufficient exercise for accruing health benefits. Poor exercise uptake might be associated with the design of previous research. We conducted a randomised controlled trial (RCT) for examining the feasibility of a 4-month home-based, exercise-training program designed based on recent physical activity guidelines for MS and supplemented by behavioural strategies for compliance. Feasibility was assessed in the domains of process (e.g., recruitment), resource (e.g., monetary costs), management (e.g., personnel time requirements) and scientific outcomes (e.g., treatment effect). We recruited persons with mild-to-moderate MS who were randomised into an intervention or wait-list control condition. Intervention participants received a pedometer, elastic resistance bands, DVD, training manual, calendars, log-book, video coaching calls and newsletters. Participants in both conditions completed home-based assessments before and after the 4-month period. Ninety-nine persons with MS were assessed for eligibility, and 57 were randomised. Fifty-one persons completed the study (90%). Total costs of the study were US $5331.03. Personnel time to conduct the study totaled 263h. Participants in the intervention group complied fully with 71% of all exercise sessions. There was a moderate increase in self-reported exercise behaviour of the intervention participants as measured by the Godin Leisure-Time Exercise Questionnaire (d≥0.5). The results support the feasibility and acceptability of a home-based exercise intervention based on physical activity guidelines and supplemented with behavioural strategies for adults with mild-to-moderate MS.

  8. Factors affecting pain relief in response to physical exercise interventions among healthcare workers.

    PubMed

    Jakobsen, M D; Sundstrup, E; Brandt, M; Andersen, L L

    2016-12-28

    The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain.

  9. Compulsive Exercise

    MedlinePlus

    ... of a Good Thing? We all know the benefits of exercise, and it seems that everywhere we turn, we ... stress. So how can something with so many benefits have the potential to cause ... out because it's fun or it makes them feel good, but exercise can become a compulsive habit when it is ...

  10. Compulsive Exercise

    MedlinePlus

    ... eating . Compulsive exercise behavior can grow out of student athletes' demanding practice schedules and their quest to ... negative image of themselves and feel worthless. Their social and academic lives may suffer as they ... and abandons responsibilities to make more time for exercise seems to ...

  11. Neutral spine control exercises in rehabilitation after lumbar spine fusion.

    PubMed

    Tarnanen, Sami P; Neva, Marko H; Häkkinen, Keijo; Kankaanpää, Markku; Ylinen, Jari; Kraemer, William J; Newton, Robert U; Häkkinen, Arja

    2014-07-01

    Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk muscles after LSF was evaluated. Muscle activity was measured by surface electromyography of the rectus abdominis, external oblique, longissimus, and multifidus muscles during 6 exercises in 22 LSF patients (mean age = 59 years; age range = 25-84 years; 50% women). Muscle activity concurrent with trunk flexion and extension during maximal voluntary isometric contraction (MVIC) was used as a reference value. Pain during the effort was assessed with a visual analog scale (VAS). The highest activity in the rectus abdominis muscles was measured during bilateral shoulder extension (51% of MVIC), and in the external oblique, it occurred during unilateral shoulder horizontal adduction (48% of MVIC) and unilateral hip extension (46% of MVIC) exercises. The highest activation of the multifidus and longissimus muscles (60-104%) was measured during bilateral shoulder flexion and modified Roman chair exercises. The mean (SD) self-reported back pain VAS scores during exercises varied from 3 (7) to 16 (26). Neutral spine control exercises activate trunk muscles and cause minimal pain and are therefore feasible exercises for home-based training to improve muscle endurance and postural control after LSF. In addition, the level of muscle activity during bilateral shoulder flexion and modified Roman chair exercises was over 60% of MVIC, justifying their use in training for strength of the trunk extensor muscles.

  12. Exercise and fatigue in rheumatoid arthritis.

    PubMed

    Balsamo, Sandor; Diniz, Leonardo R; dos Santos-Neto, Leopoldo L; da Mota, Licia M H

    2014-01-01

    Fatigue, the enduring sensation of weakness, lack of energy, tiredness or exhaustion, is described by 40%-80% of patients with rheumatoid arthritis as their most disabling symptom with wide-ranging consequences for quality of life. Little attention has been paid to its multidimensional nature or to its reliability as a measure to evaluate progression of the disease. Low impact aerobic exercise affects the level of fatigue, and this same level of fatigue influences the exercise itself. We searched Medline, Cochrane Collaboration Register of Controlled Trials (CCRCT), Lilacs, PubMed and Scopus databases for randomized controlled trials (with appropriate description of methods, materials and results) on the assessment of fatigue and exercise. Review articles, case reports, letters to the editor and editorials were excluded. Of 121 references initially identified, 4 randomized controlled trials met the inclusion criteria. Two studies used the MAF scale (Multidimensional Assessment of Fatigue), one used the MAC (Mental Adjustment to Cancer) fatigue scale, and all trials used POMS (Profile of Mood States) to assess fatigue. All four trials conducted a 12 week program of two to three times/ week and different periods of follow-up. Two studies used low impact aerobic exercise, one used dance-based exercise, and another study followed a home cardiopulmonary conditioning program using a stationary bicycle. While fatigue appears to be a reliable outcome measure in the clinical management of RA, especially when related to exercise prescription, further research is needed to evaluate the correlation between exercise, fatigue and quality of life, using fatigue scales validated to explore the different components of fatigue and its wide-ranging consequences.

  13. Home-Based Computer Gaming in Vestibular Rehabilitation of Gaze and Balance Impairment.

    PubMed

    Szturm, Tony; Reimer, Karen M; Hochman, Jordan

    2015-06-01

    Disease or damage of the vestibular sense organs cause a range of distressing symptoms and functional problems that could include loss of balance, gaze instability, disorientation, and dizziness. A novel computer-based rehabilitation system with therapeutic gaming application has been developed. This method allows different gaze and head movement exercises to be coupled to a wide range of inexpensive, commercial computer games. It can be used in standing, and thus graded balance demands using a sponge pad can be incorporated into the program. A case series pre- and postintervention study was conducted of nine adults diagnosed with peripheral vestibular dysfunction who received a 12-week home rehabilitation program. The feasibility and usability of the home computer-based therapeutic program were established. Study findings revealed that using head rotation to interact with computer games, when coupled to demanding balance conditions, resulted in significant improvements in standing balance, dynamic visual acuity, gaze control, and walking performance. Perception of dizziness as measured by the Dizziness Handicap Inventory also decreased significantly. These preliminary findings provide support that a low-cost home game-based exercise program is well suited to train standing balance and gaze control (with active and passive head motion).

  14. Writing Exercises from "Exercise Exchange."

    ERIC Educational Resources Information Center

    Long, Littleton, Ed.

    This collection focuses on writing exercises, both expository and creative, as well as areas of adjacent concern. The book is divided into nine major sections: prewriting; diction; theme, thesis, and paragraph; style; ideas for whole papers and special topics; description; research; the short story; and rewriting. The exercises deal with such…

  15. Acceptability of self-conducted home-based HIV testing among men who have sex with men in Brazil: data from an on-line survey.

    PubMed

    Lippman, Sheri A; Périssé, André R S; Veloso, Valdiléa G; Sullivan, Patrick S; Buchbinder, Susan; Sineath, R Craig; Grinsztejn, Beatriz

    2014-04-01

    The Brazilian HIV/AIDS epidemic is concentrated among men who have sex with men (MSM), however HIV testing rates among MSM are not commensurate with their risk. Strategies to expand early diagnosis may include use of self-conducted home-based testing kits, which are now available for purchase in the US. In April 2011 we conducted a survey with Brazilian MSM using Facebook to assess HIV testing preferences and acceptability of home-based testing. Among 356 previously tested, HIV-negative MSM, 47% reported a preference for home-based testing, 27% preferred clinic-based testing, and 26% had no preference. Less frequent testers and those who had considered testing but failed to test were more likely to prefer home-based testing. Close to 90% reported that they would use self-test kits; 62% and 54% said they would use home-based testing to make choices about unprotected sex with regular and new partners, respectively. Concerns included difficulty to understand the tests (32%) and receiving results alone (23%). Overall, home-based testing may appeal to MSM and result in increased testing frequency. Research on feasibility and utilization of self-tests in practice is needed.

  16. A qualitative study of community home-based care and antiretroviral adherence in Swaziland

    PubMed Central

    Root, Robin; Whiteside, Alan

    2013-01-01

    Introduction Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for individuals in many parts of the world. Adherence, however, is integral to achieving chronicity. Studies have shown both relatively high ART adherence rates in sub-Saharan Africa and the importance of community home-based care (CHBC) to facilitating this process. In light of diminished HIV and AIDS funding globally and increased reliance on CHBC throughout Africa, a better understanding of how CHBC may strengthen ART adherence is essential to improving patients’ quality of life, tending to the needs of care supporters and achieving healthier populations. Methods This article reports findings from a qualitative study of a CHBC organiztion serving an estimated 2500 clients in rural Swaziland. Semi-structured questionnaires with 79 HIV-positive clients [people living with HIV and AIDS (PLWHA)] yielded data on diverse aspects of being HIV positive, including insights on whether and how PLWHA perceived care supporters to facilitate ART adherence in a high stigma and structurally impoverished setting. Results Ninety-two percent of participants said their health had improved since care supporters came into their lives. A major finding was that an estimated 53% of participants said they would have died, a few from suicide had the care supporter never intervened. More than one in four participants (27.9%) sought HIV testing after a care supporter began visiting them. Nearly a third (31%) commenced ART after and largely as a consequence of care supporter intervention. Approximately one in four (23%) reported that their care supporter had helped them to disclose their HIV-positive status to family members. Twenty-seven percent said they had felt discouraged or had been discouraged from taking ART by members of their family or community. Discussion General inductive analysis of participant reports suggested two social mechanisms of CHBC impact on ART adherence: (i) cultivating client

  17. Sleep efficiency during sleep studies: results of a prospective study comparing home-based and in-hospital polysomnography.

    PubMed

    Bruyneel, Marie; Sanida, Christina; Art, Geneviève; Libert, Walter; Cuvelier, Laurent; Paesmans, Marianne; Sergysels, Roger; Ninane, Vincent

    2011-03-01

    To date, the clinical use of unattended home-based polysomnography (PSG) is not recommended. To assess whether sleep efficiency is better at home, we have performed a prospective, crossover, single-blind study comparing unattended home- versus attended in-hospital PSG in a population referred for high clinical suspicion of obstructive sleep apnoea syndrome (OSA). Within 2 weeks, all the patients underwent both PSG performed by the same sleep technician, which were analysed by another blinded technician. Payments for each procedure were also calculated. Sixty-six patients (mean age: 49±13 years; mean body mass index: 30±7; mean Epworth Sleepiness Scale: 10±5) were included. The quality of recordings was poor in 1.5% of the attended PSG versus 4.7% for unattended PSG (P=0.36). Sleep efficiency at home was better (82% versus 75%, P<0.001), and sleep duration longer (412 min versus 365 min, P<0.001). Sleep latency was also shorter at home (28 min versus 45 min, P=0.004), and patients spent more time in rapid eye movement sleep (19% versus 16%, P=0.006). Apnoea-hypopnoea index (23 versus 26, P=0.08) was similar at home and in the sleep lab. Sixty-seven per cent of patients preferred home-based PSG. PSG payment was also lower at home (268 Euros versus 1057 Euros). We conclude that home-based PSG is associated with a better sleep efficiency. It also appears as feasible and reliable in patients with high preclinical suspicion for OSA. It is also more comfortable for the patients whose sleep efficiency is better and allows cost saving related to the absence of hospitalization.

  18. A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol.

    PubMed

    Young, Lufei; Healey, Kathleen; Charlton, Mary; Schmid, Kendra; Zabad, Rana; Wester, Rebecca

    2015-01-01

    Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden.  Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease. Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention.   Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems.   Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If

  19. Home-based family intervention for low-income children with asthma: a randomized controlled pilot study.

    PubMed

    Celano, Marianne P; Holsey, Chanda Nicole; Kobrynski, Lisa J

    2012-04-01

    Low-income African American children have disproportionately higher asthma morbidity and mortality. Education alone may not address barriers to asthma management due to psychosocial stress. This study evaluated the efficacy of a home-based family intervention integrating asthma education and strategies to address stress using a community-based participatory research model. Children age 8 to 13 with poorly controlled asthma and their caregivers were recruited from an urban hospital and an asthma camp. Caregivers with elevated scores on a stress measure were enrolled. Forty-three families were randomized to the 4- to 6-session Home Based Family Intervention (HBFI) or the single session of Enhanced Treatment as Usual (ETAU). All families received an asthma action plan and dust mite covers; children performed spirometry and demonstrated MDI/spacer technique at each home visit. The HBFI addressed family-selected goals targeting asthma management and stressors. Asthma management, morbidity, family functioning, and caregiver stress were assessed at baseline, postintervention, and 6 months after the intervention. ED visits and hospitalizations were ascertained by medical record review for a year after intervention completion. Only one child (5%) in HBFI had an asthma-related hospitalization compared to 7 patients (35%) in ETAU in the year following intervention. Participants in both groups demonstrated improved asthma management and family functioning, and reduced ED visits, symptom days, missed school days, and caregiver stress, but there were no differential treatment effects. The results suggest that a home-based intervention addressing medical and psychosocial needs may prevent hospitalizations for children with poorly controlled asthma and caregivers under stress.

  20. A low cost virtual reality system for home based rehabilitation of the arm following stroke: a randomised controlled feasibility trial

    PubMed Central

    Standen, PJ; Threapleton, K; Richardson, A; Connell, L; Brown, DJ; Battersby, S; Platts, F; Burton, A

    2016-01-01

    Objective: To assess the feasibility of conducting a randomised controlled trial of a home-based virtual reality system for rehabilitation of the arm following stroke. Design: Two group feasibility randomised controlled trial of intervention versus usual care. Setting: Patients’ homes. Participants: Patients aged 18 or over, with residual arm dysfunction following stroke and no longer receiving any other intensive rehabilitation. Interventions: Eight weeks’ use of a low cost home-based virtual reality system employing infra-red capture to translate the position of the hand into game play or usual care. Main measures: The primary objective was to collect information on the feasibility of a trial, including recruitment, collection of outcome measures and staff support required. Patients were assessed at three time points using the Wolf Motor Function Test, Nine-Hole Peg Test, Motor Activity Log and Nottingham Extended Activities of Daily Living. Results: Over 15 months only 47 people were referred to the team. Twenty seven were randomised and 18 (67%) of those completed final outcome measures. Sample size calculation based on data from the Wolf Motor Function Test indicated a requirement for 38 per group. There was a significantly greater change from baseline in the intervention group on midpoint Wolf Grip strength and two subscales of the final Motor Activity Log. Training in the use of the equipment took a median of 230 minutes per patient. Conclusions: To achieve the required sample size, a definitive home-based trial would require additional strategies to boost recruitment rates and adequate resources for patient support. PMID:27029939

  1. Multidimensional heritability analysis of neuroanatomical shape

    PubMed Central

    Ge, Tian; Reuter, Martin; Winkler, Anderson M.; Holmes, Avram J.; Lee, Phil H.; Tirrell, Lee S.; Roffman, Joshua L.; Buckner, Randy L.; Smoller, Jordan W.; Sabuncu, Mert R.

    2016-01-01

    In the dawning era of large-scale biomedical data, multidimensional phenotype vectors will play an increasing role in examining the genetic underpinnings of brain features, behaviour and disease. For example, shape measurements derived from brain MRI scans are multidimensional geometric descriptions of brain structure and provide an alternate class of phenotypes that remains largely unexplored in genetic studies. Here we extend the concept of heritability to multidimensional traits, and present the first comprehensive analysis of the heritability of neuroanatomical shape measurements across an ensemble of brain structures based on genome-wide SNP and MRI data from 1,320 unrelated, young and healthy individuals. We replicate our findings in an extended twin sample from the Human Connectome Project (HCP). Our results demonstrate that neuroanatomical shape can be significantly heritable, above and beyond volume, and can serve as a complementary phenotype to study the genetic determinants and clinical relevance of brain structure. PMID:27845344

  2. Resonance beyond frequency-matching: multidimensional resonance

    NASA Astrophysics Data System (ADS)

    Wang, Zhenyu; Li, Mingzhe; Wang, Ruifang

    2017-03-01

    Resonance, conventionally defined as the oscillation of a system when the temporal frequency of an external stimulus matches a natural frequency of the system, is important in both fundamental physics and applied disciplines. However, the spatial character of oscillation is not considered in this definition. We reveal the creation of spatial resonance when the stimulus matches the space pattern of a normal mode in an oscillating system. The complete resonance, which we call multidimensional resonance, should be a combination of both the temporal and the spatial resonance. We further elucidate that the spin wave produced by multidimensional resonance drives considerably faster reversal of the vortex core in a magnetic nanodisc. Multidimensional resonance provides insight into the nature of wave dynamics and opens the door to novel applications.

  3. Multidimensional energy operator for image processing

    NASA Astrophysics Data System (ADS)

    Maragos, Petros; Bovik, Alan C.; Quatieri, Thomas F.

    1992-11-01

    The 1-D nonlinear differential operator (Psi) (f) equals (f')2 - ff' has been recently introduced to signal processing and has been found very useful for estimating the parameters of sinusoids and the modulating signals of AM-FM signals. It is called an energy operator because it can track the energy of an oscillator source generating a sinusoidal signal. In this paper we introduce the multidimensional extension (Phi) (f) equals (parallel)DELf(parallel)2 - fDEL2f of the 1-D energy operator and briefly outline some of its applications to image processing. We discuss some interesting properties of the multidimensional operator and develop demodulation algorithms to estimate the amplitude envelope and instantaneous frequencies of 2-D spatially-varying AM-FM signals, which can model image texture. The attractive features of the multidimensional operator and the related amplitude/frequency demodulation algorithms are their simplicity, efficiency, and ability to track instantaneously- varying spatial modulation patterns.

  4. Home-based telecommuting and quality of life: further evidence on an employee-oriented human resource practice.

    PubMed

    Hornung, Severin; Glaser, Jürgen

    2009-04-01

    Building on previous research, further evidence for the potential of home-based telecommuting as an employee-oriented human resource practice is provided from a study in the German public administration. Survey data from 1,008 public employees were analyzed using structural equation modeling. Mean age of the sample was 43.6 yr. (SD = 8.8 yr.), and 27.5% (277) of the participants were women. Analysis supported the roles of higher Autonomy and lower Work-Family Conflict as psychological mediators between Telecommunication Intensity and both Job Satisfaction and Quality of Life. Implications for the design of flexible working arrangements are discussed.

  5. Feasibility and effect of home-based therapy programmes for children with cerebral palsy: a protocol for a systematic review

    PubMed Central

    Beckers, L W M E; Schnackers, M L A P; Janssen-Potten, Y J; Kleijnen, J; Steenbergen, B

    2017-01-01

    Introduction Given the promising advantages of upper extremity home-based programmes in children with cerebral palsy (CP), a systematic review of the available literature on this topic is warranted. The purpose of the systematic review described in this protocol is to investigate currently available home-based occupational therapy and physiotherapy programmes regarding both their feasibility and effect. Methods and analysis This protocol describes a systematic review, developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015. Studies will be included in which primary data are collected, participants are children aged <18 years with any type of CP and the intervention of interest is a home-based occupational therapy or physiotherapy intervention. Comparators of interest are: no therapy, care as usual, centre-based occupational therapy or physiotherapy, an alternative home-based programme and a medical intervention. Studies will be included that report either on feasibility (ie, acceptability, demand, implementation, practicality, adaptation, expansion or integration) or on efficacy/effectiveness (ie, child-related upper extremity outcomes within all International Classification of Functioning, Disability and Health levels or parent-related/caregiver-related outcomes on the psychological and social domain). Relevant studies will be identified by searching the databases MEDLINE, EMBASE, CINAHL, PsycINFO, PEDro, OTSeeker and CPCI-S as well as the trial registers ICTRP and CENTRAL, the reference lists of included records and by circulating a bibliography of the included records to authors of included studies. There will be no restrictions on language or year of publication. The search strategy consists of terms related to the population and intervention. Data will be extracted in duplicate using a digital data extraction form. Ethics and dissemination The proposed study does not involve collection of

  6. Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education

    PubMed Central

    2013-01-01

    Background Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient’s TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Methods Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO’s standard for information security risk management. Results A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Conclusions Most of the identified threats are applicable for healthcare services intended for patients or

  7. A comparison of published multidimensional indices to predict outcome in idiopathic pulmonary fibrosis

    PubMed Central

    Sharp, Charles; Adamali, Huzaifa I.

    2017-01-01

    Idiopathic pulmonary fibrosis (IPF) has an unpredictable course and prognostic factors are incompletely understood. We aimed to identify prognostic factors, including multidimensional indices from a significant IPF cohort at the Bristol Interstitial Lung Disease Centre in the UK. Patients diagnosed with IPF between 2007 and 2014 were identified. Longitudinal pulmonary physiology and exercise testing results were collated, with all-cause mortality used as the primary outcome. Factors influencing overall, 12- and 24-month survival were identified using Cox proportional hazards modelling and receiver operating characteristic curve analysis. We found in this real-world cohort of 167 patients, diffusing capacity for carbon monoxide (DLCO) and initiation of long-term oxygen were independent markers of poor prognosis. Exercise testing results predicted 12-month mortality as well as DLCO, but did not perform as well for overall survival. The Composite Physiological Index was the best performing multidimensional index, but did not outperform DLCO. Our data confirmed that patients who experienced a fall in forced vital capacity (FVC) >10% had significantly worse survival after that point (p=0.024). Our data from longitudinal follow-up in IPF show that DLCO is the best individual prognostic marker, outperforming FVC. Exercise testing is important in predicting early poor outcome. Regular and complete review should be conducted to ensure appropriate care is delivered in a timely fashion. PMID:28326312

  8. Compulsive Exercise

    MedlinePlus

    ... diets, and for some, this may develop into eating disorders such as anorexia and bulimia. And some people ... exercise, especially when it is combined with an eating disorder, can cause serious and permanent health problems, and ...

  9. Preface: Special Topic on Multidimensional Spectroscopy

    NASA Astrophysics Data System (ADS)

    Mukamel, Shaul; Bakker, Huib J.

    2015-06-01

    Multidimensional signals are generated by subjecting molecules to sequences of short optical pulses and recording correlation plots related to the various controlled delay periods. These techniques which span all the way from the THz to the x-ray regimes provide qualitatively new structural and dynamical molecular information not available from conventional one-dimensional techniques. This issue surveys the recent experimental and theoretical progresses in this rapidly developing 20 year old field which illustrates the novel insights provided by multidimensional techniques into electronic and nuclear motions. It should serve as a valuable source for experts in the field and help introduce newcomers to this exciting and challenging branch of nonlinear spectroscopy.

  10. "We Smoke the Same Pipe": Religion and Community Home-Based Care for PLWH in Rural Swaziland.

    PubMed

    Root, Robin; Van Wyngaard, Arnau; Whiteside, Alan

    2017-04-01

    We draw on a study of a church-run community home-based care organization in Swaziland to explore how individuals living with HIV perceived caregivers' impact on well-being. Our primary concern was to examine how religion, as a heuristic practice of Christian-based caregiving, was felt to be consequential in a direly underserved region. Part of a larger medical anthropological project, we conducted semi-structured interviews with 79 community home-based care clients, of whom half (53%) said they would have died, some from suicide, without its services. We utilized a critical phenomenological approach to interpret semantic and latent themes, and explicated these themes within a 'healthworld' framework. Participants were resolute that caregivers be Christian, less for ideological positioning than for perceived ontological sameness and ascribed traits: "telling the truth" about treatment, confidentiality, and an ethos of unconditional love that restored clients' desire to live and adhere to treatment. Findings are intended to help theorize phenomenological meanings of care, morality, health, and sickness, and to interrogate authoritative biomedically based rationalities that underwrite most HIV-related global health policy.

  11. Home-based vs. laboratory-based practical activities in the learning of human physiology: the perception of students.

    PubMed

    Neves, Ben-Hur S; Altermann, Caroline; Gonçalves, Rithiele; Lara, Marcus Vinícius; Mello-Carpes, Pâmela B

    2017-03-01

    Different tools have been used to facilitate the teaching and learning process in different areas of knowledge. Practical activities represent a form of teaching in which students not only listen to theoretical concepts but are also able to link theory and practice, and their importance in the biological sciences is notable. Sometimes, however, there is neither the time nor the resources to promote laboratory practices in physiology classes. In this sense, home-based practical activities may be an interesting alternative. Here, different approaches of practical activities were used and students' perceptions of the contributions of home-based practical activities (HBPA) and laboratory-based practical activities (LBPA) for physiology learning were collected. After each approach, the students evaluated the activities through an anonymous questionnaire. A total of 49 students completed the questionnaires, and the results demonstrate that both HBPA and LBPA were considered important contributors to physiology learning but that this contribution was more significant in the case of LBPA (χ(2) = 4.356, P = 0.037).

  12. Office versus Home-Based Family Therapy for Runaway, Alcohol Abusing Adolescents: Examination of Factors Associated with Treatment Attendance

    PubMed Central

    Slesnick, Natasha; Prestopnik, Jillian L.

    2008-01-01

    There is a dearth of research examining treatment engagement and attendance among runaway youth and their families. Such research is needed in order to inform treatment providers on factors associated with engagement and maintenance of these difficult to engage families into counseling. This study examined differential treatment attendance for alcohol abusing runaway youth residing at a local shelter. A traditional office-based family systems approach, Functional Family Therapy (FFT), was compared to a non-traditional, home-based, multi-systemic family therapy approach, Ecologically Based Family Therapy (EBFT). As expected, treatment engagement and attendance was significantly higher for those assigned to EBFT (N = 37) compared to FFT (N = 40). Predictors of treatment attendance (income, family chaos, externalization problems and level of youth substance use) were examined within each treatment modality. Findings suggest that home-based (compared to office-based) treatment modalities may significantly increase treatment attendance and engagement of runaway youth and their families. Non-traditional forms of treatment may need to be considered in order to best meet the needs of highly chaotic and disorganized family systems. PMID:18607515

  13. A multidimensional approach to measure poverty in rural Bangladesh.

    PubMed

    Bhuiya, Abbas; Mahmood, Shehrin Shaila; Rana, A K M Masud; Wahed, Tania; Ahmed, Syed Masud; Chowdhury, A Mushtaque R

    2007-06-01

    Poverty is increasingly being understood as a multidimensional phenomenon. Other than income-consumption, which has been extensively studied in the past, health, education, shelter, and social involvement are among the most important dimensions of poverty. The present study attempts to develop a simple tool to measure poverty in its multidimensionality where it views poverty as an inadequate fulfillment of basic needs, such as food, clothing, shelter, health, education, and social involvement. The scale score ranges between 72 and 24 and is constructed in such a way that the score increases with increasing level of poverty. Using various techniques, the study evaluates the poverty-measurement tool and provides evidence for its reliability and validity by administering it in various areas of rural Bangladesh. The reliability coefficients, such as test-retest coefficient (0.85) and Cronbach's alpha (0.80) of the tool, were satisfactorily high. Based on the socioeconomic status defined by the participatory rural appraisal (PRA) exercise, the level of poverty identified by the scale was 33% in Chakaria, 26% in Matlab, and 32% in other rural areas of the country. The validity of these results was tested against some traditional methods of identifying the poor, and the association of the scores with that of the traditional indicators, such as ownership of land and occupation, asset index (r=0.72), and the wealth ranking obtained from the PRA exercise, was consistent. A statistically significant inverse relationship of the poverty scores with the socioeconomic status was observed in all cases. The scale also allowed the absolute level of poverty to be measured, and in the present study, the highest percentage of absolute poor was found in terms of health (44.2% in Chakaria, 36.4% in Matlab, and 39.1% in other rural areas), followed by social exclusion (35.7% in Chakaria, 28.5% in Matlab, and 22.3% in other rural areas), clothing (6.2% in Chakaria, 8.3% in Matlab, and 20

  14. Utilisation of home-based physician, nurse and personal support worker services within a palliative care programme in Ontario, Canada: trends over 2005-2015.

    PubMed

    Sun, Zhuolu; Laporte, Audrey; Guerriere, Denise N; Coyte, Peter C

    2016-12-26

    With health system restructuring in Canada and a general preference by care recipients and their families to receive palliative care at home, attention to home-based palliative care continues to increase. A multidisciplinary team of health professionals is the most common delivery model for home-based palliative care in Canada. However, little is known about the changing temporal trends in the propensity and intensity of home-based palliative care. The purpose of this study was to assess the propensity to use home-based palliative care services, and once used, the intensity of that use for three main service categories: physician visits, nurse visits and care by personal support workers (PSWs) over the last decade. Three prospective cohort data sets were used to track changes in service use over the period 2005 to 2015. Service use for each category was assessed using a two-part model, and a Heckit regression was performed to assess the presence of selectivity bias. Service propensity was modelled using multivariate logistic regression analysis and service intensity was modelled using log-transformed ordinary least squares regression analysis. Both the propensity and intensity to use home-based physician visits and PSWs increased over the last decade, while service propensity and the intensity of nurse visits decreased. Meanwhile, there was a general tendency for service propensity and intensity to increase as the end of life approached. These findings demonstrate temporal changes towards increased use of home-based palliative care, and a shift to substitute care away from nursing to less expensive forms of care, specifically PSWs. These findings may provide a general idea of the types of services that are used more intensely and require more resources from multidisciplinary teams, as increased use of home-based palliative care has placed dramatic pressures on the budgets of local home and community care organisations.

  15. Confirmatory Factor Analysis and Profile Analysis via Multidimensional Scaling

    ERIC Educational Resources Information Center

    Kim, Se-Kang; Davison, Mark L.; Frisby, Craig L.

    2007-01-01

    This paper describes the Confirmatory Factor Analysis (CFA) parameterization of the Profile Analysis via Multidimensional Scaling (PAMS) model to demonstrate validation of profile pattern hypotheses derived from multidimensional scaling (MDS). Profile Analysis via Multidimensional Scaling (PAMS) is an exploratory method for identifying major…

  16. The Efficacy of Multidimensional Constraint Keys in Database Query Performance

    ERIC Educational Resources Information Center

    Cardwell, Leslie K.

    2012-01-01

    This work is intended to introduce a database design method to resolve the two-dimensional complexities inherent in the relational data model and its resulting performance challenges through abstract multidimensional constructs. A multidimensional constraint is derived and utilized to implement an indexed Multidimensional Key (MK) to abstract a…

  17. A combined multidimensional scaling and hierarchical clustering view for the exploratory analysis of multidimensional data

    NASA Astrophysics Data System (ADS)

    Craig, Paul; Roa-Seïler, Néna

    2013-01-01

    This paper describes a novel information visualization technique that combines multidimensional scaling and hierarchical clustering to support the exploratory analysis of multidimensional data. The technique displays the results of multidimensional scaling using a scatter plot where the proximity of any two items' representations is approximate to their similarity according to a Euclidean distance metric. The results of hierarchical clustering are overlaid onto this view by drawing smoothed outlines around each nested cluster. The difference in similarity between successive cluster combinations is used to colour code clusters and make stronger natural clusters more prominent in the display. When a cluster or group of items is selected, multidimensional scaling and hierarchical clustering are re-applied to a filtered subset of the data, and animation is used to smooth the transition between successive filtered views. As a case study we demonstrate the technique being used to analyse survey data relating to the appropriateness of different phrases to different emotionally charged situations.

  18. Multidimensional Perspectives on Principal Leadership Effectiveness

    ERIC Educational Resources Information Center

    Beycioglu, Kadir, Ed.; Pashiardis, Petros, Ed.

    2015-01-01

    Exceptional management skills are crucial to success in educational environments. As school leaders, principals are expected to effectively supervise the school system while facing a multitude of issues and demands. "Multidimensional Perspectives on Principal Leadership Effectiveness" combines best practices and the latest approaches in…

  19. A New Heterogeneous Multidimensional Unfolding Procedure

    ERIC Educational Resources Information Center

    Park, Joonwook; Rajagopal, Priyali; DeSarbo, Wayne S.

    2012-01-01

    A variety of joint space multidimensional scaling (MDS) methods have been utilized for the spatial analysis of two- or three-way dominance data involving subjects' preferences, choices, considerations, intentions, etc. so as to provide a parsimonious spatial depiction of the underlying relevant dimensions, attributes, stimuli, and/or subjects'…

  20. Multidimensional neural growing networks and computer intelligence

    SciTech Connect

    Yashchenko, V.A.

    1995-03-01

    This paper examines information-computation processes in time and in space and some aspects of computer intelligence using multidimensional matrix neural growing networks. In particular, issues of object-oriented {open_quotes}thinking{close_quotes} of computers are considered.

  1. Multidimensional Treatment of Fear of Death.

    ERIC Educational Resources Information Center

    Hoelter, Jon W.

    1979-01-01

    Presents a multidimensional conception of fear of death and provides subscales for measuring suggested dimensions (fear of the dying process, of the dead, of being destroyed, for significant others, of the unknown, of conscious death, for body after death, and of premature death). Evidence for construct validity is provided. (Author/BEF)

  2. Multidimensional IRT Models for Composite Scores

    ERIC Educational Resources Information Center

    Yen, Shu Jing; Walker, Leah

    2007-01-01

    Tests of English Language Proficiency are often designed such that each section of the test measures a single latent ability. For instance an English Proficiency Assessment might consist of sections measuring Speaking, Listening, and Reading ability. However, Overall English Proficiency and composite abilities are naturally multidimensional. This…

  3. Multidimensional Screening as a Pharmacology Laboratory Experience.

    ERIC Educational Resources Information Center

    Malone, Marvin H.; And Others

    1979-01-01

    A multidimensional pharmacodynamic screening experiment that addresses drug interaction is included in the pharmacology-toxicology laboratory experience of pharmacy students at the University of the Pacific. The student handout with directions for the procedure is reproduced, drug compounds tested are listed, and laboratory evaluation results are…

  4. DICON: interactive visual analysis of multidimensional clusters.

    PubMed

    Cao, Nan; Gotz, David; Sun, Jimeng; Qu, Huamin

    2011-12-01

    Clustering as a fundamental data analysis technique has been widely used in many analytic applications. However, it is often difficult for users to understand and evaluate multidimensional clustering results, especially the quality of clusters and their semantics. For large and complex data, high-level statistical information about the clusters is often needed for users to evaluate cluster quality while a detailed display of multidimensional attributes of the data is necessary to understand the meaning of clusters. In this paper, we introduce DICON, an icon-based cluster visualization that embeds statistical information into a multi-attribute display to facilitate cluster interpretation, evaluation, and comparison. We design a treemap-like icon to represent a multidimensional cluster, and the quality of the cluster can be conveniently evaluated with the embedded statistical information. We further develop a novel layout algorithm which can generate similar icons for similar clusters, making comparisons of clusters easier. User interaction and clutter reduction are integrated into the system to help users more effectively analyze and refine clustering results for large datasets. We demonstrate the power of DICON through a user study and a case study in the healthcare domain. Our evaluation shows the benefits of the technique, especially in support of complex multidimensional cluster analysis.

  5. Career Success: Constructing a Multidimensional Model

    ERIC Educational Resources Information Center

    Dries, Nicky; Pepermans, Roland; Carlier, Olivier

    2008-01-01

    A multidimensional model of career success was developed aiming to be more inclusive than existing models. In a first study, 22 managers were asked to tell the story of their careers. At the end of each interview, idiosyncratic career success "construct ladders" were constructed for each interviewee through an interactive process with the…

  6. White Dialectics as Multidimensional, Contextual, and Transformational

    ERIC Educational Resources Information Center

    Abrams, Elizabeth M.; Todd, Nathan R.

    2011-01-01

    This rejoinder provides a response to reactions by Ponterotto, Sue, and Toporek to the White dialectics framework presented in Todd and Abrams's article. The present response focuses on incorporating multidimensionality, the multilevel nature of context, and the potential for transformation in the White dialectics framework. The authors expand…

  7. A Multidimensional Construct of Self-Esteem

    ERIC Educational Resources Information Center

    Norem-Hebeisen, Ardyth A.

    1976-01-01

    Evidence for construct validity of this multi-dimensional concept of self esteem includes the relative congruence of the factor structure with the theoretical construct, the stability of the structure when subjected to a series of empirical tests, increasingly positive self-referent responses with increasing age, willingness to become more…

  8. Uncertainty of Comparative Judgments and Multidimensional Structure

    ERIC Educational Resources Information Center

    Sjoberg, Lennart

    1975-01-01

    An analysis of preferences with respect to silhouette drawings of nude females is presented. Systematic intransitivities were discovered. The dispersions of differences (comparatal dispersons) were shown to reflect the multidimensional structure of the stimuli, a finding expected on the basis of prior work. (Author)

  9. Multidimensional Tauberian theorems for generalized functions

    NASA Astrophysics Data System (ADS)

    Drozhzhinov, Yu N.

    2016-12-01

    This is a brief survey of multidimensional Tauberian theorems for generalized functions. Included are theorems of Hardy-Littlewood type, Tauberian and Abelian comparison theorems of Keldysh type, theorems of Wiener type, and Tauberian theorems for generalized functions with values in Banach spaces. Bibliography: 58 titles.

  10. Multidimensional Human Dynamics in Mobile Phone Communications

    PubMed Central

    Quadri, Christian; Zignani, Matteo; Capra, Lorenzo; Gaito, Sabrina; Rossi, Gian Paolo

    2014-01-01

    In today's technology-assisted society, social interactions may be expressed through a variety of techno-communication channels, including online social networks, email and mobile phones (calls, text messages). Consequently, a clear grasp of human behavior through the diverse communication media is considered a key factor in understanding the formation of the today's information society. So far, all previous research on user communication behavior has focused on a sole communication activity. In this paper we move forward another step on this research path by performing a multidimensional study of human sociality as an expression of the use of mobile phones. The paper focuses on user temporal communication behavior in the interplay between the two complementary communication media, text messages and phone calls, that represent the bi-dimensional scenario of analysis. Our study provides a theoretical framework for analyzing multidimensional bursts as the most general burst category, that includes one-dimensional bursts as the simplest case, and offers empirical evidence of their nature by following the combined phone call/text message communication patterns of approximately one million people over three-month period. This quantitative approach enables the design of a generative model rooted in the three most significant features of the multidimensional burst - the number of dimensions, prevalence and interleaving degree - able to reproduce the main media usage attitude. The other findings of the paper include a novel multidimensional burst detection algorithm and an insight analysis of the human media selection process. PMID:25068479

  11. Multidimensional stochastic approximation using locally contractive functions

    NASA Technical Reports Server (NTRS)

    Lawton, W. M.

    1975-01-01

    A Robbins-Monro type multidimensional stochastic approximation algorithm which converges in mean square and with probability one to the fixed point of a locally contractive regression function is developed. The algorithm is applied to obtain maximum likelihood estimates of the parameters for a mixture of multivariate normal distributions.

  12. Implications of Changes in Households and Living Arrangements for Future Home-based Care Needs and Costs of Disabled Elders in China1

    PubMed Central

    Zeng, Yi; Chen, Huashuai; Wang, Zhenglian; Land, Kenneth C.

    2016-01-01

    Objectives Understand future home-based care needs/costs for disabled elders in China. Method Further develop/apply ProFamy extended cohort-component method. Results (1) Chinese disabled elders and percentage of national GDP devoted to home-based care costs for disabled elders will increase much quicker than growth of total elderly population; (2) Home-based care needs/costs for disabled oldest-old aged 80+ will increase much faster than that for disabled young-old aged 65–79 after 2030; (3) Disabled unmarried elders living alone and their home-based care costs increase substantially faster than disabled unmarried elders living with children; (4) Sensitivity analyses shown that possible changes in mortality and elderly disability status are the major factors affecting home-based care needs and costs; (5) Caregivers resources under two-child policy will be substantially better than under current fertility policy unchanged. Discussion Policy recommendations concerning reductions of prevalence of disability, gender equality, two-child policy, encouraging elder’s residential proximity to their adult children, etc. PMID:25213460

  13. Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression.

    PubMed

    Luxton, David D; Pruitt, Larry D; O'Brien, Karen; Stanfill, Katherine; Jenkins-Guarnieri, Michael A; Johnson, Kristine; Wagner, Amy; Thomas, Elissa; Gahm, Gregory A

    2014-05-01

    Home-based telemental health (TMH) treatments have the potential to address current and future health needs of military service members, veterans, and their families, especially for those who live in rural or underserved areas. The use of home-based TMH treatments to address the behavioral health care needs of U.S. military healthcare beneficiaries is not presently considered standard of care in the Military Health System. The feasibility, safety, and clinical efficacy of home-based TMH treatments must be established before broad dissemination of home-based treatment programs can be implemented. This paper describes the design, methodology, and protocol of a clinical trial that compares in-office to home-based Behavioral Activation for Depression (BATD) treatment delivered via web-based video technology for service members and veterans with depression. This grant funded three-year randomized clinical trial is being conducted at the National Center for Telehealth and Technology at Joint-base Lewis-McChord and at the Portland VA Medical Center. Best practice recommendations regarding the implementation of in-home telehealth in the military setting as well as the cultural and contextual factors of providing in-home care to active duty and veteran military populations are also discussed.

  14. Physical Activity (Exercise)

    MedlinePlus

    ... Physical activity (exercise) fact sheet ePublications Physical activity (exercise) fact sheet How can physical activity improve my ... recent hip surgery More information on physical activity (exercise) For more information about physical activity (exercise), call ...

  15. Why Exercise Is Wise

    MedlinePlus

    ... Surgery? A Week of Healthy Breakfasts Shyness Why Exercise Is Wise KidsHealth > For Teens > Why Exercise Is ... exercise, strength training, and flexibility training. continue Aerobic Exercise Like other muscles, the heart enjoys a good ...

  16. Kids and Exercise

    MedlinePlus

    ... Your 1- to 2-Year-Old Kids and Exercise KidsHealth > For Parents > Kids and Exercise A A ... or when playing tag. The Many Benefits of Exercise Everyone can benefit from regular exercise. Kids who ...

  17. Exercise-Induced Urticaria

    MedlinePlus

    ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation ...

  18. Rotator Cuff Exercises

    MedlinePlus

    ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation ... Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation ...

  19. Exercise at Home

    MedlinePlus

    ... Training Home Health Insights Exercise Exercise at Home Exercise at Home Ask a Question Find a Doctor ... with the movement and contact your provider. Posture Exercises Better posture means better breathing and movement. Axial ...

  20. Exercise-Induced Bronchoconstriction

    MedlinePlus

    ... Conditions & Treatments ▸ Conditions Dictionary ▸ Exercise-Induced Bronchoconstriction Share | Exercise-Induced Bronchoconstriction (EIB) « Back to A to Z Listing Exercise-Induced Bronchoconstriction, (EIB), often known as exercise-induced ...

  1. Diabetes and exercise

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000083.htm Diabetes and exercise To use the sharing features on this page, ... not exercising at all. Your Blood Sugar and Exercise Check your blood sugar before you exercise. Also, ...

  2. Exercise-induced asthma

    MedlinePlus

    Wheezing - exercise-induced; Reactive airway disease - exercise ... Having asthma symptoms when you exercise does not mean you cannot or should not exercise. But be aware of your EIA triggers. Cold or dry air may ...

  3. The seven Cs of the high acceptability of home-based VCT: results from a mixed methods approach in Zambia.

    PubMed

    Jürgensen, Marte; Sandøy, Ingvild F; Michelo, Charles; Fylkesnes, Knut; Mwangala, Sheila; Blystad, Astrid

    2013-11-01

    HIV testing and counselling is a critical gateway to prevention and treatment. Yet, coverage remains insufficient, few couples are tested together and gender differences in access exist. We used an embedded mixed methods approach to investigate possible explanations for the high acceptance of home-based voluntary HIV counselling and testing (HB-VCT) in a pair-matched cluster-randomized trial in Zambia. A baseline survey included 1694 individuals in 36 clusters. Adults in 18 intervention clusters were offered HB-VCT by lay counsellors. Standard testing services were available in both trial arms. After the completion of the intervention, a follow-up survey was conducted in all trial clusters. In addition, 21 in-depth interviews and one focus group discussion were conducted with home-based VCT clients in the intervention arm. Informants favoured the convenience, confidentiality and credibility of HB-VCT. Counsellors were perceived as trustworthy owing to their closeness and conduct, and the consent process was experienced as convincing. Couple testing was selected by 70% of cohabiting couples and was experienced as beneficial by both genders. Levels of first-time testing (68% vs. 29%, p < 0.0001) and re-testing (94% vs. 74%, p < 0.0001) were higher in the intervention than in the control arm. Acceptance of HIV testing and counselling is dependent on stigma, trust and gender. The confidentiality of home-based VCT was essential for overcoming stigma-related barriers, and the selection of local counsellors was important to ensure trust in the services. The high level of couple counselling within HB-VCT may contribute to closing the gender gap in HIV testing, and has benefits for both genders and potentially for prevention of HIV transmission. The study demonstrates the feasibility of achieving high test coverage with an opt-in consent approach. The embedded qualitative component confirmed the high satisfaction with HB-VCT reported in the quantitative survey and was

  4. Home-Based Intervention Program to Reduce Food Insecurity in Elderly Populations Using a TV App: Study Protocol of the Randomized Controlled Trial Saúde.Come Senior

    PubMed Central

    Gregório, Maria João; Gein, Pierre; Eusébio, Mónica; Santos, Maria José; de Sousa, Rute Dinis; Coelho, Pedro S; Mendes, Jorge M; Graça, Pedro; Oliveira, Pedro; Branco, Jaime C; Canhão, Helena

    2017-01-01

    recruit a total of 1,128 subjects considering that 50% of the target individuals are food insecure (based on INFOFAMÍLIA Survey) (567) and about 50% of those will adhere to the study (282). Results The randomized controlled trial with the 12-week home-based intervention with a comprehensive program on healthy eating and physical activity delivery is planned to start recruiting participants at the end of 2017. Conclusions This study will assess the efficacy of this innovative tool (Saúde.Come Senior) for disseminating relevant health information, modifying behaviors, and decreasing food insecurity in an easy, low-cost, and massive way. PMID:28288956

  5. Enhancing provider knowledge and patient screening for palliative care needs in chronic multimorbid patients receiving home-based primary care.

    PubMed

    Wharton, Tracy; Manu, Erika; Vitale, Caroline A

    2015-02-01

    This article describes a pilot model to increase palliative care (PC) knowledge and collaboration among providers and to systematically identify chronic multimorbid home care patients who would benefit from focused discussion of potential PC needs. Thirty health care providers from a home-based primary care team attended interdisciplinary trainings. The Palliative Performance Scale (PPS) tool was used to trigger discussions of potential palliative needs at team rounds for patients who scored below a cutoff point on the tool. Palliative Performance Scale implementation added little burden on nurses and triggered a discussion in 51 flagged patients. The tool successfully identified 75% of patients who died or were discharged. Screening was systematic and consistent and resulted in targeted discussions about PC needs without generating additional burden on our PC consult service. This model shows promise for enhancing collaborative patient care and access to PC.

  6. An international randomized study of a home-based self-management program for severe COPD: the COMET

    PubMed Central

    Bourbeau, Jean; Casan, Pere; Tognella, Silvia; Haidl, Peter; Texereau, Joëlle B; Kessler, Romain

    2016-01-01

    Introduction Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET) is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions. Design Multicenter parallel randomized controlled, open-label superiority trial. Setting Thirty-three hospitals in four European countries. Participants A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD. Intervention The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease), an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center’s routine practice. Main outcome measures Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs. PMID:27418817

  7. Assessing Health Status Differences Between Veterans Affairs Home-Based Primary Care and State Medicaid Waiver Program Clients

    PubMed Central

    Wharton, Tracy C.; Nnodim, Joseph; Hogikyan, Robert; Mody, Lona; James, Mary; Montagnini, Marcos; Fries, Brant E.

    2013-01-01

    Objectives Comprehensive health care for older adults is complex, involving multiple comorbidities and functional impairments of varying degrees and numbers. In response to this complexity and associated barriers to care, home-based care models have become prevalent. The home-based primary care (HBPC) model, based at a Michigan Department of Veterans Affairs Medical Center, and the Michigan Waiver Program (MWP) that includes home-based care are 2 of these. Although both models are formatted to address barriers to effective and efficient health care, there are differences in disease prevalence and functional performance between groups. The objective of this study was to explore the differences between the 2 groups, to shed some light on potential trends that could suggest areas for resource allocation by service providers. Design Using a retrospective analysis of data collected using the interRAI-home care, we examined a cross-sectional representation of clients enrolled in HBPC and MWP in 2008. Participants The HBPC sample had 89 participants. The MWP database contained 9324 participants from across the State of Michigan and were weighted to be comparable to the HBPC population in sex and age, and to simulate the HBPC sample size. Results Veterans were more independent in basic activities of daily living performance, but there was no difference in the rate of reported falls between the 2 groups. Veterans had more pain and a higher prevalence of coronary artery disease (z = 7.0; P <.001), Chronic obstructive pulmonary disease (z = 3.9; P < .001), and cancer (z = 8.5; P < .001). There was no statistically significant difference between the 2 groups in terms of the prevalence of geriatric syndromes. Scores on subscales of the interRAI-home care indicated a lower risk of serious health decline and adverse outcomes for MWP compared with HBPC clients (1.4 ± 1.1 vs 0.9 ± 0.1; z = 2.5; P = .012). Veterans receiving home-based care through the Veterans Affairs Medical

  8. The team approach to home-based primary care: restructuring care to meet individual, program, and system needs.

    PubMed

    Reckrey, Jennifer M; Soriano, Theresa A; Hernandez, Cameron R; DeCherrie, Linda V; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2015-02-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address individual, program, and system needs, a portion of a large, physician-led academic home-based primary care practice was restructured into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. The Team Approach is an innovative way to improve interdisciplinary, team-based care through practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound.

  9. Occupational Safety, Health, and Well-being Among Home-based Workers in the Informal Economy of Thailand.

    PubMed

    Nankongnab, Noppanun; Silpasuwan, Pimpan; Markkanen, Pia; Kongtip, Pornpimol; Woskie, Susan

    2015-08-01

    The objective of this article is to provide a summary of the issues related to occupational safety and health and well-being among workers in the informal economy of Thailand, with a special emphasis on home-based workers. The reviewed literature includes documents and information sources developed by the International Labour Organization, the National Statistical Office of Thailand, peer-reviewed scientific publications, and master's theses conducted in Thailand. This work is part of a needs and opportunities analysis carried out by the Center for Work, Environment, Nutrition and Development--a partnership between Mahidol University and University of Massachusetts Lowell to identify the gaps in knowledge and research to support government policy development in the area of occupational and environmental health for workers in the informal economy.

  10. The Team Approach to Home-Based Primary Care: Restructuring Care to Meet Patient, Program, and System Needs

    PubMed Central

    Reckrey, Jennifer M.; Soriano, Theresa A.; Hernandez, Cameron R.; DeCherrie, Linda V.; Chavez, Silvia; Zhang, Meng; Ornstein, Katherine

    2016-01-01

    Team-based models of care are an important way to meet the complex medical and psychosocial needs of the homebound. As part of a quality improvement project to address patient, program, and system needs, we restructured a portion of our large, physician-led academic home-based primary care practice into a team-based model. With support from an office-based nurse practitioner, a dedicated social worker, and a dedicated administrative assistant, physicians were able to care for a larger number of patients. Hospitalizations, readmissions, and patient satisfaction remained the same while physician panel size increased and physician satisfaction improved. Our Team Approach is an innovative way to improve interdisciplinary, team-based care though practice restructuring and serves as an example of how other practices can approach the complex task of caring for the homebound. PMID:25645568

  11. ERMHAN: A Context-Aware Service Platform to Support Continuous Care Networks for Home-Based Assistance.

    PubMed

    Paganelli, Federica; Spinicci, Emilio; Giuli, Dino

    2008-01-01

    Continuous care models for chronic diseases pose several technology-oriented challenges for home-based continuous care, where assistance services rely on a close collaboration among different stakeholders such as health operators, patient relatives, and social community members. Here we describe Emilia Romagna Mobile Health Assistance Network (ERMHAN) a multichannel context-aware service platform designed to support care networks in cooperating and sharing information with the goal of improving patient quality of life. In order to meet extensibility and flexibility requirements, this platform has been developed through ontology-based context-aware computing and a service oriented approach. We also provide some preliminary results of performance analysis and user survey activity.

  12. Illness experiences of persons with chronic obstructive pulmonary disease: self-perceived efficacy of home-based pulmonary rehabilitation.

    PubMed

    Pinto, Juliana Maria de Sousa; Martín-Nogueras, Ana; Nations, Marilyn

    2014-06-01

    This qualitative study explores the illness experiences, the efficacy of pulmonary rehabilitation as perceived by patients with chronic obstructive pulmonary disease (COPD) and their rationale for improvements in health. 23 patients participated in a daily, three-month home-based pulmonary rehabilitation. A pre-post self-perceived assessment of efficacy was conducted. Semi-structured interviews, illness narratives and participant-observation provided a "dense description" of patients' lived-experience before and after the program. Interviews and narratives were tape-recorded, transcribed and coded. Qualitative data was subjected to "thematic content analysis" and "contextualized semantic interpretation". Patients compare functional status before and after falling ill, experience loss, stigma and depression, describe health improvements and judge the pulmonary rehabilitation's efficacy. Giving voice to chronically-ill patients, as individuals, is needed. To reduce clinical conflicts, health professionals should encourage illness narratives and value their patients' lived-experience.

  13. Exercise apparatus

    NASA Technical Reports Server (NTRS)

    Schaffner, Grant (Inventor); Bentley, Jason R. (Inventor); Loehr, James A. (Inventor); Gundo, Daniel P. (Inventor)

    2006-01-01

    An apparatus and method for exercising whereby the user is supported by various mechanisms in such as way that the user's shoulder area is free to translate and rotate; the user's pelvic area is free to translate and rotate; or in any combination.

  14. Exercise and sleep in community-dwelling older adults: evidence for a reciprocal relationship.

    PubMed

    Dzierzewski, Joseph M; Buman, Matthew P; Giacobbi, Peter R; Roberts, Beverly L; Aiken-Morgan, Adrienne T; Marsiske, Michael; McCrae, Christina S

    2014-02-01

    Exercise behaviour and sleep are both important health indicators that demonstrate significant decreases with age, and remain modifiable well into later life. The current investigation examined both the chronic and acute relationships between exercise behaviour and self-reported sleep in older adults through a secondary analysis of a clinical trial of a lifestyle intervention. Seventy-nine community-dwelling, initially sedentary, older adults (mean age = 63.58 years, SD = 8.66 years) completed daily home-based assessments of exercise behaviour and sleep using daily diary methodology. Assessments were collected weekly and continued for 18 consecutive weeks. Multilevel models revealed a small positive chronic (between-person mean-level) association between exercise and wake time after sleep onset, and a small positive acute (within-person, day-to-day) association between exercise and general sleep quality rating. The within-person exercise and general sleep quality rating relationship was found to be reciprocal (i.e. sleep quality also predicted subsequent exercise behaviour). As such, it appears exercise and sleep are dynamically related in older adults. Efforts to intervene on either sleep or exercise in late-life would be wise to take the other into account. Light exposure, temperature regulation and mood may be potential mechanisms of action through which exercise can impact sleep in older adults.

  15. Home-Based Telemanagement in Advanced COPD: Who Uses it Most? Real-Life Study in Lombardy.

    PubMed

    Vitacca, Michele; Fumagalli, Lia Paola; Borghi, Gabriella; Colombo, Fausto; Castelli, Alberto; Scalvini, Simonetta; Masella, Cristina

    2016-08-01

    Current evidence indicates that the benefits of tele-health may not be uniform across all patients. Therefore, to understand what specific variables influence use of home-based telemanagement in COPD, we conducted this retrospective study.  A 6-month home-based telemanagement program (HTP) was offered to 1,074 COPD patients over a 4-year period. Multivarible linear regression analysis was used to identify predictors of HTP use/week (phone calls and specialist consultations) among all variables: clinical (body mass index, co-morbidities, HTP prescription not following an exacerbation, long-term oxygen therapy use, COPD severity, hospital readmissions, exacerbations and death), socio-demographic (sex, age, place of abode), smoking history, arterial blood gases (ABG), and specialist/general practitioner (GP) urgent need. Logistic regression was conducted to predict relapses/hospitalizations risk as well as the disease impact (COPD Assessment Test, CAT) at the end of the program.  Presence of relapses (p < 0.001), ABGs (p < 0.001) and GP request (p < 0.001) were significantly associated with higher HTP-use. Smoking history (OR 1.542 [IC 95% 1.069-2.217], p = 0.020), specialist (OR 2.895 [2.144-3.910], p < 0.001) and GP consultations (OR 6.575 [4.521-9.561], p < 0.001) were the only independent risk factors for relapse. No predictor of hospitalization was found. High final CAT score was inversely related to oxygen therapy use (p = 0.001) and HTP prescription (p < 0.001), and positively related to presence of co-morbidities (p = 0.001) and baseline CAT (p < 0.001).  This HTP in Lombardy shows that relapsers, people requiring several ABGs and urgent GP visits are the patient subgroup most likely to consume telemanagement services (scheduled and unscheduled). We propose a patient 'identikit' to improve prioritization for HTP prescriptions.

  16. An evaluation of the routine use of amoxicillin as part of the home-based treatment of severe acute malnutrition

    PubMed Central

    Trehan, Indi; Amthor, Rachel E.; Maleta, Kenneth; Manary, Mark J.

    2010-01-01

    Objective To determine if the inclusion of amoxicillin correlates with better recovery rates in the home-based treatment of severe acute malnutrition with ready-to-use therapeutic food. Methods This retrospective cohort study compared data from the treatment of two groups of children in Malawi aged 6–59 months with uncomplicated severe acute malnutrition. The standard protocol group received a 7 day course of amoxicillin at the onset of treatment. The alternate protocol group received no antibiotics. All children were treated with the same ready-to-use therapeutic food. The primary outcome was nutritional recovery, defined as achieving a weight-for-height Z-score > −2 without edema. Results 498 children were treated according to the standard protocol with amoxicillin and 1955 were treated under the alternate protocol without antibiotics. The group of children treated with amoxicillin was slightly older and more stunted at baseline. The recovery rate for children who received amoxicillin was worse at 4 weeks (40% vs. 71%) but similar after up to 12 weeks of therapy (84% vs. 86%), compared to the children treated without antibiotics. Regression modeling indicated that this difference at 4 weeks was most strongly associated with the receipt of amoxicillin. Conclusions This review of two therapeutic feeding programs suggests that children with severe acute malnutrition who were treated without amoxicillin did not have an inferior rate of recovery. Given the limitations of this retrospective analysis, a prospective trial is warranted to determine the effect of antibiotics on recovery from uncomplicated malnutrition with home-based therapy. PMID:20545919

  17. Effective Friedmann model from multidimensional cosmologies

    NASA Astrophysics Data System (ADS)

    Zhuk, A.

    2006-10-01

    We investigate the possibility of the construction of the conventional Friedmann cosmology for our observable Universe if the underlying theory is the multidimensional Kaluza-Klein model. We show that the effective Friedmann model obtained by dynamic compactification of the multidimensional model is faced with too strong variations in the fundamental constants. On the other hand, models with stable compactification of the internal space are free from this problem and also result in conventional four-dimensonal cosmological behaviour for our Universe. We prove a no-go theorem, which shows that stable compactification of the internal spaces is possible only if the equations of state in the external and internal spaces are properly adjusted to each other. With a proper choice of parameters (fine tuning), the effective cosmological constant in this model provides the late-time acceleration of the Universe.

  18. Visualization of Multidimensional Data in Nursing Science.

    PubMed

    Docherty, Sharron L; Vorderstrasse, Allison; Brandon, Debra; Johnson, Constance

    2016-10-18

    Nursing scientists have long been interested in complex, context-dependent questions addressing individual- and population-level challenges in health and illness. These critical questions require multilevel data (e.g., genetic, physiologic, biologic, behavioral, affective, and social). Advances in data-gathering methods have resulted in the collection of large sets of complex, multifaceted, and often non-comparable data. Scientific visualization is a powerful methodological tool for facilitating understanding of these multidimensional data sets. Our purpose is to demonstrate the utility of scientific visualization as a method for identifying associations, patterns, and trends in multidimensional data as exemplified in two studies. We describe a brief history of visual analysis, processes involved in scientific visualization, and opportunities and challenges in the use of visualization methods. Scientific visualization can play a crucial role in helping nurse scientists make sense of the structure and underlying patterns in their data to answer vital questions in the field.

  19. Multidimensional X-Space Magnetic Particle Imaging

    PubMed Central

    Conolly, Steven M.

    2012-01-01

    Magnetic particle imaging (MPI) is a promising new medical imaging tracer modality with potential applications in human angiography, cancer imaging, in vivo cell tracking, and inflammation imaging. Here we demonstrate both theoretically and experimentally that multidimensional MPI is a linear shift-in-variant imaging system with an analytic point spread function. We also introduce a fast image reconstruction method that obtains the intrinsic MPI image with high signal-to-noise ratio via a simple gridding operation in x-space. We also demonstrate a method to reconstruct large field-of-view (FOV) images using partial FOV scanning, despite the loss of first harmonic image information due to direct feedthrough contamination. We conclude with the first experimental test of multidimensional x-space MPI. PMID:21402508

  20. Multidimensional x-space magnetic particle imaging.

    PubMed

    Goodwill, Patrick W; Conolly, Steven M

    2011-09-01

    Magnetic particle imaging (MPI) is a promising new medical imaging tracer modality with potential applications in human angiography, cancer imaging, in vivo cell tracking, and inflammation imaging. Here we demonstrate both theoretically and experimentally that multidimensional MPI is a linear shift-invariant imaging system with an analytic point spread function. We also introduce a fast image reconstruction method that obtains the intrinsic MPI image with high signal-to-noise ratio via a simple gridding operation in x-space. We also demonstrate a method to reconstruct large field-of-view (FOV) images using partial FOV scanning, despite the loss of first harmonic image information due to direct feedthrough contamination. We conclude with the first experimental test of multidimensional x-space MPI.

  1. Exercise and relaxation intervention for patients with advanced lung cancer: a qualitative feasibility study.

    PubMed

    Adamsen, L; Stage, M; Laursen, J; Rørth, M; Quist, M

    2012-12-01

    Lung cancer patients experience loss of physical capacity, dyspnea, pain, reduced energy and psychological distress. The aim of this study was to explore feasibility, health benefits and barriers of exercise in former sedentary patients with advanced stage lung cancer, non-small cell lung cancer (NSCLC) (III-IV) and small cell lung cancer (SCLC) (ED), undergoing chemotherapy. The intervention consisted of a hospital-based, supervised, group exercise and relaxation program comprising resistance-, cardiovascular- and relaxation training 4 h weekly, 6 weeks, and a concurrent unsupervised home-based exercise program. An explorative study using individual semi-structured interviews (n=15) and one focus group interview (n=8) was conducted among the participants. Throughout the intervention the patients experienced increased muscle strength, improvement in wellbeing, breathlessness and energy. The group exercise and relaxation intervention showed an adherence rate of 76%, whereas the patients failed to comply with the home-based exercise. The hospital-based intervention initiated at time of diagnosis encouraged former sedentary lung cancer patients to participation and was undertaken safely by cancer patients with advanced stages of disease, during treatment. The patients experienced physical, functional and emotional benefits. This study confirmed that supervised training in peer-groups was beneficial, even in a cancer population with full-blown symptom burden and poor prognosis.

  2. “It is always HIV/AIDS and TB”: Home-based carers’ perspectives on epilepsy in Cape Town, South Africa

    PubMed Central

    Keikelame, Mpoe Johannah; Swartz, Leslie

    2016-01-01

    The study highlights the complex cultural religious factors affecting epilepsy and a need for integrated home-based care services. Two focus group discussions exploring home-based carers’ (HBCs) perspectives on epilepsy were conducted using a semi-structured focus group interview guide, which was based on Kleinman's explanatory model framework. The audio-recorded data were transcribed verbatim, and a thematic analysis was done. The three main themes were epilepsy names and metaphors, religious beliefs about the cause and treatment of epilepsy, and HBCs’ perceived roles and strategies for engaging in epilepsy care. Findings provide some insights for research, policy, and practice. PMID:27258583

  3. Progress in Multi-Dimensional Upwind Differencing

    DTIC Science & Technology

    1992-09-01

    advances in each of these components are discussed; putting them all together is the present focus of a worldwide research effort. Some numerical results ...as 1983 by Phil Roe [1]. A study of discrete multi-dimensional wave models by Roe followed in 1985 (ICASE Report 85-18, also [21), but it took until...consider the numerical results shown in Figure :3 and 4, taken from [:34] and [35], respectively. In Figure 3a the exact and discrete Mach-number

  4. On the Need for Multidimensional Stirling Analysis

    NASA Technical Reports Server (NTRS)

    Dyson, Rodger; Wilson, Scott; Tew, Roy; Demko, Rikako

    2006-01-01

    Contents include the following: Dual opposed convertors. High efficiency. Low mass space power. One-dimensional analysis. Fast computation. Design optimizations are easily done. Need for multidimensional modeling. Axisymmetric simulation. Flow characteristics. Low mach number. Laminar, transitional, and turbulent flow. Conjugate heat transfer. Third order analysis. Recent whole engine modeling. Regenerator geometry. Turbulence modeling. Flat head heater not 1-D. Empirical coefficients needed. Experiment design. Flow distribution. Sensor placement. Calibration. Validation.

  5. Elements Of Theory Of Multidimensional Complex Variables

    NASA Technical Reports Server (NTRS)

    Martin, E. Dale

    1993-01-01

    Two reports describe elements of theory of multidimensional complex variables, with emphasis on three dimensions. First report introduces general theory. Second, presents further developments in theory of analytic functions of single three-dimensional variable and applies theory to representation of ideal flows. Results of preliminary studies suggest analytic functions of new three-dimensional complex variables useful in numerous applications, including representing of three-dimensional flows and potentials.

  6. Multidimensional reaction rate theory with anisotropic diffusion.

    PubMed

    Berezhkovskii, Alexander M; Szabo, Attila; Greives, Nicholas; Zhou, Huan-Xiang

    2014-11-28

    An analytical expression is derived for the rate constant that describes diffusive transitions between two deep wells of a multidimensional potential. The expression, in contrast to the Kramers-Langer formula for the rate constant, is valid even when the diffusion is highly anisotropic. Our approach is based on a variational principle for the reactive flux and uses a trial function for the splitting probability or commitor. The theoretical result is validated by Brownian dynamics simulations.

  7. Trellis coding with multidimensional QAM signal sets

    NASA Technical Reports Server (NTRS)

    Pietrobon, Steven S.; Costello, Daniel J.

    1993-01-01

    Trellis coding using multidimensional QAM signal sets is investigated. Finite-size 2D signal sets are presented that have minimum average energy, are 90-deg rotationally symmetric, and have from 16 to 1024 points. The best trellis codes using the finite 16-QAM signal set with two, four, six, and eight dimensions are found by computer search (the multidimensional signal set is constructed from the 2D signal set). The best moderate complexity trellis codes for infinite lattices with two, four, six, and eight dimensions are also found. The minimum free squared Euclidean distance and number of nearest neighbors for these codes were used as the selection criteria. Many of the multidimensional codes are fully rotationally invariant and give asymptotic coding gains up to 6.0 dB. From the infinite lattice codes, the best codes for transmitting J, J + 1/4, J + 1/3, J + 1/2, J + 2/3, and J + 3/4 bit/sym (J an integer) are presented.

  8. Multidimensional Homophily in Friendship Networks1

    PubMed Central

    Block, Per; Grund, Thomas

    2014-01-01

    Homophily – the tendency for individuals to associate with similar others – is one of the most persistent findings in social network analysis. Its importance is established along the lines of a multitude of sociologically relevant dimensions, e.g. sex, ethnicity and social class. Existing research, however, mostly focuses on one dimension at a time. But people are inherently multidimensional, have many attributes and are members of multiple groups. In this article, we explore such multidimensionality further in the context of network dynamics. Are friendship ties increasingly likely to emerge and persist when individuals have an increasing number of attributes in common? We analyze eleven friendship networks of adolescents, draw on stochastic actor-oriented network models and focus on the interaction of established homophily effects. Our results indicate that main effects for homophily on various dimensions are positive. At the same time, the interaction of these homophily effects is negative. There seems to be a diminishing effect for having more than one attribute in common. We conclude that studies of homophily and friendship formation need to address such multidimensionality further. PMID:25525503

  9. Exercise as an augmentation strategy for treatment of major depression.

    PubMed

    Trivedi, Madhukar H; Greer, Tracy L; Grannemann, Bruce D; Chambliss, Heather O; Jordan, Alexander N

    2006-07-01

    The use of augmentation strategies among patients with major depression is increasing because rates of complete remission with standard antidepressant monotherapy are quite low. Clinical and neurobiological data suggest that exercise may be a good candidate for use as an augmentation treatment for depression. This pilot study examined the use of exercise to augment antidepressant medication in patients with major depression. Seventeen patients with incomplete remission of depressive symptoms began a 12-week exercise program while continuing their antidepressant medication (unchanged in type or dose). Individual exercise prescriptions were calculated based on an exercise dose consistent with currently recommended public health guidelines. The exercise consisted of both supervised and home-based sessions. The 17-item Hamilton Rating Scale for Depression (HRSD17) and the Inventory of Depressive Symptomatology-Self-Report (IDS-SR30) were used to assess symptoms of depression on a weekly basis. Intent-to-treat analyses yielded significant decreases on both the HRSD17 (5.8 points, p < 0.008) and IDS-SR30 (13.9 points, p < 0.002). For patients who completed the study (n = 8), HRSD17 scores decreased by 10.4 points and IDS-SR30 scores decreased by 18.8 points. This study provides preliminary evidence for exercise as an effective augmentation treatment for antidepressant medication. This is a lower-cost augmentation strategy that has numerous health benefits and may further reduce depressive symptoms in partial responders to antidepressant treatment. Practical tips on how practitioners can use exercise to enhance antidepressant treatment are discussed. Longer-term use of exercise is also likely to confer additional health benefits for this population.

  10. Attitudes of Older Adults in a Group-Based Exercise Program Toward a Blended Intervention; A Focus-Group Study

    PubMed Central

    Mehra, Sumit; Dadema, Tessa; Kröse, Ben J. A.; Visser, Bart; Engelbert, Raoul H. H.; Van Den Helder, Jantine; Weijs, Peter J. M.

    2016-01-01

    Ageing is associated with a decline in daily functioning and mobility. A physically active life and physical exercise can minimize the decline of daily functioning and improve the physical-, psychological- and social functioning of older adults. Despite several advantages of group-based exercise programs, older adults participating in such interventions often do not meet the frequency, intensity or duration of exercises needed to gain health benefits. An exercise program that combines the advantages of group-based exercises led by an instructor with tailored home-based exercises can increase the effectiveness. Technology can assist in delivering a personalized program. The aim of the study was to determine the susceptibility of older adults currently participating in a nationwide group-based exercise program to such a blended exercise program. Eight focus-groups were held with adults of 55 years of age or older. Two researchers coded independently the remarks of the 30 participants that were included in the analysis according to the three key concepts of the Self Determination Theory: autonomy, competence, and relatedness. The results show that maintaining self-reliance and keeping in touch with others were the main motives to participate in the weekly group-based exercises. Participants recognized benefits of doing additional home-based exercises, but had concerns regarding guidance, safety, and motivation. Furthermore, some participants strongly rejected the idea to use technology to support them in doing exercises at home, but the majority was open to it. Insights are discussed how these findings can help design novel interventions that can increase the wellbeing of older adults and preserve an independent living. PMID:27920744

  11. Attitudes of Older Adults in a Group-Based Exercise Program Toward a Blended Intervention; A Focus-Group Study.

    PubMed

    Mehra, Sumit; Dadema, Tessa; Kröse, Ben J A; Visser, Bart; Engelbert, Raoul H H; Van Den Helder, Jantine; Weijs, Peter J M

    2016-01-01

    Ageing is associated with a decline in daily functioning and mobility. A physically active life and physical exercise can minimize the decline of daily functioning and improve the physical-, psychological- and social functioning of older adults. Despite several advantages of group-based exercise programs, older adults participating in such interventions often do not meet the frequency, intensity or duration of exercises needed to gain health benefits. An exercise program that combines the advantages of group-based exercises led by an instructor with tailored home-based exercises can increase the effectiveness. Technology can assist in delivering a personalized program. The aim of the study was to determine the susceptibility of older adults currently participating in a nationwide group-based exercise program to such a blended exercise program. Eight focus-groups were held with adults of 55 years of age or older. Two researchers coded independently the remarks of the 30 participants that were included in the analysis according to the three key concepts of the Self Determination Theory: autonomy, competence, and relatedness. The results show that maintaining self-reliance and keeping in touch with others were the main motives to participate in the weekly group-based exercises. Participants recognized benefits of doing additional home-based exercises, but had concerns regarding guidance, safety, and motivation. Furthermore, some participants strongly rejected the idea to use technology to support them in doing exercises at home, but the majority was open to it. Insights are discussed how these findings can help design novel interventions that can increase the wellbeing of older adults and preserve an independent living.

  12. Pendulum Exercises After Hip Arthroscopy: A Video Technique.

    PubMed

    Sauber, Ryan; Saborio, George; Nickel, Beth M; Kivlan, Benjamin R; Christoforetti, John J

    2016-08-01

    Advanced hip joint-preserving arthroscopic techniques have been shown to improve patient-reported functional outcomes with low rates of postoperative complications. Prior work has shown that formation of adhesive scar is a potential source of persistent pain and cause for revision surgery. As resources for postoperative in-studio physical therapy become scarce, a home-based strategy to avoid scar formation without adding formal therapy cost may be beneficial. The purpose of this technical note is to introduce a patient-centered educational video technique for home-caregiver delivery of manual hip pendulum exercises in the postoperative setting. This video technique offers access to our method for pendulum exercise as part of early recovery after advanced hip arthroscopy.

  13. Exercise for Mild Balance Dysfunction: Research into Practice.

    PubMed

    Williams, Susan; Meyer, Claudia; Batchelor, Frances; Hill, Keith

    2015-10-01

    The objective of this study was to determine whether improved balance outcomes achieved in a randomized controlled trial (RCT) using balance screening to identify mild balance dysfunction and home exercises could be translated into community settings. Community-dwelling people aged over 65 who expressed concerns about their balance, had less than two falls in the preceding 12 months, and who had mild balance impairment on screening were given an individualized home-based balance and strengthening exercise program with intermittent home-visit support by a physiotherapist. Of 71 participants assessed (mean age 77.3 years, 76% female), 58 (82%) completed the six-month intervention. Twenty six percent of participants regained balance performance within normal limits--similar to those achieved in the previous RCT. Successful results from a previous RCT were able to be translated into community settings, with a similar magnitude of effect on balance and mobility.

  14. Impact of a Home-Based Physical and Nutritional Intervention Program Conducted by Lay-Volunteers on Handgrip Strength in Prefrail and Frail Older Adults: A Randomized Control Trial

    PubMed Central

    Haider, Sandra; Dorner, Thomas E.; Luger, Eva; Kapan, Ali; Titze, Sylvia; Lackinger, Christian; Schindler, Karin E.

    2017-01-01

    A randomized controlled trial was performed to compare the effects of a home-based physical and nutritional intervention program carried out by lay-volunteers to home visits with social support alone. Buddies visited 80 prefrail or frail older persons at home twice a week for 12 weeks. The physical training and nutrition group (PTN, n = 39) performed two sets of six strength exercises, discussed nutritional topics and received social support. The social support group (SoSu, n = 41) received home visits with social support only. In the PTN group, handgrip strength increased significantly by 2.4 kg (95% CI: 1.0–3.8). In the SoSu group we did not see a significant improvement. However, no significant between-group difference was found. Physical performance increased in both groups, although with a higher increase of 1.0 point (95% CI: 0.1–2.0) in the PTN group. In none of the groups muscle mass changed. Further results showed that frail individuals benefit more from the intervention than prefrail individuals (OR: 2.78; 95% CI: 1.01–7.66). Handgrip strength in the intervention group increased by a clinically relevant value and this effect is comparable to that obtained by health-care professionals. Therefore, home visits with a physical training and nutritional program could offer a new perspective in the care of community-dwelling prefrail and frail older persons. PMID:28085913

  15. Impact of a Home-Based Physical and Nutritional Intervention Program Conducted by Lay-Volunteers on Handgrip Strength in Prefrail and Frail Older Adults: A Randomized Control Trial.

    PubMed

    Haider, Sandra; Dorner, Thomas E; Luger, Eva; Kapan, Ali; Titze, Sylvia; Lackinger, Christian; Schindler, Karin E

    2017-01-01

    A randomized controlled trial was performed to compare the effects of a home-based physical and nutritional intervention program carried out by lay-volunteers to home visits with social support alone. Buddies visited 80 prefrail or frail older persons at home twice a week for 12 weeks. The physical training and nutrition group (PTN, n = 39) performed two sets of six strength exercises, discussed nutritional topics and received social support. The social support group (SoSu, n = 41) received home visits with social support only. In the PTN group, handgrip strength increased significantly by 2.4 kg (95% CI: 1.0-3.8). In the SoSu group we did not see a significant improvement. However, no significant between-group difference was found. Physical performance increased in both groups, although with a higher increase of 1.0 point (95% CI: 0.1-2.0) in the PTN group. In none of the groups muscle mass changed. Further results showed that frail individuals benefit more from the intervention than prefrail individuals (OR: 2.78; 95% CI: 1.01-7.66). Handgrip strength in the intervention group increased by a clinically relevant value and this effect is comparable to that obtained by health-care professionals. Therefore, home visits with a physical training and nutritional program could offer a new perspective in the care of community-dwelling prefrail and frail older persons.

  16. Parental Satisfaction with a Home-Based Intervention for Developmentally Delayed Children in Switzerland: A Survey over a 10-year Period

    ERIC Educational Resources Information Center

    Favez, Nicolas; Metral, Eric; Govaerts, Patrice

    2008-01-01

    This article presents a study of parental satisfaction with services provided to their child by an Early Intervention Service in Geneva, Switzerland. The Service offers psycho-educational home-based interventions for developmentally delayed children. Parents whose child used the service between 1991 and 2001 filled out a questionnaire with Likert…

  17. Determining the Reach of a Home-Based Physical Activity Program for Older Adults within the Context of a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Harden, Samantha M.; Fanning, Jason T.; Motl, Robert W.; McAuley, Edward; Estabrooks, Paul A.

    2014-01-01

    Determining the reach of physical activity (PA) programs is challenging due to inconsistent reporting across studies. The purpose of this study was to document multiple indicators of program reach for a 6-month, Digital Versatile Disc (DVD)-delivered home-based PA program. Radio, newspaper and direct mailing advertisements were tracked to…

  18. Home-Based Businesses: Implications for the Rural Economy of the South. The Rural South: Preparing for the Challenges of the 21st Century, No. 16.

    ERIC Educational Resources Information Center

    Brown, Pamela J.; Muske, Glenn

    In the face of changing agriculture, an aging population, and the outflow of citizens seeking livable wages, rural Southern communities are challenged with how to enhance their economies to insure long-term business viability. Home-based businesses are an effective aspect of rural economic development. They allow flexibility and choice of work…

  19. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border.

    PubMed

    Ramírez, Denise Moreno; Ramírez-Andreotta, Mónica D; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A; Kilungo, Aminata; Spitz, Anna H; Betterton, Eric A

    2015-09-09

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered "hard-to-reach" by government-led programs.

  20. A Novel, Self-Guided, Home-Based Intervention to Improve Condom Use among Young Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Emetu, Roberta E.; Marshall, Alexandra; Sanders, Stephanie A.; Yarber, William L.; Milhausen, Robin R.; Crosby, Richard A.; Graham, Cynthia A.

    2014-01-01

    Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a…

  1. Infection control in home-based care for people living with HIV/AIDS/TB in South Africa: an exploratory study.

    PubMed

    Akintola, Olagoke; Hangulu, Lydia

    2014-01-01

    The majority of HIV and AIDS patients in sub-Saharan African countries receive health care services at home. Yet research on infection control in home-based care settings is virtually non-existent. This study explored infection control practices in home-based care in a South African province with a high HIV/TB prevalence. We conducted interviews with 10 managers of home-based care organizations and 10 focus group discussions with 80 volunteer caregivers working in high HIV/TB prevalent communities in South Africa. Findings show that volunteers had insufficient training on infection control. Materials necessary for the maintenance of hygiene and protective equipment were in short supply and the protective equipment supplied was of poor quality. Home-based care patients lived in crowded and poor conditions, and family members were negatively disposed to the use of protective devices. Together, these factors put volunteers and family caregivers at risk of infection with HIV and TB. Health policy should address the training of volunteer caregivers and the regular supply of good quality materials to ensure effective infection control. It is also important to educate families on infection control. Finally, there is a need to integrate HIV and TB control at the community level.

  2. A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

    ERIC Educational Resources Information Center

    Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

    2011-01-01

    This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

  3. Factors of Good Collaboration in Home-Based End-of-Life Care: A Questionnaire Survey of Japanese Home Care Nurses, Home Helpers, and Care Managers.

    PubMed

    Yamamoto-Mitani, Noriko; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Takemura, Yukie; Suzuki, Miho

    2015-01-01

    Good interprofessional work (IPW) is essential to provide quality home-based end-of-life (EOL) care. The purpose of this study was to explore the factors of "good collaboration," as evaluated separately by home care nurses (HNs), home helpers (HHs), and care managers (CMs). The relationship was examined between their evaluation of good collaboration and their recent actual experience of interprofessional collaborative work for a home-based EOL case. The questionnaire was returned nationwide by 378 HNs, 305 HHs, and 476 CMs, and data were collected on 177 EOL cases from HNs, 84 cases from HHs, and 123 cases from CMs. Evaluation of good collaboration by HNs was associated with working with a CM with whom they had multiple collaborative experiences, the client being independent for their toileting until just before dying, and sharing information regarding the client's EOL decision with an HH 1 month before dying. Evaluation of good collaboration by HHs was associated with working at an agency that collaborated with fewer CM agencies and working at an agency that allowed staff to visit dying clients. Evaluation of good collaboration by CMs was associated only with the client being dependent for toileting. Our results highlighted the characteristics of how each professional seeks to collaborate depending on their preparedness, contexts, and resultant expectations toward other professionals when entering the IPW for home-based EOL care. To promote good IPW for home-based EOL care further, professionals need to understand these differences among ourselves and try to meet others' expectations.

  4. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border

    PubMed Central

    Moreno Ramírez, Denise; Ramírez-Andreotta, Mónica D.; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A.; Kilungo, Aminata; Spitz, Anna H.; Betterton, Eric A.

    2015-01-01

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered “hard-to-reach” by government-led programs. PMID:26371028

  5. Community SES, perceived environment, and physical activity during home-based cardiac rehabilitation: is there a need to consider the urban vs. rural distinction?

    PubMed

    Blanchard, Chris; Rainham, Daniel; McSweeney, Jill; Spence, John; McDonnell, Lisa; Rhodes, Ryan; Reid, Robert; McGannon, Kerry; Edwards, Nancy

    2012-04-01

    Physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) remain problematic. Consequently, the present study examined the association between MVPA and urban vs. rural residential status and the perceived environment in patients attending home-based CR. A total of 280 patients completed a questionnaire assessing demographic, clinical, MVPA, and perceived environmental variables measured at baseline and 3 months later. Patient addresses were geocoded and linked to the 2006 Canadian census to establish the urban/rural distinction. Results showed that urban and rural patients had similar baseline MVPA and improvements in MVPA by 3 months. Several perceived environmental variables were significantly related to MVPA throughout home-based CR that were common and urban/rural-specific. Therefore, although there does not appear to be an urban vs. rural advantage in MVPA levels during home-based CR, there does appear to be environmental/MVPA-specific relationships specific to urban and rural patients that may warrant attention.

  6. The Impact of Home-Based Child Care Provider Unionization on the Cost, Type, and Availability of Subsidized Child Care in Illinois

    ERIC Educational Resources Information Center

    Grindal, Todd; West, Martin R.; Willett, John B.; Yoshikawa, Hirokazu

    2015-01-01

    In February 2005, Illinois became the first U.S. state to grant home-based child care providers (HBCPs) the right to form a labor union in order to bargain collectively with the state government. This policy inspired similar efforts across the country and represents a potentially important direction for child care policy. To date, the implications…

  7. Orthostasis: exercise and exercise training

    NASA Technical Reports Server (NTRS)

    Geelen, G.; Greenleaf, J. E.

    1993-01-01

    There are two major problems here that are not independent. One is the more practically oriented problem of determining the effect of various modes of exercise training on gravitational tolerances, i.e., the point of syncope (unconsciousness) usually estimated from the time of appearance of presyncopal signs and symptoms. The other is more theoretical and concerns the mechanism of blood pressure failure that results in syncope. In many experimental designs these two problems or purposes have been intermingled, with equivocal results.

  8. Internet Protocol Television for Personalized Home-Based Health Information: Design-Based Research on a Diabetes Education System

    PubMed Central

    Clarke, Ken; Kwong, Mabel; Alzougool, Basil; Hines, Carolyn; Tidhar, Gil; Frukhtman, Feodor

    2014-01-01

    Background The use of Internet protocol television (IPTV) as a channel for consumer health information is a relatively under-explored area of medical Internet research. IPTV may afford new opportunities for health care service providers to provide health information and for consumers, patients, and caretakers to access health information. The technologies of Web 2.0 add a new and even less explored dimension to IPTV’s potential. Objective Our research explored an application of Web 2.0 integrated with IPTV for personalized home-based health information in diabetes education, particularly for people with diabetes who are not strong computer and Internet users, and thus may miss out on Web-based resources. We wanted to establish whether this system could enable diabetes educators to deliver personalized health information directly to people with diabetes in their homes; and whether this system could encourage people with diabetes who make little use of Web-based health information to build their health literacy via the interface of a home television screen and remote control. Methods This project was undertaken as design-based research in two stages. Stage 1 comprised a feasibility study into the technical work required to integrate an existing Web 2.0 platform with an existing IPTV system, populated with content and implemented for user trials in a laboratory setting. Stage 2 comprised an evaluation of the system by consumers and providers of diabetes information. Results The project succeeded in developing a Web 2.0 IPTV system for people with diabetes and low literacies and their diabetes educators. The performance of the system in the laboratory setting gave them the confidence to engage seriously in thinking about the actual and potential features and benefits of a more widely-implemented system. In their feedback they pointed out a range of critical usability and usefulness issues related to Web 2.0 affordances and learning fundamentals. They also described

  9. The effects of COREPOWER machine training versus home-based core training on golfers' physical fitness and sport performance.

    PubMed

    Loock, Henriëtte V; Grace, Jeanne M; Semple, Stuart J

    2013-10-21

    The purpose of this study was to determine the effects of a 36 session COREPOWER machine training intervention and those of a 36 session home-based core training intervention programme on golfers' physical fitness and sport specific performance. It was hypothesised that both modalities will improve on golf related fitness aspects. Subjects comprised of experienced golfers and were randomly divided into a machine group (M: n = 51) and a home group (H: n = 50). The following variables were measured both pre- and post-intervention: lower back flexibility (sit & reach), muscle endurance (sit-ups and push-ups), muscle strength (wall-squats and back dynamometer), cardio-respiratory fitness (3 minute step-test), balance (Biodex Balance System), club head speed and carry distance (Flightscope). The Wilcoxon and Mann-Whitney signed-rank test was used to compare pre and post-intervention measurements within each group with significance set at p < 0.05. An ANCOVA analyses was also run as well as Pearson Product Moment correlations. Results portrayed that with the exception of cardiorespiratory fitness, all variables in both groups showed significant (p<0.05) improvement post intervention. Push-ups (p = 0.000; ↑17.03%; d = 0.92) and driver carry distance (p = 0.000; ↑30.30%; d = 0.40) showed the greatest percentage improvement post intervention within group M, while sit-ups (p = 0.000; ↑14.41%; d = 0.77) and push-ups (p = 0.000; ↑12.52%; d = 0.90) showed the greatest percentage improvement within group H. Lower back strength holds significant correlation to golf performance. Thus both modalities, the COREPOWER machine training and the home-based manual core training were equally effective in improving selected fitness components; however the machine was more effective in improving golf performance parameters. These observations can be applied to golfers in addition to their usual golfing activities as well as to other sport populations as this study formed an evidence

  10. Exercise and Compulsive Behavior.

    ERIC Educational Resources Information Center

    Polivy, Janet; Clendenen, Vanessa

    Although reports on the positive effects of fitness and exercise predominate in the exercise literature, some researchers describe frequent exercise as compulsive or addictive behavior. This paper addresses these "negative addictions" of exercise. As early as 1970, researchers recognized the addictive qualities of exercise. Short-term…

  11. Learning Outcomes from Business Simulation Exercises: Challenges for the Implementation of Learning Technologies

    ERIC Educational Resources Information Center

    Clarke, Elizabeth

    2009-01-01

    Purpose: High order leadership, problem solving skills, and the capacity for innovation in new markets, and technologically complex and multidimensional contexts, are the new set of skills that are most valued by companies and employers alike. Business simulation exercises are one way of enhancing these skills. This article aims to examine the…

  12. Assessment of water, sanitation, and hygiene practice and associated factors among people living with HIV/AIDS home based care services in Gondar city, Ethiopia

    PubMed Central

    2012-01-01

    Background People living with HIV/AIDS have substantially greater need for water, sanitation, and hygiene. Encouraging hygiene education for People Living with HIV/AIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended. Methods A cross-sectional study was carried during 2009 to assess water, sanitation status and hygiene practices and associated factors among People Living with HIV/AIDS in home based care services in Gondar city of Ethiopia. A systematic random sampling was used to select study subjects from 900 Home Based Care clients of People Living HIV/AIDS in Gondar city. Data was collected from 296 People Living with HIV/AIDS from two NGO’s in the city. For in-depth interview, four different categories were participated. Logistic regression and thematic framework analysis were performed for quantitative and qualitative part respectively. Results Two hundred ninety four subjects (72.8% (214) females and 27.2% (80) males) were studied. The mean age was 35.8 ± 8.7 years. In the study, 42.9% (126) of the households have unimproved water status, 67% (197) of the households have unimproved sanitation status, and 51.7% (152) of the households have poor hygienic practice. Diarrhoea with water status; educational status and latrine availability with sanitation status; and hand washing device availability and economical reasons for the affordability of soap with hygienic practice were significantly associated. Economical reasons and hygiene education were factors that affect water, sanitation, and hygienic practice. Stigma and discrimination were minimized as a factor in the study area. Conclusions There is high burden of water, sanitation and hygiene in people living HIV/AIDS in home based care services. Encouraging hygiene education for people living HIVAIDS in home based care services and additional support for the provision of water, sanitation, and hygiene services is recommended

  13. Nuclear Forensic Inferences Using Iterative Multidimensional Statistics

    SciTech Connect

    Robel, M; Kristo, M J; Heller, M A

    2009-06-09

    Nuclear forensics involves the analysis of interdicted nuclear material for specific material characteristics (referred to as 'signatures') that imply specific geographical locations, production processes, culprit intentions, etc. Predictive signatures rely on expert knowledge of physics, chemistry, and engineering to develop inferences from these material characteristics. Comparative signatures, on the other hand, rely on comparison of the material characteristics of the interdicted sample (the 'questioned sample' in FBI parlance) with those of a set of known samples. In the ideal case, the set of known samples would be a comprehensive nuclear forensics database, a database which does not currently exist. In fact, our ability to analyze interdicted samples and produce an extensive list of precise materials characteristics far exceeds our ability to interpret the results. Therefore, as we seek to develop the extensive databases necessary for nuclear forensics, we must also develop the methods necessary to produce the necessary inferences from comparison of our analytical results with these large, multidimensional sets of data. In the work reported here, we used a large, multidimensional dataset of results from quality control analyses of uranium ore concentrate (UOC, sometimes called 'yellowcake'). We have found that traditional multidimensional techniques, such as principal components analysis (PCA), are especially useful for understanding such datasets and drawing relevant conclusions. In particular, we have developed an iterative partial least squares-discriminant analysis (PLS-DA) procedure that has proven especially adept at identifying the production location of unknown UOC samples. By removing classes which fell far outside the initial decision boundary, and then rebuilding the PLS-DA model, we have consistently produced better and more definitive attributions than with a single pass classification approach. Performance of the iterative PLS-DA method

  14. Multidimensional voice analysis of reflux laryngitis patients.

    PubMed

    Pribuisienë, Rûta; Uloza, Virgilijus; Saferis, Viktoras

    2005-01-01

    The aim of the study was to analyze and quantify the voice characteristics of reflux laryngitis (RL) patients and to determine the most important voice tests and voice-quality parameters in the functional diagnostics of RL. The voices of 83 RL patients and 31 persons in the control group were evaluated. Vocal function was assessed using a multidimensional set of video laryngostroboscopic, perceptual, acoustic, aerodynamic and subjective measurements according to the protocol elaborated by the Committee on Phoniatrics of the European Laryngological Society. The mean values of the hoarseness visual analogue scale assessment and voice handicap index were significantly higher (P<0.05) in the group of RL patients as compared to the controls. Objective voice assessment revealed a significant increase in mean values of jitter, shimmer and normalized noise energy (NNE), along with a significant decrease in pitch range, maximum frequency, phonetogram area (S) and maximum phonation time (MPT) in RL patients, both in the male and female subgroups. According to the results of discriminant analysis, the NNE, MPT, S and intensity range were determined as an optimum set for functional diagnostics of RL. The derived function (equation) makes it possible to assign the person to the group of RL patients with an accuracy of 86.7%. The sensitivity and specificity of eight voice parameters were found to be higher than 50%. The results of the present study demonstrate a reduction of phonation capabilities and voice quality in RL patients. Multidimensional voice evaluation makes it possible to detect significant differences in mean values of perceptual, subjective and objective voice quality parameters between RL patients and controls groups. Therefore, multidimensional voice analysis is an important tool in the functional diagnostics of RL.

  15. Construct continuity in the presence of multidimensionality

    NASA Astrophysics Data System (ADS)

    Staniewska, Dorota

    Unidimensionality -- a condition, under which only one dominant construct is being measured by the test, is a fundamental assumption of most modern day psychometric models. However, some tests are multidimensional by design. A test, for instance, might measure physics, biology and chemistry subscales combined to measure a "general science" composite. The relative magnitudes of those subscales sometimes shift from administration to administration, which results in an altered composite. This study examined the conditions under which two different forms of a multidimensional test measure the same composite construct to a degree that allows them to be equated, i.e. used interchangeably. IRT true-score equating was used in a simulation study to assess the closeness of the scores on the forms. Conditions examined included the correlations between subscales, varying number of items per subscale form to form, and different subpopulation ability estimates on the subscales. Differences in the equating errors due to generating model (1PL or 3PL) were also examined. A way of calculating a unidimensional composite from a two-dimensional ability was devised and compared to the unidimensional composite obtained from Parscale. It was found that in general, the errors increase with decreasing correlation between traits and increased divergence of the two forms to be equated, with the later being the main predictor of the equating errors. However, the magnitude of those errors was small for the population as a whole especially when all examinee abilities are drawn from the same distribution. It was concluded that IRT true score equating is relatively robust to multidimensionality for the conditions examined, especially if the overall population score is desired. However, when accurate estimate of the equated score for individuals at the extremes of the population is needed, or whenever population abilities are drawn from more than one distribution, the unidimensional true score

  16. A Multidimensional Scaling Approach to Dimensionality Assessment for Measurement Instruments Modeled by Multidimensional Item Response Theory

    ERIC Educational Resources Information Center

    Toro, Maritsa

    2011-01-01

    The statistical assessment of dimensionality provides evidence of the underlying constructs measured by a survey or test instrument. This study focuses on educational measurement, specifically tests comprised of items described as multidimensional. That is, items that require examinee proficiency in multiple content areas and/or multiple cognitive…

  17. A multidimensional representation model of geographic features

    USGS Publications Warehouse

    Usery, E. Lynn; Timson, George; Coletti, Mark

    2016-01-28

    A multidimensional model of geographic features has been developed and implemented with data from The National Map of the U.S. Geological Survey. The model, programmed in C++ and implemented as a feature library, was tested with data from the National Hydrography Dataset demonstrating the capability to handle changes in feature attributes, such as increases in chlorine concentration in a stream, and feature geometry, such as the changing shoreline of barrier islands over time. Data can be entered directly, from a comma separated file, or features with attributes and relationships can be automatically populated in the model from data in the Spatial Data Transfer Standard format.

  18. Multidimensional world, inflation, and modern acceleration

    SciTech Connect

    Bronnikov, K. A.; Rubin, S. G.; Svadkovsky, I. V.

    2010-04-15

    Starting from pure multidimensional gravity with curvature-nonlinear terms but no matter fields in the initial action, we obtain a cosmological model with two effective scalar fields related to the size of two extra factor spaces. The model includes both an early inflationary stage and that of modern accelerated expansion and satisfies the observational data. There are no small parameters; the effective inflaton mass depends on the initial conditions which explain its small value as compared to the Planck mass. At the modern stage, the size of extra dimensions slowly increases, therefore this model predicts drastic changes in the physical laws of our Universe in the remote future.

  19. Multidimensional world, inflation, and modern acceleration

    NASA Astrophysics Data System (ADS)

    Bronnikov, K. A.; Rubin, S. G.; Svadkovsky, I. V.

    2010-04-01

    Starting from pure multidimensional gravity with curvature-nonlinear terms but no matter fields in the initial action, we obtain a cosmological model with two effective scalar fields related to the size of two extra factor spaces. The model includes both an early inflationary stage and that of modern accelerated expansion and satisfies the observational data. There are no small parameters; the effective inflaton mass depends on the initial conditions which explain its small value as compared to the Planck mass. At the modern stage, the size of extra dimensions slowly increases, therefore this model predicts drastic changes in the physical laws of our Universe in the remote future.

  20. Evolution of multidimensional flat anisotropic cosmological models

    SciTech Connect

    Beloborodov, A. ); Demianski, M. Nicolaus Copernicus Astronomical Center, Bartycka 18, 00-716 Warsaw International Center for Relativistic Astrophysics , Universita di Roma I, La Sapienza, Rome ); Ivanov, P.; Polnarev, A.G. )

    1993-07-15

    We study the dynamics of a flat multidimensional anisotropic cosmological model filled with an anisotropic fluidlike medium. By an appropriate choice of variables, the dynamical equations reduce to a two-dimensional dynamical system. We present a detailed analysis of the time evolution of this system and the conditions of the existence of spacetime singularities. We investigate the conditions under which violent, exponential, and power-law inflation is possible. We show that dimensional reduction cannot proceed by anti-inflation (rapid contraction of internal space). Our model indicates that it is very difficult to achieve dimensional reduction by classical means.

  1. Effect of a Home-based Balance Training Protocol on Dynamic Postural Control in Subjects with Chronic Ankle Instability.

    PubMed

    De Ridder, R; Willems, T M; Vanrenterghem, J; Roosen, P

    2015-06-01

    The aim of this study was to establish the presence of postural deficits in subjects with chronic ankle instability (CAI) and to assess the effect of an 8-week balance training program on dynamic postural control. A total of 43 subjects with CAI and 31 controls participated in this case-control study. Participants with CAI performed an 8-week home-based balance training, including 3 sessions a week. As main outcome measure, postural control was quantified after a vertical drop by means of the dynamic postural stability index (DPSI). Perceptual outcomes were documented using the FADI, FADI-Sport and VAS scales. At baseline, subjects with CAI displayed higher anterior/posterior and vertical postural instability, a poorer DPSI, and lower subjective stability scores compared to the control group. After balance training, all subjective stability scores improved significantly, although no changes were noted for the stability indices. In conclusion, subjects with CAI have an impaired postural control. As a treatment modality, balance training exhibits the capability of improving the subjective feeling of instability in subjects with CAI. However, there was no effect on dynamic postural control. Further research on the explanatory mechanisms of balance training is warranted, and other training modalities should be considered.

  2. Effectiveness and Limitations of Unsupervised Home-Based Balance Rehabilitation with Nintendo Wii in People with Multiple Sclerosis

    PubMed Central

    Pau, Massimiliano; Coghe, Giancarlo; Corona, Federica; Leban, Bruno; Marrosu, Maria Giovanna; Cocco, Eleonora

    2015-01-01

    Balance training represents a critical part of the rehabilitation process of individuals living with multiple sclerosis (MS) since impaired postural control is a distinctive symptom of the disease. In recent years, the use of the Nintendo Wii system has become widespread among rehabilitation specialists for this purpose, but few studies have verified the effectiveness of such an approach using quantitative measures of balance. In this study, we analyzed the postural sway features of a cohort of twenty-seven individuals with MS before and after 5 weeks of unsupervised home-based balance training with the Wii system. Center of pressure (COP) time-series were recorded using a pressure platform and processed to calculate sway area, COP path length, displacements, and velocities in mediolateral (ML) and anteroposterior (AP) directions. Although the results show a significant reduction in sway area, COP displacements, and velocity, such improvements are essentially restricted to the ML direction, as the Wii platform appears to properly stimulate the postural control system in the frontal plane but not in the sagittal one. Available Wii games, although somewhat beneficial, appear not fully suitable for rehabilitation in MS owing to scarce flexibility and adaptability to MS needs and thus specific software should be developed. PMID:26583146

  3. Feasibility of caregiver-directed home-based hand-arm bimanual intensive training: A brief report

    PubMed Central

    Ferre, Claudio L.; Brandão, Marina B.; Hung, Ya-Ching; Carmel, Jason B.; Gordon, Andrew M.

    2015-01-01

    Objective To determine feasibility of a home-based, intensive bimanual intervention with children with unilateral spastic cerebral palsy. Methods Eleven children (aged 29–54 months) received 90 hours of home hand-arm bimanual intensive therapy (H-HABIT) provided by their trained caregivers. Parenting stress levels and compliance were monitored using the Parenting Stress Index and daily logs. Quality of bimanual performance and changes in performance/satisfaction of functional goals were assessed using the Assisting Hand Assessment (AHA) and Canadian Occupational Performance Measure (COPM), respectively, at two pretreatment baseline sessions and two posttreatment sessions (immediate and six months). Results Ten children completed the study with caregivers completing on average 85.6 hours of H-HABIT. Daily logs indicated high caregiver compliance. Stress levels remained stable across the intervention. Children demonstrated significant improvements in the AHA and COPM. Conclusion H-HABIT is a feasible intervention for improving hand function and merits further investigation in a randomized-control trial. PMID:25180530

  4. Home-based administration of Sayana® Press: review and assessment of needs in low-resource settings.

    PubMed

    Keith, Bonnie; Wood, Siri; Tifft, Sara; Hutchings, Jane

    2014-05-01

    A new presentation of the subcutaneous (SC) injectable contraceptive depot medroxyprogesterone acetate (DMPA) increases the possibilities for home and self-administration of this popular contraceptive method. Sayana® Press is DMPA-SC in the prefilled Uniject™ injection system and consists of one dose that provides 3 months of contraceptive protection. Studies indicate that lay caregiver and self-injection of various medications, including other injectable presentations of DMPA-SC, are acceptable and effective. Introduction of Sayana® Press in developing countries could extend injectable contraceptive delivery safely and effectively beyond the clinic and, eventually, into the home, allowing lay caregiver or self-administration. Research needs for low-resource settings include assessing the acceptability and feasibility of self-injection with Sayana® Press. Feasibility studies necessary for implementing a sustainable home-based delivery program include assessment of training, health systems, policies, infrastructure needs and programmatic considerations to optimize women's ability to manage their self-injection schedule.

  5. Home-based management of severely acute malnutrition: feasibility of ethically designed, community-based randomised clinical trials.

    PubMed

    Patil, Rajan R

    2015-01-01

    The Indian Council of Medical Research had, on May 31, 2011, called for research proposals on severely acute malnourished (SAM) children to generate evidence for the development of practical and scalable regimens to medically rehabilitate children suffering from SAM, without serious complications, at the home/community level and/or peripheral inpatient facilities. The primary outcomes of the proposed research study are recovery from SAM in the short term, as well as sustenance of recovery (for at least six months after the initiation of treatment). The secondary outcomes are the acceptability, feasibility and safety of the regimes being tested. It was suggested that the studies be designed as individual or cluster randomised or quasi randomised controlled trials (RCTs). This paper analyses the methodological, operational, and most importantly, ethical challenges and implications of conducting community-based RCTs involving SAM children. The paper dwells in detail on why and how the RCT design is inappropriate and unsuitable for studying the effectiveness of home-based management of SAM children in the community.

  6. The impact of perceived stress, social support, and home-based physical activity on mental health among older adults.

    PubMed

    Kwag, Kyung Hwa; Martin, Peter; Russell, Daniel; Franke, Warren; Kohut, Marian

    2011-01-01

    This study investigated how perceived stress, social support, and home-based physical activity affected older adults' fatigue, loneliness, and depression. We also explored whether social support and physical activity mediated the relationships between stress and mental health problems. The data of 163 older participants were analyzed in this study. Structural equation modeling using LISREL 8.71 was performed to assess the effects of stress, support, and physical activity on mental health. The findings indicate that perceived stress predicted higher levels of depression, social support predicted lower levels of loneliness and fatigue, and physical activity predicted lower levels of fatigue among older adults. Social support and physical activity mediated the relationships between stress and mental health, except depression. In conclusion, the relative impacts of perceived stress, social support, and physical activity on types of mental health (e.g., fatigue, loneliness, and depression) were different. Furthermore, stress had direct and indirect effects on each construct of mental health (e.g., fatigue, loneliness, and depression).

  7. Markerless motion capture and measurement of hand kinematics: validation and application to home-based upper limb rehabilitation.

    PubMed

    Metcalf, Cheryl D; Robinson, Rebecca; Malpass, Adam J; Bogle, Tristan P; Dell, Thomas A; Harris, Chris; Demain, Sara H

    2013-08-01

    Dynamic movements of the hand, fingers, and thumb are difficult to measure due to the versatility and complexity of movement inherent in function. An innovative approach to measuring hand kinematics is proposed and validated. The proposed system utilizes the Microsoft Kinect and goes beyond gesture recognition to develop a validated measurement technique of finger kinematics. The proposed system adopted landmark definition (validated through ground truth estimation against assessors) and grip classification algorithms, including kinematic definitions (validated against a laboratory-based motion capture system). The results of the validation show 78% accuracy when identifying specific markerless landmarks. In addition, comparative data with a previously validated kinematic measurement technique show accuracy of MCP ± 10° (average absolute error (AAE) = 2.4°), PIP ± 12° (AAE = 4.8°), and DIP ± 11° (AAE = 4.8°). These results are notably better than clinically based alternative manual measurement techniques. The ability to measure hand movements, and therefore functional dexterity, without interfering with underlying composite movements, is the paramount objective to any bespoke measurement system. The proposed system is the first validated markerless measurement system using the Microsoft Kinect that is capable of measuring finger joint kinematics. It is suitable for home-based motion capture for the hand and, therefore, achieves this objective.

  8. Provider cultural competency, client satisfaction, and engagement in home-based programs to treat child abuse and neglect.

    PubMed

    Damashek, Amy; Bard, David; Hecht, Debra

    2012-02-01

    Home-based programs to treat child abuse and neglect suffer from high rates of attrition, limiting their impact. Thus, research is needed to identify factors related to client engagement. Using data (N = 1,305) from a statewide family preservation program, this study investigated the role of program type (i.e., SafeCare(®) [SC] vs. Services as Usual [SAU]) and client perceived provider cultural competence on client satisfaction and engagement with services. Families in SC completed more treatment goals than those in SAU. In addition, provider cultural competence and client satisfaction were higher in SC than in SAU. Higher provider cultural competence was associated with higher goal attainment and satisfaction, and these effects partially mediated the service program differences. The effects of service type and cultural competence on goal attainment and satisfaction varied somewhat by client ethnicity. Findings suggest that clients receiving manualized programs for child maltreatment may be more likely to meet their goals and may perceive such programs to be culturally appropriate and satisfactory.

  9. A home-based method to reduce phytate content and increase zinc bioavailability in maize-based complementary diets.

    PubMed

    Hotz, C; Gibson, R S; Temple, L

    2001-03-01

    This study aimed to develop and assess the feasibility of a home-based method to reduce the phytate content of maize and improve zinc bioavailability from maize-based complementary diets in rural Malawi. A method of extracting phytate through the soaking of pounded maize was developed, and found to reduce phytate content to 49% of unrefined maize. An educational program was used to teach the processing method to mothers of children receiving complementary foods in rural Malawian communities. Samples of maize flour prepared by this process by participants were collected and analysed for phytate and zinc content. Of these, 70% of samples were found to be adequately prepared; mean phytate content of these samples was 48% of unprocessed, unrefined maize flour controls. Most participants found the cooked product to have an acceptable taste (99%) and texture (68%), and felt the processing method took little or no extra time (86%) and was culturally acceptable (96%). The phytate and zinc content of the processed maize flour samples analysed from community prepared samples was substituted into the dietary analysis of complementary foods for 9- to 11-month-old children (n = 31). The bioavailability of zinc from the complementary diet would predict an increase from low (24%) to moderate (33%) levels.

  10. Mediators of the impact of a home-based intervention (beat the blues) on depressive symptoms among older African Americans.

    PubMed

    Gitlin, Laura N; Roth, David L; Huang, Jin

    2014-09-01

    Older African Americans (N = 208) with depressive symptoms were randomly assigned to a home-based nonpharmacologic intervention (Beat the Blues, or BTB) or wait-list control group. BTB was delivered by licensed social workers and involved up to 10 home visits focused on care management, referral and linkage, depression knowledge and efficacy in symptom recognition, instruction in stress reduction techniques, and behavioral activation through identification of personal goals and action plans for achieving them. Structured interviews by assessors masked to study assignment were used to assess changes in depressive symptoms (main trial endpoint), behavioral activation, depression knowledge, formal care service utilization, and anxiety (mediators) at baseline and 4 months. At 4 months, the intervention had a positive effect on depressive symptoms and all mediators except formal care service utilization. Structural equation models indicated that increased activation, enhanced depression knowledge, and decreased anxiety each independently mediated a significant proportion of the intervention's impact on depressive symptoms as assessed with 2 different measures (PHQ-9 and CES-D). These 3 factors also jointly explained over 60% of the intervention's total effect on both indicators of depressive symptoms. Our findings suggest that most of the impact of BTB on depressive symptoms is driven by enhancing activation or becoming active, reducing anxiety, and improving depression knowledge/efficacy. The intervention components appear to work in concert and may be mutually necessary for maximal benefits from treatment to occur. Implications for designing tailored interventions to address depressive symptoms among older African Americans are discussed.

  11. Home-based nursing interventions improve knowledge of disease and management in patients with heart failure 1

    PubMed Central

    Azzolin, Karina de Oliveira; Lemos, Dayanna Machado; Lucena, Amália de Fátima; Rabelo-Silva, Eneida Rejane

    2015-01-01

    OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire. METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered. RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4. CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument. PMID:25806630

  12. Implementation processes associated with a home-based phonological awareness intervention for children with specific language impairment.

    PubMed

    Skibbe, Lori E; Justice, Laura M; Bowles, Ryan P

    2011-04-01

    The implementation processes associated with a home-based phonological awareness intervention were observed for mothers and their 4-year-old children with specific language impairment (SLI). Mother-child dyads (n = 13) read books four times per week over 12 weeks; each book contained nine embedded phonological awareness (PA) tasks. Four hundred and ninety-eight book reading sessions were coded for three variables of interest: maternal support of concept development, quantity of maternal instructional support, and accuracy of children's responses to the PA tasks. Using growth curve modelling, results indicate that maternal support of concept development decreased over the course of the 12-week program, and the quantity of maternal supports changed considerably reflecting intra-individual differences among mothers. Both support of concept development and quantity of support decreased over the course of a given week. In addition, children's responses to the phonological awareness tasks significantly increased over the 12-week intervention. Overall, mothers did not provide support that consistently supported children's learning over time, and the increases in children's correct responses, although significant, were less than anticipated given the length of the intervention. These findings indicate that mothers may need additional supports when implementing emergent literacy programs with their children.

  13. Independent Living Capacity Evaluation in Home-Based Primary Care: Considerations and Outcomes of a Quality Improvement Project

    PubMed Central

    Feng, Michelle C.; Murphy, Margaret R.; Mlinac, Michelle

    2016-01-01

    Objectives This article describes results of a quality improvement project review of 5 years of capacity evaluations for independent living conducted in one Home-Based Primary Care (HBPC) Program. Methods A retrospective chart review was conducted for all patients evaluated for independent living capacity through the Boston VA HBPC Program (N = 25) to identify differences in outcomes for those with and without capacity. Descriptive information included referral sources, capacity decisions, time remaining in the home, and trajectory of patients following evaluation. Results All patients evaluated had been diagnosed with a cognitive disorder, and on average, a relatively lower prevalence of mental illness compared with the national HBPC population. Referrals were made primarily by the HBPC team. Patients with capacity were found to have remained in their home longer than those who lacked capacity. Conclusions Referral for a higher level of care was typically only recommended when no further intervention could be implemented and active risk in the home could not be managed. Clinical Implications In home capacity evaluations are complex and challenging, yet results help family and HBPC team support patients’ preferences for staying in their own home as long as possible. PMID:28111494

  14. The Dangers of Involving Children as Family Caregivers of Palliative Home-Based-Care to Advanced HIV/AIDS Patients

    PubMed Central

    Kangethe, Simon

    2010-01-01

    The aim of this research paper is to explore the dangers of involving children as family caregivers of palliative care and home-based-care to advanced HIV/AIDS patients, while its objective is to discuss the dangers or perfidiousness that minors especially the girl children face as they handle care giving of advanced HIV/AIDS patients. The article has relied on eclectic data sources. The research has foundminors disadvantaged by the following: being engulfed by fear and denied rights through care giving; being emotionally and physiologically overwhelmed; being oppressed and suppressed by caring duties; being at risk of contracting HIV/AIDS; and having their education compromised by care giving. The paper recommends: (1) strengthening and emphasizing on children’s rights; (2) maintaining gender balance in care giving; (3) implementation and domestication of the United Nations conventions on the rights of children; (4) community awareness on equal gender co participation in care giving; (5) and fostering realization that relying on child care giving is a negative score in fulfilling global Millennium Development Goals. PMID:21218000

  15. Exercise intervention in breast cancer patients with aromatase inhibitor-associated arthralgia: a pilot study.

    PubMed

    DeNysschen, C A; Burton, H; Ademuyiwa, F; Levine, E; Tetewsky, S; O'Connor, T

    2014-07-01

    Aromatase inhibitors (AIs) block estrogen synthesis and are commonly used as adjuvant treatments for breast cancer patients. A common side effect is joint pain. This was a pilot study to examine implementation of an exercise program in reducing joint pain and improving quality of life (QoL) and functional performance in breast cancer patients treated with AIs. Twenty-six participants completed an 8-week, home-based program that combined upper and lower body resistance exercises with self-selected aerobic exercises. We measured: (1) anthropometry (2) functional performance (grip strength, biceps curl to exhaustion, and sit-to-stand and cardiovascular endurance (3-min step test). Joint pain and QoL were assessed using self-administered surveys. Participants reported a significantly lower number of painful joints, an improvement in QoL and a reduction in depressive symptoms. Significant improvements in grip strength, biceps curl, and sit-to-stand (by 14%, 51% and 15% respectively) were also observed. However, we found no significant changes in cardiovascular endurance or in anthropometric measures. An 8-week, home-based exercise program may provide potential benefit to the breast cancer patients undergoing AI treatment by reducing joint pain, improving functional performance and QoL, and reducing depressive symptoms. Further studies are needed to confirm these results.

  16. Exercise-Induced Asthma

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Exercise-Induced Asthma KidsHealth > For Parents > Exercise-Induced Asthma ... they choose. previous continue Tips for Kids With Exercise-Induced Asthma For the most part, kids with ...

  17. Why Exercise Is Cool

    MedlinePlus

    ... Room? What Happens in the Operating Room? Why Exercise Is Cool KidsHealth > For Kids > Why Exercise Is ... day and your body will thank you later! Exercise Makes Your Heart Happy You may know that ...

  18. Learn to love exercise

    MedlinePlus

    Prevention - learn to love exercise; Wellness - learn to love exercise ... With so many options for exercise, there is no need to suffer through a workout you do not like. Be true to yourself. Look for activities that ...

  19. Exercise and immunity

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/007165.htm Exercise and immunity To use the sharing features on ... take a daily walk or follow a simple exercise routine a few times a week. Exercise helps ...

  20. Exercise Equipment: Neutral Buoyancy

    NASA Technical Reports Server (NTRS)

    Shackelford, Linda; Valle, Paul

    2016-01-01

    Load Bearing Equipment for Neutral Buoyancy (LBE-NB) is an exercise frame that holds two exercising subjects in position as they apply counter forces to each other for lower extremity and spine loading resistance exercises. Resistance exercise prevents bone loss on ISS, but the ISS equipment is too massive for use in exploration craft. Integrating the human into the load directing, load generating, and motion control functions of the exercise equipment generates safe exercise loads with less equipment mass and volume.

  1. Effect of a randomized controlled exercise trial on bone outcomes: influence of adjuvant endocrine therapy.

    PubMed

    Knobf, M Tish; Jeon, Sangchoon; Smith, Barbara; Harris, Lyndsay; Kerstetter, Jane; Thompson, A Siobhan; Insogna, Karl

    2016-02-01

    Bone loss is a significant clinical problem for female cancer survivors (FCS) and increases fracture risk. The aim of the Yale Fitness Intervention Trial (Yale FIT) was to determine the effects of a 12-month aerobic-resistance exercise intervention compared to a home-based physical activity group on bone outcomes [bone mineral density (BMD)] and biomarkers bone turnover). Early postmenopausal FCS (N = 154) were randomized to the exercise intervention (3 times/week) or to a home-based physical activity group. Calcium (1200 mg) and Vitamin D (400 IU) supplements were provided to both groups. BMD was measured at baseline and 12 months. No significant difference in BMD was observed for the exercise vs home-based group. However, subjects on Tamoxifen or no endocrine therapy did not significantly lose BMD, with the exception of the femoral neck (FN). In contrast subjects on aromatase inhibitors (AIs) had significant BMD loss at all sites. The majority of subjects had sufficient serum levels of Vitamin D (>20 ng/mL) but there was significantly less bone loss in subjects in the 20-29 ng/mL range at the LS (p = 0.01), hip (p = 0.03), and GT (p = 0.008) compared to lower or higher levels. Exercise stimulates bone remodeling but the intervention was not superior for BMD outcomes at one year. The dose of the osteogenic stimulus in the intervention has been effective in preserving BMD in healthy postmenopausal women but it may be inadequate for survivors with chemotherapy-induced menopause and for those on adjuvant AI therapy.

  2. Multi-dimensional MHD simple waves

    SciTech Connect

    Webb, G. M.; Ratkiewicz, R.; Brio, M.; Zank, G. P.

    1996-07-20

    In this paper we consider a formalism for multi-dimensional simple MHD waves using ideas developed by Boillat. For simple wave solutions one assumes that all the physical variables (the density {rho}, gas pressure p, fluid velocity u, gas entropy S, and magnetic induction B in the MHD case) depend on a single phase function {phi}(r,t). The simple wave solution ansatz and the MHD equations then require that the phase function {phi} satisfies an implicit equation of the form f({phi})=r{center_dot}n({phi})-{lambda}({phi})t, where n({phi})={nabla}{phi}/|{nabla}{phi}| is the wave normal, {lambda}({phi})={omega}/k=-{phi}{sub t}/|{nabla}{phi}| is the normal speed of the wave front, and f({phi}) is an arbitrary differentiable function of {phi}. The formalism allows for more general simple waves than that usually dealt with in which n({phi}) is a constant unit vector that does not vary along the wave front. The formalism has implications for shock formation and wave breaking for multi-dimensional waves.

  3. Multi-dimensional MHD simple waves

    NASA Technical Reports Server (NTRS)

    Webb, G. M.; Ratkiewicz, R.; Brio, M.; Zank, G. P.

    1995-01-01

    In this paper we consider a formalism for multi-dimensional simple MHD waves using ideas developed by Boillat. For simple wave solutions one assumes that all the physical variables (the density rho, gas pressure p, fluid velocity V, gas entropy S, and magnetic induction B in the MHD case) depend on a single phase function phi(r,t). The simple wave solution ansatz and the MHD equations then require that the phase function has the form phi = r x n(phi) - lambda(phi)t, where = n(phi) = Delta phi / (absolute value of Delta phi) is the wave normal and lambda(phi) = omega/k = -phi t / (absolute value of Delta phi) is the normal speed of the wave front. The formalism allows for more general simple waves than that usually dealt with in which n(phi) is a constant unit vector that does not vary along the wave front. The formalism has implications for shock formation for multi-dimensional waves.

  4. Testlet-Based Multidimensional Adaptive Testing.

    PubMed

    Frey, Andreas; Seitz, Nicki-Nils; Brandt, Steffen

    2016-01-01

    Multidimensional adaptive testing (MAT) is a highly efficient method for the simultaneous measurement of several latent traits. Currently, no psychometrically sound approach is available for the use of MAT in testlet-based tests. Testlets are sets of items sharing a common stimulus such as a graph or a text. They are frequently used in large operational testing programs like TOEFL, PISA, PIRLS, or NAEP. To make MAT accessible for such testing programs, we present a novel combination of MAT with a multidimensional generalization of the random effects testlet model (MAT-MTIRT). MAT-MTIRT compared to non-adaptive testing is examined for several combinations of testlet effect variances (0.0, 0.5, 1.0, and 1.5) and testlet sizes (3, 6, and 9 items) with a simulation study considering three ability dimensions with simple loading structure. MAT-MTIRT outperformed non-adaptive testing regarding the measurement precision of the ability estimates. Further, the measurement precision decreased when testlet effect variances and testlet sizes increased. The suggested combination of the MTIRT model therefore provides a solution to the substantial problems of testlet-based tests while keeping the length of the test within an acceptable range.

  5. Testlet-Based Multidimensional Adaptive Testing

    PubMed Central

    Frey, Andreas; Seitz, Nicki-Nils; Brandt, Steffen

    2016-01-01

    Multidimensional adaptive testing (MAT) is a highly efficient method for the simultaneous measurement of several latent traits. Currently, no psychometrically sound approach is available for the use of MAT in testlet-based tests. Testlets are sets of items sharing a common stimulus such as a graph or a text. They are frequently used in large operational testing programs like TOEFL, PISA, PIRLS, or NAEP. To make MAT accessible for such testing programs, we present a novel combination of MAT with a multidimensional generalization of the random effects testlet model (MAT-MTIRT). MAT-MTIRT compared to non-adaptive testing is examined for several combinations of testlet effect variances (0.0, 0.5, 1.0, and 1.5) and testlet sizes (3, 6, and 9 items) with a simulation study considering three ability dimensions with simple loading structure. MAT-MTIRT outperformed non-adaptive testing regarding the measurement precision of the ability estimates. Further, the measurement precision decreased when testlet effect variances and testlet sizes increased. The suggested combination of the MTIRT model therefore provides a solution to the substantial problems of testlet-based tests while keeping the length of the test within an acceptable range. PMID:27917132

  6. MULTIDIMENSIONAL MODELING OF CORONAL RAIN DYNAMICS

    SciTech Connect

    Fang, X.; Xia, C.; Keppens, R.

    2013-07-10

    We present the first multidimensional, magnetohydrodynamic simulations that capture the initial formation and long-term sustainment of the enigmatic coronal rain phenomenon. We demonstrate how thermal instability can induce a spectacular display of in situ forming blob-like condensations which then start their intimate ballet on top of initially linear force-free arcades. Our magnetic arcades host a chromospheric, transition region, and coronal plasma. Following coronal rain dynamics for over 80 minutes of physical time, we collect enough statistics to quantify blob widths, lengths, velocity distributions, and other characteristics which directly match modern observational knowledge. Our virtual coronal rain displays the deformation of blobs into V-shaped features, interactions of blobs due to mostly pressure-mediated levitations, and gives the first views of blobs that evaporate in situ or are siphoned over the apex of the background arcade. Our simulations pave the way for systematic surveys of coronal rain showers in true multidimensional settings to connect parameterized heating prescriptions with rain statistics, ultimately allowing us to quantify the coronal heating input.

  7. Temporal masking of multidimensional tactual stimuli

    NASA Astrophysics Data System (ADS)

    Tan, Hong Z.; Reed, Charlotte M.; Delhorne, Lorraine A.; Durlach, Nathaniel I.; Wan, Natasha

    2003-12-01

    Experiments were performed to examine the temporal masking properties of multidimensional tactual stimulation patterns delivered to the left index finger. The stimuli consisted of fixed-frequency sinusoidal motions in the kinesthetic (2 or 4 Hz), midfrequency (30 Hz), and cutaneous (300 Hz) frequency ranges. Seven stimuli composed of one, two, or three spectral components were constructed at each of two signal durations (125 or 250 ms). Subjects identified target signals under three different masking paradigms: forward masking, backward masking, and sandwiched masking (in which the target is presented between two maskers). Target identification was studied as a function of interstimulus interval (ISI) in the range 0 to 640 ms. For both signal durations, percent-correct scores increased with ISI for each of the three masking paradigms. Scores with forward and backward masking were similar and significantly higher than scores obtained with sandwiched masking. Analyses of error trials revealed that subjects showed a tendency to respond, more often than chance, with the masker, the composite of the masker and target, or the combination of the target and a component of the masker. The current results are compared to those obtained in previous studies of tactual recognition masking with brief cutaneous spatial patterns. The results are also discussed in terms of estimates of information transfer (IT) and IT rate, are compared to previous studies with multidimensional tactual signals, and are related to research on the development of tactual aids for the deaf.

  8. Multidimensional Conservation Laws and Low Regularity Solutions

    SciTech Connect

    Barbara Lee Keyfitz

    2007-06-16

    This is the concluding report for the project, a continuation of research by Keyfitz and co-workers on multidimensional conservation laws, and applications of nonhyperbolic conservation laws in the two-fluid model for multiphase flow. The multidimensional research project was started with Suncica Canic, at the University of Houston and with Eun Heui Kim, now at California State University Long Beach. Two postdoctoral researchers, Katarina Jegdic and Allen Tesdall, also worked on this research. Jegdic's research was supported (for a total of one year) by this grant. Work on nonhyperbolic models for two-phase flows is being pursued jointly with Michael Sever, Hebrew University. Background for the project is contained in earlier reports. Note that in 2006, the project received a one-year no-cost extension that will end in September, 2007. A new proposal, for continuation of the research and for new projects, will be submitted in the Fall of 2007, with funding requested to begin in the summer of 2008. The reason for the 'funding gap' is Keyfitz's four-year stint as Director of the Fields Institute in Toronto, Canada. The research has continued, but has been supported by Canadian grant funds, as seems appropriate during this period.

  9. Noncommutative accelerated multidimensional universe dominated by quintessence

    NASA Astrophysics Data System (ADS)

    El-Nabulsi, Ahmad Rami

    2010-04-01

    Noncommutative Geometry recently attracted growing interest of cosmologists, mainly after the greatest success of unifying the forces of nature into a single gravitational spectral action in a purely algebraic way, rather than as being an entirely new formalism. In the present work, we discuss a multidimensional Friedmann-Robertson-Walker flat universe in which the perfect fluid has a Gaussian profile in time and depends on a fundamental minimal length sqrt{θ} like ρ= ρ(0)exp (- t 2/4 θ) for some positive constant ρ(0). This special form is motivated by a more recent noncommutative inflationary cosmological model, which was found to be able to drive the universe through a bounce without the need of any scalar field. Furthermore, we conjecture that the generalized equation of state has the special form p= ω a m ρ- ρ,( ω, m)∈ℝ where a( t) is the scale factor. It was found that the expansion of the multidimensional universe accelerates in time and is dominated for very large time by quintessence. Many additional consequences are revealed and discussed in some detail.

  10. Multidimensional Modeling of Coronal Rain Dynamics

    NASA Astrophysics Data System (ADS)

    Fang, X.; Xia, C.; Keppens, R.

    2013-07-01

    We present the first multidimensional, magnetohydrodynamic simulations that capture the initial formation and long-term sustainment of the enigmatic coronal rain phenomenon. We demonstrate how thermal instability can induce a spectacular display of in situ forming blob-like condensations which then start their intimate ballet on top of initially linear force-free arcades. Our magnetic arcades host a chromospheric, transition region, and coronal plasma. Following coronal rain dynamics for over 80 minutes of physical time, we collect enough statistics to quantify blob widths, lengths, velocity distributions, and other characteristics which directly match modern observational knowledge. Our virtual coronal rain displays the deformation of blobs into V-shaped features, interactions of blobs due to mostly pressure-mediated levitations, and gives the first views of blobs that evaporate in situ or are siphoned over the apex of the background arcade. Our simulations pave the way for systematic surveys of coronal rain showers in true multidimensional settings to connect parameterized heating prescriptions with rain statistics, ultimately allowing us to quantify the coronal heating input.

  11. Benchmarking the Multidimensional Stellar Implicit Code MUSIC

    NASA Astrophysics Data System (ADS)

    Goffrey, T.; Pratt, J.; Viallet, M.; Baraffe, I.; Popov, M. V.; Walder, R.; Folini, D.; Geroux, C.; Constantino, T.

    2017-03-01

    We present the results of a numerical benchmark study for the MUltidimensional Stellar Implicit Code (MUSIC) based on widely applicable two- and three-dimensional compressible hydrodynamics problems relevant to stellar interiors. MUSIC is an implicit large eddy simulation code that uses implicit time integration, implemented as a Jacobian-free Newton Krylov method. A physics based preconditioning technique which can be adjusted to target varying physics is used to improve the performance of the solver. The problems used for this benchmark study include the Rayleigh-Taylor and Kelvin-Helmholtz instabilities, and the decay of the Taylor-Green vortex. Additionally we show a test of hydrostatic equilibrium, in a stellar environment which is dominated by radiative effects. In this setting the flexibility of the preconditioning technique is demonstrated. This work aims to bridge the gap between the hydrodynamic test problems typically used during development of numerical methods and the complex flows of stellar interiors. A series of multidimensional tests were performed and analysed. Each of these test cases was analysed with a simple, scalar diagnostic, with the aim of enabling direct code comparisons. As the tests performed do not have analytic solutions, we verify MUSIC by comparing it to established codes including ATHENA and the PENCIL code. MUSIC is able to both reproduce behaviour from established and widely-used codes as well as results expected from theoretical predictions. This benchmarking study concludes a series of papers describing the development of the MUSIC code and provides confidence in future applications.

  12. Heterogeneous multidimensional scaling for complex networks

    NASA Astrophysics Data System (ADS)

    Xuan, Qi; Ma, Xiaodi; Fu, Chenbo; Dong, Hui; Zhang, Guijun; Yu, Li

    2015-07-01

    Many real-world networks are essentially heterogeneous, where the nodes have different abilities to gain connections. Such networks are difficult to be embedded into low-dimensional Euclidean space if we ignore the heterogeneity and treat all the nodes equally. In this paper, based on a newly defined heterogeneous distance and a generalized network distance under the constraints of network and triangle inequalities, respectively, we propose a new heterogeneous multidimensional scaling method (HMDS) to embed different networks into proper Euclidean spaces. We find that HMDS behaves much better than the traditional multidimensional scaling method (MDS) in embedding different artificial and real-world networks into Euclidean spaces. Besides, we also propose a method to estimate the appropriate dimensions of Euclidean spaces for different networks, and find that the estimated dimensions are quite close to the real dimensions for those geometrical networks under study. These methods thus can help to better understand the evolution of real-world networks, and have practical importance in network visualization, community detection, link prediction and localization of wireless sensors.

  13. Multidimensional Learner Model In Intelligent Learning System

    NASA Astrophysics Data System (ADS)

    Deliyska, B.; Rozeva, A.

    2009-11-01

    The learner model in an intelligent learning system (ILS) has to ensure the personalization (individualization) and the adaptability of e-learning in an online learner-centered environment. ILS is a distributed e-learning system whose modules can be independent and located in different nodes (servers) on the Web. This kind of e-learning is achieved through the resources of the Semantic Web and is designed and developed around a course, group of courses or specialty. An essential part of ILS is learner model database which contains structured data about learner profile and temporal status in the learning process of one or more courses. In the paper a learner model position in ILS is considered and a relational database is designed from learner's domain ontology. Multidimensional modeling agent for the source database is designed and resultant learner data cube is presented. Agent's modules are proposed with corresponding algorithms and procedures. Multidimensional (OLAP) analysis guidelines on the resultant learner module for designing dynamic learning strategy have been highlighted.

  14. Multidimensional Approximation Operators Generated by Lebesgue-Stieltjes Measures

    NASA Astrophysics Data System (ADS)

    Volkov, Yu I.

    1984-06-01

    A general class of sequences of multidimensional positive linear operators is defined and studied; it includes, in particular, sequences of multidimensional Berstein polynomials. The main asymptotic term is obtained in the remainder when derivatives of functions in certain classes are approximated by derivatives of the values of the operators on these functions. Bibliography: 10 titles.

  15. Multidimensional Linking for Tests with Mixed Item Types

    ERIC Educational Resources Information Center

    Yao, Lihua; Boughton, Keith

    2009-01-01

    Numerous assessments contain a mixture of multiple choice (MC) and constructed response (CR) item types and many have been found to measure more than one trait. Thus, there is a need for multidimensional dichotomous and polytomous item response theory (IRT) modeling solutions, including multidimensional linking software. For example,…

  16. Multidimensional Computerized Adaptive Testing for Indonesia Junior High School Biology

    ERIC Educational Resources Information Center

    Kuo, Bor-Chen; Daud, Muslem; Yang, Chih-Wei

    2015-01-01

    This paper describes a curriculum-based multidimensional computerized adaptive test that was developed for Indonesia junior high school Biology. In adherence to the Indonesian curriculum of different Biology dimensions, 300 items was constructed, and then tested to 2238 students. A multidimensional random coefficients multinomial logit model was…

  17. Entropic uncertainty relations in multidimensional position and momentum spaces

    SciTech Connect

    Huang Yichen

    2011-05-15

    Commutator-based entropic uncertainty relations in multidimensional position and momentum spaces are derived, twofold generalizing previous entropic uncertainty relations for one-mode states. They provide optimal lower bounds and imply the multidimensional variance-based uncertainty principle. The article concludes with an open conjecture.

  18. Multidimensional Physical Self-Concept of Athletes with Physical Disabilities

    ERIC Educational Resources Information Center

    Shapiro, Deborah R.; Martin, Jeffrey J.

    2010-01-01

    The purposes of this investigation were first to predict reported PA (physical activity) behavior and self-esteem using a multidimensional physical self-concept model and second to describe perceptions of multidimensional physical self-concept (e.g., strength, endurance, sport competence) among athletes with physical disabilities. Athletes (N =…

  19. Heteronuclear Multidimensional Protein NMR in a Teaching Laboratory

    ERIC Educational Resources Information Center

    Wright, Nathan T.

    2016-01-01

    Heteronuclear multidimensional NMR techniques are commonly used to study protein structure, function, and dynamics, yet they are rarely taught at the undergraduate level. Here, we describe a senior undergraduate laboratory where students collect, process, and analyze heteronuclear multidimensional NMR experiments using an unstudied Ig domain (Ig2…

  20. The Concept of Aptitude and Multidimensional Validity Revisited.

    ERIC Educational Resources Information Center

    Roeser, Robert W.; Shavelson, Richard J.; Kupermintz, Haggai; Lau, Shun; Ayala, Carlos; Haydel, Angela; Schultz, Susan; Gallagher, Larry; Quihuis, Gisell

    2002-01-01

    Provides an overview of the approach of Richard E. Snow to the concept of aptitude and multidimensional validity and summarizes the studies in this special issue. Overall, studies confirmed the multidimensional structure of science achievement scores, the validity of some key motivational constructs for predicting achievement, and other ideas…

  1. Evaluating Item Fit for Multidimensional Item Response Models

    ERIC Educational Resources Information Center

    Zhang, Bo; Stone, Clement A.

    2008-01-01

    This research examines the utility of the s-x[superscript 2] statistic proposed by Orlando and Thissen (2000) in evaluating item fit for multidimensional item response models. Monte Carlo simulation was conducted to investigate both the Type I error and statistical power of this fit statistic in analyzing two kinds of multidimensional test…

  2. N-Acetylcysteine Combined with Home Based Physical Activity: Effect on Health Related Quality of Life in Stable COPD Patients- A Randomised Controlled Trial

    PubMed Central

    Atram, Jitesh S.

    2016-01-01

    Introduction Quality of life is adversely affected in Chronic Obstructive Pulmonary Disease (COPD), due to irreversible, progressive nature of the disease and limitations of current treatment options available. One of the important aim of treatment of COPD is to improve Quality of Life (QoL). Cigarette smoke contains numerous free radicals and other oxidants. Oxidative stress has been implicated in pathogenesis, progression of disease and exacerbation in COPD. Pulmonary tuberculosis, outdoor and indoor air pollution and many others are aetiologies of COPD in non-smokers. N-Acetylcysteine (NAC) is a precursor of endogenous anti-oxidant, Glutathione (GSH) and both agents act as free radical scavengers. Exercise limitation results in poor physical performance and eventually poor QoL in COPD. Aim To observe the combined effect of 600mg of NAC once daily and physical activity (home based) in addition to standard treatment for ten weeks, compared with placebo as control group with standard treatment. Materials and Methods This randomised controlled trial was conducted at a tertiary care centre in Mumbai for two years from December 2011 to December 2013. Hundred patients diagnosed as stable COPD (as per Global Initiative against Obstructive Lung Disease (GOLD) 2010 guidelines) were enrolled in the study. There were 50 patients in study group and control group each. The QoL was assessed using Saint George Respiratory Questionnaire-C (SGRQ-C) initially and at the end of ten weeks. The study group was treated with NAC 600mg once a day combined with daily physical activity in addition to standard treatment. Control group patients were treated with placebo and standard treatment. Results At the end of 10 weeks, it was observed that, mean change in SGRQ-C was significant in “study group” as compared to “control group”. Mean change in score among study group was 4.72 and the same in control was 1.32, p-value=0.007. There was significant improvement in SGRQ-C score at the

  3. Exercise, lifestyle, and your bones

    MedlinePlus

    Osteoporosis - exercise; Low bone density - exercise; Osteopenia - exercise ... To build up bone density, the exercise must make your muscles pull on your bones. These are called weight-bearing exercises. Some of them are: ...

  4. Physical properties of multidimensional and multiferroic composites

    NASA Astrophysics Data System (ADS)

    Mori, Kiyotaka

    The properties of multidimensional and multiferroic composite systems consisting of smart materials are investigated for the intended use in microelectromechanical systems (MEMS) sensor and actuator applications. A multidimensional composite system combines within it different dimensionalities such as 1-D, 2-D, and 3-D constituents. A multiferroic composite system, meanwhile, consists of different ferroics such as ferroelastic, ferromagnetic and ferroelectric materials. We demonstrate effects of dimensionality on thermoelastic properties of NiTi/Si cantilevers for MEMS actuators. The stress state of the bimorph cantilevers is controlled by the dimensionality of the Si cantilever surface (2-D or 1-D corrugated) or the NiTi thin film (2-D or 1-D patterned). Compared to single dimensional NiTi/Si cantilevers the multidimensional device features an improved actuation performance, that is, it combines a small thermoelastic with a large martensitic transformational deflection. We also demonstrate magnetoelectric effects as examples of multiferroic composite systems for novel sensor applications. An example is the magnetic field induced magnetoelectric effect, MEH, in a ferroelectric/ferromagnetic composite PVDF/Terfenol-D. Here, an applied magnetic field induces a piezomagnetic strain in Terfenol-D, which couples to PVDF and induces a piezoelectric charge or voltage. We obtained a MEH coefficient of 1.43 V/cm Oe in agreement with an analytical calculation. The magnetoelastic coupling coefficient of the PVDF/Terfenol-D composite is estimated as 11%. Further, we demonstrate an electrical field induced magnetoelectric effect, MEE, in the ferromagnetic/ferroelectric composites CoB/PZT and PZT/Metglas/PZT. In this case the application of an electric field induces a piezoelectric strain in the PZT ceramic. The strain couples to piezomagnetic CoB or Metglas. Hence, the magnetization of the ferromagnetic materials changes with the electrical field applied to the ferroelectric

  5. A Pilot Randomized Controlled Trial of a Clinic and Home-Based Behavioral Intervention to Decrease Obesity in Preschoolers

    PubMed Central

    Stark, Lori J.; Spear, Stephanie; Boles, Richard; Kuhl, Elizabeth; Ratcliff, Megan; Scharf, Cindy; Bolling, Christopher; Rausch, Joseph

    2015-01-01

    We evaluated the efficacy of a 6-month clinic and home-based behavioral intervention (Learning about Activity and Understanding Nutrition for Child Health; LAUNCH) to reduce obesity in preschool children ≥95th BMI percentile compared to enhanced standard of care (Pediatrician Counseling; PC). LAUNCH was a family-based behavioral intervention that taught parents to use child behavior management strategies to increase healthy eating and activity for their children and themselves. PC presented the same diet and activity recommendations, but was delivered in a one-time PC session. Eighteen children aged 2–5 years (mean 4.71 ± 1.01) with an average BMI percentile of 98 (±1.60) and an overweight parent were randomized to LAUNCH or PC. Assessments were conducted at baseline, 6 months (end of LAUNCH treatment) and 12 months (6 months following LAUNCH treatment). LAUNCH showed a significantly greater decrease on the primary outcomes of child at month 6 (post-treatment) BMI z (−0.59 ± 0.17), BMI percentile (−2.4 ± 1.0), and weight gain (−2.7 kg ± 1.2) than PC and this difference was maintained at follow-up (month 12). LAUNCH parents also had a significantly greater weight loss (−5.5 kg ± 0.9) at month 6 and 12 (−8.0 kg ± 3.5) than PC parents. Based on the data from this small sample, an intensive intervention that includes child behavior management strategies to improve healthy eating and activity appears more promising in reducing preschool obesity than a low intensity intervention that is typical of treatment that could be delivered in primary care. PMID:20395948

  6. Results from a survey of national immunization programmes on home-based vaccination record practices in 2013

    PubMed Central

    Young, Stacy L.; Gacic-Dobo, Marta; Brown, David W.

    2015-01-01

    Background Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. Methods During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether records were provided free-of-charge or required by schools, whether there was a stock-out and the duration of any stock-outs that occurred, as well as the total expenditure for printing HBRs during 2013. Results A total of 140 countries returned a completed HBR questionnaire. Two countries were excluded from analysis because they did not use a HBR during 2013. HBR types varied across countries (vaccination only cards, 32/138 [23.1%]; vaccination plus growth monitoring records, 31/138 [22.4%]; child health books, 48/138 [34.7%]; combination of these, 27/138 [19.5%] countries). HBRs were provided free-of-charge in 124/138 (89.8%) respondent countries. HBRs were required for school entry in 62/138 (44.9%) countries. Nearly a quarter of countries reported HBR stock-outs during 2013. Computed printing cost per record was

  7. The contribution of home-based technology to older people's quality of life in extra care housing

    PubMed Central

    2011-01-01

    Background British government policy for older people focuses on a vision of active ageing and independent living. In the face of diminishing personal capacities, the use of appropriate home-based technology (HBT) devices could potentially meet a wide range of needs and consequently improve many aspects of older people's quality of life such as physical health, psychosocial well-being, social relationships, and their physical or living environment. This study aimed to examine the use of HBT devices and the correlation between use of such devices and quality of life among older people living in extra-care housing (ECH). Methods A structured questionnaire was administered for this study. Using purposive sampling 160 older people living in extra-care housing schemes were selected from 23 schemes in England. A face-to-face interview was conducted in each participant's living unit. In order to measure quality of life, the SEIQoL-Adapted and CASP-19 were used. Results Although most basic appliances and emergency call systems were used in the living units, communally provided facilities such as personal computers, washing machines, and assisted bathing equipment in the schemes were not well utilised. Multiple regression analysis adjusted for confounders including age, sex, marital status, living arrangement and mobility use indicated a coefficient of 1.17 with 95% CI (0.05, 2.29) and p = 0.04 [SEIQoL-Adapted] and 2.83 with 95% CI (1.17, 4.50) and p = 0.001 [CASP-19]. Conclusions The findings of the present study will be value to those who are developing new form of specialised housing for older people with functional limitations and, in particular, guiding investments in technological aids. The results of the present study also indicate that the home is an essential site for developing residential technologies. PMID:22040111

  8. Adverse events in an integrated home-based treatment program for MDR-TB and HIV in KwaZulu-Natal, South Africa.

    PubMed

    Brust, James C M; Shah, N Sarita; van der Merwe, Theo L; Bamber, Sheila; Ning, Yuming; Heo, Moonseong; Moll, Anthony P; Loveday, Marian; Lalloo, Umesh G; Friedland, Gerald H; Gandhi, Neel R

    2013-04-01

    Most patients with multidrug-resistant tuberculosis (MDR-TB) in South Africa are HIV-infected, but the safety and tolerability of cotreatment are unknown. The authors reviewed all adverse events (AEs) for patients with MDR-TB in a home-based treatment program in rural KwaZulu-Natal. Of 91 MDR-TB patients, 74 (81%) were HIV-positive and receiving antiretroviral therapy. AEs were common, but most were mild and did not require therapy modification. The most common severe AEs were hypothyroidism (36%) and psychosis (5%). Patients receiving concurrent antiretroviral therapy did not experience AEs more frequently than those on MDR-TB therapy alone. Concurrent treatment for MDR-TB/HIV can be safely administered in a home-based care setting.

  9. FIRST-GENERATION LATINA MOTHERS' EXPERIENCES OF SUPPLEMENTING HOME-BASED EARLY HEAD START WITH THE ATTACHMENT AND BIOBEHAVIORAL CATCH-UP PROGRAM.

    PubMed

    Aparicio, Elizabeth M; Denmark, Nicole; Berlin, Lisa J; Jones Harden, Brenda

    2016-09-01

    This qualitative pilot study examined first-generation Latina mothers' experiences of supplementing home-based Early Head Start (EHS) services with the evidence-based Attachment and Biobehavioral Catch-up (ABC; M. Dozier, O. Lindheim, & J. Ackerman, 2005) program. Ten low-income, first-generation Latina mothers with infants and toddlers enrolled in home-based EHS were provided 10 ABC home visits by a supplemental parent coach. Following delivery of ABC, mothers participated in in-depth, semistructured, qualitative interviews about their experiences. Interview themes included positive experiences of both EHS and the ABC, a high value placed on receiving both programs, and cultural relevance of the ABC program for Latino families. Participants offered several suggestions for improved program delivery. Study findings suggest that a model of EHS supplemented by ABC delivered to the Latino community is feasible, valuable to participants, and culturally relevant. Considerations for sustainability of this supplemental model are discussed.

  10. Multidimensional scaling of musical time estimations.

    PubMed

    Cocenas-Silva, Raquel; Bueno, José Lino Oliveira; Molin, Paul; Bigand, Emmanuel

    2011-06-01

    The aim of this study was to identify the psycho-musical factors that govern time evaluation in Western music from baroque, classic, romantic, and modern repertoires. The excerpts were previously found to represent variability in musical properties and to induce four main categories of emotions. 48 participants (musicians and nonmusicians) freely listened to 16 musical excerpts (lasting 20 sec. each) and grouped those that seemed to have the same duration. Then, participants associated each group of excerpts to one of a set of sine wave tones varying in duration from 16 to 24 sec. Multidimensional scaling analysis generated a two-dimensional solution for these time judgments. Musical excerpts with high arousal produced an overestimation of time, and affective valence had little influence on time perception. The duration was also overestimated when tempo and loudness were higher, and to a lesser extent, timbre density. In contrast, musical tension had little influence.

  11. AMADA-Analysis of multidimensional astronomical datasets

    NASA Astrophysics Data System (ADS)

    de Souza, R. S.; Ciardi, B.

    2015-09-01

    We present AMADA, an interactive web application to analyze multidimensional datasets. The user uploads a simple ASCII file and AMADA performs a number of exploratory analysis together with contemporary visualizations diagnostics. The package performs a hierarchical clustering in the parameter space, and the user can choose among linear, monotonic or non-linear correlation analysis. AMADA provides a number of clustering visualization diagnostics such as heatmaps, dendrograms, chord diagrams, and graphs. In addition, AMADA has the option to run a standard or robust principal components analysis, displaying the results as polar bar plots. The code is written in R and the web interface was created using the SHINY framework. AMADA source-code is freely available at https://goo.gl/KeSPue, and the shiny-app at http://goo.gl/UTnU7I.

  12. Biological evolution in a multidimensional fitness landscape

    NASA Astrophysics Data System (ADS)

    Saakian, David B.; Kirakosyan, Zara; Hu, Chin-Kun

    2012-09-01

    We considered a multiblock molecular model of biological evolution, in which fitness is a function of the mean types of alleles located at different parts (blocks) of the genome. We formulated an infinite population model with selection and mutation, and calculated the mean fitness. For the case of recombination, we formulated a model with a multidimensional fitness landscape (the dimension of the space is equal to the number of blocks) and derived a theorem about the dynamics of initially narrow distribution. We also considered the case of lethal mutations. We also formulated the finite population version of the model in the case of lethal mutations. Our models, derived for the virus evolution, are interesting also for the statistical mechanics and the Hamilton-Jacobi equation as well.

  13. Masking failures of multidimensional sensors (extended abstract)

    NASA Technical Reports Server (NTRS)

    Chew, Paul; Marzullo, Keith

    1990-01-01

    When a computer monitors a physical process, the computer uses sensors to determine the values of the physical variables that represent the state of the process. A sensor can sometimes fail, however, and in the worst case report a value completely unrelated to the true physical value. The work described is motivated by a methodology for transforming a process control program that can not tolerate sensor failure into one that can. In this methodology, a reliable abstract sensor is created by combining information from several real sensors that measure the same physical value. To be useful, an abstract sensor must deliver reasonably accurate information at reasonable computational cost. Sensors are considered that deliver multidimensional values (e.g., location or velocity in three dimensions, or both temperature and pressure). Geometric techniques are used to derive upper bounds on abstract sensor accuracy and to develop efficient algorithms for implementing abstract sensors.

  14. Biological evolution in a multidimensional fitness landscape.

    PubMed

    Saakian, David B; Kirakosyan, Zara; Hu, Chin-Kun

    2012-09-01

    We considered a multiblock molecular model of biological evolution, in which fitness is a function of the mean types of alleles located at different parts (blocks) of the genome. We formulated an infinite population model with selection and mutation, and calculated the mean fitness. For the case of recombination, we formulated a model with a multidimensional fitness landscape (the dimension of the space is equal to the number of blocks) and derived a theorem about the dynamics of initially narrow distribution. We also considered the case of lethal mutations. We also formulated the finite population version of the model in the case of lethal mutations. Our models, derived for the virus evolution, are interesting also for the statistical mechanics and the Hamilton-Jacobi equation as well.

  15. Multidimensional gas chromatography beyond simple volatiles separation.

    PubMed

    Chin, Sung-Tong; Marriott, Philip J

    2014-08-18

    Multidimensional separation in gas chromatography (MDGC) plays an important role in chemical analysis. This review presents selected literature on MDGC development and examples of the range of functionality reported for MDGC methods over the past 2 decades. With the most obvious advantage of providing much greater capacity for resolving constituents of a sample, MDGC extends analytical efficiency to a more substantial molecular coverage, combined with operational flexibility. But by judicious choice of implementation method, important chemical information relating to the sample, its components, potentially physico-chemical properties, and improved capacity for absolute identification may be realised. Sample-to-sample comparison is improved, and sample characterisation is facilitated especially when MDGC is combined with the informing power of modern mass spectrometry. Innovative MDGC arrangements allow high resolution coupled with spectroscopy and alternative bioassays, and delivers molecular elucidation in ways that are beyond just simple analysis of volatiles.

  16. Multidimensional integrable models of gravitation and cosmology

    NASA Astrophysics Data System (ADS)

    Ivashchuk, V. D.; Melnikov, V. N.

    Review of the motivation and main results in multidimentional gravitation and cosmology is presented. Special attention is devoted to results within the model with scalar fields and fields of forms in the billiard approach for obtaining cosmological solutions with branes and integrable configurations with fluxand black branes. In case of the quantum billiard with branes it is shown that the basis solutions for wave functions vanish in the limit of the formation of billiard walls (i.e., at the singularity) for the D = 11 model which mimics the D = 11 supergravitational cosmology. Another fruitful approach - to multidimensional gravity with higher derivatives is mentioned, which leads to a unified description of inflation and the present accelerated expansion of the Universe. Some of these models explain possible spatial and temporal variations of the fine structure and the gravitational constants.

  17. Quantum effects in homogeneous multidimensional cosmologies

    SciTech Connect

    Szydlowski, M.; Szczesny, J.

    1988-12-15

    In the present paper we determine quantum distribution functions for a wide class of multidimensional cosmological models. The exact formulas for quantum distribution functions are given and their universal character at high and low temperatures shown. The obtained formulas provide us with the possibility to investigate the metric back reaction and to discuss the dimensional reduction problem. The assumption of the low-temperature approximation gives us the possibility to discuss the dynamics by using the methods of dynamical systems. Stable solutions, within the class FRW x S/sup 3/ x S/sup 3/ models, where FRW denotes Friedmann, Robertson and Walker, are discussed, and it is shown that only a zero-measure set of trajectories in the phase space leads to a solution with a static microspace. This analysis shows that, insofar as quantum effects lead to solutions with a static microspace, these solutions are unstable.

  18. DRACO---A New Multidimensional Hydrocode

    NASA Astrophysics Data System (ADS)

    Keller, D.; Collins, T. J. B.; Delettrez, J. A.; McKenty, P. W.; Radha, P. B.; Town, R. P. J.; Whitney, B.; Moses, G. A.

    1999-11-01

    A program to develop a new multidimensional hydrocode is underway at LLE. DRACO is an arbitrary Lagrange-Eulerian (ALE) code designed to run in 1, 2, and 3 dimensions in planar (cartesian), cylindrical, and spherical geometries. The basic hydroportion of DRACO employs second-order rezoning and interface tracking. A mixed-material equation of state (EOS) using SESAME or Wisconsin table lookups has recently been incorporated. One of the main objectives of the program is to fully exploit the parallel capabilities of the 32-processor SGI Origin-2000. This paper will describe the basic code, present results of our parallel work, and show results of recent burnthrough calculations. This work was supported by the U.S. Department of Energy Office of Inertial Confinement Fusion under Cooperative Agreement No. DE-FC03-92SF19460, the University of Rochester, and the New York State Energy Research and Development Authority.

  19. Multidimensional student skills with collaborative filtering

    NASA Astrophysics Data System (ADS)

    Bergner, Yoav; Rayyan, Saif; Seaton, Daniel; Pritchard, David E.

    2013-01-01

    Despite the fact that a physics course typically culminates in one final grade for the student, many instructors and researchers believe that there are multiple skills that students acquire to achieve mastery. Assessment validation and data analysis in general may thus benefit from extension to multidimensional ability. This paper introduces an approach for model determination and dimensionality analysis using collaborative filtering (CF), which is related to factor analysis and item response theory (IRT). Model selection is guided by machine learning perspectives, seeking to maximize the accuracy in predicting which students will answer which items correctly. We apply the CF to response data for the Mechanics Baseline Test and combine the results with prior analysis using unidimensional IRT.

  20. Multidimensional Scaling Visualization Using Parametric Entropy

    NASA Astrophysics Data System (ADS)

    Lopes, António M.; Tenreiro Machado, J. A.; Galhano, Alexandra M.

    2015-12-01

    This paper studies complex systems using a generalized multidimensional scaling (MDS) technique. Complex systems are characterized by time-series responses, interpreted as a manifestation of their dynamics. Two types of time-series are analyzed, namely 18 stock markets and the gross domestic product per capita of 18 countries. For constructing the MDS charts, indices based on parametric entropies are adopted. Multiparameter entropies allow the variation of the parameters leading to alternative sets of charts. The final MDS maps are then assembled by means of Procrustes’ method that maximizes the fit between the individual charts. Therefore, the proposed method can be interpreted as a generalization to higher dimensions of the standard technique that represents (and discretizes) items by means of single “points” (i.e. zero-dimensional “objects”). The MDS plots, involving one-, two- and three-dimensional “objects”, reveal a good performance in capturing the correlations between data.

  1. Testing for uniformity in multidimensional data.

    PubMed

    Smith, S P; Jain, A K

    1984-01-01

    Testing for uniformity in multidimensional data is important in exploratory pattern analysis, statistical pattern recognition, and image processing. The goal of this paper is to determine whether the data follow the uniform distribution over some compact convex set in K-dimensional space, called the sampling window. We first provide a simple, computationally efficient method for generating a uniformly distributed sample over a set which approximates the convex hul of the data. We then test for uniformity by comparing this generated sample to the data by using Friedman-Rafsky's minimal spanning tree (MST) based test. Experiments with both simulated and real data indicate that this MST-based test is useful in deciding if data are uniform.

  2. Multidimensional numerical modeling of heat exchangers

    NASA Astrophysics Data System (ADS)

    Sha, W. T.; Yang, C. I.; Kao, T. T.; Cho, S. M.

    A comprehensive, multidimensional, thermal-hydraulic model is developed for the analysis of shell-and-tube heat exchangers for liquid-metal services. For the shellside fluid, the conservation equations of mass, momentum, and energy for continuum fluids are modified using the concept of porosity, surface permeability and distributed resistance to account for the blockage effects due to the presence of heat-transfer tubes, flow baffles/shrouds, the support plates, etc. On the tubeside, the heat-transfer tubes are connected in parallel between the inlet and outlet plenums, and tubeside flow distribution is calculated based on the plenum-to-plenum pressure difference being equal for all tubes. It is assumed that the fluid remains single-phase on the shell side and may undergo phase-change on the tube side, thereby simulating the conditions of Liquid Metal Fast Breeder Reactor (LMFBR) intermediate heat exchangers (IHX) and steam generators (SG).

  3. Transonic Shocks in Multidimensional Divergent Nozzles

    NASA Astrophysics Data System (ADS)

    Bae, Myoungjean; Feldman, Mikhail

    2011-07-01

    We establish existence, uniqueness and stability of transonic shocks for a steady compressible non-isentropic potential flow system in a multidimensional divergent nozzle with an arbitrary smooth cross-section, for a prescribed exit pressure. The proof is based on solving a free boundary problem for a system of partial differential equations consisting of an elliptic equation and a transport equation. In the process, we obtain unique solvability for a class of transport equations with velocity fields of weak regularity (non-Lipschitz), an infinite dimensional weak implicit mapping theorem which does not require continuous Fréchet differentiability, and regularity theory for a class of elliptic partial differential equations with discontinuous oblique boundary conditions.

  4. Improving quality of home-based postnatal care by microteaching of multipurpose workers in rural and urban slum areas of Chandigarh, India: a pilot study

    PubMed Central

    Gupta, Madhu; Tripathy, Jaya Prasad; Jamir, Limalemla; Sarwa, Ashutosh; Sinha, Smita; Bhag, Chering

    2017-01-01

    Background Microteaching is an efficient teaching tool to improve skills. Until now, its use is very limited in the health sector. A pilot study was carried out to improve the quality of home-based postnatal care by microteaching of health workers (HWs) and ascertain its feasibility for supportive supervision. Methods All (n=12) the HWs catering to a population of ~0.1 million were video recorded while performing home-based postnatal check up in Chandigarh from August 2013 to December 2014. After each round, HWs were shown their videos and trained in the facility and at home. Video recordings, assessments followed by training, continued until HWs acquired the intended skills. A pretested structured checklist based on the national home-based postnatal care guidelines was used for recording and assessing of postnatal skills. A score “0” given for no task, “1” for incorrectly done or partially done task, and “2” for correct task. The average score of each round was calculated and compared. Results The overall skill assessment score improved from 0.64 to 1.76, newborn examination skill from 0.52 to 1.63, maternal examination from 0.54 to 1.62, and counseling from 1.01 to 1.85 after three rounds of video recording. The proportion of HWs carrying a thermometer increased from 21% to 100%. Second and third rounds of video recording and microteaching were successfully carried out by the program supervisors. Conclusion This was the first study to report on the effective use of microteaching in improving home-based postnatal care skills of the health care workers and its feasibility for supportive supervision. PMID:28031730

  5. Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

    PubMed Central

    2012-01-01

    Background The high incidence of falls associated with Parkinson’s disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated. Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined. Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD. Trial registration The trial is registered on the Australian and New Zealand Clinical Trials Registry (ACTRN12608000390381). PMID:22799601

  6. WHO/UNICEF recommended therapeutic food versus home based therapeutic food in the management of severe acute malnutrition: A randomized controlled trial

    PubMed Central

    Mittal, Mahima; Kushwaha, K P

    2016-01-01

    Malnutrition is a major public health problem especially in the developing countries. The objective of the study was to compare WHO/UNICEF recommended therapeutic food with home based therapeutic food in the management of severe acute malnutrition. It was a randomized controlled trial at tertiary care level hospital with nutritional rehabilitation centre. Children (6 month to 5 years) having severe acute malnutrition were included in the study. Group A (n=74 children) was given WHO recommended therapeutic food and group B (n=75 children) was given home based therapeutic food. The mean rate of weight gain, gain in height and increase in mid-upper arm circumference were significantly higher (p<0.05) in the group received home based therapeutic food. Mean duration to achieve target weight was 21.44±3.33 days in group A and 16.28±2.11 days in group B (phome based therapeutic food was found to be more effective. This could be explained by better acceptability in terms of better palatability, more affordability, increased frequency of feeding, and having less difficulty in making. PMID:28096555

  7. Easy Exercises for Teens

    MedlinePlus

    ... Surgery? A Week of Healthy Breakfasts Shyness Easy Exercises for Teens KidsHealth > For Teens > Easy Exercises for Teens A A A en español Ejercicios ... all the running around we do counts as exercise. (It does. But if it's the only exercise ...

  8. Exercise After Pregnancy

    MedlinePlus

    ... moderate-intensity exercise. Remember, even 10 minutes of exercise benefits your body. If you exercised vigorously before pregnancy ... want to join a gym but want the benefits of having someone to exercise with, ask a friend to be your workout ...

  9. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program

    PubMed Central

    Mankikar, Deepa; Campbell, Carla; Greenberg, Rachael

    2016-01-01

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children’s asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013–2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p < 0.05) of children’s asthma-related doctor visits and hospital admissions at program completion. In addition, there were significantly reduced reports of the presence of home-based hazards, including basement or roof leaks (p = 0.011), plumbing leaks (p = 0.019), and use of an oven to heat the home (p < 0.001). Participants’ pre- and post- test scores showed significant improvement (p < 0.05) in knowledge and awareness of home hazards. Comprehensive home interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term. PMID:27618087

  10. Motor activity (exploration) and formation of home bases in mice (C57BL/6) influenced by visual and tactile cues: modification of movement distribution, distance, location, and speed.

    PubMed

    Clark, Benjamin J; Hamilton, Derek A; Whishaw, Ian Q

    2006-04-15

    The motor activity of mice in tests of "exploration" is organized. Mice establish home bases, operationally defined as places where they spend long periods of time, near physical objects and nesting material from which they make excursions. This organization raises the question of the extent to which mouse motoric activity is modulated by innate predispositions versus environmental influences. Here the influence of contextual cues (visual and tactile) on the motor activity of C57BL/6 mice was examined: (1) on an open field that had no walls, a partial wall, or a complete wall, (2) in the presence of distinct visual cues, room cues, or in the absence of visual cues (infrared light), and (3) in the presence of configurations of visual and tactile cues. Mice were generally less active in the presence of salient cues and formed home bases near those cues. In addition, movement speed, path distribution, and the number and length of stops were modulated by contextual cues. With repeated tests, mice favored tactile cues over visual cues as their home base locations. Although responses to cues were robust over test days, conditioning to context was generally weak. That the exploratory behavior of mice is affected by experience and context provides insights into performance variability and may prove useful in investigating the genetic and neural influences on mouse behavior.

  11. Determining Dimensionality of Exercise Readiness Using Exploratory Factor Analysis.

    PubMed

    Strohacker, Kelley; Zakrajsek, Rebecca A

    2016-06-01

    , exercise readiness appears to be supported by 4 dimensions: vitality, physical fatigue, discomfort, and health.These findings prove a theoretical basis to construct a brief, multidimensional measure of exercise readiness.

  12. Determining Dimensionality of Exercise Readiness Using Exploratory Factor Analysis

    PubMed Central

    Strohacker, Kelley; Zakrajsek, Rebecca A.

    2016-01-01

    analysis, exercise readiness appears to be supported by 4 dimensions: vitality, physical fatigue, discomfort, and health. These findings prove a theoretical basis to construct a brief, multidimensional measure of exercise readiness. PMID:27274659

  13. Oral health related quality of life in pregnant and post partum women in two social network domains; predominantly home-based and work-based networks

    PubMed Central

    2012-01-01

    Background Individuals connected to supportive social networks have better general and oral health quality of life. The objective of this study was to assess whether there were differences in oral health related quality of life (OHRQoL) between women connected to either predominantly home-based and work-based social networks. Methods A follow-up prevalence study was conducted on 1403 pregnant and post-partum women (mean age of 25.2 ± 6.3 years) living in two cities in the State of Rio de Janeiro, Brazil. Women were participants in an established cohort followed from pregnancy (baseline) to post-partum period (follow-up). All participants were allocated to two groups; 1. work-based social network group - employed women with paid work, and, 2. home-based social network group - women with no paid work, housewives or unemployed women. Measures of social support and social network were used as well as questions on sociodemographic characteristics and OHRQoL and health related behaviors. Multinomial logistic regression was performed to obtain OR of relationships between occupational contexts, affectionate support and positive social interaction on the one hand, and oral health quality of life, using the Oral Health Impacts Profile (OHIP) measure, adjusted for age, ethnicity, family income, schooling, marital status and social class. Results There was a modifying effect of positive social interaction on the odds of occupational context on OHRQoL. The odds of having a poorer OHIP score, ≥4, was significantly higher for women with home-based social networks and moderate levels of positive social interactions [OR 1.64 (95% CI: 1.08-2.48)], and for women with home-based social networks and low levels of positive social interactions [OR 2.15 (95% CI: 1.40-3.30)] compared with women with work-based social networks and high levels of positive social interactions. Black ethnicity was associated with OHIP scores ≥4 [OR 1.73 (95% CI: 1.23-2.42)]. Conclusions Pregnant and post

  14. Effects of home-based constraint-induced therapy versus dose-matched control intervention on functional outcomes and caregiver well-being in children with cerebral palsy.

    PubMed

    Lin, Keh-chung; Wang, Tien-ni; Wu, Ching-yi; Chen, Chia-ling; Chang, Kai-chieh; Lin, Yu-chan; Chen, Yi-ju

    2011-01-01

    This study compared home-based constraint-induced therapy (CIT) with a dose-matched home-based control intervention for children with cerebral palsy (CP). The differences in unilateral and bilateral motor performance, daily functions, and quality of parental well-being (i.e., the stress level of their parents) were evaluated. The study included 21 children with CP (age range, 48-119 months) who were randomly assigned to the CIT or control group. All participants received individualized home-based interventions, 3.5-4h a day, twice a week for 4weeks. Primary outcomes were measured by the Peabody Developmental Motor Scales II (PDMS-2) and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) is the whole name of the assessment. All first letters of this instrument title should be in upper case. Secondary outcome measures were the Pediatric Motor Activity Log (PMAL), the Caregiver Functional Use Survey (CFUS), and the Parenting Stress Index-Short Form (PSI). Outcome measures were performed at baseline (pretreatment), 4weeks (posttreatment), and 6-month (follow-up). Compared with the control group, the CIT group exhibited significantly better performance in grasping control as measured by the PDMS-2, unilateral/bilateral motor efficacy as measured by the BOTMP, and unilateral hand function as measured by the PMAL immediately after the treatment. At the 6-month follow-up, CIT had beneficial effects on grasping control assessed by PDMS-2 and on unilateral/bilateral functional performance measured by the PMAL and CFUS. Parents in both groups reported comparable stress levels at the 6-month follow-up, although the parent-child dysfunctional interaction deteriorated more immediately after CIT than after the control intervention. The follow-up of this randomized controlled trial suggested beneficial effects of home-based CIT on unilateral grasping skills and unilateral/bilateral functional performance at 6 months. The higher stress level reported by the parents in the

  15. The role of home-based records in the establishment of a continuum of care for mothers, newborns, and children in Indonesia

    PubMed Central

    Osaki, Keiko; Hattori, Tomoko; Kosen, Soewarta

    2013-01-01

    Background The provision of appropriate care along the continuum of maternal, newborn, and child health (MNCH) service delivery is a challenge in developing countries. To improve this, in the 1990s, Indonesia introduced the maternal and child health (MCH) handbook, as an integrated form of parallel home-based records. Objective This study aimed to identify the roles of home-based records both before and after childbirth, especially in provinces where the MCH handbook (MCHHB) was extensively promoted, by examining their association with MNCH service uptake. Design This was a cross-sectional study using nationally representative data sets, the Indonesia Demographic and Health Surveys (IDHSs) from 1997, 2002–2003, and 2007. The IDHS identifies respondents’ ownership of home-based records before and after childbirth. Multivariate logistic regression was used to examine associations between record ownership and service utilisation in national data and data from two provinces, West Sumatra and North Sulawesi, where ownership of pre- and post-natal records served as a proxy for MCHHB ownership. Results Pre- and post-natal record ownership increased from 1997 to 2007. Provincial data from 2007 showed that handbook ownership was associated with having delivery assisted by trained personnel [adjusted odds ratio (aOR): 2.12, 95% confidence interval (CI): 1.05–4.25], receiving maternal care (aOR: 3.92, 95% CI: 2.35–6.52), completing 12 doses of child immunisation for seven diseases (aOR: 4.86, 95% CI: 2.37–9.95), and having immunisation before and after childbirth (aOR: 5.40, 95% CI: 2.28–12.76), whereas national data showed that service utilisation was associated with ownership of both records compared with owning a single record or none. Conclusion Our results suggest that pre- and post-natal home-based record use may be effective for ensuring service utilisation. In addition, since the handbook is an efficient home-based record for use throughout children's life

  16. Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review

    PubMed Central

    Gogia, S; Sachdev, H P S

    2016-01-01

    The objective of this review is to assess the effect of home-based neonatal care provided by community health workers (CHWs) for preventing neonatal, infant and perinatal mortality in resource-limited settings with poor access to health facility-based care. The authors conducted a systematic review, including meta-analysis and meta-regression of controlled trials. The data sources included electronic databases, with a hand search of reviews, abstracts and proceedings of conferences to search for randomized, or cluster randomized, controlled trials evaluating the effect of home-based neonatal care provided by CHWs for preventing neonatal, infant and perinatal mortality. Among the included trials, all from South Asian countries, information on neonatal, infant and perinatal mortality was available in five, one and three trials, respectively. The intervention package comprised three components, namely, home visits during pregnancy (four trials), home-based preventive and/or curative neonatal care (all trials) and community mobilization efforts (four trials). Intervention was associated with a reduced risk of mortality during the neonatal (random effects model relative risk (RR) 0.75; 95% confidence intervals (CIs) 0.61 to 0.92, P=0.005; I2=82.2%, P<0.001 for heterogeneity; high-quality evidence) and perinatal periods (random effects model RR 0.78; 95% CI 0.64 to 0.94, P=0.009; I2=79.6%, P=0.007 for heterogeneity; high-quality evidence). In one trial, a significant decline in infant mortality (RR 0.85; 95% CI 0.77 to 0.94) was documented. Subgroup and meta-regression analyses suggested a greater effect with a higher baseline neonatal mortality rate. The authors concluded that home-based neonatal care is associated with a reduction in neonatal and perinatal mortality in South Asian settings with high neonatal-mortality rates and poor access to health facility-based care. Adoption of a policy of home-based neonatal care provided by CHWs is justified in such settings

  17. A study of multidimensional modeling approaches for data warehouse

    NASA Astrophysics Data System (ADS)

    Yusof, Sharmila Mat; Sidi, Fatimah; Ibrahim, Hamidah; Affendey, Lilly Suriani

    2016-08-01

    Data warehouse system is used to support the process of organizational decision making. Hence, the system must extract and integrate information from heterogeneous data sources in order to uncover relevant knowledge suitable for decision making process. However, the development of data warehouse is a difficult and complex process especially in its conceptual design (multidimensional modeling). Thus, there have been various approaches proposed to overcome the difficulty. This study surveys and compares the approaches of multidimensional modeling and highlights the issues, trend and solution proposed to date. The contribution is on the state of the art of the multidimensional modeling design.

  18. A Conceptual Model for Multidimensional Analysis of Documents

    NASA Astrophysics Data System (ADS)

    Ravat, Franck; Teste, Olivier; Tournier, Ronan; Zurlfluh, Gilles

    Data warehousing and OLAP are mainly used for the analysis of transactional data. Nowadays, with the evolution of Internet, and the development of semi-structured data exchange format (such as XML), it is possible to consider entire fragments of data such as documents as analysis sources. As a consequence, an adapted multidimensional analysis framework needs to be provided. In this paper, we introduce an OLAP multidimensional conceptual model without facts. This model is based on the unique concept of dimensions and is adapted for multidimensional document analysis. We also provide a set of manipulation operations.

  19. Home-Based Psychiatric Outpatient Care Through Videoconferencing for Depression: A Randomized Controlled Follow-Up Trial

    PubMed Central

    Rössler, Wulf

    2016-01-01

    Background There is a tremendous opportunity for innovative mental health care solutions such as psychiatric care through videoconferencing to increase the number of people who have access to quality care. However, studies are needed to generate empirical evidence on the use of psychiatric outpatient care via videoconferencing, particularly in low- and middle-income countries and clinically unsupervised settings. Objective The objective of this study was to evaluate the effectiveness and feasibility of home-based treatment for mild depression through psychiatric consultations via videoconferencing. Methods A randomized controlled trial with a 6- and 12-month follow-up including adults with mild depression treated in an ambulatory setting was conducted. In total, 107 participants were randomly allocated to the videoconferencing intervention group (n=53) or the face-to-face group (F2F; n=54). The groups did not differ with respect to demographic characteristics at baseline. The F2F group completed monthly follow-up consultations in person. The videoconferencing group received monthly follow-up consultations with a psychiatrist through videoconferencing at home. At baseline and after 6 and 12 months, in-person assessments were conducted with all participants. Clinical outcomes (severity of depression, mental health status, medication course, and relapses), satisfaction with treatment, therapeutic relationship, treatment adherence (appointment compliance and dropouts), and medication adherence were assessed. Results The severity of depression decreased significantly over the 12-month follow-up in both the groups. There was a significant difference between groups regarding treatment outcomes throughout the follow-up period, with better results in the videoconferencing group. There were 4 relapses in the F2F group and only 1 in the videoconferencing group. No significant differences between groups regarding mental health status, satisfaction with treatment, therapeutic

  20. Impact of a home-based social welfare program on care for palliative patients in the Basque Country (SAIATU Program)

    PubMed Central

    2013-01-01

    Background SAIATU is a program of specially trained in-home social assistance and companionship which, since February 2011, has provided support to end-of-life patients, enabling the delivery of better clinical care by healthcare professionals in Osakidetza (Basque Health Service), in Guipúzcoa (Autonomous Community of the Basque Country). In January 2012, a retrospective observational study was carried out, with the aim of describing the characteristics of the service and determining if the new social service and the associated socio-health co-ordination had produced any effect on the use of healthcare resources by end-of-life patients. The results of a comparison of a cohort of cases and controls demonstrated evidence that the program could reduce the use of hospital resources and promote the continuation of living at home, increasing the home-based activity of primary care professionals. The objective of this study is to analyse whether a program of social intervention in palliative care (SAIATU) results in a reduction in the consumption of healthcare resources and cost by end-of-life patients and promotes a shift towards a more community-based model of care. Method/design Comparative prospective cohort study, with randomised selection of patients, which will systematically measure patient characteristics and their consumption of resources in the last 30 days of life, with and without the intervention of a social support team trained to provide in-home end-of-life care. For a sample of approximately 150 patients, data regarding the consumption of public healthcare resources, SAIATU activity, home hospitalisation teams, and palliative care will be recorded. Such data will also include information dealing with the socio-demographic and clinical characteristics of the patients and attending carers, as well as particular characteristics of patient outcomes (Karnofsky Index), and of the outcomes of palliative care received (Palliative Outcome Scale). Ethical

  1. HIV/AIDS and access to water: A case study of home-based care in Ngamiland, Botswana

    NASA Astrophysics Data System (ADS)

    Ngwenya, B. N.; Kgathi, D. L.

    This case study investigates access to potable water in HIV/AIDS related home-based care households in five rural communities in Ngamiland, Botswana. Primary data collected from five villages consisted of two parts. The first survey collected household data on demographic and rural livelihood features and impacts of HIV/AIDS. A total of 129 households were selected using a two-stage stratified random sampling method. In the second survey, a total of 39 family primary and community care givers of continuously ill, bed-ridden or non-bed-ridden HIV/AIDS patients were interviewed. A detailed questionnaire, with closed and open-ended questions, was used to collect household data. In addition to using the questionnaire, data were also collected through participant observation, informal interviews and secondary sources. The study revealed that there are several sources of water for communities in Ngamiland such as off-plot, outdoor (communal) and on-plot outdoor and/or indoor (private) water connections, as well as other sources such as bowsed water, well-points, boreholes and open perennial/ephemeral water from river channels and pans. There was a serious problem of unreliable water supply caused by, among other things, the breakdown of diesel-powered water pumps, high frequency of HIV/AIDS related absenteeism, and the failure of timely delivery of diesel fuel. Some villages experienced chronic supply disruptions while others experienced seasonal or occasional water shortages. Strategies for coping with unreliability of water supply included economizing on water, reserve storage, buying water, and collection from river/dug wells or other alternative sources such as rain harvesting tanks in government institutions. The unreliability of water supply resulted in an increase in the use of water of poor quality and other practices of poor hygiene as well as a high opportunity cost of water collection. In such instances, bathing of patients was cut from twice daily to once or

  2. Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a Home-based, Individually-tailored Physical activity Print intervention for African American women in the Deep South

    PubMed Central

    Pekmezi, Dori; Ainsworth, Cole; Joseph, Rodney; Bray, Molly S.; Kvale, Elizabeth; Isaac, Shiney; Desmond, Renee; Meneses, Karen; Marcus, Bess; Demark-Wahnefried, Wendy

    2016-01-01

    African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD= 4.7), a BMI of 32.1 kg/m2 (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5 minutes/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health. PMID:26944022

  3. Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a home-based, individually-tailored physical activity print intervention for African American women in the Deep South.

    PubMed

    Pekmezi, Dori; Ainsworth, Cole; Joseph, Rodney; Bray, Molly S; Kvale, Elizabeth; Isaac, Shiney; Desmond, Renee; Meneses, Karen; Marcus, Bess; Demark-Wahnefried, Wendy

    2016-03-01

    African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD=4.7), a BMI of 32.1 kg/m(2) (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5 min/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health.

  4. NASA Multidimensional Stirling Convertor Code Developed

    NASA Technical Reports Server (NTRS)

    Tew, Roy C.; Thieme, Lanny G.

    2004-01-01

    A high-efficiency Stirling Radioisotope Generator (SRG) for use on potential NASA Space Science missions is being developed by the Department of Energy, Lockheed Martin, Stirling Technology Company, and the NASA Glenn Research Center. These missions may include providing spacecraft onboard electric power for deep space missions or power for unmanned Mars rovers. Glenn is also developing advanced technology for Stirling convertors, aimed at substantially improving the specific power and efficiency of the convertor and the overall power system. Performance and mass improvement goals have been established for second- and third-generation Stirling radioisotope power systems. Multiple efforts are underway to achieve these goals, both in house at Glenn and under various grants and contracts. These efforts include the development of a multidimensional Stirling computational fluid dynamics code, high-temperature materials, advanced controllers, an end-to-end system dynamics model, low-vibration techniques, advanced regenerators, and a lightweight convertor. Under a NASA grant, Cleveland State University (CSU) and its subcontractors, the University of Minnesota (UMN) and Gedeon Associates, have developed a twodimensional computer simulation of a CSUmod Stirling convertor. The CFD-ACE commercial software developed by CFD Research Corp. of Huntsville, Alabama, is being used. The CSUmod is a scaled version of the Stirling Technology Demonstrator Convertor (TDC), which was designed and fabricated by the Stirling Technology Company and is being tested by NASA. The schematic illustrates the structure of this model. Modeled are the fluid-flow and heat-transfer phenomena that occur in the expansion space, the heater, the regenerator, the cooler, the compression space, the surrounding walls, and the moving piston and displacer. In addition, the overall heat transfer, the indicated power, and the efficiency can be calculated. The CSUmod model is being converted to a two

  5. Exploring multidimensional free energy surfaces of peptides

    NASA Astrophysics Data System (ADS)

    Wang, Yan; Kuczera, Krzysztof

    1997-03-01

    A new statistical mechanics thermodynamic integration method is presented, enabling exploration of multidimensional conformational free energy surfaces of large flexible molecules. In this approach a single molecular dynamics simulation in which a set of coordinates has been constrained to fixed values yields the free energy gradient with respect to all coordinates in the set. The availability of the multidimensional gradient opens new possibilities for exploration of molecular conformational free energy surfaces, including free energy optimization to locate free energy minima, calculation of higher free energy derivatives, and finding optimal free energy paths between states. Additionally, choosing of all "soft" degrees of freedom as the constrained set leads to accelerated convergence of averages, effectively overcoming the sampling problem of free energy simulations. Two applications of the method are presented: Helical states of model peptides. For model peptides (Ala)n and (Aib)n where n=6,8,10 and Aib is α-methylalanine in vacuum, free energy maps and free energy optimization in φ-ψ space are used to locate free energy minima corresponding to α-, π- and 3_10-helical structures. The stability of the minima is characterized by calculating numerical second derivatives of the free energy. Free energy decomposition is employed to reveal the molecular mechanism for the improved stability of the 3_10h relative to the ah in Aib-containing peptides. DPDPE peptide pre-organization. For the linear form of the opioid peptide DPDPE in aqueous solution, the effective local sampling made possible by fixing all soft degrees of freedom is used to calculate the free energy difference between the open and cyclic-like structures, providing an estimate of the free energy of pre-organizing the peptide for disulfide bond formation. The open structure was found to be more stable by 4.0 ± 0.8 kcal/mol. The cyclic-like conformation was much better solvated than the open

  6. A Scalar Product Model for the Multidimensional Scaling of Choice

    ERIC Educational Resources Information Center

    Bechtel, Gordon G.; And Others

    1971-01-01

    Contains a solution for the multidimensional scaling of pairwise choice when individuals are represented as dimensional weights. The analysis supplies an exact least squares solution and estimates of group unscalability parameters. (DG)

  7. The Measurement of Self-Rated Depression: A Multidimensional Approach.

    ERIC Educational Resources Information Center

    Bolon, Kevin; Barling, Julian

    1980-01-01

    Investigates the capacity of the Zung Self-Rating Depression Scale for providing specific multidimensional descriptors of depressive behavior. Ideational, physiological and behavioral depression factors were evident in data from 96 normal, white university student volunteers. (Author/RH)

  8. Design of Multidimensional Shinnar-Le Roux RF Pulses

    PubMed Central

    Ma, Chao; Liang, Zhi-Pei

    2014-01-01

    Purpose To generalize the conventional Shinnar-Le Roux (SLR) method for the design of multidimensional RF pulses. Methods Using echo-planar gradients, the multidimensional RF pulse design problem was converted into a series of 1D polynomial design problems. Each of the 1D polynomial design problems was solved efficiently. B0 inhomogeneity compensation and design of spatial-spectral pulses were also considered. Results The proposed method was used to design 2D excitation and refocusing pulses. The results were validated through Bloch equation simulation and experiments on a 3.0 T scanner. Large-tip-angle, equiripple-error, multidimensional excitation was achieved with ripple levels closely matching the design specifications. Conclusion The conventional SLR method can be extended to design multidimensional RF pulses. The proposed method achieves almost equiripple excitation errors, allows easy control of the tradeoff among design parameters, and is computationally efficient. PMID:24578212

  9. A multidimensional subdiffusion model: An arbitrage-free market

    NASA Astrophysics Data System (ADS)

    Li, Guo-Hua; Zhang, Hong; Luo, Mao-Kang

    2012-12-01

    To capture the subdiffusive characteristics of financial markets, the subordinated process, directed by the inverse α-stale subordinator Sα(t) for 0 < α < 1, has been employed as the model of asset prices. In this article, we introduce a multidimensional subdiffusion model that has a bond and K correlated stocks. The stock price process is a multidimensional subdiffusion process directed by the inverse α-stable subordinator. This model describes the period of stagnation for each stock and the behavior of the dependency between multiple stocks. Moreover, we derive the multidimensional fractional backward Kolmogorov equation for the subordinated process using the Laplace transform technique. Finally, using a martingale approach, we prove that the multidimensional subdiffusion model is arbitrage-free, and also gives an arbitrage-free pricing rule for contingent claims associated with the martingale measure.

  10. The space transformation in the simulation of multidimensional random fields

    USGS Publications Warehouse

    Christakos, G.

    1987-01-01

    Space transformations are proposed as a mathematically meaningful and practically comprehensive approach to simulate multidimensional random fields. Within this context the turning bands method of simulation is reconsidered and improved in both the space and frequency domains. ?? 1987.

  11. Central Schemes for Multi-Dimensional Hamilton-Jacobi Equations

    NASA Technical Reports Server (NTRS)

    Bryson, Steve; Levy, Doron; Biegel, Bryan (Technical Monitor)

    2002-01-01

    We present new, efficient central schemes for multi-dimensional Hamilton-Jacobi equations. These non-oscillatory, non-staggered schemes are first- and second-order accurate and are designed to scale well with an increasing dimension. Efficiency is obtained by carefully choosing the location of the evolution points and by using a one-dimensional projection step. First-and second-order accuracy is verified for a variety of multi-dimensional, convex and non-convex problems.

  12. Multidimensional Programming Methods for Energy Facility Siting: Alternative Approaches

    NASA Technical Reports Server (NTRS)

    Solomon, B. D.; Haynes, K. E.

    1982-01-01

    The use of multidimensional optimization methods in solving power plant siting problems, which are characterized by several conflicting, noncommensurable objectives is addressed. After a discussion of data requirements and exclusionary site screening methods for bounding the decision space, classes of multiobjective and goal programming models are discussed in the context of finite site selection. Advantages and limitations of these approaches are highlighted and the linkage of multidimensional methods with the subjective, behavioral components of the power plant siting process is emphasized.

  13. Towards a genuinely multi-dimensional upwind scheme

    NASA Technical Reports Server (NTRS)

    Powell, Kenneth G.; Vanleer, Bram; Roe, Philip L.

    1990-01-01

    Methods of incorporating multi-dimensional ideas into algorithms for the solution of Euler equations are presented. Three schemes are developed and tested: a scheme based on a downwind distribution, a scheme based on a rotated Riemann solver and a scheme based on a generalized Riemann solver. The schemes show an improvement over first-order, grid-aligned upwind schemes, but the higher-order performance is less impressive. An outlook for the future of multi-dimensional upwind schemes is given.

  14. Multidimensional Hybridization of Dark Surface Plasmons.

    PubMed

    Yankovich, Andrew B; Verre, Ruggero; Olsén, Erik; Persson, Anton E O; Trinh, Viet; Dovner, Gudrun; Käll, Mikael; Olsson, Eva

    2017-04-07

    Synthetic three-dimensional (3D) nanoarchitectures are providing more control over light-matter interactions and rapidly progressing photonic-based technology. These applications often utilize the strong synergy between electromagnetic fields and surface plasmons (SPs) in metallic nanostructures. However, many of the SP interactions hosted by complex 3D nanostructures are poorly understood because they involve dark hybridized states that are typically undetectable with far-field optical spectroscopy. Here, we use experimental and theoretical electron energy loss spectroscopy to elucidate dark SPs and their interactions in layered metal-insulator-metal disc nanostructures. We go beyond the established dipole SP hybridization analysis by measuring breathing and multipolar SP hybridization. In addition, we reveal multidimensional SP hybridization that simultaneously utilizes in-plane and out-of-plane SP coupling. Near-field classic electrodynamics calculations provide excellent agreement with all experiments. These results advance the fundamental understanding of SP hybridization in 3D nanostructures and provide avenues to further tune the interaction between electromagnetic fields and matter.

  15. Multidimensional In Vivo Hazard Assessment Using Zebrafish

    PubMed Central

    Tanguay, Robert L.

    2014-01-01

    There are tens of thousands of man-made chemicals in the environment; the inherent safety of most of these chemicals is not known. Relevant biological platforms and new computational tools are needed to prioritize testing of chemicals with limited human health hazard information. We describe an experimental design for high-throughput characterization of multidimensional in vivo effects with the power to evaluate trends relating to commonly cited chemical predictors. We evaluated all 1060 unique U.S. EPA ToxCast phase 1 and 2 compounds using the embryonic zebrafish and found that 487 induced significant adverse biological responses. The utilization of 18 simultaneously measured endpoints means that the entire system serves as a robust biological sensor for chemical hazard. The experimental design enabled us to describe global patterns of variation across tested compounds, evaluate the concordance of the available in vitro and in vivo phase 1 data with this study, highlight specific mechanisms/value-added/novel biology related to notochord development, and demonstrate that the developmental zebrafish detects adverse responses that would be missed by less comprehensive testing strategies. PMID:24136191

  16. Multidimensional indexing tools for the virtual observatory

    NASA Astrophysics Data System (ADS)

    Csabai, I.; Dobos, L.; Trencséni, M.; Herczegh, G.; Józsa, P.; Purger, N.; Budavári, T.; Szalay, A. S.

    2007-10-01

    The last decade has seen a dramatic change in the way astronomy is carried out. The dawn of the the new microelectronic devices, like CCDs has dramatically extended the amount of observed data. Large, in some cases all sky surveys emerged in almost all the wavelength ranges of the observable spectrum of electromagnetic waves. This large amount of data has to be organized, published electronically and a new style of data retrieval is essential to exploit all the hidden information in the multiwavelength data. Many statistical algorithms required for these tasks run reasonably fast when using small sets of in-memory data, but take noticeable performance hits when operating on large databases that do not fit into memory. We utilize new software technologies to develop and evaluate fast multidimensional indexing schemes that inherently follow the underlying, highly non-uniform distribution of the data: they are layered uniform indices, hierarchical binary space partitioning, and sampled flat Voronoi tessellation of the data. These techniques can dramatically speed up operations such as finding similar objects by example, classifying objects or comparing extensive simulation sets with observations.

  17. Correlative visualization techniques for multidimensional data

    NASA Technical Reports Server (NTRS)

    Treinish, Lloyd A.; Goettsche, Craig

    1989-01-01

    Critical to the understanding of data is the ability to provide pictorial or visual representation of those data, particularly in support of correlative data analysis. Despite the advancement of visualization techniques for scientific data over the last several years, there are still significant problems in bringing today's hardware and software technology into the hands of the typical scientist. For example, there are other computer science domains outside of computer graphics that are required to make visualization effective such as data management. Well-defined, flexible mechanisms for data access and management must be combined with rendering algorithms, data transformation, etc. to form a generic visualization pipeline. A generalized approach to data visualization is critical for the correlative analysis of distinct, complex, multidimensional data sets in the space and Earth sciences. Different classes of data representation techniques must be used within such a framework, which can range from simple, static two- and three-dimensional line plots to animation, surface rendering, and volumetric imaging. Static examples of actual data analyses will illustrate the importance of an effective pipeline in data visualization system.

  18. Multi-dimensional cosmology and GUP

    SciTech Connect

    Zeynali, K.; Motavalli, H.; Darabi, F. E-mail: f.darabi@azaruniv.edu

    2012-12-01

    We consider a multidimensional cosmological model with FRW type metric having 4-dimensional space-time and d-dimensional Ricci-flat internal space sectors with a higher dimensional cosmological constant. We study the classical cosmology in commutative and GUP cases and obtain the corresponding exact solutions for negative and positive cosmological constants. It is shown that for negative cosmological constant, the commutative and GUP cases result in finite size universes with smaller size and longer ages, and larger size and shorter age, respectively. For positive cosmological constant, the commutative and GUP cases result in infinite size universes having late time accelerating behavior in good agreement with current observations. The accelerating phase starts in the GUP case sooner than the commutative case. In both commutative and GUP cases, and for both negative and positive cosmological constants, the internal space is stabilized to the sub-Planck size, at least within the present age of the universe. Then, we study the quantum cosmology by deriving the Wheeler-DeWitt equation, and obtain the exact solutions in the commutative case and the perturbative solutions in GUP case, to first order in the GUP small parameter, for both negative and positive cosmological constants. It is shown that good correspondence exists between the classical and quantum solutions.

  19. Multidimensional imaging of the thorax: practical applications.

    PubMed

    Ravenel, J G; McAdams, H P; Remy-Jardin, M; Remy, J

    2001-10-01

    Over the past decade, faster CT scan times, thinner collimation, and the development of multirow detectors, coupled with the increasing capability of computers to process large amounts of data in short periods of time, have lead to an expansion in the ability to create diagnostically useful two-dimensional (2D) and three-dimensional (3D) images within the thorax. Applications within the thorax include, but are not limited to, evaluation of pulmonary and systemic vasculature, evaluation of the tracheobronchial tree, and delineation of diffuse lung disease. Pulmonary nodule volume and growth can be more accurately predicted, and represents an improvement in the evaluation of the solitary pulmonary nodule. Multiplanar images increase our understanding of thoracic anatomy and can help to guide bronchoscopic procedures. Because there are strengths and weaknesses to all the reconstruction algorithms, the utility of any given technique is dependent on the clinical question to be answered. For instance, although maximum intensity projection imaging (MIP) is helpful in the evaluation of micronodular lung disease, it is of little value in the diagnosis of aortic dissection. As the ability to generate faster and more precise multidimensional images grow, the demand for such imaging is likely to increase. In this review, the authors discuss the various reconstruction techniques available, followed by a discussion of the clinical applications.

  20. A physical fitness follow-up in children with cerebral palsy receiving 12-week individualized exercise training.

    PubMed

    Jeng, Shiau-Chian; Yeh, Kuo-Kuang; Liu, Wen-Yu; Huang, Wei-Pin; Chuang, Yu-Fen; Wong, Alice M K; Lin, Yang-Hua

    2013-11-01

    Physical fitness in children with cerebral palsy (CP) is lower than in their peers. A 12-week individualized home-based exercise program completed by 11 children with CP 10 years earlier showed a favorable effect on physical fitness performance. We follow-up the physical fitness of those 11 children with CP, and compare their physical fitness and health-related quality of life (HRQoL) to children with CP without exercise training matched with age and motor levels. Eleven children with CP in the 2003 program as a follow-up group (FUG) and 12 volunteers recruited as a control group (CG) participated in this study. Physical fitness measures, including cardiopulmonary endurance, muscle strength, body mass index (BMI), flexibility, agility, balance, and the SF-36 Taiwan version, were assessed in both groups. After 10 years, the FUG showed better physical fitness in cardiopulmonary endurance and muscle strength (p<.05). Compared to the CG, the FUG demonstrated better muscle strength, agility, and balance (p<.05). However, the HRQoL did not show a significant difference between the FUG and the CG. Individualized home-based exercise training is beneficial for children with CP. Over 10 years, the FUG was more devoted to physical activity than was the CG. Physical exercise may not directly affect the HRQoL in this study.