Talk the talk and walk the walk. Evaluation of autonomy in aging and Alzheimer disease by simulating instrumental activities of daily living: the S-IADL

PubMed Central

Gounden, Yannick; Lacot, Emilie; Couvillers, Frédérique; Lions, Amandine; Hainselin, Mathieu

2016-01-01

Objective The autonomy of individuals is linked to the achievement of instrumental activities of daily living that require complex behavior. In the elderly, the assessment of autonomy is usually based on questionnaires that have strong subjective constraints. Considering this fact, we tested elderly healthy adults and Alzheimer disease patients using a new measure, the S-IADL (Simulation of Instrumental Activities for Daily Living), to assess the ability to perform effectively activities of daily living. Method The S-IADL shares many items with the well-known IADL questionnaire proposed by Lawton & Brody (1969). However, as opposed to the IADL, the assessment of autonomy is not based on the completion of a questionnaire but requires the realization or simulation of various activities of daily living. Eighty-three participants (69 healthy elderly, and 14 Alzheimer Disease patients) completed the IADL and performed the S-IADL assessment. Results Results revealed that, like the IADL, the S-IADL is able to identify AD patients who are likely to encounter difficulties in performing everyday activities, and no major differences were found between the IADL and the S-IADL. Conclusions We outlined some advantages for prefering, in certain situation, this new tool based on simulation of activities in functional evaluation. Finally, we discuss the main limits of the S-IADL that should be investigated prior to its utilization by clinicians. PMID:27672491

The use of an Energy Monitor in the management of diabetes: a pilot study.

PubMed

Voon, Rudi; Celler, Branko G; Lovell, Nigel H

2009-02-01

This study evaluated the use of an accelerometer-based device in helping to manage blood glucose levels (BGLs) in people with diabetes mellitus. Five people with diabetes were given a triaxial accelerometer-based device (Energy Monitor) that measured energy levels associated with activities of daily living. For 3 months, they were required to wear the device and to continue with their usual diabetes therapy. The body mass index (BMI) and glycosylated hemoglobin (HbA(1c)) were recorded to assess any potential improvement in blood glucose control. The relationship between BGL and measured energy level was also investigated. Overall, there was a significant reduction of HbA(1c) from 7.48 +/- 1.21% to 6.98 +/- 1.44% (P < 0.05). There was no significant change in BMI. It was also found that higher energy levels resulted in much lower fluctuations in BGL change between meals compared to low energy levels. Moreover, the weekly mean activity score showed an increase in activity levels from the second week to the final week. This pilot study demonstrated that the Energy Monitor could improve the management of diabetes by allowing people with diabetes to view and manage daily physical activity in addition to their usual diabetes therapy.

From regained function to daily use: experiences of surgical reconstruction of grip in people with tetraplegia.

PubMed

Wangdell, Johanna; Carlsson, Gunnel; Friden, Jan

2014-01-01

To capture patients' relearning processes from regained function to improvements in daily life after grip reconstructive surgery in tetraplegia. Eleven people with tetraplegia who underwent grip reconstructive surgery during February 2009 to March 2011. Qualitative interviews were conducted 7 to 17 months after surgery and analysed using grounded theory. Determination to reach a higher level of independence was the core concept to integrate regained function into daily life. There were 3 phases identified; "Initiate activity training," "Establish hand control in daily activities," and "Challenge dependence." Between the phases psychological stages occurred, first; "a belief in improved ability", and later in the process; "confidence in ability". The process to fully integrate regain function in daily life was described as long and time-consuming. However, the participants claimed it useful to do the skills training in their home environment, without long-term in clinic rehabilitation. Relearning activities in daily life after a grip reconstruction is a time-consuming and demanding process. It includes skills training, mental strategies and psychological stages together with environmental and social factors. Accordingly, rehabilitation after grip reconstruction in tetraplegia should focus on both grip skills and psychological stages, to encourage that patient's keep their determination and achieve greater independence. Implications for Rehabilitation There is a stepwise process to transform improved function into daily use. The most important factor to transform improved function into daily use was motivation to reach a higher independence. Other important factors were; skills training, use of individual learning strategies, belief and confidence in personal ability, social and environmental factors. There was a long and demanding process to fully transform the improved function into daily use. The participants preferred to do activity training in the specific environment, usually at home.

Short- and long-term effects of a physical activity counselling programme in COPD: a randomized controlled trial.

PubMed

Altenburg, Wytske A; ten Hacken, Nick H T; Bossenbroek, Linda; Kerstjens, Huib A M; de Greef, Mathieu H G; Wempe, Johan B

2015-01-01

We were interested in the effects of a physical activity (PA) counselling programme in three groups of COPD patients from general practice (primary care), outpatient clinic (secondary care) and pulmonary rehabilitation (PR). In this randomized controlled trial 155 COPD patients, 102 males, median (IQR) age 62 (54-69) y, FEV1predicted 60 (40-75) % were assigned to a 12-weeks' physical activity counselling programme or usual care. Physical activity (pedometer (Yamax SW200) and metabolic equivalents), exercise capacity (6-min walking distance) and quality of life (Chronic Respiratory Questionnaire and Clinical COPD Questionnaire) were assessed at baseline, after three and 15 months. A significant difference between the counselling and usual care group in daily steps (803 steps, p = 0.001) and daily physical activity (2214 steps + equivalents, p = 0.001)) from 0 to 3 months was found in the total group, as well as in the outpatient (1816 steps, 2616 steps + equivalents, both p = 0.007) and PR (758 steps, 2151 steps + equivalents, both p = 0.03) subgroups. From 0 to 15 months no differences were found in physical activity. However, when patients with baseline physical activity>10,000 steps per day (n = 8), who are already sufficiently active, were excluded, a significant long-term effect of the counselling programme on daily physical activity existed in the total group (p = 0.02). Differences in exercise capacity and quality of life were found only from 0 to 3 months, in the outpatient subgroup. Our PA counselling programme effectively enhances PA level in COPD patients after three months. Sedentary patients at baseline still benefit after 15 months. ClinicalTrials.gov: registration number NCT00614796. Copyright © 2014. Published by Elsevier Ltd.

The importance of physical activity and sleep for affect on stressful days: Two intensive longitudinal studies.

PubMed

Flueckiger, Lavinia; Lieb, Roselind; Meyer, Andrea H; Witthauer, Cornelia; Mata, Jutta

2016-06-01

We investigated the potential stress-buffering effect of 3 health behaviors-physical activity, sleep quality, and snacking-on affect in the context of everyday life in young adults. In 2 intensive longitudinal studies with up to 65 assessment days over an entire academic year, students (Study 1, N = 292; Study 2, N = 304) reported stress intensity, sleep quality, physical activity, snacking, and positive and negative affect. Data were analyzed using multilevel regression analyses. Stress and positive affect were negatively associated; stress and negative affect were positively associated. The more physically active than usual a person was on a given day, the weaker the association between stress and positive affect (Study 1) and negative affect (Studies 1 and 2). The better than usual a person's sleep quality had been during the previous night, the weaker the association between stress and positive affect (Studies 1 and 2) and negative affect (Study 2). The association between daily stress and positive or negative affect did not differ as a function of daily snacking (Studies 1 and 2). On stressful days, increasing physical activity or ensuring high sleep quality may buffer adverse effects of stress on affect in young adults. These findings suggest potential targets for health-promotion and stress-prevention programs, which could help reduce the negative impact of stress in young adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Stop the escalators: using the built environment to increase usual daily activity

PubMed Central

Westfall, John M; Fernald, Doug H

2010-01-01

Background Obesity is an epidemic in the United States. Two-thirds of the population is overweight and does not get enough exercise. Eastern cities are full of escalators that transport obese Americans to and from the subway. Walking stairs is a moderate activity requiring 3–6 metabolic equivalent tasks (METS) and burning 3.5–7 kcal/min. We determined the caloric expenditure and potential weight change of the population of one eastern city if all the subway riders walked the stairs rather than ride the escalators. Methods There are 5,000,000 daily journeys made on the New York City Subway. Subway entrances include a stairway or escalator of approximately 25 steps. Each step up requires 0.11–0.15 kcals; each step down requires 0.05 kcals. To lose one pound requires burning 3500 kcals. We assumed each rider made a round trip so about 2.5 million individual people ride the subway each day. Results By walking stairs rather than riding escalators, the riders of the New York Subway would lose more than 2.6 million pounds per year. Discussion The average subway rider would lose about one pound per year. While this may sound insignificant, in one decade the average subway rider would lose 10 pounds, effectively reversing the trend in the United States of gaining 10 pounds per decade. This conservative estimate of the number of stairs ascended daily means that subway riders might lose even more weight. We believe that this novel approach might lead to other public and private efforts to increase physical activity such as elevators that only stop on even numbered floors, making stairwells more attractive and well lit, and stopping moving sidewalks. The built environment may support small, incremental changes in usual daily physical activity that can have significant impact on populations and individuals. PMID:27774003

A Microswitch-Based Program to Enable Students with Multiple Disabilities to Choose among Environmental Stimuli

ERIC Educational Resources Information Center

Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Didden, Robert; Oliva, Doretta; Severini, Laura

2006-01-01

Students with multiple disabilities, such as severe to profound mental retardation combined with motor and visual impairment, are usually unable to engage in constructive activity or play a positive role in their daily context. Microswitches are technical tools that may help them improve their status by allowing them to control environmental…

Loneliness, Daily Pain, and Perceptions of Interpersonal Events in Adults with Fibromyalgia

PubMed Central

Wolf, Laurie Dempsey; Davis, Mary C.

2014-01-01

Objective This study examined whether individual differences in loneliness and/or daily exacerbations in loneliness relate to daily pain and frequency and perception of interpersonal events among individuals with fibromyalgia (FM). Methods 118 participants with FM completed electronic diaries each evening for 21 days to assess the occurrence of positive and negative interpersonal events, event appraisals, and pain. Multilevel modeling was used to examine relations of chronic and transitory loneliness to daily life outcomes, controlling for daily depressive symptoms. Results Chronic and transitory loneliness were associated with more frequent reports of negative and less frequent reports of positive interpersonal daily events, higher daily stress ratings and lower daily enjoyment ratings, and higher daily pain levels. Neither chronic nor transitory loneliness moderated the relations between daily negative events and either stress appraisals or pain. However, both chronic and transitory loneliness moderated the relation between daily positive events and enjoyment appraisals. Specifically, on days of greater numbers of positive events than usual, lonely people had larger boosts in enjoyment than did nonlonely people. Similarly, days with greater than usual numbers of positive events were related to larger boosts in enjoyment if an individual was also experiencing higher than usual loneliness levels. Conclusions Chronic and transient episodes of loneliness are associated with more negative daily social relations and pain. However, boosts in positive events yield greater boosts in day-to-day enjoyment of social relations for lonely versus nonlonely individuals, and during loneliness episodes, a finding that can inform future interventions for individuals with chronic pain. PMID:25180546

Daily Parental Knowledge of Youth Activities Is Linked to Youth Physical Symptoms and HPA functioning

PubMed Central

Lippold, Melissa A.; Davis, Kelly D.; McHale, Susan M.; Almeida, David M.

2015-01-01

Considerable evidence documents linkages between parental knowledge of youth activities and youth risky behavior. We extended this research to determine whether parental knowledge was associated with youth physical health, including reports of physical symptoms (e.g., headaches, stomachaches) and a biomarker of hypothalamic pituitary adrenocortical (HPA) axis functioning (i.e., salivary cortisol levels). Participants were children of employees in the Information Technology division of a Fortune 500 company (N = 132, Mean Age Youth = 13.39 years, 55% female) who participated in a daily diary study. Data were collected via telephone calls on eight consecutive evenings. On four study days, cortisol samples were collected at 4 time points (waking, 30 min after waking, before dinner, bedtime). Multi-level models revealed that, at the between-person level, youth whose parents had higher average knowledge about their activities, exhibited lower bedtime cortisol levels. Furthermore, at the within-person level, on days when parents displayed more knowledge than usual (relative to their own eight-day average), youth had lower before-dinner cortisol than usual. Linkages between average parental knowledge and physical health symptoms were moderated by youth age: Younger but not older adolescents whose parents were more knowledgeable had fewer physical health symptoms, on average. A next step is to identify the processes that underlie these associations. PMID:26751757

Prognostic indicators of social outcomes in persons who sustained an injury in a road traffic crash.

PubMed

Gopinath, Bamini; Jagnoor, Jagnoor; Harris, Ian A; Nicholas, Michael; Casey, Petrina; Blyth, Fiona; Maher, Christropher G; Cameron, Ian D

2015-05-01

There is a lack of longitudinal studies with adequate sample size and follow-up period which have objectively assessed social outcomes among those with mild or moderate musculoskeletal injury or that are not limited to hospital inpatients. We aimed to address this gap by prospectively assessing the potential predictors of return to pre-injury work and daily activities. Persons with mild/moderate musculoskeletal injuries from a vehicle-related crash were surveyed within the first 3 months after the crash (baseline; n=364), and at 12 (n=284) and 24 months (n=252). Participants self-reported return to work, and whether it was return to full or modified duties at work. Analyses were restricted to 170 participants who reported being in pre-injury paid work and had provided information at either 12 months only or at both 12 and 24 months. Return to usual activities was assessed using the European Quality of Life-5 Dimensions (EQ-5D) scale 'Usual Activities' dimension. Twenty-four months after injury 82% (n=121) had returned to work. After multivariable adjustment, not being admitted to hospital was associated with 44% higher likelihood of returning to work at 24 months. Not having any pre-injury chronic illness was associated with returning to work after 24 months, multivariable-adjusted risk ratio (RR), 1.21 (95% confidence intervals, CI: 1.02-1.45). Each 1-SD increase in Medical Outcomes Survey Short Form-12 Mental Component Summary (SF-12 MCS) score at baseline was associated with returning to work at 24 months RR 1.13 (95% CI: 1.02-1.25). Younger age, higher SF-12 physical component summary (PCS), and EQ-5D visual analogue scale (VAS) scores were mutually independent predictors of returning to usual activities 24 months later. A range of bio-psychosocial factors, particularly quality of life measures, independently predicted social outcomes including return to work and return to usual daily activities. These determinants could be measured early in the recovery process and be potentially amenable to intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Experiences With Parents and Youth Physical Health Symptoms and Cortisol: A Daily Diary Investigation

PubMed Central

Lippold, Melissa A.; McHale, Susan M.; Davis, Kelly D.; Almeida, David M.; King, Rosalind B.

2014-01-01

Using daily diary data, this study examined the associations between positive and negative parent-youth experiences and youth cortisol and physical health symptoms among a sample of adolescents (N=132, Mean Age = 13.39). On days when girls reported more negative experiences than usual, they exhibited more physical health symptoms and flatter evening cortisol slopes than usual. Negative experiences with mothers were associated with higher dinner and bedtime youth cortisol levels (between-person). Daily positive experiences with fathers were linked with lower dinner cortisol levels. Youth with high levels of negative experiences, on average, were less sensitive to daily variation in negative experiences than youth who experienced lower parental negativity. We discuss the benefits of a daily diary approach. PMID:27231418

Effectiveness of a Multi-Component Intervention for Overweight and Obese Children (Nereu Program): A Randomized Controlled Trial

PubMed Central

Serra-Paya, Noemi; Ensenyat, Assumpta; Castro-Viñuales, Iván; Real, Jordi; Sinfreu-Bergués, Xènia; Zapata, Amalia; Mur, Jose María; Galindo-Ortego, Gisela; Solé-Mir, Eduard; Teixido, Concepció

2015-01-01

Introduction Treatment of childhood obesity is a complex challenge for primary health care professionals. Objectives To evaluate the effectiveness of the Nereu Program in improving anthropometric parameters, physical activity and sedentary behaviours, and dietary intake. Methods Randomized, controlled, multicentre clinical trial comparing Nereu Program and usual counselling group interventions in primary care settings. The 8-month study recruited 113 children aged 6 to 12 years with overweight/obesity. Before recruitment, eligible participants were randomly allocated to an intensive, family-based multi-component behavioural intervention (Nereu Program group) or usual advice from their paediatrician on healthy eating and physical activity. Anthropometric parameters, objectively measured sedentary and physical activity behaviours, and dietary intake were evaluated pre- and post-intervention. Results At the end of the study period, both groups achieved a similar decrease in body mass index (BMIsd) compared to baseline. Nereu Program participants (n = 54) showed greater increases in moderate-intense physical activity (+6.27% vs. -0.61%, p<0.001) and daily fruit servings (+0.62 vs. +0.13, p<0.026), and decreased daily soft drinks consumption (-0.26 vs. -0.02, p<0.047), respectively, compared to the counselling group (n = 59). Conclusions At the end of the 8-month intervention, participants in the Nereu Program group showed improvement in physical activity and dietary behaviours, compared to the counselling group. Trial Registration ClinicalTrials.gov NCT01878994 PMID:26658988

Evaluation of an education and activation programme to prevent chronic shoulder complaints: design of an RCT [ISRCTN71777817

PubMed Central

Bruijn, Camiel De; de Bie, Rob; Geraets, Jacques; Goossens, Marielle; Köke, Albère; van den Heuvel, Wim; van der Heijden, Geert; Dinant, Geert-Jan

2005-01-01

Background About half of all newly presented episodes of shoulder complaints (SC) in general practice are reported to last for at least six months. Early interventions aimed at the psychological and social determinants of SC are not common in general practice, although such interventions might prevent the development of chronic SC. The Education and Activation Programme (EAP) consists of an educational part and a time-contingent activation part. The aim of the EAP is to provide patients with the proper cognitions by means of education, and to stimulate adequate behaviour through advice on activities of daily living. Design The article describes the design of a randomised clinical trial (RCT) to evaluate the effectiveness and cost-effectiveness of an EAP in addition to usual care, compared to usual care only, in the prevention of chronic SC after six months. It also describes the analysis of the cost and effect balance. Patients suffering from SC for less than three months are recruited in general practice and through open recruitment. A trained general practitioner or a trained therapist administers the EAP. Primary outcome measures are patient-perceived recovery, measured by self-assessment on a seven-point scale, and functional limitations in activities of daily living. Questionnaires are used to study baseline measures, prognostic measures, process measures and outcome measures. Discussion The inclusion of patients in the study lasted until December 31st 2003. Data collection is to end in June 2004. PMID:15715914

Individual and Day-to-Day Differences in Active Coping Predict Diurnal Cortisol Patterns among Early Adolescent Girls.

PubMed

Sladek, Michael R; Doane, Leah D; Stroud, Catherine B

2017-01-01

Prior work has identified alterations in activity of the hypothalamic-pituitary-adrenal axis as a potential mechanism underlying stress-induced emotional health problems, which disproportionately impact girls beginning in mid-adolescence. How adolescent girls differ from one another in dispositional coping tendencies and shift specific coping strategies in response to varying stressors have been theorized as important predictors of their adaptation, health, and well-being during this dynamic period of development. The goal of this study was to examine whether individual and day-to-day (within-person) differences in adolescent girls' coping responses are associated with daily patterns of hypothalamic-pituitary-adrenal axis activity, indexed by cortisol. Participants were 122 early adolescent girls (M age  = 12.39) who provided three saliva samples per day for 3 days and completed daily coping reports, as well as a standard coping survey. Participants and primary caregivers also completed objective life stress interviews. On average, girls who were more likely to respond to interpersonal stress with voluntary engagement (active) coping exhibited generally adaptive daily physiological regulation-steeper diurnal cortisol slopes, lower total diurnal cortisol output, and lower cortisol awakening responses. Chronic interpersonal stress level significantly moderated these associations in different ways for two distinct components of the diurnal pattern-the slope and cortisol awakening responses. Regarding within-person differences, using active coping more than usual was associated with higher waking cortisol the following morning, which may help to prepare adolescent girls for perceived daily demands. These findings highlight the interactive influence of stress and coping in the prediction of daily hypothalamic-pituitary-adrenal axis activity and support the stress-buffering role of active coping for adolescent girls.

Combined Cognitive-Strategy and Task-Specific Training Improve Transfer to Untrained Activities in Subacute Stroke: An Exploratory Randomized Controlled Trial.

PubMed

McEwen, Sara; Polatajko, Helene; Baum, Carolyn; Rios, Jorge; Cirone, Dianne; Doherty, Meghan; Wolf, Timothy

2015-07-01

The purpose of this study was to estimate the effect of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach compared with usual outpatient rehabilitation on activity and participation in people <3 months poststroke. An exploratory, single-blind, randomized controlled trial, with a usual-care control arm, was conducted. Participants referred to 2 stroke rehabilitation outpatient programs were randomized to receive either usual care or CO-OP. The primary outcome was actual performance of trained and untrained self-selected activities, measured using the Performance Quality Rating Scale (PQRS). Additional outcomes included the Canadian Occupational Performance Measure (COPM), the Stroke Impact Scale Participation Domain, the Community Participation Index, and the Self-Efficacy Gauge. A total of 35 eligible participants were randomized; 26 completed the intervention. Post intervention, PQRS change scores demonstrated that CO-OP had a medium effect over usual care on trained self-selected activities (d = 0.5) and a large effect on untrained activities (d = 1.2). At a 3-month follow-up, PQRS change scores indicated a large effect of CO-OP on both trained (d = 1.6) and untrained activities (d = 1.1). CO-OP had a small effect on COPM and a medium effect on the Community Participation Index perceived control and on the Self-Efficacy Gauge. CO-OP was associated with a large treatment effect on follow-up performances of self-selected activities and demonstrated transfer to untrained activities. A larger trial is warranted. © The Author(s) 2014.

Nursing home residents' self-perceived resources for good sleep.

PubMed

Herrmann, Wolfram J; Flick, Uwe

2011-12-01

To explore the nursing home residents' self-perceived resources for good sleep. A qualitative research design. Episodic interviews were conducted, and analysis was done using thematic coding. Five German nursing homes from different providers. Thirty nursing home residents who were at least 64 years old and oriented to place and person. The nursing home residents' self-perceived resources for good sleep can be classified into three general patterns: calmness, daily activity, and environmental factors. The residents see calmness as a psychological state and a prerequisite for good sleep. Rumination was reported as the main reason for disruption of calmness. Daily activity is also seen by residents to foster sleep, but most residents do not know how to be physically active. Environmental factors such as fresh air, silence, or the type of bed contribute individually to good sleep; however, nursing home residents usually lack strategies to foster these resources by themselves. The nursing home residents' self-perceived resources for good sleep--calmness, daily activity, and environmental factors--can be starting points for non-pharmacological treatment of sleep disorders. The residents' primary care physicians should explore these individual resources during consultation and attempt to foster them.

Problem-solving strategies of women undergoing chemotherapy for breast cancer.

PubMed

Lyons, Kathleen D; Erickson, Kelly S; Hegel, Mark T

2012-02-01

Many women undergoing chemotherapy for breast cancer experience side effects that make it difficult to perform daily occupations. To summarize the types of challenges, goals, and adaptive strategies identified by women with stage 1-3 breast cancer participating in a pilot study of Problem-solving Treatment-Occupational Therapy (PST-OT). Content analysis of 80 PST-OT sessions. Women addressed 11 types of challenging activities, with exercise and instrumental activities of daily living (IADL) being the most common. Most women set a goal to adapt a current activity, but also set goals to find a new activity, plan the steps of a current activity, or gather information about a possible activity change in the future. The adaptive strategies generated by the women were grouped into five types. Most often they found ways to add a new step to an activity, but they also brainstormed about when, how, where, and with whom they could do activities. The women were usually trying to adapt familiar activities but also were looking for ways to include new, healthy occupations into their routines.

Durable clinical activity of single-agent bevacizumab in a nonagenarian patient with metastatic alveolar soft part sarcoma.

PubMed

Mir, Olivier; Boudou-Rouquette, Pascaline; Larousserie, Frédérique; Blanchet, Benoit; Babinet, Antoine; Anract, Philippe; Goldwasser, François

2012-08-01

Alveolar soft part sarcoma is a rare malignancy usually considered resistant to conventional chemotherapy, but recent data suggest that the multikinase inhibitors sunitinib and cediranib could be active in this setting. A 90-year-old lady with alveolar soft part sarcoma of the leg and lung metastases was started on sunitinib 37.5 mg daily. The treatment was poorly tolerated with grade 3 hypertension and grade 3 thrombocytopenia, which persisted after dose reduction to 25 mg daily. The patient was subsequently started on bevacizumab 10 mg/kg every 2 weeks, resulting in a marked improvement in pain and a partial response on lung metastases for 16 months and ongoing. Agents targeting the vascular endothelial growth factor-signalling pathway seem to exert clinically relevant and prolonged activity against alveolar soft part sarcoma and deserve further evaluation in the treatment of this rare soft tissue sarcoma.

Combined cognitive-strategy and task-specific training improves transfer to untrained activities in sub-acute stroke: An exploratory randomized controlled trial

PubMed Central

McEwen, Sara; Polatajko, Helene; Baum, Carolyn; Rios, Jorge; Cirone, Dianne; Doherty, Meghan; Wolf, Timothy

2014-01-01

Purpose The purpose of this study was to estimate the effect of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach compared to usual outpatient rehabilitation on activity and participation in people less than 3 months post stroke. Methods An exploratory, single blind, randomized controlled trial with a usual care control arm was conducted. Participants referred to 2 stroke rehabilitation outpatient programs were randomized to receive either Usual Care or CO-OP. The primary outcome was actual performance of trained and untrained self-selected activities, measured using the Performance Quality Rating Scale (PQRS). Additional outcomes included the Canadian Occupational Performance Measure (COPM), the Stroke Impact Scale Participation Domain, the Community Participation Index, and the Self Efficacy Gauge. Results Thirty-five (35) eligible participants were randomized; 26 completed the intervention. Post-intervention, PQRS change scores demonstrated CO-OP had a medium effect over Usual Care on trained self-selected activities (d=0.5) and a large effect on untrained (d=1.2). At a 3 month follow-up, PQRS change scores indicated a large effect of CO-OP on both trained (d=1.6) and untrained activities (d=1.1). CO-OP had a small effect on COPM and a medium effect on the Community Participation Index perceived control and the Self-Efficacy Gauge. Conclusion CO-OP was associated with a large treatment effect on follow up performances of self-selected activities, and demonstrated transfer to untrained activities. A larger trial is warranted. PMID:25416738

Prospects of effective microorganisms technology in wastes treatment in Egypt.

PubMed

Shalaby, Emad A

2011-06-01

Sludge dewatering and treatment may cost as much as the wastewater treatment. Usually large proportion of the pollutants in wastewater is organic. They are attacked by saprophytic microorganisms, i.e. organisms that feed upon dead organic matter. Activity of organisms causes decomposition of organic matter and destroys them, where the bacteria convert the organic matter or other constituents in the wastewater to new cells, water, gases and other products. Demolition activities, including renovation/remodeling works and complete or selective removal/demolishing of existing structures either by man-made processes or by natural disasters, create an extensive amount of wastes. These demolition wastes are characterized as heterogeneous mixtures of building materials that are usually contaminated with chemicals and dirt. In developing countries, it is estimated that demolition wastes comprise 20% to 30% of the total annual solid wastes. In Egypt, the daily quantity of construction and demolition (C&D) waste has been estimated as 10 000 tones. That is equivalent to one third of the total daily municipal solid wastes generated per day in Egypt. The zabbaliin have since expanded their activities and now take the waste they collect back to their garbage villages where it is sorted into recyclable components: paper, plastics, rags, glass, metal and food. The food waste is fed to pigs and the other items are sold to recycling centers. This paper summarizes the wastewater and solid wastes management in Egypt now and future.

Family caregivers' experience of activities of daily living handling in older adult with stroke: a qualitative research in the Iranian context.

PubMed

Hesamzadeh, Ali; Dalvandi, Asghar; Bagher Maddah, Sadat; Fallahi Khoshknab, Masoud; Ahmadi, Fazlollah; Mosavi Arfa, Nazila

2017-09-01

Patients with stroke require additional support from family to live independently in the area of activities of daily living. Family members are usually the main caregivers of stroke patients. Comprehensive explanation of ADL handling from family caregivers' view is lacking. This study explores and describes family caregivers' experiences about the strategies to handle activities of daily living (ADL) dependency of elderly patient with stroke in the Iranian context. A qualitative content analysis approach was conducted to analyse data. Nineteen family caregivers participated in the study from multiple physiotherapy clinics of physiotherapy in Sari (Iran) between September 2013 and May 2014. Data were generated through in-depth interviews, and content analysis method was used to analyse the data and determine themes. The findings show that family caregivers manage the ADL dependency of their elderly stroke patients through seven strategies including encouraging physical movements, providing personal hygiene, nutritional consideration, facilitating religious activities, filling leisure time, and facilitating transfer and assisting in financial issues. Family has an important role in handling of elderly stroke patients' ADL dependency. Health practitioners can take benefit from the findings to help the stroke families play more active role in the handling ADL dependency of their patients after stroke. © 2016 Nordic College of Caring Science.

Daily stressor reactivity during adolescence: The buffering role of parental warmth.

PubMed

Lippold, Melissa A; Davis, Kelly D; McHale, Susan M; Buxton, Orfeu M; Almeida, David M

2016-09-01

This study examined youth stressor reactivity in the form of links between daily stressors and adolescents' negative affect, physical health symptoms, and cortisol patterns. We also tested whether youth gender and parental warmth moderated these linkages. Participants were the children of employees in the information technology division of a large company (N = 132, mean age = 13.39 years, 55% female). Youth completed daily diary telephone interviews on 8 consecutive evenings and provided saliva samples at 4 time points over 4 days to assess daily stressors and youth physiological and affective functioning. Parental warmth was assessed during in-home interviews. Multilevel modeling was used to account for interdependencies in the data. Youth who experienced more daily stressors, on average, reported more negative affect and physical health symptoms, on average. Furthermore, on days youth reported more stressors than usual (compared to their own across-day average), they also exhibited more physical health symptoms, reduced evening cortisol decline (e.g., flatter slopes), higher bedtime cortisol, and more negative affect. Girls had stronger within-person linkages between daily stressors and daily negative affect than boys. Parental warmth moderated these within-person linkages: Youth who experienced more parental warmth had lower negative affect and steeper cortisol decline than usual on less stressful days. However, youth who experienced less parental warmth had higher negative affect and their cortisol levels declined less, even on days with lower-than-usual stress. Daily stressors are associated with youth's affective and physiological functioning, but parental warmth can support youth's stress recovery. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Daily Stressor Reactivity during Adolescence: The Buffering Role of Parental Warmth

PubMed Central

Lippold, Melissa; Davis, Kelly D.; McHale, Susan M.; Buxton, Orfeu; Almeida, David M.

2016-01-01

Objective This study examined youth stressor reactivity in the form of links between daily stressors and adolescents’ negative affect, physical health symptoms, and cortisol patterns. We also tested whether youth gender and parental warmth moderated these linkages. Method Participants were the children of employees in the Information Technology division of a large company (N = 132, mean age = 13.39 years, 55% female). Youth completed daily diary telephone interviews on 8 consecutive evenings and provided saliva samples at 4 time points over 4 days to assess daily stressors and youth physiological and affective functioning. Parental warmth was assessed during in-home interviews. Multi-level modeling was used to account for interdependencies in the data. Results Youth who experienced more daily stressors, on average, reported more negative affect and physical health symptoms, on average. Further, on days youth reported more stressors than usual (compared to their own across-day average), they also exhibited more physical health symptoms, reduced evening cortisol decline (e.g., flatter slopes), higher bedtime cortisol, and more negative affect. Girls had stronger within-person linkages between daily stressors and daily negative affect than boys. Parental warmth moderated these within-person linkages: Youth who experienced more parental warmth had lower negative affect and steeper cortisol decline than usual on less stressful days. Yet, youth who experienced less parental warmth had higher negative affect and their cortisol levels declined less, even on days with lower-than-usual stress. Conclusions Daily stressors are associated with youth's affective and physiological functioning, but parental warmth can support youth's stress recovery. PMID:27175577

Fast food intake in Canada: Differences among Canadians with diverse demographic, socio-economic and lifestyle characteristics.

PubMed

Black, Jennifer L; Billette, Jean-Michel

2015-02-03

To estimate the contribution of fast food to daily energy intake, and compare intake among Canadians with varied demographic, socioeconomic and lifestyle characteristics. Using the National Cancer Institute method, nationally representative estimates of mean usual daily caloric intake from fast food were derived from 24-hour dietary recall data from the Canadian Community Health Survey Cycle 2.2 (n = 17,509) among participants age ≥ 2 years. Mean daily intake and relative proportion of calories derived from fast food were compared among respondents with diverse demographic (age, sex, provincial and rural/urban residence), socio-economic (income, education, food security status) and health and lifestyle characteristics (physical activity, fruit/vegetable intake, vitamin/ mineral supplement use, smoking, binge drinking, body mass index (BMI), self-rated health and dietary quality). On average, Canadians reported consuming 146 kcal/day from fast food, contributing to 6.3% of usual energy intake. Intake was highest among male teenagers (248 kcal) and lowest among women ≥ 70 years of age (32 kcal). Fast food consumption was significantly higher among respondents who reported lower fruit and vegetable intake, poorer dietary quality, binge drinking, not taking vitamin/mineral supplements (adults only), and persons with higher BMI. Socio-economic status, physical activity, smoking and self-rated health were not significantly associated with fast food intake. While average Canadian fast food consumption is lower than national US estimates, intake was associated with lower dietary quality and higher BMI. Findings suggest that research and intervention strategies should focus on dietary practices of children and adolescents, whose fast food intakes are among the highest in Canada.

Return to work outcomes of the Redesigning Daily Occupations (ReDO) program for women with stress-related disorders--a comparative study.

PubMed

Eklund, Mona; Erlandsson, Lena-Karin

2011-11-01

Stress-related disorders are a frequent cause for sick leave, with consequences such as great distress and adverse economic effects for the affected person and substantial costs for society. Identifying effective interventions that facilitate return to work is thus important. The aim of this study was to evaluate the effectiveness of the 16-week Redesigning Daily Occupations program as a work rehabilitation method for Swedish women with stress-related disorders. The authors of this study hypothesized that, compared to women who got Care as Usual, 12 months after completed rehabilitation a larger proportion of the Redesigning Daily Occupations women would have returned to work, and they would have less sick leave, perceive less stress, and have greater self-esteem. Forty-two women entered the Redesigning Daily Occupations intervention and a matched comparison group received Care as Usual. The data, collected between 2007 and 2010, consisted of registry information and questionnaires targeting socio-demographics, perceived stress, and self-esteem. The findings partly verified the hypotheses. A larger proportion of the Redesigning Daily Occupations women returned to work and they decreased their sick leave and increased their self-esteem more than the Care as Usual group, but the groups did not differ in stress reduction. Thus, the Redesigning Daily Occupations seems to be a promising work rehabilitation method for women with stress-related disorders.

How Do Pain, Fatigue, Depressive, and Cognitive Symptoms Relate to Well-Being and Social and Physical Functioning in the Daily Lives of Individuals With Multiple Sclerosis?

PubMed

Kratz, Anna L; Braley, Tiffany J; Foxen-Craft, Emily; Scott, Eric; Murphy, John F; Murphy, Susan L

2017-11-01

To examine the relative association between daily change in pain, fatigue, depressed mood, and cognitive function and 4 outcomes-positive affect and well-being, ability to participate in social roles and activities, upper extremity (UE) functioning, and lower extremity (LE) functioning. Data analysis, multilevel mixed modeling. General community. Ambulatory adults (N=102) with multiple sclerosis. Not applicable. Customized short-forms of the Quality of Life in Neurological Disorders positive affect and well-being, UE functioning, and LE functioning item banks and the Patient-Reported Outcomes Measurement Information System ability to participate in social roles and activities item bank adapted for daily use and administered as end-of-day diaries. Above and beyond the effects of demographic and clinical covariates, daily pain was associated with 3 of the 4 outcomes; days of higher than usual pain were related to lower same-day social participation (unstandardized β, B=-1.00; P=.002), UE functioning (B=-1.04; P=.01), and LE functioning (B=-.71; P=.04). Daily fatigue and depressed mood were independently related to daily positive affect and well-being; days of worse fatigue (B=-.54; P=.006) and depressed mood (B=-1.17; P<.0001) were related to lower same-day well-being. The results indicate the role of fluctuations in symptoms in daily functioning and quality of life of individuals with multiple sclerosis. Daily increases in pain intensity are related to social and physical functioning, whereas increases in fatigue and depressed mood are related to lower daily well-being. Findings implicate a person-centered approach to monitoring and treating symptoms. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Hydroxychloroquine

MedlinePlus

... to treat discoid or systemic lupus erythematosus and rheumatoid arthritis in patients whose symptoms have not improved with ... are usually taken once or twice daily. For rheumatoid arthritis, one to three tablets are usually taken once ...

Housework time from middle childhood through adolescence: Links to parental work hours and youth adjustment.

PubMed

Lam, Chun Bun; Greene, Kaylin M; McHale, Susan M

2016-12-01

The developmental course, family correlates, and adjustment implications of youth housework participation from age 8-18 were examined. Mothers, fathers, and 2 siblings from 201 European American families provided questionnaire and/or daily diary data on 6 occasions across 7 years. Multilevel modeling within an accelerated longitudinal design revealed that girls spent more time on housework than did boys, but that housework time of both girls and boys increased from middle childhood to mid-adolescence and leveled off thereafter. In years when mothers were employed for more hours than usual, girls, but not boys, spent more time on housework than usual. Housework time was linked to more depressive symptoms (at a between-person level) and predicted lower school grades (at a within-person level) for youth with low familism values. Housework time also predicted more depressive symptoms (at a within-person level) for youth with high parent-youth conflict about housework. Findings highlight the gendered nature of housework allocation and the importance of considering both individual and contextual factors when examining youth daily activities. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Housework Time from Middle Childhood through Adolescence: Links to Parental Work Hours and Youth Adjustment

PubMed Central

Lam, Chun Bun; Greene, Kaylin M.; McHale, Susan M.

2016-01-01

The developmental course, family correlates, and adjustment implications of youth housework participation from age 8–18 were examined. Mothers, fathers, and two siblings from 201 European American families provided questionnaire and/or daily diary data on six occasions across 7 years. Multilevel modeling within an accelerated longitudinal design revealed that girls spent more time on housework than did boys but that housework time of both girls and boys increased from middle childhood to mid-adolescence and leveled off thereafter. In years when mothers were employed for more hours than usual, girls, but not boys, spent more time on housework than usual. Housework time was linked to more depressive symptoms (at a between-person level) and predicted lower school grades (at a within-person level) for youth with low familism values. Housework time also predicted more depressive symptoms (at a within-person level) for youth with high parent-youth conflict about housework. Findings highlight the gendered nature of housework allocation and the importance of considering both individual and contextual factors when examining youth daily activities. PMID:27736102

Wearable motion sensors to continuously measure real-world physical activities.

PubMed

Dobkin, Bruce H

2013-12-01

Rehabilitation for sensorimotor impairments aims to improve daily activities, walking, exercise, and motor skills. Monitoring of practice and measuring outcomes, however, is usually restricted to laboratory-based procedures and self-reports. Mobile health devices may reverse these confounders of daily care and research trials. Wearable, wireless motion sensor data, analyzed by activity pattern-recognition algorithms, can describe the type, quantity, and quality of mobility-related activities in the community. Data transmission from the sensors to a cell phone and the Internet enable continuous monitoring. Remote access to laboratory quality data about walking speed, duration and distance, gait asymmetry and smoothness of movements, as well as cycling, exercise, and skills practice, opens new opportunities to engage patients in progressive, personalized therapies with feedback about the performance. Clinical trial designs will be able to include remote verification of the integrity of complex physical interventions and compliance with practice, as well as capture repeated, ecologically sound, ratio scale outcome measures. Given the progressively falling cost of miniaturized wearable gyroscopes, accelerometers, and other physiologic sensors, as well as inexpensive data transmission, sensing systems may become as ubiquitous as cell phones for healthcare. Neurorehabilitation can develop these mobile health platforms for daily care and clinical trials to improve exercise and fitness, skills learning, and physical functioning.

Risk and resilience factors in coping with daily stress in adulthood: the role of age, self-concept incoherence, and personal control.

PubMed

Diehl, Manfred; Hay, Elizabeth L

2010-09-01

This study observed young, middle-aged, and older adults (N = 239; Mage = 49.6 years; range = 18-89 years) for 30 consecutive days to examine the association between daily stress and negative affect, taking into account potential risk (i.e., self-concept incoherence) and resilience (i.e., age, perceived personal control) factors. Results indicated that younger individuals and individuals with a more incoherent self-concept showed higher average negative affect across the study. As well, individuals reported higher negative affect on days that they experienced more stress than usual and on days that they reported less control than usual. These main effects were qualified by significant interactions. In particular, the association between daily stress and negative affect was stronger on days on which adults reported low control compared with days on which they reported high control (i.e., perceptions of control buffered stress). Reactivity to daily stress did not differ for individuals of different ages or for individuals with different levels of self-concept incoherence. Although all individuals reported higher negative affect on days on which they reported less control than usual, this association was more pronounced among younger adults. The current study helps to elucidate the role of risk and resilience factors when adults are faced with daily stress.

Usual sodium intakes compared with current dietary guidelines --- United States, 2005-2008.

PubMed

2011-10-21

High sodium intake can increase blood pressure and the risk for heart disease and stroke. According to the Dietary Guidelines for Americans, 2010, persons in the United States aged ≥2 years should limit daily sodium intake to <2,300 mg. Subpopulations that would benefit from further reducing sodium intake to 1,500 mg daily include 1) persons aged ≥51 years, 2) blacks, and 3) persons with hypertension, diabetes, or chronic kidney disease. To estimate the proportion of the U.S. population for whom the 1,500 mg recommendation applies and to assess the usual sodium intake for those persons, CDC and the National Institutes of Health used data for 2005-2008 from the National Health and Nutrition Examination Survey (NHANES). This report summarizes the results of that assessment, which determined that, although 47.6% of persons aged ≥2 years meet the criteria to limit their daily sodium intake to 1,500 mg, the usual daily sodium intake for 98.6% of those persons was >1,500 mg. Moreover, for 88.2% of the remaining U.S. population, daily sodium intake was greater than the recommended <2,300 mg. New population-based strategies and increased public health and private efforts will be needed to meet the Dietary Guidelines recommendations.

Ecological momentary assessment of environmental and personal factors and snack food intake in African American women

PubMed Central

Zenk, Shannon N.; Horoi, Irina; McDonald, Ashley; Corte, Colleen; Riley, Barth; Odoms-Young, Angela M.

2015-01-01

This study examined contributions of environmental and personal factors (specifically, food availability and expense, daily hassles, self-efficacy, positive and negative affect) to within-person and betweenperson variations in snack food intake in 100 African American women. Participants were signaled at random five times daily for seven days to complete a survey on a study-provided smartphone. Women reported consuming snack foods at 35.2% of signals. Easier food availability accounting for one's usual level was associated with higher snack food intake. Being near outlets that predominately sell snacks (e.g., convenience stores), while accounting for one's usual proximity to them, was associated with higher snack food intake. Accounting for one's usual daily hassle level, we found that on days with more frequent daily hassles snack food intake was higher. The positive association between within-person daily hassles frequency and snack food intake was stronger when foods were easily available. Public and private policies to curb ubiquitous food availability and mobile health interventions that take into account timevarying influences on food choices and provide real-time assistance in dealing with easy food availability and coping with stressors may be beneficial in improving African American women's day to day food choices. PMID:25239402

Ecological momentary assessment of environmental and personal factors and snack food intake in African American women.

PubMed

Zenk, Shannon N; Horoi, Irina; McDonald, Ashley; Corte, Colleen; Riley, Barth; Odoms-Young, Angela M

2014-12-01

This study examined contributions of environmental and personal factors (specifically, food availability and expense, daily hassles, self-efficacy, positive and negative affect) to within-person and between-person variations in snack food intake in 100 African American women. Participants were signaled at random five times daily for seven days to complete a survey on a study-provided smartphone. Women reported consuming snack foods at 35.2% of signals. Easier food availability accounting for one's usual level was associated with higher snack food intake. Being near outlets that predominately sell snacks (e.g., convenience stores), while accounting for one's usual proximity to them, was associated with higher snack food intake. Accounting for one's usual daily hassle level, we found that on days with more frequent daily hassles snack food intake was higher. The positive association between within-person daily hassles frequency and snack food intake was stronger when foods were easily available. Public and private policies to curb ubiquitous food availability and mobile health interventions that take into account time-varying influences on food choices and provide real-time assistance in dealing with easy food availability and coping with stressors may be beneficial in improving African American women's day to day food choices. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exercise-based cardiac rehabilitation increases daily physical activity of patients following myocardial infarction: subanalysis of two randomised controlled trials.

PubMed

Ribeiro, F; Oliveira, N L; Silva, G; Campos, L; Miranda, F; Teixeira, M; Alves, A J; Oliveira, J

2017-03-01

To assess the effects of an exercise-based cardiac rehabilitation programme on daily physical activity levels of patients following myocardial infarction. Subanalysis of two randomised, prospective controlled trials. Outpatient clinic of a secondary hospital. Fifty consecutive patients randomised to the exercise group {n=25; 23 males; mean age 54 [standard deviation (SD) 9] years} or the control group [n=25; 20 males; mean age 58 (SD 9) years]. The exercise group participated in an 8-week aerobic exercise programme plus usual medical care and follow-up. The control group received usual medical care and follow-up. The primary outcome measure was change in time spent undertaking moderate-to-vigorous physical activity per day, assessed by accelerometer over 7 consecutive days. Secondary outcome measures were cardiorespiratory fitness, body mass, and resting blood pressure and heart rate. Moderate-to-vigorous physical activity levels increased significantly in the exercise group [43.2 (SD 36.3) to 53.5 (SD 31.9) minutes/day, P=0.030], and remained unchanged in the control group [40.8 (SD 26.2) to 36.8 (SD 26.5) minutes/day, P=0.241] from baseline to the end of the programme. Cardiorespiratory fitness increased significantly in the exercise group (mean difference 2.8; 95% of the difference 1.3 to 4.4ml/kg/minute, P=0.001) after the 8-week programme. In patients under optimal medication following myocardial infarction, participation in an 8-week exercise-based cardiac rehabilitation programme was found to improve physical activity levels consistent with health-related benefits. Future studies are needed to determine whether the increase in physical activity is maintained in the long term. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Promoting Activity in Geriatric Rehabilitation: A Randomized Controlled Trial of Accelerometry.

PubMed

Peel, Nancye M; Paul, Sanjoy K; Cameron, Ian D; Crotty, Maria; Kurrle, Susan E; Gray, Leonard C

2016-01-01

Low activity levels in inpatient rehabilitation are associated with adverse outcomes. The study aimed to test whether activity levels can be increased by the provision of monitored activity data to patients and clinicians in the context of explicit goal setting. A randomized controlled trial in three sites in Australia included 255 inpatients aged 60 and older who had a rehabilitation goal to become ambulant. The primary outcome was patients' walking time measured by accelerometers during the rehabilitation admission. Walking times from accelerometry were made available daily to treating therapists and intervention participants to motivate patients to improve incidental activity levels and reach set goals. For the control group, 'usual care' was followed, including the setting of mobility goals; however, for this group, neither staff nor patients received data on walking times to aid the setting of daily walking time targets. The median daily walking time in the intervention group increased from 10.3 minutes at baseline to 32.1 minutes at day 28, compared with an increase from 9.5 to 26.5 minutes per day in the control group. Subjects in the intervention group had significantly higher non-therapy walking time by about 7 minutes [mean (95% CI): 24.6 (21.7, 27.4)] compared to those in the control group [mean(95% CI): 17.3 (14.4, 20.3)] (p = 0.001). Daily feedback to patients and therapists using an accelerometer increased walking times during rehabilitation admissions. The results of this study suggest objective monitoring of activity levels could provide clinicians with information on clinically important, mobility-related activities to assist goal setting. Australian New Zealand Clinical Trials Registry ACTRN12611000034932 http://www.ANZCTR.org.au/.

Ertapenem: a new opportunity for outpatient parenteral antimicrobial therapy.

PubMed

Tice, Alan D

2004-06-01

Ertapenem is a parenteral carbapenem antimicrobial with pharmacological properties that allow it to be given once daily. This makes it a consideration for outpatient parenteral antimicrobial therapy (OPAT). In comparison with information from the OPAT Outcomes Registry, ertapenem seems well suited for the types of infections and bacteria that are commonly treated with OPAT, plus it has additional activity against anaerobic bacteria. This added spectrum makes it possible to treat complicated skin/skin-structure, complicated intra-abdominal and pelvic infections with a single antibiotic instead of the multiple agents that have usually been required. Ertapenem is also comparable to other OPAT antimicrobials in terms of adverse effects and clinical outcomes. This antimicrobial can be given with any delivery model, although its stability when mixed is such that daily preparation or self-mixing systems need to be considered. Ertapenem should be added to the growing list of once-daily parenteral antibiotics that can be given to outpatients.

Prospects of effective microorganisms technology in wastes treatment in Egypt

PubMed Central

Shalaby, Emad A

2011-01-01

Sludge dewatering and treatment may cost as much as the wastewater treatment. Usually large proportion of the pollutants in wastewater is organic. They are attacked by saprophytic microorganisms, i.e. organisms that feed upon dead organic matter. Activity of organisms causes decomposition of organic matter and destroys them, where the bacteria convert the organic matter or other constituents in the wastewater to new cells, water, gases and other products. Demolition activities, including renovation/remodeling works and complete or selective removal/demolishing of existing structures either by man-made processes or by natural disasters, create an extensive amount of wastes. These demolition wastes are characterized as heterogeneous mixtures of building materials that are usually contaminated with chemicals and dirt. In developing countries, it is estimated that demolition wastes comprise 20% to 30% of the total annual solid wastes. In Egypt, the daily quantity of construction and demolition (C&D) waste has been estimated as 10 000 tones. That is equivalent to one third of the total daily municipal solid wastes generated per day in Egypt. The zabbaliin have since expanded their activities and now take the waste they collect back to their garbage villages where it is sorted into recyclable components: paper, plastics, rags, glass, metal and food. The food waste is fed to pigs and the other items are sold to recycling centers. This paper summarizes the wastewater and solid wastes management in Egypt now and future. PMID:23569767

Objectively Measured Patterns of Activities of Different Intensity Categories and Steps Taken Among Working Adults in a Multi-ethnic Asian Population.

PubMed

Müller-Riemenschneider, Falk; Ng, Sheryl Hui Xian; Koh, David; Chu, Anne Hin Yee

2016-06-01

To objectively assess sedentary behavior (SB), light- and moderate-to-vigorous intensity physical activity (MVPA), and steps among Singaporean office-based workers across days of the week. A convenience sample of office-based employees of a public University was recruited. Time spent for SB, light-, and MVPA using different validated accelerometry counts per minute (CPM), and step count were determined. Depending on applied CPM for SB (less than 100, less than 150 and less than 200 CPM), 107 working adults spent between 69.2% and 76.4% of their daily wakeful time in SB. Time spent in SB and MVPA were higher on weekdays than weekends. The hourly analysis highlights patterns of greater SB during usual working hours on weekdays but not on weekends. SB at work contributes greatly toward total daily sitting time. Low PA levels and high SB levels were found on weekends.

The dose-response effects of aerobic exercise on musculoskeletal injury: a post hoc analysis of a randomized trial.

PubMed

Brown, Justin C; Schmitz, Kathryn H

2017-01-01

In a post hoc analysis, we quantified the risk of musculoskeletal injury (MSI) associated with different volumes of aerobic exercise in a randomized trial. Premenopausal women (n = 119) were randomized to one of three groups: low-dose aerobic exercise (150 min·per week), high-dose aerobic exercise (300 min·per week) or control (usual activity) for 5 months. Compared to the control group, the risk of reporting an acute MSI increased with higher volumes of aerobic exercise, with a similar pattern observed for recurrent MSI. The risk of reporting an MSI severe enough to impair activities of daily living did not increase with higher volumes of aerobic exercise. Approximately half of MSI were causally attributed to aerobic exercise. The risk of experiencing an acute or recurrent MSI increases with higher volumes of aerobic exercise; however, the risk of experiencing an MSI severe enough to impair activities of daily living does not increase with higher volumes of aerobic exercise.

Parents’ Daily Time With Their Children: A Workplace Intervention

PubMed Central

Lawson, Katie M.; Almeida, David M.; King, Rosalind B.; Hammer, Leslie; Casper, Lynne M.; Okechukwu, Cassandra A.; Hanson, Ginger; McHale, Susan M.

2015-01-01

OBJECTIVES: In the context of a group randomized field trial, we evaluated whether parents who participated in a workplace intervention, designed to increase supervisor support for personal and family life and schedule control, reported significantly more daily time with their children at the 12-month follow-up compared with parents assigned to the Usual Practice group. We also tested whether the intervention effect was moderated by parent gender, child gender, or child age. METHODS: The Support-Transform-Achieve-Results Intervention was delivered in an information technology division of a US Fortune 500 company. Participants included 93 parents (45% mothers) of a randomly selected focal child aged 9 to 17 years (49% daughters) who completed daily telephone diaries at baseline and 12 months after intervention. During evening telephone calls on 8 consecutive days, parents reported how much time they spent with their child that day. RESULTS: Parents in the intervention group exhibited a significant increase in parent-child shared time, 39 minutes per day on average, between baseline and the 12-month follow-up. By contrast, parents in the Usual Practice group averaged 24 fewer minutes with their child per day at the 12-month follow-up. Intervention effects were evident for mothers but not for fathers and for daughters but not sons. CONCLUSIONS: The hypothesis that the intervention would improve parents’ daily time with their children was supported. Future studies should examine how redesigning work can change the quality of parent-child interactions and activities known to be important for youth health and development. PMID:25869371

Parents' daily time with their children: a workplace intervention.

PubMed

Davis, Kelly D; Lawson, Katie M; Almeida, David M; Kelly, Erin L; King, Rosalind B; Hammer, Leslie; Casper, Lynne M; Okechukwu, Cassandra A; Hanson, Ginger; McHale, Susan M

2015-05-01

In the context of a group randomized field trial, we evaluated whether parents who participated in a workplace intervention, designed to increase supervisor support for personal and family life and schedule control, reported significantly more daily time with their children at the 12-month follow-up compared with parents assigned to the Usual Practice group. We also tested whether the intervention effect was moderated by parent gender, child gender, or child age. The Support-Transform-Achieve-Results Intervention was delivered in an information technology division of a US Fortune 500 company. Participants included 93 parents (45% mothers) of a randomly selected focal child aged 9 to 17 years (49% daughters) who completed daily telephone diaries at baseline and 12 months after intervention. During evening telephone calls on 8 consecutive days, parents reported how much time they spent with their child that day. Parents in the intervention group exhibited a significant increase in parent-child shared time, 39 minutes per day on average, between baseline and the 12-month follow-up. By contrast, parents in the Usual Practice group averaged 24 fewer minutes with their child per day at the 12-month follow-up. Intervention effects were evident for mothers but not for fathers and for daughters but not sons. The hypothesis that the intervention would improve parents' daily time with their children was supported. Future studies should examine how redesigning work can change the quality of parent-child interactions and activities known to be important for youth health and development. Copyright © 2015 by the American Academy of Pediatrics.

The effect of a sit-stand workstation intervention on daily sitting, standing and physical activity: protocol for a 12 month workplace randomised control trial.

PubMed

Hall, Jennifer; Mansfield, Louise; Kay, Tess; McConnell, Alison K

2015-02-15

A lack of physical activity and excessive sitting can contribute to poor physical health and wellbeing. The high percentage of the UK adult population in employment, and the prolonged sitting associated with desk-based office-work, make these workplaces an appropriate setting for interventions to reduce sedentary behaviour and increase physical activity. This pilot study aims to determine the effect of an office-based sit-stand workstation intervention, compared with usual desk use, on daily sitting, standing and physical activity, and to examine the factors that underlie sitting, standing and physical activity, within and outside, the workplace. A randomised control trial (RCT) comparing the effects of a sit-stand workstation only and a multi-component sit-stand workstation intervention, with usual desk-based working practice (no sit-stand workstation) will be conducted with office workers across two organisations, over a 12 month period (N = 30). The multicomponent intervention will comprise organisational, environmental and individual elements. Objective data will be collected at baseline, and after 2-weeks, 3-months, 6-months and 12-months of the intervention. Objective measures of sitting, standing, and physical activity will be made concurrently (ActivPAL3™ and ActiGraph (GT3X+)). Activity diaries, ethnographic participant observation, and interviews with participants and key organisational personnel will be used to elicit understanding of the influence of organisational culture on sitting, standing and physical activity behaviour in the workplace. This study will be the first long-term sit-stand workstation intervention study utilising an RCT design, and incorporating a comprehensive process evaluation. The study will generate an understanding of the factors that encourage and restrict successful implementation of sit-stand workstation interventions, and will help inform future occupational wellbeing policy and practice. Other strengths include the objective measurement of physical activity during both work and non-work hours. Clinicaltrials.gov identifier NCT02172599, 22nd June 2014.

Evaluating an extended rehabilitation service for stroke patients (EXTRAS): study protocol for a randomised controlled trial.

PubMed

Rodgers, Helen; Shaw, Lisa; Cant, Robin; Drummond, Avril; Ford, Gary A; Forster, Anne; Hills, Katie; Howel, Denise; Laverty, Anne-Marie; McKevitt, Christopher; McMeekin, Peter; Price, Christopher

2015-05-05

Development of longer term stroke rehabilitation services is limited by lack of evidence of effectiveness for specific interventions and service models. We describe the protocol for a multicentre randomised controlled trial which is evaluating an extended stroke rehabilitation service. The extended service commences when routine 'organised stroke care' (stroke unit and early supported discharge (ESD)) ends. This study is a multicentre randomised controlled trial with health economic and process evaluations. It is set within NHS stroke services which provide ESD. Participants are adults who have experienced a new stroke (and carer if appropriate), discharged from hospital under the care of an ESD team. The intervention group receives an extended stroke rehabilitation service provided for 18 months following completion of ESD. The extended rehabilitation service involves regular contact with a senior ESD team member who leads and coordinates further rehabilitation. Contact is usually by telephone. The control group receives usual stroke care post-ESD. Usual care may involve referral of patients to a range of rehabilitation services upon completion of ESD in accordance with local clinical practice. Randomisation is via a central independent web-based service. The primary outcome is extended activities of daily living (Nottingham Extended Activities of Daily Living Scale) at 24 months post-randomisation. Secondary outcomes (at 12 and 24 months post-randomisation) are health status, quality of life, mood and experience of services for patients, and quality of life, experience of services and carer stress for carers. Resource use and adverse events are also collected. Outcomes are undertaken by a blinded assessor. Implementation and delivery of the extended stroke rehabilitation service will also be described. Semi-structured interviews will be conducted with a subsample of participants and staff to gain insight into perceptions and experiences of rehabilitation services delivered or received. Allowing for 25% attrition, 510 participants are needed to provide 90% power to detect a difference in mean Nottingham Extended Activities of Daily Living Scale score of 6 with a 5% significance level. The provision of longer term support for stroke survivors is currently limited. The results from this trial will inform future stroke service planning and configuration. This trial was registered with ISRCTN (identifier: ISRCTN45203373 ) on 9 August 2012.

Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial.

PubMed

Brummel, N E; Girard, T D; Ely, E W; Pandharipande, P P; Morandi, A; Hughes, C G; Graves, A J; Shintani, A; Murphy, E; Work, B; Pun, B T; Boehm, L; Gill, T M; Dittus, R S; Jackson, J C

2014-03-01

Cognitive impairment after critical illness is common and debilitating. We developed a cognitive therapy program for critically ill patients and assessed the feasibility and safety of administering combined cognitive and physical therapy early during a critical illness. We randomized 87 medical and surgical ICU patients with respiratory failure and/or shock in a 1:1:2 manner to three groups: usual care, early once-daily physical therapy, or early once-daily physical therapy plus a novel, progressive, twice-daily cognitive therapy protocol. Cognitive therapy included orientation, memory, attention, and problem-solving exercises, and other activities. We assessed feasibility outcomes of the early cognitive plus physical therapy intervention. At 3 months, we also assessed cognitive, functional, and health-related quality of life outcomes. Data are presented as median (interquartile range) or frequency (%). Early cognitive therapy was a delivered to 41/43 (95%) of cognitive plus physical therapy patients on 100% (92-100%) of study days beginning 1.0 (1.0-1.0) day following enrollment. Physical therapy was received by 17/22 (77%) of usual care patients, by 21/22 (95%) of physical therapy only patients, and 42/43 (98%) of cognitive plus physical therapy patients on 17% (10-26%), 67% (46-87%), and 75% (59-88%) of study days, respectively. Cognitive, functional, and health-related quality of life outcomes did not differ between groups at 3-month follow-up. This pilot study demonstrates that early rehabilitation can be extended beyond physical therapy to include cognitive therapy. Future work to determine optimal patient selection, intensity of treatment, and benefits of cognitive therapy in the critically ill is needed.

Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial

PubMed Central

Brummel, N.E.; Girard, T.D.; Ely, E.W.; Pandharipande, P.P.; Morandi, A.; Hughes, C.G.; Graves, A.J.; Shintani, A.K.; Murphy, E.; Work, B.; Pun, B.T.; Boehm, L.; Gill, T.M.; Dittus, R.S.; Jackson, J.C.

2013-01-01

PURPOSE Cognitive impairment after critical illness is common and debilitating. We developed a cognitive therapy program for critically ill patients and assessed the feasibility and safety of administering combined cognitive and physical therapy early during a critical illness. METHODS We randomized 87 medical and surgical ICU patients with respiratory failure and/or shock in a 1:1:2 manner to three groups: usual care, early once-daily physical therapy, or early once-daily physical therapy plus a novel, progressive, twice-daily cognitive therapy protocol. Cognitive therapy included orientation, memory, attention, and problem solving exercises, and other activities. We assessed feasibility outcomes of the early cognitive plus physical therapy intervention. At 3-months, we also assessed cognitive, functional and health-related quality of life outcomes. Data are presented as median [interquartile range] or frequency (%). RESULTS Early cognitive therapy was a delivered to 41/43 (95%) of cognitive plus physical therapy patients on 100% [92–100%] of study days beginning 1.0 [1.0–1.0] day following enrollment. Physical therapy was received by 17/22 (77%) of usual care patients, by 21/22 (95%) of physical therapy only patients and 42/43 (98%) of cognitive plus physical therapy patients on 17% [10–26%], 67% [46–87%] and 75% [59–88%] of study days, respectively. Cognitive, functional and health-related quality of life outcomes did not differ between groups at 3-month follow-up. CONCLUSIONS This pilot study demonstrates that early rehabilitation can be extended beyond physical therapy to include cognitive therapy. Future work to determine optimal patient selection, intensity of treatment and benefits of cognitive therapy in the critically ill is needed. PMID:24257969

Sedentary Behavior as a Daily Process Regulated by Habits and Intentions

PubMed Central

Conroy, David E.; Maher, Jaclyn P.; Elavsky, Steriani; Hyde, Amanda L.; Doerksen, Shawna E.

2014-01-01

Objective Sedentary behavior is a health risk but little is known about the motivational processes that regulate daily sedentary behavior. This study was designed to test a dual-process model of daily sedentary behavior, with an emphasis on the role of intentions and habits in regulating daily sedentary behavior. Methods College students (N = 128) self-reported on their habit strength for sitting and completed a 14-day ecological momentary assessment study that combined daily diaries for reporting motivation and behavior with ambulatory monitoring of sedentary behavior using accelerometers. Results Less than half of the variance in daily sedentary behavior was attributable to between-person differences. People with stronger sedentary habits reported more sedentary behavior on average. People whose intentions for limiting sedentary behavior were stronger, on average, exhibited less self-reported sedentary behavior (and marginally less monitored sedentary behavior). Daily deviations in those intentions were negatively associated with changes in daily sedentary behavior (i.e., stronger than usual intentions to limit sedentary behavior were associated with reduced sedentary behavior). Sedentary behavior also varied within-people as a function of concurrent physical activity, the day of week, and the day in the sequence of the monitoring period. Conclusions Sedentary behavior was regulated by both automatic and controlled motivational processes. Interventions should target both of these motivational processes to facilitate and maintain behavior change. Links between sedentary behavior and daily deviations in intentions also indicate the need for ongoing efforts to support controlled motivational processes on a daily basis. PMID:23477579

Risk and Resilience Factors in Coping with Daily Stress in Adulthood: The Role of Age, Self-Concept Incoherence, and Personal Control

PubMed Central

Diehl, Manfred; Hay, Elizabeth L.

2010-01-01

This study observed young, middle-aged and older adults (N = 239; Mage = 49.6 years, range = 18-89 years) for 30 consecutive days to examine the association between daily stress and negative affect taking into account potential risk (i.e., self-concept incoherence) and resilience factors (i.e., age, perceived personal control). Results indicated that younger individuals and individuals with a more incoherent self-concept showed higher average negative affect across the study. As well, individuals reported higher negative affect on days that they experienced more stress than usual and on days that they reported less control than usual. These main effects were qualified by significant interactions. In particular, the association between daily stress and negative affect was stronger on days on which adults reported low control compared to days on which they reported high control (i.e., perceptions of control buffered stress). Reactivity to daily stress did not differ for individuals of different ages or for individuals with different levels of self-concept incoherence. Although all individuals reported higher negative affect on days on which they reported less control than usual, this association was more pronounced among younger adults. This study helps to elucidate the role of risk and resilience factors when adults are faced with daily stress. PMID:20822228

Usual coffee intake in Brazil: results from the National Dietary Survey 2008-9.

PubMed

Sousa, Alessandra Gaspar; da Costa, Teresa Helena Macedo

2015-05-28

Coffee is central to the economy of many developing countries, as well as to the world economy. However, despite the widespread consumption of coffee, there are very few available data showing the usual intake of this beverage. Surveying usual coffee intake is a way of monitoring one aspect of a population's usual dietary intake. Thus, the present study aimed to characterise the usual daily coffee intake in the Brazilian population. We used data from the National Dietary Survey collected in 2008-9 from a probabilistic sample of 34,003 Brazilians aged 10 years and older. The National Cancer Institute method was applied to obtain the usual intake based on two nonconsecutive food diaries, and descriptive statistical analyses were performed by age and sex for Brazil and its regions. The estimated average usual daily coffee intake of the Brazilian population was 163 (SE 2.8) ml. The comparison by sex showed that males had a 12% greater usual coffee intake than females. In addition, the highest intake was recorded among older males. Among the five regions surveyed, the North-East had the highest usual coffee intake (175 ml). The most common method of brewing coffee was filtered/instant coffee (71%), and the main method of sweetening beverages was with sugar (87%). In Brazil, the mean usual coffee intake corresponds to 163 ml, or 1.5 cups/d. Differences in usual coffee intake according to sex and age differed among the five Brazilian regions.

Varying behavior of different window sizes on the classification of static and dynamic physical activities from a single accelerometer.

PubMed

Fida, Benish; Bernabucci, Ivan; Bibbo, Daniele; Conforto, Silvia; Schmid, Maurizio

2015-07-01

Accuracy of systems able to recognize in real time daily living activities heavily depends on the processing step for signal segmentation. So far, windowing approaches are used to segment data and the window size is usually chosen based on previous studies. However, literature is vague on the investigation of its effect on the obtained activity recognition accuracy, if both short and long duration activities are considered. In this work, we present the impact of window size on the recognition of daily living activities, where transitions between different activities are also taken into account. The study was conducted on nine participants who wore a tri-axial accelerometer on their waist and performed some short (sitting, standing, and transitions between activities) and long (walking, stair descending and stair ascending) duration activities. Five different classifiers were tested, and among the different window sizes, it was found that 1.5 s window size represents the best trade-off in recognition among activities, with an obtained accuracy well above 90%. Differences in recognition accuracy for each activity highlight the utility of developing adaptive segmentation criteria, based on the duration of the activities. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Daily Stress, Coping, and Negative and Positive Affect in Depression: Complex Trigger and Maintenance Patterns.

PubMed

Dunkley, David M; Lewkowski, Maxim; Lee, Ihno A; Preacher, Kristopher J; Zuroff, David C; Berg, Jody-Lynn; Foley, J Elizabeth; Myhr, Gail; Westreich, Ruta

2017-05-01

Major depressive disorder is characterized by emotional dysfunction, but mood states in daily life are not well understood. This study examined complex explanatory models of daily stress and coping mechanisms that trigger and maintain daily negative affect and (lower) positive affect in depression. Sixty-three depressed patients completed perfectionism measures, and then completed daily questionnaires of stress appraisals, coping, and affect for 7 consecutive days. Multilevel structural equation modeling (MSEM) demonstrated that, across many stressors, when the typical individual with depression perceives more criticism than usual, he/she uses more avoidant coping and experiences higher event stress than usual, and this is connected to daily increases in negative affect as well as decreases in positive affect. In parallel, results showed that perceived control, less avoidant coping, and problem-focused coping commonly operate together when daily positive affect increases. MSEM also showed that avoidant coping tendencies and ongoing stress, in combination, explain why people with depression and higher self-critical perfectionism maintain daily negative affect and lower positive affect. These findings advance a richer and more detailed understanding of specific stress and coping patterns to target in order to more effectively accomplish the two predominant therapy goals of decreasing patients' distress and strengthening resilience. Copyright © 2016. Published by Elsevier Ltd.

Mild cognitive impairment and everyday function: evidence of reduced speed in performing instrumental activities of daily living.

PubMed

Wadley, Virginia G; Okonkwo, Ozioma; Crowe, Michael; Ross-Meadows, Lesley A

2008-05-01

Mild cognitive impairment (MCI) may involve subtle functional losses that are not detected with typical self- or informant-report assessments of daily function. Information about the nature of functional difficulties in MCI can be used to augment common clinical assessment procedures, and aspects of function that are affected in MCI can serve as meaningful endpoints for intervention trials. Cross-sectional case and comparison group study. University medical center. Fifty participants with MCI and 59 cognitively normal participants. The authors compared the groups on dimensions of both speed and accuracy in performing instrumental activities of daily living (IADLs), using a standardized Timed IADL measure that evaluates five functional domains commonly encountered in everyday life (telephone use, locating nutrition information on food labels, financial abilities, grocery shopping, medication management). Across Timed IADL domains, MCI participants demonstrated accuracy comparable with cognitively normal participants but took significantly longer to complete the functional activities, controlling for depressive symptoms (p< 0.001). Slower performance was demonstrated in each discrete domain except financial abilities. These results suggest that slower speed of task performance is an important component and perhaps an early marker of functional change in MCI that would not be detected using traditional measurements of daily function. Future research should address the question of whether performance-based functional measures, as well as simple queries regarding whether functional activities take longer than usual to complete, may improve the prediction of future cognitive decline and disease progression among those individuals in whom MCI represents impending dementia.

Clinical usefulness of fracture site in situ block on lumbar spine transverse process fracture.

PubMed

Park, Jun-Mo; Kwak, Kyung-Hwa

2014-11-01

Lumbar spine transverse process fractures (LSTPFs) are uncommon and frequently overlooked on plain film radiographs. Even when recognized, they are often regarded as trivial and minimally painful injuries compared with combined serious major abdominal, pelvic, and spinal injuries. Conservative treatments are usually offered to patients with LSTPFs. This report presents 4 cases of LSTPFs where symptoms did not improve after more than 1 week of conservative management. Local anesthetics and steroids were injected directly into the fracture site under computed tomography guidance, referred to as a fracture site in situ block, in an attempt to accelerate the return to daily lives and professional activities. Three of the 4 patients returned to their daily lives almost immediately after completing the procedure. Although the procedure was appropriately performed at L4, 1 patient still complained of pain. This patient's all films were meticulously re-examined, and it was determined that a transverse process fracture was present at not only L4 but also L1. This report introduces a method of active treatment to help patients with LSTPFs quickly return to their daily lives and professional activities. The positive results in these cases suggest that fracture site in situ block might be a useful option for treating patients with LSTPFs. © 2014 World Institute of Pain.

Spa therapy adjunct to pharmacotherapy is beneficial in rheumatoid arthritis: a crossover randomized controlled trial

NASA Astrophysics Data System (ADS)

Karagülle, Mine; Kardeş, Sinan; Dişçi, Rian; Karagülle, Müfit Zeki

2018-02-01

This study aims to investigate whether 2-week spa therapy, as an adjunct to usual pharmacological therapy, has any beneficial effect in patients with rheumatoid arthritis (RA). In this single-blind crossover study, 50 patients were randomly assigned in a 1:1 manner to receive usual pharmacological therapy plus 2-week spa therapy or usual pharmacological therapy alone (period 1.6 months); after a 9-month washout, patients were crossed over to the opposite assignment (period 2.6 months). Spa therapy program included a daily saline balneotherapy session at 36-37 °C for 20 min except Sundays. The clinical outcomes were evaluated at baseline, after spa therapy (2 weeks) and 3 and 6 months after the spa therapy in both period and were pain (Visual Analogue Scale (VAS)), patient and physician global assessments (VAS), Health Assessment Questionnaire (HAQ), and Disease Activity Score (DAS28). Spa therapy was superior to control therapy in improving all the assessed clinical outcomes at the end of the spa therapy. This superiority persisted significantly in physician global assessment ( p = 0.010) and with a trend in favor of spa group in patient global assessment ( p = 0.058), function ( p = 0.092), and disease activity ( p = 0.098) at 3 months. Statistically significant improvements were found in spa therapy compared to control in disease activity ( p = 0.006) and patient ( p = 0.020) and physician global ( p = 0.011) assessments, and a trend toward improvements in pain ( p = 0.069) and swollen joints ( p = 0.070) at 6 months. A 2-week spa therapy adjunct to usual pharmacological therapy provided beneficial clinical effects compared to usual pharmacological therapy alone, in RA patients treated with traditional disease-modifying antirheumatic drugs. These beneficial effects may last for 6 months.

Usual Dietary Intakes: SAS Macros for the NCI Method

Cancer.gov

SAS macros are currently available to facilitate modeling of a single dietary component, whether consumed daily or episodically; ratios of two dietary components that are consumed nearly every day; multiple dietary components, whether consumed daily or episodically.

Sex differences in long-term quality of life after stroke: Influence of mood and functional status.

PubMed

López Espuela, F; Portilla Cuenca, J C; Leno Díaz, C; Párraga Sánchez, J M; Gamez-Leyva, G; Casado Naranjo, I

2017-12-19

To evaluate long-term quality of life (QoL) in patients who have experienced a stroke and to analyse differences in QoL between sexes. We conducted a descriptive, cross-sectional, observational study to gather sociodemographic variables and risk factors; data were also obtained on QoL, mood, and functional status using validated scales. The study was approved by our centre's ethics committee. Our final sample included 124 patients; mean age was 71.30±11.99 years. In the QoL study, the EuroQol-5D dimensions in which participants presented most problems were anxiety/depression (66.7%) and pain/discomfort (62.2%). We found significant inter-sex differences in the dimensions of mobility and usual activities (P=.016 and P=.005, respectively). Women also achieved substantially poorer EuroQoL-5D index values than men (0.45±0.45 vs. 0.65±0.38; P=.013). QoL was found to be associated with dependence for the activities of daily living (r=0.326; P=.001) and depressed mood (r=-0.514; P<.0001). According to the predictive model for the EQ-5D index, 72% of the score on QoL items is explained by functional status, dependence for the activities of daily living (basic and instrumental), and depressed mood. Being married, in contrast, seems to be a protective factor. Stroke survivors have poor long-term QoL; this is more marked in women than in men, especially in the dimensions of mobility and usual activities. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

The Effects of Highly Challenging Balance Training in Elderly With Parkinson's Disease: A Randomized Controlled Trial.

PubMed

Conradsson, David; Löfgren, Niklas; Nero, Håkan; Hagströmer, Maria; Ståhle, Agneta; Lökk, Johan; Franzén, Erika

2015-10-01

Highly challenging exercises have been suggested to induce neuroplasticity in individuals with Parkinson's disease (PD); however, its effect on clinical outcomes remains largely unknown. To evaluate the short-term effects of the HiBalance program, a highly challenging balance-training regimen that incorporates both dual-tasking and PD-specific balance components, compared with usual care in elderly with mild to moderate PD. Participants with PD (n = 100) were randomized, either to the 10-week HiBalance program (n = 51) or to the control group (n = 49). Participants were evaluated before and after the intervention. The main outcomes were balance performance (Mini-BESTest), gait velocity (during normal and dual-task gait), and concerns about falling (Falls Efficacy Scale-International). Performance of a cognitive task while walking, physical activity level (average steps per day), and activities of daily living were secondary outcomes. A total of 91 participants completed the study. After the intervention, the between group comparison showed significantly improved balance and gait performance in the training group. Moreover, although no significant between group difference was observed regarding gait performance during dual-tasking; the participants in the training group improved their performance of the cognitive task while walking, as compared with the control group. Regarding physical activity levels and activities of daily living, in comparison to the control group, favorable results were found for the training group. No group differences were found for concerns about falling. The HiBalance program significantly benefited balance and gait abilities when compared with usual care and showed promising transfer effects to everyday living. Long-term follow-up assessments will further explore these effects. © The Author(s) 2015.

Embedding an enriched environment in an acute stroke unit increases activity in people with stroke: a controlled before-after pilot study.

PubMed

Rosbergen, Ingrid Cm; Grimley, Rohan S; Hayward, Kathryn S; Walker, Katrina C; Rowley, Donna; Campbell, Alana M; McGufficke, Suzanne; Robertson, Samantha T; Trinder, Janelle; Janssen, Heidi; Brauer, Sandra G

2017-11-01

To determine whether an enriched environment embedded in an acute stroke unit could increase activity levels in acute stroke patients and reduce adverse events. Controlled before-after pilot study. An acute stroke unit in a regional Australian hospital. Acute stroke patients admitted during (a) initial usual care control period, (b) an enriched environment period and (c) a sustainability period. Usual care participants received usual one-on-one allied health intervention and nursing care. The enriched environment participants were provided stimulating resources, communal areas for eating and socializing and daily group activities. Change management strategies were used to implement an enriched environment within existing staffing levels. Behavioural mapping was used to estimate patient activity levels across groups. Participants were observed every 10 minutes between 7.30 am and 7.30 pm within the first 10 days after stroke. Adverse and serious adverse events were recorded using a clinical registry. The enriched environment group ( n = 30, mean age 76.7 ± 12.1) spent a significantly higher proportion of their day engaged in 'any' activity (71% vs. 58%, P = 0.005) compared to the usual care group ( n = 30, mean age 76.0 ± 12.8). They were more active in physical (33% vs. 22%, P < 0.001), social (40% vs. 29%, P = 0.007) and cognitive domains (59% vs. 45%, P = 0.002) and changes were sustained six months post implementation. The enriched group experienced significantly fewer adverse events (0.4 ± 0.7 vs.1.3 ± 1.6, P = 0.001), with no differences found in serious adverse events (0.5 ± 1.6 vs.1.0 ± 2.0, P = 0.309). Embedding an enriched environment in an acute stroke unit increased activity in stroke patients.

'Pharyngocise': Randomized Controlled Trial of Preventative Exercises to Maintain Muscle Structure and Swallowing Function During Head-and-Neck Chemoradiotherapy

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

Carnaby-Mann, Giselle, E-mail: gmann@phhp.ufl.edu; Crary, Michael A.; Schmalfuss, Ilona

2012-05-01

Purpose: Dysphagia after chemoradiotherapy is common. The present randomized clinical trial studied the effectiveness of preventative behavioral intervention for dysphagia compared with the 'usual care.' Methods and Materials: A total of 58 head-and-neck cancer patients treated with chemoradiotherapy were randomly assigned to usual care, sham swallowing intervention, or active swallowing exercises (pharyngocise). The intervention arms were treated daily during chemoradiotherapy. The primary outcome measure was muscle size and composition (determined by T{sub 2}-weighted magnetic resonance imaging). The secondary outcomes included functional swallowing ability, dietary intake, chemosensory function, salivation, nutritional status, and the occurrence of dysphagia-related complications. Results: The swallowing musculaturemore » (genioglossus, hyoglossuss, and mylohyoid) demonstrated less structural deterioration in the active treatment arm. The functional swallowing, mouth opening, chemosensory acuity, and salivation rate deteriorated less in the pharyngocise group. Conclusion: Patients completing a program of swallowing exercises during cancer treatment demonstrated superior muscle maintenance and functional swallowing ability.« less

Work outcomes and their predictors in the Redesigning Daily Occupations (ReDO) rehabilitation programme for women with stress-related disorders.

PubMed

Eklund, Mona; Wästberg, Birgitta A; Erlandsson, Lena-Karin

2013-04-01

Previous research has shown that the Redesigning Daily Occupations programme reduced the degree of sick leave and increased return to work rates among women on sick leave for stress-related disorders when compared with "care as usual". To further investigate the Redesigning Daily Occupations intervention, this study explored changes in the work situation from baseline to a 12-month follow-up in the Redesigning Daily Occupations group compared with the "care as usual" group and analysed any predictors of change. A matched-control design was used and 84 women were recruited. Objective (return to work and sick leave) and subjective work outcomes (perceptions of the worker role and the work environment) were explored. Potential predictors were clinical and demographic variables and an anxiety-depression factor. In both groups, large positive effect sizes from baseline to follow-up were found regarding the objective outcomes, a moderate positive effect size was found for perceived work environment, whereas perceived worker role remained unaffected. Previous work rehabilitation predicted objective work outcomes in both groups. Higher education and older age were predictors of subjective outcomes in the Redesigning Daily Occupations group, whereas a more severe anxiety-depression rating was negative for work environment ratings in the "care as usual" group. Return to work seemed possible without a change in the women's perceptions of the worker role; rather they renegotiated their view of the work environment. The Redesigning Daily Occupations programme was found to be promising, with a positive effect on return to work and sick leave reduction. It seemed more suitable for the higher educated and older women. © 2012 The Authors Australian Occupational Therapy Journal © 2012 Occupational Therapy Australia.

The effect of occupational therapy in patients with chronic obstructive pulmonary disease: A randomized controlled trial.

PubMed

Martinsen, Unni; Bentzen, Hege; Holter, Morag Kelly; Nilsen, Tove; Skullerud, Hallvard; Mowinckel, Petter; Kjeken, Ingvild

2017-03-01

Aim The main aim of this study was to evaluate the effect of individualized occupational therapy in patients with chronic obstructive pulmonary disease (COPD). Additionally, the authors wanted to explore the occupational problems experienced in daily life by individuals with COPD. Methods A total of 52 patients were randomly assigned to the intervention group (occupational therapy) or control group (treatment as usual). The primary outcome was assessed using the Canadian Occupational Performance Measure (COPM), and participants were assessed at baseline and after four and 12 months. Results There were no treatment effects on occupational performance or satisfaction with performance, as measured by the COPM. However, we found a significant effect in favour of the intervention group at exertion when performing an individually chosen activity, and in the activity dimension of St George's Respiratory Questionnaire. A total of 595 occupational problems were reported, most frequently within mobility, active recreation, and household management. Conclusions The results show that, compared with the usual care, individualized occupational therapy did not improve occupational performance or satisfaction with performance. Small but significant changes in activity performance in favour of the intervention group were found in some of the secondary outcomes.

The pain experience of inpatients in a teaching hospital: revisiting a strategic priority.

PubMed

Jabusch, Kimberly M; Lewthwaite, Barbara J; Mandzuk, Lynda L; Schnell-Hoehn, Karen N; Wheeler, Barbara J

2015-02-01

For hospital executives and clinicians to improve pain management, organizations must examine the current pain experience of in-patients beyond simply measuring patient satisfaction. The aim of this study was to quantify the prevalence of pain among adult in-patients and the degree of interference pain had on daily activities. A descriptive, cross-sectional study was undertaken in a 530 bed tertiary care, teaching hospital in central Canada. A convenience sample (N = 88) of adult medical-surgical patients completed the Short Form-Brief Pain Inventory survey. Pain prevalence was 70.4%. The mean pain severity score was 3.76 (standard deviation, SD = 2.88) and mean pain interference score on daily activities was 4.56 (SD = 3.93). The most frequently identified site of pain was the lower extremities (n = 15, 28%). Women had higher mean scores on pain "right now" compared to men (p < 0.05). The sample majority (n = 81) indicated hospital staff asked about the presence of pain. Seventy-nine percent (n = 57) reported hospital staff "always" did everything they could to help manage pain. Eighty-four percent (n = 61) selected "always" or "usually" to describe their ability to be involved in deciding pain treatments. The mean pain relief score from treatments was 61% (SD = 34.79). Significant positive correlations were found between pain intensity ratings and pain interference on all daily activities (p < 0.001). Pain prevalence remains high with a significant relationship between pain and activities of daily living. The study provides baseline data to direct future initiatives at improving pain management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

A simple approach to estimate daily loads of total, refractory, and labile organic carbon from their seasonal loads in a watershed.

PubMed

Ouyang, Ying; Grace, Johnny M; Zipperer, Wayne C; Hatten, Jeff; Dewey, Janet

2018-05-22

Loads of naturally occurring total organic carbons (TOC), refractory organic carbon (ROC), and labile organic carbon (LOC) in streams control the availability of nutrients and the solubility and toxicity of contaminants and affect biological activities through absorption of light and complex metals with production of carcinogenic compounds. Although computer models have become increasingly popular in understanding and management of TOC, ROC, and LOC loads in streams, the usefulness of these models hinges on the availability of daily data for model calibration and validation. Unfortunately, these daily data are usually insufficient and/or unavailable for most watersheds due to a variety of reasons, such as budget and time constraints. A simple approach was developed here to calculate daily loads of TOC, ROC, and LOC in streams based on their seasonal loads. We concluded that the predictions from our approach adequately match field measurements based on statistical comparisons between model calculations and field measurements. Our approach demonstrates that an increase in stream discharge results in increased stream TOC, ROC, and LOC concentrations and loads, although high peak discharge did not necessarily result in high peaks of TOC, ROC, and LOC concentrations and loads. The approach developed herein is a useful tool to convert seasonal loads of TOC, ROC, and LOC into daily loads in the absence of measured daily load data.

Is leisure time availability associated with more or less severe daily stressors? An examination using eight-day diary data

PubMed Central

Qian, Xinyi Lisa; Yarnal, Careen M.; Almeida, David M.

2014-01-01

The stress suppressing model proposes that sufficient resources reduce stress. The stress exposure model suggests that certain factors expose individuals to more stress. The current study tested these two models by assessing the within-person lagging effect of leisure time on perceived severity of daily stressors. Analyzing eight-day diary data (N=2,022), we found that having more leisure time than usual on a day reduced perceived severity of daily stressors the next day and that the decrease in severity became larger with further increase in leisure time. Additionally, the effect is much stronger among busy individuals who usually had little leisure time. The findings demonstrated an accelerated suppressing effect that differed between-person, and the lagging effect affords stronger implication for causality than correlational analysis. PMID:24563564

The economic and clinical impact of an inpatient palliative care consultation service: a multifaceted approach.

PubMed

Ciemins, Elizabeth L; Blum, Linda; Nunley, Marsha; Lasher, Andrew; Newman, Jeffrey M

2007-12-01

While there has been a rapid increase of inpatient palliative care (PC) programs, the financial and clinical benefits have not been well established. Determine the effect of an inpatient PC consultation service on costs and clinical outcomes. Multifaceted study included: (1) interrupted time-series design utilizing mean daily costs preintervention and postintervention; (2) matched cohort analysis comparing PC to usual care patients; and (3) analysis of symptom control after consultation. Large private, not-for-profit, academic medical center in San Francisco, California, 2004-2006. Time series analysis included 282 PC patients; matched cohorts included 27 PC with 128 usual care patients; clinical outcome analysis of 48 PC patients. Mean daily patient costs and length of stay (LOS); pain, dyspnea, and secretions assessment scores. Mean daily costs were reduced 33% (p < 0.01) from preintervention to postintervention period. Mean length of stay (LOS) was reduced 30%. Mean daily costs for PC patients were 14.5% lower compared to usual care patients (p < 0.01). Pain, dyspnea, and secretions scores were reduced by 86%, 64%, and 87%, respectively. Over the study period, time to PC referral as well as overall ALOS were reduced by 50%. The large reduction in mean daily costs and LOS resulted in an estimated annual savings of $2.2 million in the study hospital. Our results extend the evidence base of financial and clinical benefits associated with inpatient PC programs. We recommend additional study of best practices for identifying patients and providing consultation services, in addition to progressive management support and reimbursement policy.

Association among measures of mobility-related disability and self-perceived fatigue among older people: a population-based study

PubMed Central

Soares, Wuber J. S.; Lima, Camila A.; Bilton, Tereza L.; Ferrioli, Eduardo; Dias, Rosângela C.; Perracini, Monica R.

2015-01-01

Objective: To investigate the relationship between self-perceived fatigue with different physical functioning tests and functional performance scales used for evaluating mobility-related disability among community-dwelling older persons. Method: This is a cross-sectional, population-based study. The sample was composed of older persons with 65 years of age or more living in Cuiabá, MT, and Barueri, SP, Brazil. The data for this study is from the FIBRA Network Study. The presence of self-perceived fatigue was assessed using self-reports based on the Center for Epidemiologic Studies-Depression Scale. The Lawton instrumental activities of daily living scale (IADL) and the advanced activities of daily living scale (AADL) were used to assess performance and participation restriction. The following physical functioning tests were used: five-step test (FST), the Short Physical Performance Battery (SPPB), and usual gait speed (UGS). Three models of logistic regression analysis were conducted, and a significance level of α<0.05 was adopted. Results: The sample was composed of 776 older adults with a mean age (SD) of 71.9 (5.9) years, of whom the majority were women (74%). The prevalence of self-perceived fatigue within the participants was 20%. After adjusting for covariates, SPPB, UGS, IADL, and AADL remained associated with self-perceived fatigue in the final multivariate regression model. Conclusion: Our results suggest that there is an association between self-perceived fatigue and lower extremity function, usual gait speed and activity limitation and participation restriction in older adults. Further cohort studies are needed to investigate which physical performance measure may be able to predict the negative impact of fatigue in older adults. PMID:26039035

Text Messaging to Improve Disease Management in Patients With Painful Diabetic Peripheral Neuropathy.

PubMed

Bauer, Victoria; Goodman, Nancy; Lapin, Brittany; Cooley, Camille; Wang, Ed; Craig, Terri L; Glosner, Scott E; Juhn, Mark S; Cappelleri, Joseph C; Sadosky, Alesia B; Masi, Christopher

2018-06-01

Purpose The purpose of the study was to determine the impact of educational text messages on diabetes self-management activities and outcomes in patients with painful diabetic peripheral neuropathy (pDPN). Methods Patients with pDPN identified from a large integrated health system who agreed to participate were randomized to 6 months of usual care (UC) or UC plus twice-daily diabetes self-management text messages (UC+TxtM). Outcomes included the Pain Numerical Rating Scale, Summary of Diabetes Self-Care Activities (SDSCA), questions on diabetes health beliefs, and glycated hemoglobin (A1C). Changes from baseline were evaluated at 6 months and compared between groups. Results Demographic characteristics were balanced between groups (N = 62; 53% female, mean age = 63 years, 94% type 2 diabetes), as were baseline measures. After 6 months, pain decreased with UC+TxtM from 6.3 to 5.5 and with UC from 6.5 to 6.0, with no difference between groups. UC+TxtM but not UC was associated with significant improvements from baseline on all SDSCA subscales. On diabetes health beliefs, UC+TxtM patients reported significantly increased benefits and reduced barriers and susceptibility relative to UC at 6 months. A1C declined in both groups, but neither change was significant relative to baseline. Conclusions Patients with pDPN who receive twice-daily text messages regarding diabetes management reported reduced pain relative to baseline, although this change was not significant compared with usual care. In addition, text messaging was associated with increased self-management activities and improved diabetes health beliefs and total self-care. These results warrant further investigation.

New evidence for therapies in stroke rehabilitation.

PubMed

Dobkin, Bruce H; Dorsch, Andrew

2013-06-01

Neurologic rehabilitation aims to reduce impairments and disabilities so that persons with serious stroke can return to participation in usual self-care and daily activities as independently as feasible. New strategies to enhance recovery draw from a growing understanding of how types of training, progressive task-related practice of skills, exercise for strengthening and fitness, neurostimulation, and drug and biological manipulations can induce adaptations at multiple levels of the nervous system. Recent clinical trials provide evidence for a range of new interventions to manage walking, reach and grasp, aphasia, visual field loss, and hemi-inattention.

Update of Inpatient Treatment for Refractory Chronic Daily Headache.

PubMed

Lai, Tzu-Hsien; Wang, Shuu-Jiun

2016-01-01

Chronic daily headache (CDH) is a group of headache disorders, in which headaches occur daily or near-daily (>15 days per month) and last for more than 3 months. Important CDH subtypes include chronic migraine, chronic tension-type headache, hemicrania continua, and new daily persistent headache. Other headaches with shorter durations (<4 h/day) are usually not included in CDH. Common comorbidities of CDH are medication overuse headache and various psychiatric disorders, such as depression and anxiety. Indications of inpatient treatment for CDH patients include poor responses to outpatient management, need for detoxification for overuse of specific medications (particularly opioids and barbiturates), and severe psychiatric comorbidities. Inpatient treatment usually involves stopping acute pain, preventing future attacks, and detoxifying medication overuse if present. Multidisciplinary integrated care that includes medical staff from different disciplines (e.g., psychiatry, clinical psychology, and physical therapy) has been recommended. The outcomes of inpatient treatment are satisfactory in terms of decreasing headache intensity or frequency, withdrawal from medication overuse, reducing disability, and improving life quality, although long-term relapse is not uncommon. In conclusion, inpatient treatment may be useful for select patients with refractory CDH and should be incorporated in a holistic headache care program.

Inertial Sensor Measurements of Upper-Limb Kinematics in Stroke Patients in Clinic and Home Environment.

PubMed

Held, Jeremia P O; Klaassen, Bart; Eenhoorn, Albert; van Beijnum, Bert-Jan F; Buurke, Jaap H; Veltink, Peter H; Luft, Andreas R

2018-01-01

Upper-limb impairments in stroke patients are usually measured in clinical setting using standard clinical assessment. In addition, kinematic analysis using opto-electronic systems has been used in the laboratory setting to map arm recovery. Such kinematic measurements cannot capture the actual function of the upper extremity in daily life. The aim of this study is to longitudinally explore the complementarity of post-stroke upper-limb recovery measured by standard clinical assessments and daily-life recorded kinematics. The study was designed as an observational, single-group study to evaluate rehabilitation progress in a clinical and home environment, with a full-body sensor system in stroke patients. Kinematic data were recorded with a full-body motion capture suit during clinical assessment and self-directed activities of daily living. The measurements were performed at three time points for 3 h: (1) 2 weeks before discharge of the rehabilitation clinic, (2) right after discharge, and (3) 4 weeks after discharge. The kinematic analysis of reaching movements uses the position and orientation of each body segment to derive the joint angles. Newly developed metrics for classifying activity and quality of upper extremity movement were applied. The data of four stroke patients (three mildly impaired, one sever impaired) were included in this study. The arm motor function assessment improved during the inpatient rehabilitation, but declined in the first 4 weeks after discharge. A change in the data (kinematics and new metrics) from the daily-life recording was seen in in all patients. Despite this worsening patients increased the number of reaches they performed during daily life in their home environment. It is feasible to measure arm kinematics using Inertial Measurement Unit sensors during daily life in stroke patients at the different stages of rehabilitation. Our results from the daily-life recordings complemented the data from the clinical assessments and illustrate the potential to identify stroke patient characteristics, based on kinematics, reaching counts, and work area. https://clinicaltrials.gov, identifier NCT02118363.

Pharmacist-provided diabetes management and education via a telemonitoring program.

PubMed

Shane-McWhorter, Laura; McAdam-Marx, Carrie; Lenert, Leslie; Petersen, Marta; Woolsey, Sarah; Coursey, Jeffrey M; Whittaker, Thomas C; Hyer, Christian; LaMarche, Deb; Carroll, Patricia; Chuy, Libbey

2015-01-01

To assess clinical outcomes (glycosylated hemoglobin [A1C], blood pressure, and lipids) and other measurements (disease state knowledge, adherence, and self-efficacy) associated with the use of approved telemonitoring devices to expand and improve chronic disease management of patients with diabetes, with or without hypertension. Four community health centers (CHCs) in Utah. Federally qualified safety net clinics that provide medical care to underserved patients. Pharmacist-led diabetes management using telemonitoring was compared with a group of patients receiving usual care (without telemonitoring). Daily blood glucose (BG) and blood pressure (BP) values were reviewed and the pharmacist provided phone follow-up to assess and manage out-of-range BG and BP values. Changes in A1C, BP, and low-density lipoprotein (LDL) at approximately 6 months were compared between the telemonitoring group and the usual care group. Patient activation, diabetes/hypertension knowledge, and medication adherence were measured in the telemonitoring group. Of 150 patients, 75 received pharmacist-provided diabetes management and education via telemonitoring, and 75 received usual medical care. Change in A1C was significantly greater in the telemonitoring group compared with the usual care group (2.07% decrease vs. 0.66% decrease; P <0.001). Although BP and LDL levels also declined, differences between the two groups were not statistically significant. Patient activation measure, diabetes/hypertension knowledge, and medication adherence with antihypertensives (but not diabetes medications) improved in the telemonitoring group. Pharmacist-provided diabetes management via telemonitoring resulted in a significant improvement in A1C in federally qualified CHCs in Utah compared with usual medical care. Telemonitoring may be considered a model for providing clinical pharmacy services to patients with diabetes.

Regular Breakfast Consumption and Type 2 Diabetes Risk Markers in 9- to 10-Year-Old Children in the Child Heart and Health Study in England (CHASE): A Cross-Sectional Analysis

PubMed Central

Donin, Angela S.; Nightingale, Claire M.; Owen, Chris G.; Rudnicka, Alicja R.; Perkin, Michael R.; Jebb, Susan A.; Stephen, Alison M.; Sattar, Naveed; Cook, Derek G.; Whincup, Peter H.

2014-01-01

Background Regular breakfast consumption may protect against type 2 diabetes risk in adults but little is known about its influence on type 2 diabetes risk markers in children. We investigated the associations between breakfast consumption (frequency and content) and risk markers for type 2 diabetes (particularly insulin resistance and glycaemia) and cardiovascular disease in children. Methods and Findings We conducted a cross-sectional study of 4,116 UK primary school children aged 9–10 years. Participants provided information on breakfast frequency, had measurements of body composition, and gave fasting blood samples for measurements of blood lipids, insulin, glucose, and glycated haemoglobin (HbA1c). A subgroup of 2,004 children also completed a 24-hour dietary recall. Among 4,116 children studied, 3,056 (74%) ate breakfast daily, 450 (11%) most days, 372 (9%) some days, and 238 (6%) not usually. Graded associations between breakfast frequency and risk markers were observed; children who reported not usually having breakfast had higher fasting insulin (percent difference 26.4%, 95% CI 16.6%–37.0%), insulin resistance (percent difference 26.7%, 95% CI 17.0%–37.2%), HbA1c (percent difference 1.2%, 95% CI 0.4%–2.0%), glucose (percent difference 1.0%, 95% CI 0.0%–2.0%), and urate (percent difference 6%, 95% CI 3%–10%) than those who reported having breakfast daily; these differences were little affected by adjustment for adiposity, socioeconomic status, and physical activity levels. When the higher levels of triglyceride, systolic blood pressure, and C-reactive protein for those who usually did not eat breakfast relative to those who ate breakfast daily were adjusted for adiposity, the differences were no longer significant. Children eating a high fibre cereal breakfast had lower insulin resistance than those eating other breakfast types (p for heterogeneity <0.01). Differences in nutrient intakes between breakfast frequency groups did not account for the differences in type 2 diabetes markers. Conclusions Children who ate breakfast daily, particularly a high fibre cereal breakfast, had a more favourable type 2 diabetes risk profile. Trials are needed to quantify the protective effect of breakfast on emerging type 2 diabetes risk. Please see later in the article for the Editors' Summary PMID:25181492

A Novel Pathway for Sensory-Mediated Arousal Involves Splicing of an Intron in the period Clock Gene

PubMed Central

Cao, Weihuan; Edery, Isaac

2015-01-01

Study Objectives: D. melanogaster is an excellent animal model to study how the circadian (≅ 24-h) timing system and sleep regulate daily wake-sleep cycles. Splicing of a temperature-sensitive 3'-terminal intron (termed dmpi8) from the circadian clock gene period (per) regulates the distribution of daily activity in Drosophila. The role of dmpi8 splicing on daily behavior was further evaluated by analyzing sleep. Design: Transgenic flies of the same genetic background but expressing either a wild-type recombinant per gene or one where the efficiency of dmpi8 splicing was increased were exposed to different temperatures in daily light-dark cycles and sleep parameters measured. In addition, transgenic flies were briefly exposed to a variety of sensory-mediated stimuli to measure arousal responses. Results: Surprisingly, we show that the effect of dmpi8 splicing on daytime activity levels does not involve a circadian role for per but is linked to adjustments in sensory-dependent arousal and sleep behavior. Genetically altered flies with high dmpi8 splicing efficiency remain aroused longer following short treatments with light and non-photic cues such as mechanical stimulation. Conclusions: We propose that the thermal regulation of dmpi8 splicing acts as a temperature-calibrated rheostat in a novel arousal mechanism, so that on warm days the inefficient splicing of the dmpi8 intron triggers an increase in quiescence by decreasing sensory-mediated arousal, thus ensuring flies minimize being active during the hot midday sun despite the presence of light in the environment, which is usually a strong arousal cue for diurnal animals. Citation: Cao W, Edery I. A novel pathway for sensory-mediated arousal involves splicing of an intron in the period clock gene. SLEEP 2015;38(1):41–51. PMID:25325457

A home-based exercise program to improve function, fatigue, and sleep quality in patients with Stage IV lung and colorectal cancer: a randomized controlled trial.

PubMed

Cheville, Andrea L; Kollasch, Jenny; Vandenberg, Justin; Shen, Tiffany; Grothey, Axel; Gamble, Gail; Basford, Jeffrey R

2013-05-01

Exercise benefits patients with cancer, but studies of home-based approaches, particularly among those with Stage IV disease, remain small and exploratory. To conduct an adequately powered trial of a home-based exercise intervention that can be facilely integrated into established delivery and reimbursement structures. Sixty-six adults with Stage IV lung or colorectal cancer were randomized, in an eight-week trial, to usual care or incremental walking and home-based strength training. The exercising participants were instructed during a single physiotherapy visit and subsequently exercised four days or more per week; training and step-count goals were advanced during bimonthly telephone calls. The primary outcome measure was mobility assessed with the Ambulatory Post Acute Care Basic Mobility Short Form. Secondary outcomes included ratings of pain and sleep quality as well as the ability to perform daily activities (Ambulatory Post Acute Care Daily Activities Short Form), quality of life (Functional Assessment of Cancer Therapy-General), and fatigue (Functional Assessment of Cancer Therapy-Fatigue). Three participants dropped out and seven died (five in the intervention and two in the control group, P=0.28). At Week 8, the intervention group reported improved mobility (P=0.01), fatigue (P=0.02), and sleep quality (P=0.05) compared with the usual care group, but did not differ on the other measures. A home-based exercise program seems capable of improving the mobility, fatigue, and sleep quality of patients with Stage IV lung and colorectal cancer. Copyright © 2013. Published by Elsevier Inc.

[Patients' need for consultation after a geriatric assessment in family practice : Survey].

PubMed

Afshar, Kambiz; Bokhof, Beate; Wiese, Birgitt; Dierks, Marie-Luise; Junius-Walker, Ulrike

2016-10-01

During a doctor-patient consultation patients usually seek information by disclosing their reasons for requesting the encounter. Geriatric assessment allows a proactive examination of patients' overall health and function and provides an opportunity to broach issues beyond the initial purposes of the consultation. The study aimed at investigating older patients' information seeking behavior following a geriatric assessment and the kind of topics they wished to discuss, taking a variety of patient and health-related factors into account. A total of 317 patients (≥ 70 years) underwent a geriatric assessment in 40 general practices. Subsequently they obtained a list of the problems uncovered and rated the relevance and information needs for each problem. Analyses consisted of determining the prevalence of information need for each health topic and identifying predictors in a mixed model (multilevel regression analysis). The 317 patients presented with a median of 11 health problems (interquartile range, IQR 8-14) and 80 % of the patients had information needs concerning only a few of the problems. High information needs were present for physical complaints and for vaccination issues. Little information seeking behavior was evident for unhealthy lifestyles, falls, limitations in daily activities and psychosocial problems. In the mixed model the personal relevance and the type of health problem both had a significant and independent effect on information seeking behavior. A geriatric assessment generates a moderate need for information. It provides physicians with an opportunity to focus on those health problems that are important to older patients but not usually addressed in normal consultations. This particularly applies to limitations in daily activities and psychosocial problems.

Daily sleep, weekly working hours, and risk of work-related injury: US National Health Interview Survey (2004-2008).

PubMed

Lombardi, David A; Folkard, Simon; Willetts, Joanna L; Smith, Gordon S

2010-07-01

The impact on health and safety of the combination of chronic sleep deficits and extended working hours has received worldwide attention. Using the National Health Interview Survey (NHIS), an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian, non-institutionalized population, the authors estimated the effect of total daily self-reported sleep time and weekly working hours on the risk of a work-related injury. During the survey period 2004-2008, 177,576 persons (ages 18-74) sampled within households reported that they worked at a paid job the previous week and reported their total weekly work hours. A randomly selected adult in each household (n = 75,718) was asked to report his/her usual (average) total daily sleep hours the prior week; complete responses were obtained for 74,415 (98.3%) workers. Weighted annualized work-related injury rates were then estimated across a priori defined categories of both average total daily sleep hours and weekly working hours. To account for the complex sampling design, weighted multiple logistic regression was used to independently estimate the risk of a work-related injury for categories of usual daily sleep duration and weekly working hours, controlling for important covariates and potential confounders of age, sex, race/ethnicity, education, type of pay, industry, occupation (proxy for job risk), body mass index, and the interaction between sleep duration and work hours. Based on the inclusion criteria, there were an estimated 129,950,376 workers annually at risk and 3,634,446 work-related medically treated injury episodes (overall injury rate 2.80/100 workers). Unadjusted annualized injury rates/100 workers across weekly work hours were 2.03 (< or =20 h), 3.01 (20-30 h), 2.45 (31-40 h), 3.45 (40-50 h), 3.71 (50-60 h), and 4.34 (>60 h). With regards to self-reported daily sleep time, the estimated annualized injury rates/100 workers were 7.89 (<5 h sleep), 5.21 (5-5.9 h), 3.62 (6-6.9 h), 2.27 (7-7.9 h), 2.50 (8-8.9 h), 2.22 (9-9.9 h), and 4.72 (>10 h). After controlling for weekly work hours, and aforementioned covariates, significant increases in risk/1 h decrease were observed for several sleep categories. Using 7-7.9 h sleep as reference, the adjusted injury risk (odds ratio [OR] for a worker sleeping a total of <5 h/day was 2.65 (95% confidence interval [CI]: 1.57-4.47), for 5-5.9 h 1.79 (95% CI: 1.22-2.62), and for 6-6.9 h 1.40 (95% CI: 1.10-1.79). No other usual sleep duration categories were significantly different than the reference; however, for >10 h of usual daily sleep, the OR was marginally significantly elevated, 1.82 (95% CI: 0.96-3.47). These results suggest significant increases in work-related injury risk with decreasing usual daily self-reported sleep hours and increasing weekly work hours, independent of industry, occupation, type of pay, sex, age, education, and body mass.

Strength training, walking, and social activity improve sleep in nursing home and assisted living residents: randomized controlled trial.

PubMed

Richards, Kathy C; Lambert, Corinne; Beck, Cornelia K; Bliwise, Donald L; Evans, William J; Kalra, Gurpreet K; Kleban, Morton H; Lorenz, Rebecca; Rose, Karen; Gooneratne, Nalaka S; Sullivan, Dennis H

2011-02-01

To compare the effects of physical resistance strength training and walking (E), individualized social activity (SA), and E and SA (ESA) with a usual care control group on total nocturnal sleep time in nursing home and assisted living residents. Pretest-posttest experimental design with assignment to one of four groups for 7 weeks: E (n=55), SA (n=50), ESA (n=41), and usual care control (n=47). Ten nursing homes and three assisted living facilities. One hundred ninety-three residents were randomly assigned; 165 completed the study. The E group participated in high-intensity physical resistance strength training 3 days a week and on 2 days walked for up to 45 minutes, the SA group received social activity 1 hour daily 5 days a week, the ESA group received both E and SA, and the control group participated in usual activities provided in the homes. Total nocturnal sleep time was measured using 2 nights of polysomnography before and 2 nights of polysomnography after the intervention. Sleep efficiency (SE), non-rapid eye movement (NREM) sleep, rapid eye movement sleep, and sleep onset latency were also analyzed. Total nocturnal sleep time was significantly greater in the ESA group than in the control group (adjusted means 364.2 minutes vs 328.9 minutes), as was SE and NREM sleep. High-intensity physical resistance strength training and walking combined with social activity significantly improved sleep in nursing home and assisted living residents. The interventions by themselves did not have significant effects on sleep in this population. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Effectiveness of integrated disease management for primary care chronic obstructive pulmonary disease patients: results of cluster randomised trial.

PubMed

Kruis, Annemarije L; Boland, Melinde R S; Assendelft, Willem J J; Gussekloo, Jacobijn; Tsiachristas, Apostolos; Stijnen, Theo; Blom, Coert; Sont, Jacob K; Rutten-van Mölken, Maureen P H M; Chavannes, Niels H

2014-09-10

To investigate the long term effectiveness of integrated disease management delivered in primary care on quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with usual care. 24 month, multicentre, pragmatic cluster randomised controlled trial 40 general practices in the western part of the Netherlands Patients with COPD according to GOLD (Global Initiative for COPD) criteria. Exclusion criteria were terminal illness, cognitive impairment, alcohol or drug misuse, and inability to fill in Dutch questionnaires. Practices were included if they were willing to create a multidisciplinary COPD team. General practitioners, practice nurses, and specialised physiotherapists in the intervention group received a two day training course on incorporating integrated disease management in practice, including early recognition of exacerbations and self management, smoking cessation, physiotherapeutic reactivation, optimal diagnosis, and drug adherence. Additionally, the course served as a network platform and collaborating healthcare providers designed an individual practice plan to integrate integrated disease management into daily practice. The control group continued usual care (based on international guidelines). The primary outcome was difference in health status at 12 months, measured by the Clinical COPD Questionnaire (CCQ); quality of life, Medical Research Council dyspnoea, exacerbation related outcomes, self management, physical activity, and level of integrated care (PACIC) were also assessed as secondary outcomes. Of a total of 1086 patients from 40 clusters, 20 practices (554 patients) were randomly assigned to the intervention group and 20 clusters (532 patients) to the usual care group. No difference was seen between groups in the CCQ at 12 months (mean difference -0.01, 95% confidence interval -0.10 to 0.08; P=0.8). After 12 months, no differences were seen in secondary outcomes between groups, except for the PACIC domain "follow-up/coordination" (indicating improved integration of care) and proportion of physically active patients. Exacerbation rates as well as number of days in hospital did not differ between groups. After 24 months, no differences were seen in outcomes, except for the PACIC follow-up/coordination domain. In this pragmatic study, an integrated disease management approach delivered in primary care showed no additional benefit compared with usual care, except improved level of integrated care and a self reported higher degree of daily activities. The contradictory findings to earlier positive studies could be explained by differences between interventions (provider versus patient targeted), selective reporting of positive trials, or little room for improvement in the already well developed Dutch healthcare system. Netherlands Trial Register NTR2268. © Kruis et al 2014.

The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial.

PubMed

Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Linde, Mattias; Gard, Gunvor; Jensen, Rigmor Højland

2018-01-01

Aim To evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 minutes, three times/week. Controls continued usual daily activities. Pain frequency, intensity, and duration; physical fitness, level of physical activity, well-being and ability to engage in daily activities were assessed at baseline, after treatment and at follow-up. Results Fifty-two persons completed the study. Significant between-group improvements for the exercise group were found for physical fitness, level of physical activity, migraine burden and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Within the exercise group, significant reduction was found for migraine frequency, pain intensity and duration, neck pain intensity, and burden of migraine; an increase in physical fitness and well-being. Conclusions Exercise significantly reduced the burden of migraine and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Exercise also reduced migraine frequency, pain intensity and duration, although this was not significant compared to controls. These results emphasize the importance of regular aerobic exercise for reduction of migraine burden.

Ischemic stroke in a patient with moderate to severe inherited factor VII deficiency.

PubMed

Reddy, Manasa; Tawfik, Bernard; Gavva, Chakri; Yates, Sean; De Simone, Nicole; Hofmann, Sandra L; Rambally, Siayareh; Sarode, Ravi

2016-12-01

Thrombosis is known to occur in patients with rare inherited bleeding disorders, usually in the presence of a thrombotic risk factor such as surgery and/or factor replacement therapy, but sometimes spontaneously. We present the case of a 72-year-old African American male diagnosed with congenital factor VII (FVII) deficiency after presenting with ischemic stroke, presumably embolic, in the setting of atherosclerotic carotid artery stenosis. The patient had an international normalized ratio (INR) of 2.0 at presentation, with FVII activity of 6% and normal Extem clotting time in rotational thromboelastometry. He was treated with aspirin (325 mg daily) and clopidogrel (75 mg daily) with no additional bleeding or thrombotic complications throughout his admission. This case provides further evidence that moderate to severe FVII deficiency does not protect against thrombosis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using Problem-solving Therapy to Improve Problem-solving Orientation, Problem-solving Skills and Quality of Life in Older Hemodialysis Patients.

PubMed

Erdley-Kass, Shiloh D; Kass, Darrin S; Gellis, Zvi D; Bogner, Hillary A; Berger, Andrea; Perkins, Robert M

2017-08-24

To determine the effectiveness of Problem-Solving Therapy (PST) in older hemodialysis (HD) patients by assessing changes in health-related quality of life and problem-solving skills. 33 HD patients in an outpatient hemodialysis center without active medical and psychiatric illness were enrolled. The intervention group (n = 15) received PST from a licensed social worker for 6 weeks, whereas the control group (n = 18) received usual care treatment. In comparison to the control group, patients receiving PST intervention reported improved perceptions of mental health, were more likely to view their problems with a positive orientation and were more likely to use functional problem-solving methods. Furthermore, this group was also more likely to view their overall health, activity limits, social activities and ability to accomplish desired tasks with a more positive mindset. The results demonstrate that PST may positively impact mental health components of quality of life and problem-solving coping among older HD patients. PST is an effective, efficient, and easy to implement intervention that can benefit problem-solving abilities and mental health-related quality of life in older HD patients. In turn, this will help patients manage their daily living activities related to their medical condition and reduce daily stressors.

Misclassification of Fourth-Grade Children’s Participation in School-Provided Meals Based on Parental Responses Relative to Administrative Daily Records

PubMed Central

Baxter, Suzanne Domel; Paxton-Aiken, Amy E.; Royer, Julie A.; Hitchcock, David B.; Guinn, Caroline H.; Finney, Christopher J.

2014-01-01

Although many studies have relied on parental responses concerning children’s school-meal participation, few studies have evaluated parental response accuracy. This article’s analyses investigated misclassification of fourth-grade children’s participation in school-meal programs based on parental responses relative to administrative daily records using cross-sectional study data collected for three school years (2004–05, 2005–06, 2006–07) for 1,100 fourth-grade children (87% Black; 52% girls) from 18 schools total in one district. Parents reported children’s usual school-meal participation on paper consent forms. The district provided administrative daily records of individual children’s school-meal participation. Researchers measured children’s weight and height. “Usual participation” in breakfast/lunch was defined as ≥50% of days. Parental responses misclassified 16.3%, 12.8%, 19.8%, and 4.7% of children for participation in breakfast, classroom breakfast, cafeteria breakfast, and lunch, respectively. Parental responses misclassified more children for participation in cafeteria than classroom breakfast (P=0.0008); usual-participant misclassification probabilities were less than non-usual-participant misclassification probabilities for classroom breakfast, cafeteria breakfast, and lunch (P<0.0001 for each) [two-proportion z-tests]. Parental responses concerning children’s participation were more accurate for lunch than breakfast; parents overstated breakfast participation (both classroom and cafeteria) and lunch participation. Breakfast participation misclassification was not related to body mass index (P=0.41), sex (P=0.40), age (P=0.63), or socioeconomic status (P=0.21) [multi-category logistic regression controlling for school year, breakfast location, and school]. Relying on parental responses concerning children’s school-meal participation may hamper researchers’ abilities to detect relationships that have policy implications for the child nutrition community. The use of administrative daily records of children’s school-meal participation is recommended. PMID:24973169

Late Diagnosed Left Coronary to the Pulmonary Artery Large Fistulae: An Interesting and Incidental Cath Lab Finding

PubMed Central

de Melo, Pedro H. M. Craveiro; Abreu-Silva, Érlon O.; Coura, Fernando Barbiero; Rios, Gleyson Moraes; Potério, Daniel Izzet

2016-01-01

Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or at autopsies. A coronary artery fistulae involve a communication between a coronary artery and a chamber of the heart or any segment of the systemic or pulmonary circulation. We present herein the case of a 67-year-old man with a recent history of exertional angina and dyspnea to usual daily activities whose coronary angiogram revealed an interesting and incidental coronary-pulmonary artery large fistulae. PMID:28053791

Late Diagnosed Left Coronary to the Pulmonary Artery Large Fistulae: An Interesting and Incidental Cath Lab Finding.

PubMed

Oliveira, Marcos Danillo P; de Melo, Pedro H M Craveiro; Abreu-Silva, Érlon O; Coura, Fernando Barbiero; Rios, Gleyson Moraes; Potério, Daniel Izzet

2016-01-01

Coronary artery anomalies are congenital changes in their origin, course, and/or structure. Most of them are discovered as incidental findings during coronary angiographic studies or at autopsies. A coronary artery fistulae involve a communication between a coronary artery and a chamber of the heart or any segment of the systemic or pulmonary circulation. We present herein the case of a 67-year-old man with a recent history of exertional angina and dyspnea to usual daily activities whose coronary angiogram revealed an interesting and incidental coronary-pulmonary artery large fistulae.

Mobility of Vulnerable Elders (MOVE): study protocol to evaluate the implementation and outcomes of a mobility intervention in long-term care facilities.

PubMed

Slaughter, Susan E; Estabrooks, Carole A; Jones, C Allyson; Wagg, Adrian S

2011-12-16

Almost 90% of residents living in long-term care facilities have limited mobility which is associated with a loss of ability in activities of daily living, falls, increased risk of serious medical problems such as pressure ulcers, incontinence and a significant decline in health-related quality of life. For health workers caring for residents it may also increase the risk of injury. The effectiveness of rehabilitation to facilitate mobility has been studied with dedicated research assistants or extensively trained staff caregivers; however, few investigators have examined the effectiveness of techniques to encourage mobility by usual caregivers in long-term care facilities. This longitudinal, quasi-experimental study is designed to demonstrate the effect of the sit-to-stand activity carried out by residents in the context of daily care with health care aides. In three intervention facilities health care aides will prompt residents to repeat the sit-to-stand action on two separate occasions during each day and each evening shift as part of daily care routines. In three control facilities residents will receive usual care. Intervention and control facilities are matched on the ownership model (public, private for-profit, voluntary not-for-profit) and facility size. The dose of the mobility intervention is assessed through the use of daily documentation flowsheets in the health record. Resident outcome measures include: 1) the 30-second sit-to-stand test; 2) the Functional Independence Measure; 3) the Health Utilities Index Mark 2 and 3; and, 4) the Quality of Life - Alzheimer's Disease. There are several compelling reasons for this study: the widespread prevalence of limited mobility in this population; the rapid decline in mobility after admission to a long-term care facility; the importance of mobility to quality of life; the increased time (and therefore cost) required to care for residents with limited mobility; and, the increased risk of injury for health workers caring for residents who are unable to stand. The importance of these issues is magnified when considering the increasing number of people living in long-term care facilities and an aging population. This clinical trial is registered with ClinicalTrials.gov (trial registration number: NCT01474616).

Dancing for Parkinson Disease: A Randomized Trial of Irish Set Dancing Compared With Usual Care.

PubMed

Shanahan, Joanne; Morris, Meg E; Bhriain, Orfhlaith Ni; Volpe, Daniele; Lynch, Tim; Clifford, Amanda M

2017-09-01

To examine the feasibility of a randomized controlled study design and to explore the benefits of a set dancing intervention compared with usual care. Randomized controlled design, with participants randomized to Irish set dance classes or a usual care group. Community based. Individuals with idiopathic Parkinson disease (PD) (N=90). The dance group attended a 1.5-hour dancing class each week for 10 weeks and undertook a home dance program for 20 minutes, 3 times per week. The usual care group continued with their usual care and daily activities. The primary outcome was feasibility, determined by recruitment rates, success of randomization and allocation procedures, attrition, adherence, safety, willingness of participants to be randomized, resource availability, and cost. Secondary outcomes were motor function (motor section of the Unified Parkinson's Disease Rating Scale), quality of life (Parkinson's Disease Questionnaire-39), functional endurance (6-min walk test), and balance (mini-BESTest). Ninety participants were randomized (45 per group). There were no adverse effects or resource constraints. Although adherence to the dancing program was 93.5%, there was >40% attrition in each group. Postintervention, the dance group had greater nonsignificant gains in quality of life than the usual care group. There was a meaningful deterioration in endurance in the usual care group. There were no meaningful changes in other outcomes. The exit questionnaire showed participants enjoyed the classes and would like to continue participation. For people with mild to moderately severe PD, set dancing is feasible and enjoyable and may improve quality of life. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Treadmill training with an incline reduces ankle joint stiffness and improves active range of movement during gait in adults with cerebral palsy.

PubMed

Lorentzen, Jakob; Kirk, Henrik; Fernandez-Lago, Helena; Frisk, Rasmus; Scharff Nielsen, Nanna; Jorsal, Martin; Nielsen, Jens Bo

2017-05-01

We investigated if 30 min of daily treadmill training with an incline for 6 weeks would reduce ankle joint stiffness and improve active range of movement in adults with cerebral palsy (CP). The study was designed as a randomized controlled clinical trial including 32 adults with CP (GMFCS 1-3) aged 38.1 SD 12 years. The training group (n = 16) performed uphill treadmill training at home daily for 30 min for 6 weeks in addition to their usual activities. Passive and reflex mediated stiffness and range of motion (ROM) of the ankle joint, kinematic and functional measures of gait were obtained before and after the intervention/control period. Intervention subjects trained 31.4 SD 10.1 days for 29.0 SD 2.3 min (total) 15.2 h. Passive ankle joint stiffness was reduced (F = 5.1; p = 0.031), maximal gait speed increased (F = 42.8, p < 0.001), amplitude of toe lift prior to heel strike increased (F = 5.3, p < 0.03) and ankle angle at heel strike was decreased (F = 12.5; p < 0.001) significant in the training group as compared to controls. Daily treadmill training with an incline for 6 weeks reduces ankle joint stiffness and increases active ROM during gait in adults with CP. Intensive gait training may thus be beneficial in preventing and reducing contractures and help to maintain functional gait ability in adults with CP. Implications for rehabilitation Uphill gait training is an effective way to reduce ankle joint stiffness in adult with contractures. 6 weeks of daily uphill gait training improves functional gait parameters such as gait speed and dorsal flexion during gait in adults with cerebral palsy.

Circadian force and EMG activity in hindlimb muscles of rhesus monkeys

NASA Technical Reports Server (NTRS)

Hodgson, J. A.; Wichayanuparp, S.; Recktenwald, M. R.; Roy, R. R.; McCall, G.; Day, M. K.; Washburn, D.; Fanton, J. W.; Kozlovskaya, I.; Edgerton, V. R.;

Levonorgestrel intrauterine system versus medical therapy for menorrhagia.

PubMed

Gupta, Janesh; Kai, Joe; Middleton, Lee; Pattison, Helen; Gray, Richard; Daniels, Jane

2013-01-10

Menorrhagia is a common problem, yet evidence to inform decisions about therapy is limited. In a pragmatic, multicenter, randomized trial, we compared the levonorgestrel-releasing intrauterine system (levonorgestrel-IUS) with usual medical treatment in women with menorrhagia who presented to their primary care providers. We randomly assigned 571 women with menorrhagia to treatment with levonorgestrel-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined estrogen-progestogen, or progesterone alone). The primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) (ranging from 0 to 100, with lower scores indicating greater severity), assessed over a 2-year period. Secondary outcomes included general quality-of-life and sexual-activity scores and surgical intervention. MMAS scores improved from baseline to 6 months in both the levonorgestrel-IUS group and the usual-treatment group (mean increase, 32.7 and 21.4 points, respectively; P<0.001 for both comparisons). The improvements were maintained over a 2-year period but were significantly greater in the levonorgestrel-IUS group than in the usual-treatment group (mean between-group difference, 13.4 points; 95% confidence interval, 9.9 to 16.9; P<0.001). Improvements in all MMAS domains (practical difficulties, social life, family life, work and daily routine, psychological well-being, and physical health) were significantly greater in the levonorgestrel-IUS group than in the usual-treatment group, and this was also true for seven of the eight quality-of-life domains. At 2 years, more of the women were still using the levonorgestrel-IUS than were undergoing the usual medical treatment (64% vs. 38%, P<0.001). There were no significant between-group differences in the rates of surgical intervention or sexual-activity scores. There were no significant differences in serious adverse events between groups. In women with menorrhagia who presented to primary care providers, the levonorgestrel-IUS was more effective than usual medical treatment in reducing the effect of heavy menstrual bleeding on quality of life. (Funded by the National Institute of Health Research Health Technology Assessment Programme; ECLIPSE Controlled-Trials.com number, ISRCTN86566246.).

Daily antecedents and consequences of nightly sleep.

PubMed

Lee, Soomi; Crain, Tori L; McHale, Susan M; Almeida, David M; Buxton, Orfeu M

2017-08-01

Sleep can serve as both cause and consequence of individuals' everyday experiences. We built upon prior studies of the correlates of sleep, which have relied primarily on cross-sectional data, to examine the antecedents and consequences of sleep using a daily diary design. Specifically, we assessed the temporal sequence between nightly sleep and daily psychosocial stressors. Parents employed in a US information technology company (n = 102) completed eight consecutive daily diaries at both baseline and 1 year later. In telephone interviews each evening, participants reported on the previous night's sleep hours, sleep quality and sleep latency. They also reported daily work-to-family conflict and time inadequacy (i.e. perceptions of not having enough time) for their child and for themselves to engage in exercise. Multi-level models testing lagged and non-lagged effects simultaneously revealed that sleep hours and sleep quality were associated with next-day consequences of work-to-family conflict and time inadequacy, whereas psychosocial stressors as antecedents did not predict sleep hours or quality that night. For sleep latency, the opposite temporal order emerged: on days with more work-to-family conflict or time inadequacy for child and self than usual, participants reported longer sleep latencies than usual. An exception to this otherwise consistent pattern was that time inadequacy for child also preceded shorter sleep hours and poorer sleep quality that night. The results highlight the utility of a daily diary design for capturing the temporal sequences linking sleep and psychosocial stressors. © 2016 European Sleep Research Society.

Estimating evaporative vapor generation from automobiles based on parking activities.

PubMed

Dong, Xinyi; Tschantz, Michael; Fu, Joshua S

2015-07-01

A new approach is proposed to quantify the evaporative vapor generation based on real parking activity data. As compared to the existing methods, two improvements are applied in this new approach to reduce the uncertainties: First, evaporative vapor generation from diurnal parking events is usually calculated based on estimated average parking duration for the whole fleet, while in this study, vapor generation rate is calculated based on parking activities distribution. Second, rather than using the daily temperature gradient, this study uses hourly temperature observations to derive the hourly incremental vapor generation rates. The parking distribution and hourly incremental vapor generation rates are then adopted with Wade-Reddy's equation to estimate the weighted average evaporative generation. We find that hourly incremental rates can better describe the temporal variations of vapor generation, and the weighted vapor generation rate is 5-8% less than calculation without considering parking activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster-randomised clinical trial.

PubMed

van Schijndel-Speet, M; Evenhuis, H M; van Wijck, R; van Montfort, K C A G M; Echteld, M A

2017-01-01

The physical activity level of older adults with intellectual disabilities (ID) is extremely low, and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people. A physical activity programme, including an education programme, was developed for older adults with ID using behaviour change techniques. The programme aimed at improving or maintaining adequate levels of physical activity (primary outcome measure) and motor fitness, cardio respiratory fitness, morphologic and metabolic fitness, activities of daily living, cognitive functioning and depressive symptoms (secondary outcome measures). The programme's efficacy was evaluated in a cluster-randomised clinical trial among people aged 43 years and over with mild-moderate levels of ID. Five day-activity centres were randomised to the participation group. In these centres, 81 older adults participated in groups of 8 to 10 in the programme, three times a week during 8 months. The programme was executed by physical activity instructors and staff of day-activity centres. Five other day-activity centres were randomised to the control group; 70 older adults in these centres received care as usual. The generalised linear model with mixed effects was used to test the programme's effectiveness. Significant effects were found on physical activity, muscle strength, systolic and diastolic blood pressure, serum cholesterol level and cognitive functioning, in favour of the programme's participants. No significant improvements were found on balance, serum glucose, weight, waist circumference, walking speed, mobility, depression or instrumental activities of daily living. The physical activity and fitness programme has established small but significant effects in this sample, but generalising the findings to other settings is difficult due to significant participant dropout. Implementation of evidence-based physical activity programmes among older adults with ID is recommended. Further research is needed to investigate the effectiveness of physical activity on daily life functioning and the development on chronic diseases in the long run. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

The PACT trial: PAtient Centered Telerehabilitation: effectiveness of software-supported and traditional mirror therapy in patients with phantom limb pain following lower limb amputation: protocol of a multicentre randomised controlled trial.

PubMed

Rothgangel, Andreas Stefan; Braun, Susy; Schulz, Ralf Joachim; Kraemer, Matthias; de Witte, Luc; Beurskens, Anna; Smeets, Rob Johannes

2015-01-01

Non-pharmacological interventions such as mirror therapy are gaining increased recognition in the treatment of phantom limb pain; however, the evidence in people with phantom limb pain is still weak. In addition, compliance to self-delivered exercises is generally low. The aim of this randomised controlled study is to investigate the effectiveness of mirror therapy supported by telerehabilitation on the intensity, duration and frequency of phantom limb pain and limitations in daily activities compared to traditional mirror therapy and care as usual in people following lower limb amputation. A three-arm multi-centre randomised controlled trial will be performed. Participants will be randomly assigned to care as usual, traditional mirror therapy or mirror therapy supported by telerehabilitation. During the first 4 weeks, at least 10 individual sessions will take place in every group. After the first 4 weeks, participants will be encouraged to perform self-delivered exercises over a period of 6 weeks. Outcomes will be assessed at 4 and 10 weeks after baseline and at 6 months follow-up. The primary outcome measure is the average intensity of phantom limb pain during the last week. Secondary outcome measures include the different dimensions of phantom limb pain, pain-related limitations in daily activities, global perceived effect, pain-specific self-efficacy, and quality of life. Several questions concerning the study design that emerged during the preparation of this trial will be discussed. This will include how these questions were addressed and arguments for the choices that were made. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Crew factors in flight operations 9: Effects of planned cockpit rest on crew performance and alertness in long-haul operations

NASA Technical Reports Server (NTRS)

Rosekind, Mark R.; Graeber, R. Curtis; Dinges, David F.; Connell, Linda J.; Rountree, Michael S.; Spinweber, Cheryl L.; Gillen, Kelly A.

1994-01-01

This study examined the effectiveness of a planned cockpit rest period to improve alertness and performance in long-haul flight operations. The Rest Group (12 crew members) was allowed a planned 40 minute rest period during the low workload, cruise portion of the flight, while the No-Rest Group (9 crew members) had a 40 minute planned control period when they maintained usual flight activities. Measures used in the study included continuous ambulatory recordings of brain wave and eye movement activity, a reaction time/vigilance task, a wrist activity monitor, in-flight fatigue and alertness ratings, a daily log for noting sleep periods, meals, exercise, flight and duty periods, and the NASA Background Questionnaire. The Rest Group pilots slept on 93 percent of the opportunities, falling asleep in 5.6 minutes and sleeping for 25.8 minutes. This nap was associated with improved physiological alertness and performance compared to the No-Rest Group. The benefits of the nap were observed through the critical descent and landing phases of flight. The nap did not affect layover sleep or the cumulative sleep debt. The nap procedures were implemented with minimal disruption to usual flight operations and there were no reported or identified concerns regarding safety.

Engagement in paid work as a protective predictor of basic activities of daily living disability in Japanese urban and rural community-dwelling elderly residents: An 8-year prospective study.

PubMed

Fujiwara, Yoshinori; Shinkai, Shoji; Kobayashi, Erika; Minami, Ushio; Suzuki, Hiroyuki; Yoshida, Hideyo; Ishizaki, Tatsuro; Kumagai, Shu; Watanabe, Shuichiro; Furuna, Taketo; Suzuki, Takao

2016-01-01

To examine whether engaging in paid work is a predictor of maintaining good functional health among Japanese older adults in both urban and rural communities. We used the 8-year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging with 306 and 675 persons aged 65-84 years from Koganei City (urban) and Nangai Village (rural), respectively, who are independent in basic activities of daily living (BADL). In order to examine the declining patterns in BADL and evaluate the predictive value of working status for future BADL disability, we applied the log-rank test of cumulative proportion curves and the Cox proportional hazard model by sex, controlling for age, research fields, years of education, marital state, chronic medical conditions, pain, instrumental activities of daily living (IADL), smoking status, exercise habits, life satisfaction, usual walking speed and serum albumin for evaluating the predictive value of working status at baseline for future BADL disability. In both areas, participants who were not working were more likely to decline in BADL than those working (P < 0.05), except for women in urban Koganei. Male participants who did not engage in paid work had a higher adjusted hazard ratio of onset of BADL disability, compared with those working, but this was not seen for female participants. Working might be protective from a decline in BADL only for men, but not for women. Regarding the difference of sex roles in conventional Japanese society, working would be an effective solution especially for men to participate in social activities. © 2015 Japan Geriatrics Society.

Coffee Drinking Is Widespread in the United States, but Usual Intake Varies by Key Demographic and Lifestyle Factors123

PubMed Central

Loftfield, Erikka; Freedman, Neal D; Dodd, Kevin W; Vogtmann, Emily; Xiao, Qian; Sinha, Rashmi; Graubard, Barry I

2016-01-01

Background: Despite widespread popularity and possible health effects, the prevalence and distribution of coffee consumption in US adults are poorly characterized. Objective: We sought to estimate usual daily coffee intakes from all coffee-containing beverages, including decaffeinated and regular coffee, among US adults according to demographic, socioeconomic, and health-related factors. Methods: Dietary intake data from ≤2 nonconsecutive 24-h dietary recalls and a food-frequency questionnaire administered during the NHANES 2003–2006 were used to estimate the person-specific probability of consuming coffee on a particular day and the usual amount consumed on consumption days. Trends in population mean coffee consumption over time were evaluated by using multiple linear regression and 1-d 24-h recall data from NHANES 2003–2012. Analyses were weighted to be representative of the US adult population aged ≥20 y. Results: An estimated 154 million adults, or 75% of the US population, aged ≥20 y reported drinking coffee; 49% reported drinking coffee daily. Prevalence did not vary by sex, education, income, or self-reported general health (all P ≥ 0.05) but did vary by age, race/ethnicity, smoking status, and alcohol drinking (all P < 0.05). Among coffee drinkers, the mean ± SE usual intake was 14.1 ± 0.5 fluid ounces/d (417 ± 15 mL/d). Mean usual intakes were higher in men than women, in older age groups than in those aged 20 to <30 y, in non-Hispanic whites than in non-Hispanic blacks or Hispanic/other races, in smokers than in never smokers, and in daily alcohol consumers than in nonconsumers (all P < 0.05). Population mean coffee consumption was stable from 2003 to 2012 (P-trend = 0.09). Conclusions: Coffee is widely consumed in the United States, with usual intakes varying by lifestyle and demographic factors, most notably by age. Longitudinal studies are needed to determine whether observed differences by age reflect birth cohort effects or changes in drinking patterns over the lifetime. PMID:27489008

Cost-Effectiveness of a Chronic Care Model for Frail Older Adults in Primary Care: Economic Evaluation Alongside a Stepped-Wedge Cluster-Randomized Trial.

PubMed

van Leeuwen, Karen M; Bosmans, Judith E; Jansen, Aaltje P D; Hoogendijk, Emiel O; Muntinga, Maaike E; van Hout, Hein P J; Nijpels, Giel; van der Horst, Henriette E; van Tulder, Maurits W

2015-12-01

To evaluate the cost-effectiveness of the Geriatric Care Model (GCM), an integrated care model for frail older adults based on the Chronic Care Model, with that of usual care. Economic evaluation alongside a 24-month stepped-wedge cluster-randomized controlled trial. Primary care (35 practices) in two regions in the Netherlands. Community-dwelling older adults who were frail according to their primary care physicians and the Program on Research for Integrating Services for the Maintenance of Autonomy case-finding tool questionnaire (N = 1,147). The GCM consisted of the following components: a regularly scheduled in-home comprehensive geriatric assessment by a practice nurse followed by a customized care plan, management and training of practice nurses by a geriatric expert team, and coordination of care through community network meetings and multidisciplinary team consultations of individuals with complex care needs. Outcomes were measured every 6 months and included costs from a societal perspective, health-related quality of life (Medical Outcomes Study 12-item Short-Form Survey (SF-12) physical (PCS) and mental component summary (MCS) scales), functional limitations (Katz activities of daily living and instrumental activities of daily living), and quality-adjusted life years based on the EQ-5D. Multilevel regression models adjusted for time and baseline confounders showed no significant differences in costs ($356, 95% confidence interval = -$488-1,134) and outcomes between intervention and usual care phases. Cost-effectiveness acceptability curves showed that, for the SF-12 PCS and MCS, the probability of the intervention being cost-effective was 0.76 if decision-makers are willing to pay $30,000 per point improvement on the SF-12 scales (range 0-100). For all other outcomes the probability of the intervention being cost-effective was low. Because the GCM was not cost-effective compared to usual care after 24 months of follow-up, widespread implementation in its current form is not recommended. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Effect of a multifactorial fall-and-fracture risk assessment and management program on gait and balance performances and disability in hospitalized older adults: a controlled study.

PubMed

Trombetti, A; Hars, M; Herrmann, F; Rizzoli, R; Ferrari, S

2013-03-01

This controlled intervention study in hospitalized oldest old adults showed that a multifactorial fall-and-fracture risk assessment and management program, applied in a dedicated geriatric hospital unit, was effective in improving fall-related physical and functional performances and the level of independence in activities of daily living in high-risk patients. Hospitalization affords a major opportunity for interdisciplinary cooperation to manage fall-and-fracture risk factors in older adults. This study aimed at assessing the effects on physical performances and the level of independence in activities of daily living (ADL) of a multifactorial fall-and-fracture risk assessment and management program applied in a geriatric hospital setting. A controlled intervention study was conducted among 122 geriatric inpatients (mean ± SD age, 84 ± 7 years) admitted with a fall-related diagnosis. Among them, 92 were admitted to a dedicated unit and enrolled into a multifactorial intervention program, including intensive targeted exercise. Thirty patients who received standard usual care in a general geriatric unit formed the control group. Primary outcomes included gait and balance performances and the level of independence in ADL measured 12 ± 6 days apart. Secondary outcomes included length of stay, incidence of in-hospital falls, hospital readmission, and mortality rates. Compared to the usual care group, the intervention group had significant improvements in Timed Up and Go (adjusted mean difference [AMD] = -3.7s; 95 % CI = -6.8 to -0.7; P = 0.017), Tinetti (AMD = -1.4; 95 % CI = -2.1 to -0.8; P < 0.001), and Functional Independence Measure (AMD = 6.5; 95 %CI = 0.7-12.3; P = 0.027) test performances, as well as in several gait parameters (P < 0.05). Furthermore, this program favorably impacted adverse outcomes including hospital readmission (hazard ratio = 0.3; 95 % CI = 0.1-0.9; P = 0.02). A multifactorial fall-and-fracture risk-based intervention program, applied in a dedicated geriatric hospital unit, was effective and more beneficial than usual care in improving physical parameters related to the risk of fall and disability among high-risk oldest old patients.

Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING]: study protocol of a non-inferiority randomized trial.

PubMed

Massoudi, Btissame; Blanker, Marco H; van Valen, Evelien; Wouters, Hans; Bockting, Claudi L H; Burger, Huibert

2017-06-13

The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients' own GP or general practice mental health worker (MHW) in routine primary care is unknown. We aim to demonstrate non-inferiority of blended care compared with usual care in patients with depressive symptoms or a depressive disorder in general practice. Additionally, we will explore the real-time course over the day of emotions and affect, and events within individuals during treatment. This is a pragmatic non-inferiority trial including 300 patients with depressive symptoms, recruited by collaborating GPs and MHWs. After inclusion, participants are randomized to either blended care or usual care in routine general practice. Blended care consists of the 'Act and Feel' treatment: an eight-week web-based program based on behavioral activation with integrated monitoring of depressive symptomatology and automatized feedback. GPs or their MHWs coach the participants through regular face-to-face or telephonic consultations with at least three sessions. Depressive symptomatology, health status, functional impairment, treatment satisfaction, daily activities and resource use are assessed during a follow-up period of 12 months. During treatment, real-time fluctuations in emotions and affect, and daily events will be rated using ecological momentary assessment. The primary outcome is the reduction of depressive symptoms from baseline to three months follow-up. We will conduct intention-to-treat analyses and supplementary per-protocol analyses. This trial will show whether blended care might be an appropriate treatment strategy for patients with depressive symptoms and depressive disorder in general practice. Netherlands Trial Register: NTR4757; 25 August 2014. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4757 . (Archived by WebCite® at http://www.webcitation.org/6mnXNMGef ).

The Role of Sugar-Sweetened Beverage Consumption in Adolescent Obesity: A Review of the Literature

ERIC Educational Resources Information Center

Harrington, Susan

2008-01-01

Soft drink consumption has increased by 300% in the past 20 years, and 56-85% of children in school consume at least one soft drink daily. The odds ratio of becoming obese among children increases 1.6 times for each additional can or glass of sugar-sweetened drink consumed beyond their usual daily intake of the beverage. Soft drinks currently…

Normal Child Behavior

MedlinePlus

... that they are embarrassed by in public. The parents' own temperament, usual mood, and daily pressures will also influence how they interpret the child's behavior. Easygoing parents may accept a wider range ...

Riding the Wave to Reach the Masses: Natural Events in Early Twentieth Century Portuguese Daily Press

NASA Astrophysics Data System (ADS)

Simões, Ana; Carneiro, Ana; Diogo, Maria Paula

2012-03-01

This paper brings together science communicated in newspapers in Portugal by looking at how news on natural events were communicated in two different newspapers—the capital newspaper Diário de Notícias ( Daily News) and the Diário dos Açores ( Azores Daily). In particular, we look at how the 1900 solar eclipse, a hot topic throughout Europe, was reported by the capital newspaper, and how news on seismology were conveyed in the period 1907-1910 in the newspaper published in Azores, an archipelago with a significant seismic and volcanic activity. We argue that the importance conceded to these scientific news was related to their overwhelming features, that their dissimilar presentation stemmed from their local relevance allied to their different nature, predictable in the case of eclipses, and unpredictable in the case of earthquakes, and that behind these two instances of science journalism laid an attempt by the scientific and political communities to gain the support of the general public to such an extent that these two specific instances of science journalism transcended their usual features to become successful forms of expository science.

Harmful excipients in medicines for neonates in Spain.

PubMed

Garcia-Palop, Beatriz; Movilla Polanco, Emma; Cañete Ramirez, Carmen; Cabañas Poy, Maria Jose

2016-04-01

Neonates may respond differently from adults to drug components. Hence, ingredients that seem safe in adults may not be safe in this age group. To describe the content of harmful excipients in drugs used in our neonatal wards and compare the daily dose a neonate may receive with the accepted daily intake (ADI) in adults. All drugs included in the hospital's neonatal treatment guide were reviewed, using information from the package inserts or the summary of product characteristics. Those containing at least one harmful excipient (e.g., metabisulfite, sorbitol) were analyzed. Minimum and maximum usual daily drug doses were determined, and excipient exposure was estimated by extrapolation of the minimum and maximum of excipient referred to the active ingredient. These amounts were compared with ADIs for each excipient in adults. In total, 32 % of intravenous and 62 % of oral formulations used in neonates contained at least one harmful excipient. On quantitative analysis, 25 % of intravenous and 19 % of oral drugs contained harmful excipients exceeding the ADI in adults. Several drugs commonly used to treat neonates contain harmful excipients in amounts that may exceed the ADI in adults. Clinicians should be aware of this to prescribe appropriate treatment in this population.

Estimation of Daily Proteinuria in Patients with Amyloidosis by Using the Protein-To-Creatinine ratio in Random Urine Samples.

PubMed

Talamo, Giampaolo; Mir Muhammad, A; Pandey, Manoj K; Zhu, Junjia; Creer, Michael H; Malysz, Jozef

2015-02-11

Measurement of daily proteinuria in patients with amyloidosis is recommended at the time of diagnosis for assessing renal involvement, and for monitoring disease activity. Renal involvement is usually defined by proteinuria >500 mg/day. We evaluated the accuracy of the random urine protein-to-creatinine ratio (Pr/Cr) in predicting 24 hour proteinuria in patient with amyloidosis. We compared results of random urine Pr/Cr ratio and concomitant 24-hour urine collections in 44 patients with amyloidosis. We found a strong correlation (Spearman's ρ=0.874) between the Pr/Cr ratio and the 24 hour urine protein excretion. For predicting renal involvement, the optimal cut-off point of the Pr/Cr ratio was 715 mg/g. The sensitivity and specificity for this point were 91.8% and 95.5%, respectively, and the area under the curve value was 97.4%. We conclude that the random urine Pr/Cr ratio could be useful in the screening of renal involvement in patients with amyloidosis. If validated in a prospective study, the random urine Pr/Cr ratio could replace the 24 hour urine collection for the assessment of daily proteinuria and presence of nephrotic syndrome in patients with amyloidosis.

Determinants of 24-hour energy expenditure in man. Methods and results using a respiratory chamber.

PubMed Central

Ravussin, E; Lillioja, S; Anderson, T E; Christin, L; Bogardus, C

1986-01-01

Daily human energy requirements calculated from separate components of energy expenditure are inaccurate and usually in poor agreement with measured energy intakes. Measurement of energy expenditure over periods of 24 h or longer is needed to determine more accurately rates of daily energy expenditure in humans. We provide a detailed description of a human respiratory chamber and methods used to determine rates of energy expenditure over 24-h periods in 177 subjects. The results show that: fat-free mass (FFM) as estimated by densitometry is the best available determinant of 24-h energy expenditures (24EE) and explains 81% of the variance observed between individuals (24EE [kcal/d] = 597 + 26.5 FFM); 24EE in an individual is very reproducible (coefficient of variation = 2.4%); and even when adjusted for differences in FFM, there is still considerable interperson variability of the daily energy expenditure. A large portion of the variability of 24EE among individuals, independent of differences in body size, was due to variability in the degree of spontaneous physical activity, i.e., "fidgeting," which accounted for 100-800 kcal/d in these subjects. Images PMID:3782471

Aphasia and activities of daily living in stroke patients.

PubMed

Gialanella, Bernardo; Prometti, Paola; Vanoglio, Fabio; Comini, Laura; Santoro, Raffaele

2016-12-01

Few studies have investigated the relationships between aphasia and activities of daily living (ADLs) in stroke patients. This study was aimed firstly to determine which task within the ADLs has poorer functional recovery in stroke patients with aphasia after rehabilitation, second to identify which specific task is related to aphasia. This is a prospective and observational study. Inpatients of our Rehabilitation Unit. The study was carried out in 219 patients with primary diagnosis of stroke with (104) and without aphasia (115). All patients underwent usual rehabilitation. Aachen Aphasia Test and Functional Independence Measure scale were used to assess severity of aphasia and ADLs, respectively. Gain in ADLs was the main outcome measure. At the end of rehabilitation patients with aphasia had lower gain in bathing, dressing upper body, dressing lower body, toileting, stair climbing, and higher gain in social interaction, problem solving, and memory with respect to patients without aphasia. However, when data were adjusted for side of hemiplegia, Fugl-Meyer score and trunk control test, patients with aphasia showed lower gain in dressing upper body (P=0.027), dressing lower body (P=0.009), lower toileting (P=0.027), and higher gain in social interaction (P<0.001). In the multivariate regression analysis, aphasia was an important determinant of gain in bathing (β=0.26), dressing upper body (β=0.24), dressing lower body (β=0.22), lower toileting (β=0.22), and social interaction (β=-0.29). The current study points out that, after usual rehabilitation, the patients with aphasia show a poor gain in personal care activities and higher gain in social interaction. Knowledge of these findings: 1) can guide the rehabilitation team in selecting specific and appropriate therapies aimed to give patient with aphasia the highest possible functional independence in ADLs; 2) is useful to family members and social rehabilitation services for domiciliary management of patients with aphasia.

Nutrient intakes among children and adolescents eating usual pizza products in school lunch compared with pizza meeting HealthierUS School Challenge criteria.

PubMed

Hur, In Young; Marquart, Len; Reicks, Marla

2014-05-01

Pizza is a popular food that can contribute to high intakes of saturated fat and sodium among children and adolescents. The objective of this study was to compare daily nutrient intakes when a pizza product meeting the US Department of Agriculture's criteria for competitive food entrées under the HealthierUS School Challenge (HUSSC) was substituted for usual pizza products consumed during foodservice-prepared school lunch. The study used National Health and Nutrition Examination Survey (2005-2008) dietary recall data from a cross-sectional sample of US children and adolescents (age 5 to 18 years, n=337) who ate pizza during school lunch on 1 day of dietary recall. Daily nutrient intakes based on the consumption of usual pizza products for school lunch (pre-modeled) were compared with intakes modeled by substituting nutrient values from an HUSSC whole-grain pizza product (post-modeled). Paired t tests were used to make the comparison. Post-modeled intakes were lower in daily energy, carbohydrate, total fat, saturated fat, cholesterol, and sodium compared with pre-modeled intakes among children and adolescents (P<0.01). Protein, dietary fiber, vitamin A, and potassium intakes were higher in the post-modeled intake condition compared with the pre-modeled condition (P<0.01). Substituting the healthier pizza product for usual pizza products may significantly improve dietary quality of children and adolescents eating pizza for school lunch, indicating that it could be an effective approach to improve the nutritional quality of school lunch programs. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Is a change in mode of travel to school associated with a change in overall physical activity levels in children? Longitudinal results from the SPEEDY study.

PubMed

Smith, Lee; Sahlqvist, Shannon; Ogilvie, David; Jones, Andy; Corder, Kirsten; Griffin, Simon J; van Sluijs, Esther

2012-11-21

Children who use active modes of travel (walking or cycling) to school are more physically active than those who use passive (motorised) modes. However, less is known on whether a change in mode of travel to school is associated with a change in children's physical activity levels. The purpose of this analysis was to investigate the association between change in mode of travel to school and change in overall physical activity levels in children. Data from 812 9-10 year old British children (59% girls) who participated in the SPEEDY study were analysed. During the summer terms of 2007 and 2008 participants completed a questionnaire and wore an accelerometer for at least three days. Two-level multiple linear regression models were used to explore the association between change in usual mode of travel to school and change in objectively measured time spent in MVPA. Compared to children whose reported mode of travel did not change, a change from a passive to an active mode of travel was associated with an increase in daily minutes spent in MVPA (boys: beta 11.59, 95% CI 0.94 to 22.24; girls: beta 11.92, 95% CI 5.00 to 18.84). This increase represented 12% of boys' and 13% of girls' total daily time spent in MVPA at follow-up. This analysis provides further evidence that promoting active travel to school may have a role in contributing to increasing physical activity levels in children.

The effectiveness of corticosteroid injection in the treatment of plantar fasciitis

PubMed Central

Ang, Teck Wee Andrew

2015-01-01

Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient’s daily activities and work. PubMed and Cochrane Central Register of Controlled Trials databases were searched for randomised controlled trials (RCTs) and a total of ten RCTs were selected for evaluation. These RCTs involved the use of either palpation- or ultrasonography-guided corticosteroid injections in patients diagnosed with plantar fasciitis. All placebo-controlled RCTs showed a significant reduction in pain with the use of corticosteroid injections. Some studies also showed that corticosteroid injections yielded better results than other treatment modalities. However, it is evident from these studies that the effects of corticosteroid injections are usually short-term, lasting 4–12 weeks in duration. Complications such as plantar fascia rupture are uncommon, but physicians need to weigh the treatment benefits against such risks. PMID:26311907

The effectiveness of corticosteroid injection in the treatment of plantar fasciitis.

PubMed

Ang, Teck Wee Andrew

2015-08-01

Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient's daily activities and work. PubMed and Cochrane Central Register of Controlled Trials databases were searched for randomised controlled trials (RCTs) and a total of ten RCTs were selected for evaluation. These RCTs involved the use of either palpation- or ultrasonography-guided corticosteroid injections in patients diagnosed with plantar fasciitis. All placebo-controlled RCTs showed a significant reduction in pain with the use of corticosteroid injections. Some studies also showed that corticosteroid injections yielded better results than other treatment modalities. However, it is evident from these studies that the effects of corticosteroid injections are usually short-term, lasting 4-12 weeks in duration. Complications such as plantar fascia rupture are uncommon, but physicians need to weigh the treatment benefits against such risks.

Phase Transition in a Healthy Human Heart Rate

NASA Astrophysics Data System (ADS)

Kiyono, Ken; Struzik, Zbigniew R.; Aoyagi, Naoko; Togo, Fumiharu; Yamamoto, Yoshiharu

2005-07-01

A healthy human heart rate displays complex fluctuations which share characteristics of physical systems in a critical state. We demonstrate that the human heart rate in healthy individuals undergoes a dramatic breakdown of criticality characteristics, reminiscent of continuous second order phase transitions. By studying the germane determinants, we show that the hallmark of criticality—highly correlated fluctuations—is observed only during usual daily activity, and a breakdown of these characteristics occurs in prolonged, strenuous exercise and sleep. This finding is the first reported discovery of the dynamical phase transition phenomenon in a biological control system and will be a key to understanding the heart rate control system in health and disease.

[Poisonous animals at bathing beaches].

PubMed

Junghanss, T; Bodio, M

2000-05-18

Tourists and native inhabitants of tropical and subtropical regions differ significantly with regard to the risk and nature of incidents involving venomous and poisonous animals. While the indigenous population encounters such risks daily during work and other activities, tourists are usually endangered while swimming or diving, or by ingesting toxin-containing fish and/or other seafood. Whether abroad or at home, allergic reactions to the stings of bees, wasps and hornets are probably the most common manifestations of an encounter with a "poisonous animal". Travellers should be well acquainted with the dangers entailed in encountering or ingesting a venomous or poisonous animal--prevention is the most important measure.

Recognition of Activities of Daily Living Based on Environmental Analyses Using Audio Fingerprinting Techniques: A Systematic Review

PubMed Central

Santos, Rui; Pombo, Nuno; Flórez-Revuelta, Francisco

2018-01-01

An increase in the accuracy of identification of Activities of Daily Living (ADL) is very important for different goals of Enhanced Living Environments and for Ambient Assisted Living (AAL) tasks. This increase may be achieved through identification of the surrounding environment. Although this is usually used to identify the location, ADL recognition can be improved with the identification of the sound in that particular environment. This paper reviews audio fingerprinting techniques that can be used with the acoustic data acquired from mobile devices. A comprehensive literature search was conducted in order to identify relevant English language works aimed at the identification of the environment of ADLs using data acquired with mobile devices, published between 2002 and 2017. In total, 40 studies were analyzed and selected from 115 citations. The results highlight several audio fingerprinting techniques, including Modified discrete cosine transform (MDCT), Mel-frequency cepstrum coefficients (MFCC), Principal Component Analysis (PCA), Fast Fourier Transform (FFT), Gaussian mixture models (GMM), likelihood estimation, logarithmic moduled complex lapped transform (LMCLT), support vector machine (SVM), constant Q transform (CQT), symmetric pairwise boosting (SPB), Philips robust hash (PRH), linear discriminant analysis (LDA) and discrete cosine transform (DCT). PMID:29315232

A Multisite, Randomized Controlled Clinical Trial of Computerized Cognitive Remediation Therapy for Schizophrenia.

PubMed

Gomar, Jesús J; Valls, Elia; Radua, Joaquim; Mareca, Celia; Tristany, Josep; del Olmo, Francisco; Rebolleda-Gil, Carlos; Jañez-Álvarez, María; de Álvaro, Francisco J; Ovejero, María R; Llorente, Ana; Teixidó, Cristina; Donaire, Ana M; García-Laredo, Eduardo; Lazcanoiturburu, Andrea; Granell, Luis; Mozo, Cristina de Pablo; Pérez-Hernández, Mónica; Moreno-Alcázar, Ana; Pomarol-Clotet, Edith; McKenna, Peter J

2015-11-01

The effectiveness of cognitive remediation therapy (CRT) for the neuropsychological deficits seen in schizophrenia is supported by meta-analysis. However, a recent methodologically rigorous trial had negative findings. In this study, 130 chronic schizophrenic patients were randomly assigned to computerized CRT, an active computerized control condition (CC) or treatment as usual (TAU). Primary outcome measures were 2 ecologically valid batteries of executive function and memory, rated under blind conditions; other executive and memory tests and a measure of overall cognitive function were also employed. Carer ratings of executive and memory failures in daily life were obtained before and after treatment. Computerized CRT was found to produce improvement on the training tasks, but this did not transfer to gains on the primary outcome measures and most other neuropsychological tests in comparison to either CC or TAU conditions. Nor did the intervention result in benefits on carer ratings of daily life cognitive failures. According to this study, computerized CRT is not effective in schizophrenia. The use of both active and passive CCs suggests that nature of the control group is not an important factor influencing results. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

Effectiveness of prolonged use of continuous passive motion (CPM) as an adjunct to physiotherapy following total knee arthroplasty: design of a randomised controlled trial [ISRCTN85759656].

PubMed

Lenssen, Anton F; Crijns, Yvonne H F; Waltjé, Eddie M H; Roox, George M; van Steyn, Mike J A; Geesink, Ruud J T; van den Brandt, Piet A; de Bie, Rob A

2006-02-23

Adequate and intensive rehabilitation is an important requirement for successful Total Knee Arthroplasty. The primary focus of early rehabilitation is ambulation of patients and regaining range of motion in the knee. Although research suggests that Continuous Passive Motion should be implemented in the first rehabilitation phase following surgery, there is substantial debate about the duration of each session and the total period of CPM application and. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. In a randomised controlled trial we intend to investigate the efficacy of prolonged use of a continuous passive motion (CPM) device in the home situation as an adjunct to standardised physical therapy. The experimental treatment is compared to standardised physical therapy, in patients with osteoarthritis of the knee undergoing Total Knee Arthroplasty (TKA). Efficacy will be assessed in terms of faster improvements in range of motion and functional recovery. Seventy patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment (less than 80 degrees of knee flexion at the time of discharge) will be randomised over two treatment groups, a usual care group and an experimental group. The experimental group will receive CPM + physiotherapy for 17 consecutive days after surgery, whereas the usual care group will receive the same treatment during the in-hospital phase (i.e. about four days), followed by physical therapy alone (usual care) in the first two weeks after hospital discharge. From 18 days to three months after discharge, both groups will receive standardised PT. The primary focus of rehabilitation will be functional recovery (e.g. ambulation) and regaining range of motion (ROM) in the knee. Because restricted knee ROM affects functional activities, knee ROM and knee function are regarded as the primary indicators of successful TKA. Potential effects of the intervention under study include rapid return of knee flexion accompanied by earlier return to functional activities of daily life. If patients benefit significantly from prolonged CPM use, this treatment should be added to the standard PT treatment at home. We expect the additional home CPM programme to be more effective than the usual physiotherapy programme, resulting in a difference in ROM of at least 5 degrees , 17 days after surgery. This clinically important difference, with a possible flexion ROM of about 100 degrees , is expected to lead to better functioning in activities of daily life, like walking, and earlier ability to cycle. These advantages should result in earlier and increasing independence.

Effectiveness of prolonged use of continuous passive motion (CPM) as an adjunct to physiotherapy following total knee arthroplasty: Design of a randomised controlled trial [ISRCTN85759656

PubMed Central

Lenssen, Anton F; Crijns, Yvonne HF; Waltjé, Eddie MH; Roox, George M; van Steyn, Mike JA; Geesink, Ruud JT; van den Brandt, Piet A; de Bie, Rob A

2006-01-01

Background Adequate and intensive rehabilitation is an important requirement for successful Total Knee Arthroplasty. The primary focus of early rehabilitation is ambulation of patients and regaining range of motion in the knee. Although research suggests that Continuous Passive Motion should be implemented in the first rehabilitation phase following surgery, there is substantial debate about the duration of each session and the total period of CPM application and. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we intend to investigate the efficacy of prolonged use of a continuous passive motion (CPM) device in the home situation as an adjunct to standardised physical therapy. The experimental treatment is compared to standardised physical therapy, in patients with osteoarthritis of the knee undergoing Total Knee Arthroplasty (TKA). Efficacy will be assessed in terms of faster improvements in range of motion and functional recovery. Seventy patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment (less than 80° of knee flexion at the time of discharge) will be randomised over two treatment groups, a usual care group and an experimental group The experimental group will receive CPM + physiotherapy for 17 consecutive days after surgery, whereas the usual care group will receive the same treatment during the in-hospital phase (i.e. about four days), followed by physical therapy alone (usual care) in the first two weeks after hospital discharge. From 18 days to three months after discharge, both groups will receive standardised PT. The primary focus of rehabilitation will be functional recovery (e.g. ambulation) and regaining range of motion (ROM) in the knee. Discussion Because restricted knee ROM affects functional activities, knee ROM and knee function are regarded as the primary indicators of successful TKA. Potential effects of the intervention under study include rapid return of knee flexion accompanied by earlier return to functional activities of daily life. If patients benefit significantly from prolonged CPM use, this treatment should be added to the standard PT treatment at home. We expect the additional home CPM programme to be more effective than the usual physiotherapy programme, resulting in a difference in ROM of at least 5°, 17 days after surgery. This clinically important difference, with a possible flexion ROM of about 100°, is expected to lead to better functioning in activities of daily life, like walking, and earlier ability to cycle. These advantages should result in earlier and increasing independence. PMID:16504087

Butoconazole Vaginal Cream

MedlinePlus

... is used to treat yeast infections of the vagina.This medication is sometimes prescribed for other uses; ... comes as a cream to insert into the vagina. It is usually used daily at bedtime. Follow ...

Strawberries Added to the Usual Diet Suppress Fasting Plasma Paraoxonase Activity and Have a Weak Transient Decreasing Effect on Cholesterol Levels in Healthy Nonobese Subjects.

PubMed

Zasowska-Nowak, Anna; Nowak, Piotr J; Bialasiewicz, Piotr; Prymont-Przyminska, Anna; Zwolinska, Anna; Sarniak, Agata; Wlodarczyk, Anna; Markowski, Jaroslaw; Rutkowski, Krzysztof P; Nowak, Dariusz

2016-07-01

Strawberries can improve oxidants-antioxidants balance and reduce some cardiovascular risk factors in obese subjects. Paraoxonase-1 (PON-1) is a high-density lipoprotein-associated enzyme with antioxidant properties that can protect from coronary artery disease in humans. We examined the effect of strawberry consumption on plasma PON-1 activity and lipid profile in healthy nonobese subjects. Thirty-one subjects (body mass index [BMI] 24.4 ± 4.0 kg/m(2)) on their usual diet consumed 500 g of strawberry pulp daily for 30 days (first course) and after a 10-day washout the cycle was repeated (second course). Fasting blood and spot morning urine samples were collected before, during, and after each strawberry course (8 time points) for determination of paraoxonase and arylesterase PON-1 activities and lipid profile. Twenty subjects served as controls with respect to cholesterol and PON-1 activities changes over the study period. Strawberries decreased mean plasma paraoxonase PON-1 activity and this effect was more evident after the second course (by 11.6%, p < 0.05) than after the first course (5.4%, p = 0.06), whereas arylesterase activity was constant. Strawberries altered total cholesterol levels (p < 0.05) with a tendency to transiently decrease it (by 5.1%) only after 15 days of the first course. Triglycerides and high- and low-density lipoprotein cholesterol did not change in response to fruit consumption. No changes in PON-1 activities and lipid profile were noted in controls. Paraoxonase correlated with arylesterase activity (ƿ from 0.33 to 0.46 at the first 7 time points, p < 0.05). This association disappeared at the end of study (ƿ = 0.07) when the strongest inhibition of paraoxonase was noted. Supplementation of the usual diet with strawberries decreased paraoxonase PON-1 activity and did not improve lipid profiles in healthy nonobese subjects. Further studies are necessary to establish the clinical significance of paraoxonase suppression and to define a group of healthy subjects who can benefit from strawberry consumption with respect to cholesterol levels.

Statistical analyses and characteristics of volcanic tremor on Stromboli Volcano (Italy)

NASA Astrophysics Data System (ADS)

Falsaperla, S.; Langer, H.; Spampinato, S.

A study of volcanic tremor on Stromboli is carried out on the basis of data recorded daily between 1993 and 1995 by a permanent seismic station (STR) located 1.8km away from the active craters. We also consider the signal of a second station (TF1), which operated for a shorter time span. Changes in the spectral tremor characteristics can be related to modifications in volcanic activity, particularly to lava effusions and explosive sequences. Statistical analyses were carried out on a set of spectra calculated daily from seismic signals where explosion quakes were present or excluded. Principal component analysis and cluster analysis were applied to identify different classes of spectra. Three clusters of spectra are associated with two different states of volcanic activity. One cluster corresponds to a state of low to moderate activity, whereas the two other clusters are present during phases with a high magma column as inferred from the occurrence of lava fountains or effusions. We therefore conclude that variations in volcanic activity at Stromboli are usually linked to changes in the spectral characteristics of volcanic tremor. Site effects are evident when comparing the spectra calculated from signals synchronously recorded at STR and TF1. However, some major spectral peaks at both stations may reflect source properties. Statistical considerations and polarization analysis are in favor of a prevailing presence of P-waves in the tremor signal along with a position of the source northwest of the craters and at shallow depth.

Age and education influence the performance of elderly women on the dual-task Timed Up and Go test.

PubMed

Gomes, Gisele de Cássia; Teixeira-Salmela, Luci Fuscaldi; Fonseca, Bruna Espeschit; Freitas, Flávia Alexandra Silveira de; Fonseca, Maria Luísa Morais; Pacheco, Bruna Débora; Gonçalves, Marisa Rocha; Caramelli, Paulo

2015-03-01

Gait variability is related to functional decline in the elderly. The dual-task Timed Up and Go Test (TUG-DT) reflects the performance in daily activities. Objective To evaluate the differences in time to perform the TUG with and without DT in elderly women with different ages and levels of education and physical activity. Method Ninety-two elderly women perfomed the TUG at usual and fast speeds, with and without motor and cognitive DT. Results Increases in the time to perform the TUG-DT were observed at older ages and lower educational levels, but not at different levels of physical activity. More educated women performed the test faster with and without DT at both speeds. When age was considered, significant differences were found only for the TUG-DT at both speeds. Conclusion Younger women with higher education levels demonstrated better performances on the TUG-DT.

Functional Assessment and Intervention by Nursing Assistants in Hospice and Palliative Care Inpatient Care Settings: A Quality Improvement Pilot Study.

PubMed

Mueller, Karen; Hamilton, Gillian; Rodden, Betheny; DeHeer, Hendrick D

2016-03-01

This study assessed the impact of a nursing assistant-led functional intervention in an urban hospice. Thirty-three patients participated. A physical therapist trained 4 nursing assistants to assess 4 basic functional activities at admission and discharge and to provide daily activity training to intervention group participants. Control group participants were assessed at admission and discharge and received the usual standard of care. Both groups improved. The intervention group participants demonstrated significant improvement in the Timed up and Go test as well as their self-reported ability to achieve goals on the Patient-Specific Functional Scale. Control group participants made significant improvements in the ability to move from supine to sit in bed. These findings suggest that nursing assistants can provide activity-based assessment and intervention leading to improved function among patients in hospice. © The Author(s) 2014.

Combining users' activity survey and simulators to evaluate human activity recognition systems.

PubMed

Azkune, Gorka; Almeida, Aitor; López-de-Ipiña, Diego; Chen, Liming

2015-04-08

Evaluating human activity recognition systems usually implies following expensive and time-consuming methodologies, where experiments with humans are run with the consequent ethical and legal issues. We propose a novel evaluation methodology to overcome the enumerated problems, which is based on surveys for users and a synthetic dataset generator tool. Surveys allow capturing how different users perform activities of daily living, while the synthetic dataset generator is used to create properly labelled activity datasets modelled with the information extracted from surveys. Important aspects, such as sensor noise, varying time lapses and user erratic behaviour, can also be simulated using the tool. The proposed methodology is shown to have very important advantages that allow researchers to carry out their work more efficiently. To evaluate the approach, a synthetic dataset generated following the proposed methodology is compared to a real dataset computing the similarity between sensor occurrence frequencies. It is concluded that the similarity between both datasets is more than significant.

Motivational counselling and SMS-reminders for reduction of daily sitting time in patients with rheumatoid arthritis: a descriptive randomised controlled feasibility study.

PubMed

Thomsen, T; Aadahl, M; Beyer, N; Hetland, M L; Løppenthin, K; Midtgaard, J; Christensen, R; Esbensen, B A

2016-10-18

Patients with rheumatoid arthritis (RA) spend a high proportion of their waking time in sedentary behaviour (SB) and have an increased risk of cardiovascular disease. Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems. Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary populations. To evaluate descriptively the feasibility of recruitment, randomisation, outcome assessments, retention and the acceptability of an individually tailored, theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA. A randomised, controlled trial with two parallel groups. RA patients >18 years of age and Health Assessment Questionnaire (HAQ) score < 2.5 were consecutively invited and screened for daily leisure time sitting > 4 h. The 16-week intervention included 1) three individual motivational counselling sessions and 2) individual text message reminders aimed at reducing daily sitting time. The control group was encouraged to maintain their usual lifestyles. Outcomes were assessed at baseline and after the 16 week intervention. Daily sitting time was measured using an ActivPAL3 TM activity monitor. The study was not powered to show superiority; rather the objective was to focus on acceptability among patients and clinical health professionals. In total, 107 patients were invited and screened before 20 met eligibility criteria and consented; reasons for declining study participation were mostly flares, lack of time and co-morbidities. One patient from the control group dropped out before end of intervention (due to a RA flare). Intervention participants completed all counselling sessions. All procedures regarding implementation of the trial protocol were feasible. The daily sitting time was reduced on average by 0.30 h in the intervention group unlike the control group that tended to increase it by 0.15 h after 16 weeks. This study shows that an individually tailored behavioural intervention targeting reduction of SB was feasible and acceptable to patients with RA. The Danish Data Protection Agency (ref.nb. 711-1-08 - 20 March 2011), the Ethics Committee of the Capital Region of Denmark (ref.nb. H-2-2012-112- 17 October 2012), clinicaltrials.gov ( NCT01969604 - October 17 2013, retrospectively registered).

Terconazole Vaginal Cream, Vaginal Suppositories

MedlinePlus

... to treat fungal and yeast infections of the vagina.This medication is sometimes prescribed for other uses; ... a cream and suppository to insert into the vagina. It is usually used daily at bedtime for ...

Hyperhidrosis (Excessive Sweating)

MedlinePlus

... your daily routine Sweating causes emotional distress or social withdrawal You suddenly begin to sweat more than usual ... can lead to heavy sweating, as can opioid ... infections. Social and emotional effects. Having clammy or dripping hands ...

The Daily Mile makes primary school children more active, less sedentary and improves their fitness and body composition: a quasi-experimental pilot study.

PubMed

Chesham, Ross A; Booth, Josephine N; Sweeney, Emma L; Ryde, Gemma C; Gorely, Trish; Brooks, Naomi E; Moran, Colin N

2018-05-10

The Daily Mile is a physical activity programme made popular by a school in Stirling, Scotland. It is promoted by the Scottish Government and is growing in popularity nationally and internationally. The aim is that each day, during class time, pupils run or walk outside for 15 min (~1 mile) at a self-selected pace. It is anecdotally reported to have a number of physiological benefits including increased physical activity, reduced sedentary behaviour, increased fitness and improved body composition. This study aimed to investigate these reports. We conducted a quasi-experimental repeated measures pilot study in two primary schools in the Stirling Council area: one school with, and one without, intention to introduce the Daily Mile. Pupils at the control school followed their usual curriculum. Of the 504 children attending the schools, 391 children in primary classes 1-7 (age 4-12 years) at the baseline assessment took part. The follow-up assessment was in the same academic year. Outcomes were accelerometer-assessed average daily moderate to vigorous intensity physical activity (MVPA) and average daily sedentary behaviour, 20-m shuttle run fitness test performance and adiposity assessed by the sum of skinfolds at four sites. Valid data at both time points were collected for 118, 118, 357 and 327 children, respectively, for each outcome. After correction for age and gender, significant improvements were observed in the intervention school relative to the control school for MVPA, sedentary time, fitness and body composition. For MVPA, a relative increase of 9.1 min per day (95% confidence interval or 95%CI 5.1-13.2 min, standardised mean difference SMD = 0.407, p = 0.027) was observed. For sedentary time, there was a relative decrease of 18.2 min per day (10.7-25.7 min, SMD = 0.437, p = 0.017). For the shuttle run, there was a relative increase of 39.1 m (21.9-56.3, SMD = 0.236, p = 0.037). For the skinfolds, there was a relative decrease of 1.4 mm (0.8-2.0 mm, SMD = 0.246, p = 0.036). Similar results were obtained when a correction for socioeconomic groupings was included. The findings show that in primary school children, the Daily Mile intervention is effective at increasing levels of MVPA, reducing sedentary time, increasing physical fitness and improving body composition. These findings have relevance for teachers, policymakers, public health practitioners, and health researchers.

Weight gain in preterm infants following parent-administered Vimala massage: a randomized controlled trial.

PubMed

Gonzalez, Alma Patricia; Vasquez-Mendoza, Guadalupe; García-Vela, Alfonso; Guzmán-Ramirez, Andres; Salazar-Torres, Marcos; Romero-Gutierrez, Gustavo

2009-04-01

Massage has been proposed as a way of facilitating development and growth of newborns through its effects on increasing blood flow, heart rate, digestion, and immunity. Massage might increase basal metabolism and nutrient absorption through endocrine effects such as increase in insulin and adrenaline and decrease in cortisol. Preliminary studies have suggested significant impact on weight gain with shortening of in-hospital stays of up to 6 days. We compared weight gain among preterm infants receiving Vimala massage plus usual care versus usual care alone. A randomized controlled trial was conducted. Sixty clinically stable preterm newborns with a corrected gestational age of 30 to 35 weeks receiving enteral nutrition in the hospital nursery were included. Half of them were assigned at random to receive Vimala massage twice daily for 10 days plus usual nursery care; the others received usual nursery care. Weight, head circumference, caloric intake, and nutritional method were recorded daily. Group characteristics were compared with analysis of variance, T test, and chi (2) test as appropriate. There were no differences between groups in gender, gestational age, initial weight, head circumference, and caloric intake and type of nutrition at baseline. Infants receiving massage had a larger weight gain versus the control group since the third day (188.2 +/- 41.20 g/kg versus 146.7 +/- 56.43 g/kg, P < 0.001). Hospital stay was shorter in infants receiving massage and usual nursery care (15.63 +/- 5.41 days versus 19.33 +/- 7.92 days, P = 0.03). The addition of parent-administered Vimala massage to usual nursery care resulted in increased weight gain and shorter hospital stay among clinically stable preterm newborns.

Impact of cough and common cold on productivity, absenteeism, and daily life in the United States: ACHOO Survey.

PubMed

Dicpinigaitis, Peter V; Eccles, Ron; Blaiss, Michael S; Wingertzahn, Mark A

2015-08-01

Although the common cold is among the most frequent ailments encountered in clinical practice, little is known about its impact on productivity, absenteeism, and daily life. The United States Attitudes of Consumers Toward Health, Cough, and Cold (ACHOO) survey was developed to inform healthcare providers on patients' experience of cough/cold. This analysis focuses on the impact of cough/cold on daily activity, productivity, and absenteeism; other results are reported elsewhere. ACHOO was a 36-question online survey. US adult Internet/mobile device users (N = 3333) were recruited in October 2012. Response quotas modeled on 2010 US Census data ensured a demographically representative sample; 75% of completed surveys were randomized as the primary analysis pool. Demographics and impact of cough/cold were reported using means, frequencies, and percentages. Weighted least squares regression or weighted paired t-test were used to identify factors associated with greater impact. The analysis pool (N = 2505) included 1342 (53.6%) women and 1163 (46.4%) men (mean ages, 46.7 and 45.9 years). A majority (84.7%) had ≥1 cold in the past year. Fifty-two percent said cough/cold impacted daily life a fair amount to a lot. Productivity decreased by a mean 26.4%, and 44.5% of respondents reported work/school absenteeism (usually 1-2 days) during a cold. Overall, 93% of survey participants reported sleep difficulty (slight to extreme) during a cough/cold. Among all respondents, 57% reported cough or nasal congestion as the symptoms making sleep difficult. Higher frequency of colds, more cold symptoms, difficulty sleeping, and worse overall health status correlated with greater impact on productivity, absenteeism, and daily life. Study limitations include the potential for recall bias given the retrospective nature of the self-reports. Furthermore, no attempt was made to distinguish treatment effects, if any, from those of the underlying cough/cold. To our knowledge, this is the first large national survey to quantify adverse effects of cough/cold on daily activity, productivity, and absenteeism. Cold- and patient-related characteristics influence the degree of impact.

New daily persistent headache in children and adolescents.

PubMed

Baron, Eric P; Rothner, A David

2010-03-01

New daily persistent headache (NDPH) is a form of chronic daily headache (CDH) that may have features of both migraine and tension-type headache. In contrast with other types of CDH, NDPH is characterized by patients recalling the specific date their unremitting daily headache began. In comparison, chronic tension-type headache and chronic migraine are preceded by a gradually increasing frequency of headache. After several months, all three of these CDH forms often have a similar phenotype, making early history a key to diagnosing NDPH. Evaluations to exclude secondary causes are necessary but usually negative. NDPH is difficult to treat and requires a multimodal approach. Questions regarding NDPH remain unanswered. Additional prospective studies are necessary to further understand, characterize, diagnose, and treat NDPH.

Evaluation of a workplace treadmill desk intervention: a randomized controlled trial.

PubMed

Schuna, John M; Swift, Damon L; Hendrick, Chelsea A; Duet, Megan T; Johnson, William D; Martin, Corby K; Church, Timothy S; Tudor-Locke, Catrine

2014-12-01

To evaluate the effectiveness of a 3-month treadmill desk intervention in eliciting changes in physical activity and sedentary behavior among overweight/obese office workers. A randomized controlled trial was conducted among overweight/obese office workers (n = 41; mean age = 40.1 ± 10.1 years) at a private workplace. Participants were randomly assigned to a shared-treadmill desk intervention (n = 21) or a usual working condition control group (n = 20). Accelerometer-determined physical activity and sedentary behavior were measured before and after the intervention. Compared with the control group, the intervention group increased daily steps (1622 steps/day; P = 0.013) and light physical activity (1.6 minutes/hour; P = 0.008), and decreased sedentary time (-3.6 minutes/hour; P = 0.047) during working hours. Shared-treadmill desks in the workplace can be effective at promoting favorable changes in light physical activity (specifically 40 to 99 steps/minute) and sedentary behavior among overweight/obese office workers.

Antibacterial, Antifungal and Nematicidal Activities of Rare Earth Ions.

PubMed

Wakabayashi, Tokumitsu; Ymamoto, Ayumi; Kazaana, Akira; Nakano, Yuta; Nojiri, Yui; Kashiwazaki, Moeko

2016-12-01

Despite the name, rare earth elements are relatively abundant in soil. Therefore, these elements might interact with biosphere during the history of life. In this study, we have examined the effect of rare earth ions on the growth of bacteria, fungi and soil nematode. All rare earth ions, except radioactive promethium that we have not tested, showed antibacterial and antifungal activities comparable to that of copper ions, which is widely used as antibacterial metals in our daily life. Rare earth ions also have nematicidal activities as they strongly perturb the embryonic development of the nematode, Caenorhabditis elegans. Interestingly, the nematicidal activity increased with increasing atomic number of lanthanide ions. Since the rare earth ions did not show high toxicity to the human lymphoblastoid cell line or even stimulate the growth of the cultured cells at 1 mM, it raised the possibility that we can substitute rare earth elements for the antibacterial metals usually used because of their safety.

Idiopathic orthostatic hypotension: Recent data (eleven cases) and review of the literature

NASA Technical Reports Server (NTRS)

Ninet, J.; Annat, G.; Boisson, D.; Holzhapfel, L.; Vincent, M.; Peyrin, L.; Michel, D.; Schott, B.; Devic, M.; Levrat, R.

1981-01-01

Eight cases of Shy-Drager syndrome and three of Bradbury-Eggleston idiopathic orthostatic hypotension were examined. In all cases, examination of circulatory reflexes showed major dysfunction of the sympathetic vasoconstrictor system. Anomalies in the vagal cardiomoderator system were less constant. Normal urinary elimination of catecholamines was recorded daily. Characteristically, no elevation of blood or urine norepinephrine levels were found in orthostatism. Insulin hypoglycemia normally raised urinary adrenalin elimination in three of ten patients. Plasma dopa-beta-hydroxylase activity was normal. Renin-angiotensin-aldosterone system showed variable activity at basal state but usually rose during orthostatism. On the average, very low homovanillic acid levels were found in cerebrospinal fluid before and after probenecid; hydroxyindolacetic acid was normal. Cerebral autoregulation had deteriorated in two of four cases. Physiopathologically the two clinical types are indistinguishable with or without central neurological signs.

Gaussian Quadrature is an efficient method for the back-transformation in estimating the usual intake distribution when assessing dietary exposure.

PubMed

Dekkers, A L M; Slob, W

2012-10-01

In dietary exposure assessment, statistical methods exist for estimating the usual intake distribution from daily intake data. These methods transform the dietary intake data to normal observations, eliminate the within-person variance, and then back-transform the data to the original scale. We propose Gaussian Quadrature (GQ), a numerical integration method, as an efficient way of back-transformation. We compare GQ with six published methods. One method uses a log-transformation, while the other methods, including GQ, use a Box-Cox transformation. This study shows that, for various parameter choices, the methods with a Box-Cox transformation estimate the theoretical usual intake distributions quite well, although one method, a Taylor approximation, is less accurate. Two applications--on folate intake and fruit consumption--confirmed these results. In one extreme case, some methods, including GQ, could not be applied for low percentiles. We solved this problem by modifying GQ. One method is based on the assumption that the daily intakes are log-normally distributed. Even if this condition is not fulfilled, the log-transformation performs well as long as the within-individual variance is small compared to the mean. We conclude that the modified GQ is an efficient, fast and accurate method for estimating the usual intake distribution. Copyright © 2012 Elsevier Ltd. All rights reserved.

Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults.

PubMed

Qin, Chenxi; Lv, Jun; Guo, Yu; Bian, Zheng; Si, Jiahui; Yang, Ling; Chen, Yiping; Zhou, Yonglin; Zhang, Hao; Liu, Jianjun; Chen, Junshi; Chen, Zhengming; Yu, Canqing; Li, Liming

2018-05-21

To examine the associations between egg consumption and cardiovascular disease (CVD), ischaemic heart disease (IHD), major coronary events (MCE), haemorrhagic stroke as well as ischaemic stroke. During 2004-2008, over 0.5 million adults aged 30-79 years were recruited from 10 diverse survey sites in China. Participants were asked about the frequency of egg consumption and were followed up via linkages to multiple registries and active investigation. Among 461 213 participants free of prior cancer, CVD and diabetes, a total of 83 977 CVD incident cases and 9985 CVD deaths were documented, as well as 5103 MCE. Stratified Cox regression was performed to yield adjusted hazard ratios for CVD endpoints associated with egg consumption. At baseline, 13.1% of participants reported daily consumption (usual amount 0.76 egg/day) and 9.1% reported never or very rare consumption (usual amount 0.29 egg/day). Compared with non-consumers, daily egg consumption was associated with lower risk of CVD (HR 0.89, 95% CI 0.87 to 0.92). Corresponding multivariate-adjusted HRs (95% CI) for IHD, MCE, haemorrhagic stroke and ischaemic stroke were 0.88 (0.84 to 0.93), 0.86 (0.76 to 0.97), 0.74 (0.67 to 0.82) and 0.90 (0.85 to 0.95), respectively. There were significant dose-response relationships of egg consumption with morbidity of all CVD endpoints (P for linear trend <0.05). Daily consumers also had an 18% lower risk of CVD death and a 28% lower risk of haemorrhagic stroke death compared to non-consumers. Among Chinese adults, a moderate level of egg consumption (up to <1 egg/day) was significantly associated with lower risk of CVD, largely independent of other risk factors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Estimation of Daily Proteinuria in Patients with Amyloidosis by Using the Protein-To-Creatinine ratio in Random Urine Samples

PubMed Central

Talamo, Giampaolo; Mir Muhammad, A.; Pandey, Manoj K.; Zhu, Junjia; Creer, Michael H.; Malysz, Jozef

2015-01-01

Measurement of daily proteinuria in patients with amyloidosis is recommended at the time of diagnosis for assessing renal involvement, and for monitoring disease activity. Renal involvement is usually defined by proteinuria >500 mg/day. We evaluated the accuracy of the random urine protein-to-creatinine ratio (Pr/Cr) in predicting 24 hour proteinuria in patient with amyloidosis. We compared results of random urine Pr/Cr ratio and concomitant 24-hour urine collections in 44 patients with amyloidosis. We found a strong correlation (Spearman’s ρ=0.874) between the Pr/Cr ratio and the 24 hour urine protein excretion. For predicting renal involvement, the optimal cut-off point of the Pr/Cr ratio was 715 mg/g. The sensitivity and specificity for this point were 91.8% and 95.5%, respectively, and the area under the curve value was 97.4%. We conclude that the random urine Pr/Cr ratio could be useful in the screening of renal involvement in patients with amyloidosis. If validated in a prospective study, the random urine Pr/Cr ratio could replace the 24 hour urine collection for the assessment of daily proteinuria and presence of nephrotic syndrome in patients with amyloidosis. PMID:25918613

Who benefits most from THC:CBD spray? Learning from clinical experience.

PubMed

Koehler, Jürgen

2014-01-01

Patients with multiple sclerosis (MS) represent a diverse and heterogeneous population varying in terms of disease type, its severity and variable progression/time-course, and with regard to the wide range of presenting symptoms. Consequently, detailed experience with individual patients is important to provide examples of therapy to specific patient types. In this article, real-life data from clinical practice showing specific aspects relating to use of 9-delta-tetrahydocannabinol and cannabidiol (THC:CBD) oromucosal spray (Sativex®) in patients with moderate to severe spasticity resistant to usual therapy will be presented. Three common clinical scenarios will be considered: MS patients with resistance to usual spasticity therapies; patients with impairment in MS spasticity symptoms; MS patients with relevant impairment in quality of life/activities of daily living (QoL/ADL). These case reports highlight the diverse nature of the MS spasticity population and they show the possible usefulness of THC:CBD oromucosal spray in individual patients with moderate to severe spasticity resistant to existing therapies, within the frame of use approved after large clinical trial results. Perhaps the most important finding is the possibility of obtaining relevant improvements in QoL/ADL in some patients with resistant MS spasticity, allowing them to engage back in physical and social activities. © 2014 S. Karger AG, Basel.

29 CFR 516.6 - Records to be preserved 2 years.

Code of Federal Regulations, 2010 CFR

2010-07-01

... time and earning cards or sheets on which are entered the daily starting and stopping time of... like) which the employer retains or makes in the usual course of business operations. (c) Records of...

Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial).

PubMed

James, Erica L; Ewald, Ben; Johnson, Natalie; Brown, Wendy; Stacey, Fiona G; Mcelduff, Patrick; Booth, Angela; Yang, Fan; Hespe, Charlotte; Plotnikoff, Ronald C

2014-12-29

Physical inactivity is fourth in the list of risk factors for global mortality. General practitioners are well placed to offer physical activity counseling but insufficient time is a barrier. Although referral to an exercise specialist is an alternative, in Australia, these allied health professionals are only publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. Accordingly, this trial aims to determine the efficacy of GP referral of insufficiently active patients (regardless of their chronic disease status) for physical activity counseling (either face-to-face or predominately via telephone) by exercise specialists, based on patients' objectively assessed physical activity levels, compared with usual care. If the trial is efficacious, the equivalence and cost-effectiveness of face-to-face counseling versus telephone counseling will be assessed. This three arm pragmatic randomized trial will involve the recruitment of 261 patients from primary care clinics in metropolitan and regional areas of New South Wales, Australia. Insufficiently active (less than 7000 steps/day) consenting adult patients will be randomly assigned to: 1) five face-to-face counseling sessions, 2) one face-to-face counseling session followed by four telephone calls, or 3) a generic mailed physical activity brochure (usual care). The interventions will operationalize social cognitive theory via a behavior change counseling framework. Participants will complete a survey and seven days of pedometry at baseline, and at three and 12 months post-randomization. The primary analyses will be based on intention-to-treat principles and will compare: (i) mean change in average daily step counts between baseline and 12 months for the combined intervention group (Group 1: face-to-face, and Group 2: telephone) and usual care (Group 3); (ii) step counts at 3 months post-randomization. Secondary outcomes include: self-reported physical activity, sedentary behavior, quality of life, and depression. If referral of primary care patients to exercise specialists increases physical activity, this process offers the prospect of systematically and sustainably reaching a large proportion of insufficiently active adults. If shown to be efficacious this trial provides evidence to expand public funding beyond those with a chronic disease and for delivery via telephone as well as face-to-face consultations. Australian New Zealand Clinical Trials Registry ACTRN12611000884909 .

Overeat today, skip the scale tomorrow: An examination of caloric intake predicting nonadherence to daily self-weighing.

PubMed

Tanenbaum, Molly L; Ross, Kathryn M; Wing, Rena R

2016-11-01

Daily self-weighing is an effective weight loss strategy. Little is known about "micro" factors influencing nonadherence to self-weighing (e.g., daily overeating). It was hypothesized that increased caloric intake on a given day would increase odds of not self-weighing the following day. Daily self-reports of weight and caloric intake were collected from 74 adults with overweight and obesity (mean BMI = 31.2 ± 4.5 kg/m 2 , age = 50.6 ± 10 years, 69% female, 87% Caucasian) throughout a 12-week Internet-based weight management intervention. Multilevel logistic regression investigated odds of nonadherence to self-weighing on a given day based on the previous day's caloric intake. Self-monitoring adherence was high (weights: 87%; calories: 85%); adherence was associated with greater 12-week weight loss (weighing: r = -0.24, P = 0.04; calories: r = -0.26, P = 0.04). Increased caloric intake on a given day, relative to the individual's average intake, was associated with increased odds of nonadherence to self-weighing the next day (F (1,5106)  = 12.66, P = 0.0004, β = 0.001). For example, following a day of eating 300 calories more than usual, odds of not self-weighing increased by 1.33. Odds of nonadherence to self-weighing increased following a day with higher-than-usual caloric intake. Weight management interventions collecting daily self-monitoring data could provide support to participants who report increased caloric intake to prevent self-weighing nonadherence. © 2016 The Obesity Society.

Prevention and treatment of hand oedema after stroke.

PubMed

Kuppens, Stefanie P M; Pijlman, Hanneke C P; Hitters, Minou W M G C; van Heugten, Caroline M

2014-01-01

As there is no evidence for a specific treatment for post-stroke-induced hand oedema, rehabilitation centre Blixembosch formalized a best practice protocol. We investigated whether the Blixembosch hand oedema protocol is usable in daily practice and leads to lower incidence (prevention) and shorter duration (treatment) compared with care as usual. In a non-randomised comparative trial, we investigated 206 post-stroke patients admitted to two Dutch rehabilitation centres. Hand volumes were measured at least bi-weekly using a volumeter. Treatment was started according the protocol (Blixembosch) or following care as usual (Leijpark). Usability was assessed with a survey among professionals. In the Blixembosch group, 16% developed oedema after admission, compared with 21% in the control group (p = 0.019). Average duration of oedema (both developed before and after admission) was 6.5 weeks in the Blixembosch group compared with 3.1 weeks in the control group (p = 0.000). Professionals were positive about the protocol. The study showed that the protocol is usable in daily practice and has a small beneficial effect on hand oedema incidence rates compared with care as usual. The negative effect on duration of hand oedema could also be caused by the difference in prognosis between the two groups.

The 'Cancer Home-Life Intervention': A randomised controlled trial evaluating the efficacy of an occupational therapy-based intervention in people with advanced cancer.

PubMed

Pilegaard, Marc Sampedro; la Cour, Karen; Gregersen Oestergaard, Lisa; Johnsen, Anna Thit; Lindahl-Jacobsen, Line; Højris, Inger; Brandt, Åse

2018-04-01

People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. To evaluate the efficacy of the 'Cancer Home Life-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life. A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The 'Cancer Home-Life Intervention' is a brief, tailored, occupational therapy-based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: -0.04 logits (95% confidence interval: -0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. In most cases, the 'Cancer Home-Life Intervention' was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants' everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.

Active Mobility and Environment: A Pilot Qualitative Study for the Design of a New Questionnaire

PubMed Central

Salze, Paul; Weber, Christiane; Feuillet, Thierry; Charreire, Hélène; Menai, Mehdi; Perchoux, Camille; Nazare, Julie-Anne; Simon, Chantal; Oppert, Jean-Michel

2017-01-01

It is generally accepted that active mobility, mainly walking and cycling, contributes to people’s physical and mental health. One of the current challenges is to improve our understanding of this type of behaviour. This study aims to identify factors from the daily-life environment that may be related to active mobility behaviours, in order to design a new questionnaire for a quantitative study of a large adult population. The new questionnaire obtained through this pilot study combines information from interviews with existing questionnaires materials in order to introduce new factors while retaining the factors already assessed. This approach comprises three stages. The first was a content analysis (Reinert method) of interviews with a sample of participants about daily living activities as well as mobility. This stage led to a typology of factors suggested by interviews. The second was a scoping review of the literature in order to identify the active mobility questionnaires currently used in international literature. The last stage was a cross-tabulation of the factors resulting from the written interviews and the questionnaires. A table of the inter-relationships between the interview-based typology and the questionnaires shows discrepancies between factors considered by the existing questionnaires, and factors coming from individual interviews. Independent factors which were ignored in or absent from the questionnaires are the housing situation within the urban structure, overall consideration of the activity space beyond the limits of the residential neighbourhood, the perception of all the transportation modes, and the time scheduling impacting the modes actually used. Our new questionnaire integrates both the usual factors and the new factors that may be related to active mobility behaviours. PMID:28052086

Active Mobility and Environment: A Pilot Qualitative Study for the Design of a New Questionnaire.

PubMed

Hess, Franck; Salze, Paul; Weber, Christiane; Feuillet, Thierry; Charreire, Hélène; Menai, Mehdi; Perchoux, Camille; Nazare, Julie-Anne; Simon, Chantal; Oppert, Jean-Michel; Enaux, Christophe

2017-01-01

It is generally accepted that active mobility, mainly walking and cycling, contributes to people's physical and mental health. One of the current challenges is to improve our understanding of this type of behaviour. This study aims to identify factors from the daily-life environment that may be related to active mobility behaviours, in order to design a new questionnaire for a quantitative study of a large adult population. The new questionnaire obtained through this pilot study combines information from interviews with existing questionnaires materials in order to introduce new factors while retaining the factors already assessed. This approach comprises three stages. The first was a content analysis (Reinert method) of interviews with a sample of participants about daily living activities as well as mobility. This stage led to a typology of factors suggested by interviews. The second was a scoping review of the literature in order to identify the active mobility questionnaires currently used in international literature. The last stage was a cross-tabulation of the factors resulting from the written interviews and the questionnaires. A table of the inter-relationships between the interview-based typology and the questionnaires shows discrepancies between factors considered by the existing questionnaires, and factors coming from individual interviews. Independent factors which were ignored in or absent from the questionnaires are the housing situation within the urban structure, overall consideration of the activity space beyond the limits of the residential neighbourhood, the perception of all the transportation modes, and the time scheduling impacting the modes actually used. Our new questionnaire integrates both the usual factors and the new factors that may be related to active mobility behaviours.

Alcohol consumption and cardiovascular mortality accounting for possible misclassification of intake: 11-year follow-up of the Melbourne Collaborative Cohort Study.

PubMed

Harriss, Linton R; English, Dallas R; Hopper, John L; Powles, John; Simpson, Julie A; O'Dea, Kerin; Giles, Graham G; Tonkin, Andrew M

2007-10-01

To investigate the relationship between usual daily alcohol intake, beverage type and drinking frequency on cardiovascular (CVD) and coronary heart disease (CHD) mortality, accounting for systematic misclassification of intake. Prospective cohort study with mean follow-up of 11.4 years. Setting The Melbourne Collaborative Cohort Study, Australia. A total of 38 200 volunteers (23 044 women) aged 40-69 years at baseline (1990-1994). Self-reported alcohol intake using beverage-specific quantity-frequency questions (usual intake) and drinking diary for previous week. Compared with life-time abstention, usual daily alcohol intake was associated with lower CVD and CHD mortality risk for women but not men. For women, the hazard ratio [HR (95% CI)] for CVD for those drinking > 20 g/day alcohol was 0.43 (0.19-0.95; P trend = 0.18), and for CHD, 0.19 (0.05-0.82; P trend = 0.24). Male former drinkers had over twice the mortality risk for CVD [HR = 2.58 (1.51-4.41)] and CHD [HR = 2.91 (1.59-5.33)]. Wine was the only beverage associated inversely with mortality for women. Compared with drinkers who consumed no alcohol in the week before baseline, drinking frequency was associated inversely with CVD and CHD mortality risk for men but not women. HR for men drinking 6-7 days/week was 0.49 (0.29-0.81; P trend = 0.02) for CVD, and 0.49 (0.26-0.92: P trend = 0.23) for CHD. Usual daily alcohol intake was associated with reduced CVD and CHD mortality for women but not men. This benefit appeared to be mainly from wine, although comparison of beverages was not possible. Drinking frequency was associated inversely with CVD and CHD death for men but not women.

Diurnal characteristics of ecosystem respiration of alpine meadow on the Qinghai-Tibetan Plateau: implications for carbon budget estimation.

PubMed

Qin, Yu; Yi, Shuhua

2013-01-01

Accurately estimating daily mean ecosystem respiration rate (Re) is important for understanding how ecosystem carbon budgets will respond to climate change. Usually, daily mean Re is represented by measurement using static chamber on alpine meadow ecosystems from 9:00 to 11:00 h a.m. local time directly. In the present study, however, we found that the calculated daily mean Re from 9:00 to 11:00 h a.m. local time was significantly higher than that from 0:00 to 23:30 h local time in an alpine meadow site, which might be caused by special climate condition on the Qinghai-Tibetan Plateau. Our results indicated that the calculated daily mean Re from 9:00 to 11:00 h a.m. local time cannot be used to represent daily mean Re directly.

Pain interference impacts response to treatment for anxiety disorders.

PubMed

Teh, Carrie Farmer; Morone, Natalia E; Karp, Jordan F; Belnap, Bea Herbeck; Zhu, Fang; Weiner, Debra K; Rollman, Bruce L

2009-01-01

Anxiety disorders and pain are commonly comorbid, though little is known about the effect of pain on the course and treatment of anxiety. This is a secondary analysis of a randomized controlled trial for anxiety treatment in primary care. Participants with panic disorder (PD) and/or generalized anxiety disorder (GAD) (N=191; 81% female, mean age 44) were randomized to either their primary-care physician's usual care or a 12-month course of telephone-based collaborative care. Anxiety severity, pain interference, health-related quality of life, health services use, and employment status were assessed at baseline, and at 2-, 4-, 8-, and 12-month follow-up. We defined response to anxiety treatment as a 40% or greater improvement from baseline on anxiety severity scales at 12-month follow-up. The 39% who reported high pain interference at baseline had more severe anxiety (mean SIGH-A score: 21.8 versus 18.0, P<.001), greater limitations in activities of daily living, and more work days missed in the previous month (5.8 versus 4.0 days, P=.01) than those with low pain interference. At 12-month follow-up, high pain interference was associated with a lower likelihood of responding to anxiety treatment (OR=.28; 95% CI=.12-.63) and higher health services use (26.1% with >/=1 hospitalization versus 12.0%, P<.001). Pain that interferes with daily activities is prevalent among primary care patients with PD/GAD and associated with more severe anxiety, worse daily functioning, higher health services use, and a lower likelihood of responding to treatment for PD/GAD. (c) 2009 Wiley-Liss, Inc.

Misclassification of fourth-grade children's participation in school-provided meals based on parental responses relative to administrative daily records.

PubMed

Baxter, Suzanne Domel; Paxton-Aiken, Amy E; Royer, Julie A; Hitchcock, David B; Guinn, Caroline H; Finney, Christopher J

2014-09-01

Although many studies have relied on parental responses concerning children's school-meal participation, few studies have evaluated parental response accuracy. We investigated misclassification of fourth-grade children's participation in school-meal programs based on parental responses relative to administrative daily records using cross-sectional study data collected for 3 school years (2004-05, 2005-06, and 2006-07) for 1,100 fourth-grade children (87% black; 52% girls) from 18 schools total in one district. Parents reported children's usual school-meal participation on paper consent forms. The district provided administrative daily records of individual children's school-meal participation. Researchers measured children's weight and height. "Usual participation" in breakfast/lunch was defined as ≥50% of days. Parental responses misclassified 16.3%, 12.8%, 19.8%, and 4.7% of children for participation in breakfast, classroom breakfast, cafeteria breakfast, and lunch, respectively. Parental responses misclassified more children for participation in cafeteria than classroom breakfast (P=0.0008); usual-participant misclassification probabilities were less than nonusual-participant misclassification probabilities for classroom breakfast, cafeteria breakfast, and lunch (P<0.0001 for each) (two-proportion z tests). Parental responses concerning children's participation were more accurate for lunch than breakfast; parents overstated breakfast participation (both classroom and cafeteria) and lunch participation. Breakfast participation misclassification was not related to body mass index (P=0.41), sex (P=0.40), age (P=0.63), or socioeconomic status (P=0.21) (multicategory logistic regression controlling for school year, breakfast location, and school). Relying on parental responses concerning children's school-meal participation may hamper researchers' abilities to detect relationships that have policy implications for the child nutrition community. The use of administrative daily records of children's school-meal participation is recommended. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Effects of tai chi on cognition and instrumental activities of daily living in community dwelling older people with mild cognitive impairment.

PubMed

Siu, Mei-Yi; Lee, Diana T F

2018-02-02

Cognitive impairment places older adults at high risk of functional disability in their daily-life activities, and thus affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong. The study adopted a multi-site nonequivalent control-group pretest-posttest design. 160 community-dwelling older people, aged ≥60, with MCI, from four community elderly centers participated in the study. The intervention group (IG, n = 80) received training in the Yang-style simple form of Tai Chi, at a frequency of two lessons per week for 16 weeks. Each lesson lasted for one hour. The control group (CG, n = 80) had no treatment regime and joined different recreational activity groups in community centers as usual within the study period. Outcome measures included measures of global cognitive status and IADL. The Chinese version of the Mini-Mental State Examination (CMMSE) was used for global cognitive assessment. The Hong Kong Chinese version of Lawton's Instrumental Activities of Daily Living (IADL-CV) was used to assess the participants' IADL levels. General Estimating Equations (GEE) was used to examine each of the outcome variables for the two groups at the two study time points (the baseline and at the end of the study). Meanwhile, minimum detectable change (MDC) was calculated to estimate the magnitude of changes required to eradicate the possibility of measurement error of outcome measures. Seventy four participants in the IG and 71 participants in the CG completed the study. With adjustments for differences in age, education, marital status and living conditions, the findings revealed that the participants in the IG scored significantly better on the CMMSE test (P = 0.001), and the instrumental ADL questionnaire (P = 0.004). However, those scores changes did not exceed the limits of the respective MDCs in the study, the possibility of measurement variation due to error could not be excluded. Tai Chi may be an effective strategy to enhance cognitive health and maintain functional abilities in instrumental ADL in older people with MCI. NCT03404765 (Retrospectively registered January 19, 2018).

Independent effects of sleep duration and body mass index on the risk of a work-related injury: evidence from the US National Health Interview Survey (2004-2010).

PubMed

Lombardi, David A; Wirtz, Anna; Willetts, Joanna L; Folkard, Simon

2012-06-01

Fatigue has been linked to adverse safety outcomes, and poor quality or decreased sleep has been associated with obesity (higher body mass index, BMI). Additionally, higher BMI is related to an increased risk for injury; however, it is unclear whether BMI modifies the effect of short sleep or has an independent effect on work-related injury risk. To answer this question, the authors examined the risk of a work-related injury as a function of total daily sleep time and BMI using the US National Health Interview Survey (NHIS). The NHIS is an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian population. Data were pooled for the 7-yr survey period from 2004 to 2010 for 101 891 "employed" adult subjects (51.7%; 41.1 ± yrs of age [mean ± SEM]) with data on both sleep and BMI. Weighted annualized work-related injury rates were estimated across a priori defined categories of BMI: healthy weight (BMI: <25), overweight (BMI: 25-29.99), and obese (BMI: ≥30) and also categories of usual daily sleep duration: <6, 6-6.99, 7-7.99, 8-8.99, and ≥9 h. To account for the complex sampling design, including stratification, clustering, and unequal weighting, weighted multiple logistic regression was used to estimate the risk of a work-related injury. The initial model examined the interaction among daily sleep duration and BMI, controlling for weekly working hours, age, sex, race/ethnicity, education, type of pay, industry, and occupation. No significant interaction was found between usual daily sleep duration and BMI (p = .72); thus, the interaction term of the final logistic model included these two variables as independent predictors of injury, along with the aforementioned covariates. Statistically significant covariates (p ≤ .05) included age, sex, weekly work hours, occupation, and if the worker was paid hourly. The lowest categories of usual sleep duration (<6 and 6-6.9 h) showed significantly (p ≤ .05) elevated injury risks than the referent category (7-8 h sleep), whereas sleeping >7-8 h did not significantly elevate risk. The adjusted injury risk odds ratio (OR) for a worker with a usual daily sleep of <6 h was 1.86 (95% confidence interval [CI]: 1.37-2.52), and for 6-6.9 h it was 1.46 (95% CI: 1.18-1.80). With regards to BMI, the adjusted injury risk OR comparing workers who were obese (BMI: ≥30) to healthy weight workers (BMI: <25) was 1.34 (95% CI: 1.09-1.66), whereas the risk in comparing overweight workers (BMI: 25-29.99) to healthy weight risk was elevated, but not statistically significant (OR = 1.08; 95% CI: .88-1.33). These results from a large representative sample of US workers suggest increase in work-related injury risk for reduced sleep regardless of worker's body mass. However, being an overweight worker also increases work-injury risk regardless of usual daily sleep duration. The independent additive risk of these factors on work-related injury suggests a substantial, but at least partially preventable, risk.

Correlation structures in short-term variabilities of stock indices and exchange rates

NASA Astrophysics Data System (ADS)

Nakamura, Tomomichi; Small, Michael

2007-09-01

Financial data usually show irregular fluctuations and some trends. We investigate whether there are correlation structures in short-term variabilities (irregular fluctuations) among financial data from the viewpoint of deterministic dynamical systems. Our method is based on the small-shuffle surrogate method. The data we use are daily closing price of Standard & Poor's 500 and the volume, and daily foreign exchange rates, Euro/US Dollar (USD), British Pound/USD and Japanese Yen/USD. We found that these data are not independent.

COMPARISON OF THE EFFECTS OF PAPAIN AND VITAMIN A ON CARTILAGE

PubMed Central

Thomas, Lewis; McCluskey, Robert T.; Potter, Jacobus L.; Weissmann, Gerald

1960-01-01

The administration of large amounts of vitamin A to rabbits has been shown to result in depletion of cartilage matrix. The normal basophilic, metachromatic, and Alcian blue staining properties of the matrix are lost, especially in articular and epiphyseal cartilage. The cartilage cells remain intact, but are reduced in size. These changes sometimes appeared as early as 48 hours after the initiation of daily injection of 1 million units of vitamin A, and were usually well established by 5 days. Some rabbits failed to show changes in cartilage, even after 5 daily injections. Increased amounts of material presumed to be chondroitin sulfate were present in the sera of vitamin A-treated rabbits, usually by 72 hours after the first injection. This was demonstrated by a turbidimetric procedure using hexamminecobaltic chloride. In rabbits given sulfur-35 (Na2S35O4) 5 days before the initiation of vitamin A treatment, it was shown that sulfur-35 was lost from articular and epiphyseal cartilage. This was associated with an increase in the non-dialyzable sulfur-35 in both serum and in the cobalt-precipitable material. These rabbits also excreted more sulfur-35 than rabbits not given vitamin A. There was a reduction in sulfur-35 activity in chondromucoprotein extracted from the ear cartilage of vitamin A-treated rabbits. The changes are interpreted as indicating that the administration of large amounts of vitamin A to rabbits results in removal of chondroitin sulfate from cartilage matrix. The administration of small amounts of crude papain causes histologic changes in cartilage that are remarkably similar to those seen in vitamin A-treated rabbits. The possibility is suggested that the changes in cartilage produced by administration of vitamin A to rabbits may be the result of activation of a proteolytic enzyme or enzymes, with properties similar to those of papain. PMID:13776507

The Sea Floor: A Living Learning Residential Community

NASA Astrophysics Data System (ADS)

Guentzel, J. L.; Rosch, E.; Stoughton, M. A.; Bowyer, R.; Mortensen, K.; Smith, M.

2016-02-01

Living learning communities are collaborations between university housing and academic departments designed to enhance the overall student experience by integrating classroom/laboratory learning, student life and extracurricular activities. At Coastal Carolina University, the residential community associated with the Marine Science program is known as the Sea Floor. Students selected to become members of the Sea Floor remain "in residence" for two consecutive semesters. These students are first-time freshman that share a common course connection. This course is usually Introduction to Marine Science (MSCI 111) or MSCI 399s, which are one credit field/laboratory centered internships. The common course connection is designed so residents can establish and maintain an educational dialog with their peers. Activities designed to enhance the students' networking skills and educational and social development skills include monthly lunches with marine science faculty and dinner seminars with guest speakers from academia, industry and government. Additionally, each semester several activities outside the classroom are planned so that students can more frequently interact with themselves and their faculty and staff partners. These activities include field trips to regional aquariums, local boat trips that include water sample collection and analysis, and an alternative spring break trip to the Florida Keys to study the marine environment firsthand. The resident advisor that supervises the Sea Floor is usually a sophomore or junior marine science major. This provides the residents with daily communication and mentoring from a marine science major that is familiar with the marine science program and residence life. Assessment activities include: a university housing community living survey, student interest housing focus groups, fall to spring and fall to fall retention, and evaluation of program advisors and program activities.

Why do children think they get discomfort related to daily activities?

PubMed

Coleman, Jemma; Straker, Leon; Ciccarelli, Marina

2009-01-01

Children commonly report musculoskeletal discomfort related to different activities such as computer use, playing electronic games, watching TV, reading, and performing physical and hand intensive activities. Discomfort can result in disability and is a strong predictor of future discomfort in adulthood. Adult beliefs regarding discomfort can affect the level of disability and are modifiable. Children's beliefs regarding discomfort could potentially be modified to minimise disability related to musculoskeletal disorders. The aim of this study was to describe children's beliefs about why they experience musculoskeletal discomfort, both in general and related to specific activities. Eighty eight school children completed questionnaires on frequency and usual duration of nine activities, whether they had felt discomfort and what they believed was the cause of any discomfort in relation to those activities. The most common activity was TV watching, and most activities were performed for 1 hour or shorter. Bad posture and doing too much of a certain activity were the most common beliefs regarding reasons for discomfort. This study shows that children are developing beliefs that tend to reflect scientific knowledge about risk factors. These beliefs could be incorporated into preventative health interventions.

A structured training programme for caregivers of inpatients after stroke (TRACS): a cluster randomised controlled trial and cost-effectiveness analysis.

PubMed

Forster, Anne; Dickerson, Josie; Young, John; Patel, Anita; Kalra, Lalit; Nixon, Jane; Smithard, David; Knapp, Martin; Holloway, Ivana; Anwar, Shamaila; Farrin, Amanda

2013-12-21

Most patients who have had a stroke are dependent on informal caregivers for activities of daily living. The TRACS trial investigated a training programme for caregivers (the London Stroke Carers Training Course, LSCTC) on physical and psychological outcomes, including cost-effectiveness, for patients and caregivers after a disabling stroke. We undertook a pragmatic, multicentre, cluster randomised controlled trial with a parallel cost-effectiveness analysis. Stroke units were eligible if four of five criteria used to define a stroke unit were met, a substantial number of patients on the unit had a diagnosis of stroke, staff were able to deliver the LSCTC, and most patients were discharged to a permanent place of residence. Stroke units were randomly assigned to either LSCTC or usual care (control group), stratified by geographical region and quality of care, and using blocks of size 2. Patients with a diagnosis of stroke, likely to return home with residual disability and with a caregiver providing support were eligible. The primary outcome for patients was self-reported extended activities of daily living at 6 months, measured with the Nottingham Extended Activities of Daily Living (NEADL) scale. The primary outcome for caregivers was self-reported burden at 6 months, measured with the caregivers burden scale (CBS). We combined patient and caregiver costs with primary outcomes and quality-adjusted life-years (QALYs) to assess cost-effectiveness. This trial is registered with controlled-trials.com, number ISRCTN 49208824. We assessed 49 stroke units for eligibility, of which 36 were randomly assigned to either the intervention group or the control group. Between Feb 27, 2008, and Feb 9, 2010, 928 patient and caregiver dyads were registered, of which 450 were in the intervention group, and 478 in the control group. Patients' self-reported extended activities of daily living did not differ between groups at 6 months (adjusted mean NEADL score 27·4 in the intervention group versus 27·6 in the control group, difference -0·2 points [95% CI -3·0 to 2·5], p value=0·866, ICC=0·027). The caregiver burden scale did not differ between groups either (adjusted mean CBS 45·5 in the intervention group versus 45·0 in the control group, difference 0·5 points [95% CI -1·7 to 2·7], p value=0·660, ICC=0·013). Patient and caregiver costs were similar in both groups (length of the initial stroke admission and associated costs were £13,127 for the intervention group and £12,471 for the control group; adjusted mean difference £1243 [95% CI -1533 to 4019]; p value=0·380). Probabilities of cost-effectiveness based on QALYs were low. In a large scale, robust evaluation, results from this study have shown no differences between the LSCTC and usual care on any of the assessed outcomes. The immediate period after stroke might not be the ideal time to deliver structured caregiver training. Medical Research Council. Copyright © 2013 Elsevier Ltd. All rights reserved.

Longitudinal wearable tremor measurement system with activity recognition algorithms for upper limb tremor.

PubMed

Jeonghee Kim; Parnell, Claire; Wichmann, Thomas; DeWeerth, Stephen P

2016-08-01

Assessments of tremor characteristics by movement disorder physicians are usually done at single time points in clinic settings, so that the description of the tremor does not take into account the dependence of the tremor on specific behavioral situations. Moreover, treatment-induced changes in tremor or behavior cannot be quantitatively tracked for extended periods of time. We developed a wearable tremor measurement system with tremor and activity recognition algorithms for long-term upper limb behavior tracking, to characterize tremor characteristics and treatment effects in their daily lives. In this pilot study, we collected sensor data of arm movement from three healthy participants using a wrist device that included a 3-axis accelerometer and a 3-axis gyroscope, and classified tremor and activities within scenario tasks which resembled real life situations. Our results show that the system was able to classify the tremor and activities with 89.71% and 74.48% accuracies during the scenario tasks. From this results, we expect to expand our tremor and activity measurement in longer time period.

Effects of Self-Management Support on Structure, Process, and Outcomes Among Vulnerable Patients With Diabetes

PubMed Central

Schillinger, Dean; Handley, Margaret; Wang, Frances; Hammer, Hali

2009-01-01

OBJECTIVE Despite the importance of self-management support (SMS), few studies have compared SMS interventions, involved diverse populations, or entailed implementation in safety net settings. We examined the effects of two SMS strategies across outcomes corresponding to the Chronic Care Model. RESEARCH DESIGN AND METHODS A total of 339 outpatients with poorly controlled diabetes from county-run clinics were enrolled in a three-arm trial. Participants, more than half of whom spoke limited English, were uninsured, and/or had less than a high school education, were randomly assigned to usual care, interactive weekly automated telephone self-management support with nurse follow-up (ATSM), or monthly group medical visits with physician and health educator facilitation (GMV). We measured 1-year changes in structure (Patient Assessment of Chronic Illness Care [PACIC]), communication processes (Interpersonal Processes of Care [IPC]), and outcomes (behavioral, functional, and metabolic). RESULTS Compared with the usual care group, the ATSM and GMV groups showed improvements in PACIC, with effect sizes of 0.48 and 0.50, respectively (P < 0.01). Only the ATSM group showed improvements in IPC (effect sizes 0.40 vs. usual care and 0.25 vs. GMV, P < 0.05). Both SMS arms showed improvements in self-management behavior versus the usual care arm (P < 0.05), with gains being greater for the ATSM group than for the GMV group (effect size 0.27, P = 0.02). The ATSM group had fewer bed days per month than the usual care group (−1.7 days, P = 0.05) and the GMV group (−2.3 days, P < 0.01) and less interference with daily activities than the usual care group (odds ratio 0.37, P = 0.02). We observed no differences in A1C change. CONCLUSIONS Patient-centered SMS improves certain aspects of diabetes care and positively influences self-management behavior. ATSM seems to be a more effective communication vehicle than GMV in improving behavior and quality of life. PMID:19131469

Actual and Potential Effects of Medical Resident Coverage on Reimbursement for Inpatient Visits by Attending Physicians

PubMed Central

Shine, Daniel; Jessen, Laurie; Bajaj, Jasmeet; Pencak, Dorothy; Panush, Richard

2002-01-01

CONTEXT The impact of residents on hospital finance has been studied; there are no data describing the economic effect of residents on attending physicians. OBJECTIVE In a community teaching hospital, we compared allowable inpatient visit codes and payments (based on documentation in the daily progress notes) between a general medicine teaching unit and nonteaching general medicine units. DESIGN Retrospective chart review, matched cohort study. SETTING Six hundred fifty–bed community teaching hospital. PATIENTS Patients were discharged July 1998 through February 1999 from Saint Barnabas Medical Center. We randomly selected 200 patients in quartets. Each quartet consisted of a pair of patients cared for by residents and a pair cared for only by an attending physician. In each pair, 1 of the patients was under the care of an attending physician who usually admitted to the teaching service, and 1 was under the care of a usually nonteaching attending. Within each quartet, patients were matched for diagnosis-related group, length of stay, and discharge date. MAIN OUTCOME MEASURES We assigned the highest daily visit code justifiable by resident and attending chart documentation, determining relative value units (RVUs) and reimbursements allowed by each patient's insurance company. RESULTS Although more seriously ill, teaching-unit patients generated a mean 1.75 RVUs daily, compared with 1.84 among patients discharged from nonteaching units (P = .3). Median reimbursement, daily and per hospitalization, was similar on teaching and nonteaching units. Nonteaching attendings documented higher mean daily RVUs than teaching attendings (1.83 vs 1.76, P = .2). Median allowable reimbursements were $267 per case ($53 daily) among teaching attendings compared with $294 per case ($58 daily) among nonteaching attendings (Z = 1.54, P = .1). When only the resident note was considered, mean daily RVUs increased 39% and median allowable dollars per day 27% (Z = 4.21, P < .001). CONCLUSIONS Nonteaching attendings appear to document their visits more carefully from a billing perspective than do teaching attendings. Properly counter-documented, resident notes could substantially increase payments to attending physicians. PMID:12133156

Increasing physical activity in stroke survivors using STARFISH, an interactive mobile phone application: a pilot study.

PubMed

Paul, Lorna; Wyke, Sally; Brewster, Stephen; Sattar, Naveed; Gill, Jason M R; Alexander, Gillian; Rafferty, Danny; McFadyen, Angus K; Ramsay, Andrew; Dybus, Aleksandra

2016-06-01

Following stroke, people are generally less active and more sedentary which can worsen outcomes. Mobile phone applications (apps) can support change in health behaviors. We developed STARFISH, a mobile phone app-based intervention, which incorporates evidence-based behavior change techniques (feedback, self-monitoring and social support), in which users' physical activity is visualized by fish swimming. To evaluate the potential effectiveness of STARFISH in stroke survivors. Twenty-three people with stroke (12 women; age: 56.0 ± 10.0 years, time since stroke: 4.2 ± 4.0 years) from support groups in Glasgow completed the study. Participants were sequentially allocated in a 2:1 ratio to intervention (n = 15) or control (n = 8) groups. The intervention group followed the STARFISH program for six weeks; the control group received usual care. Outcome measures included physical activity, sedentary time, heart rate, blood pressure, body mass index, Fatigue Severity Scale, Instrumental Activity of Daily Living Scale, Ten-Meter Walk Test, Stroke Specific Quality of Life Scale, and Psychological General Well-Being Index. The average daily step count increased by 39.3% (4158 to 5791 steps/day) in the intervention group and reduced by 20.2% (3694 to 2947 steps/day) in the control group (p = 0.005 for group-time interaction). Similar patterns of data and group-time interaction were seen for walking time (p = 0.002) and fatigue (p = 0.003). There were no significant group-time interactions for other outcome measures. Use of STARFISH has the potential to improve physical activity and health outcomes in people after stroke and longer term intervention trials are warranted.

Exercise or Social Intervention for Nursing Home Residents with Dementia: A Pilot Randomized, Controlled Trial.

PubMed

de Souto Barreto, Philipe; Cesari, Matteo; Denormandie, Philippe; Armaingaud, Didier; Vellas, Bruno; Rolland, Yves

2017-09-01

To compare the effects of exercise with those of a structured nonphysical intervention on ability to perform activities of daily living (ADLs) and physical and cognitive function of persons with dementia (PWDs) living in nursing homes (NH). Cluster-randomized pilot-controlled trial. Seven French NHs. PWDs living in NHs. NHs were randomized to an exercise group (4 NHs, n = 47) or structured social activity group (3 NHs, n = 50) for a 24-week intervention performed twice per week for 60 minutes per session. The main endpoint was ADL performance (Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory for Severe Alzheimer's Disease Scale (ADCS-ADL-sev); range 0-54, higher is better); secondary endpoints were overall cognitive function (Mini-Mental State Examination (MMSE)) and performance-based tests of physical function (Short Physical Performance Battery (SPPB), usual gait speed). Ninety-one participants with at least one postbaseline ADL assessment were included in efficacy analysis. Groups differed at baseline in terms of sex, neuropsychiatric symptoms, and nutritional status. Multilevel analysis adjusted for baseline differences between groups found no significant difference between effects of exercise and social activity (group-by-time interaction), with adjusted mean differences at 6 months of 1.9 points for ADCS-ADL-sev and 0.55 points for MMSE favoring social activity and 0.6 points for SPPB and 0.05 m/s favoring exercise. Adverse events did not differ between groups, except that the social activity group had more falls than the exercise group. A larger, longer trial is required to determine whether exercise has greater health benefits than nonphysical interventions for institutionalized PWDs. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Women's gender role orientation predicts their drinking patterns: a follow-up study of Czech women.

PubMed

Kubicka, Ludek; Csémy, Ladislav

2008-06-01

Evaluation of the hypothesis that women's non-traditional gender role orientation contributes to drinking patterns typical for men. A two-wave prospective study with data collected in 1992 and 1997. The data reflect Czech women's changing gender role orientation and their drinking patterns during a historical period of post-totalitarian societal transformation. A representative cohort of 497 Prague women aged 30-59 years in 1997. Face-to-face interview data on drinking patterns and individually collected original questionnaire on gender role orientation. An analysis of the principal components of the gender role orientation questionnaire has led to four components, designated as egalitarianism, liberalism, feminism and hedonism. Constructed role orientation scales had Cronbachs's alpha reliabilities ranging from 0.57 to 0.74. With possible confounders controlled (thanks mainly to the prospective design), non-traditional gender role orientation components assessed in 1992 predicted the usual quantities of alcohol women have consumed per occasion in 1997, as well as three hazardous drinking patterns (occasional use of > or = 96 g alcohol, usual use of > or = 48 g and daily intake of > or = 40 g). Specifically, women's usual quantity per occasion and occasional use of > or = 96 g were predicted by egalitarianism and hedonism, and hedonism predicted usual use of > or = 48 g as well as average daily intake of > or = 40 g ethanol. Women's gender role orientation can be associated with their drinking patterns with non-traditional gender role identification being associated with greater likelihood of hazardous drinking.

Daily physical activity in stable heart failure patients.

PubMed

Dontje, Manon L; van der Wal, Martje H L; Stolk, Ronald P; Brügemann, Johan; Jaarsma, Tiny; Wijtvliet, Petra E P J; van der Schans, Cees P; de Greef, Mathieu H G

2014-01-01

Physical activity is the only nonpharmacological therapy that is proven to be effective in heart failure (HF) patients in reducing morbidity. To date, little is known about the levels of daily physical activity in HF patients and about related factors. The objectives of this study were to (a) describe performance-based daily physical activity in HF patients, (b) compare it with physical activity guidelines, and (c) identify related factors of daily physical activity. The daily physical activity of 68 HF patients was measured using an accelerometer (SenseWear) for 48 hours. Psychological characteristics (self-efficacy, motivation, and depression) were measured using questionnaires. To have an indication how to interpret daily physical activity levels of the study sample, time spent on moderate- to vigorous-intensity physical activities was compared with the 30-minute activity guideline. Steps per day was compared with the criteria for healthy adults, in the absence of HF-specific criteria. Linear regression analyses were used to identify related factors of daily physical activity. Forty-four percent were active for less than 30 min/d, whereas 56% were active for more than 30 min/d. Fifty percent took fewer than 5000 steps per day, 35% took 5000 to 10 000 steps per day, and 15% took more than 10 000 steps per day. Linear regression models showed that New York Heart Association classification and self-efficacy were the most important factors explaining variance in daily physical activity. The variance in daily physical activity in HF patients is considerable. Approximately half of the patients had a sedentary lifestyle. Higher New York Heart Association classification and lower self-efficacy are associated with less daily physical activity. These findings contribute to the understanding of daily physical activity behavior of HF patients and can help healthcare providers to promote daily physical activity in sedentary HF patients.

Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial.

PubMed

Bul, Kim C M; Kato, Pamela M; Van der Oord, Saskia; Danckaerts, Marina; Vreeke, Leonie J; Willems, Annik; van Oers, Helga J J; Van Den Heuvel, Ria; Birnie, Derk; Van Amelsvoort, Thérèse A M J; Franken, Ingmar H A; Maras, Athanasios

2016-02-16

The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called "Plan-It Commander") as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder (ADHD). The aim was to determine the effects of Plan-It Commander on daily life skills of children with ADHD in a multisite randomized controlled crossover open-label trial. Participants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged in age from 8 to 12 years (male: 80.6%, 137/170; female: 19.4%, 33/170). They were randomized to a serious game intervention group (group 1; n=88) or a treatment-as-usual crossover group (group 2; n=82). Participants randomized to group 1 received a serious game intervention in addition to treatment as usual for the first 10 weeks and then received treatment as usual for the next 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10 weeks and crossed over to the serious game intervention in addition to treatment as usual for the subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and child self-report) outcome measures were administered at baseline, 10 weeks, and 10-week follow-up. After 10 weeks, participants in group 1 compared to group 2 achieved significantly greater improvements on the primary outcome of time management skills (parent-reported; P=.004) and on secondary outcomes of the social skill of responsibility (parent-reported; P=.04), and working memory (parent-reported; P=.02). Parents and teachers reported that total social skills improved over time within groups, whereas effects on total social skills and teacher-reported planning/organizing skills were nonsignificant between groups. Within group 1, positive effects were maintained or further improved in the last 10 weeks of the study. Participants in group 2, who played the serious game during the second period of the study (weeks 10 to 20), improved on comparable domains of daily life functioning over time. Plan-It Commander offers an effective therapeutic approach as an adjunct intervention to traditional therapeutic ADHD approaches that improve functional outcomes in daily life. International Standard Randomized Controlled Trial Number (ISRCTN): 62056259; http://www.controlled-trials.com/ISRCTN62056259 (Archived by WebCite at http://www.webcitation.org/6eNsiTDJV).

Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

PubMed Central

2016-01-01

Background The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called “Plan-It Commander”) as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder (ADHD). Objective The aim was to determine the effects of Plan-It Commander on daily life skills of children with ADHD in a multisite randomized controlled crossover open-label trial. Methods Participants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged in age from 8 to 12 years (male: 80.6%, 137/170; female: 19.4%, 33/170). They were randomized to a serious game intervention group (group 1; n=88) or a treatment-as-usual crossover group (group 2; n=82). Participants randomized to group 1 received a serious game intervention in addition to treatment as usual for the first 10 weeks and then received treatment as usual for the next 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10 weeks and crossed over to the serious game intervention in addition to treatment as usual for the subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and child self-report) outcome measures were administered at baseline, 10 weeks, and 10-week follow-up. Results After 10 weeks, participants in group 1 compared to group 2 achieved significantly greater improvements on the primary outcome of time management skills (parent-reported; P=.004) and on secondary outcomes of the social skill of responsibility (parent-reported; P=.04), and working memory (parent-reported; P=.02). Parents and teachers reported that total social skills improved over time within groups, whereas effects on total social skills and teacher-reported planning/organizing skills were nonsignificant between groups. Within group 1, positive effects were maintained or further improved in the last 10 weeks of the study. Participants in group 2, who played the serious game during the second period of the study (weeks 10 to 20), improved on comparable domains of daily life functioning over time. Conclusions Plan-It Commander offers an effective therapeutic approach as an adjunct intervention to traditional therapeutic ADHD approaches that improve functional outcomes in daily life. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 62056259; http://www.controlled-trials.com/ISRCTN62056259 (Archived by WebCite at http://www.webcitation.org/6eNsiTDJV). PMID:26883052

Effect of local diets with added sucrose on glycemic profiles of healthy and diabetic Brazilian subjects.

PubMed

Marchini, J S; Fáccio, J R; Rodrigues, M M; Unamuno, M R; Foss, M C; Dutra-de-Oliveira, J E

1994-12-01

We set out to determine the daily glycemic profile of healthy and non-insulin-dependent diabetes mellitus (NIDDM) persons and to test the hypothesis that small amounts of sucrose added to NIDDM meals would not change their responses. Thirteen NIDDM and six healthy volunteers participated in the study. They initially consumed a diet similar to their home diet and later a diabetic hospital dietary regimen, with and without 30 g/day sugar replacing equivalent food energy. The hospital diet included their usual foods: bread, milk, rice, beans, meat, vegetables and fruits at breakfast, lunch and dinner. To follow their glycemic profile we drew several blood samples during a 22-hour period. The day-long plasma glucose profile of the NIDDM and healthy subjects showed similar patterns, increasing after the meals and returning later to baseline levels. The extra amount of sucrose consumed did not change the daily glycemic profile or the calculated glycemic area under the 22-hour glycemic curves. These results call attention to the importance of the 22-hour glycemic profile compared to other shorter glycemic indexes. The 22-hour profile has obvious advantage for planning day-long diabetic diets, taking in consideration local daily foods and usual eating habits. Maintenance of a small and traditional amount of food, e.g., sucrose, without harmful effects to the subjects, is another advantage of this proposition. It improves patient compliance as well as social daily life.

Does leisure time moderate or mediate the effect of daily stress on positive affect? An examination using eight-day diary data

PubMed Central

Qian, Xinyi Lisa; Yarnal, Careen M.; Almeida, David M.

2013-01-01

This study tested the applicability of moderation and mediation models to leisure time as a stress coping resource. Analyzing eight-day diary data (N=2,022), we examined the within-person process of using leisure time to cope with daily stressors. We found that relatively high daily stress frequency, while reducing positive affect, prompted an individual to allocate more time to leisure than usual, which then increased positive affect, thus partially remedying the damage by high daily stress frequency. This within-person process, however, is significantly stronger among those with less leisure time on average than leisure-rich individuals. The findings support a partial counteractive mediation model, demonstrate between-person difference in the within-person coping process, and reveal the importance of positive affect as a coping outcome. PMID:25221350

Does leisure time moderate or mediate the effect of daily stress on positive affect? An examination using eight-day diary data.

PubMed

Qian, Xinyi Lisa; Yarnal, Careen M; Almeida, David M

2014-01-01

This study tested the applicability of moderation and mediation models to leisure time as a stress coping resource. Analyzing eight-day diary data (N=2,022), we examined the within -person process of using leisure time to cope with daily stressors. We found that relatively high daily stress frequency, while reducing positive affect, prompted an individual to allocate more time to leisure than usual, which then increased positive affect, thus partially remedying the damage by high daily stress frequency. This within-person process, however, is significantly stronger among those with less leisure time on average than leisure-rich individuals. The findings support a partial counteractive mediation model, demonstrate between-person difference in the within-person coping process, and reveal the importance of positive affect as a coping outcome.

[Age-related changes of sensory system].

PubMed

Iwamoto, Toshihiko; Hanyu, Haruo; Umahara, Takahiko

2013-10-01

Pathological processes usually superimpose on physiological aging even in the sensory system including visual, hearing, olfactory, taste and somatosensory functions. Representative changes of age-related changes are presbyopia, cataracts, and presbyacusis. Reduced sense of smell is seen in normal aging, but the prominent reduction detected by the odor stick identification test is noticed especially in early stage of Alzheimer or Parkinson disease. Reduced sense of taste is well-known especially in salty sense, while the changes of sweet, bitter, and sour tastes are different among individuals. Finally, deep sensation of vibration and proprioception is decreased with age as well as superficial sensation (touch, temperature, pain). As a result, impaired sensory system could induce deterioration of the activities of daily living and quality of life in the elderly.

Nanogenerators for Human Body Energy Harvesting.

PubMed

Proto, Antonino; Penhaker, Marek; Conforto, Silvia; Schmid, Maurizio

2017-07-01

Humans generate remarkable quantities of energy while performing daily activities, but this energy usually dissipates into the environment. Here, we address recent progress in the development of nanogenerators (NGs): devices that are able to harvest such body-produced biomechanical and thermal energies by exploiting piezoelectric, triboelectric, and thermoelectric physical effects. In designing NGs, the end-user's comfort is a primary concern. Therefore, we focus on recently developed materials giving flexibility and stretchability to NGs. In addition, we summarize common fabrics for NG design. Finally, the mid-2020s market forecasts for these promising technologies highlight the potential for the commercialization of NGs because they may help contribute to the route of innovation for developing self-powered systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Overactive Bladder Syndrome: Evaluation and Management.

PubMed

Leron, Elad; Weintraub, Adi Y; Mastrolia, Salvatore A; Schwarzman, Polina

2018-03-01

Overactive bladder (OAB) syndrome is a chronic medical condition which has a major influence on the quality of life in a significant amount of the population. OAB affects performance of daily activities and has an estimated prevalence of 16.5%. Many sufferers do not seek medical help. Moreover, many family physicians and even gynecologists are not familiar with this issue. Usually patients suffer from OAB in advanced age. Nocturia is reported as the most bothersome symptom in the elderly population. The aim of our review was to discuss all aspects of this challenging disorder and suggest tools for assessment and management strategies. Practitioners can easily overlook urinary complains if they not directly queried. We would like to encourage practitioners to give more attention to this issue.

Effectiveness of Personalized Feedback Alone or Combined with Peer Support to Improve Physical Activity in Sedentary Older Malays with Type 2 Diabetes: A Randomized Controlled Trial.

PubMed

Sazlina, Shariff-Ghazali; Browning, Colette Joy; Yasin, Shajahan

2015-01-01

Regular physical activity is an important aspect of self-management among older people with type 2 diabetes but many remain inactive. Interventions to improve physical activity levels have been studied but few studies have evaluated the effects of personalized feedback (PF) or peer support (PS); and there was no study on older people of Asian heritage. Hence, this trial evaluated whether PF only or combined with PS improves physical activity among older Malays with type 2 diabetes (T2DM) compared to usual care only. A three-arm randomized controlled trial was conducted in a primary healthcare clinic in Malaysia. Sixty-nine sedentary Malays aged 60 years and older with T2DM who received usual diabetes care were randomized to PF or PS interventions or as controls for 12 weeks with follow-ups at weeks 24 and 36. Intervention groups performed unsupervised walking activity and received written feedback on physical activity. The PS group also received group and telephone contacts from trained peer mentors. The primary outcome was pedometer steps. Secondary outcomes were self-reported physical activity, cardiovascular risk factors, cardiorespiratory fitness, balance, quality of life, and psychosocial wellbeing. Fifty-two (75.4%) completed the 36-week study. The PS group showed greater daily pedometer readings than the PF and controls (p = 0.001). The PS group also had greater improvement in weekly duration (p < 0.001) and frequency (p < 0.001) of moderate intensity physical activity, scores on the Physical Activity Scale for Elderly (p = 0.003), 6-min walk test (p < 0.001), and social support from friends (p = 0.032) than PF and control groups. The findings suggest that PF combined with PS in older Malays with T2DM improved their physical activity levels, cardiorespiratory fitness, and support from friends. Current Controlled Trials ISRCTN71447000.

Balance and gait performance in an urban and a rural population.

PubMed

Ringsberg, K A; Gärdsell, P; Johnell, O; Jónsson, B; Obrant, K J; Sernbo, I

1998-01-01

To compare the differences in standing balance and gait performance between two populations, correlated with age and physical activities of daily living. A cross-sectional study. Malmö, the third largest city in Sweden, and Sjöbo, a typical agricultural community 60 km east of Malmö. Participants were 570 men and women from the urban community (urban) and 391 from the rural community (rural), born in 1938, 1928, 1918, and 1908, and women born in 1948. The two cohorts were subdivided into true urbans, who had lived only in the city (n = 269), and true rurals, who had never lived in a city (n = 354). Information about workload, housing, spare time activities, medication, and illness during different decades of life was gathered using two questionnaires. The first questionnaire was sent to the home after agreement to participate, and the second was presented at the test session. The clinical measurements were standing balance, gait speed, and step length. The urban subjects had significantly (P < .001) impaired balance compared with rural subjects. This difference increased with increasing age. The urban subjects walked faster than the rural subjects (P < .001), and the urban subjects used fewer steps than their rural counterparts (P < .001). Spare time activities had a significant influence on the above tests, but, except for gait velocity (P = .011), workload was of minor importance according to analysis of covariance. Background factors such as usual daily activities of living and lifestyle seem to be of importance when evaluating and comparing different populations with respect to their balance and gait performance.

Quantifying daily physical activity and determinants in sedentary patients with Parkinson's disease.

PubMed

Dontje, M L; de Greef, M H G; Speelman, A D; van Nimwegen, M; Krijnen, W P; Stolk, R P; Kamsma, Y P T; Bloem, B R; Munneke, M; van der Schans, C P

2013-10-01

Although physical activity is beneficial for Parkinson's disease (PD) patients, many do not meet the recommended levels. The range of physical activity among sedentary PD patients is unknown, as are factors that determine this variability. Hence, we aimed to (1) assess daily physical activity in self-identified sedentary PD patients; (2) compare this with criteria of a daily physical activity guideline; and (3) identify determinants of daily physical activity. Daily physical activity of 586 self-identified sedentary PD patients was measured with a tri-axial accelerometer for seven consecutive days. Physical fitness and demographic, disease-specific, and psychological characteristics were assessed. Daily physical activity was compared with the 30-min activity guideline. A linear mixed-effects model was estimated to identify determinants of daily physical activity. Accelerometer data of 467 patients who fulfilled all criteria revealed that >98% of their day was spent on sedentary to light-intensity activities. Eighty-two percent of the participants were 'physically inactive' (0 days/week of 30-min activity); 17% were 'semi-active' (1-4 days/week of 30-min activity). Age, gender, physical fitness, and scores on the Unified Parkinson's Disease Rating Scale explained 69% of the variability in daily physical activity. Performance-based measurements confirmed that most self-identified sedentary PD patients are 'physically inactive'. However, the variance in daily physical activity across subjects was considerable. Higher age, being female, and lower physical capacity were the most important determinants of reduced daily physical activity. Future therapeutic interventions should aim to improve daily physical activity in these high-risk patients, focusing specifically on modifiable risk factors. Copyright © 2013 Elsevier Ltd. All rights reserved.

Integrated approach using multi-platform sensors for enhanced high-resolution daily ice cover product

NASA Astrophysics Data System (ADS)

Bonev, George; Gladkova, Irina; Grossberg, Michael; Romanov, Peter; Helfrich, Sean

2016-09-01

The ultimate objective of this work is to improve characterization of the ice cover distribution in the polar areas, to improve sea ice mapping and to develop a new automated real-time high spatial resolution multi-sensor ice extent and ice edge product for use in operational applications. Despite a large number of currently available automated satellite-based sea ice extent datasets, analysts at the National Ice Center tend to rely on original satellite imagery (provided by satellite optical, passive microwave and active microwave sensors) mainly because the automated products derived from satellite optical data have gaps in the area coverage due to clouds and darkness, passive microwave products have poor spatial resolution, automated ice identifications based on radar data are not quite reliable due to a considerable difficulty in discriminating between the ice cover and rough ice-free ocean surface due to winds. We have developed a multisensor algorithm that first extracts maximum information on the sea ice cover from imaging instruments VIIRS and MODIS, including regions covered by thin, semitransparent clouds, then supplements the output by the microwave measurements and finally aggregates the results into a cloud gap free daily product. This ability to identify ice cover underneath thin clouds, which is usually masked out by traditional cloud detection algorithms, allows for expansion of the effective coverage of the sea ice maps and thus more accurate and detailed delineation of the ice edge. We have also developed a web-based monitoring system that allows comparison of our daily ice extent product with the several other independent operational daily products.

Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study.

PubMed

Sharman, James E; Marwick, Thomas H; Gilroy, Deborah; Otahal, Petr; Abhayaratna, Walter P; Stowasser, Michael

2013-12-01

Arm cuff blood pressure (BP) may overestimate cardiovascular risk. Central aortic BP predicts mortality and could be a better method for patient management. We sought to determine the usefulness of central BP to guide hypertension management. This was a prospective, open-label, blinded-end point study in 286 patients with hypertension randomized to treatment decisions guided by best-practice usual care (n=142; using office, home, and 24-hour ambulatory BP) or, in addition, by central BP intervention (n=144; using SphygmoCor). Therapy was reviewed every 3 months for 12 months, and recommendations were provided to each patient and his/her doctor on antihypertensive medication titration. Outcome measures were as follows: medication quantity (daily defined dose), quality of life, and left ventricular mass (3-dimensional echocardiography). There was 92% compliance with recommendations on medication titration, and quality of life improved in both groups (post hoc P<0.05). For usual care, there was no change in daily defined dose (all P>0.10), but with intervention there was a significant stepwise decrease in daily defined dose from baseline to 3 months (P=0.008) and each subsequent visit (all P<0.001). Intervention was associated with cessation of medication in 23 (16%) patients versus 3 (2%) in usual care (P<0.001). Despite this, there were no differences between groups in left ventricular mass index, 24-hour ambulatory BP, home systolic BP, or aortic stiffness (all P>0.05). We conclude that guidance of hypertension management with central BP results in a significantly different therapeutic pathway than conventional cuff BP, with less use of medication to achieve BP control and no adverse effects on left ventricular mass, aortic stiffness, or quality of life.

Local warming: daily temperature change influences belief in global warming.

PubMed

Li, Ye; Johnson, Eric J; Zaval, Lisa

2011-04-01

Although people are quite aware of global warming, their beliefs about it may be malleable; specifically, their beliefs may be constructed in response to questions about global warming. Beliefs may reflect irrelevant but salient information, such as the current day's temperature. This replacement of a more complex, less easily accessed judgment with a simple, more accessible one is known as attribute substitution. In three studies, we asked residents of the United States and Australia to report their opinions about global warming and whether the temperature on the day of the study was warmer or cooler than usual. Respondents who thought that day was warmer than usual believed more in and had greater concern about global warming than did respondents who thought that day was colder than usual. They also donated more money to a global-warming charity if they thought that day seemed warmer than usual. We used instrumental variable regression to rule out some alternative explanations.

Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors: a randomised controlled trial protocol.

PubMed

Johnson, Liam; Bird, Marie-Louise; Muthalib, Makii; Teo, Wei-Peng

2018-01-09

The STRoke Interactive Virtual thErapy (STRIVE) intervention provides community-dwelling stroke survivors access to individualised, remotely supervised progressive exercise training via an online platform. This trial aims to determine the clinical efficacy of the STRIVE intervention and its effect on brain activity in community-dwelling stroke survivors. In a multisite, assessor-blinded randomised controlled trial, 60 stroke survivors >3 months poststroke with mild-to-moderate upper extremity impairment will be recruited and equally randomised by location (Melbourne, Victoria or Launceston, Tasmania) to receive 8 weeks of virtual therapy (VT) at a local exercise training facility or usual care. Participants allocated to VT will perform 3-5 upper limb exercises individualised to their impairment severity and preference, while participants allocated to usual care will be asked to maintain their usual daily activities. The primary outcome measures will be upper limb motor function and impairment, which will be assessed using the Action Research Arm Test and Upper Extremity Fugl-Meyer, respectively. Secondary outcome measures include upper extremity function and spasticity, as measured by the box and block test and Modified AshworthScale, respectively, and task-related changes in bilateral sensorimotor cortex haemodynamics during hand reaching and wrist extension movements as measured by functional near-infrared spectroscopy. Quality of life will be measured using the Euro-Quality of Life-5 Dimension-5 Level Scale, and the Motor Activity Log-28 will be used to measure use of the hemiparetic arm. All measures will be assessed at baseline and immediately postintervention. The study was approved by the Deakin University Human Research Ethics Committee in May 2017 (No. 2017-087). The results will be disseminated in peer-reviewed journals and presented at major international stroke meetings. ACTRN12617000745347; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors: a randomised controlled trial protocol

PubMed Central

Bird, Marie-Louise; Muthalib, Makii

2018-01-01

Introduction The STRoke Interactive Virtual thErapy (STRIVE) intervention provides community-dwelling stroke survivors access to individualised, remotely supervised progressive exercise training via an online platform. This trial aims to determine the clinical efficacy of the STRIVE intervention and its effect on brain activity in community-dwelling stroke survivors. Methods and analysis In a multisite, assessor-blinded randomised controlled trial, 60 stroke survivors >3 months poststroke with mild-to-moderate upper extremity impairment will be recruited and equally randomised by location (Melbourne, Victoria or Launceston, Tasmania) to receive 8 weeks of virtual therapy (VT) at a local exercise training facility or usual care. Participants allocated to VT will perform 3–5 upper limb exercises individualised to their impairment severity and preference, while participants allocated to usual care will be asked to maintain their usual daily activities. The primary outcome measures will be upper limb motor function and impairment, which will be assessed using the Action Research Arm Test and Upper Extremity Fugl-Meyer, respectively. Secondary outcome measures include upper extremity function and spasticity, as measured by the box and block test and Modified AshworthScale, respectively, and task-related changes in bilateral sensorimotor cortex haemodynamics during hand reaching and wrist extension movements as measured by functional near-infrared spectroscopy. Quality of life will be measured using the Euro-Quality of Life-5 Dimension-5 Level Scale, and the Motor Activity Log-28 will be used to measure use of the hemiparetic arm. All measures will be assessed at baseline and immediately postintervention. Ethics and dissemination The study was approved by the Deakin University Human Research Ethics Committee in May 2017 (No. 2017–087). The results will be disseminated in peer-reviewed journals and presented at major international stroke meetings. Trial registration number ACTRN12617000745347; Pre-results. PMID:29317414

Assessment of exposure for baby cosmetic care products in a Korean population.

PubMed

Lee, Eunyoung; Yun, Jongbok; Ha, Jaehyoun; Park, Byung Cheol; Park, Gyeong Hun; Kim, Hak Rim; Hong, Seung Phil; Kim, Kyu Bong; Kim, Myung Hwa

2017-08-01

Assessment of exposure to cosmetic products via the skin is important for evaluating the risks associated with the use of these products. However, few exposure studies have been conducted with babies, particularly in Asia. The aim of our study was to assess the exposure to selected cosmetic products in babies under the age of 36 months, over both winter and summer months. We evaluated exposure for seven cosmetic baby care products identified in a previous web-based survey as being commonly used by Korean parents. Parents were instructed to use their baby's products as per their usual habit, recording usage for each product on a daily basis over a 14-day period. Products were weighed at the start and completion of the study, with the change in weight used to determine the total amount of product used. Descriptive statistics for daily exposure were calculated. In this study, daily exposure for different products was influenced by sex, age groups and seasons. Of specific note, 3.51% of the lotion in a wet wipe was transferred to the skin. In conclusion, we provide baseline exposure data for baby products, with exposure being based on parents' usual use of the products. Copyright © 2017 Elsevier Ltd. All rights reserved.

5 CFR 351.203 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... competitive levels within the pay band, including (as appropriate) any applicable locality payment authorized... and forth daily to their usual employment. Modal rating is the summary rating level assigned most frequently among the actual ratings of record that are: (1) Assigned under the summary level pattern that...

PAIN INTERFERENCE IMPACTS RESPONSE TO TREATMENT FOR ANXIETY DISORDERS

PubMed Central

Teh, Carrie Farmer; Morone, Natalia E.; Karp, Jordan F.; Belnap, Bea Herbeck; Zhu, Fang; Weiner, Debra K.; Rollman, Bruce L.

2010-01-01

Background Anxiety disorders and pain are commonly comorbid, though little is known about the effect of pain on the course and treatment of anxiety. Methods This is a secondary analysis of a randomized controlled trial for anxiety treatment in primary care. Participants with panic disorder (PD) and/or generalized anxiety disorder (GAD) (N = 191; 81% female, mean age 44) were randomized to either their primary-care physician’s usual care or a 12-month course of telephone-based collaborative care. Anxiety severity, pain interference, health-related quality of life, health services use, and employment status were assessed at baseline, and at 2-, 4-, 8-, and 12-month follow-up. We defined response to anxiety treatment as a 40% or greater improvement from baseline on anxiety severity scales at 12-month follow-up. Results The 39% who reported high pain interference at baseline had more severe anxiety (mean SIGH-A score: 21.8 versus 18.0, P<.001), greater limitations in activities of daily living, and more work days missed in the previous month (5.8 versus 4.0 days, P = .01) than those with low pain interference. At 12-month follow-up, high pain interference was associated with a lower likelihood of responding to anxiety treatment (OR = .28; 95% CI = .12–.63) and higher health services use (26.1% with ≥1 hospitalization versus 12.0%, P<.001). Conclusions Pain that interferes with daily activities is prevalent among primary care patients with PD/GAD and associated with more severe anxiety, worse daily functioning, higher health services use, and a lower likelihood of responding to treatment for PD/GAD. PMID:19133701

Late-Life Exercise and Difficulty with Activities of Daily Living: an 8-Year Nationwide Follow-up Study in Taiwan.

PubMed

Ku, Po-Wen; Fox, Kenneth R; Gardiner, Paul A; Chen, Li-Jung

2016-04-01

Many studies have shown that low levels of exercise in later life are associated with the progression of difficulties with activities of daily living. However, few have assessed the independent effect of exercise components on difficulty in performing activities of daily living and explored whether the relationship between exercise and activities of daily living is reciprocal. This study aimed to examine, in a nationally representative sample of older Taiwanese, the independent effect of the frequency, duration, and intensity of exercise on difficulty with activities of daily living. A secondary objective was to explore the degree to which the relationship of late-life exercise with activities of daily living is bi-directional. Data from a fixed cohort (n = 1268, aged 70+) in 1999 with 8 years of follow-up were analyzed. Generalized estimating equation models with multivariate adjustment were performed. Participants engaging in higher levels of exercise had less difficulty with subsequent activities of daily living. Among the components of exercise, only duration, especially 30 min or more per session, was associated with fewer difficulties with activities of daily living. The relationship between exercise and activities of daily living was reciprocal, although the influence of activities of daily living on subsequent exercise levels was weaker. Exercise in later life may be able to minimize the difficulties in activities of daily living and help maintain the mobility and independence of older adults.

Leflunomide in active rheumatoid arthritis: a prospective study in daily practice.

PubMed

Van Roon, E N; Jansen, T L Th A; Mourad, L; Houtman, P M; Bruyn, G A W; Griep, E N; Wilffert, B; Tobi, H; Brouwers, J R B J

2004-06-01

We prospectively studied the efficacy, incidence of adverse drug reactions and withdrawal from leflunomide in an outpatient population with rheumatoid arthritis in a setting of care-as-usual. In this prospective case series study, from outpatient medical records a standard dataset was collected including patient and disease characteristics, data on leflunomide use and adverse drug reactions. During the study period 136 rheumatoid arthritis patients started leflunomide. Median (range) follow-up duration was 317 (11-911) days. Sixty-five percent of patients experienced at least one adverse drug reaction related to leflunomide. During follow-up 76 patients (56%) withdrew from leflunomide treatment, mainly because of adverse drug reactions (29%) or lack of efficacy (13%). The overall incidence density for withdrawal from leflunomide was 56.2 per 100 patient-years. Complete data for calculating efficacy using a validated disease activity score on 28 joints (DAS(28)) was available for 48, 36, and 35% of patients at 2, 6, and 12 months follow-up, respectively. Within a 12-month period after start of leflunomide treatment 76% of the evaluable patients were classified as moderate or good responders according to the DAS(28) response criteria. In the setting of care-as-usual, rheumatoid arthritis patients starting leflunomide frequently experienced adverse drug reactions. More than half of the patients withdrew from leflunomide treatment within a year after start of leflunomide treatment, mainly because of adverse drug reactions.

Leflunomide in active rheumatoid arthritis: a prospective study in daily practice.

PubMed

Van Roon, E N; Jansen, T L Th A; Mourad, L; Houtman, P M; Bruyn, G A W; Griep, E N; Wilffert, B; Tobi, H; Brouwers, J R B J

2004-08-01

We prospectively studied the efficacy, incidence of adverse drug reactions and withdrawal from leflunomide in an outpatient population with rheumatoid arthritis in a setting of care-as-usual. In this prospective case series study, a standard dataset was collected from outpatient medical records, including patient and disease characteristics, data on leflunomide use and adverse drug reactions. During the study period 136 rheumatoid arthritis patients started leflunomide. Median (range) follow-up duration was 317 (11-911) days. Sixty-five percent of patients experienced at least one adverse drug reaction related to leflunomide. During follow-up 76 patients (56%) withdrew from leflunomide treatment, mainly because of adverse drug reactions (29%) or lack of efficacy (13%). The overall incidence density for withdrawal from leflunomide was 56.2 per 100 patient years. Complete data for calculating efficacy using a validated disease activity score on 28 joints (DAS(28)) was available for 48, 36, and 35% of patients at 2, 6, and 12 months follow-up, respectively. Within a 12-month period after start of leflunomide treatment 76% of the evaluable patients were classified as moderate or good responders according to the DAS(28) response criteria. In the setting of care-as-usual rheumatoid arthritis patients starting leflunomide frequently experienced adverse drug reactions. More than half of the patients withdrew from leflunomide treatment within 1 year of starting leflunomide treatment, mainly because of adverse drug reactions.

The crossover of daily work engagement: test of an actor-partner interdependence model.

PubMed

Bakker, Arnold B; Xanthopoulou, Despoina

2009-11-01

This study of 62 dyads of employees (N = 124) examined the crossover of work engagement-a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption. We hypothesized that work engagement crosses over from an employee (the actor) to his or her colleague (the partner) on a daily basis. The frequency of daily communication was expected to moderate the crossover of daily work engagement, which in turn would relate to colleagues' daily performance. Participants first filled in a general questionnaire and then completed a diary study over 5 consecutive workdays. The hypotheses were tested with multilevel analyses, using an actor-partner interdependence model. Results confirmed the crossover of daily work engagement, but only on days when employees within a dyad interacted more frequently than usual. Moreover, we found that actor's work engagement (particularly vigor), when frequently communicated, had a positive indirect relationship with partner's performance through partner's work engagement. Finally, results showed that actor's vigor was negatively related to partner's performance when communication was low. However, this negative effect was counteracted when mediated by the vigor of the partner.

Gender differences in physical activity, sedentary behavior, and their relation to body composition in active Brazilian adolescents.

PubMed

Nogueira, Julia Aparecida Devide; Macedo da Costa, Teresa Helena

2009-01-01

Body weight and composition are determined by genotype, environment, and energy balance. Physical activity or sedentary behavior have different associations with body weight, fat mass, and fat-free mass, a relationship that is not clear in adolescents. The aim of this study was to test the associations between gender, physical activity, sedentary behavior, and body composition in physically active adolescents. Weight, height, and skinfold thickness were measured in 326 physically active boys and girls age 11 to 15 years. All subjects answered a questionnaire assessing their usual daily activities for the last month. Time spent on each activity was used to estimate the physical activity level (PAL). PAL was associated with body composition after adjustment for age and maturation, with differences between genders. For boys, PAL was positively and significantly associated with body mass index (BMI) and fat-free mass index (beta=0.14 and 0.15, respectively). For girls, PAL was negatively and significantly associated with BMI and fat mass index (beta=-0.11 and -0.75, respectively). Sedentary behavior, expressed by hours of TV, videogame, and computer use, was not associated with any body-composition outcome for either gender. The accumulated amount of physical activity, but not of sedentary behavior, was related to body composition in active adolescents.

Reading space characteristics in campus environment

NASA Astrophysics Data System (ADS)

Tampubolon, A. C.; Kusuma, H. E.

2018-03-01

Reading activity is a part of daily learning activities that are usually done by college students and takes place in the facilities that are provided by the campus. However, students tend to have a perception of a particular location that is considered appropriate with the activities undertaken. This study identified students’ perceptions of reading space characteristics in campus environment which are considered able to accommodate reading activity. Exploratory qualitative research methods were used to collect data from selected types of space and the reasons for the students in choosing the specifics space to do their reading. The results showed that students do not only use library facilities as a support unit of academic activities. This study found that students tend to use some places with non-library function, such as students’ union room, hallway, and classroom. Students perceive reading space by its physical and social characteristics. The physical consist of ambiance, quiet place, tranquility, availability of facilities, the level of coolness, lighting, location accessibility, connection with nature, convenience furniture, air quality, aesthetics, the flexibility of activities, the crowd of place, the level of shade, outdoor, ownership, and indoor. While the social characteristics of the reading space are to have privacy, favorable reading position, and the presence of others.

Observability of market daily volatility

NASA Astrophysics Data System (ADS)

Petroni, Filippo; Serva, Maurizio

2016-02-01

We study the price dynamics of 65 stocks from the Dow Jones Composite Average from 1973 to 2014. We show that it is possible to define a Daily Market Volatility σ(t) which is directly observable from data. This quantity is usually indirectly defined by r(t) = σ(t) ω(t) where the r(t) are the daily returns of the market index and the ω(t) are i.i.d. random variables with vanishing average and unitary variance. The relation r(t) = σ(t) ω(t) alone is unable to give an operative definition of the index volatility, which remains unobservable. On the contrary, we show that using the whole information available in the market, the index volatility can be operatively defined and detected.

Night-time sedating H1-antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urticaria: a randomized controlled trial

PubMed Central

Staevska, M; Gugutkova, M; Lazarova, C; Kralimarkova, T; Dimitrov, V; Zuberbier, T; Church, MK; Popov, TA

2014-01-01

Background Many physicians believe that the most effective way to treat chronic urticaria is to take a nonsedating second-generation H1-antihistamine in the morning and a sedating first-generation H1-antihistamine, usually hydroxyzine, at night to enhance sleep. But is this belief well founded? Objectives To test this belief by comparing the effectiveness and prevalence of unwanted sedative effects when treating patients with chronic spontaneous urticaria (CSU) with levocetirizine 15 mg daily plus hydroxyzine 50 mg at night (levocetirizine plus hydroxyzine) vs. levocetirizine 20 mg daily (levocetirizine monotherapy). Methods In this randomized, double-blind, cross-over study, 24 patients with difficult-to-treat CSU took levocetirizine plus hydroxyzine or levocetirizine monotherapy for periods of 5 days each. At the end of each treatment period, assessments were made of quality of life (Chronic Urticaria Quality of Life Questionnaire, CU-Q2oL), severity of urticaria symptoms (Urticaria Activity Score, UAS), sleep disturbance during the night and daytime somnolence. Results Both treatments significantly decreased UAS, night-time sleep disturbances and CU-Q2oL scores (P < 0·001) without significant differences between the two. Compared with baseline, daytime somnolence was significantly reduced by levocetirizine monotherapy (P = 0·006) but not by levocetirizine plus hydroxyzine (P = 0·218). Direct comparison of the two treatment modalities in terms of daytime somnolence favoured levocetirizine monotherapy (P = 0·026). Conclusions The widespread belief that sleep is aided by the addition of a sedating first-generation H1-antihistamine, usually hydroxyzine, at night is not supported. These results are in line with the urticaria guidelines, which state that first-line treatment for urticaria should be new-generation, nonsedating H1-antihistamines only. PMID:24472058

Dietary iron intervention using a staple food product for improvement of iron status in female runners.

PubMed

Alaunyte, Ieva; Stojceska, Valentina; Plunkett, Andrew; Derbyshire, Emma

2014-01-01

Adequate nutrient intake is critically important for achieving optimal sports performance. Like all athletes, female runners require a nutritionally balanced diet to maintain daily activities and a successful training regime. This study investigates the effects of cereal product based dietary iron intervention on iron status of recreational female runners (n = 11; 32 ± 7yr; 239 ± 153 minutes exercise/week, of which 161 ± 150 minutes running activity/week; VO2max 38 ± 4 ml/kg/min). Participants completed a 6-week dietary intervention study. They were asked to replace their usual bread with iron-rich Teff bread as part of their daily diet. During this period, their dietary habits were assessed by multiple pass 24-hr recalls; iron status was determined by venous blood analysis for serum transferrin, serum transferrin receptor, serum ferritin, total iron-binding capacity and transferrin receptor/ferritin log index. Pre-intervention a cohort of 11 female runners reported inadequate daily dietary iron intake of 10.7 ± 2.7 mg/day, which was associated with overall compromised iron status. Over a third of all participants showed depleted bodily iron stores (serum ferritin <12 μg/L). Pre-intervention macronutrient assessment revealed adequate energy, protein and fibre intakes, whilst total fat and saturated fat intake was above the recommendations at the expense of carbohydrate intake. A 6-week dietary intervention resulted in significantly higher total iron intakes (18.5 mg/day, P < 0.05) and improved iron tissue supply but not enlarged iron stores. Improvements in heamatological indices were associated with compromised baseline iron status, prolonged intervention period and increase in dietary iron intake. Dietary iron interventions using a staple cereal product offer an alternative way of improving dietary iron intake and favourable affecting overall iron status in physically active females.

Cervical dystonia: effectiveness of a standardized physical therapy program; study design and protocol of a single blind randomized controlled trial

PubMed Central

2013-01-01

Background Cervical dystonia is characterized by involuntary muscle contractions of the neck and abnormal head positions that affect daily life activities and social life of patients. Patients are usually treated with botulinum toxin injections into affected neck muscles to relief pain and improve control of head postures. In addition, many patients are referred for physical therapy to improve their ability to perform activities of daily living. A recent review on allied health interventions in cervical dystonia showed a lack of randomized controlled intervention studies regarding the effectiveness of physical therapy interventions. Methods/design The (cost-) effectiveness of a standardized physical therapy program compared to regular physical therapy, both as add-on treatment to botulinum toxin injections will be determined in a multi-centre, single blinded randomized controlled trial with 100 cervical dystonia patients. Primary outcomes are disability in daily functioning assessed with the disability subscale of the Toronto Western Spasmodic Torticollis Rating Scale. Secondary outcomes are pain, severity of dystonia, active range of motion of the head, quality of life, anxiety and depression. Data will be collected at baseline, after six months and one year by an independent blind assessor just prior to botulinum toxin injections. For the cost effectiveness, an additional economic evaluation will be performed with the costs per quality adjusted life-year as primary outcome parameter. Discussion Our study will provide new evidence regarding the (cost-) effectiveness of a standardized, tailored physical therapy program for patients with cervical dystonia. It is widely felt that allied health interventions, including physical therapy, may offer a valuable supplement to the current therapeutic options. A positive outcome will lead to a greater use of the standardized physical therapy program. For the Dutch situation a positive outcome implies that the standardized physical therapy program forms the basis for a national treatment guideline for cervical dystonia. Trial registration Number Dutch Trial registration (Nederlands Trial Register): NTR3437 PMID:23855591

Cervical dystonia: effectiveness of a standardized physical therapy program; study design and protocol of a single blind randomized controlled trial.

PubMed

van den Dool, Joost; Visser, Bart; Koelman, J Hans T M; Engelbert, Raoul H H; Tijssen, Marina A J

2013-07-15

Cervical dystonia is characterized by involuntary muscle contractions of the neck and abnormal head positions that affect daily life activities and social life of patients. Patients are usually treated with botulinum toxin injections into affected neck muscles to relief pain and improve control of head postures. In addition, many patients are referred for physical therapy to improve their ability to perform activities of daily living. A recent review on allied health interventions in cervical dystonia showed a lack of randomized controlled intervention studies regarding the effectiveness of physical therapy interventions. The (cost-) effectiveness of a standardized physical therapy program compared to regular physical therapy, both as add-on treatment to botulinum toxin injections will be determined in a multi-centre, single blinded randomized controlled trial with 100 cervical dystonia patients. Primary outcomes are disability in daily functioning assessed with the disability subscale of the Toronto Western Spasmodic Torticollis Rating Scale. Secondary outcomes are pain, severity of dystonia, active range of motion of the head, quality of life, anxiety and depression. Data will be collected at baseline, after six months and one year by an independent blind assessor just prior to botulinum toxin injections. For the cost effectiveness, an additional economic evaluation will be performed with the costs per quality adjusted life-year as primary outcome parameter. Our study will provide new evidence regarding the (cost-) effectiveness of a standardized, tailored physical therapy program for patients with cervical dystonia. It is widely felt that allied health interventions, including physical therapy, may offer a valuable supplement to the current therapeutic options. A positive outcome will lead to a greater use of the standardized physical therapy program. For the Dutch situation a positive outcome implies that the standardized physical therapy program forms the basis for a national treatment guideline for cervical dystonia. Number Dutch Trial registration (Nederlands Trial Register): NTR3437.

Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study.

PubMed

Meize-Grochowski, Robin; Shuster, George; Boursaw, Blake; DuVal, Michelle; Murray-Krezan, Cristina; Schrader, Ron; Smith, Bruce W; Herman, Carla J; Prasad, Arti

2015-01-01

This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the study's end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the 0.10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study. Copyright © 2015 Elsevier Inc. All rights reserved.

Report of Sugar-Sweetened Beverages Offered in Pennsylvania Childcare Centers.

PubMed

Lutzkanin, Kristen M; Myers, Abigail K; Schaefer, Eric W; Sekhar, Deepa L

2016-06-01

The study objective was to quantify sugar-sweetened beverage (SSB) offerings to children in Pennsylvania (PA) childcare centers and determine whether this information is communicated to parents. In October 2014, a SurveyMonkey link was sent to 4461 PA childcare centers. The 518 respondents represented 88% of PA counties. 279 centers (54%) serve SSBs. 330 (65%) of childcare centers provide parents a report of their child's daily intake. Of 185 centers serving SSBs and providing a daily intake report, 91% include SSB consumption. In total, 38% of centers (103/272) offer but do not report SSB consumption. In 96% of centers, parents may request their child not receive SSBs. In conclusion, though more than half of PA childcare centers surveyed offer SSBs, those providing daily intake reports usually include SSB consumption. Requiring daily intake reports may be a strategy to increase parental awareness of items consumed outside the home. © The Author(s) 2015.

Effect of interaction between dynapenic component of the European working group on sarcopenia in older people sarcopenia criteria and obesity on activities of daily living in the elderly.

PubMed

Kim, Yeon-Pyo; Kim, Sun; Joh, Ju-Youn; Hwang, Hwan-Sik

2014-05-01

To examine the effects of interaction between dynapenic component of the European Working Group on Sarcopenia in Older People (EWGSOP) sarcopenia and obesity (dynapenia × obesity) on activities of daily living (ADL) in older participants. Cross-sectional analysis of the Validity and Reliability of Korean Frailty Index and the Validity and Reliability of the Kaigo-Yobo Checklist in Korean Elderly studies. Six welfare facilities operated by government in South Korea. Four hundred eighty-seven community-dwelling individuals (157 males, 330 females) >65 years of age. Dynapenic component of the EWGSOP sarcopenia was defined as usual gait speed <0.8 m/s or grip strength lower than cut-off value (male <25.3 kg, female <12.0 kg). Obesity was defined as body mass index ≥27.5 kg/m(2). ADL were assessed using the Barthel index. There were 14 obese with dynapenic component cases (2 males, 12 females) of the 487 participants. Interaction of dynapenia and obesity was significant on multivariate generalized linear model analysis (P = .015). Dynapenic component of the EWGSOP sarcopenia and obesity in the elderly is associated with multiplicative interactions rather than additive interactions in ADL. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Imagery rehearsal therapy in addition to treatment as usual for patients with diverse psychiatric diagnoses suffering from nightmares: a randomized controlled trial.

PubMed

van Schagen, Annette M; Lancee, Jaap; de Groot, Izaäk W; Spoormaker, Victor I; van den Bout, Jan

2015-09-01

Nightmares are associated with psychopathology and daily distress. They are highly prevalent in a psychiatric population (30%). Currently, imagery rehearsal therapy (IRT) is the treatment of choice for nightmares. With IRT, the script of the nightmare is changed into a new dream, which is imagined during the day. However, the effects of IRT in a psychiatric population remain unknown. The aim of this study was to determine the effectiveness of IRT in a heterogeneous psychiatric population. Between January 2006 and July 2010, 90 patients with psychiatric disorders (DSM-IV-TR) were randomized to IRT or treatment-as-usual conditions. IRT consisted of 6 individual sessions added to the treatment as usual. Nightmare frequency was assessed using daily nightmare logs and the Nightmare Frequency Questionnaire. Nightmare distress was assessed using the Nightmare Distress Questionnaire and the Nightmare Effects Survey. General psychiatric symptoms were assessed using the Symptom Checklist-90 and a PTSD symptom questionnaire. Assessments were administered at the start of the trial, after the IRT and at follow-up 3 months later. IRT showed a moderate effect (Cohen d = 0.5-0.7, P < .05) on nightmare frequency, nightmare distress, and psychopathology measures compared with treatment as usual. These effects were largely sustained at the 3-month follow-up (Cohen d = 0.4-0.6, P < .10). IRT is an effective treatment for nightmares among patients with comorbid psychiatric disorders and can be employed in addition to the on-going treatment. ClinicalTrials.gov identifier: NCT00291031. © Copyright 2015 Physicians Postgraduate Press, Inc.

Differences in ability to perform activities of daily living among women with fibromyalgia: A cross-sectional study.

PubMed

von Bülow, Cecilie; Amris, Kirstine; la Cour, Karen; Danneskiold-Samsøe, Bente; Ejlersen, Eva Wæhrens

2015-11-01

To investigate whether the Assessment of Motor and Process Skills (AMPS), the physical function subscales of the Fibromyalgia Impact Questionnaire (FIQ PF) and the 36-item Short Form (SF-36 PF) can identify subgroups of women with fibromyalgia with clinically relevant differences in ability to perform activities of daily living. Cross-sectional study. A total of 257 women with fibromyalgia. Participants were evaluated with the AMPS (measuring activities of daily living motor and activities of daily living process ability), FIQ and SF-36. AMPS independence cut-offs were used to divide the participants into 4 subgroups. Clinically relevant differences between subgroups were investigated based on the AMPS, FIQ PF and SF-36 PF. Participants in the 4 AMPS-derived subgroups demon-strated clinically relevant differences in observed activities of daily living motor and process ability. Neither the FIQ PF nor the SF-36 PF could differentiate between subgroups with clinically relevant differences in AMPS activities of daily living process ability. Activities of daily living process skills reflect underlying organizational and adaptive capacities of the individual and are relevant targets for interventions aiming at improving activities of daily living ability. Since self-report instruments do not capture differences in activities of daily living process ability, clinicians should include observations-based assessment of activities of daily living ability in order to individualize interventions offered.

A randomized controlled trial of very early rehabilitation in speech after stroke.

PubMed

Godecke, Erin; Armstrong, Elizabeth A; Rai, Tapan; Middleton, Sandy; Ciccone, Natalie; Whitworth, Anne; Rose, Miranda; Holland, Audrey; Ellery, Fiona; Hankey, Graeme J; Cadilhac, Dominique A; Bernhardt, Julie

2016-07-01

The efficacy of rehabilitation therapy for aphasia caused by stroke is uncertain. The Very Early Rehabilitation of Speech (VERSE) trial aims to determine if intensive prescribed aphasia therapy (VERSE) is more effective and cost saving than non-prescribed, intensive (usual care-plus) and non-intensive usual care (UC) therapy when started within 15 days of stroke onset and continued daily over four weeks. We hypothesize that aphasia therapy when started very early after stroke and delivered daily could enhance recovery of communication compared with UC. A total of 246 participants (82 per arm) will provide 80% power to detect a 4.4% improvement on aphasia quotient between VERSE and UC plus at a significance level of α = 0.05. Acute-care hospitals and accompanying rehabilitation services throughout Australia, 2014-2017. Three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment (PROBE) trial. Acute stroke in previous 14 days and aphasia diagnosed by aphasia quotient (AQ) of the Western Aphasia Battery (WAB). Computer-generated blocked randomization procedure stratified by aphasia severity according to Western Aphasia Battery, to one of three arms. All participants receive UC-usual ward-based aphasia therapy. Arm 1: UC-no additional therapy; Arm 2: UC-plus usual ward-based therapy; Arm 3: VERSE therapy-a prescribed and structured aphasia therapy program. Arms 2 and 3 receive a total of 20 additional sessions (45-60 min, provided daily) of aphasia therapy. The additional intervention must be provided before day 50 post stroke. The aphasia quotient of Western Aphasia Battery at 12 weeks post stroke. Secondary outcomes include discourse measures, the Stroke and Aphasia Quality of Life Scale-39 and the Aphasia Depression Rating Scale at 12 and 26 weeks. Incremental cost-effectiveness ratios at 26 weeks will be reported. This trial is designed to test whether the intensive and prescribed VERSE intervention is effective in promoting maximum recovery and preventing costly health complications in a vulnerable population of survivors of stroke. It will also provide novel, prospective, aphasia specific cost-effectiveness data to guide future policy development for this population. © 2016 World Stroke Organization.

Diabetes and Insulin

MedlinePlus

... are usually used twice daily before breakfast and dinner. They can be used alone or in combination with oral medicines. The type of insulin your doctor prescribes will depend on the type of diabetes you have, your lifestyle (when and what you eat, how much you exercise), your age, and your ...

Advocacy Simplified

ERIC Educational Resources Information Center

Dowd, Karen J.; Curva, Fely

2008-01-01

Most state professional associations promote and fund at some level, an advocacy program. These advocacy programs usually aim to support or plead for a program, policy, or proposal. They can range from simple communication to complex strategies, from daily interactions to annual productions, and from position papers to onsite, legislative visits.…

Residential Learning Communities. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2014

2014-01-01

Residential learning communities in postsecondary education, also known as living-learning programs, aim to improve student learning and success by integrating students' academic and daily living environments. Students participating in these programs live together (usually in a residential dormitory), take certain classes together, and engage in…

Understanding Teachers' Routines to Inform Classroom Technology Design

ERIC Educational Resources Information Center

An, Pengcheng; Bakker, Saskia; Eggen, Berry

2017-01-01

Secondary school teachers have quite busy and complex routines in their classrooms. However, present classroom technologies usually require focused attention from teachers while being interacted with, which restricts their use in teachers' daily routines. Peripheral interaction is a human-computer interaction style that aims to enable interaction…

A Comparison of Satellite Based, Modeled Derived Daily Solar Radiation Data with Observed Data for the Continental US

NASA Technical Reports Server (NTRS)

White, Jeffrey W.; Hoogenboom, Gerrit; Wilkens, Paul W.; Stackhouse, Paul W., Jr.; Hoell, James M.

2010-01-01

Many applications of simulation models and related decision support tools for agriculture and natural resource management require daily meteorological data as inputs. Availability and quality of such data, however, often constrain research and decision support activities that require use of these tools. Daily solar radiation (SRAD) data are especially problematic because the instruments require electronic integrators, accurate sensors are expensive, and calibration standards are seldom available. The Prediction Of Worldwide Energy Resources (NASA/POWER; power.larc.nasa.gov) project at the NASA Langley Research Center estimates daily solar radiation based on data that are derived from satellite observations of outgoing visible radiances and atmospheric parameters based upon satellite observations and assimilation models. The solar data are available for a global 1 degree x 1 degree coordinate grid. SRAD can also be estimated based on attenuation of extraterrestrial radiation (Q0) using daily temperature and rainfall data to estimate the optical thickness of the atmosphere. This study compares daily solar radiation data from NASA/POWER (SRADNP) with instrument readings from 295 stations (SRADOB), as well as with values that were estimated with the WGENR solar generator. WGENR was used both with daily temperature and precipitation records from the stations reporting solar data and records from the NOAA Cooperative Observer Program (COOP), thus providing two additional sources of solar data, SRADWG and SRADCO. Values of SRADNP for different grid cells consistently showed higher correlations (typically 0.85 to 0.95) with SRADOB data than did SRADWG or SRADCO for sites within the corresponding cells. Mean values of SRADOB, SRADWG and SRADNP for sites within a grid cell usually were within 1 MJm-2d-1 of each other, but NASA/POWER values averaged 1.1 MJm-2d-1 lower than SRADOB. The magnitude of this bias was greater at lower latitudes and during summer months and may be at least partially explained by assumptions in ambient aerosol properties. Overall, the NASA/POWER solar radiation data are a promising resource for regional modeling studies where realistic accounting of historic variation is required.

Characterization of physical activity and sitting time among patients on hemodialysis using a new physical activity instrument.

PubMed

Johansen, Kirsten L; Painter, Patricia; Delgado, Cynthia; Doyle, Julie

2015-01-01

Physical activity questionnaires usually focus on moderate to vigorous activities and may not accurately capture physical activity or variation in levels of activity among extremely inactive groups like dialysis patients. Cross-sectional study. Three dialysis facilities in the San Francisco Bay Area. Sixty-eight prevalent hemodialysis patients. We administered a new physical activity questionnaire designed to capture activity in the lower end of the range, the Low Physical Activity Questionnaire (LoPAQ). Outcome measures were correlation with a validated physical activity questionnaire, the Minnesota Leisure Time Activity (LTA) questionnaire and with self-reported physical function (physical function score of the SF-36) and physical performance (gait speed, chair stand, balance, and short physical performance battery). We also determined whether patients who were frail or reported limitations in activities of daily living were less active on the LoPAQ. Sixty-eight participants (mean age 59 ± 14 years, 59% men) completed the study. Patients were inactive according to the LoPAQ, with a median (interquartile range) of 517 (204-1190) kcal/week of physical activity. Although activity from the LTA was lower than on the LoPAQ (411 [61-902] kcal/week), the difference was not statistically significant (P = .20), and results from the 2 instruments were strongly correlated (rho = 0.62, P < .001). In addition, higher physical activity measured by the LoPAQ was correlated with better self-reported functioning (rho = 0.64, P < .001), better performance on gait speed (rho = 0.32, P = .02), balance (rho = 0.45, P < .001), and chair rising (rho = -0.32, P = .03) tests and with higher short physical performance battery total score (rho = 0.51, P < .001). Frail patients and patients with activities of daily living limitations were less active than those who were not frail or limited. The LoPAQ performed similarly to the Minnesota LTA questionnaire in our cohort despite being shorter and easier to administer. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Study protocol: the effectiveness and cost effectiveness of an employer-led intervention to increase walking during the daily commute: the Travel to Work randomised controlled trial.

PubMed

Audrey, Suzanne; Cooper, Ashley R; Hollingworth, William; Metcalfe, Chris; Procter, Sunita; Davis, Adrian; Campbell, Rona; Gillison, Fiona; Rodgers, Sarah E

2015-02-18

Physical inactivity increases the risk of many chronic diseases including coronary heart disease, type 2 diabetes and some cancers. It is recommended that adults should undertake at least 150 minutes of moderate intensity physical activity throughout the week but many adults do not achieve this. An opportunity for working adults to accumulate the recommended activity levels is through the daily commute. Employees will be recruited from workplaces in south-west England and south Wales. In the intervention arm, workplace Walk-to-Work promoters will be recruited and trained. Participating employees will receive Walk-to-Work materials and support will be provided through four contacts from the promoters over 10 weeks. Workplaces in the control arm will continue with their usual practice. The intervention will be evaluated by a cluster randomized controlled trial including economic and process evaluations. The primary outcome is daily minutes of moderate to vigorous physical activity (MVPA). Secondary outcomes are: overall physical activity; sedentary time; modal shift away from private car use during the commute; and physical activity/MVPA during the commute. Accelerometers, GPS receivers and travel diaries will be used at baseline and one year follow-up. Questionnaires will be used at baseline, immediately post intervention, and one year follow-up. The process evaluation will examine the context, delivery and response to the intervention from the perspectives of employers, Walk-to-Work promoters and employees using questionnaires, descriptive statistics, fieldnotes and interviews. A cost-consequence study will include employer, employee and health service costs and outcomes. Time and consumables used in implementing the intervention will be measured. Journey time, household commuting costs and expenses will be recorded using travel diaries to estimate costs to employees. Presenteeism, absenteeism, employee wellbeing and health service use will be recorded. Compared with other forms of physical activity, walking is a popular, familiar and convenient, and the main option for increasing physical activity in sedentary populations. To our knowledge, this is the first full-scale randomised controlled trial to objectively measure (using accelerometers and GPS receivers) the effectiveness of a workplace intervention to promote walking during the commute to and from work. ISRCTN15009100 (10 December 2014).

A Cluster Randomized Controlled Trial to Reduce Office Workers' Sitting Time: Effect on Activity Outcomes.

PubMed

Healy, Genevieve N; Eakin, Elizabeth G; Owen, Neville; Lamontagne, Anthony D; Moodie, Marj; Winkler, Elisabeth A H; Fjeldsoe, Brianna S; Wiesner, Glen; Willenberg, Lisa; Dunstan, David W

2016-09-01

This study aimed to evaluate the initial and long-term effectiveness of a workplace intervention compared with usual practice, targeting the reduction of sitting on activity outcomes. Office worksites (≥1 km apart) from a single organization in Victoria, Australia, were cluster randomized to intervention (n = 7) or control (n = 7). Participants were 231 desk-based office workers (5-39 participants per worksite) working at least 0.6 full-time equivalent. The workplace-delivered intervention addressed organizational, physical environment, and individual behavioral changes to reduce sitting time. Assessments occurred at baseline, 3 months, and 12 months, with the primary outcome participants' objectively measured (activPAL3 device) workplace sitting time (minutes per 8-h workday). Secondary activity outcomes were workplace time spent standing, stepping (light, moderate to vigorous, and total), and in prolonged (≥30 min) sitting bouts (hours per 8-h workday); usual duration of workplace sitting bouts; and overall sitting, standing, and stepping time (minutes per 16-h day). Analysis was by linear mixed models, accounting for repeated-measures and clustering and adjusting for baseline values and potential confounders. At baseline, on average, participants (68% women; mean ± SD age = 45.6 ± 9.4 yr) sat, stood, and stepped for 78.8% ± 9.5%, 14.3% ± 8.2%, and 6.9% ± 2.9% of work hours, respectively. Workplace sitting time was significantly reduced in the intervention group compared with the controls at 3 months (-99.1 [95% confidence interval = -116.3 to -81.8] min per 8-h workday) and 12 months (-45.4 [-64.6 to -26.2] min per 8-h workday). Significant intervention effects (all favoring intervention) were observed for standing, prolonged sitting, and usual sitting bout duration at work, as well as overall sitting and standing time, with no significant or meaningful effects observed for stepping. This workplace-delivered multicomponent intervention was successful at reducing workplace and overall daily sitting time in both the short term and the long term.

Daily fluctuation of hepatic P450 monooxygenase activities in male rats is controlled by the suprachiasmatic nucleus but remains unaffected by adrenal hormones.

PubMed

Furukawa, T; Manabe, S; Watanabe, T; Sehata, S; Sharyo, S; Okada, T; Mori, Y

1999-09-01

Hepatic P450 monooxygenase activities, which strongly influence the efficacy and/or toxicity of drugs, are known to fluctuate daily. We also know that the P450 activities assessed by measurement of 7-alkoxycoumarin O-dealkylase (ACD) activities fluctuate daily, with apparently high values during the dark period in male rats. However, there is little knowledge about the factors that regulate daily fluctuation of P450 monooxygenase activities. In the present study using rats, we induced lesions in the suprachiasmatic nucleus (SCN) of the brain, the known site of the body's internal clock, and examined the effects on the daily fluctuation of the ACD activities to clarify the relationship between the SCN and the daily fluctuation of P450 monooxygenase activities. In addition, adrenalectomy was performed to re-evaluate the influence of adrenal hormones on the P450 activities. Our results indicated that daily fluctuations of the hepatic ACD activities were completely eliminated in the SCN-lesioned rats. However, the ACD activities in the adrenalectomized rats showed apparent daily fluctuations with high values during the dark period and low values during the light period. Therefore, this study demonstrated that the daily fluctuation of the hepatic P450 monooxygenase activities in male rats is controlled by the SCN but remains unaffected by the adrenal hormones.

The geriatric assessment.

PubMed

Elsawy, Bassem; Higgins, Kim E

2011-01-01

The geriatric assessment is a multidimensional, multidisciplinary assessment designed to evaluate an older person's functional ability, physical health, cognition and mental health, and socioenvironmental circumstances. It is usually initiated when the physician identifies a potential problem. Specific elements of physical health that are evaluated include nutrition, vision, hearing, fecal and urinary continence, and balance. The geriatric assessment aids in the diagnosis of medical conditions; development of treatment and follow-up plans; coordination of management of care; and evaluation of long-term care needs and optimal placement. The geriatric assessment differs from a standard medical evaluation by including nonmedical domains; by emphasizing functional capacity and quality of life; and, often, by incorporating a multidisciplinary team. It usually yields a more complete and relevant list of medical problems, functional problems, and psychosocial issues. Well-validated tools and survey instruments for evaluating activities of daily living, hearing, fecal and urinary continence, balance, and cognition are an important part of the geriatric assessment. Because of the demands of a busy clinical practice, most geriatric assessments tend to be less comprehensive and more problem-directed. When multiple concerns are presented, the use of a "rolling" assessment over several visits should be considered. Academy of Family Physicians.

Educational interventions for the management of cancer-related fatigue in adults.

PubMed

Bennett, Sally; Pigott, Amanda; Beller, Elaine M; Haines, Terry; Meredith, Pamela; Delaney, Christie

2016-11-24

Cancer-related fatigue is reported as the most common and distressing symptom experienced by patients with cancer. It can exacerbate the experience of other symptoms, negatively affect mood, interfere with the ability to carry out everyday activities, and negatively impact on quality of life. Educational interventions may help people to manage this fatigue or to cope with this symptom, and reduce its overall burden. Despite the importance of education for managing cancer-related fatigue there are currently no systematic reviews examining this approach. To determine the effectiveness of educational interventions for managing cancer-related fatigue in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, OTseeker and PEDro up to 1st November 2016. We also searched trials registries. We included randomised controlled trials (RCTs) of educational interventions focused on cancer-related fatigue where fatigue was a primary outcome. Studies must have aimed to evaluate the effect of educational interventions designed specifically to manage cancer-related fatigue, or to evaluate educational interventions targeting a constellation of physical symptoms or quality of life where fatigue was the primary focus. The studies could have compared educational interventions with no intervention or wait list controls, usual care or attention controls, or an alternative intervention for cancer-related fatigue in adults with any type of cancer. Two review authors independently screened studies for inclusion and extracted data. We resolved differences in opinion by discussion. Trial authors were contacted for additional information. A third independent person checked the data extraction. The main outcome considered in this review was cancer-related fatigue. We assessed the evidence using GRADE and created a 'Summary of Findings' table. We included 14 RCTs with 2213 participants across different cancer diagnoses. Four studies used only 'information-giving' educational strategies, whereas the remainder used mainly information-giving strategies coupled with some problem-solving, reinforcement, or support techniques. Interventions differed in delivery including: mode of delivery (face to face, web-based, audiotape, telephone); group or individual interventions; number of sessions provided (ranging from 2 to 12 sessions); and timing of intervention in relation to completion of cancer treatment (during or after completion). Most trials compared educational interventions to usual care and meta-analyses compared educational interventions to usual care or attention controls. Methodological issues that increased the risk of bias were evident including lack of blinding of outcome assessors, unclear allocation concealment in over half of the studies, and generally small sample sizes. Using the GRADE approach, we rated the quality of evidence as very low to moderate, downgraded mainly due to high risk of bias, unexplained heterogeneity, and imprecision.There was moderate quality evidence of a small reduction in fatigue intensity from a meta-analyses of eight studies (1524 participants; standardised mean difference (SMD) -0.28, 95% confidence interval (CI) -0.52 to -0.04) comparing educational interventions with usual care or attention control. We found low quality evidence from twelve studies (1711 participants) that educational interventions had a small effect on general/overall fatigue (SMD -0.27, 95% CI -0.51 to -0.04) compared to usual care or attention control. There was low quality evidence from three studies (622 participants) of a moderate size effect of educational interventions for reducing fatigue distress (SMD -0.57, 95% CI -1.09 to -0.05) compared to usual care, and this could be considered clinically significant. Pooled data from four studies (439 participants) found a small reduction in fatigue interference with daily life (SMD -0.35, 95% CI -0.54 to -0.16; moderate quality evidence). No clear effects on fatigue were found related to type of cancer treatment or timing of intervention in relation to completion of cancer treatment, and there were insufficient data available to determine the effect of educational interventions on fatigue by stage of disease, tumour type or group versus individual intervention.Three studies (571 participants) provided low quality evidence for a reduction in anxiety in favour of the intervention group (mean difference (MD) -1.47, 95% CI -2.76 to -0.18) which, for some, would be considered clinically significant. Two additional studies not included in the meta-analysis also reported statistically significant improvements in anxiety in favour of the educational intervention, whereas a third study did not. Compared with usual care or attention control, educational interventions showed no significant reduction in depressive symptoms (four studies, 881 participants, SMD -0.12, 95% CI -0.47 to 0.23; very low quality evidence). Three additional trials not included in the meta-analysis found no between-group differences in the symptoms of depression. No between-group difference was evident in the capacity for activities of daily living or physical function when comparing educational interventions with usual care (4 studies, 773 participants, SMD 0.33, 95% CI -0.10 to 0.75) and the quality of evidence was low. Pooled evidence of low quality from two of three studies examining the effect of educational interventions compared to usual care found an improvement in global quality of life on a 0-100 scale (MD 11.47, 95% CI 1.29 to 21.65), which would be considered clinically significant for some.No adverse events were reported in any of the studies. Educational interventions may have a small effect on reducing fatigue intensity, fatigue's interference with daily life, and general fatigue, and could have a moderate effect on reducing fatigue distress. Educational interventions focused on fatigue may also help reduce anxiety and improve global quality of life, but it is unclear what effect they might have on capacity for activities of daily living or depressive symptoms. Additional studies undertaken in the future are likely to impact on our confidence in the conclusions.The incorporation of education for the management of fatigue as part of routine care appears reasonable. However, given the complex nature of this symptom, educational interventions on their own are unlikely to optimally reduce fatigue or help people manage its impact, and should be considered in conjunction with other interventions. Just how educational interventions are best delivered, and their content and timing to maximise outcomes, are issues that require further research.

Broadcast media and the dissemination of weather information

NASA Technical Reports Server (NTRS)

Byrnes, J.

1973-01-01

Although television is the public's most preferred source of weather information, it fails to provide weather reports to those groups who seek the information early in the day and during the day. The result is that many people most often use radio as a source of information, yet preferring the medium of television. The public actively seeks weather information from both radio and TV stations, usually seeking information on current conditions and short range forecasts. forecasts. Nearly all broadcast stations surveyed were eager to air severe weather bulletins quickly and often. Interest in Nowcasting was high among radio and TV broadcasters, with a significant portion indicating a willingness to pay something for the service. However, interest among TV stations in increasing the number of daily reports was small.

[Fibromyalgia].

PubMed

Jäckel, W H; Genth, E

2007-11-01

The characteristic symptoms of fibromyalgia are chronic widespread musculoskeletal pain in various parts of the body and abnormal tenderness at 18 specified tender points. Associated symptoms often reported include stiffness, sleep disorders, fatigue, and problems with concentration. The prevalence is about 3.5% for women and 0.5% for men. The impact of the disease is considerable both for those directly affected (restriction in activities of daily living and in ability to take part in family, professional, and social life) and for society as a whole (direct and indirect costs). The disease usually has a chronic course. An abnormality of the central pain-processing mechanisms is highly relevant for the pathogenesis. In addition to early diagnosis and intensive patient education, pharmacotherapy, exercise therapy, behavior therapy, and multidisciplinary treatment are particularly important for the management of fibromyalgia.

Improving health sector travel.

PubMed

Hurdle, David; Davis, Adrian

2004-10-01

Preventing ill health and obesity and building more physical activity into our daily lives have never been so high on the agenda, and the way we travel can help. Many workplaces and schools are drawing up travel plans, with the aims usually to minimise car use and encourage healthier and more environmentally friendly travel. The Transport White Paper of 1998 advocated travel plans and singled out hospitals for action. Travel plans continue to be a focus within the latest Transport White Paper, launched in July 2004. This article covers various prompts to the health sector to implement travel plans. It addresses issues and concerns facing NHS Trusts, the practical things Trusts can do, and the increasing amount of good practice available. Finally, it demonstrates that travel plans can work, and are working, in the health sector.

Sodium and potassium intake among U.S. adults, National Health and Nutrition Examination Survey, 2003-2008

USDA-ARS?s Scientific Manuscript database

The 2010 Dietary Guidelines recommend Americans reduce sodium intake and choose foods that contain potassium to decrease the risk of hypertension and subsequent heart disease and stroke. We estimated the distributions of usual daily sodium and potassium intakes by sociodemographic and health charact...

Rupture of esophagus by compressed air.

PubMed

Wu, Jie; Tan, Yuyong; Huo, Jirong

2016-11-01

Currently, beverages containing compressed air such as cola and champagne are widely used in our daily life. Improper ways to unscrew the bottle, usually by teeth, could lead to an injury, even a rupture of the esophagus. This letter to editor describes a case of esophageal rupture caused by compressed air.

Mobile Technology to Support the Interactive Classroom

ERIC Educational Resources Information Center

Fardoun, Habib M.; Awada, Hachem

2017-01-01

At the current classrooms, teachers continue using traditional techniques for monitoring the class. However, there are more participation of mobile devices, and concretely, the tablets. In addition, the network access by both students and teachers in daily life is something usual and a routine work. For this reason, the authors propose the…

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

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

PubMed

Standen, P J; Threapleton, K; Richardson, A; Connell, L; Brown, D J; Battersby, S; Platts, F; Burton, A

2017-03-01

To assess the feasibility of conducting a randomised controlled trial of a home-based virtual reality system for rehabilitation of the arm following stroke. Two group feasibility randomised controlled trial of intervention versus usual care. Patients' homes. Patients aged 18 or over, with residual arm dysfunction following stroke and no longer receiving any other intensive rehabilitation. 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. 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. 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. 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.

Health Cobenefits and Transportation-Related Reductions in Greenhouse Gas Emissions in the San Francisco Bay Area

PubMed Central

Woodcock, James; Co, Sean; Ostro, Bart; Fanai, Amir; Fairley, David

2013-01-01

Objectives. We quantified health benefits of transportation strategies to reduce greenhouse gas emissions (GHGE). Methods. Statistics on travel patterns and injuries, physical activity, fine particulate matter, and GHGE in the San Francisco Bay Area, California, were input to a model that calculated the health impacts of walking and bicycling short distances usually traveled by car or driving low-emission automobiles. We measured the change in disease burden in disability-adjusted life years (DALYs) based on dose–response relationships and the distributions of physical activity, particulate matter, and traffic injuries. Results: Increasing median daily walking and bicycling from 4 to 22 minutes reduced the burden of cardiovascular disease and diabetes by 14% (32 466 DALYs), increased the traffic injury burden by 39% (5907 DALYS), and decreased GHGE by 14%. Low-carbon driving reduced GHGE by 33.5% and cardiorespiratory disease burden by less than 1%. Conclusions: Increased physical activity associated with active transport could generate a large net improvement in population health. Measures would be needed to minimize pedestrian and bicyclist injuries. Together, active transport and low-carbon driving could achieve GHGE reductions sufficient for California to meet legislative mandates. PMID:23409903

Daily and seasonal activity patterns in the eastern gray squirrel

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

Bland, M.E.

1977-03-01

The daily and seasonal activity patterns of the eastern gray squirrel were investigated between July 1, 1971 and September 16, 1972. Seasonal variations existed in the amount of time per day squirrels were active, the time of onset and cessation of activity, and the size of home range. Squirrels were most active in the fall and spring and least active in the winter. Two peaks in activity (morning and evening) with a mid-day resting period were characteristic of the summer activity pattern. During the winter one brief period of activity occurred during the warm mid-day hours. In the fall themore » time of onset of activity was consistent and occurred 20 to 30 minutes before sunrise. Cessation of activity was also regular and took place 20 to 30 minutes after sunset. Times of onset and cessation of activity were irregular during the winter and summer with onset usually occurring after sunrise and cessation before sunset. Home range size was smallest in winter and largest in late spring and late summer. Male and female range sizes were similar in fall and winter but in the spring and summer ranges of males exceeded those of females. During winter one night nest location was used per given two week period and daytime activity was restricted to the area around the den site. In spring, summer, and fall each squirrel used between two and three nest locations per two week period and squirrels traveled considerable distance from the den site. Hardwood and cedar forests were heavily utilized by the squirrels with approximately 53 percent of the locations occurring in hardwood forests and 38 percent in cedar forests. Correlations between the amount of time per day squirrels were active and various abiotic and biotic factors were made. Snow cover and/or extremely cold temperatures during the winter and early spring curtailed movement, and rainy weather in summer decreased activity. The availability of acorns in the autumn and the appearance of food in the spring increased movement.« less

Intensity of Daily Drinking and its Relation to Alcohol Use Disorders.

PubMed

Vergés, Alvaro; Ellingson, Jarrod M; Schroder, Stephanie A; Slutske, Wendy S; Sher, Kenneth J

2018-06-12

Daily drinking is an important public health concern and informative for evaluating diagnostic classification. In particular, daily binge drinkers might be considered as the prototype of some forms of alcoholism, as this drinking pattern may drive many alcohol use disorder (AUD) symptoms. However, daily drinking potentially captures a wide range of drinkers, including light-moderate daily drinkers who exhibit presumed control over their drinking behavior and might benefit from salutary effects on health. The current study examined the heterogeneity of daily drinkers in detail. Data from the two waves of the National Epidemiological Survey of Alcohol and Related Conditions were used. Participants who reported drinking "every day" during the last 12 months were classified as daily drinkers. A series of regression and logistic regression analyses were conducted to investigate the association between daily drinking and various outcomes. Daily drinkers were found to vary considerably from each other with respect to diagnostic status, level of consumption, demographic composition, and a range of drinking and health correlates. Further, a substantial number of daily binge drinkers were not diagnosed with AUD under the DSM-IV or DSM-5, although in most groups the DSM-5 criteria diagnosed a larger percentage of participants. Daily drinkers represents a highly heterogeneous group, and the correlates of daily drinking depend on the usual quantity of daily drinks and the frequency of alcohol-related problems in a given sample. Moreover, AUD, defined both according to DSM-IV and DSM-5, did not capture more than 68% of daily binge drinkers. Given that daily binge drinking is an extremely high threshold for use, this finding may present a challenge for our current classification system. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Major Pesticides Are More Toxic to Human Cells Than Their Declared Active Principles

PubMed Central

Spiroux de Vendômois, Joël; Séralini, Gilles-Eric

2014-01-01

Pesticides are used throughout the world as mixtures called formulations. They contain adjuvants, which are often kept confidential and are called inerts by the manufacturing companies, plus a declared active principle, which is usually tested alone. We tested the toxicity of 9 pesticides, comparing active principles and their formulations, on three human cell lines (HepG2, HEK293, and JEG3). Glyphosate, isoproturon, fluroxypyr, pirimicarb, imidacloprid, acetamiprid, tebuconazole, epoxiconazole, and prochloraz constitute, respectively, the active principles of 3 major herbicides, 3 insecticides, and 3 fungicides. We measured mitochondrial activities, membrane degradations, and caspases 3/7 activities. Fungicides were the most toxic from concentrations 300–600 times lower than agricultural dilutions, followed by herbicides and then insecticides, with very similar profiles in all cell types. Despite its relatively benign reputation, Roundup was among the most toxic herbicides and insecticides tested. Most importantly, 8 formulations out of 9 were up to one thousand times more toxic than their active principles. Our results challenge the relevance of the acceptable daily intake for pesticides because this norm is calculated from the toxicity of the active principle alone. Chronic tests on pesticides may not reflect relevant environmental exposures if only one ingredient of these mixtures is tested alone. PMID:24719846

Routine Support to Parents and Stressors in Everyday Domains: Associations With Negative Affect and Cortisol.

PubMed

Savla, Jyoti; Zarit, Steven H; Almeida, David M

2018-03-02

Adult children are involved a myriad of roles including providing routine (non-caregiving) support to a parent. Yet we know little about whether providing routine support to a parent is stressful and whether it has any associations with stressors in other life domains. We use daily diary data (N = 127; Study Days = 424) from the National Study of Daily Experiences to determine whether providing routine support to an older parent is associated with higher negative affect and salivary cortisol. Results confirm that providing routine support and experiencing stressors at work were independently associated with negative affect and greater cortisol output. Stress reactions were not amplified, however, on days when adult children concurrently provided support to a parent and reported work stressors. Cutting back usual activities at work or home elevated negative affect but were not associated with an upsurge of cortisol production. Findings lend support to the caregiving career framework for understanding even casual routine assistance provided to a parent. Published by Oxford University Press on behalf of The Gerontological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Surveillance study of health effects associated with cleanup of a hazardous waste site, Ralph Gray Trucking Company (a/k/a Westminster Tract Number 2633), Westminster, Orange County, California, Region 9: CERCLIS number CAD981995947

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

Hoshiko, S.; Underwood, M.C.; Smith, D.

1999-04-01

Excavation of a Superfund site, the Ralph Gray Truncking Company located in Westminster Orange County, California was anticipated to release sulfur dioxide and other chemicals. The California Department of Health Services, under cooperative agreement with the Agency for Toxic Substances and Disease Registry, conducted a surveillance study to assess whether illnesses were associated with cleanup activities. A panel primarily composed of more sensitive persons (n = 36) was selected to report daily respiratory symptoms and odors. Exposures included sulfur dioxide (SO{sub 2}) measurements and daily tonnage of waste removed. Analysis used Conditional Likelihood Regression and Generalized Estimating Equations (GEE) methods.more » Levels of SO{sub 2} were generally higher than usual ambient air, at times exceeding levels which can cause health effects among asthmatics in laboratory settings. Wheeze and cough were significantly associated with tonnage of waste removed, especially on days when the highest amounts of waste were removed. Upper respiratory symptoms were found to be associated with SO{sub 2}, and weak relationships were found with nausea and burning nose and SO{sub 2}.« less

Changes in smoking habits of smokers under bombing by rockets.

PubMed

Keinan-Boker, L; Enav, T; Rozentraub, T; Shohat, T

2011-03-01

Stress is known to impact smoking. This survey assessed changes in smoking behaviour of smokers in Southern Israel during a military operation (December 2008-January 2009) that exposed several civilian communities to intensive rocket bombing and acute stress. Households with an active land telephone line in Jewish Gaza vicinity communities were sampled. Inclusion criteria were age (18+ years) and being a daily or an occasional smoker. A telephone interview was carried out, focusing on socio-demographic characteristics and change in smoking behaviour during the military operation. Personal, demographic and circumstantial correlates of smoking behaviour were assessed using univariate and multivariate analyses. A total of 425 smokers took part in the survey. Most (85%) reported being daily smokers, and smoked, on average, 10-20 cigarettes/day before the operation. During the operation, 38% of the smokers changed their smoking habits and most (88%) reported higher than usual smoking rates. Correlates significantly associated with higher smoking during the operation were sex (female), education (lower) and not working due to the operation. Exposure to acute stress has an impact on smoking rates, especially in certain subgroups of smokers. Relevant smoking cessation interventions should address the special needs of smokers exposed to stressful circumstances.

Potential role of licofelone, minocycline and their combination against chronic fatigue stress induced behavioral, biochemical and mitochondrial alterations in mice.

PubMed

Kumar, Anil; Vashist, Aditi; Kumar, Puneet; Kalonia, Harikesh; Mishra, Jitendriya

2012-01-01

Chronic fatigue stress (CFS) is a common complaint among general population. Persistent and debilitating fatigue severely impairs daily functioning and is usually accompanied by combination of several physical and psychiatric problems. It is now well established fact that oxidative stress and neuroinflammation are involved in the pathophysiology of chronic fatigue and related disorders. Targeting both COX (cyclooxygenase) and 5-LOX (lipoxygenase) pathways have been proposed to be involved in neuroprotective effect. In the present study, mice were put on the running wheel apparatus for 6 min test session daily for 21 days, what produced fatigue like condition. The locomotor activity and anxiety like behavior were measured on 0, 8(th), 15(th) and 22(nd) day. The brains were isolated on 22(nd) day immediately after the behavioral assessments for the estimation of oxidative stress parameters and mitochondrial enzyme complexes activity. Pre-treatment with licofelone (2.5, 5 and 10 mg/kg, po) and minocycline (50 and 100 mg/kg, po) for 21 days, significantly attenuated fatigue like behavior as compared to the control (rotating wheel activity test session, RWATS) group. Further, licofelone (5 and 10 mg/kg, po) and minocycline (50 and 100 mg/kg, po) drug treatments for 21 days significantly attenuated behavioral alterations, oxidative damage and restored mitochondrial enzyme complex activities (I, II, III and IV) as compared to control, whereas combination of licofelone (5 mg/kg) with minocycline (50 mg/kg) significantly potentiated their protective effect which was significant as compared to their effect per se. The present study highlights the therapeutic potential of licofelone, minocycline and their combination against CFS in mice.

Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE): a randomized controlled trial protocol.

PubMed

Winstein, Carolee J; Wolf, Steven L; Dromerick, Alexander W; Lane, Christianne J; Nelsen, Monica A; Lewthwaite, Rebecca; Blanton, Sarah; Scott, Charro; Reiss, Aimee; Cen, Steven Yong; Holley, Rahsaan; Azen, Stanley P

2013-01-11

Residual disability after stroke is substantial; 65% of patients at 6 months are unable to incorporate the impaired upper extremity into daily activities. Task-oriented training programs are rapidly being adopted into clinical practice. In the absence of any consensus on the essential elements or dose of task-specific training, an urgent need exists for a well-designed trial to determine the effectiveness of a specific multidimensional task-based program governed by a comprehensive set of evidence-based principles. The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (ICARE) Stroke Initiative is a parallel group, three-arm, single blind, superiority randomized controlled trial of a theoretically-defensible, upper extremity rehabilitation program provided in the outpatient setting.The primary objective of ICARE is to determine if there is a greater improvement in arm and hand recovery one year after randomization in participants receiving a structured training program termed Accelerated Skill Acquisition Program (ASAP), compared to participants receiving usual and customary therapy of an equivalent dose (DEUCC). Two secondary objectives are to compare ASAP to a true (active monitoring only) usual and customary (UCC) therapy group and to compare DEUCC and UCC. Following baseline assessment, participants are randomized by site, stratified for stroke duration and motor severity. 360 adults will be randomized, 14 to 106 days following ischemic or hemorrhagic stroke onset, with mild to moderate upper extremity impairment, recruited at sites in Atlanta, Los Angeles and Washington, D.C. The Wolf Motor Function Test (WMFT) time score is the primary outcome at 1 year post-randomization. The Stroke Impact Scale (SIS) hand domain is a secondary outcome measure.The design includes concealed allocation during recruitment, screening and baseline, blinded outcome assessment and intention to treat analyses. Our primary hypothesis is that the improvement in log-transformed WMFT time will be greater for the ASAP than the DEUCC group. This pre-planned hypothesis will be tested at a significance level of 0.05. ICARE will test whether ASAP is superior to the same number of hours of usual therapy. Pre-specified secondary analyses will test whether 30 hours of usual therapy is superior to current usual and customary therapy not controlled for dose. www.ClinicalTrials.gov Identifier: NCT00871715

Temporal patterns of charcoal burning suicides among the working age population in Hong Kong SAR: the influence of economic activity status and sex

PubMed Central

2012-01-01

Background Charcoal burning in a sealed room has recently emerged as the second most common suicide means in Hong Kong, causing approximately 200 deaths each year. As charcoal burning suicide victims have a unique sociodemographic profile (i.e., predominantly economically active men), they may commit suicide at specific times. However, little is known about the temporal patterns of charcoal burning suicides. Methods Suicide data from 2001 to 2008 on victims of usual working age (20–59) were obtained from the registered death files of the Census and Statistics Department of Hong Kong. A total of 1649 cases of charcoal burning suicide were analyzed using a two-step procedure, which first examined the temporal asymmetries in the incidence of suicide, and second investigated whether these asymmetries were influenced by sex and/or economic activity status. Poisson regression analyses were employed to model the monthly and daily patterns of suicide by economic activity status and sex. Results Our findings revealed pronounced monthly and daily temporal variations in the pattern of charcoal burning suicides in Hong Kong. Consistent with previous findings on overall suicide deaths, there was an overall spring peak in April, and Monday was the common high risk day for all groups. Although sex determined the pattern of variation in charcoal burning suicides, the magnitude of the variation was influenced by the economic activity status of the victims. Conclusion The traditional classification of suicide methods as either violent or nonviolent tends to elide the temporal variations of specific methods. The interaction between sex and economic activity status observed in the present study indicates that sex should be taken into consideration when investigating the influence of economic activity status on temporal variations of suicide. This finding also suggests that suicide prevention efforts should be both time- and subgroup-specific. PMID:22770504

The ‘Cancer Home-Life Intervention’: A randomised controlled trial evaluating the efficacy of an occupational therapy–based intervention in people with advanced cancer

PubMed Central

la Cour, Karen; Gregersen Oestergaard, Lisa; Johnsen, Anna Thit; Lindahl-Jacobsen, Line; Højris, Inger; Brandt, Åse

2018-01-01

Background: People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the ‘Cancer Home-Life Intervention’. Aim: To evaluate the efficacy of the ‘Cancer Home Life-Intervention’ compared with usual care with regard to patients’ performance of, and participation in, everyday activities, and their health-related quality of life. Design and intervention: A randomised controlled trial (ClinicalTrials.gov NCT02356627). The ‘Cancer Home-Life Intervention’ is a brief, tailored, occupational therapy–based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. Setting/participants: Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. Results: A total of 242 participants were randomised either to the intervention group (n = 121) or the control group (n = 121). No effect was found on the primary outcome (between-group mean change: −0.04 logits (95% confidence interval: −0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. Conclusion: In most cases, the ‘Cancer Home-Life Intervention’ was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants’ everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing. PMID:29299957

Temporal patterns of charcoal burning suicides among the working age population in Hong Kong SAR: the influence of economic activity status and sex.

PubMed

Law, Chi-kin; Leung, Candi M C

2012-07-06

Charcoal burning in a sealed room has recently emerged as the second most common suicide means in Hong Kong, causing approximately 200 deaths each year. As charcoal burning suicide victims have a unique sociodemographic profile (i.e., predominantly economically active men), they may commit suicide at specific times. However, little is known about the temporal patterns of charcoal burning suicides. Suicide data from 2001 to 2008 on victims of usual working age (20-59) were obtained from the registered death files of the Census and Statistics Department of Hong Kong. A total of 1649 cases of charcoal burning suicide were analyzed using a two-step procedure, which first examined the temporal asymmetries in the incidence of suicide, and second investigated whether these asymmetries were influenced by sex and/or economic activity status. Poisson regression analyses were employed to model the monthly and daily patterns of suicide by economic activity status and sex. Our findings revealed pronounced monthly and daily temporal variations in the pattern of charcoal burning suicides in Hong Kong. Consistent with previous findings on overall suicide deaths, there was an overall spring peak in April, and Monday was the common high risk day for all groups. Although sex determined the pattern of variation in charcoal burning suicides, the magnitude of the variation was influenced by the economic activity status of the victims. The traditional classification of suicide methods as either violent or nonviolent tends to elide the temporal variations of specific methods. The interaction between sex and economic activity status observed in the present study indicates that sex should be taken into consideration when investigating the influence of economic activity status on temporal variations of suicide. This finding also suggests that suicide prevention efforts should be both time- and subgroup-specific.

Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL) questionnaire.

PubMed

Collingwood, Cecilia; Paddick, Stella-Maria; Kisoli, Aloyce; Dotchin, Catherine L; Gray, William K; Mbowe, Godfrey; Mkenda, Sarah; Urasa, Sarah; Mushi, Declare; Chaote, Paul; Walker, Richard W

2014-01-01

The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly due to difficulties in assessing function, an essential step in diagnosis. As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, to develop, pilot, and validate an Instrumental Activities of Daily Living (IADL) questionnaire for use in a rural Tanzanian population to assist in the identification of people with dementia alongside cognitive screening. The questionnaire was developed at a workshop for rural primary healthcare workers, based on culturally appropriate roles and usual activities of elderly people in this community. It was piloted in 52 individuals under follow-up from a dementia prevalence study. Validation subsequently took place during a community dementia-screening programme. Construct validation against gold standard clinical dementia diagnosis using DSM-IV criteria was carried out on a stratified sample of the cohort and validity assessed using area under the receiver operating characteristic (AUROC) curve analysis. An 11-item questionnaire (IDEA-IADL) was developed after pilot testing. During formal validation on 130 community-dwelling elderly people who presented for screening, the AUROC curve was 0.896 for DSM-IV dementia when used in isolation and 0.937 when used in conjunction with the IDEA cognitive screen, previously validated in Tanzania. The internal consistency was 0.959. Performance on the IDEA-IADL was not biased with regard to age, gender or education level. The IDEA-IADL questionnaire appears to be a useful aid to dementia screening in this setting. Further validation in other healthcare settings in SSA is required.

Discussion of Yellow Starthistle Response to Irradiance, Photoperiod, and CO2

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

2016-01-01

Yellow Starthistle (Centaurea solstitialis) is a native annual weed of Eurasia and since introduction into the US has become an invasive and noxious weed. It grows in a rosette habit during the vegetative state and usually bolts in summer to produce a large and branched flowering stem. Time to flowering in Yellow Starthistle has been attributed to photoperiod, nitrogen nutrition, temperature, and water stress. We executed a series of studies to investigate the role of light, both photoperiod and photosynthetic photon flux, on flowering and development in Yellow Starthistle. Treatments were presented in 4 ways: (1) Varying day length with constant photosynthetic photon flus (PPF) - providing increasing daily integrated Photosynthetic Photon (PP) exposure with longer day lengths, (2) Varying day length while adjusting PPF to maintain daily PP exposure for all treatments, (3) Extending photoperiod treatments beyond common 12-h photosynthetic period with low light levels to maintain both PPF and daily PP across all treatments; and (4) Reciprocal exchange of plant among photoperiod treatments. Yellow Starthistle appears to be a long-day plant with a critical day length requirement between 14-h and 16-h to induce transition from vegetative to floral stages in development. PPF and daily absorbed photons did not affect time to vegetative / floral stage transition, but did affect factors such as biomass accumulation and canopy parameters such as specific leaf mass. Reciprocal exchange of plants between floral inducing and inhibiting photoperiod treatments, starting at 2-weeks post germination, had no effect on to flower. Flowering was determined by photoperiod experienced during the first 2-weeks (or less) post germination. Yellow Starthistle net photosynthetic response to elevated atmospheric CO2 concentrations over a range of photosynthetically active radiation flux rates and temperatures will also be presented and discussed.

Nasal budesonide offers superior symptom relief in perennial allergic rhinitis in comparison to nasal azelastine.

PubMed

Stern, M A; Wade, A G; Ridout, S M; Cambell, L M

1998-10-01

Allergic rhinitis is usually treated with oral antihistamines or nasal steroids. Topically active nasal antihistamine is a new treatment modality for allergic rhinitis. The efficacy in comparison to well established topical treatment alternatives is not fully known. To compare the efficacy of intranasally administered azelastine to budesonide, at their respectively recommended dosage, on the symptoms of perennial rhinitis patients. A placebo-controlled, randomized, parallel group study was conducted to compare the efficacy and tolerability of intranasal budesonide aqueous suspension (256 microg once daily) with azelastine hydrochloride nasal spray (280 microg twice daily (560 microg/day)) and with placebo in the treatment of perennial allergic rhinitis. The 195 patients (with at least a 2-year history of perennial allergic rhinitis) recorded individual nasal symptom scores, the degree of symptom control achieved and any adverse events experienced over a 2-week baseline period and a 6-week treatment period. Following treatment, the reductions in mean combined and individual nasal symptom scores from baseline values were significantly greater in the budesonide group compared with the placebo group (P < .0001 for all variables except runny nose P = .01). In patients treated with budesonide, there were also significantly larger reductions from baseline values in combined nasal symptom scores (P < .01) and in scores for all individual nasal symptoms (P < or = .05) compared with those treated with azelastine. The reductions from baseline in both combined and individual nasal symptom scores did not differ between azelastine and placebo. The study medications were well tolerated, producing no unexpected or serious treatment-related adverse events. A once-daily dose of 256 microg of intranasal budesonide aqueous suspension is significantly more effective at relieving the symptoms of perennial allergic rhinitis compared with a twice daily dose of 280 microg of azelastine nasal spray.

Discussion of Yellow Starthistle Response to Photosynthetic Irradiance, Photoperiod, and CO2

NASA Technical Reports Server (NTRS)

Bubenheim, David

2017-01-01

Yellow Starthistle (Centaurea solstitialis) is a native annual weed of Eurasia and since introduction into the United STates has become an invasive and noxious weed. It grows in a rosette habit during the vegetative state and usually bolts in summer to produce a large and branched flowering stem. Time to flowering in Yellow Starthistle has been attributed to photoperiod, nitrogen nutrition, temperature, and water stress. We executed a series of studies to investigate the role of light, both photoperiod and photosynthetic photon flux, on flowering and development in Yellow Starthistle. Treatments were presented in 4 ways: 1) varying day length with constant photosynthetic photon flus (PPF) providing increasing daily integrated Photosynthetic Photon (PP) exposure with longer day lengths 2) varying day length while adjusting PPF to maintain daily PP exposure for all treatments 3) extending photoperiod treatments beyond common 12-h photosynthetic period with low light levels to maintain both PPF and daily PP across all treatments4)reciprocal exchange of plant among photoperiod treatments Yellow Starthistle appears to be a long-day plant with a critical day length requirement between 14-h and 16-h to induce transition from vegetative to floral stages in development. PPF and daily absorbed photons did not affect time to vegetative floral stage transition, but did affect factors such as biomass accumulation and canopy parameters such as specific leaf mass. Reciprocal exchange of plants between floral inducing and inhibiting photoperiod treatments, starting at 2-weeks post germination, had no effect on to flower. Flowering was determined by photoperiod experienced during the first 2-weeks (or less) post germination.Yellow Starthistle net photosynthetic response to elevated atmospheric CO2 concentrations over a range of photosynthetically active radiation flux rates and temperatures will also be presented and discussed.

Activities of daily living and manual hand dexterity in persons with idiopathic parkinson disease.

PubMed

Choi, Yoo-Im; Song, Chiang-Soon; Chun, Byung-Yoon

2017-03-01

[Purpose] The purpose of this study was to evaluate the relationship between daily activities and manual dexterity in persons with Parkinson disease. [Subjects and Methods] The study participants were 25 patients with idiopathic Parkinson disease. This study used two clinical tools, the box-and-block test and Schwab and England Activities of Daily Living scale, to investigate the relationship between manual dexterity and Schwab and England Activities of Daily Living score. [Results] A positive correlation was observed between the Schwab and England Activities of Daily Living and the box-and-block test scores on the more and less affected sides. Moreover, the Schwab and England Activities of Daily Living score had a greater correlation with the box-and-block test score on the less affected side than that on the more affected side. [Conclusion] Manual dexterity and activities of daily living showed a positive correlation in individuals with Parkinson disease. The results of this study suggest that manual dexterity is an important factor for predicting physical performance in daily living in persons with Parkinson disease.

Instantaneous-to-daily GPP upscaling schemes based on a coupled photosynthesis-stomatal conductance model: correcting the overestimation of GPP by directly using daily average meteorological inputs.

PubMed

Wang, Fumin; Gonsamo, Alemu; Chen, Jing M; Black, T Andrew; Zhou, Bin

2014-11-01

Daily canopy photosynthesis is usually temporally upscaled from instantaneous (i.e., seconds) photosynthesis rate. The nonlinear response of photosynthesis to meteorological variables makes the temporal scaling a significant challenge. In this study, two temporal upscaling schemes of daily photosynthesis, the integrated daily model (IDM) and the segmented daily model (SDM), are presented by considering the diurnal variations of meteorological variables based on a coupled photosynthesis-stomatal conductance model. The two models, as well as a simple average daily model (SADM) with daily average meteorological inputs, were validated using the tower-derived gross primary production (GPP) to assess their abilities in simulating daily photosynthesis. The results showed IDM closely followed the seasonal trend of the tower-derived GPP with an average RMSE of 1.63 g C m(-2) day(-1), and an average Nash-Sutcliffe model efficiency coefficient (E) of 0.87. SDM performed similarly to IDM in GPP simulation but decreased the computation time by >66%. SADM overestimated daily GPP by about 15% during the growing season compared to IDM. Both IDM and SDM greatly decreased the overestimation by SADM, and improved the simulation of daily GPP by reducing the RMSE by 34 and 30%, respectively. The results indicated that IDM and SDM are useful temporal upscaling approaches, and both are superior to SADM in daily GPP simulation because they take into account the diurnally varying responses of photosynthesis to meteorological variables. SDM is computationally more efficient, and therefore more suitable for long-term and large-scale GPP simulations.

Usual gait speed independently predicts mortality in very old people: a population-based study.

PubMed

Toots, Annika; Rosendahl, Erik; Lundin-Olsson, Lillemor; Nordström, Peter; Gustafson, Yngve; Littbrand, Håkan

2013-07-01

In older people, usual gait speed has been shown to independently predict mortality; however, less is known about whether usual gait speed is as informative in very old populations, in which prevalence of multimorbidity and disability is high. The aim of this study was to investigate if usual gait speed can independently predict all-cause mortality in very old people, and whether the prediction is influenced by dementia disorder, dependency in activities of daily living (ADL), or use of walking aids in the gait speed test. Prospective cohort study. Population-based study in northern Sweden and Finland (the Umeå 85+/GERDA Study). A total of 772 participants with a mean age of 89.6 years, 70% women, 33% with dementia disorders, 54% with ADL dependency, and 39% living in residential care facilities. Usual gait speed assessed over 2.4 meters and mortality followed-up for 5 years. The mean ± SD gait speed was 0.52 ± 0.21 m/s for the 620 (80%) participants able to complete the gait speed test. Cox proportional hazard regression analyses adjusted for potential confounders were performed. Compared with the fastest gait speed group (≥ 0.64 m/s), the hazard ratio for mortality was for the following groups: unable = 2.27 (P < .001), ≤ 0.36 m/s = 1.97 (P = .001), 0.37 to 0.49 m/s = 1.99 (P < .001), 0.50 to 0.63 m/s = 1.11 (P = .604). No interaction effects were found between gait speed and age, sex, dementia disorder, dependency in ADLs, or use of walking aids. Among people aged 85 or older, including people dependent in ADLs and with dementia disorders, usual gait speed was an independent predictor of 5-year all-cause mortality. Inability to complete the gait test or gait speeds slower than 0.5 m/s appears to be associated with higher mortality risk. Gait speed might be a useful clinical indicator of health status among very old people. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

What proportion of people who try one cigarette become daily smokers? A meta analysis of representative surveys.

PubMed

Birge, Max; Duffy, Stephen; Miler, Joanna Astrid; Hajek, Peter

2017-11-04

The 'conversion rate' from initial experimentation to daily smoking is a potentially important metric of smoking behavior, but estimates of it based on current representative data are lacking. The Global Health Data Exchange was searched for representative surveys conducted in English speaking, developed countries after year 2000 that included questions about ever trying a cigarette and ever smoking daily. The initial search identified 2776 surveys that were further screened for language, location, year, sample size, survey structure and representativeness. 44 surveys that passed the screening process were accessed and their codebooks were examined to see whether the two questions of interest were included. Eight datasets allowed extraction or estimation of relevant information. Survey quality was assessed with regards to response rates, sampling methods and data collection procedures. PRISMA guidelines were followed, with explicit rules for approaching derived variables and skip patterns. Proportions were pooled using random effects meta-analysis. The eight surveys used representative samples of the general adult population. Response rates varied from 45% to 88%. Survey methods were on par with the best practice in this field. Altogether 216,314 respondents were included of whom 60.3% (95%CI 51.3-69.3) ever tried a cigarette. Among those, 68.9% (95% CI 60.9-76.9%) progressed to daily smoking. Over two thirds of people who try one cigarette become, at least temporarily, daily smokers. The finding provides strong support for the current efforts to reduce cigarette experimentation among adolescents. The transition from trying the first cigarette through occasional to daily smoking usually implies that a recreational activity is turning into a compulsive need that has to be satisfied virtually continuously. The 'conversion rate' from initial experimentation to daily smoking is thus a potentially important metric of smoking behavior, but estimates of it based on representative data are lacking. The present meta analysis addressed this gap. Currently, about two thirds of non-smokers experimenting with cigarettes progress to daily smoking. The finding supports strongly the current efforts to reduce cigarette experimentation among adolescents. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Older Adults with Diabetes and Osteoarthritis and Their Spouses: Effects of Activity Limitations, Marital Happiness, and Social Contacts on Partners' Daily Mood

ERIC Educational Resources Information Center

Roper, Susanne Olsen; Yorgason, Jeremy B.

2009-01-01

Using daily diary data from 28 later life couples where one spouse had diabetes and osteoarthritis, we examined crossover effects of target spouses' daily activity limitations and their partners' daily mood. On days when target spouses' daily activity limitations were higher than average, partners' positive mood decreased and negative mood…

Flight Dynamics Operations Management of the Large and Heterogeneous Eutelsat Fleet of Commercial Satellites

NASA Astrophysics Data System (ADS)

Bellido, E.

The EUTELSAT FDU (Flight Dynamics Unit) manages the resources to perform the typical activities of the large satellite operators and faces the usual difficulties raising from a vast and heterogeneous fleet. At present 20 satellites from 9 different platforms/sub-platforms are controlled from our Satellite Control Centre. The FDU was created in 2002 with the aim to respond to the operational needs of a growing fleet in terms of number of satellites and activities. It is at present composed of 6 engineering staff with the objective to provide operations service covering the whole lifecycle of the satellites from the procurement phase till the decommissioning. The most demanding activity is the daily operations, which must ensure maximum safety and continuity of service with the highest efficiency. Solutions have been applied from different areas: management, structure, operations organisation, processes, facilities, quality standards, etc. In addition to this, EUTELSAT is a growing communications operator and the FDU needs to contribute to the global objectives of the company. This paper covers our approach.

Family science: What is it?

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

Whitlow, B.

Family science is an informal science education program designed to teach science skills by having children and parents learn and enjoy science together. Aimed at addressing the underrepresentation of women and ethnic and racial minorities in science-based careers, FAMILY SCIENCE involves parents and children in kindergarten through eighth grade in science activities that demonstrate the role science plays in their daily life and future. Family involvement is the key to the program`s effectiveness. Family classes are usually offered in a series of one- to two-hour class meetings for parents and their children after school, evenings, and weekends. During classes, parentsmore » and children work in pairs and small groups to solve problems, work cooperatively, and talk science. The activities provide experiences for the entire family that build skills, confidence, and interest in science. In addition, guest speakers and career activities illustrate for parents in the workforce the significance of math and science in their own jobs, and for kids, it highlights the diversity of jobs and the relevance of math and science.« less

Breathlessness during daily activity: The psychometric properties of the London Chest Activity of Daily Living Scale in patients with advanced disease and refractory breathlessness.

PubMed

Reilly, Charles C; Bausewein, Claudia; Garrod, Rachel; Jolley, Caroline J; Moxham, John; Higginson, Irene J

2017-10-01

The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034). All patients completed the following questionnaires: the London Chest Activities of Daily Living Scale, Chronic Respiratory Questionnaire, the Palliative care Outcome Scale, Palliative care Outcome Scale-symptoms, the Hospital Anxiety and Depression Scale and breathlessness measured on a numerical rating scale. Data quality, scaling assumptions, acceptability, internal consistency and construct validity of the London Chest Activities of Daily Living Scale were determined using standard psychometric approaches. Breathless patients with advanced malignant and non-malignant disease. A total of 88 patients were studied, primary diagnosis included; chronic obstructive pulmonary disease = 53, interstitial lung disease = 17, cancer = 18. Median (range) London Chest Activities of Daily Living Scale total score was 46.5 (14-67). No floor or ceiling effect was observed for the London Chest Activities of Daily Living Scale total score. Internal consistency was good, and Cronbach's alpha for the London Chest Activities of Daily Living Scale total score was 0.90. Construct validity was good with 13 out of 15 a priori hypotheses met. Psychometric analyses suggest that the London Chest Activities of Daily Living Scale is acceptable, reliable and valid in patients with advanced disease and refractory breathlessness.

Breathlessness during daily activity: The psychometric properties of the London Chest Activity of Daily Living Scale in patients with advanced disease and refractory breathlessness

PubMed Central

Reilly, Charles C; Bausewein, Claudia; Garrod, Rachel; Jolley, Caroline J; Moxham, John; Higginson, Irene J

2016-01-01

Background: The London Chest Activities of Daily Living Scale measures the impact of breathlessness on both activity and social functioning. However, the London Chest Activities of Daily Living Scale is not routinely used in patients with advanced disease. Aim: To assess the psychometric properties of the London Chest Activities of Daily Living Scale in patients with refractory breathlessness due to advanced disease. Design: A cross-sectional secondary analysis of data from a randomised controlled parallel-group, pragmatic, single-blind fast-track trial (randomised controlled trial) investigating the effectiveness of an integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness, known as the Breathlessness Support Service (NCT01165034). All patients completed the following questionnaires: the London Chest Activities of Daily Living Scale, Chronic Respiratory Questionnaire, the Palliative care Outcome Scale, Palliative care Outcome Scale–symptoms, the Hospital Anxiety and Depression Scale and breathlessness measured on a numerical rating scale. Data quality, scaling assumptions, acceptability, internal consistency and construct validity of the London Chest Activities of Daily Living Scale were determined using standard psychometric approaches. Setting/participants: Breathless patients with advanced malignant and non-malignant disease. Results: A total of 88 patients were studied, primary diagnosis included; chronic obstructive pulmonary disease = 53, interstitial lung disease = 17, cancer = 18. Median (range) London Chest Activities of Daily Living Scale total score was 46.5 (14–67). No floor or ceiling effect was observed for the London Chest Activities of Daily Living Scale total score. Internal consistency was good, and Cronbach’s alpha for the London Chest Activities of Daily Living Scale total score was 0.90. Construct validity was good with 13 out of 15 a priori hypotheses met. Conclusion: Psychometric analyses suggest that the London Chest Activities of Daily Living Scale is acceptable, reliable and valid in patients with advanced disease and refractory breathlessness. PMID:27932629

An exploratory study on the impact of daily activities on the pleasure and physical activity of older adults.

PubMed

Cabrita, Miriam; Lousberg, Richel; Tabak, Monique; Hermens, Hermie J; Vollenbroek-Hutten, Miriam M R

2017-01-01

Pleasure is one determinant of intrinsic motivation and yet a dimension often forgotten when promoting physical activity among the older population. In this study we investigate the relation between daily activities and physical activity, experience of pleasure, and the interaction between pleasure and physical activity in the daily lives of community-dwelling older adults. Participants carried a hip-worn accelerometer during 30 consecutive days resulting in a total of 320 days of data collection. Current activity, location, companion and experience of pleasure during each activity were assessed through experience sampling on a smartphone every 1-2 h. Between- and within-individual differences were analysed with multi-level models and 10xN = 1 regression analysis. Outdoor activities were associated with higher physical activity than indoor activities ( p  < 0.001). Performing leisure activities, outdoors and not alone significantly predicted pleasure in daily life (all p's < 0.05). Being more active while performing leisure activities resulted in higher experiences of pleasure ( p  < 0.001). However, when performing basic activities of daily living (e.g. commuting or households) this relation was inverted. Results provide meaningful indication for individual variance. The 30 days of data collected from each participant allow for identification of individual differences. Daily activities and their contexts do influence the experience of pleasure and physical activity of older adults in daily life of older adults, although similar research with larger population is recommended. Results are in accordance with the literature, indicating that the method adopted (accelerometry combined with experience sampling) provides reliable representation of daily life. Identification of individual differences can eventually be automatically performed through data mining techniques. Further research could look at innovative approaches to promote Active Ageing using mobile technology in the daily life, by promoting physical activity through recommendation of pleasurable activities, and thus likely to increase the intrinsic motivation to become physically active.

Estimating daily climatologies for climate indices derived from climate model data and observations

PubMed Central

Mahlstein, Irina; Spirig, Christoph; Liniger, Mark A; Appenzeller, Christof

2015-01-01

Climate indices help to describe the past, present, and the future climate. They are usually closer related to possible impacts and are therefore more illustrative to users than simple climate means. Indices are often based on daily data series and thresholds. It is shown that the percentile-based thresholds are sensitive to the method of computation, and so are the climatological daily mean and the daily standard deviation, which are used for bias corrections of daily climate model data. Sample size issues of either the observed reference period or the model data lead to uncertainties in these estimations. A large number of past ensemble seasonal forecasts, called hindcasts, is used to explore these sampling uncertainties and to compare two different approaches. Based on a perfect model approach it is shown that a fitting approach can improve substantially the estimates of daily climatologies of percentile-based thresholds over land areas, as well as the mean and the variability. These improvements are relevant for bias removal in long-range forecasts or predictions of climate indices based on percentile thresholds. But also for climate change studies, the method shows potential for use. Key Points More robust estimates of daily climate characteristics Statistical fitting approach Based on a perfect model approach PMID:26042192

Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR): a phase II randomised feasibility study of a multidisciplinary rehabilitation package following hip fracture.

PubMed

Williams, Nefyn H; Roberts, Jessica L; Din, Nafees Ud; Totton, Nicola; Charles, Joanna M; Hawkes, Claire A; Morrison, Val; Hoare, Zoe; Williams, Michelle; Pritchard, Aaron W; Alexander, Swapna; Lemmey, Andrew; Woods, Robert T; Sackley, Catherine; Logan, Pip; Edwards, Rhiannon T; Wilkinson, Clare

2016-10-05

To conduct a rigorous feasibility study for a future definitive parallel-group randomised controlled trial (RCT) and economic evaluation of an enhanced rehabilitation package for hip fracture. Recruitment from 3 acute hospitals in North Wales. Intervention delivery in the community. Older adults (aged ≥65) who received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by clinical team) and received rehabilitation in the North Wales area. Remote randomisation to usual care (control) or usual care+enhanced rehabilitation package (intervention), including six additional home-based physiotherapy sessions delivered by a physiotherapist or technical instructor, novel information workbook and goal-setting diary. Primary: Barthel Activities of Daily Living (BADL). Secondary measures included Nottingham Extended Activities of Daily Living scale (NEADL), EQ-5D, ICECAP capability, a suite of self-efficacy, psychosocial and service-use measures and costs. Outcome measures were assessed at baseline and 3-month follow-up by blinded researchers. 62 participants were recruited, 61 randomised (control 32; intervention 29) and 49 (79%) completed 3-month follow-up. Minimal differences occurred between the 2 groups for most outcomes, including BADL (adjusted mean difference 0.5). The intervention group showed a medium-sized improvement in the NEADL relative to the control group, with an adjusted mean difference between groups of 3.0 (Cohen's d 0.63), and a trend for greater improvement in self-efficacy and mental health, but with small effect sizes. The mean cost of delivering the intervention was £231 per patient. There was a small relative improvement in quality-adjusted life year in the intervention group. No serious adverse events relating to the intervention were reported. The trial methods were feasible in terms of eligibility, recruitment and retention. The effectiveness and cost-effectiveness of the rehabilitation package should be tested in a phase III RCT. ISRCTN22464643; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Immediate efficacy of neuromuscular exercise in patients with severe osteoarthritis of the hip or knee: a secondary analysis from a randomized controlled trial.

PubMed

Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders; Christensen, Robin; Roos, Ewa M

2014-07-01

Knowledge about the effects of exercise in severe and endstage osteoarthritis (OA) is limited. The aim was to evaluate the efficacy of a neuromuscular exercise program in patients with clinically severe hip or knee OA. This was a randomized controlled assessor-blinded trial. Patients received an educational package (care-as-usual) only, or care-as-usual plus an 8-week neuromuscular exercise intervention (NEMEX-TJR). NEMEX-TJR was supervised by a physiotherapist, twice weekly for 1 h. The primary outcome was Activities of Daily Living (ADL) subscale from the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb muscle power. Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor of NEMEX-TJR compared with control. Second, there were statistically significant differences between groups in favor of NEMEX-TJR on all self-reported outcomes and most functional performance tests (walk, chair stands, and 1-leg knee bends). Stratified analyses according to joint revealed moderate effect size for ADL for hip patients (0.63, 95% CI 0.26 to 1.00). Corresponding effect size for knee patients was small (0.23 95% CI -0.14 to 0.60). Feasibility of neuromuscular exercise was confirmed in patients about to have total joint replacement. Self-reported activities of daily living and objective performance were improved and pain reduced immediately following 8 weeks of neuromuscular exercise. While the effects were moderate in hip OA, they were only small in knee OA. ClinicalTrials.gov Identifier: NCT01003756.

The Effects of Affect on Study Abroad Students

ERIC Educational Resources Information Center

Savicki, Victor

2013-01-01

Being a study abroad student is not all sweetness and light. By definition, study abroad students are faced with acculturative stress (Berry, 2005) by virtue of encountering differences in assumptions, values, and expectations of daily living in their host culture. Add to that the usual challenge of hearing and speaking a different language, and…

The Geriatric Child in Today's Culture.

ERIC Educational Resources Information Center

Lamson, Frank E.

This paper develops the premise that there is today a new "child" in our culture developed in response to expectations of daily functioning, family relationships, societal status, economic level, medical illness, emotional needs, and financial management. This new "child" is a person who has usually passed the age of 65, and has found that the…

Nutrition and the Pregnant Teen.

ERIC Educational Resources Information Center

James, Vicki; McCamey, Jody

This illustrated guide for pregnant teenagers discusses the nutritional needs of the mother and her unborn child in a month-by-month format. The information presented for each of the 9 months typically includes a sample daily menu; a checklist of recommended servings per day for each of four food groups; a description of the usual emotional and…

Should We Use Colours as Symbolic Representations of Hot and Cold?

ERIC Educational Resources Information Center

Carvalho, Paulo Simeao; Sampaio e Sousa, Adriano

2006-01-01

People usually talk about "hot and cold" colours without really thinking of the impact these definitions may have on scientific understanding. These colours are associated with the human sensations of hot and cold, and this idea is consistent with commonsense and daily experience. Interacting with students, we detect conceptual conflicts when they…

Teachers Little Helper: Multi-Math-Coach

ERIC Educational Resources Information Center

Ebner, Martin; Schön, Martin; Taraghi, Behnam; Steyre, Michael

2013-01-01

Individual learning is out of sync with the elements of a curricula and the daily program of a teacher. At a time when multidigit multiplication methods are taught, many children are not perfectly performing the basic multiplication table. Teachers organize settings for learning and they usually have no time to give an individual feedback to every…

Diarrhoea, constipation and intestinal transit in a northern Nigerian population.

PubMed

Fakunle, Y M; Ajagbonna, S O; Ani, O E; Awofeso, O

1978-07-01

Healthy Nigerians from Zaria have a short intestinal transit time. It is usual for them to open their bowels daily and their concept of diarrhoea and constipation differs widely from the standard medical definition. To avoid confusion care must be taken to inquire exactly what patients mean when they present with these symptoms.

Three Major Sins of Professional Development: How Can We Make It Better?

ERIC Educational Resources Information Center

Varela, Alejandra M.

2012-01-01

Teachers often complain about the professional development opportunities. And it is not uncommon for absenteeism to increase among teachers and staff during in-service days. The biggest problem that professional development has encountered is that it is usually developed as an isolated requirement, with no real connection to daily teaching and…

The effects of fatigue and pain on daily life activities in systemic lupus erythematosus.

PubMed

Özel, Filiz; Argon, Gülümser

2015-01-01

The aim of this study was to determine the effects of pain and fatigue on daily life activities of systemic lupus erythematosus (SLE) patients. The study sample included 74 SLE patients who presented to outpatient departments of a university hospital and two local hospitals between 30.9.2009 and 15.5.2010. Data was collected using the Fatigue Severity Scale, Katz's Activity's Daily Living Index, Lawton and Brody's Instrumental Activities of Daily Living, and the McGill Pain Questionnaire. The mean scores were 6.0 (fatigue) on the Fatigue Severity Scale, 18.0 (independent) on the Daily Life Activities Index, 24.0 (independent) on the Instrumental Daily Life Activities Index, and 1.56 (discomforting) on the McGill Pain Scale for pain felt at the moment of questioning. A low-level negative relationship was observed between the scores on the Fatigue Severity Scale and the Daily Life Activities Index (p<0.05, r=-0.298), and between Fatigue and Instrumental Daily Life Activities scores (p<0.05, r=-0.354). A medium-level positive relationship was observed between the scores on the Fatigue Severity Scale and the McGill Pain Scale (p<0.05, r=0.478). This study determined that pain and fatigue affected the daily lives of SLE patients. The study should be repeated on a larger sample.

The benefits of being self-compassionate on days when interactions with body-focused others are frequent.

PubMed

Kelly, Allison C; Miller, Kathryn E; Stephen, Elizabeth

2016-12-01

We examined whether a woman's level of self-compassion on a given day (within-persons) and over a week (between-persons) influenced her eating, body image, and affect in the face of frequent daily and/or weekly interactions with body-focused others. For seven nights, 92 female undergraduates reported on their daily social interactions, self-compassion, body image, eating, and affect. On days when women were less self-compassionate than usual, frequent interactions with body-focused others were associated with more body image concerns and negative affect, and less body appreciation and intuitive eating. However, these relationships were absent or inversed on days when women were more self-compassionate than usual. Self-compassion played a similar buffering role at the between-persons level. Results suggest that by treating themselves with a higher degree of self-compassion than what is typical for them, young women may be able to maintain healthier approaches to eating and body image when faced with body image threats. Copyright © 2016 Elsevier Ltd. All rights reserved.

Need Satisfaction Moderates the Association Between Physical Activity and Affective States in Adults Aged 50+: an Activity-Triggered Ambulatory Assessment.

PubMed

Kanning, Martina; Hansen, Sylvia

2017-02-01

Substantial evidence shows that physical activities of daily living are positively correlated with affective states in middle-aged and older adults. However, people's physical activity decreases when they grow older, and conditions that enhance older individuals' physical activities of daily living are not well understood. This study investigated need satisfaction (competence, relatedness, and autonomy) and its moderating effect on the within-subject relation between physical activities of daily living and three dimensions of affective states (valence, energetic arousal, and calmness) based on an ambulatory assessment that used activity-triggered e-diaries. The physical activities of daily living of 68 adults aged 50+ (mean age = 60.1 ± 7.1) were measured objectively for three consecutive days, and need satisfaction and affective states were assessed as a function of the amount of physical activity during the preceding 10 min before the affect measurement (in activity-triggered e-diaries). Hierarchical multilevel analyses were performed. Need satisfaction was significantly and positively correlated with the three dimensions of affective states. Further, physical activities of daily living were significantly associated with energetic arousal and calmness, but not valence. However, when physical activities of daily living were more autonomously regulated, the association of physical activities of daily living and valence became significant and positive. The findings regarding the significant moderating effects of need satisfaction are crucial for interventions aiming to improve the health-enhancing effects of physical activity in adults aged 50+. Positive feelings owing to physical activities in daily living depend on the extent that psychological needs are satisfied.

[Adult form of Pompe disease].

PubMed

Ziółkowska-Graca, Bozena; Kania, Aleksander; Zwolińska, Grazyna; Nizankowska-Mogilnicka, Ewa

2008-01-01

Pompe disease (glycogen-storage disease type II) is an autosomal recessive disorder caused by a deficiency of lysosomal acid alpha-glucosidase (GAA), leading to the accumulation of glycogen in the lysosomes primarily in muscle cells. In the adult form of the disease, proximal muscle weakness is noted and muscle volume is decreased. The infantile form is usually fatal. In the adult form of the disease the prognosis is relatively good. Muscle weakness may, however, interfere with normal daily activities, and respiratory insufficiency may be associated with obstructive sleep apnea. Death usually results from respiratory failure. Effective specific treatment is not available. Enzyme replacement therapy with recombinant human GAA (rh-GAA) still remains a research area. We report the case of a 24-year-old student admitted to the Department of Pulmonary Diseases because of severe respiratory insufficiency. Clinical symptoms such as dyspnea, muscular weakness and increased daytime sleepiness had been progressing for 2 years. Clinical examination and increased blood levels of CK suggested muscle pathology. Histopathological analysis of muscle biopsy, performed under electron microscope, confirmed the presence of vacuoles containing glycogen. Specific enzymatic activity of alpha-glucosidase was analyzed confirming Pompe disease. The only effective method to treat respiratory insufficiency was bi-level positive pressure ventilation. Respiratory rehabilitation was instituted and is still continued by the patient at home. A high-protein, low-sugar diet was proposed for the patient. Because of poliglobulia low molecular weight heparin was prescribed. The patient is eligible for experimental replacement therapy with rh-GAA.

Activities of daily living in children with developmental coordination disorder: dressing, personal hygiene, and eating skills.

PubMed

Summers, Janet; Larkin, Dawne; Dewey, Deborah

2008-04-01

In order to understand how age, culture, and problems in motor coordination impact the performance of activities of daily living, we used focus groups and in-depth interviews with Australian and Canadian parents to examine activities of daily living of younger (5-7 years of age) and older (8-9 years of age) children with and without DCD. By comparison with their typically developing age group, children with DCD had more difficulty with dressing, personal hygiene, and eating skills. Difficulties with postural control and fine-motor skills were reported to contribute to poorer performance of activities of daily living. As expected, competence in the performance of activities of daily living improved in the older children with and without DCD and there were few differences in the performance of daily living tasks between typical children in Australia and Canada. Overall, the motor difficulties of children with DCD had a significant impact on performance of a wide range of daily activities.

Lifestyle Behaviors in Metabolically Healthy and Unhealthy Overweight and Obese Women: A Preliminary Study.

PubMed

Camhi, Sarah M; Crouter, Scott E; Hayman, Laura L; Must, Aviva; Lichtenstein, Alice H

2015-01-01

Few studies have examined dietary data or objective measures of physical activity (PA) and sedentary behavior among metabolically healthy overweight/obese (MHO) and metabolically unhealthy overweight/obese (MUO). Thus, the purpose is to determine whether PA, sedentary behavior and/or diet differ between MHO and MUO in a sample of young women. Forty-six overweight/obese (BMI ≥25 kg/m2) African American and Caucasian women 19-35 years were classified by cardiometabolic risk factors, including elevated blood pressure, triglyceride, glucose and C-reactive protein, low high density lipoprotein, and insulin resistance (MUO ≥2; MHO, <2). Time (mins/day) in light, moderate, vigorous PA, and sedentary behavior were estimated using an accelerometer (≥3 days; ≥8 hrs wear time). Questionnaires were used to quantify sitting time, TV/computer use and usual daily activity. The Block Food Frequency Questionnaire assessed dietary food intake. Differences between MHO and MUO for lifestyle behaviors were tested with linear regression (continuous data) or logistic regression (categorical data) after adjusting for age, race, BMI, smoking and accelerometer wear and/or total kilocalories, as appropriate. Women were 26.7±4.7 years, with a mean BMI of 31.1±3.7 kg/m2, and 61% were African American. Compared to MUO (n = 9), MHO (n = 37; 80%) spent less mins/day in sedentary behavior (difference: -58.1±25.5, p = 0.02), more mins/day in light PA (difference: 38.2±16.1, p = 0.02), and had higher daily METs (difference: 0.21±0.09, p = 0.03). MHO had higher fiber intakes (g/day of total fiber, soluble fiber, fruit/vegetable fiber, bean fiber) and daily servings of vegetables; but lower daily dairy servings, saturated fat, monounsaturated fat and trans fats (g/day) compared to MUO. Compared to MUO, MHO young women demonstrate healthier lifestyle habits with less sedentary behavior, more time in light PA, and healthier dietary quality for fat type and fiber. Future studies are needed to replicate findings with larger samples that include men and women of diverse race/ethnic groups.

Daily Physical Activity in Total Hip Arthroplasty Patients Undergoing Different Surgical Approaches: A Cohort Study.

PubMed

Engdal, Monika; Foss, Olav A; Taraldsen, Kristin; Husby, Vigdis S; Winther, Siri B

2017-07-01

Muscle weakness due to trauma from the surgical approach is anticipated to affect the ability of the patient to undertake daily physical activity early after total hip arthroplasty (THA). The objective of this study was to compare daily physical activity on days 1 to 4 after discharge, in patients following THA performed by 1 of 3 surgical approaches. A cohort study included 60 hip osteoarthritis patients, scheduled for THA, allocated to direct lateral approach, posterior approach, or anterior approach. Daily physical activity was measured by an accelerometer, with upright time per 24 hours as primary outcome and walking time, number of steps, and number of upright events per 24 hours as secondary outcomes. There were no statistically significant group differences in any of the measures of daily physical activity (P > 0.290) or between days of follow-up (P > 0.155). Overall, the median participant had 3.50 hours (interquartile range, 2.85-4.81 hours) of upright time, and participants showed wide variation in all outcomes of daily physical activity. There were no differences in daily physical activity between THA patients undergoing different surgical approaches. The surgical approach may not be a limiting factor for daily physical activity early after surgery in a fast-track treatment course.

Feeding frequency, but not dietary water content, affects voluntary physical activity in young lean adult female cats.

PubMed

de Godoy, M R C; Ochi, K; de Oliveira Mateus, L F; de Justino, A C C; Swanson, K S

2015-05-01

The objective of this study was to investigate whether increased dietary water content and feeding frequency increased voluntary physical activity of young, lean adult female cats. A replicated 4 × 4 Latin square design with a 2 × 2 factorial treatment arrangement (feeding frequency and water content) was used. The 4 treatments consisted of 1 meal daily dry pet food without added water (1D; 12% moisture as is), 1 meal daily dry pet food with added water (1W; 70% total water content), 4 meals daily dry pet food without added water (4D; 12% moisture as is), and 4 meals daily dry pet food with added water (4W; 70% total water content). Eight healthy adult, lean, intact, young, female domestic shorthair cats were used in this experiment. Voluntary physical activity was evaluated using Actical activity monitors placed on collars and worn around the cats' necks for the last 7 d of each experimental period of 14 d. Food anticipatory activity (FAA) was calculated based on 2 h prior to feeding periods and expressed as a percentage of total daily voluntary physical activity. Increased feeding frequency (4 vs. 1 meal daily) resulted in greater average daily activity (P = 0.0147), activity during the light period (P = 0.0023), and light:dark activity ratio (P = 0.0002). In contrast, physical activity during the dark period was not altered by feeding frequency (P > 0.05). Cats fed 4 meals daily had increased afternoon FAA (P= 0.0029) compared with cats fed once daily. Dietary water content did not affect any measure of voluntary physical activity. Increased feeding frequency is an effective strategy to increase the voluntary physical activity of cats. Thus, it may assist in the prevention and management of obesity.

Efficacy of occupational therapy for patients with Parkinson's disease: a randomised controlled trial.

PubMed

Sturkenboom, Ingrid H W M; Graff, Maud J L; Hendriks, Jan C M; Veenhuizen, Yvonne; Munneke, Marten; Bloem, Bastiaan R; Nijhuis-van der Sanden, Maria W

2014-06-01

There is insufficient evidence to support use of occupational therapy interventions for patients with Parkinson's disease. We aimed to assess the efficacy of occupational therapy in improving daily activities of patients with Parkinson's disease. We did a multicentre, assessor-masked, randomised controlled clinical trial in ten hospitals in nine Dutch regional networks of specialised health-care professionals (ParkinsonNet), with assessment at 3 months and 6 months. Patients with Parkinson's disease with self-reported difficulties in daily activities were included, along with their primary caregivers. Patients were randomly assigned (2:1) to the intervention or control group by a computer-generated minimisation algorithm. The intervention consisted of 10 weeks of home-based occupational therapy according to national practice guidelines; control individuals received usual care with no occupational therapy. The primary outcome was self-perceived performance in daily activities at 3 months, assessed with the Canadian Occupational Performance Measure (score 1-10). Data were analysed using linear mixed models for repeated measures (intention-to-treat principle). Assessors monitored safety by asking patients about any unusual health events during the preceding 3 months. This trial is registered with ClinicalTrials.gov, NCT01336127. Between April 14, 2011, and Nov 2, 2012, 191 patients were randomly assigned to the intervention group (n=124) or the control group (n=67). 117 (94%) of 124 patients in the intervention group and 63 (94%) of 67 in the control group had a participating caregiver. At baseline, the median score on the Canadian Occupational Performance Measure was 4·3 (IQR 3·5-5·0) in the intervention group and 4·4 (3·8-5·0) in the control group. At 3 months, these scores were 5·8 (5·0-6·4) and 4·6 (4·6-6·6), respectively. The adjusted mean difference in score between groups at 3 months was in favour of the intervention group (1·2; 95% CI 0·8-1·6; p<0·0001). There were no adverse events associated with the study. Home-based, individualised occupational therapy led to an improvement in self-perceived performance in daily activities in patients with Parkinson's disease. Further work should identify which factors related to the patient, environmental context, or therapist might predict which patients are most likely to benefit from occupational therapy. Prinses Beatrix Spierfonds and Parkinson Vereniging. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study

PubMed Central

2012-01-01

Background Based on findings primarily using self-report measures, physical activity has been recommended to reduce disability in old age. Collecting objective measures of total daily physical activity in community-dwelling older adults is uncommon, but might enhance the understanding of the relationship of physical activity and disability. We examined whether greater total daily physical activity was associated with less report of disability in the elderly. Methods Data were from the Rush Memory and Aging Project, a longitudinal prospective cohort study of common, age-related, chronic conditions. Total daily physical activity was measured in community-dwelling participants with an average age of 82 using actigraphy for approximately 9 days. Disability was measured via self-reported basic activities of daily living (ADL). The odds ratio and 95% Confidence Interval (CI) were determined for the baseline association of total daily physical activity and ADL disability using a logistic regression model adjusted for age, education level, gender and self-report physical activity. In participants without initial report of ADL disability, the hazard ratio and 95% CI were determined for the relationship of baseline total daily physical activity and the development of ADL disability using a discrete time Cox proportional hazard model adjusted for demographics and self-report physical activity. Results In 870 participants, the mean total daily physical activity was 2. 9 × 105 counts/day (range in 105 counts/day = 0.16, 13. 6) and the mean hours/week of self-reported physical activity was 3.2 (SD = 3.6). At baseline, 718 (82.5%) participants reported being independent in all ADLs. At baseline, total daily physical activity was protective against disability (OR per 105 counts/day difference = 0.55; 95% CI = 0.47, 0.65). Of the participants without baseline disability, 584 were followed for 3.4 years on average. Each 105 counts/day additional total daily physical activity was associated with reduced hazard of developing disability by 25% (HR = 0.75, 95% CI = 0.66, 0.84). The results were unchanged after controlling for important covariates including cognition, depressive symptoms, and chronic health conditions. Conclusions Greater total daily physical activity is independently associated with less disability even after controlling for self-reported physical activity. PMID:23072476

Do Chinese Children Get Enough Micronutrients?

PubMed Central

Wang, Huijun; Wang, Dantong; Ouyang, Yifei; Huang, Feifei; Ding, Gangqiang; Zhang, Bing

2017-01-01

The aim of this study was to examine usual daily micronutrient intake of Chinese children based on data from the 2011 China Health and Nutrition Survey. We analyzed data from 4 to 17-year-old participants, who provided dietary data on three consecutive days combined with the household weighing method in 2011. Usual daily intake of each nutrient was estimated using a mixed effects model based on the China Food Composition published in 2009. The means, medians and percentages below Estimated Average Requirements (EAR) were reported for selected micronutrients, including calcium, sodium, potassium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C. For sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI) level. The average usual daily intakes of all micronutrients increase with age, and the intakes of boys were found to be higher than girls in the same age group. The average calcium intake increased from 272 mg/day in 4–6 years to 391 mg/day in 14–17 years, but the percentage of inadequate calcium intake remained very high (>96%). The prevalence of inadequacy of calcium was the highest among the mineral nutrients reported in this study. As the requirements of micronutrients increased with age, the percentage of subjects with inadequate intake increased in the 11–17 years age groups. Among 14–17 years group, the percentages of study participants with dietary intakes of calcium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C below the EAR were 96.8%, 18.8%, 37.6%, 72.8%, 36.8%, 91.8%. 85.9% and 75.5%, respectively. Among 11–13 years group, the percentages of study participants with dietary intakes of iron, zinc and vitamin A below the EAR were 23.5%, 41.5%, and 41.6%, respectively. Thus, micronutrient deficiency is a problem in Chinese children. Nutrition education and intervention programs are needed to address these nutritional gaps. PMID:28420205

The impact of neighbourhood walkability on the effectiveness of a structured education programme to increase objectively measured walking.

PubMed

Carter, P; Bodicoat, D H; Jones, A; Khunti, K; Davies, M J; Edwardson, C L; Henson, J; Yates, T; Coombes, E

2018-03-01

Incorporating physical activity into daily activities is key for the effectiveness of lifestyle education interventions aimed at improving health outcomes; however, consideration of the environmental context in which individuals live is not always made. Walkability is a characteristic of the physical environment, and may be a potential facilitator to changing physical activity levels. Using data collected during the Walking Away from Diabetes randomized controlled trial, we examined the association between the walkability of the home neighbourhood and physical activity of participants. We also determined whether home neighbourhood walkability of participants was associated with the intervention effect of the education programme. Data from 706 participants were available for analysis. Neighbourhood walkability was not significantly associated with any of the physical activity measures at baseline, or at 12, 24 or 36 months following the intervention (P > 0.05 for all). There was no association between walkability and change in purposeful steps/day from baseline to 36 months in the usual care or intervention arm; 25.77 (-99.04, 150.58) and 42.97 (-327.63, 413.45), respectively. Neighbourhood walkability appeared to have no association with objectively measured physical activity in this population. Furthermore, the walkability of participant's neighbourhood did not influence the effectiveness of a lifestyle programme.

Weight Management for Athletes and Active Individuals: A Brief Review.

PubMed

Manore, Melinda M

2015-11-01

Weight management for athletes and active individuals is unique because of their high daily energy expenditure; thus, the emphasis is usually placed on changing the diet side of the energy balance equation. When dieting for weight loss, active individuals also want to preserve lean tissue, which means that energy restriction cannot be too severe or lean tissue is lost. First, this brief review addresses the issues of weight management in athletes and active individuals and factors to consider when determining a weight-loss goal. Second, the concept of dynamic energy balance is reviewed, including two mathematical models developed to improve weight-loss predictions based on changes in diet and exercise. These models are now available on the Internet. Finally, dietary strategies for weight loss/maintenance that can be successfully used with active individuals are given. Emphasis is placed on teaching the benefits of consuming a low-ED diet (e.g., high-fiber, high-water, low-fat foods), which allows for the consumption of a greater volume of food to increase satiety while reducing energy intake. Health professionals and sport dietitians need to understand dynamic energy balance and be prepared with effective and evidence-based dietary approaches to help athletes and active individuals achieve their body-weight goals.

Patients' experiences of physical limitations in daily life activities when suffering from chronic heart failure; a phenomenographic analysis.

PubMed

Pihl, Emma; Fridlund, Bengt; Mårtensson, Jan

2011-03-01

The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one's own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one's social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities. © 2010 The Authors. Scandinavian Journal of Caring Sciences © 2010 Nordic College of Caring Science.

Use of locally delivered dequalinium chloride in the treatment of vaginal infections: a review.

PubMed

Mendling, Werner; Weissenbacher, Ernst Rainer; Gerber, Stefan; Prasauskas, Valdas; Grob, Philipp

2016-03-01

Vaginal infections are responsible for a large proportion of gynaecological outpatient visits. Those are bacterial vaginosis (BV), vulvovaginal candidosis (VVC), aerobic vaginitis (AV) associated with aerobic bacteria, and mixed infections. Usual treatments show similar acceptable short-term efficacy, but frequent recurrences and increasing microbial resistance are unsolved issues. Furthermore, vaginal infections are associated with a variety of serious adverse outcomes in pregnancy and generally have a major impact on quality of life. Identifying the correct therapy can be challenging for the clinician, particularly in mixed infections. Dequalinium chloride (DQC) is an anti-microbial antiseptic agent with a broad bactericidal and fungicidal activity. Systemic absorption after vaginal application of DQC is very low and systemic effects negligible. Vaginal DQC (Fluomizin vaginal tablets) has been shown to have equal clinical efficacy as clindamycin in the treatment of BV. Its broad antimicrobial activity makes it appropriate for the treatment of mixed vaginal infections and in case of uncertain diagnosis. Moreover, resistance of pathogens is unlikely due to its multiple mode of action, and vaginal DQC provides also a reduced risk for post-treatment vaginal infections. Vaginal DQC (10 mg) as 6-day therapy offers a safe and effective option for empiric therapy of different vaginal infections in daily practice. This review summarizes the available and relevant pharmacological and clinical data for the therapy of vaginal infections with vaginal DQC and provides the rationale for its use in daily gynaecologic practice.

[Disease versus disorder. Medical and socio-environmental aspects of mental suffering].

PubMed

Heinz, A

2015-01-01

A disease concept should be broad enough to provide social protection for all subjects suffering from this malady but at the same time it needs to be narrow enough to avoid pathologization of behavior that is merely socially undesirable. From a medical perspective a"disease" is present if functions are impaired that are relevant for individual survival. In the field of psychiatry and psychotherapy, such medically relevant functions include the ability to be alert and fully oriented, to ascribe one's own intentions to oneself and to modulate affects according to the situation. Beyond such medically relevant symptoms of a disease, any clinically relevant dysfunction should also be harmful for the individual if a mental malady is to be diagnosed. One such harmful consequence of a disease can be that the person feels ill and suffers from this state, another negative consequence for the individual can be due to an impairment of activities of daily living and social participation. These harmful consequences of a disease are usually discussed under the heading of the"illness experience" and the"sickness aspect" of any disorder. Beyond mental maladies characterized by disease symptoms that are accompanied either by an illness experience or impaired activities of daily living and social participation (sickness), there are many states of human suffering which can be objectified and classified but do not constitute a disease in the medical sense and should more aptly be named a disorder.

Concurrent and convergent validity of the mobility- and multidimensional-hierarchical disability categorization models with physical performance in community older adults.

PubMed

Hu, Ming-Hsia; Yeh, Chih-Jun; Chen, Tou-Rong; Wang, Ching-Yi

2014-01-01

A valid, time-efficient and easy-to-use instrument is important for busy clinical settings, large scale surveys, or community screening use. The purpose of this study was to validate the mobility hierarchical disability categorization model (an abbreviated model) by investigating its concurrent validity with the multidimensional hierarchical disability categorization model (a comprehensive model) and triangulating both models with physical performance measures in older adults. 604 community-dwelling older adults of at least 60 years in age volunteered to participate. Self-reported function on mobility, instrumental activities of daily living (IADL) and activities of daily living (ADL) domains were recorded and then the disability status determined based on both the multidimensional hierarchical categorization model and the mobility hierarchical categorization model. The physical performance measures, consisting of grip strength and usual and fastest gait speeds (UGS, FGS), were collected on the same day. Both categorization models showed high correlation (γs = 0.92, p < 0.001) and agreement (kappa = 0.61, p < 0.0001). Physical performance measures demonstrated significant different group means among the disability subgroups based on both categorization models. The results of multiple regression analysis indicated that both models individually explain similar amount of variance on all physical performances, with adjustments for age, sex, and number of comorbidities. Our results found that the mobility hierarchical disability categorization model is a valid and time efficient tool for large survey or screening use.

Association of sarcopenia with functional decline in community-dwelling elderly subjects in Japan.

PubMed

Tanimoto, Yoshimi; Watanabe, Misuzu; Sun, Wei; Tanimoto, Keiji; Shishikura, Kanako; Sugiura, Yumiko; Kusabiraki, Toshiyuki; Kono, Koichi

2013-10-01

The present study aimed to determine the association of sarcopenia, defined by muscle mass, muscle strength and physical performance, with functional disability from a 2-year cohort study of community-dwelling elderly Japanese people. Participants were 743 community-dwelling elderly Japanese people aged 65 years or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. Functional disability was defined using an activities of daily living (ADL) scale and instrumental activities of daily living (IADL) scale at baseline and during follow-up examinations 2 years later. Logistic regression analysis, adjusted for age and body mass index, was used to examine the association between sarcopenia and the occurrence of functional disability. In the present study, 7.8% of men and 10.2% of women were classified as having sarcopenia. Among sarcopenia patients in the baseline study, 36.8% of men and 18.8% of women became dependent in ADL at 2-year follow up. From the logistic regression analysis adjusted by age and body mass index, sarcopenia was significantly associated with the occurrences of physical disability compared with normal subjects in both men and women. Sarcopenia, defined by muscle mass, muscle strength and physical performance, was associated with functional decline over a 2-year period in elderly Japanese. Interventions to prevent sarcopenia are very important to prevent functional decline among elderly individuals. © 2013 Japan Geriatrics Society.

[Food groups consumption and sociodemographic characteristics in Mexican population].

PubMed

Gaona-Pineda, Elsa B; Martínez-Tapia, Brenda; Arango-Angarita, Andrea; Valenzuela-Bravo, Danae; Gómez-Acosta, Luz M; Shamah-Levy, Teresa; Rodríguez-Ramírez, Sonia

2018-01-01

To estimate the recommendable and non-recommendable food groups for usual consumption by sociodemographic characteristics in Mexican population. Through a 7-day, semi-quan¬titative food frequency questionnaire used in 2016 National Health and Nutrition Survey, we estimated the proportions of population (preschool and school children, adolescents and adults) who consumed food groups that are relevant for public health by area, region and socioeconomic status (SES). Less than 50% of population consumed vegetables daily; almost 80% of the population consumed plain water daily and sweetened beverages (3 d/week). Center and Mexico City regions had the highest percentage of fruits and vegetables consumers (p<0.012). High SES had the highest consumer´s percentage of recommendable and non-recommendable food groups. A high percentage of the population do not consume fruits, vegetables and plain water daily.

Focal hyperhidrosis: diagnosis and management

PubMed Central

Haider, Aamir; Solish, Nowell

2005-01-01

HYPERHIDROSIS, A CONDITION CHARACTERIZED by excessive sweating, can be generalized or focal. Generalized hyperhidrosis involves the entire body and is usually part of an underlying condition, most often an infectious, endocrine or neurologic disorder. Focal hyperhidrosis is idiopathic, occurring in otherwise healthy people. It affects 1 or more body areas, most often the palms, armpits, soles or face. Almost 3% of the general population, largely people aged between 25 and 64 years, experience hyperhidrosis. The condition carries a substantial psychological and social burden, since it interferes with daily activities. However, patients rarely seek a physician's help because many are unaware that they have a treatable medical disorder. Early detection and management of hyperhidrosis can significantly improve a patient's quality of life. There are various topical, systemic, surgical and nonsurgical treatments available with efficacy rates greater than 90%–95%. PMID:15632408

[Topical therapy of ulcerative colitis].

PubMed

Rogler, G; Beglinger, C; Mottet, C; Seibold, F; Gross, V

2011-11-16

The availability of new topical preparations for the treatment of left sided ulcerative colitis ulcerosa offers a therapy optimization for many patients. Rectal application of steroids and 5-aminosalicylic acid (5-ASA) is associated with fewer side effects and has a higher therapeutic efficacy in mild to moderate-active left-sided colitis as compared to a systemic therapy. Often it is argued that the patients' compliance is insufficient with a rectal therapy. However, with sufficient information on the proven advantages this is usually not the case. The rectal application of drugs in distal ulcerative colitis is suitable also for the maintenance of remission. Therefore the new therapy guidelines recommend topical therapy more than in former times. Subsequently, these manuscripts focussed specifically on the topical therapy of distal colitis, to elucidate that clear treatment advantages are present in daily practice.

After-school setting, physical activity, and sedentary behavior in 5th grade boys and girls.

PubMed

Taverno Ross, S E; Dowda, M; Colabianchi, N; Saunders, R; Pate, R R

2012-09-01

After-school hours are considered critical for children's physical activity (PA) and sedentary behaviors (SB); however, whether the after-school setting influences children's activity patterns is unknown. This study examined the influence of after-school setting (i.e., parent report of the child's usual after-school setting) on 5th grade children's PA and SB, and differences by race/ethnicity. Boys whose parents reported they usually attended an after-school program had higher PA than boys who usually went home after school. A significant interaction between race/ethnicity and after-school setting showed that minority girls whose parents reported they usually attended an after-school program had higher PA and engaged in less SB compared with those who usually went home, whereas the activity patterns of white girls did not differ by after-school setting. Children's usual after-school setting affects their activity patterns; after-school programs may potentially increase PA in boys and minority girls. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

PubMed

Kamo, Tomohiko; Nishida, Yuusuke

2014-10-01

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

Physiotherapy to improve physical activity in community-dwelling older adults with mobility problems (Coach2Move): study protocol for a randomized controlled trial.

PubMed

de Vries, Nienke M; Staal, J Bart; Teerenstra, Steven; Adang, Eddy M M; Rikkert, Marcel G M Olde; Nijhuis-van der Sanden, Maria W G

2013-12-17

Older adults can benefit from physical activity in numerous ways. Physical activity is considered to be one of the few ways to influence the level of frailty. Standardized exercise programs do not necessarily lead to more physical activity in daily life, however, and a more personalized approach seems appropriate. The main objective of this study is to investigate whether a focused, problem-oriented coaching intervention ('Coach2Move') delivered by a physiotherapist specializing in geriatrics is more effective for improving physical activity, mobility and health status in community-dwelling older adults than usual physiotherapy care. In addition, cost-effectiveness will be determined. The design of this study is a single-blind randomized controlled trial in thirteen physiotherapy practices. Randomization will take place at the individual patient level. The study population consists of older adults, ≥70 years of age, with decreased physical functioning and mobility and/or a physically inactive lifestyle. The intervention group will receive geriatric physiotherapy according to the Coach2Move strategy. The control group will receive the usual physiotherapy care. Measurements will be performed by research assistants not aware of group assignment. The results will be evaluated on the amount of physical activity (LASA Physical Activity Questionnaire), mobility (modified 'get up and go' test, walking speed and six-minute walking test), quality of life (SF-36), degree of frailty (Evaluative Frailty Index for Physical Activity), fatigue (NRS-fatigue), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire) and health care costs. Most studies on the effect of exercise or physical activity consist of standardized programs. In this study, a personalized approach is evaluated within a group of frail older adults, many of whom suffer from multiple and complex diseases and problems. A complicating factor in evaluating a new approach is that it may not be automatically adopted by clinicians. Specific actions are undertaken to optimize implementation of the Coach2Move strategy during the trial. Whether or not these will be sufficient is a matter we will consider subsequently, using quality indicators and process analysis. The Netherlands National Trial Register: NTR3527.

Effectiveness of app-based relaxation for patients with chronic low back pain (Relaxback) and chronic neck pain (Relaxneck): study protocol for two randomized pragmatic trials.

PubMed

Blödt, Susanne; Pach, Daniel; Roll, Stephanie; Witt, Claudia M

2014-12-15

Chronic low back pain (LBP) and neck pain (NP) are highly prevalent conditions resulting in high economic costs. Treatment guidelines recommend relaxation techniques, such as progressive muscle relaxation, as adjuvant therapies. Self-care interventions could have the potential to reduce costs in the health care system, but their effectiveness, especially in a usual care setting, is unclear. The aim of these two pragmatic randomized studies is to evaluate whether an additional app-delivered relaxation is more effective in the reduction of chronic LBP or NP than usual care alone. Each pragmatic randomized two-armed study aims to include a total of 220 patients aged 18 to 65 years with chronic (>12 weeks) LBP or NP and an average pain intensity of ≥ 4 on a numeric rating scale (NRS) in the 7 days before recruitment. The participants will be randomized into an intervention and a usual care group. The intervention group will be instructed to practice one of these 3 relaxation techniques on at least 5 days/week for 15 minutes/day over a period of 6 months starting on the day of randomization: autogenic training, mindfulness meditation, or guided imagery. Instructions and exercises will be provided using a smartphone app, baseline information will be collected using paper and pencil. Follow-up information (daily, weekly, and after 3 and 6 months) will be collected using electronic diaries and questionnaires included in the app. The primary outcome measure will be the mean LBP or NP intensity during the first 3 months of intervention based on daily pain intensity measurements on a NRS (0 = no pain, 10 = worst possible pain). The secondary outcome parameters will include the mean pain intensity during the first 6 months after randomization based on daily measurements, the mean pain intensity measured weekly as the average pain intensity of the previous 7 days over 3 and 6 months, pain acceptance, 'LBP- and NP-related' stress, sick leave days, pain medication intake, adherence, suspected adverse reaction, and serious adverse events. The designed studies reflect a usual self-care setting and will provide evidence on a pragmatic self-care intervention that is easy to combine with care provided by medical professionals. ClinicalTrials.gov identifier Relaxback NCT02019498, Relaxneck NCT02019134 registered on 18 December 2013.

Individual-based measurements of light intensity provide new insights into the effects of artificial light at night on daily rhythms of urban-dwelling songbirds.

PubMed

Dominoni, Davide M; Carmona-Wagner, Esther O; Hofmann, Michaela; Kranstauber, Bart; Partecke, Jesko

2014-05-01

The growing interest in the effects of light pollution on daily and seasonal cycles of animals has led to a boost of research in recent years. In birds, it has been hypothesized that artificial light at night can affect daily aspects of behaviour, but one caveat is the lack of knowledge about the light intensity that wild animals, such as birds, are exposed to during the night. Organisms have naturally evolved daily rhythms to adapt to the 24-h cycle of day and night, thus, it is important to investigate the potential shifts in daily cycles due to global anthropogenic processes such as urbanization. We captured adult male European blackbirds (Turdus merula) in one rural forest and two urban sites differing in the degree of anthropogenic disturbance. We tagged these birds with light loggers and simultaneously recorded changes in activity status (active/non-active) through an automated telemetry system. We first analysed the relationship between light at night, weather conditions and date with daily activity onset and end. We then compared activity, light at night exposure and noise levels between weekdays and weekends. Onset of daily activity was significantly advanced in both urban sites compared to the rural population, while end of daily activity did not vary either among sites. Birds exposed to higher amounts of light in the late night showed earlier onset of activity in the morning, but light at night did not influence end of daily activity. Light exposure at night and onset/end of daily activity timing was not different between weekdays and weekends, but all noise variables were. A strong seasonal effect was detected in both urban and rural populations, such as birds tended to be active earlier in the morning and later in the evening (relative to civil twilight) in the early breeding season than at later stages. Our results point at artificial light at night as a major driver of change in timing of daily activity. Future research should focus on the costs and benefits of altered daily rhythmicity in birds thriving in urban areas. © 2013 The Authors. Journal of Animal Ecology © 2013 British Ecological Society.

Community occupational therapy for people with dementia and family carers (COTiD-UK) versus treatment as usual (Valuing Active Life in Dementia [VALID] programme): study protocol for a randomised controlled trial.

PubMed

Wenborn, Jennifer; Hynes, Sinéad; Moniz-Cook, Esme; Mountain, Gail; Poland, Fiona; King, Michael; Omar, Rumana; Morris, Steven; Vernooij-Dassen, Myrra; Challis, David; Michie, Susan; Russell, Ian; Sackley, Catherine; Graff, Maud; O'Keeffe, Aidan; Crellin, Nadia; Orrell, Martin

2016-02-03

A community-based occupational therapy intervention for people with mild to moderate dementia and their family carers (Community Occupational Therapy in Dementia (COTiD)) was found clinically and cost effective in the Netherlands but not in Germany. This highlights the need to adapt and implement complex interventions to specific national contexts. The current trial aims to evaluate the United Kingdom-adapted occupational therapy intervention for people with mild to moderate dementia and their family carers living in the community (COTiD-UK) compared with treatment as usual. This study is a multi-centre, parallel-group, pragmatic randomised trial with internal pilot. We aim to allocate 480 pairs, with each pair comprising a person with mild to moderate dementia and a family carer, who provides at least 4 hours of practical support per week, at random between COTiD-UK and treatment as usual. We shall assess participants at baseline, 12 and 26 weeks, and by telephone at 52 and 78 weeks (first 40% of recruits only) after randomisation. The primary outcome measure is the Bristol Activities of Daily Living Scale (BADLS) at 26 weeks. Secondary outcome measures will include quality of life, mood, and resource use. To assess intervention delivery, and client experience, we shall collect qualitative data via audio recordings of COTiD-UK sessions and conduct semi-structured interviews with pairs and occupational therapists. COTiD-UK is an evidence-based person-centred intervention that reflects the current priority to enable people with dementia to remain in their own homes by improving their capabilities whilst reducing carer burden. If COTiD-UK is clinically and cost effective, this has major implications for the future delivery of dementia services across the UK. Current Controlled Trials ISRCTN10748953 Date of registration: 18 September 2014.

Weather impacts on leisure activities in Halifax, Nova Scotia

NASA Astrophysics Data System (ADS)

Spinney, Jamie E. L.; Millward, Hugh

2011-03-01

The aim of this study was to investigate the impact of daily atmospheric weather conditions on daily leisure activity engagement, with a focus on physically active leisure. The methods capitalize on time diary data that were collected in Halifax, Nova Scotia to calculate objective measures of leisure activity engagement. Daily meteorological data from Environment Canada and daily sunrise and sunset times from the National Research Council of Canada are used to develop objective measures of the natural atmospheric environment. The time diary data were merged with the meteorological data in order to quantify the statistical association between daily weather conditions and the type, participation rate, frequency, and duration of leisure activity engagement. The results indicate that inclement and uncomfortable weather conditions, especially relating to thermal comfort and mechanical comfort, pose barriers to physically active leisure engagement, while promoting sedentary and home-based leisure activities. Overall, daily weather conditions exhibit modest, but significant, effects on leisure activity engagement; the strongest associations being for outdoor active sports and outdoor active leisure time budgets. In conclusion, weather conditions influence the type, participation rate, frequency, and duration of leisure activity engagement, which is an important consideration for health-promotion programming.

The State of the World's Children, 2001: Early Childhood.

ERIC Educational Resources Information Center

United Nations Children's Fund, New York, NY.

Although the experiences from birth to age three influence how the rest of childhood unfolds, this critical time is usually neglected in the policies, programs, and budgets of countries around the world. This report details the daily lives of parents and other caregivers who are striving to protect the rights and meet the needs of young children.…

Micro- and Macroscale Ideas of Current among Upper-Division Electrical Engineering Students

ERIC Educational Resources Information Center

Adam, Gina C.; Harlow, Danielle B.; Lord, Susan M.; Kautz, Christian H.

2017-01-01

The concept of electric current is fundamental in the study of electrical engineering (EE). Students are often exposed to this concept in their daily lives and early in middle school education. Lower-division university courses are usually limited to the study of passive electronic devices and simple electric circuits. Semiconductor physics is an…

Use of beta-adrenoceptor blocking drugs in hyperthyroidism.

PubMed

Feely, J; Peden, N

1984-05-01

There is an increasing use and variety of beta-adrenoceptor blocking agents (beta-blockers) available for the treatment of hyperthyroidism. Recent comparative studies suggest that atenolol (200mg daily), metoprolol (200mg daily); acebutolol (400mg daily), oxprenolol ( 160mg daily), nadolol ( 80mg daily) and timolol (20mg daily) produce a beneficial clinical response equal to that seen with propranolol ( 160mg daily). Most beta-blockers reduce resting heart rate by approximately 25 to 30 beats/min, although a lesser reduction is seen with those possessing intrinsic sympathomimetic activity such as oxprenolol and pindolol. While earlier studies employing large doses of intravenous propranolol concluded that beta-blockade reduced myocardial contractility, more recent non-invasive studies suggest that the predominant cardiac effect is on heart rate. In patients with cardiac failure, beta-blockers may, however, produce a profound fall in cardiac output. Nevertheless, in combination with digoxin they may be useful in controlling the atrial fibrillation of thyrocardiac disease. beta-Blockers improve nervousness and tremor (although to a lesser extent with cardioselective agents) and severe myopathy, and they also reduce the frequency of paralysis in patients with thyrotoxic periodic paralysis. There is often subjective improvement in sweating but usually no major effect on eye signs. Recent studies show a 10% reduction in oxygen consumption/basal metabolic rate with long term oral use of selective or nonselective beta-blockers. In addition, many agents (propranolol, metoprolol, nadolol and sotalol but not acebutolol, atenolol or oxprenolol) reduce circulating tri-iodothyronine (T3) concentration by between 10 and 40%, although the clinical significance of this effect (if any) is not established. beta-Blockers may also have endocrinological effects on gastrin, cyclic AMP, catecholamines and other hormone levels. Given in adequate dosage, propranolol has been shown to control thyrotoxic hypercalcaemia. Minor side effects (nausea, headaches, tiredness, etc.) are quite common but overall beta-blockers are well tolerated by the thyrotoxic patient. The major use of these drugs is in symptomatic control while awaiting definitive diagnosis or treatment. As an adjunct to antithyroid drugs or radioactive iodine, beta-blockers will produce a satisfactory clinical response in the weeks to months before these forms of therapy produce a euthyroid state. beta-Blockers are more convenient than antithyroid drugs in the control of patients receiving therapeutic radioiodine, in that continuous therapy and assessment of biochemical response is possible.(ABSTRACT TRUNCATED AT 400 WORDS)

Cigarette brand preference as a function of price among smoking youths in Canada: are they smoking premium, discount or native brands?

PubMed

Leatherdale, S T; Ahmed, R; Barisic, A; Murnaghan, D; Manske, S

2009-12-01

Given that little is known about the price-related cigarette brand preferences of youths, the current study seeks to characterise cigarette brand preferences and examine factors associated with smoking discount or native cigarette brands among Canadian youths who are current smokers. This study used nationally representative data collected from 71,003 grade 5-12 students as part of the 2006-7 Canadian Youth Smoking Survey (YSS). Using data from current smokers, logistic regression models were used to examine factors associated with smoking discount or native cigarette brands relative to premium cigarette brands. In 2006, premium cigarettes were the most prevalent brand of cigarette youths report usually smoking (49.4%); a substantial number of youths do report usually smoking either discount (12.9%) or native (9.3%) cigarette brands. Occasional smokers were more likely to report usually smoking premium cigarettes whereas daily smokers were more likely to report smoking either discount or native cigarettes. In particular, discount and native brands appear to be appealing among smoking youths with less spending money or those who are heavier smokers compared to youths smoking premium brands. Discount and native cigarette brands are commonly used by a substantial number of smoking youths in Canada. Additional research is required to better understand the reasons behind different cigarette brand preferences and how youths are able to access premium, discount and illicit native cigarettes. Moreover, ongoing surveillance of the cigarette brand preferences of youths is required for guiding future tobacco control policy and programming activities.

Predicting therapy success for treatment as usual and blended treatment in the domain of depression.

PubMed

van Breda, Ward; Bremer, Vincent; Becker, Dennis; Hoogendoorn, Mark; Funk, Burkhardt; Ruwaard, Jeroen; Riper, Heleen

2018-06-01

In this paper, we explore the potential of predicting therapy success for patients in mental health care. Such predictions can eventually improve the process of matching effective therapy types to individuals. In the EU project E-COMPARED, a variety of information is gathered about patients suffering from depression. We use this data, where 276 patients received treatment as usual and 227 received blended treatment, to investigate to what extent we are able to predict therapy success. We utilize different encoding strategies for preprocessing, varying feature selection techniques, and different statistical procedures for this purpose. Significant predictive power is found with average AUC values up to 0.7628 for treatment as usual and 0.7765 for blended treatment. Adding daily assessment data for blended treatment does currently not add predictive accuracy. Cost effectiveness analysis is needed to determine the added potential for real-world applications.

Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study.

PubMed

Alhassan, Sofiya; Nwaokelemeh, Ogechi; Mendoza, Albert; Shitole, Sanyog; Whitt-Glover, Melicia C; Yancey, Antronette K

2012-08-01

Most preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day. Within this time frame, children accumulate most of their activity within the first 10 min. This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study. The STEP study is a cluster randomized controlled study designed to examine the effects of short bouts of structured physical activity (SBS-PA) implemented within the classroom setting as part of designated gross-motor playtime on during-school physical activity (PA) in preschoolers. Ten preschool centers serving low-income families were randomized into SBS-PA versus unstructured PA (UPA). SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting, twice daily, followed by 20 min of usual unstructured playtime. UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily. Interventions were implemented during the morning and afternoon designated gross-motor playtime for 30 min/session, five days/week for six months. Outcome measures were between group difference in during-preschool PA (accelerometers and direct observation) over six-months. Ten preschool centers, representing 34 classrooms and 315 children, enrolled in the study. The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile, respectively. Participants spent 74% and 6% of their preschool day engaged in sedentary and MVPA, respectively. Results from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers' PA levels.

Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL) questionnaire

PubMed Central

Collingwood, Cecilia; Paddick, Stella-Maria; Kisoli, Aloyce; Dotchin, Catherine L.; Gray, William K.; Mbowe, Godfrey; Mkenda, Sarah; Urasa, Sarah; Mushi, Declare; Chaote, Paul; Walker, Richard W.

2014-01-01

Background The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly due to difficulties in assessing function, an essential step in diagnosis. Objectives As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, to develop, pilot, and validate an Instrumental Activities of Daily Living (IADL) questionnaire for use in a rural Tanzanian population to assist in the identification of people with dementia alongside cognitive screening. Design The questionnaire was developed at a workshop for rural primary healthcare workers, based on culturally appropriate roles and usual activities of elderly people in this community. It was piloted in 52 individuals under follow-up from a dementia prevalence study. Validation subsequently took place during a community dementia-screening programme. Construct validation against gold standard clinical dementia diagnosis using DSM-IV criteria was carried out on a stratified sample of the cohort and validity assessed using area under the receiver operating characteristic (AUROC) curve analysis. Results An 11-item questionnaire (IDEA-IADL) was developed after pilot testing. During formal validation on 130 community-dwelling elderly people who presented for screening, the AUROC curve was 0.896 for DSM-IV dementia when used in isolation and 0.937 when used in conjunction with the IDEA cognitive screen, previously validated in Tanzania. The internal consistency was 0.959. Performance on the IDEA-IADL was not biased with regard to age, gender or education level. Conclusions The IDEA-IADL questionnaire appears to be a useful aid to dementia screening in this setting. Further validation in other healthcare settings in SSA is required. PMID:25537940

Graded exposure in vivo in the treatment of pain-related fear: a replicated single-case experimental design in four patients with chronic low back pain.

PubMed

Vlaeyen, J W; de Jong, J; Geilen, M; Heuts, P H; van Breukelen, G

2001-02-01

The aim of this investigation was to examine the effectiveness of a graded exposure in vivo treatment with behavioural experiments as compared to usual graded activity in reducing pain-related fears, catastrophising and pain disability in chronic low back pain patients reporting substantial fear of movement/(re)injury. Included in the study were four consecutive CLBP patients who were referred for outpatient behavioural rehabilitation, and who reported substantial fear of movement/(re)injury (Tampa Scale for Kinesiophobia score>40). A replicated single-case cross-over design was used. After a no-treatment baseline measurement period, the patients were randomly assigned to one of two interventions. In intervention A, patients received the exposure first, followed by graded activity. In intervention B, the sequence of treatment modules was reversed. Sixty-three daily measures of pain-related cognitions and fears were recorded with visual analogue scales. Before and after the treatment, the following measures were taken: pain-related fear, pain catastrophising, pain control and pain disability. Using time series analysis on the daily measures of pain-related cognitions and fears, we found that improvements only occurred during the graded exposure in vivo, and not during the graded activity, irrespective of the treatment order. Analysis of the pre-post treatment differences also revealed that decreases in pain-related fear concurred with decreases in pain catastrophising and pain disability, and in half of the cases an increase in pain control. This study shows that the external validity of exposure in vivo also extends to the subgroup of chronic low back pain patients who report substantial fear of movement/(re)injury.

Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study

PubMed Central

2012-01-01

Background Most preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day. Within this time frame, children accumulate most of their activity within the first 10 min. This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study. The STEP study is a cluster randomized controlled study designed to examine the effects of short bouts of structured physical activity (SBS-PA) implemented within the classroom setting as part of designated gross-motor playtime on during-school physical activity (PA) in preschoolers. Methods/Design Ten preschool centers serving low-income families were randomized into SBS-PA versus unstructured PA (UPA). SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting, twice daily, followed by 20 min of usual unstructured playtime. UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily. Interventions were implemented during the morning and afternoon designated gross-motor playtime for 30 min/session, five days/week for six months. Outcome measures were between group difference in during-preschool PA (accelerometers and direct observation) over six-months. Ten preschool centers, representing 34 classrooms and 315 children, enrolled in the study. The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile, respectively. Participants spent 74% and 6% of their preschool day engaged in sedentary and MVPA, respectively. Discussion Results from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers’ PA levels. Trial registration Clinicaltrials.gov, NCT01588392 PMID:22853642

Comparative characteristics of the home care nursing services used by community-dwelling older people from urban and rural environments.

PubMed

Borowiak, Ewa; Kostka, Tomasz

2013-06-01

To compare home care nursing services use by community-dwelling older people from urban and rural environments in Poland. In the current literature, there is a lack of data based on multidimensional geriatric assessment concerning the provision of care delivered by nurses for older people from urban and rural environments. Cross-sectional random survey. Between 2006-2010, a random sample of 935 older people (over 65 years of age) from an urban environment and 812 from a neighbouring rural environment were interviewed in a cross-sectional survey. The rural dwellers (82·8%) nominated their family members as care providers more often than the city inhabitants (51·2%). Home nursing care was provided to 4·1% of people in the city and 6·5% in the county. Poststroke condition, poor nutritional status, and low physical activity level, as well as low scores for activities of daily living, instrumental activities of daily living, and Mini-Mental State Examination values, were all determinants of nursing care, both in urban and rural areas. In the urban environment, additional predictors of nursing care use were age, presence of ischaemic heart disease, diabetes and respiratory disorders, number of medications taken, and a high depression score. Poor functional status is the most important determinant of nursing care use in both environments. In the urban environment, a considerable proportion of community-dwelling elders live alone. In the rural environment, older people usually have someone available for potential care services. The main problem seems to be seeking nursing care only in advanced deterioration of functional status. © 2012 Blackwell Publishing Ltd.

Pleural/pericardic effusions during dasatinib treatment: incidence, management and risk factors associated to their development.

PubMed

Breccia, Massimo; Alimena, Giuliana

2010-09-01

Despite the beneficial effect of imatinib treatment in chronic myeloid leukemia patients, some patients develop resistance and/or intolerance and need a switch to second-generation tyrosine kinase inhibitors. Dasatinib is indicated for chronic myeloid leukemia patients with resistance or intolerance to imatinib; it has 325-fold increase potency compared to imatinib and is active in mutated and unmutated resistant patients. Pleural/pericardic effusions are frequent complications during treatment with dasatinib, and usually are reported to require dose reduction or drug discontinuation. Changing the dasatinib regimen from 70 mg twice daily to 100 mg once daily reduces the risk of pleural effusions. In this article, we review the incidence of the phenomenon observed in different dasatinib trials (Phase I - III) and the currently suggested management. We also describe the identified pathogenetic mechanisms related to the development and discuss the associated risk factors. The aim of this paper is to provide healthcare professionals with clear guidance on the management of pleural effusions associated with dasatinib treatment. Recommendations are based on the published data and clinical experience from a number of different centers. Literature evidences support the fact that with adequate management and monitoring of patients with predisposing factors, pleural effusions can be easily managed.

Effects of chronic methamphetamine on psychomotor and cognitive functions and dopamine signaling in the brain.

PubMed

Thanos, Panayotis K; Kim, Ronald; Delis, Foteini; Rocco, Mark J; Cho, Jacob; Volkow, Nora D

2017-03-01

Methamphetamine (MA) studies in animals usually involve acute, binge, or short-term exposure to the drug. However, addicts take substantial amounts of MA for extended periods of time. Here we wished to study the effects of MA exposure on brain and behavior, using an animal model analogous to this pattern of MA intake. MA doses, 4 and 8mg/kg/day, were based on previously reported average daily freely available MA self-administration levels. We examined the effects of 16 week MA treatment on psychomotor and cognitive function in the rat using open field and novel object recognition tests and we studied the adaptations of the dopaminergic system, using in vitro and in vivo receptor imaging. We show that chronic MA treatment, at doses that correspond to the average daily freely available self-administration levels in the rat, disorganizes open field activity, impairs alert exploratory behavior and anxiety-like state, and downregulates dopamine transporter in the striatum. Under these treatment conditions, dopamine terminal functional integrity in the nucleus accumbens is also affected. In addition, lower dopamine D1 receptor binding density, and, to a smaller degree, lower dopamine D2 receptor binding density were observed. Potential mechanisms related to these alterations are discussed. Copyright © 2016. Published by Elsevier B.V.

Specific treatment of Prader-Willi syndrome through cyclical rehabilitation programmes.

PubMed

Grolla, Emanuele; Andrighetto, Gilberto; Parmigiani, Pietro; Hladnik, Uros; Ferrari, Gabriela; Bernardelle, Roberta; Lago, Martina Dal; Albarello, Anna; Baschirotto, Giuseppe; Filippi, Giuseppe; Lovato, Roberto; Dolcetta, Diego

2011-01-01

 To evaluate retrospectively the efficiency of our rehabilitation programme for patients with Prader-Willi Syndrome. In total, 49 patients were examined, 21 female and 28 male, the youngest in their late teens. Prader-Willi syndrome is generally characterised by cognitive impairment, behavioural abnormalities, and hyperphagia. Patients are usually considerably adverse to any form of physical exercise, and despite hormonal therapy, weight control in adult patients can be difficult.  Four times a year, disease-specific residential programmes were organised, each lasting 4 weeks. The patients were restricted to a 1500 Kcal diet. In addition, they were required to do 6.5 h of physical exercise daily, stamina being built up by using music therapy, psychomotor therapy, education and entertainment activities. BMI decreased by 2.1 average points in every residential session. For three patients who attended our treatments regularly, a reduction of 8.9 points over 6 years was recorded. An attendance of at least three sessions per year seemed to be necessary to substantially reduce weight. A multidisciplinary approach and a daily calorie-counted diet can lead to significant weight loss in teenage and adult PWS patients. This approach would also be suitable in treating patients with other obesity syndromes with mental retardation.

Use of betahistine in the treatment of peripheral vertigo.

PubMed

Ramos Alcocer, Rubén; Ledezma Rodríguez, José Gregorio; Navas Romero, Antonio; Cardenas Nuñez, José Luis; Rodríguez Montoya, Vicente; Deschamps, Jose Junior; Liviac Ticse, Jorge Anibal

2015-01-01

Clinical studies and meta-analyses demonstrated that betahistine is effective and safe in the treatment of Ménière's disease, BPPV (benign paroxysmal positional vertigo), vestibular neuronitis, and other types of peripheral vertigo. The goal of this paper is to review the pharmacological profile of betahistine and the evidence for its effectiveness and safety in the treatment of peripheral vertigo. Selection criteria for the publications on betahistine included randomized clinical trials that evaluated the effectiveness and safety of betahistine vs placebo or active control in the treatment of peripheral vertigo. Recent meta-analyses were also included. Databases searched included PubMed, the Cochrane Ear, Nose and Throat Disorders Group Trials Register, and ICTRP. The review also presents an update on the mechanisms of action, pharmacodynamics, and pharmacokinetics of betahistine. Efficacy and safety of betahistine has been demonstrated in numerous clinical trials. The precise mechanism of action of betahistine is still not completely understood, but the clinical experience demonstrated the benefit of betahistine in different types of peripheral vertigo. In more than 40 years of clinical use, betahistine has shown an excellent safety profile with the usual dose range from 8-48 mg daily. According to clinical studies, betahistine 48 mg daily during 3 months is an effective and safe option for the treatment of peripheral vertigo.

Obesity History and Daily Patterns of Physical Activity at Age 60-64 Years: Findings From the MRC National Survey of Health and Development.

PubMed

Cooper, Rachel; Huang, Lei; Hardy, Rebecca; Crainiceanu, Adina; Harris, Tamara; Schrack, Jennifer A; Crainiceanu, Ciprian; Kuh, Diana

2017-10-01

The aim of this study was to investigate associations of current body mass index (BMI) and obesity history with daily patterns of physical activity. At age 60-64, participants from a British birth cohort study wore accelerometers for 5 days. Accelerometry counts were log-transformed and mean log-counts were used to derive a summary variable indicating total daily log-activity counts. Among those with complete data (n = 1,388) the associations of current BMI and age of first obesity were examined with: (a) total daily log-activity counts and (b) total log-activity counts in four segments of the day. Higher current BMI and younger age at obesity were strongly associated with lower levels of total daily activity at age 60-64 even after adjustment for sex, socioeconomic factors, and health status. The fully-adjusted mean difference in total daily log-activity counts was -581.7 (95% confidence interval: -757.2, -406.3) when comparing BMI ≥35 kg/m2 with <25 kg/m2, representing an 18.4% difference. Participants who had been obese since early adulthood had the lowest levels of activity (mean difference in total daily log-activity counts was -413.1 (-638.1, -188.2) when comparing those who were obese by age 26 or 36 with those who were never obese, representing a 13.1% difference). Obese older adults may require targeted interventions and additional support to improve their daily activity levels. As younger generations with greater lifetime exposure to obesity reach old age the proportion of adults achieving sufficient levels of activity to realize its associated health benefits is likely to decline. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America.

Obesity History and Daily Patterns of Physical Activity at Age 60–64 Years: Findings From the MRC National Survey of Health and Development

PubMed Central

Cooper, Rachel; Huang, Lei; Hardy, Rebecca; Crainiceanu, Adina; Harris, Tamara; Schrack, Jennifer A; Crainiceanu, Ciprian; Kuh, Diana

2017-01-01

Abstract Background The aim of this study was to investigate associations of current body mass index (BMI) and obesity history with daily patterns of physical activity. Methods At age 60–64, participants from a British birth cohort study wore accelerometers for 5 days. Accelerometry counts were log-transformed and mean log-counts were used to derive a summary variable indicating total daily log-activity counts. Among those with complete data (n = 1,388) the associations of current BMI and age of first obesity were examined with: (a) total daily log-activity counts and (b) total log-activity counts in four segments of the day. Results Higher current BMI and younger age at obesity were strongly associated with lower levels of total daily activity at age 60–64 even after adjustment for sex, socioeconomic factors, and health status. The fully-adjusted mean difference in total daily log-activity counts was −581.7 (95% confidence interval: −757.2, −406.3) when comparing BMI ≥35 kg/m2 with <25 kg/m2, representing an 18.4% difference. Participants who had been obese since early adulthood had the lowest levels of activity (mean difference in total daily log-activity counts was −413.1 (−638.1, −188.2) when comparing those who were obese by age 26 or 36 with those who were never obese, representing a 13.1% difference). Conclusions Obese older adults may require targeted interventions and additional support to improve their daily activity levels. As younger generations with greater lifetime exposure to obesity reach old age the proportion of adults achieving sufficient levels of activity to realize its associated health benefits is likely to decline. PMID:28329086

Trial Protocol: randomised controlled trial of the effects of very low calorie diet, modest dietary restriction, and sequential behavioural programme on hunger, urges to smoke, abstinence and weight gain in overweight smokers stopping smoking.

PubMed

Lycett, Deborah; Hajek, Peter; Aveyard, Paul

2010-10-07

Weight gain accompanies smoking cessation, but dieting during quitting is controversial as hunger may increase urges to smoke. This is a feasibility trial for the investigation of a very low calorie diet (VLCD), individual modest energy restriction, and usual advice on hunger, ketosis, urges to smoke, abstinence and weight gain in overweight smokers trying to quit. This is a 3 armed, unblinded, randomized controlled trial in overweight (BMI > 25 kg/m2), daily smokers (CO > 10 ppm); with at least 30 participants in each group. Each group receives identical behavioural support and NRT patches (25 mg(8 weeks),15 mg(2 weeks),10 mg(2 weeks)). The VLCD group receive a 429-559 kcal/day liquid formula beginning 1 week before quitting and continuing for 4 weeks afterwards. The modest energy restricted group (termed individual dietary and activity planning(IDAP)) engage in goal-setting and receive an energy prescription based on individual basal metabolic rate(BMR) aiming for daily reduction of 600 kcal. The control group receive usual dietary advice that accompanies smoking cessation i.e. avoiding feeling hungry but eating healthy snacks. After this, the VLCD participants receive IDAP to provide support for changing eating habits in the longer term; the IDAP group continues receiving this support. The control group receive IDAP 8 weeks after quitting. This allows us to compare IDAP following a successful quit attempt with dieting concurrently during quitting. It also aims to prevent attrition in the unblinded, control group by meeting their need for weight management. Follow-up occurs at 6 and 12 months.Outcome measures include participant acceptability, measured qualitatively by semi-structured interviewing and quantitatively by recruitment and attrition rates. Feasibility of running the trial within primary care is measured by interview and questionnaire of the treatment providers. Adherence to the VLCD is verified by the presence of urinary ketones measured weekly. Daily urges to smoke, hunger and withdrawal are measured using the Mood and Physical Symptoms Scale-Combined (MPSS-C) and a Hunger Craving Score (HCS). 24 hour, 7 day point prevalence and 4-week prolonged abstinence (Russell Standard) is confirmed by CO < 10 ppm. Weight, waist and hip circumference and percentage body fat are measured at each visit. Current controlled trials ISRCTN83865809.

Impact of scheduling multiple outdoor free-play periods in childcare on child moderate-to-vigorous physical activity: a cluster randomised trial.

PubMed

Razak, Lubna Abdul; Yoong, Sze Lin; Wiggers, John; Morgan, Philip J; Jones, Jannah; Finch, Meghan; Sutherland, Rachel; Lecathelnais, Christophe; Gillham, Karen; Clinton-McHarg, Tara; Wolfenden, Luke

2018-04-04

Increasing the frequency of periods of outdoor free-play in childcare may represent an opportunity to increase child physical activity. This study aimed to assess the efficacy of scheduling multiple periods of outdoor free-play in increasing the time children spend in moderate-to-vigorous physical activity (MVPA) while attending childcare. The study employed a cluster randomised controlled trial design involving children aged 3 to 6 years, attending ten childcare services in the Hunter New England region of New South Wales, Australia. Five services were randomised to receive the intervention and five to a control condition. The intervention involved services scheduling three separate periods of outdoor free-play from 9 am to 3 pm per day, each at least 15 min in duration, with the total equivalent to their usual daily duration of outdoor play period. Control services implemented the usual single continuous period of outdoor free-play over this time. The primary outcome, children's moderate-to-vigorous physical activity (MVPA) while in care per day, was measured over 5 days via accelerometers at baseline and at 3 months post baseline. Secondary outcomes included percentage of time spent in MVPA while in care per day, total physical activity while in care per day and documented child injury, a hypothesised potential unintended adverse event. Childcare services and data collectors were not blind to the experimental group allocation. Parents of 439 (71.6%) children attending participating childcare services consented for their child to participate in the trial. Of these, 316 (72.0%) children provided valid accelerometer data at both time points. Relative to children in control services, mean daily minutes of MVPA in care was significantly greater at follow-up among children attending intervention services (adjusted difference between groups 5.21 min, 95% CI 0.59-9.83 p = 0.03). Percentage of time spent in MVPA in care per day was also greater at follow-up among children in intervention services relative to control services (adjusted difference between groups 1.57, 95% CI 0.64-2.49 p < 0.001). Total physical activity while in care per day, assessed via counts per minute approached but did not reach significance (adjusted difference between groups 14.25, 95% CI 2.26-30.76 p = 0.09). There were no differences between groups in child injury nor subgroup interactions for the primary trial outcome by child age, sex, or baseline MVPA levels. Scheduling multiple periods of outdoor free-play significantly increased the time children spent in MVPA while in attendance at childcare. This simple ecological intervention could be considered for broader dissemination as a strategy to increase child physical activity at a population level. This trial was prospectively registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) ( ACTRN1261000347460 ). Prospectively registered 17th March 2016.

Year-round effects of a four-week randomized controlled trial using different types of feedback on employees' physical activity.

PubMed

Van Hoye, Karen; Wijtzes, Anne I; Lefevre, Johan; De Baere, Stijn; Boen, Filip

2018-04-12

This follow-up study investigated the year-round effects of a four-week randomized controlled trial using different types of feedback on employees' physical activity, including a need-supportive coach intervention. Participants (n = 227) were randomly assigned to a Minimal Intervention Group (MIG; no feedback), a Pedometer Group (PG; feedback on daily steps only), a Display Group (DG; feedback on daily steps, on daily moderate-to-vigorous physical activity [MVPA] and on total energy expenditure [EE]), or a Coaching Group (CoachG; same as DG with need supportive coaching). Daily physical activity level (PAL; Metabolic Equivalent of Task [MET]), number of daily steps, daily minutes of moderate to vigorous physical activity (MVPA), active daily EE (EE > 3 METs) and total daily EE were measured at five time points: before the start of the 4-week intervention, one week after the intervention, and 3, 6, and 12 months after the intervention. For minutes of MVPA, MIG showed higher mean change scores compared with the DG. For steps and daily minutes of MVPA, significantly lower mean change scores emerged for MIG compared with the PG. Participants of the CoachG showed significantly higher change scores in PAL, steps, minutes of MVPA, active EE, total EE compared with the MIG. As hypothesized, participants of the CoachG had significantly higher mean change scores in PAL and total EE compared with groups that only received feedback. However, no significant differences were found for steps, minutes of MVPA and active EE between CoachG and PG. Receiving additional need-supportive coaching resulted in a higher PAL and active EE compared with measurement (display) feedback only. These findings suggest to combine feedback on physical activity with personal coaching in order to facilitate long-term behavioral change. When it comes to increasing steps, minutes of MVPA or active EE, a pedometer constitutes a sufficient tool. Clinical Trails.gov NCT01432327 . Date registered: 12 September 2011.

Unsupervised daily routine and activity discovery in smart homes.

PubMed

Jie Yin; Qing Zhang; Karunanithi, Mohan

2015-08-01

The ability to accurately recognize daily activities of residents is a core premise of smart homes to assist with remote health monitoring. Most of the existing methods rely on a supervised model trained from a preselected and manually labeled set of activities, which are often time-consuming and costly to obtain in practice. In contrast, this paper presents an unsupervised method for discovering daily routines and activities for smart home residents. Our proposed method first uses a Markov chain to model a resident's locomotion patterns at different times of day and discover clusters of daily routines at the macro level. For each routine cluster, it then drills down to further discover room-level activities at the micro level. The automatic identification of daily routines and activities is useful for understanding indicators of functional decline of elderly people and suggesting timely interventions.

Effectiveness of Fluticasone Furoate-Vilanterol for COPD in Clinical Practice.

PubMed

Vestbo, Jørgen; Leather, David; Diar Bakerly, Nawar; New, John; Gibson, J Martin; McCorkindale, Sheila; Collier, Susan; Crawford, Jodie; Frith, Lucy; Harvey, Catherine; Svedsater, Henrik; Woodcock, Ashley

2016-09-29

Evidence for the management of chronic obstructive pulmonary disease (COPD) comes from closely monitored efficacy trials involving groups of patients who were selected on the basis of restricted entry criteria. There is a need for randomized trials to be conducted in conditions that are closer to usual clinical practice. In a controlled effectiveness trial conducted in 75 general practices, we randomly assigned 2799 patients with COPD to a once-daily inhaled combination of fluticasone furoate at a dose of 100 μg and vilanterol at a dose of 25 μg (the fluticasone furoate-vilanterol group) or to usual care (the usual-care group). The primary outcome was the rate of moderate or severe exacerbations among patients who had had an exacerbation within 1 year before the trial. Secondary outcomes were the rates of primary care contact (contact with a general practitioner, nurse, or other health care professional) and secondary care contact (inpatient admission, outpatient visit with a specialist, or visit to the emergency department), modification of the initial trial treatment for COPD, and the rate of exacerbations among patients who had had an exacerbation within 3 years before the trial, as assessed in a time-to-event analysis. The rate of moderate or severe exacerbations was significantly lower, by 8.4% (95% confidence interval, 1.1 to 15.2), with fluticasone furoate-vilanterol therapy than with usual care (P=0.02). There was no significant difference in the annual rate of COPD-related contacts to primary or secondary care. There were no significant between-group differences in the rates of the first moderate or severe exacerbation and the first severe exacerbation in the time-to-event analyses. There were no excess serious adverse events of pneumonia in the fluticasone furoate-vilanterol group. The numbers of other serious adverse events were similar in the two groups. In patients with COPD and a history of exacerbations, a once-daily treatment regimen of combined fluticasone furoate and vilanterol was associated with a lower rate of exacerbations than usual care, without a greater risk of serious adverse events. (Funded by GlaxoSmithKline; Salford Lung Study ClinicalTrials.gov number, NCT01551758 .).

Validity of questions about activities of daily living to screen for dependency in older adults

PubMed Central

Rebouças, Monica; Coelho-Filho, João Macedo; Veras, Renato Peixoto; Lima-Costa, Maria Fernanda; Ramos, Luiz Roberto

2017-01-01

ABSTRACT OBJECTIVE To determine the criterion validity of the activities of daily living present in functionality questionnaires in older adults for population surveys and to identify which activities are valid to quantify the real daily need for help of this population. METHODS This is a population sample of older adults stratified by levels of functionality, according to self-perception of dependency in the activities of daily living. Self-perception was compared with the gold standard – direct observation of these activities in the household of older adults by a trained professional, blinded to the answers in the questionnaire. At the visit, it was decided if the older adult needed help to perform any of the activities of daily living for the research. The sensitivity of each activity of daily living was greater when the self-assessment that there was no need for help coincided with the assessment of the professional. Specificity indicates coincidence regarding the need for help in the activities of daily living – coefficients of sensitivity and specificity above 70% were considered as indicative of good validity. RESULTS Self-assessments showed better sensitivity than specificity – older adults and observers agreed more on daily independency than on dependency. All activities showed sensitivity above 70%. Some activities had low (go shopping: 55%) or very low specificity (brush the hair: 33%). The best specificities were to take a shower and dress up (95.8% for both), among the personal ones, and to use transportation and perform banking transactions (78% for both), among the instrumental ones. CONCLUSIONS Activities of daily living can be valid indicators of functional dependence. The best coefficients of validity were generally obtained for personal activities. Some activities with good sensitivities and specificities – walk 100 meters, take a shower, and lie down in and get out of the bed – can be used to classify older adults into low, average, and high need for help depending on the affected activities and, therefore, can help in the planning of health services aimed at them. PMID:28876414

Night-time sedating H1 -antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urticaria: a randomized controlled trial.

PubMed

Staevska, M; Gugutkova, M; Lazarova, C; Kralimarkova, T; Dimitrov, V; Zuberbier, T; Church, M K; Popov, T A

2014-07-01

Many physicians believe that the most effective way to treat chronic urticaria is to take a nonsedating second-generation H1 -antihistamine in the morning and a sedating first-generation H1 -antihistamine, usually hydroxyzine, at night to enhance sleep. But is this belief well founded? To test this belief by comparing the effectiveness and prevalence of unwanted sedative effects when treating patients with chronic spontaneous urticaria (CSU) with levocetirizine 15 mg daily plus hydroxyzine 50 mg at night (levocetirizine plus hydroxyzine) vs. levocetirizine 20 mg daily (levocetirizine monotherapy). In this randomized, double-blind, cross-over study, 24 patients with difficult-to-treat CSU took levocetirizine plus hydroxyzine or levocetirizine monotherapy for periods of 5 days each. At the end of each treatment period, assessments were made of quality of life (Chronic Urticaria Quality of Life Questionnaire, CU-Q2 oL), severity of urticaria symptoms (Urticaria Activity Score, UAS), sleep disturbance during the night and daytime somnolence. Both treatments significantly decreased UAS, night-time sleep disturbances and CU-Q2 oL scores (P < 0·001) without significant differences between the two. Compared with baseline, daytime somnolence was significantly reduced by levocetirizine monotherapy (P = 0·006) but not by levocetirizine plus hydroxyzine (P = 0·218). Direct comparison of the two treatment modalities in terms of daytime somnolence favoured levocetirizine monotherapy (P = 0·026). The widespread belief that sleep is aided by the addition of a sedating first-generation H1 -antihistamine, usually hydroxyzine, at night is not supported. These results are in line with the urticaria guidelines, which state that first-line treatment for urticaria should be new-generation, nonsedating H1 -antihistamines only. © 2014 The Authors. British Association of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial

PubMed Central

Sheehan, Bart; Atherton, Nicky; Nichols, Vivien; Collins, Helen; Mistry, Dipesh; Dosanjh, Sukhdeep; Slowther, Anne Marie; Khan, Iftekhar; Petrou, Stavros; Lall, Ranjit

2018-01-01

Abstract Objective To estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with mild to moderate dementia. Design Multicentre, pragmatic, investigator masked, randomised controlled trial. Setting National Health Service primary care, community and memory services, dementia research registers, and voluntary sector providers in 15 English regions. Participants 494 people with dementia: 329 were assigned to an aerobic and strength exercise programme and 165 were assigned to usual care. Random allocation was 2:1 in favour of the exercise arm. Interventions Usual care plus four months of supervised exercise and support for ongoing physical activity, or usual care only. Interventions were delivered in community gym facilities and NHS premises. Main outcome measures The primary outcome was score on the Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog) at 12 months. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, health related quality of life, and carer quality of life and burden. Physical fitness (including the six minute walk test) was measured in the exercise arm during the intervention. Results The average age of participants was 77 (SD 7.9) years and 301/494 (61%) were men. By 12 months the mean ADAS-cog score had increased to 25.2 (SD 12.3) in the exercise arm and 23.8 (SD 10.4) in the usual care arm (adjusted between group difference −1.4, 95% confidence interval −2.6 to −0.2, P=0.03). This indicates greater cognitive impairment in the exercise group, although the average difference is small and clinical relevance uncertain. No differences were found in secondary outcomes or preplanned subgroup analyses by dementia type (Alzheimer’s disease or other), severity of cognitive impairment, sex, and mobility. Compliance with exercise was good. Over 65% of participants (214/329) attended more than three quarters of scheduled sessions. Six minute walking distance improved over six weeks (mean change 18.1 m, 95% confidence interval 11.6 m to 24.6 m). Conclusion A moderate to high intensity aerobic and strength exercise training programme does not slow cognitive impairment in people with mild to moderate dementia. The exercise training programme improved physical fitness, but there were no noticeable improvements in other clinical outcomes. Trial registration Current Controlled Trials ISRCTN10416500. PMID:29769247

21 CFR 890.5050 - Daily activity assist device.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

21 CFR 890.5050 - Daily activity assist device.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

21 CFR 890.5050 - Daily activity assist device.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

21 CFR 890.5050 - Daily activity assist device.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

21 CFR 890.5050 - Daily activity assist device.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Daily activity assist device. 890.5050 Section 890.5050 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5050 Daily activity...

The Difference in Self-Esteem between Type I Diabetics and Type II Diabetics.

ERIC Educational Resources Information Center

Ellerbrock, Linda Kay

Diabetes Mellitus is a disease which can affect an individual both physically and emotionally. Type I diabetics, representing about 10% of the diabetic population, can be characterized as having little or no insulin supply in their pancreas. Usually under the age of 30, they are required to take one or more insulin injections daily and must follow…

Validity and Reproducibility of a Self-Administered Semi-Quantitative Food-Frequency Questionnaire for Estimating Usual Daily Fat, Fibre, Alcohol, Caffeine and Theobromine Intakes among Belgian Post-Menopausal Women

PubMed Central

Bolca, Selin; Huybrechts, Inge; Verschraegen, Mia; De Henauw, Stefaan; Van de Wiele, Tom

2009-01-01

A novel food-frequency questionnaire (FFQ) was developed and validated to assess the usual daily fat, saturated, mono-unsaturated and poly-unsaturated fatty acid, fibre, alcohol, caffeine, and theobromine intakes among Belgian post-menopausal women participating in dietary intervention trials with phyto-oestrogens. The relative validity of the FFQ was estimated by comparison with 7 day (d) estimated diet records (EDR, n 64) and its reproducibility was evaluated by repeated administrations 6 weeks apart (n 79). Although the questionnaire underestimated significantly all intakes compared to the 7 d EDR, it had a good ranking ability (r 0.47–0.94; weighted κ 0.25–0.66) and it could reliably distinguish extreme intakes for all the estimated nutrients, except for saturated fatty acids. Furthermore, the correlation between repeated administrations was high (r 0.71–0.87) with a maximal misclassification of 7% (weighted κ 0.33–0.80). In conclusion, these results compare favourably with those reported by others and indicate that the FFQ is a satisfactorily reliable and valid instrument for ranking individuals within this study population. PMID:19440274

Metabolic costs of daily activity in older adults (Chores XL) study: design and methods.

PubMed

Corbett, Duane B; Wanigatunga, Amal A; Valiani, Vincenzo; Handberg, Eileen M; Buford, Thomas W; Brumback, Babette; Casanova, Ramon; Janelle, Christopher M; Manini, Todd M

2017-06-01

For over 20 years, normative data has guided the prescription of physical activity. This data has since been applied to research and used to plan interventions. While this data seemingly provides accurate estimates of the metabolic cost of daily activities in young adults, the accuracy of use among older adults is less clear. As such, a thorough evaluation of the metabolic cost of daily activities in community dwelling adults across the lifespan is needed. The Metabolic Costs of Daily Activity in Older Adults Study is a cross-sectional study designed to compare the metabolic cost of daily activities in 250 community dwelling adults across the lifespan. Participants (20+ years) performed 38 common daily activities while expiratory gases were measured using a portable indirect calorimeter (Cosmed K4b2). The metabolic cost was examined as a metabolic equivalent value (O 2 uptake relative to 3.5 milliliter• min-1•kg-1), a function of work rate - metabolic economy, and a relative value of resting and peak oxygen uptake. The primary objective is to determine age-related differences in the metabolic cost of common lifestyle and exercise activities. Secondary objectives include (a) investigating the effect of functional impairment on the metabolic cost of daily activities, (b) evaluating the validity of perception-based measurement of exertion across the lifespan, and (c) validating activity sensors for estimating the type and intensity of physical activity. Results of this study are expected to improve the effectiveness by which physical activity and nutrition is recommended for adults across the lifespan.

Randomized trial of the effect of drug presentation on asthma outcomes: the American Lung Association Asthma Clinical Research Centers.

PubMed

Wise, Robert A; Bartlett, Susan J; Brown, Ellen D; Castro, Mario; Cohen, Rubin; Holbrook, Janet T; Irvin, Charles G; Rand, Cynthia S; Sockrider, Marianna M; Sugar, Elizabeth A

2009-09-01

Information that enhances expectations about drug effectiveness improves the response to placebos for pain. Although asthma symptoms often improve with placebo, it is not known whether the response to placebo or active treatment can be augmented by increasing expectation of benefit. The study objective was to determine whether response to placebo or a leukotriene antagonist (montelukast) can be augmented by messages that increase expectation of benefit. A randomized 20-center controlled trial enrolled 601 asthmatic patients with poor symptom control who were assigned to one of 5 study groups. Participants were randomly assigned to one of 4 treatment groups in a factorial design (ie, placebo with enhanced messages, placebo with neutral messages, montelukast with enhanced messages, or montelukast with neutral messages) or to usual care. Assignment to study drug was double masked, assignment to message content was single masked, and usual care was not masked. The enhanced message aimed to increase expectation of benefit from the drug. The primary outcome was mean change in daily peak flow over 4 weeks. Secondary outcomes included lung function and asthma symptom control. Peak flow and other lung function measures were not improved in participants assigned to the enhanced message groups versus the neutral messages groups for either montelukast or placebo; no differences were noted between the neutral placebo and usual care groups. Placebo-treated participants had improved asthma control with the enhanced message but not montelukast-treated participants; the neutral placebo group did have improved asthma control compared with the usual care group after adjusting for baseline difference. Headaches were more common in participants provided messages that mentioned headache as a montelukast side effect. Optimistic drug presentation augments the placebo effect for patient-reported outcomes (asthma control) but not lung function. However, the effect of montelukast was not enhanced by optimistic messages regarding treatment effectiveness.

Modeling personal particle-bound polycyclic aromatic hydrocarbon (pb-pah) exposure in human subjects in Southern California.

PubMed

Wu, Jun; Tjoa, Thomas; Li, Lianfa; Jaimes, Guillermo; Delfino, Ralph J

2012-07-11

Exposure to polycyclic aromatic hydrocarbon (PAH) has been linked to various adverse health outcomes. Personal PAH exposures are usually measured by personal monitoring or biomarkers, which are costly and impractical for a large population. Modeling is a cost-effective alternative to characterize personal PAH exposure although challenges exist because the PAH exposure can be highly variable between locations and individuals in non-occupational settings. In this study we developed models to estimate personal inhalation exposures to particle-bound PAH (PB-PAH) using data from global positioning system (GPS) time-activity tracking data, traffic activity, and questionnaire information. We conducted real-time (1-min interval) personal PB-PAH exposure sampling coupled with GPS tracking in 28 non-smoking women for one to three sessions and one to nine days each session from August 2009 to November 2010 in Los Angeles and Orange Counties, California. Each subject filled out a baseline questionnaire and environmental and behavior questionnaires on their typical activities in the previous three months. A validated model was used to classify major time-activity patterns (indoor, in-vehicle, and other) based on the raw GPS data. Multiple-linear regression and mixed effect models were developed to estimate averaged daily and subject-level PB-PAH exposures. The covariates we examined included day of week and time of day, GPS-based time-activity and GPS speed, traffic- and roadway-related parameters, meteorological variables (i.e. temperature, wind speed, relative humidity), and socio-demographic variables and occupational exposures from the questionnaire. We measured personal PB-PAH exposures for 180 days with more than 6 h of valid data on each day. The adjusted R2 of the model was 0.58 for personal daily exposures, 0.61 for subject-level personal exposures, and 0.75 for subject-level micro-environmental exposures. The amount of time in vehicle (averaging 4.5% of total sampling time) explained 48% of the variance in daily personal PB-PAH exposure and 39% of the variance in subject-level exposure. The other major predictors of PB-PAH exposures included length-weighted traffic count, work-related exposures, and percent of weekday time. We successfully developed regression models to estimate PB-PAH exposures based on GPS-tracking data, traffic data, and simple questionnaire information. Time in vehicle was the most important determinant of personal PB-PAH exposure in this population. We demonstrated the importance of coupling real-time exposure measures with GPS time-activity tracking in personal air pollution exposure assessment.

[How the information system can contribute to the implementation of a risk management program in a hospital?].

PubMed

Staccini, P; Quaranta, J F; Staccini-Myx, A; Veyres, P; Jambou, P

2003-09-01

Nowadays, information system is recognised as one of the key points of the management strategy. An information system is regarded conceptualised as a mean to link 3 aspects of a firm (structure, organisation rules and staff). Its design and implementation have to meet the objectives of medical and economical evaluation, especially risk management objectives. In order to identify, analyse, reduce and prevent the occurrence of adverse events, and also to measure the efficacy and efficiency of the production of care services, the design of information systems should be based on a process analysis in order to describe and classify all the working practices within the hospital. According to various methodologies (usually top-down analysis), each process can be divided into activities. Each activity (especially each care activity) can be described according to its potential risks and expected results. For care professionals performing a task, the access to official or internal guidelines and the adverse events reporting forms has also to be defined. Putting together all the elements of such a process analysis will contribute to integrate, into daily practice, the management of risks, supported by the information system.

Stroke patients' functions in personal activities of daily living in relation to sleep and socio-demographic and clinical variables in the acute phase after first-time stroke and at six months of follow-up.

PubMed

Bakken, Linda N; Kim, Hesook S; Finset, Arnstein; Lerdal, Anners

2012-07-01

To explore first-time stroke patients' degree of independence in activities of daily life in relation to sleep and other essential variables that might influence activities of daily life. Sleep has received little attention in rehabilitation of activities of daily life in stroke patients. This is a longitudinal survey and observational study design from the acute phase to six months poststroke. First-time stroke patients (n = 90) were recruited from two hospitals in eastern Norway in 2007 and 2008. Data were collected by survey interview, medical records and wrist actigraphy in the first two weeks at the hospital and at six months of follow-up. Actigraph measures patient activity and estimates sleep during the day and night. Linear regression showed that high dependence in personal activities of daily living was directly related to low estimated sleep time at night and higher estimated sleep during the day in the acute phase, controlling for socio-demographic and clinical variables. Furthermore, high estimated numbers of awakenings in the acute phase were related to lower activities of daily life functioning at six months of follow-up after controlling for socio-demographic and clinical variables. Stronger pain and a lower physical functioning showed direct relationships with lower independency level of in activities of daily life both in the acute phase and after six months. Sleep patterns in the acute phase may influence the patients' activities of daily life functioning up to six months poststroke. Furthermore, pain in the acute phase may influence the level of activities of daily life functioning in stroke patients. Nurses should pay attention to stroke patients' sleep quality and pain in the rehabilitation period after a stroke. Facilitating good sleep conditions and screening for pain should be an integral part of the rehabilitation programme. © 2012 Blackwell Publishing Ltd.

Intensive group training protocol versus guideline physiotherapy for patients with chronic low back pain: a randomised controlled trial.

PubMed

van der Roer, Nicole; van Tulder, Maurits; Barendse, Johanna; Knol, Dirk; van Mechelen, Willem; de Vet, Henrica

2008-09-01

Intensive group training using principles of graded activity has been proven to be effective in occupational care for workers with chronic low back pain. Objective of the study was to compare the effects of an intensive group training protocol aimed at returning to normal daily activities and guideline physiotherapy for primary care patients with non-specific chronic low back pain. The study was designed as pragmatic randomised controlled trial with a setup of 105 primary care physiotherapists in 49 practices and 114 patients with non-specific low back pain of more than 12 weeks duration participated in the study. In the intensive group training protocol exercise therapy, back school and operant-conditioning behavioural principles are combined. Patients were treated during 10 individual sessions along 20 group sessions. Usual care consisted of physiotherapy according to the Dutch guidelines for Low Back Pain. Main outcome measures were functional disability (Roland Morris disability questionnaire), pain intensity, perceived recovery and sick leave because of low back pain assessed at baseline and after 6, 13, 26 and 52 weeks. Both an intention-to-treat analysis and a per-protocol analysis were performed. Multilevel analysis did not show significant differences between both treatment groups on any outcome measures during the complete follow-up period, with one exception. After 26 weeks the protocol group showed more reduction in pain intensity than the guideline group, but this difference was absent after 52 weeks. We finally conclude that an intensive group training protocol was not more effective than usual physiotherapy for chronic low back pain.

Piracetam improves mitochondrial dysfunction following oxidative stress

PubMed Central

Keil, Uta; Scherping, Isabel; Hauptmann, Susanne; Schuessel, Katin; Eckert, Anne; Müller, Walter E

2005-01-01

Mitochondrial dysfunction including decrease of mitochondrial membrane potential and reduced ATP production represents a common final pathway of many conditions associated with oxidative stress, for example, hypoxia, hypoglycemia, and aging. Since the cognition-improving effects of the standard nootropic piracetam are usually more pronounced under such pathological conditions and young healthy animals usually benefit little by piracetam, the effect of piracetam on mitochondrial dysfunction following oxidative stress was investigated using PC12 cells and dissociated brain cells of animals treated with piracetam. Piracetam treatment at concentrations between 100 and 1000 μM improved mitochondrial membrane potential and ATP production of PC12 cells following oxidative stress induced by sodium nitroprusside (SNP) and serum deprivation. Under conditions of mild serum deprivation, piracetam (500 μM) induced a nearly complete recovery of mitochondrial membrane potential and ATP levels. Piracetam also reduced caspase 9 activity after SNP treatment. Piracetam treatment (100–500 mg kg−1 daily) of mice was also associated with improved mitochondrial function in dissociated brain cells. Significant improvement was mainly seen in aged animals and only less in young animals. Moreover, the same treatment reduced antioxidant enzyme activities (superoxide dismutase, glutathione peroxidase, and glutathione reductase) in aged mouse brain only, which are elevated as an adaptive response to the increased oxidative stress with aging. In conclusion, therapeutically relevant in vitro and in vivo concentrations of piracetam are able to improve mitochondrial dysfunction associated with oxidative stress and/or aging. Mitochondrial stabilization and protection might be an important mechanism to explain many of piracetam's beneficial effects in elderly patients. PMID:16284628

Clinical trial: a novel high-dose 1 g mesalamine suppository (Salofalk) once daily is as efficacious as a 500-mg suppository thrice daily in active ulcerative proctitis.

PubMed

Andus, Tilo; Kocjan, Andreas; Müser, Moritz; Baranovsky, Andrey; Mikhailova, Tatyana L; Zvyagintseva, Tatyana D; Dorofeyev, Andrey E; Lozynskyy, Yurii S; Cascorbi, Ingolf; Stolte, Manfred; Vieth, Michael; Dilger, Karin; Mohrbacher, Ralf; Greinwald, Roland

2010-11-01

Mesalamine suppositories are first-line therapy in active ulcerative proctitis; the standard regime still recommends multiple doses per day. The primary objective of this study was to show the noninferiority of once-daily administration of a novel 1 g mesalamine suppository versus thrice-daily administration of the 0.5 g mesalamine suppository. This was a single-blind (investigator-blinded), randomized, multicenter, comparative, Phase III clinical trial. Patients with mild to moderately active ulcerative proctitis inserted either one mesalamine 1 g suppository at bedtime or one mesalamine 0.5 g suppository thrice daily over a 6-week period. The primary endpoint was rate of remission (Disease Activity Index below 4). In all, 354 patients were evaluable for safety and per-protocol analysis. The new regimen demonstrated noninferiority: The percentage of patients with remission was 87.9% for the once-daily 1 g mesalamine suppository and 90.7% for the thrice-daily 0.5 g mesalamine suppository. Each regimen resulted in prompt cessation of clinical symptoms (e.g., median time to ≤3 stools per day (all without blood): 5 days in the 1 g mesalamine once-daily and 7 days in the 0.5 g mesalamine thrice-daily group). Patients preferred applying suppositories once a day. In active ulcerative proctitis the once-daily administration of a 1 g mesalamine suppository is as effective and safe, yet considerably more convenient, than the standard thrice-daily administration of a 0.5 g mesalamine suppository.

Quantification of Daily Physical Activity

NASA Technical Reports Server (NTRS)

Whalen, Robert; Breit, Greg; Quintana, Jason

1994-01-01

The influence of physical activity on the maintenance and adaptation of musculoskeletal tissue is difficult to assess. Cumulative musculoskeletal loading is hard to quantify and the attributes of the daily tissue loading history affecting bone metabolism have not been completely identified. By monitoring the vertical component of the daily ground reaction force (GRFz), we have an indirect measure of cumulative daily lower limb musculoskeletal loading to correlate with bone density and structure. The objective of this research is to develop instrumentation and methods of analysis to quantify activity level in terms of the daily history of ground reaction forces.

Total daily physical activity and the risk of AD and cognitive decline in older adults

PubMed Central

Boyle, P.A.; Yu, L.; Shah, R.C.; Wilson, R.S.; Bennett, D.A.

2012-01-01

Objective: Studies examining the link between objective measures of total daily physical activity and incident Alzheimer disease (AD) are lacking. We tested the hypothesis that an objective measure of total daily physical activity predicts incident AD and cognitive decline. Methods: Total daily exercise and nonexercise physical activity was measured continuously for up to 10 days with actigraphy (Actical®; Philips Healthcare, Bend, OR) from 716 older individuals without dementia participating in the Rush Memory and Aging Project, a prospective, observational cohort study. All participants underwent structured annual clinical examination including a battery of 19 cognitive tests. Results: During an average follow-up of about 4 years, 71 subjects developed clinical AD. In a Cox proportional hazards model adjusting for age, sex, and education, total daily physical activity was associated with incident AD (hazard ratio = 0.477; 95% confidence interval 0.273–0.832). The association remained after adjusting for self-report physical, social, and cognitive activities, as well as current level of motor function, depressive symptoms, chronic health conditions, and APOE allele status. In a linear mixed-effect model, the level of total daily physical activity was associated with the rate of global cognitive decline (estimate 0.033, SE 0.012, p = 0.007). Conclusions: A higher level of total daily physical activity is associated with a reduced risk of AD. PMID:22517108

Total daily physical activity and the risk of AD and cognitive decline in older adults.

PubMed

Buchman, A S; Boyle, P A; Yu, L; Shah, R C; Wilson, R S; Bennett, D A

2012-04-24

Studies examining the link between objective measures of total daily physical activity and incident Alzheimer disease (AD) are lacking. We tested the hypothesis that an objective measure of total daily physical activity predicts incident AD and cognitive decline. Total daily exercise and nonexercise physical activity was measured continuously for up to 10 days with actigraphy (Actical®; Philips Healthcare, Bend, OR) from 716 older individuals without dementia participating in the Rush Memory and Aging Project, a prospective, observational cohort study. All participants underwent structured annual clinical examination including a battery of 19 cognitive tests. During an average follow-up of about 4 years, 71 subjects developed clinical AD. In a Cox proportional hazards model adjusting for age, sex, and education, total daily physical activity was associated with incident AD (hazard ratio = 0.477; 95% confidence interval 0.273-0.832). The association remained after adjusting for self-report physical, social, and cognitive activities, as well as current level of motor function, depressive symptoms, chronic health conditions, and APOE allele status. In a linear mixed-effect model, the level of total daily physical activity was associated with the rate of global cognitive decline (estimate 0.033, SE 0.012, p = 0.007). A higher level of total daily physical activity is associated with a reduced risk of AD.

Insulin-like growth factor-I (lGF-l): safety and efficacy.

PubMed

Laron, Zvi

2004-11-01

Insulin-like growth factor I (IGF-I) is a peptide synthesized mainly in the liver by stimulation by pituitary growth hormone (GH). It circulates almost entirely bound to its binding proteins. It is the anabolic effector hormone of GH. It is the only treatment in states of GH resistance such as Laron syndrome and blocking antibodies to human GH. As it suppresses insulin and GH secretion it has been used in states of insulin resistance including Type II diabetes mellitus. IGF-I is administered by once or twice daily injections. Adverse effects are mostly caused by overdosage. The usual daily dose in children ranges from 100-200 microg/kg.

Effects of workplace intervention on affective well-being in employees' children.

PubMed

Lawson, Katie M; Davis, Kelly D; McHale, Susan M; Almeida, David M; Kelly, Erin L; King, Rosalind B

2016-05-01

Using a group-randomized field experimental design, this study tested whether a workplace intervention-designed to reduce work-family conflict-buffered against potential age-related decreases in the affective well-being of employees' children. Daily diary data were collected from 9- to 17-year-old children of parents working in an information technology division of a U.S. Fortune 500 company prior to and 12 months after the implementation of the Support-Transform-Achieve-Results (STAR) workplace intervention. Youth (62 with parents in the STAR group, 41 in the usual-practice group) participated in 8 consecutive nightly phone calls, during which they reported on their daily stressors and affect. Well-being was indexed by positive and negative affect and affective reactivity to daily stressful events. The randomized workplace intervention increased youth positive affect and buffered youth from age-related increases in negative affect and affective reactivity to daily stressors. Future research should test specific conditions of parents' work that may penetrate family life and affect youth well-being. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A characterization of Parkinson's disease by describing the visual field motion during gait

NASA Astrophysics Data System (ADS)

Trujillo, David; Martínez, Fabio; Atehortúa, Angélica; Alvarez, Charlens; Romero, Eduardo

2015-12-01

An early diagnosis of Parkinson's Disease (PD) is crucial towards devising successful rehabilitation programs. Typically, the PD diagnosis is performed by characterizing typical symptoms, namely bradykinesia, rigidity, tremor, postural instability or freezing gait. However, traditional examination tests are usually incapable of detecting slight motor changes, specially for early stages of the pathology. Recently, eye movement abnormalities have correlated with early onset of some neurodegenerative disorders. This work introduces a new characterization of the Parkinson disease by describing the ocular motion during a common daily activity as the gait. This paper proposes a fully automatic eye motion analysis using a dense optical flow that tracks the ocular direction. The eye motion is then summarized using orientation histograms constructed during a whole gait cycle. The proposed approach was evaluated by measuring the χ2 distance between the orientation histograms, showing substantial differences between control and PD patients.

Spatial correlation analysis of cascading failures: Congestions and Blackouts

PubMed Central

Daqing, Li; Yinan, Jiang; Rui, Kang; Havlin, Shlomo

2014-01-01

Cascading failures have become major threats to network robustness due to their potential catastrophic consequences, where local perturbations can induce global propagation of failures. Unlike failures spreading via direct contacts due to structural interdependencies, overload failures usually propagate through collective interactions among system components. Despite the critical need in developing protection or mitigation strategies in networks such as power grids and transportation, the propagation behavior of cascading failures is essentially unknown. Here we find by analyzing our collected data that jams in city traffic and faults in power grid are spatially long-range correlated with correlations decaying slowly with distance. Moreover, we find in the daily traffic, that the correlation length increases dramatically and reaches maximum, when morning or evening rush hour is approaching. Our study can impact all efforts towards improving actively system resilience ranging from evaluation of design schemes, development of protection strategies to implementation of mitigation programs. PMID:24946927

Powered AFO for Achilles tendon rupture.

PubMed

Yoshizawa, Nobuyuki

2008-01-01

This paper proposes a powered ankle foot orthosis (AFO) for the treatment of a ruptured Achilles tendon. Usually, conservative orthosis treatment requires about two months, and a motionless ankle degrades activities of daily living (ADL). It is difficult to go to school or work on foot, and a pair of crutches is needed to go up and down stairs. In order to improve the ADL, an electric powered AFO has been designed to improve the ability to walk with a fixed ankle joint. The sole of the proposed AFO is equipped with an electric actuator. The prototype actuator consists of Nd magnets and electromagnets and is lightweight and battery driven. The actuator can switch the upright posture and the stepped forward posture of the patient. In an experiment, the use of this electric AFO made it possible to walk and to ascend and descend stairs with a fixed ankle joint.

[Medical and legal considerations in whiplash injury].

PubMed

Castillo-Chávez, Miguel Angel

2013-01-01

Whiplash injury usually occurs in people who suffered an automobile accident, but also occurs as a result of physical assault and other mechanisms. Diagnosis and initial management of the patient by the emergency physician or orthopedist, and prescribing indications, are taken into account by two forensic intervention specialists. One of these is the medical officer, who, through analysis of the injury mechanism, establishes a cause-effect relationship and concludes whether the accident suffered by a worker it is related to work or not, determines how long the worker will remain disabled and if the injury caused permanent disability under Federal Labor Law. The medical examiner by injury classification assists the Public Ministry so that it can frame the crime of injury to the Criminal Code of Federal District. For these reasons a review of medical information about the mechanism of injury, diagnosis, treatment and healing time was performed to help both specialists to standardize their approach in their daily activities.

Stability and Change in Health Insurance Among Older Mexican Americans: Longitudinal Evidence From the Hispanic Established Populations for Epidemiologic Study of the Elderly

PubMed Central

Angel, Ronald J.; Angel, Jacqueline L.; Markides, Kyriakos S.

2002-01-01

Objectives. This study examined the association between health insurance coverage, medical care use, limitations in activities of daily living, and mortality among older Mexican-origin individuals. Methods. We analyzed longitudinal data from the Hispanic Established Populations for Epidemiologic Study of the Elderly (H-EPESE). Results. The uninsured tend to be younger, female, poor, and foreign born. They report fewer health care visits, are less likely to have a usual source of care, and more often receive care in Mexico. Conversely, those with private health insurance are economically better off and use more health care services. Over time, the data reveal substantial changes in type of insurance coverage. Conclusions. The data reveal serious vulnerabilities among older Mexican Americans that result from a lack of private Medigap supplemental coverage. (Am J Public Health. 2002;92:1264–1271) PMID:12144982

Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free-living environments.

PubMed

Sheahan, Helen; Canning, Kimberley; Refausse, Nishka; Kinnear, Ewan M; Jorgensen, Greg; Walsh, James R; Lazzarini, Peter A

2017-12-01

The aims of our study were to investigate multiple daily activity outcomes in patients with diabetic foot ulcers (DFU) compared to diabetic peripheral neuropathy (DPN) and diabetes (DM) controls in their free-living environments. We examined daily activity outcomes of 30 patients with DFU, 23 DPN and 20 DM. All patients wore a validated multi-sensor device for > 5 days (>22 hours per day) to measure their daily activity outcomes: steps, energy expenditure (kJ), average metabolic equivalent tasks (METs), physical activity (>3·0 METs) duration and energy expenditure, lying duration, sleep duration and sleep quality. We found that DFU patients recorded fewer median (interquartile ranges, IQR) daily steps [2154 (1621-4324)] than DPN [3660 (2742-7705)] and DM [5102 (4011-7408)] controls (P < 0·05). In contrast, DFU patients recorded more mean ± SD daily energy expenditure (kJ) (13 006 ± 3559) than DPN (11 085 ± 1876) and DM (11 491 ± 1559) controls (P < 0·05). We found no other differences in daily activity outcomes (P > 0·1). We conclude that DFU patients typically take fewer steps but expend more energy during their normal daily activity than DPN and DM controls. We hypothesise that the increased energy expenditure for DFU patients may be due to wound healing or an inefficient gait strategy. Further investigations into this energy imbalance in DFU patients may improve healing in future. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

The Effect of Light on Bacterial Activity in a Seaweed Holobiont.

PubMed

Coelho-Souza, Sergio A; Jenkins, Stuart R; Casarin, Antonio; Baeta-Neves, Maria Helena; Salgado, Leonardo T; Guimaraes, Jean R D; Coutinho, Ricardo

2017-11-01

Holobionts are characterized by the relationship between host and their associated organisms such as the biofilm associated with macroalgae. Considering that light is essential to macroalgae survival, the aim of this study was to verify the effect of light on the heterotrophic activity in biofilms of the brown macroalgae Sargassum furcatum during its growth cycle. Measurements of heterotrophic activity were done under natural light levels at different times during a daily cycle and under an artificial extinction of natural light during the afternoon. We also measured Sargassum primary production under these light levels in the afternoon. Both measurements were done with and without photosynthesis inhibitor and antibiotics. Biofilm composition was mainly represented by bacteria but diatoms, cyanobacteria, and other organisms were also common. When a peak of diatom genera was recorded, the heterotrophic activity of the biofilm was higher. Heterotrophic activity was usually highest during the afternoon and the presence of a photosynthesis inhibitor caused an average reduction of 17% but there was no relationship with Sargassum primary production. These results indicate that autotrophic production in the biofilm was reduced by the inhibitor with consequences on bacterial activity. Heterotrophic activity was mainly bacterial and the antibiotics chloramphenicol and penicillin were more effective than streptomycin. We suggest primary producers in the biofilm are more important to increase bacterial activity than the macroalgae itself because of coherence of the peaks of heterotrophic and autotrophic activity in biofilm during the afternoon and the effects of autotrophic inhibitors on heterotrophic activity.

[Outdoor activity and myopia among 681 primary students in urban and rural regions of Beijing].

PubMed

Guo, Yin; Liu, Lijuan; Xu, Liang; Lü, Yanyun; Tang, Ping; Feng, Yi

2014-01-21

To explore the association between outdoor activity and myopia among 681 primary students from Beijing. School-based, cross-sectional investigation. Eye examination includes the visual acuity test, auto-refractor, slit lamp, ocular biometry and non-mydriatic fundus camera. Questionnaire includes regular items, near work, outdoor activity and social-economic status. The mean time spent outdoors was 1.6 ± 0.8 hours daily. Time spent on outdoor sports and outdoor leisure were 0.7 ± 0.1 hours daily, 1.0 ± 0.8 hours daily, respectively. Mean time of outdoor activity in urban was 1.1 ± 0.4 hours daily, compared with 2.2 ± 0.8 hours daily in rural (P = 0.000). In grade-1, total time spent outdoors is significantly different between myopia and non-myopia (1.4 ± 0.6 vs 1.8 ± 0.8 hours daily, P = 0.000), similar to outdoor leisure (0.8 ± 0.6 vs 1.1 ± 0.9 hours daily, P = 0.000). The same trend was also found in grade-4. The mean time spent outdoors was 1.6 ± 0.8 hours daily. Myopia spent a lower outdoor activity compared with non-myopia. More outdoor activity, e.g., in schools, may potentially be helpful to reduce the high prevalence of myopia in the young generation.

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

PubMed

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

2017-05-01

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

Correlates of Active Videogame Use in Children.

PubMed

Schneider, Kristin L; Carter, Jocelyn Smith; Putnam, Cynthia; Keeney, Jacey; DeCator, Draycen D; Kern, Daniel; Aylward, Laura

2018-04-01

Active videogames (AVGs) could provide a novel approach to increasing physical activity and decreasing sedentary activity in children, but little is known about which children are likely to use AVGs. This study examined whether youth demographics, social support, and AVG engagement influence use of AVGs and physical activity. A diverse sample of youth participants (42.4% non-Hispanic white), aged 8-14 years (n = 85), who owned an AVG console, completed surveys, wore an activity monitor, and logged AVG use for 1 week. Regression analyses were used to examine variables associated with daily AVG minutes and to examine the relationship between daily AVG minutes and daily steps. Older and non-Hispanic white children played AVGs for fewer minutes per day (P's < 0.03). Greater peer support for playing AVGs was associated with greater daily AVG minutes (P = 0.003). Daily AVG minutes were not associated with daily steps. Results suggest that younger children and children who do not identify as non-Hispanic white may be more open to playing AVGs. Targeting social support in AVG interventions may increase time spent playing AVGs.

Impact of estradiol valerate/dienogest on work productivity and activities of daily living in women with heavy menstrual bleeding.

PubMed

Wasiak, Radoslaw; Filonenko, Anna; Vanness, David J; Law, Amy; Jeddi, Mark; Wittrup-Jensen, Kim U; Stull, Donald E; Siak, Steven; Jensen, Jeffrey T

2013-04-01

To quantify the change in work productivity and activities of daily living in North American women with heavy menstrual bleeding (HMB) treated with estradiol valerate/dienogest (E2V/DNG; Qlaira(®)/Natazia(®)) compared to placebo. Women in the United States and Canada, aged 20-53 years with an objective diagnosis of HMB and no recognizable anatomical pathology, were treated with E2V/DNG or placebo for seven cycles (196 days). Main outcome measures included work productivity (i.e., productivity while at work) and activities of daily living measured using a modified Work Productivity and Activity Impairment Questionnaire (mWPAI) on a Likert scale from 0 to 10 (higher values denote higher impairment levels). In both countries, significant improvement was observed between baseline and end of treatment in work productivity and activities of daily living impairment. The improvements in work productivity and activities of daily living with E2V/DNG treatment relative to placebo ranged from 37.2% to 39.2% across both countries. Monthly gains due to E2V/DNG treatment (net of placebo improvement) associated with improvement in work productivity were estimated to be US$80.2 and Can$70.8 (US$58.5) and those associated with improvement in activities of daily living were estimated to be US$84.9 and Can$73.5 (US$60.7). E2V/DNG was shown to have a consistent positive impact on work productivity and activities of daily living in U.S. and Canadian women with HMB. In addition, these improvements in work productivity and activities of daily living were associated with a reduction in HMB-related monetary burden compared to the placebo group.

Combating the Epidemic of Obesity and Cardiovascular Disease: Perspectives from School-aged Children

PubMed Central

Addison, Clifton C.; White, Monique S.; Jenkins, Brenda W.; Young, Lavon

2006-01-01

This study was designed to assess students’ perceptions of the obstacles to positive dietary practices and increased physical activity and to solicit the students’ recommendations for addressing and possibly reducing the negative practices that are associated with the rise in obesity and the development of cardiovascular diseases. Data for the study were obtained from the administration of the 2005 Project Health High School Survey (PHHSS) which measured the students’ perceptions regarding obstacles to eating more nutritious, healthier foods and obstacles to participating in daily physical activity. The reasons for students’ lack of interest in practicing more life-healthy behaviors are ranked and recorded. Some of the students indicated that they usually ate what they liked to eat, and the decision about what to eat was made because of the taste of the food without regard for any health consequence or negative health outcomes. Finding ways to reach these students at their young ages is the key to successfully combating the high prevalence of obesity and the development of other chronic diseases in childhood, as well as in adulthood. PMID:16968973

Combating the epidemic of obesity and cardiovascular disease: perspectives from school-aged children.

PubMed

Addison, Clifton C; White, Monique S; Jenkins, Brenda W; Young, Lavon

2006-09-01

This study was designed to assess students' perceptions of the obstacles to positive dietary practices and increased physical activity and to solicit the students' recommendations for addressing and possibly reducing the negative practices that are associated with the rise in obesity and the development of cardiovascular diseases. Data for the study were obtained from the administration of the 2005 Project Health High School Survey (PHHSS) which measured the students' perceptions regarding obstacles to eating more nutritious, healthier foods and obstacles to participating in daily physical activity. The reasons for students' lack of interest in practicing more life-healthy behaviors are ranked and recorded. Some of the students indicated that they usually ate what they liked to eat, and the decision about what to eat was made because of the taste of the food without regard for any health consequence or negative health outcomes. Finding ways to reach these students at their young ages is the key to successfully combating the high prevalence of obesity and the development of other chronic diseases in childhood, as well as in adulthood.

Shoulder pain -- a common problem in world-class badminton players.

PubMed

Fahlström, Martin; Yeap, Joo Seng; Alfredson, Håkan; Söderman, Kerstin

2006-06-01

Badminton is a sport that requires a lot of over-shoulder motion, with the shoulder in abduction/external rotation. This questionnaire study on 188 international top-level badminton players during the World Mixed Team Championships showed that previous or present shoulder pain on the dominant side was reported by 52% of the players. Previous shoulder pain was reported by 37% of the players and on-going shoulder pain by 20% of the players. There were no significant differences in the prevalence of shoulder pain between men and women. The majority of the shoulder pain had started gradually. The pain was usually associated with shoulder activity, and stiffness was a common, associated symptom. Furthermore, the shoulder pain was associated with consequences such as sleeping disturbances, changes in training and competition habits, and it also affected activities of daily living. The majority of the players had sought medical advice and had been given different kinds of treatment. The study showed that shoulder pain is a common and significant problem in world-class badminton players, and the consequences are most likely of importance for their training and playing capacity.

Beneficial effects of spin-labelled nitrosourea on CCNU-induced oxidative stress in rat blood compared with vitamin E.

PubMed

Gadjeva, V; Kuchukova, D; Tolekova, A; Tanchev, S

2005-07-01

This study was carried out to determine the effects of a recently synthesized 1-ethyl-3-[4-(2,2,6,6-tetra-methylpiperidine-1-oxyl)]-1-nitrosourea (SLENU), compared with vitamin E as a positive control, on 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU)-induced oxidative stress in rats. We determined plasma malonyl dialdehyde (MDA) levels and the activities of erythrocyte superoxide dismutase (SOD) and catalase (CAT). Forty two white albino healthy rats were treated once daily for 30 days with oral preparations of CCNU (12.5 mg/kg and 25 mg/kg), SLENU (25-200 mg/kg), and combinations of these. The CCNU-induced increase in plasma MDA level and the usual decrease in erythrocyte SOD and CAT activities were reversed by SLENU, but not by vitamin E. We have previously demonstrated that SLENU is a superoxide scavenger. A combination of our present findings with previous results thus leads us to proposing a new chemotherapeutic combination of CCNU and SLENU that is devoid of high toxicity.

Astronaut-Induced Disturbances to the Microgravity Environment of the Mir Space Station

NASA Technical Reports Server (NTRS)

Newman, Dava J.; Amir, Amir R.; Beck, Sherwin M.

2001-01-01

In preparation for the International Space Station, the Enhanced Dynamic Load Sensors Space Flight Experiment measured the forces and moments astronauts exerted on the Mir Space Station during their daily on-orbit activities to quantify the astronaut-induced disturbances to the microgravity environment during a long-duration space mission. An examination of video recordings of the astronauts moving in the modules and using the instrumented crew restraint and mobility load sensors led to the identification of several typical astronaut motions and the quantification or the associated forces and moments exerted on the spacecraft. For 2806 disturbances recorded by the foot restraints and hand-hold sensor, the highest force magnitude was 137 N. For about 96% of the time, the maximum force magnitude was below 60 N, and for about 99% of the time the maximum force magnitude was below 90 N. For 95% of the astronaut motions, the rms force level was below 9.0 N. It can be concluded that expected astronaut-induced loads from usual intravehicular activity are considerably less than previously thought and will not significantly disturb the microgravity environment.

Active participation in preventionist professional practices: a specific ergonomics training course.

PubMed

Querelle, Léonard; Duwelz, Michel; Beaujouan, Joffrey; Pignault, Anne

2012-01-01

Currently, the different forms of corporate management methods (quality circles, lean manufacturing, etc.) are usually based on employee mobilisation. Very often, the goal of this type of approach is at best, to ensure that employees embrace corporate projects, or otherwise to impose changes on them without taking into account the real work and difficulties that they face daily. However, do these employee solicitation methods converge with participatory approaches as envisaged by ergonomists and more generally, preventionists? Based on the observation that the activity of institutional preventionists evolves with regulatory constraints and work related to the monitoring of indicators, the implementation and steering of the participatory approach within companies may be a major lever for prevention. After describing the foundations of a participatory approach, this paper will present a training experiment aimed at implementing and promoting employee participation in prevention efforts. The content of this training is then analysed with regard to the balance between methodology and the use of trainees' narratives. The results of the training session are presented from the point of view of the development prospects for pedagogical tools and the organisation of the training.

Who are the traffic offenders among ethnic groups and why?

PubMed

Elias, Wafa; Blank-Gomel, Aharon; Habib-Matar, Caroline; Shiftan, Yoram

2016-06-01

Marginalized populations, particularly ethnic minorities, are often at a higher risk of being involved in traffic crashes and committing traffic violations. Prominent explanations for this "ethnic traffic risk gap" include cultural and socioeconomic factors, usually measured at an aggregate level. In particular, it has been hypothesized that ethnic minorities commit traffic violations as a form of social resistance to what they perceive to be an oppressing regime. The current study examined the mechanisms underlying traffic violations at the individual level within a single ethnic minority, Israeli-Arabs. The study sample (n=231) included a group of known offenders (n=60) and non-offenders (n=171), all of which completed the Traffic Violation Questionnaire. The results show that offenders and non-offenders tended to have different types of occupations, although these did not translate into significant differences in level of income. Offenders reported significantly lower levels of trust in some hegemonic institutions (the police, government ministries) but not others (parliament, the juridical system). However, offenders displayed remarkably different daily activity patterns, including much higher exposure to traffic (3h/day vs. 0.75) and more complex trip patterns. Our results find little support for the social resistance hypothesis, as it fails to explain the differential treatment of hegemonic institutions. Daily activity patterns stand out as a central mechanism influencing the risk of violations. These results suggest policymakers should adopt a holistic approach for traffic safety interventions but avoid monolithic views of ethnic minorities which may lead to an inefficient use of resources. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of Behavioral Symptoms in Dementia Patients on Depression in Daughter and Daughter-in-Law Caregivers.

PubMed

Lee, Juwon; Sohn, Bo Kyung; Lee, Hyunjoo; Seong, Sujeong; Park, Soowon; Lee, Jun-Young

2017-01-01

One caregiver relationship that has been neglected in caregiver depression research is the daughter-in-law. Compared with Western countries, in which those who are closer in familial relationships such as the spouse or child usually take care of the patient, in many Asian countries, the daughter-in-law often assumes the caretaker role. However, not much research has been done on how this relationship may result in different caregiver outcomes. We sought to identify whether the association between patient characteristics and caregiver depressive symptoms differs according to the familial relationship between caregiver and patient. Ninety-five daughter (n = 47) and daughter-in-law (n = 48) caregivers of dementia patients were asked to report their own depressive symptoms and patient behavioral symptoms. Patients' cognitive abilities, daily activities, and global dementia ratings were obtained. Hierarchical linear regression was employed to determine predictors of depressive symptoms. Daughters-in-law had marginally higher depressive scores. After adjusting for caregiver and patient characteristics, in both groups, greater dependency in activities of daily living and more severe and frequent behavioral symptoms predicted higher caregiver depressive scores. However, greater severity and frequency of behavioral symptoms predicted depression to a greater degree in daughters compared with daughters-in-law. Although behavioral symptoms predicted depression in both caregiver groups, the association was much stronger for daughters. This suggests that the emotional relationship between the daughter and patient exacerbates the negative effect of behavioral symptoms on caregiver depression. The familial relationship between the caregiver and dementia patient should be considered in managing caregiver stress.

Dose relations between goal setting, theory-based correlates of goal setting and increases in physical activity during a workplace trial.

PubMed

Dishman, Rod K; Vandenberg, Robert J; Motl, Robert W; Wilson, Mark G; DeJoy, David M

2010-08-01

The effectiveness of an intervention depends on its dose and on moderators of dose, which usually are not studied. The purpose of the study is to determine whether goal setting and theory-based moderators of goal setting had dose relations with increases in goal-related physical activity during a successful workplace intervention. A group-randomized 12-week intervention that included personal goal setting was implemented in fall 2005, with a multiracial/ethnic sample of employees at 16 geographically diverse worksites. Here, we examined dose-related variables in the cohort of participants (N = 664) from the 8 worksites randomized to the intervention. Participants in the intervention exceeded 9000 daily pedometer steps and 300 weekly minutes of moderate-to-vigorous physical activity (MVPA) during the last 6 weeks of the study, which approximated or exceeded current public health guidelines. Linear growth modeling indicated that participants who set higher goals and sustained higher levels of self-efficacy, commitment and intention about attaining their goals had greater increases in pedometer steps and MVPA. The relation between change in participants' satisfaction with current physical activity and increases in physical activity was mediated by increases in self-set goals. The results show a dose relation of increased physical activity with changes in goal setting, satisfaction, self-efficacy, commitment and intention, consistent with goal-setting theory.

Double-blind, placebo-controlled evaluation of 5-ASA suppositories in active distal proctitis and measurement of extent of spread using /sup 99m/Tc-labeled 5-ASA suppositories

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

Williams, C.N.; Haber, G.; Aquino, J.A.

1987-12-01

Patients with active distal proctitis received either 5-aminosalicylic (5-ASA) acid or identical placebo suppositories, 500 mg t.i.d. for 6 weeks. Activity at 3 and 6 wks was assessed using a Disease Activity Index (DAI), derived from four categories: number of daily evacuations more than usual, evacuations containing blood, sigmoidoscopy appearance, and physician's overall assessment. Each category was graded 0-3. There was thus 0-12 points scored ranging from complete remission to severe disease. A minimum score of 3 from two categories was necessary for study entry. Of 27 patients randomized, 14 received active medication and 13 placebo. Of the 14 patients,more » with initial mean DAI 7.1 +/- 1.8, 11 were in complete remission at 6 wks (78.6%). Whereas, there was no significant change in the placebo group, with initial mean DAI 7.1 +/- 1.8. An additional 6 patients with inflammatory bowel disease and 6 healthy volunteers were given /sup 99m/Tc-labelled 5-aminosalicylic acid suppositories. The extent of spread was limited to the rectum, and the suppositories were retained for 3 hours. There was no absorbed radioactivity. 5-ASA suppositories are safe, well-tolerated, and effective treatment for active distal proctitis.« less

Relationship between convective precipitation and lightning activity using radar quantitative precipitation estimates and total lightning data

NASA Astrophysics Data System (ADS)

Pineda, N.; Rigo, T.; Bech, J.; Argemí, O.

2009-09-01

Thunderstorms can be characterized by both rainfall and lightning. The relationship between convective precipitation and lightning activity may be used as an indicator of the rainfall regime. Besides, a better knowledge of local thunderstorm phenomenology can be very useful to assess weather surveillance tasks. Two types of approach can be distinguished in the bibliography when analyzing the rainfall and lightning activity. On one hand, rain yields (ratio of rain mass to cloud-to-ground flash over a common area) calculated for long temporal and spatial domains and using rain-gauge records to estimate the amounts of precipitation. On the other hand, a case-by-case approach has been used in many studies to analyze the relationship between convective precipitation and lightning in individual storms, using weather radar data to estimate rainfall volumes. Considering a local thunderstorm case study approach, the relation between rainfall and lightning is usually quantified as the Rainfall-Lightning ratio (RLR). This ratio estimates the convective rainfall volume per lightning flash. Intense storms tend to produce lower RLR values than moderate storms, but the range of RLR found in diverse studies is quite wide. This relationship depends on thunderstorm type, local climatology, convective regime, type of lightning flashes considered, oceanic and continental storms, etc. The objective of this paper is to analyze the relationship between convective precipitation and lightning in a case-by-case approach, by means of daily radar-derived quantitative precipitation estimates (QPE) and total lightning data, obtained from observations of the Servei Meteorològic de Catalunya remote sensing systems, which covers an area of approximately 50000 km2 in the NE of the Iberian Peninsula. The analyzed dataset is composed by 45 thunderstorm days from April to October 2008. A good daily correlation has been found between the radar QPE and the CG flash counts (best linear fit with a R^2=0.74). The daily RLR found has a mean value of 86 10^3m3 rainfall volume per CG flash. The daily range of variation is quite wide, as it goes from 19 to 222 10^3m3 per CG flash. This variation has a seasonal component, related to changes in the convective regime. Summer days (July to middle September) had a mean RLR of 57 10^3m3 rainfall volume per CG flash, while from middle September to the end of October the rainfall volume per CG flash doubles (mean of 125 10^3m3 per CG flash).

P300 amplitude variation is related to ventral striatum BOLD response during gain and loss anticipation: an EEG and fMRI experiment.

PubMed

Pfabigan, Daniela M; Seidel, Eva-Maria; Sladky, Ronald; Hahn, Andreas; Paul, Katharina; Grahl, Arvina; Küblböck, Martin; Kraus, Christoph; Hummer, Allan; Kranz, Georg S; Windischberger, Christian; Lanzenberger, Rupert; Lamm, Claus

2014-08-01

The anticipation of favourable or unfavourable events is a key component in our daily life. However, the temporal dynamics of anticipation processes in relation to brain activation are still not fully understood. A modified version of the monetary incentive delay task was administered during separate functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG) sessions in the same 25 participants to assess anticipatory processes with a multi-modal neuroimaging set-up. During fMRI, gain and loss anticipation were both associated with heightened activation in ventral striatum and reward-related areas. EEG revealed most pronounced P300 amplitudes for gain anticipation, whereas CNV amplitudes distinguished neutral from gain and loss anticipation. Importantly, P300, but not CNV amplitudes, were correlated to neural activation in the ventral striatum for both gain and loss anticipation. Larger P300 amplitudes indicated higher ventral striatum blood oxygen level dependent (BOLD) response. Early stimulus evaluation processes indexed by EEG seem to be positively related to higher activation levels in the ventral striatum, indexed by fMRI, which are usually associated with reward processing. The current results, however, point towards a more general motivational mechanism processing salient stimuli during anticipation. Copyright © 2014. Published by Elsevier Inc.

Social Environment of Older People during the First Year in Senior Housing and Its Association with Physical Performance

PubMed Central

Kyngäs, Helvi; Koistinen, Pentti; Bloigu, Risto; Elo, Satu

2017-01-01

Increasing numbers of older people relocate into senior housing when their physical performance declines. The change in social environment is known to affect their wellbeing, providing both challenges and opportunities, but more information on the relations between social and physical parameters is required. Thus, we elicited perceptions of the social environment of 81 older people (aged 59–93 years, living in northern Finland) and changes in it 3 and 12 months after relocation to senior housing. We also measured their physical performance, then analysed associations between the social and physical variables. Participants reported that they had freedom to do whatever they liked and generally had enough contact with close people (which have recognized importance for older people’s wellbeing), but changes in their physical condition limited their social activity. Moreover, their usual walking speed, dominant hand’s grip strength and instrumental activities of daily living (IADL) significantly decreased. The pleasantness of the residential community, peer support, constraints on social activity imposed by changes in physical condition, meaningful activity at home and meeting close people all affected these physical performance parameters. Clearly, in addition to assessing physical performance and encouraging regular exercise, the complex interactions among social factors, physical performance and wellbeing should be considered when addressing individuals’ needs. PMID:28841198

Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial: protocol of a randomized clinical trial on tele-rehabilitation for stroke patients.

PubMed

Koh, Gerald Choon-Huat; Yen, Shih Cheng; Tay, Arthur; Cheong, Angela; Ng, Yee Sien; De Silva, Deidre Anne; Png, Carolina; Caves, Kevin; Koh, Karen; Kumar, Yogaprakash; Phan, Shi Wen; Tai, Bee Choo; Chen, Cynthia; Chew, Effie; Chao, Zhaojin; Chua, Chun En; Koh, Yen Sin; Hoenig, Helen

2015-09-05

Most acute stroke patients with disabilities do not receive recommended rehabilitation following discharge to the community. Functional and social barriers are common reasons for non-adherence to post-discharge rehabilitation. Home rehabilitation is an alternative to centre-based rehabilitation but is costlier. Tele-rehabilitation is a possible solution, allowing for remote supervision of rehabilitation and eliminating access barriers. The objective of the Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) trial is to determine if a novel tele-rehabilitation intervention for the first three months after stroke admission improves functional recovery compared to usual care. This is a single blind (evaluator blinded), parallel, two-arm randomised controlled trial study design involving 100 recent stroke patients. The inclusion criteria are age ≥40 years, having caregiver support and recent stroke defined as stroke diagnosis within 4 weeks. Consenting participants will be randomized with varying block size of 4 or 6 assuming a 1:1 treatment allocation with the participating centre as the stratification factor. The baseline assessment will be done within 4 weeks of stroke onset, followed by follow-up assessments at 3 and 6 months. The tele-rehabilitation intervention lasts for 3 months and includes exercise 5-days-a-week using an iPad-based system that allows recording of daily exercise with video and sensor data and weekly video-conferencing with tele-therapists after data review. Those allocated to the control group will receive usual care. The primary outcome measure is improvement in life task's social activity participation at three months as measured by the disability component of the Jette Late Life Functional and Disability Instrument (LLFDI). Secondary outcome variables consist of gait speed (Timed 5-Meter Walk Test) and endurance (Two-Minute Walk test), performance of basic activities of daily living (Shah-modified Barthel Index), balance confidence (Activities-Specific Balance Confidence Scale), patient self-reported health-related quality-of-life [Euro-QOL (EQ-5D)], health service utilization (Singapore Stroke Study Health Service Utilization Form) and caregiver reported stress (Zarit Caregiver Burden Inventory). The goal of this trial is to provide evidence on the potential benefit and cost-effectiveness of this novel tele-rehabilitation programme which will guide health care decision-making and potentially improve performance of post-stroke community-based rehabilitation. This trial protocol was registered under ClinicalTrials.gov on 18 July 2013 as study title "The Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) Study" (ID: The STARS Study, ClinicalTrials.gov Identifier: NCT01905917 ).

Design of the Balance@Work project: systematic development, evaluation and implementation of an occupational health guideline aimed at the prevention of weight gain among employees.

PubMed

Verweij, Lisanne M; Proper, Karin I; Weel, Andre N H; Hulshof, Carel T J; van Mechelen, Willem

2009-12-14

Occupational health professionals may play an important role in preventive health promotion activities for employees. However, due to a lack of knowledge and evidence- and practice based methods and strategies, interventions are hardly being implemented by occupational physicians to date. The aim of the Balance@Work project is to develop, evaluate, and implement an occupational health guideline aimed at the prevention of weight gain among employees. Following the guideline development protocol of the Netherlands Society of Occupational Medicine and the Intervention Mapping protocol, the guideline was developed based on literature, interviews with relevant stakeholders, and consensus among an expert group. The guideline consists of an individual and an environmental component. The individual component includes recommendations for occupational physicians on how to promote physical activity and healthy dietary behavior based on principles of motivational interviewing. The environmental component contains an obesogenic environment assessment tool. The guideline is evaluated in a randomised controlled trial among 20 occupational physicians. Occupational physicians in the intervention group apply the guideline to eligible workers during 6 months. Occupational physicians in the control group provide care as usual. Measurements take place at baseline and 6, 12, and 18 months thereafter. Primary outcome measures include waist circumference, daily physical activity and dietary behavior. Secondary outcome measures include sedentary behavior, determinants of behavior change, body weight and body mass index, cardiovascular disease risk profile, and quality of life. Additionally, productivity, absenteeism, and cost-effectiveness are assessed. Improving workers' daily physical activity and dietary behavior may prevent weight gain and subsequently improve workers' health, increase productivity, and reduce absenteeism. After an effect- and process evaluation the guideline will be adjusted and, after authorisation, published. Together with several implementation aids, the published guideline will be disseminated broadly by the Netherlands Society of Occupational Medicine. ISRCTN73545254/NTR1190.

Design of the Balance@Work project: systematic development, evaluation and implementation of an occupational health guideline aimed at the prevention of weight gain among employees

PubMed Central

2009-01-01

Background Occupational health professionals may play an important role in preventive health promotion activities for employees. However, due to a lack of knowledge and evidence- and practice based methods and strategies, interventions are hardly being implemented by occupational physicians to date. The aim of the Balance@Work project is to develop, evaluate, and implement an occupational health guideline aimed at the prevention of weight gain among employees. Methods Following the guideline development protocol of the Netherlands Society of Occupational Medicine and the Intervention Mapping protocol, the guideline was developed based on literature, interviews with relevant stakeholders, and consensus among an expert group. The guideline consists of an individual and an environmental component. The individual component includes recommendations for occupational physicians on how to promote physical activity and healthy dietary behavior based on principles of motivational interviewing. The environmental component contains an obesogenic environment assessment tool. The guideline is evaluated in a randomised controlled trial among 20 occupational physicians. Occupational physicians in the intervention group apply the guideline to eligible workers during 6 months. Occupational physicians in the control group provide care as usual. Measurements take place at baseline and 6, 12, and 18 months thereafter. Primary outcome measures include waist circumference, daily physical activity and dietary behavior. Secondary outcome measures include sedentary behavior, determinants of behavior change, body weight and body mass index, cardiovascular disease risk profile, and quality of life. Additionally, productivity, absenteeism, and cost-effectiveness are assessed. Discussion Improving workers' daily physical activity and dietary behavior may prevent weight gain and subsequently improve workers' health, increase productivity, and reduce absenteeism. After an effect- and process evaluation the guideline will be adjusted and, after authorisation, published. Together with several implementation aids, the published guideline will be disseminated broadly by the Netherlands Society of Occupational Medicine. Trial Registration ISRCTN73545254/NTR1190 PMID:20003405

Measuring Disability: Application of the Rasch Model to Activities of Daily Living (ADL/IADL).

ERIC Educational Resources Information Center

Sheehan, T. Joseph; DeChello, Laurie M.; Garcia, Ramon; Fifield, Judith; Rothfield, Naomi; Reisine, Susan

2001-01-01

Performed a comparative analysis of Activities of Daily Living (ADL) items administered to 4,430 older adults and Instrumental Activities of Daily Living administered to 605 people with rheumatoid arthritis scoring both with Likert and Rasch measurement models. Findings show the superiority of the Rasch approach over the Likert method. (SLD)

Gross motor function is an important predictor of daily physical activity in young people with bilateral spastic cerebral palsy.

PubMed

Bania, Theofani A; Taylor, Nicholas F; Baker, Richard J; Graham, H Kerr; Karimi, Leila; Dodd, Karen J

2014-12-01

The aim of the study was to describe daily physical activity levels of adolescents and young adults with bilateral spastic cerebral palsy (CP) and to identify factors that help predict these levels. Daily physical activity was measured using an accelerometer-based activity monitor in 45 young people with bilateral spastic CP (23 males, 22 females; mean age 18y 6mo [SD 2y 5mo] range 16y 1mo-20y 11mo); classified as Gross Motor Function Classification System (GMFCS) level II or III and with contractures of <20° at hip and knee. Predictor variables included demographic characteristics (age, sex, weight) and physical characteristics (gross motor function, lower limb muscle strength, 6min walk distance). Data were analyzed using the information-theoretic approach, using the Akaike information criterion (AIC) and linear regression. Daily activity levels were low compared with published norms. Gross Motor Function Measure Dimension-E (GMFM-E; walking, running, and jumping) was the only common predictor variable in models that best predicted energy expenditure, number of steps, and time spent sitting/lying. GMFM Dimension-D (standing) and bilateral reverse leg press strength contributed to the models that predicted daily physical activity. Adolescents and young adults with bilateral spastic CP and mild to moderate walking disabilities have low levels of daily activity. The GMFM-E was an important predictor of daily physical activity. © 2014 Mac Keith Press.

Objectively Measured Daily Physical Activity and Postural Changes as Related to Positive and Negative Affect Using Ambulatory Monitoring Assessments.

PubMed

Aggio, Daniel; Wallace, Karen; Boreham, Nicola; Shankar, Aparna; Steptoe, Andrew; Hamer, Mark

2017-09-01

The aim of the study was to determine whether objectively measured daily physical activity and posture of sitting, standing, and sit-to-stand transitions are associated with daily assessments of affect. Participants (N = 51, 49% female) wore ActivPal accelerometers for 24 h/d for seven consecutive days. Time spent sitting, standing, and being physically active and sit-to-stand transitions were derived for each day. Participants also completed a mood inventory each evening. Multilevel models examined within- and between-person associations of daily physical activity with positive and negative affect, adjusting for age, sex, body mass index, education, and sleep duration. Within-person associations showed that a 1-hour increase in daily physical activity was associated with a decrease in negative affect over the same day (B = -0.11, 95% confidence interval [CI], -0.21 to -0.01). Between-person associations indicated a borderline significant association between higher average daily physical activity levels and higher positive affect (B = 1.85, 95% CI = -0.25 to 3.94). There were no between- or within-person associations between sitting, standing, and sit-to-stand transitions with affect. Promoting physical activity may be a potential intervention strategy to acutely suppress negative affective states.

Performance of activities of daily living in a sample of applicants for home modification services.

PubMed

Johansson, Karin; Lilja, Margareta; Petersson, Ingela; Borell, Lena

2007-01-01

Home modification services are provided to support persons with functional limitations to live independently at home. It is not well known what causes individuals to apply for home modifications, or in what kind of life situation this need appears. The aim of this study was to examine the relationship between performance of activities of daily living, housing and living situation, and the home modification applied for in a sample of home modification applicants. Further, the aim was to examine differences in performance of activities of daily living between subgroups with different social support. A total of 102 participants were included in the study. Data on performance of activities of daily living was collected through interviews in the participants' homes, using structured instruments. The participants reported high levels of independence in activities of daily living, and were using assistive devices to a large extent. However, the applicants clearly experienced difficulties in performing activities related to the applied home modification. The study indicates that the main reason for applying for Home Modification Grants was perceived difficulties in performance of activities of daily living. This stresses the importance of including other aspects besides independence when trying to understand persons' activity performance and planning for occupational therapy interventions.

Expectations of younger patients concerning activities after knee arthroplasty: are we asking the right questions?

PubMed

Witjes, Suzanne; van Geenen, Rutger C I; Koenraadt, Koen L M; van der Hart, Cor P; Blankevoort, Leendert; Kerkhoffs, Gino M M J; Kuijer, P Paul F M

2017-02-01

Indications for total and unicondylar knee arthroplasty (KA) have expanded to younger patients, in which Patient-Reported Outcome Measures (PROMs) often show ceiling effects. This might be due to higher expectations. Our aims were to explore expectations of younger patients concerning activities in daily life, work and leisure time after KA and to assess to what extent PROMs meet and evaluate these activities of importance. Focus groups were performed among osteoarthritis (OA) patients <65 years awaiting KA, in which they indicated what activities they expected to perform better in daily life, work and leisure time after KA. Additionally, 28 activities of daily life, 17 of work and 27 of leisure time were depicted from seven PROMS, which were rated on importance, frequency and bother. A total score, representing motivation for surgery, was also calculated. Data saturation was reached after six focus groups including 37 patients. Younger OA patients expect to perform better on 16 activities after KA, including high-impact leisure time activities. From the PROMs, daily life and work activities were rated high in both importance and motivation for surgery, but for leisure time activities importance varied highly between patients. All seven PROMs score activities of importance, but no single PROM incorporates all activities rated important. Younger patients expect to perform better on many activities of daily life, work and leisure time after KA, and often at demanding levels. To measure outcomes of younger patients, we suggest using PROMs that include work and leisure time activities besides daily life activities, in which preferably scored activities can be individualized.

Beyond the Usual Approach of Chemistry Teaching in High Schools

ERIC Educational Resources Information Center

Ochonogor, Chukunoye Enunuwe

2011-01-01

There is a huge challenge of high failure rate in physical science across the world and South Africa, in particular at the high school level in recent times. This is in spite of the fact that both the educators and learners go to schools almost on daily basis perhaps doing the same thing in the same way and manner and achieving the same level or…

Community-wide promotion of physical activity in middle-aged and older Japanese: a 3-year evaluation of a cluster randomized trial.

PubMed

Kamada, Masamitsu; Kitayuguchi, Jun; Abe, Takafumi; Taguri, Masataka; Inoue, Shigeru; Ishikawa, Yoshiki; Harada, Kazuhiro; Lee, I-Min; Bauman, Adrian; Miyachi, Motohiko

2015-06-23

Promotion of physical activity (PA) is a key strategy to prevent non-communicable diseases. However, evidence on the effectiveness of community-wide interventions (CWIs) for promoting PA is limited. To evaluate the effectiveness of a 3-year CWI for promoting PA in middle-aged and older adults compared with usual public health services. This study is an extension to an original 1-year investigation study. Cluster randomized controlled trial with community as unit of randomization and individual as unit of analysis. 12 communities in Unnan, Japan were randomly allocated to the intervention (9) or the control (3). Additionally intervention communities were randomly allocated to aerobic activity promotion (Group A), flexibility and muscle-strengthening activities promotion (Group FM), or aerobic, flexibility, and muscle-strengthening activities promotion (Group AFM), each consisting of three communities. Randomly-sampled 4414 residents aged 40 to 79 years responded to the baseline survey (74%), and were analyzed in 2013-2014. A 3-year CWI based on social marketing, to promote PA from 2009 to 2012. The primary outcome was a change in regular aerobic, flexibility, and/or muscle-strengthening activities, defined by (1) engaging in 150 mins/week or more of walking, (2) engaging in daily flexibility activity, or (3) engaging 2 or more days/week in muscle-strengthening activities, evaluated at the individual level. Secondary outcomes were changes in specific types of PA and musculoskeletal pain. Outcomes were measured at baseline and at 1 and 3 years (2009, 2010, and 2012). The CWI did not significantly increase the proportion of adults who reached recommended levels of aerobic, flexibility, and/or muscle-strengthening activities (adjusted change difference = 1.6% [95% CI: -3.5, 6.6]). In the subgroup analysis, compared to the controls, adults doing flexibility activity daily significantly increased in Group FM (6.3% [95% CI: 1.9, 10.7]). In Group A and AFM for PA outcomes and in all groups for pain outcomes, there was no significant change compared to controls. The CWI did not achieve significant increase in the proportion of adults who reached recommended PA levels. However, it might be effective in promoting flexibility activity in middle-aged and older Japanese. UMIN-CTR UMIN000002683 .

Reduction of physical activity in daily life and its determinants in smokers without airflow obstruction.

PubMed

Furlanetto, Karina Couto; Mantoani, Leandro Cruz; Bisca, Gianna; Morita, Andrea Akemi; Zabatiero, Juliana; Proença, Mahara; Kovelis, Demétria; Pitta, Fabio

2014-04-01

In smokers without airflow obstruction, detailed, objective and controlled quantification of the level of physical inactivity in daily life has never been performed. This study aimed to objectively assess the level of physical activity in daily life in adult smokers without airflow obstruction in comparison with matched non-smokers, and to investigate the determinants for daily physical activity in smokers. Sixty smokers (aged 50 (39-54) years) and 50 non-smokers (aged 48 (40-53) years) matched for gender, age, anthropometric characteristics, educational level, employment status and seasons of the year assessment period were cross-sectionally assessed regarding their daily physical activity with a step counter, besides assessment of lung function, functional exercise capacity, quality of life, anxiety, depression, self-reported comorbidities carbon monoxide level, nicotine dependence and smoking habits. When compared with non-smokers, smokers walked less in daily life (7923 ± 3558 vs 9553 ± 3637 steps/day, respectively), presented worse lung function, functional exercise capacity, quality of life, anxiety and depression. Multiple regression analyses identified functional exercise capacity, Borg fatigue, self-reported motivation/physical activity behaviour and cardiac disease as significant determinants of number of steps/day in smokers (partial r(2)  = 0.10, 0.12, 0.16 and 0.05; b = 15, -997, 1207 and -2330 steps/day, respectively; overall fit of the model R(2)  = 0.38; P < 0.001). Adult smokers without airflow obstruction presented reduced level of daily physical activity. Functional exercise capacity, extended fatigue sensation, aspects of motivation/physical activity behaviour and self-reported cardiac disease are significant determinants of physical activity in daily life in smokers. © 2014 The Authors. Respirology © 2014 Asian Pacific Society of Respirology.

Reduced Gray Matter Volume Is Associated With Poorer Instrumental Activities of Daily Living Performance in Heart Failure.

PubMed

Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth; Narkhede, Atul; Griffith, Erica Y; Cohen, Ronald; Sweet, Lawrence H; Josephson, Richard; Hughes, Joel; Gunstad, John

2016-01-01

Heart failure patients require assistance with instrumental activities of daily living in part because of the high rates of cognitive impairment in this population. Structural brain insult (eg, reduced gray matter volume) is theorized to underlie cognitive dysfunction in heart failure, although no study has examined the association among gray matter, cognition, and instrumental activities of daily living in heart failure. The aim of this study was to investigate the associations among gray matter volume, cognitive function, and functional ability in heart failure. A total of 81 heart failure patients completed a cognitive test battery and the Lawton-Brody self-report questionnaire to assess instrumental activities of daily living. Participants underwent magnetic resonance imaging to quantify total gray matter and subcortical gray matter volume. Impairments in instrumental activities of daily living were common in this sample of HF patients. Regression analyses controlling for demographic and medical confounders showed that smaller total gray matter volume predicted decreased scores on the instrumental activities of daily living composite, with specific associations noted for medication management and independence in driving. Interaction analyses showed that reduced total gray matter volume interacted with worse attention/executive function and memory to negatively impact instrumental activities of daily living. Smaller gray matter volume is associated with greater impairment in instrumental activities of daily living in persons with heart failure, possibly via cognitive dysfunction. Prospective studies are needed to clarify the utility of clinical correlates of gray matter volume (eg, cognitive dysfunction) in identifying heart failure patients at risk for functional decline and determine whether interventions that target improved brain and cognitive function can preserve functional independence in this high-risk population.

Comorbidity, disability and geriatric syndromes in elderly breast cancer survivors. Results of a single-center experience.

PubMed

Gironés, Regina; Torregrosa, Dolores; Díaz-Beveridge, Roberto

2010-03-01

Advancing age is a major risk factor for breast cancer. Long-term follow-up is recommended after diagnosis and treatment of early breast cancer. With older age, the risk of comorbid conditions and functional impairment increases. A useful tool in the management and follow-up of these elderly patients could be a comprehensive geriatric assessment (CGA). A descriptive, transversal study was carried out of the prevalence of other comorbidities and of the functional impairment in elderly patients on follow-up after curative treatment of early breast cancer. Women aged> or =70 at diagnosis; early breast cancer treated surgically. No disease recurrence allowed. CGA was conducted in an oncology unit using screening instruments (activities of daily living [ADL]; instrumental activities of daily living [IADL]; body mass index [BMI]; geriatric depression scale [GDS]). Cognitive status was reported by the patient. Comorbidity was classified using the Charlson score. From January 2005 to June 2006 91 patients were seen. Mean age at surgery: 76 (70-92). Mean age at CGA: 80 (71-95). Aged population (almost 25% were more than 84 at the time of CGA). Median follow-up: 5 years (range 1-12). Good performance status (PS) in most (only 9% PS 2). Eighty-three percent were fully independent for ADL and 71% for IADL. IADL most affected was the ability to drive/use public transport. Twenty-eight percent had geriatric syndromes and 23% were classified as "frail". Increased age was associated with worsening PS (p=0.0001) and worsening function (ADL p<0.0001 and IADL p<0.0001). The study is remarkable for the high comorbidity index found in the elderly survivors. Median Charlson score was 2 (1-6). More than 75% of the series had a score >/=4. Cardiovascular disease (hypertension) was the most prevalent comorbid condition. As an effect of this, the majority of patients were polymedicated (75% took more than six drugs). Comorbidity was independent of functionality and age. Older patients with early breast cancer on follow-up have a high prevalence of comorbidity. In our series, function and independence were maintained. A selection bias cannot be excluded, as the fitter patients are those who usually continue with the follow-up, while those frail patients who do not continue because of their functional impairment are usually lost. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Criterion-Referenced Values of Grip Strength and Usual Gait Speed Using Instrumental Activities of Daily Living Disability as the Criterion.

PubMed

Lee, Meng-Chih; Hsu, Chih-Cheng; Tsai, Yi-Fen; Chen, Ching-Yu; Lin, Cheng-Chieh; Wang, Ching-Yi

Current evidence suggests that grip strength and usual gait speed (UGS) are important predictors of instrumental activities of daily living (IADL) disability. Knowing the optimum cut points of these tests for discriminating people with and without IADL disability could help clinicians or researchers to better interpret the test results and make medical decisions. The purpose of this study was to determine the cutoff values of grip strength and UGS for best discriminating community-dwelling older adults with and without IADL disability, separately for men and women, and to investigate their association with IADL disability. We conducted secondary data analysis on a national dataset collected in the Sarcopenia and Translational Aging Research in Taiwan (START). The data used in this study consisted of health data of 2420 community-dwelling older adults 65 years and older with no history of stroke and with complete data. IADL disability was defined as at least 1 IADL item scored as "need help" or "unable to perform." Receiver operating characteristics analysis was used to estimate the optimum grip strength and UGS cut points for best discriminating older adults with/without IADL disability. The association between each physical performance (grip strength and UGS) and IADL disability was assessed with odds ratios (ORs). With IADL disability as the criterion, the optimal cutoff values of grip strength were 28.7 kg for men and 16.0 kg for women, and those for UGS were 0.76 m/s for men and 0.66 m/s for women. The grip strength test showed satisfactory discriminant validity (area under the curve > 0.7) in men and a strong association with IADL disability (OR > 4). Our cut points using IADL disability as the criterion were close to those indicating frailty or sarcopenia. Our reported cutoffs can serve as criterion-referenced values, along with those previously determined using different indicators, and provide important landmarks on the performance continua of older adults' grip strength and UGS. These landmarks could be useful in interpreting test results, monitoring changes in performance, and identifying individuals requiring timely intervention. For identifying older adults at risk of IADL disability, grip strength is superior to UGS.

The STAP-study: The (cost) effectiveness of custom made orthotic insoles in the treatment for plantar fasciopathy in general practice and sports medicine: design of a randomized controlled trial.

PubMed

Rasenberg, N; Fuit, L; Poppe, E; Kruijsen-Terpstra, A J A; Gorter, K J; Rathleff, M S; van Veldhoven, P L J; Bindels, P J; Bierma-Zeinstra, S M; van Middelkoop, M

2016-01-16

Plantar fasciopathy is a common cause of foot pain, accounting for 11 to 15% of all foot symptoms requiring professional care in adults. Although many patients have complete resolution of symptoms within 12 months, many patients wish to reduce this period as much as possible. Orthotic devices are a frequently applied option of treatment in daily practice, despite a lack of evidence on the effectiveness. Therefore, the objective is to study the (cost)-effectiveness of custom made insoles by a podiatrist, compared to placebo insoles and usual care in patients with plantar fasciopathy in general practice and sports medicine clinics. This study is a multi-center three-armed participant and assessor-blinded randomized controlled trial with 6-months follow-up. Patients with plantar fasciopathy, with a minimum duration of complaints of 2 weeks and aged between 18 and 65, who visit their general practitioner or sport physician are eligible for inclusion. A total of 185 patients will be randomized into three parallel groups. One group will receive usual care by the general practitioner or sports physician alone, one group will be referred to a podiatrist and will receive a custom made insole, and one group will be referred to a podiatrist and will receive a placebo insole. The primary outcome will be the change from baseline to 12 weeks follow-up in pain severity at rest and during activity on a 0-10 numerical rating scale (NRS). Secondary outcomes include foot function (according to the Foot Function Index) at 6, 12 and 26 weeks, recovery (7-point Likert) at 6, 12 and 26 weeks, pain at rest and during activity (NRS) at 6 and 26 weeks and cost-effectiveness of the intervention at 26-weeks. Measurements will take place at baseline and at, 2, 4, 6, 12 and 26 weeks of follow-up. The treatment of plantar fasciopathy is a challenge for health care professionals. Orthotic devices are frequently applied, despite a lack of evidence of the effectiveness on patient reported outcome. The results of this randomized controlled trial will improve the evidence base for treating this troublesome condition in daily practice. Dutch Trial Registration: NTR5346 . Date of registration: August 5(th) 2015.

Impact of customized videotape education on quality of life in patients with chronic obstructive pulmonary disease.

PubMed

Petty, Thomas L; Dempsey, Edward C; Collins, Timothy; Pluss, William; Lipkus, Isaac; Cutter, Gary R; Chalmers, Robin; Mitchell, Amy; Weil, Kenneth C

2006-01-01

To compare the impact of a library of pulmonary rehabilitation videotapes versus an older videotape and usual care on quality of life and ability to perform activities of daily living in persons with chronic obstructive pulmonary disease. Two hundred fourteen patients diagnosed with chronic obstructive pulmonary disease, emphysema, or chronic bronchitis were recruited and randomized to receive customized videotapes, standard videotapes, or usual care. Outcome measures included the Fatigue Impact Scale, Seattle Obstructive Lung Disease Questionnaire, and the SF-36(R) Health Survey. Differences in coping skills and emotional functioning on the Seattle Obstructive Lung Disease Questionnaire were found among the 174 subjects who completed the study. The customized videotape group improved by 8.6 and 4.8 points, respectively, whereas the score of the other groups decreased by less than 1 point for the coping skills, and the scores of the standard video and the control groups decreased by 3.0 and 2.1 points, respectively, for emotional functioning (P < .05, all comparisons). The scores using the Fatigue Impact Scale also improved for the customized videotape group, whereas the scores of the others remained unchanged. Videotape users demonstrated better conversion to and retention of exercise habits, with over 80% of customized videotape subjects who reported exercise habits at baseline continuing the habits as compared with 40% in the usual care group. Sedentary subjects at baseline were more likely to begin and maintain exercise if randomized to videotapes. These findings demonstrate increased quality of life, lower fatigue, and better compliance with a prescribed exercise regimen among subjects using the customized videotapes. There was a significant improvement in emotional functioning and coping skills among customized videotape subjects.

Limitation of life-sustaining treatment in patients with prolonged admission to the ICU. Current situation in Spain as seen from the EPIPUSE Study.

PubMed

Hernández-Tejedor, A; Martín Delgado, M C; Cabré Pericas, L; Algora Weber, A

2015-10-01

Limitation of life-sustaining treatment (LLST) is a recommended practice in certain circumstances. Limitation practices are varied, and their application differs from one center to another. The present study evaluates the current situation of LLST practices in patients with prolonged admission to the ICU who suffer worsening of their condition. A prospective, observational cohort study was carried out. Seventy-five Spanish ICUs. A total of 589 patients suffering 777 complications or adverse events with organ function impairment after day 7 of admission, during a three-month recruitment period. The timing of limitation, the subject proposing LLST, the degree of agreement within the team, the influence of LLST upon the doctor-patient-family relationship, and the way in which LLST is implemented. LLST was proposed in 34.3% of the patients presenting prolonged admission to the ICU with severe complications. The incidence was higher in patients with moderate to severe lung disease, cancer, immunosuppressive treatment or dependence for basic activities of daily living. LLST was finally implemented in 97% of the cases in which it was proposed. The decision within the medical team was unanimous in 87.9% of the cases. The doctor-patient-family relationship usually does not change or even improves in this situation. LLST in ICUs is usually carried out under unanimous decision of the medical team, is performed more frequently in patients with severe comorbidity, and usually does not have a negative impact upon the relationship with the patients and their families. Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Structured Walking and Chronic Institutionalized Schizophrenia Inmates: A pilot RCT Study on Quality of Life.

PubMed

Loh, Siew Yim; Abdullah, Amalina; Abu Bakar, Abdul Kadir; Thambu, Maniam; Nik Jaafar, Nik Ruzyanei

2015-05-21

Lifestyle moderate-intensity physical activity can lower the risk of over twenty chronic health conditions, whilst inactivity reduces daily functioning and physical health of individuals living with schizophrenia. This study conducted in 2014 examines the effect of structured walking participation on QOL, psychosocial functioning and symptoms in Hospital Permai, one of the largest psychiatry institution in Asia Chronic patients with schizophrenia (n=104) who met inclusion criteria were randomised to either a 3-month structured walking intervention or a treatment-as-usual arm. The Positive and Negative Syndrome Scale (PANSS), global functioning (PSP) and QOL (SF-36) were measured at baseline and after the 3-month interval. At 3 month follow-up, there were significant within group differences in QOL (SF-36), psychiatric symptoms (PANSS), and personal and social performance (PSP). There were statistically significant increase in the median SF-36 scores, with increases shown in physical functioning (p<.001), physical role limitations (p<.05), social functioning (p<.01) in the intervention group compared to treatment-as-usual group. Statistically significant reduction of median PANSS score of the intervention group were noted in positive (p<0.001) and negative (p<0.01) symptom, and general psychopathology (p<0.01) scales. Statistically significant increase in the median PSP score (p<0.01) was found in the intervention group compared with the treatment-as-usual group. Between-group differences at post intervention (favouring Intervention) were significant for PANSS positive and SF36 Physical In long stayed chronic inmates, a simple but consistent, organized walking intervention has the potential to bring improvement in functioning, reduction in psychiatric symptoms and quality of Life. The emphasis of rehabilitation should target at lifestyle redesign intervention.

Circuit class or seven-day therapy for increasing intensity of rehabilitation after stroke: protocol of the CIRCIT trial.

PubMed

Hillier, Susan; English, Coralie; Crotty, Maria; Segal, Leonie; Bernhardt, Julie; Esterman, Adrian

2011-12-01

There is strong evidence for a dose-response relationship between physical therapy early after stroke and recovery of function. The optimal method of maximizing physical therapy within finite health care resources is unknown. To determine the effectiveness and cost-effectiveness of two alternative models of physical therapy service delivery (seven-days per week therapy services or group circuit class therapy over five-days a week) to usual care for people receiving inpatient rehabilitation after stroke. Multicenter, three-armed randomized controlled trial with blinded assessment of outcomes. A total of 282 people admitted to inpatient rehabilitation facilities after stroke with an admission functional independence measure (FIM) score within the moderate range (total 40-80 points or motor 38-62 points) will be randomized to receive one of three interventions: • usual care therapy over five-days a week • standard care therapy over seven-days a week, or • group circuit class therapy over five-days a week. Participants will receive the allocated intervention for the length of their hospital stay. Analysis will be by intention-to-treat. The primary outcome measure is walking ability (six-minute walk test) at four-week postintervention with three- and six-month follow-up. Economic analysis will include a costing analysis based on length of hospital stay and staffing/resource costs and a cost-utility analysis (incremental quality of life per incremental cost, relative to usual care). Secondary outcomes include walking speed and independence, ability to perform activities of daily living, arm function, quality of life and participant satisfaction. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

[Exploration of the Care Needs of Post-Chemotherapy Lung Cancer Patients and Related Factors].

PubMed

Chiu, Hui-Ying; Lin, Yu-Hua; Wang, Chin-Chou; Chen, Wan-Yi; Chang, Huang-Chih; Lin, Meng-Chih

2016-06-01

Chemotherapy (CT) is the first priority treatment for advanced stage lung cancer. However, symptom distress, impaired ability to conduct daily activities, and post-CT care needs are potential side effects of CT. To explore the factors related to the care needs of post-chemotherapy lung cancer patients. A cross-sectional study was used. One hundred and twenty-one adult patients who had been diagnosed with advanced-stage lung cancer and who had undergone CT using the Platinum and Docetaxel doublet regimen were recruited from a medical center in southern Taiwan. The instruments used included a nursing care needs survey, symptoms distress scale, daily activity interference scale, and patient characteristics datasheet. Participants self-prioritized their emergency management, health consultation, and emotional support activities based on their perceived care needs. The top three post-CT symptoms in terms of severity were: fatigue, appetite change, and sleep disorder. Primary disruptions in daily activities during the post-CT period related to: holding social activities, work, and stair climbing. Significant and positive correlations were found among daily activity interference (r = .30, p < .01), symptoms distress (r = .23, p < .01), and care needs. The regression model indicated daily activity interference as a predictor of care needs, accounting for 10.7% of the total variance. These results highlight the relationships among care needs, symptom distress, and daily activity interference in post-chemotherapy lung-cancer patients. The present study provides a reference for nursing care to reduce the symptom distress, to enhance the performance of daily activities, and to meet the care needs of lung-cancer patients.

Intermittent versus daily calorie restriction: which diet regimen is more effective for weight loss?

PubMed

Varady, K A

2011-07-01

Dietary restriction is an effective strategy for weight loss in obese individuals. The most common form of dietary restriction implemented is daily calorie restriction (CR), which involves reducing energy by 15-60% of usual caloric intake every day. Another form of dietary restriction employed is intermittent CR, which involves 24 h of ad libitum food consumption alternated with 24 h of complete or partial food restriction. Although both diets are effective for weight loss, it remains unknown whether one of these interventions produces superior changes in body weight and body composition when compared to the other. Accordingly, this review examines the effects of daily CR versus intermittent CR on weight loss, fat mass loss and lean mass retention in overweight and obese adults. Results reveal similar weight loss and fat mass loss with 3 to 12 weeks' intermittent CR (4-8%, 11-16%, respectively) and daily CR (5-8%, 10-20%, respectively). In contrast, less fat free mass was lost in response to intermittent CR versus daily CR. These findings suggest that these diets are equally as effective in decreasing body weight and fat mass, although intermittent CR may be more effective for the retention of lean mass. © 2011 The Author. obesity reviews © 2011 International Association for the Study of Obesity.

Urinary proteomics in renal pathophysiology: Impact of proteinuria.

PubMed

Sancho-Martínez, Sandra M; Prieto-García, Laura; Blanco-Gozalo, Víctor; Fontecha-Barriuso, Miguel; López-Novoa, José M; López-Hernández, Francisco J

2015-06-01

Urinary differential proteomics is used to study renal pathophysiological mechanisms, find novel markers of biological processes and renal diseases, and stratify patients according to proteomic profiles. The proteomic procedure determines the pathophysiological meaning and clinical relevance of results. Urine samples for differential proteomic studies are usually normalized by protein content, regardless of its pathophysiological characteristics. In the field of nephrology, this approach translates into the comparison of a different fraction of the total daily urine output between proteinuric and nonproteinuric samples. Accordingly, alterations in the level of specific proteins found by this method reflect the relative presence of individual proteins in the urine; but they do not necessarily show alterations in their daily excretion, which is a key parameter for the understanding of the pathophysiological meaning of urinary components. For renal pathophysiology studies and clinical biomarker identification or determination, an alternative proteomic concept providing complementary information is based on sample normalization by daily urine output, which directly informs on changes in the daily excretion of individual proteins. This is clinically important because daily excretion (rather than absolute or relative concentration) is the only self-normalized way to evaluate the real meaning of urinary parameters, which is also independent of urine concentration. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Daily activity patterns of 2316 men and women from five countries differing in socioeconomic development.

PubMed

Sani, Mamane; Refinetti, Roberto; Jean-Louis, Girardin; Pandi-Perumal, S R; Durazo-Arvizu, Ramon A; Dugas, Lara R; Kafensztok, Ruth; Bovet, Pascal; Forrester, Terrence E; Lambert, Estelle V; Plange-Rhule, Jacob; Luke, Amy

2015-06-01

Daily rhythmicity in the locomotor activity of laboratory animals has been studied in great detail for many decades, but the daily pattern of locomotor activity has not received as much attention in humans. We collected waist-worn accelerometer data from more than 2000 individuals from five countries differing in socioeconomic development and conducted a detailed analysis of human locomotor activity. Body mass index (BMI) was computed from height and weight. Individual activity records lasting 7 days were subjected to cosinor analysis to determine the parameters of the daily activity rhythm: mesor (mean level), amplitude (half the range of excursion), acrophase (time of the peak) and robustness (rhythm strength). The activity records of all individual participants exhibited statistically significant 24-h rhythmicity, with activity increasing noticeably a few hours after sunrise and dropping off around the time of sunset, with a peak at 1:42 pm on average. The acrophase of the daily rhythm was comparable in men and women in each country but varied by as much as 3 h from country to country. Quantification of the socioeconomic stages of the five countries yielded suggestive evidence that more developed countries have more obese residents, who are less active, and who are active later in the day than residents from less developed countries. These results provide a detailed characterization of the daily activity pattern of individual human beings and reveal similarities and differences among people from five countries differing in socioeconomic development.

How do academic stress and leisure activities influence college students' emotional well-being? A daily diary investigation.

PubMed

Zhang, Jieting; Zheng, Yao

2017-10-01

China has one of the largest bodies of college students who face growing academic stress that influences their well-being. Using a daily diary method in a group of Chinese college students (n = 139, mean age = 19.50 years, 27% males) who reported their daily positive and negative emotion consecutively for two weeks, this study investigated the dynamic relations between daily academic stress, leisure activities engagement, and emotion, and further examined the moderation of sex on these links. The results showed that at both between- and within-person level, academic stress was positively associated with negative emotion, and leisure activities engagement was positively associated with positive emotion. The association between leisure activities engagement and positive emotion were stronger among female students than among male students. These results suggest that effectively reducing academic stress and actively engaging in leisure activities are both important in promoting and enhancing daily emotional well-being. Copyright © 2017. Published by Elsevier Ltd.

PRIDE for PLAY: Personal Responsibility in Daily Effort for Participation in Lifelong Activity for Youths. A Singaporean Context

PubMed Central

Chia, Michael

2007-01-01

Singapore, a developed city state of four million people is experiencing the pitfalls that come with rapid modernisation and economic progress- elevated disease risk factors among adults and young people. Weekly compulsory physical education classes of 70 minutes in schools and the associated sports activities after classes are inadequate to meet emergent physical activity guidelines of a daily accumulation of at least 90 minutes of physical activity of at least moderate intensity. Daily play sessions that are exclusive of an active daily recess, physical education classes taught by trained specialists and after-school sport sessions, can provide many developmental and holistic health benefits that may carry over into adulthood. A school environment that is play-encouraging, play-enabling and play-inviting can be a useful, innovative and natural way of inculcating a love for movement and help redress a serious trend of physical activity insufficiency while youngsters engage electronic gaming activities. Pilot initiatives for the PRIDE (personal responsibility in daily effort) for PLAY (participation in lifelong activity for youths) programme is a radicalised approach in a number of primary schools in Singapore to infuse daily physical play of between 20 to 45 minutes during curriculum hours. The hope is that PRIDE for PLAY will reap benefits of improved holistic health of youngsters- better physical, social, emotional and mental attributes. While PRIDE for PLAY is no panacea to all of the ills of modernisation, it will go some way in helping the students of tomorrow to be physically healthy, socially more engaged and tolerant of others, mentally more apt to problem-solve and emotionally more proficient to embrace working life in adulthood. Key pointsPhysical play is natural among young people and a daily dose of play can help young people meet daily requirements for accumulated physical activity of at least 90 minutes and at least of a moderate intensity.Play is critical for child development and provides a healthy balance for many sedentary lifestyle activities.Parents, care-givers and teachers should emphasise and partake in daily play with young people. PMID:24149424

A Study of Activities of Daily Living and Employment in Adults with Autism Spectrum Disorders in Taiwan

ERIC Educational Resources Information Center

Lin, Ling-Yi; Yu, Shu-Ning; Yu, Ya-Tsu

2012-01-01

Research on daily living activities and employment levels of adults with autism spectrum disorders (ASD) in Taiwan is limited. The aims of the study were to investigate outcomes related to functional independence and employment among people with ASD in Taiwan. We investigated the daily living activities and the employment status of 81 adults (age…

Combined Cognitive-Strategy and Task-Specific Training Affects Cognition and Upper-Extremity Function in Subacute Stroke: An Exploratory Randomized Controlled Trial

PubMed Central

Polatajko, Helene; Baum, Carolyn; Rios, Jorge; Cirone, Dianne; Doherty, Meghan; McEwen, Sara

2016-01-01

The purpose of this study was to estimate the effect of Cognitive Orientation to Daily Occupational Performance (CO–OP) compared with usual occupational therapy on upper-extremity movement, cognitive flexibility, and stroke impact in people less than 3 mo after stroke. An exploratory, single-blind randomized controlled trial was conducted with people referred to outpatient occupational therapy services at two rehabilitation centers. Arm movement was measured with the Action Research Arm Test, cognitive flexibility with the Delis–Kaplan Executive Function System Trail Making subtest, and stroke impact with subscales of the Stroke Impact Scale. A total of 35 participants were randomized, and 26 completed the intervention. CO–OP demonstrated measurable effects over usual care on all measures. These data provide early support for the use of CO–OP to improve performance and remediate cognitive and arm movement impairments after stroke over usual care; however, future study is warranted to confirm the effects observed in this trial. PMID:26943113

The importance of a daily rhythm in a supportive environment--promoting ability in activities in everyday life among older women living alone with chronic pain.

PubMed

Cederbom, Sara; Wågert, Petra von Heideken; Söderlund, Anne; Söderbäck, Maja

2014-01-01

The aim of this study was to explore how older women living alone with chronic musculoskeletal pain, describe their ability in performing activities in everyday life and what could promote their ability in activities in everyday life as well as their perceived meaning of a changed ability to perform activities in everyday life. Qualitative interviews were conducted with 12 women, and an inductive content analysis was used. The results showed the importance of a daily rhythm of activities. Activities included in the daily rhythm were socializing with family and friends, physical activities, doing own activities as well as activities supported by relatives and the community. The activities described by the women also promoted their ability in activities in everyday life. Other findings were the women's perceived meaning of being independent and maintaining that independency, along with the meaning of accepting and adapting to a changed life situation. This paper concludes that it is important to be sensitive of individual needs regarding the daily rhythm of activities when health-care professionals intervene in the activities in everyday life of older women living alone, promote the women's independency, and enable them to participate in the community. Implications for Rehabilitation A daily rhythm of activities is important for older women who live alone with chronic musculoskeletal pain. The importance of health-care professionals being sensitive to individual needs to promote ability in activities in everyday life and to encourage the everyday activities into a daily rhythm. Facilitate the women's desire and will of independency, despite their needs of help from their environment to manage their everyday life.

Impact of continuous in-home rehabilitation on quality of life and activities of daily living in elderly clients over 1 year.

PubMed

Imanishi, Miyuki; Tomohisa, Hisao; Higaki, Kazuo

2017-11-01

To verify the effect of in-home rehabilitation on quality of life and activities of daily living in elderly clients. In this non-randomized controlled intervention trial, elderly participants were separated into a rehabilitation or a non-rehabilitation group (n = 100 each). The non-rehabilitation group received basic in-home nursing care, including assistance with cooking, cleaning, toileting, meals and medication. The rehabilitation group received a physical treatment program provided by a licensed professional once a week and basic nursing care in the home. For each group, quality of life and activities of daily living were assessed approximately every 3 months over a 1-year period. Quality of life was evaluated using the Philadelphia Geriatric Center Morale Scale, and activities of daily living were evaluated based on the Functional Independence Measure. The rehabilitation group showed statistically significant improvements in both quality of life and activities of daily living. In contrast, the non-rehabilitation group, although showing slight improvement in quality of life at 9 months, showed almost no effects at the other time-points and no significant changes in activities of daily living over the course of the study. The results of the present study suggest that long-term continuous in-home rehabilitation might improve quality of life and activities of daily living in elderly clients. Geriatr Gerontol Int 2017; 17: 1866-1872. © 2017 Japan Geriatrics Society.

Does the Q - H index show a stronger relationship than the H:Q ratio in regard to knee pain during daily activities in patients with knee osteoarthritis?

PubMed

Fujita, Remi; Matsui, Yasumoto; Harada, Atsushi; Takemura, Marie; Kondo, Izumi; Nemoto, Tetsuya; Sakai, Tadahiro; Hiraiwa, Hideki; Ota, Susumu

2016-12-01

[Purpose] The purpose of this study was to elucidate the relationship between knee muscle strength and knee pain in activities of daily living, based on consideration of the difference between extension and flexion strength (Q - H) and the hamstring:quadriceps (H:Q) ratio in patients with knee osteoarthritis. [Subjects and Methods] The participants were 78 females with knee osteoarthritis, and a total of 133 knees that had not been treated surgically were the targets of this research. The legs were divided according to dominance. Isometric knee extension and flexion muscle strength and knee pain during activities of daily living were measured. The H:Q ratio (flexion/extension muscle strength) and the difference between extension and flexion strength, (extension muscle strength/weight) minus (flexion muscle strength/weight), that is, Q - H, were calculated. The correlation between these indices and the knee pain score during activities of daily living was investigated. [Results] Greater knee pain during activities of daily living was related to lower knee extension muscle strength and Q - H in both the dominant and nondominant legs. Knee flexion muscle strength and the H:Q ratio were not significantly correlated with knee pain during any activities of daily living. [Conclusion] Knee extension muscle strength and Q - H were found to be significantly correlated with knee pain during activities of daily living, whereas the H:Q ratio was not.

Hemicrania continua and symptomatic medication overuse.

PubMed

Young, W B; Silberstein, S D

1993-10-01

Hemicrania continua (HC) is a rare, strictly unilateral, nonparoxysmal headache disorder characterized by its absolute responsiveness to indomethacin. The pain is usually moderate in intensity and frequently associated with a superimposed "jabs and jolts" headache. We report two cases of HC which presented as chronic daily headache (CDH) with abortive medication overuse. CDH can be due to transformed migraine (TM), new daily persistent headache (NDPH), chronic tension-type headache, and HC. All can be unilateral, and all can be associated with medication overuse. Our two cases meet the criteria for HC based on indomethacin responsiveness. One meets the criteria for TM, the other NDPH. Is HC a distinct disorder, or a subset of these other disorders? CDH with medication overuse includes in its differential diagnosis HC.

Voice quality after treatment of early vocal cord cancer: a randomized trial comparing laser surgery with radiation therapy.

PubMed

Aaltonen, Leena-Maija; Rautiainen, Noora; Sellman, Jaana; Saarilahti, Kauko; Mäkitie, Antti; Rihkanen, Heikki; Laranne, Jussi; Kleemola, Leenamaija; Wigren, Tuija; Sala, Eeva; Lindholm, Paula; Grenman, Reidar; Joensuu, Heikki

2014-10-01

Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO2 laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option. Copyright © 2014 Elsevier Inc. All rights reserved.

“An Impediment to Living Life”: Why and How Should We Measure Stiffness in Polymyalgia Rheumatica?

PubMed Central

Mackie, Sarah Louise; Hughes, Rodney; Walsh, Margaret; Day, John; Newton, Marion; Pease, Colin; Kirwan, John; Morris, Marianne

2015-01-01

Objectives To explore patients’ concepts of stiffness in polymyalgia rheumatica (PMR), and how they think stiffness should be measured. Methods Eight focus groups were held at three centres involving 50 patients with current/previous PMR. Each group had at least one facilitator and one rapporteur making field notes. An interview schedule was used to stimulate discussion. Interviews were recorded, transcribed and analysed using an inductive thematic approach. Results Major themes identified were: symptoms: pain, stiffness and fatigue; functional impact; impact on daily schedule; and approaches to measurement. The common subtheme for the experience of stiffness was “difficulty in moving”, and usually considered as distinct from the experience of pain, albeit with a variable overlap. Some participants felt stiffness was the “overwhelming” symptom, in that it prevented them carrying out “fundamental activities” and “generally living life”. Diurnal variation in stiffness was generally described in relation to the daily schedule but was not the same as stiffness severity. Some participants suggested measuring stiffness using a numeric rating scale or a Likert scale, while others felt that it was more relevant and straightforward to measure difficulty in performing everyday activities rather than about stiffness itself. Conclusions A conceptual model of stiffness in PMR is presented where stiffness is an important part of the patient experience and impacts on their ability to live their lives. Stiffness is closely related to function and often regarded as interchangeable with pain. From the patients’ perspective, visual analogue scales measuring pain and stiffness were not the most useful method for reporting stiffness; participants preferred numerical rating scales, or assessments of function to reflect how stiffness impacts on their daily lives. Assessing function may be a pragmatic solution to difficulties in quantifying stiffness. PMID:25955770

Predictors of marijuana relapse in the human laboratory: robust impact of tobacco cigarette smoking status.

PubMed

Haney, Margaret; Bedi, Gillinder; Cooper, Ziva D; Glass, Andrew; Vosburg, Suzanne K; Comer, Sandra D; Foltin, Richard W

2013-02-01

Few marijuana smokers in treatment achieve sustained abstinence, yet factors contributing to high relapse rates are unknown. Study 1: data from five inpatient laboratory studies assessing marijuana intoxication, withdrawal, and relapse were combined to assess factors predicting the likelihood and severity of relapse. Daily, nontreatment-seeking marijuana smokers (n = 51; 10 ± 5 marijuana cigarettes/day) were enrolled. Study 2: to isolate the effects of cigarette smoking, marijuana intoxication, withdrawal, and relapse were assessed in daily marijuana and cigarette smokers (n = 15) under two within-subject, counter-balanced conditions: while smoking tobacco cigarettes as usual (SAU), and after at least 5 days without cigarettes (Quit). Study 1: 49% of participants relapsed the first day active marijuana became available. Tobacco cigarette smokers (75%), who were not abstaining from cigarettes, were far more likely to relapse than non-cigarette smokers (odds ratio: 19, p < .01). Individuals experiencing more positive subjective effects (i.e., feeling "high") after marijuana administration and those with more negative affect and sleep disruption during marijuana withdrawal were more likely to have severe relapse episodes (p < .05). Study 2: most participants (>87%) relapsed to marijuana whether in the SAU or Quit phase. Tobacco cigarette smoking did not significantly influence relapse, nor did it affect marijuana intoxication or most symptoms of withdrawal relative to tobacco cessation. Daily marijuana smokers who also smoke cigarettes have high rates of marijuana relapse, and cigarette smoking versus recent abstinence does not directly influence this association. These data indicate that current cigarette smoking is a clinically important marker for increased risk of marijuana relapse. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

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

Aaltonen, Leena-Maija, E-mail: leena-maija.aaltonen@hus.fi; Rautiainen, Noora; Sellman, Jaana

Objective: Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials: Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO{sub 2} laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality wasmore » assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Results: Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Conclusions: Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option.« less

Lack of findings for the association between obesity risk and usual sugar-sweetened beverage consumption in adults--a primary analysis of databases of CSFII-1989-1991, CSFII-1994-1998, NHANES III, and combined NHANES 1999-2002.

PubMed

Sun, Sam Z; Empie, Mark W

2007-08-01

The relationship between obesity risk and sugar-sweetened beverage (SSB) consumption was examined together with multiple lifestyle factors. Statistical analysis was performed using population dietary survey databases of USDA CSFII 1989-1991, CSFII 1994-1996, CDC NHANES III, and combined NHANES 1999-2002. Totally, 38,409 individuals, ages 20-74 years, with accompanying data of dietary intake, lifestyle factors, and anthropometrics were included in the descriptive statistics and risk analysis. Analytical results indicate that obesity risk was significantly and positively associated with gender, age, daily TV/screen watching hours and dietary fat content, and negatively associated with smoking habit, education and physical activity; obesity risk was not significantly associated with SSB consumption pattern, dietary saturated fat content and total calorie intake. No elevated BMI values or increased obesity rates were observed in populations frequently consuming SSB compared to populations infrequently consuming SSB. Additionally, one-day food consumption data was found to overestimate SSB usual intake by up to 38.9% compared to the data of multiple survey days. multiple lifestyle factors and higher dietary fat intake were significantly associated with obesity risk. Populations who frequently consumed SSB, primarily HFCS sweetened beverages, did not have a higher obesity rate or increased obesity risk than that of populations which consumed SSB infrequently.

The Efficacy of Balance Training with Video Game-Based Therapy in Subacute Stroke Patients: A Randomized Controlled Trial

PubMed Central

Tramontano, Marco; Shofany, Jacob; Iemma, Antonella; Musicco, Massimo; Paolucci, Stefano; Caltagirone, Carlo

2014-01-01

The video game-based therapy emerged as a potential valid tool in improving balance in several neurological conditions with controversial results, whereas little information is available regarding the use of this therapy in subacute stroke patients. The aim of this study was to investigate the efficacy of balance training using video game-based intervention on functional balance and disability in individuals with hemiparesis due to stroke in subacute phase. Fifty adult stroke patients participated to the study: 25 subjects were randomly assigned to balance training with Wii Fit, and the other 25 subjects were assigned to usual balance therapy. Both groups were also treated with conventional physical therapy (40 min 2 times/day). The main outcome was functional balance (Berg Balance Scale-BBS), and secondary outcomes were disability (Barthel Index-BI), walking ability (Functional Ambulation Category), and walking speed (10-meters walking test). Wii Fit training was more effective than usual balance therapy in improving balance (BBS: 53 versus 48, P = 0.004) and independency in activity of daily living (BI: 98 versus 93, P = 0.021). A balance training performed with a Wii Fit as an add on to the conventional therapy was found to be more effective than conventional therapy alone in improving balance and reducing disability in patients with subacute stroke. PMID:24877116

Physiotherapy to improve physical activity in community-dwelling older adults with mobility problems (Coach2Move): study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background Older adults can benefit from physical activity in numerous ways. Physical activity is considered to be one of the few ways to influence the level of frailty. Standardized exercise programs do not necessarily lead to more physical activity in daily life, however, and a more personalized approach seems appropriate. The main objective of this study is to investigate whether a focused, problem-oriented coaching intervention (‘Coach2Move’) delivered by a physiotherapist specializing in geriatrics is more effective for improving physical activity, mobility and health status in community-dwelling older adults than usual physiotherapy care. In addition, cost-effectiveness will be determined. Methods/Design The design of this study is a single-blind randomized controlled trial in thirteen physiotherapy practices. Randomization will take place at the individual patient level. The study population consists of older adults, ≥70 years of age, with decreased physical functioning and mobility and/or a physically inactive lifestyle. The intervention group will receive geriatric physiotherapy according to the Coach2Move strategy. The control group will receive the usual physiotherapy care. Measurements will be performed by research assistants not aware of group assignment. The results will be evaluated on the amount of physical activity (LASA Physical Activity Questionnaire), mobility (modified ‘get up and go’ test, walking speed and six-minute walking test), quality of life (SF-36), degree of frailty (Evaluative Frailty Index for Physical Activity), fatigue (NRS-fatigue), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire) and health care costs. Discussion Most studies on the effect of exercise or physical activity consist of standardized programs. In this study, a personalized approach is evaluated within a group of frail older adults, many of whom suffer from multiple and complex diseases and problems. A complicating factor in evaluating a new approach is that it may not be automatically adopted by clinicians. Specific actions are undertaken to optimize implementation of the Coach2Move strategy during the trial. Whether or not these will be sufficient is a matter we will consider subsequently, using quality indicators and process analysis. Trial Registration The Netherlands National Trial Register: NTR3527. PMID:24345073

Eccentric Viewing Training in the Home Environment: Can It Improve the Performance of Activities of Daily Living?

ERIC Educational Resources Information Center

Vukicevic, Meri; Fitzmaurice, Kerry

2009-01-01

Macular degeneration has a severe impact on a person's ability to perform activities of daily living. This study investigated the impact of in-home training in eccentric viewing on near acuity and performance of activities of daily living. The results suggest that eccentric viewing can ameliorate the impact of the loss of vision that is due to…

Hypoglycemia associated with fluoxetine treatment in a patient with type 1 diabetes

PubMed Central

Biagetti, Betina; Corcoy, Rosa

2013-01-01

We report on a patient with type 1 diabetes mellitus who presented with recurrent episodes of hypoglycemia and a marked reduction in her daily insulin requirements after introduction of fluoxetine. This 25-year-old Caucasian woman had been followed up at the outpatient clinic for type 1 diabetes mellitus and pre-pregnancy care. She used a continuous subcutaneous insulin infusion with lispro and her daily insulin dose was 0.5 IU/kg per day. She had no chronic diabetic complications or hypoglycemia unawareness. Fluoxetine at a daily dose of 20 mg had been started because of depressive symptoms and within one week, she presented recurrent hypoglycemic episodes that prompted a progressive reduction in the insulin dose down to 0.3 IU/kg per day. The reduced insulin requirements continued during the period of fluoxetine treatment while glycated hemoglobin remained stable. She had no concurrent additional cause to explain the reduced insulin requirements. After fluoxetine was stopped, insulin requirements progressively increased and returned to the patient´s usual dose. PMID:24303494

Severe Hypernatremic Dehydration and Lower Limb Gangrene in an Infant Exposed to Lamotrigine, Aripiprazole, and Sertraline in Breast Milk.

PubMed

Morin, Caroline; Chevalier, Isabelle

Hypernatremic dehydration is well described in exclusively breastfed neonates, although life-threatening complications are rarely reported. The present article describes a case of severe hypernatremic dehydration in a previously healthy term neonate. Other published cases of severe complications of hypernatremic dehydration are discussed. The exclusively breastfed neonate described had severe hypernatremic dehydration because of inadequate milk intake, with disseminated intravascular coagulation and right lower limb gangrene that required amputation of all five toes and surgical debridement of the metatarsals. The usual etiology of hypernatremic dehydration in this age group is insufficient breast milk intake. Here, the infant's mother was treated for bipolar disorder with lamotrigine 250 mg orally once daily, aripiprazole 15 mg orally once daily, and sertraline 100 mg orally once daily. Awareness of these complications should prompt close follow-up of the infant with poor weight gain. The role of maternal medication as a risk factor for hypernatremic dehydration among exclusively breastfed infants needs to be further explored.

Effectiveness of fluticasone furoate plus vilanterol on asthma control in clinical practice: an open-label, parallel group, randomised controlled trial.

PubMed

Woodcock, Ashley; Vestbo, Jørgen; Bakerly, Nawar Diar; New, John; Gibson, J Martin; McCorkindale, Sheila; Jones, Rupert; Collier, Susan; Lay-Flurrie, James; Frith, Lucy; Jacques, Loretta; Fletcher, Joanne L; Harvey, Catherine; Svedsater, Henrik; Leather, David

2017-11-18

Evidence for management of asthma comes from closely monitored efficacy trials done in highly selected patient groups. There is a need for randomised trials that are closer to usual clinical practice. We did an open-label, randomised, controlled, two-arm effectiveness trial at 74 general practice clinics in Salford and South Manchester, UK. Patients aged 18 years or older with a general practitioner's diagnosis of symptomatic asthma and on maintenance inhaler therapy were randomly assigned to initiate treatment with a once-daily inhaled combination of either 100 μg or 200 μg fluticasone furoate with 25 μg vilanterol or optimised usual care and followed up for 12 months. The primary endpoint was the percentage of patients who achieved an asthma control test (ACT) score of 20 or greater or an increase in ACT score from baseline of 3 or greater at 24 weeks (termed responders), in patients with a baseline ACT score less than 20 (the primary effectiveness analysis population). All effectiveness analyses were done according to the intention-to-treat principle. This study is registered with ClinicalTrials.gov, number NCT01706198. Between Nov 12, 2012, and Dec 16, 2016, 4725 patients were enrolled and 4233 randomly assigned to initiate treatment with fluticasone furoate and vilanterol (n=2114) or usual care (n=2119). 1207 patients (605 assigned to usual care, 602 to fluticasone furoate and vilanterol) had a baseline ACT score greater than or equal to 20 and were thus excluded from the primary effectiveness analysis population. At week 24, the odds of being a responder were higher for patients who initiated treatment with fluticasone furoate and vilanterol than for those on usual care (977 [71%] of 1373 in the fluticasone furoate and vilanterol group vs 784 [56%] of 1399 in the usual care group; odds ratio [OR] 2·00 [95% CI 1·70-2·34], p<0·0001). At week 24, the adjusted mean ACT score increased by 4·4 points from baseline in patients initiated with fluticasone furoate and vilanterol, compared with 2·8 points in the usual care group (difference 1·6 [95% CI 1·3-2·0], p<0·0001). This result was consistent for the duration of the study. Pneumonia was uncommon, with no differences between groups; there was no difference in other serious adverse events between the groups. In patients with a general practitioner's diagnosis of symptomatic asthma and on maintenance inhaler therapy, initiation of a once-daily treatment regimen of combined fluticasone furoate and vilanterol improved asthma control without increasing the risk of serious adverse events when compared with optimised usual care. GlaxoSmithKline. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exposure of man to mercury: a review. II. Contamination of food and analytical methods

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

Hugunin, A.G.; Bradley, R.L. Jr.

Man is exposed to mercury through every facet of his life, however, for the average citizen the most probable source of toxic levels of mercury would be his food supply. Although most foods contain less than 0.02 ppm mercury, considerable variation occurs depending on the type of food, production techniques, and location. Mercury is concentrated at higher trophic levels of food chains, particularily in aquatic food chains in which concentration factor of hundreds and thousands have been observed. The concentration of mercury in some large fish has been found to exceed the 0.5 ppm tolerance limit of the FDA andmore » the 1.0 ppm limit of the Swedish government. Fifty-seven grams of fish containing 0.5 ppm mercury in the methyl form could be consumed daily without exceeding the joint FAO/WHO recommended weekly tolerable intake of 0.2 mg. In the US, Sweden, and Japan the per capita daily fish consumptions are 18, 56, and 88 g, respectively. Determination of mercury concentrations generally involves colorimetric, atomic absorption or emission spectrometry, neutron activation, or gas chromatography techniques. The sample preparations are often time consuming, subject to numerous sources of error, and complicated by the low concentrations of mercury. Differentiation of mercury compounds usually necessitates selective extraction followed by gas chromatographic analysis. 256 references, 5 tables.« less

Desiccation: An environmental and food industry stress that bacteria commonly face.

PubMed

Esbelin, Julia; Santos, Tiago; Hébraud, Michel

2018-02-01

Water is essential for all living organisms, for animals as well as for plants and micro-organisms. For these latter, the presence of water or a humid environment with a high air relative humidity (RH) is necessary for their survival and growth. Thus, variations in the availability of water or in the air relative humidity constitute widespread environmental stresses which challenge microorganisms, and especially bacteria. Indeed, in their direct environment, bacteria are often faced with conditions that remove cell-bound water through air-drying of the atmosphere. Bacterial cells are subject to daily or seasonal environmental variations, sometimes going through periods of severe desiccation. This is also the case in the food industry, where air dehumidification treatments are applied after the daily cleaning-disinfection procedures. In plants producing low-water activity products, it is also usual to significantly reduce or eliminate water usage. Periodic desiccation exposure affects bacteria viability and so they require strategies to persist. Negative effects of desiccation are wide ranging and include direct cellular damage but also changes in the biochemical and biophysical properties of cells for which planktonic cells are more exposed than cells in biofilm. Understanding the mechanisms of desiccation adaptation and tolerance has a biological and biotechnological interest. This review gives an overview of the factors influencing desiccation tolerance and the biological mechanisms involved in this stress response. Copyright © 2017 Elsevier Ltd. All rights reserved.

Price performance following stock's IPO in different price limit systems

NASA Astrophysics Data System (ADS)

Wu, Ting; Wang, Yue; Li, Ming-Xia

2018-01-01

An IPO burst occurred in China's stock markets in 2015, while price limit trading rules usually help to reduce the short-term trading mania on individual stocks. It is interesting to make clear the function of the price limits after IPOs. We firstly make a statistical analysis based on all the IPO stocks listed from 1990 to 2015. A high dependency exists between the activities in stock's IPO and various market environment. We also focus on the price dynamics in the first 40 trading days after the stock listed. We find that price limit system will delay the price movement, especially for the up-trend movements, which may lead to longer continuous price limit hits. Similar to our previous work, many results such as ;W; shape can be also observed in the future daily return after the price limit open. At last, we find most IPO measures show evident correlations with the following price limit hits. IPO stocks with lower first-day turnover and earning per share will be followed with a longer continuous price limit hits and lower future daily return under the newest trading rules, which give us a good way to estimate the occurrence of price limit hits and the following price dynamics. Our analysis provides a better understanding of the price dynamics after IPO events and offers potential practical values for investors.

Hippocampal Adult Neurogenesis is Enhanced by Chronic Eszopiclone Treatment in Rats

PubMed Central

Methippara, Melvi; Bashir, Tariq; Suntsova, Natalia; Szymusiak, Ron; McGinty, Dennis

2010-01-01

Summary The adult hippocampal dentate gyrus (DG) exhibits cell proliferation and neurogenesis throughout life. We examined the effects of daily administration of eszopiclone (Esz), a commonly used hypnotic drug and GABA agonist, compared to vehicle, on DG cell proliferation and neurogenesis, and on sleep-wake patterns. Esz was administered during the usual sleep period of rats, to mimic typical use in humans. Esz treatment for 7 days did not affect the rate of cell proliferation, as measured by 5-bromo-2’-deoxyuridine (BrdU) immunostaining. However, twice daily Esz administration for two weeks increased survival of newborn cells, by 46%. Most surviving cells exhibited a neuronal phenotype, identified BrdU-NeuN double-labeling. NeuN (Neuronal nuclei) is a marker of neurons. NREM sleep was increased on day one, but not on days 7 or 14 of Esz administration. Delta EEG activity was increased on days 1 and 7 of treatment, but not on day 14. There is evidence that enhancement of DG neurogenesis is a critical component of the effects of antidepressant treatments of major depressive disorder (MDD). Adult born DG cells are responsive to GABAergic stimulation which promotes cell maturation. The present study suggests that Esz, presumably acting as a GABA agonist, has pro-neurogenic effects in the adult DG. This result is consistent with evidence that Esz enhances antidepressant treatment response of MDD patients with insomnia. PMID:20408925

Perceived health status and daily activity participation of older Malaysians.

PubMed

Ng, Sor Tho; Tengku-Aizan, Hamid; Tey, Nai Peng

2011-07-01

This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.

Evidence Based Medicine in Pediatric Practice: Brief Review

PubMed Central

Kianifar, Hamid-Reza; Akhondian, Javad; Najafi-Sani, Mehri; Sadeghi, Ramin

2010-01-01

Practicing medicine according to the best evidence is gaining popularity in the medical societies. Although this concept, which is usually called Evidence Based Medicine (EBM) has been explained in many resources, it has not been addressed enough in pediatrics. In this review, we briefly explained Evidence Based Medicine approach and its applications in pediatrics in order to help the pediatricians to efficiently integrate EBM into their daily practice. PMID:23056715

Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT) study: design of a randomized controlled trial.

PubMed

van Vulpen, Jonna K; Siersema, Peter D; van Hillegersberg, Richard; Nieuwenhuijzen, Grard A P; Kouwenhoven, Ewout A; Groenendijk, Richard P R; van der Peet, Donald L; Hazebroek, Eric J; Rosman, Camiel; Schippers, Carlo C G; Steenhagen, Elles; Peeters, Petra H M; May, Anne M

2017-08-18

Following esophagectomy, esophageal cancer patients experience a clinically relevant deterioration of health-related quality of life, both on the short- and long-term. With the currently growing number of esophageal cancer survivors, the burden of disease- and treatment-related complaints and symptoms becomes more relevant. This emphasizes the need for interventions aimed at improving quality of life. Beneficial effects of post-operative physical exercise have been reported in several cancer types, but so far comparable evidence in esophageal cancer patients is lacking. The aim of this study is to investigate effects of physical exercise on health-related quality of life in esophageal cancer patients following surgery. The Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT) study is a multicenter randomized controlled trial including 150 esophageal cancer patients after surgery with curative intent. Patients are randomly allocated to an exercise group or usual care group. The exercise group participates in a 12-week combined aerobic and resistance exercise program, supervised by a physiotherapist near the patient's home-address. In addition, participants in the exercise group are requested to be physically active for at least 30 min per day, every day of the week. Participants allocated to the usual care group are asked to maintain their habitual physical activity pattern. The primary outcome is health-related quality of life (EORTC-QLQ-C30). Secondary outcomes include esophageal cancer specific quality of life, fatigue, anxiety and depression, sleep quality, work-related factors, cardiorespiratory fitness (VO 2peak ), muscle strength, physical activity, malnutrition risk, anthropometry, blood markers, recurrence of disease and survival. All questionnaire outcomes, diaries and accelerometers are assessed at baseline, post-intervention (12 weeks post-baseline) and 24 weeks post-baseline. Physical fitness, anthropometry and blood markers are assessed at baseline and post-intervention. In addition, adherence and safety are monitored throughout the exercise program. This randomized controlled trial investigates effects of physical exercise versus usual care in esophageal cancer patients after surgery. As the design of the exercise program closely resembles daily practice, this study can contribute both to evidence on effects of exercise in esophageal cancer patients, and to potential implementation strategies. Trial registration:Netherlands Trial Registry NTR5045 Date of trial registration: January 19th, 2015 Date and version study protocol: February 2017, version 1.

Upper limb motor training using a Saebo™ orthosis is feasible for increasing task-specific practice in hospital after stroke.

PubMed

Lannin, Natasha A; Cusick, Anne; Hills, Caroline; Kinnear, Bianca; Vogel, Karin; Matthews, Kate; Bowring, Greg

2016-12-01

Assistive technologies have the potential to increase the amount of movement practice provided during inpatient stroke rehabilitation. The primary aim of this study was to investigate the feasibility of using the Saebo-Flex ™ device in a subacute stroke setting to increase task-specific practice for people with little or no active hand movement. The secondary aim was to collect preliminary data comparing hand/upper limb function between a control group that received usual rehabilitation and an intervention group that used, in addition, the Saebo-Flex ™ device. Nine inpatients (mean three months (median six weeks) post-stroke) participated in this feasibility study conducted in an Australian rehabilitation setting, using a randomised pre-test and post-test design with concealed allocation and blinded outcome assessment. In addition to usual rehabilitation, the intervention group received eight weeks of daily motor training using the Saebo-Flex ™ device. The control group received usual rehabilitation (task-specific motor training) only. Participants were assessed at baseline (pre-randomisation) and at the end of the eight-week study period. Feasibility was assessed with respect to ease of recruitment, application of the device, compliance with the treatment programme and safety. Secondary outcome measures included the Motor Assessment Scale (upper limb items), Box and Block Test, grip strength and the Stroke Impact Scale. Recruitment to the study was very slow because of the low number of patients with little or no active hand movement. Otherwise, the study was feasible in terms of being able to apply the Saebo-Flex ™ device and compliance with the treatment programme. There were no adverse events, and a greater amount of upper limb rehabilitation was provided to the intervention group. While there were trends in favour of the intervention group, particularly for dexterity, no between-group differences were seen for any of the secondary outcomes. This pilot feasibility study showed that the use of assistive technology, specifically the Saebo-Flex ™ device, could be successfully used in a sample of stroke patients with little or no active hand movement. However, recruitment to the trial was very slow. The use of the Saebo-Flex TM device had variable results on outcomes, with some positive trends seen in hand function, particularly dexterity. © 2016 Occupational Therapy Australia.

Discrepancy between functional exercise capacity and daily physical activity: a cross-sectional study in patients with mild to moderate COPD.

PubMed

Fastenau, Annemieke; van Schayck, Onno C P; Gosselink, Rik; Aretz, Karin C P M; Muris, Jean W M

2013-12-01

In patients with moderate to severe chronic obstructive pulmonary disease (COPD) the six-minute walk distance reflects the functional exercise level for daily physical activity. It is unknown if this also applies to patients with mild to moderate COPD in primary care. To assess the relationship between functional exercise capacity and physical activity in patients with mild to moderate COPD. A cross-sectional study was performed in 51 patients with mild to moderate COPD in primary care. Functional exercise capacity was assessed by the six-minute walk test and physical activity was measured with an accelerometer-based activity monitor. Functional exercise capacity was close to normal values. However, the daily physical activity of the patients could be classified as 'sedentary' and 'low active'. No significant correlations were observed between six-minute walk distance (% predicted) and any of the physical activity variables (steps per day, movement intensity during walking, total active time, total walking time, physical activity level, and time spent in moderate physical activity). A discrepancy was found between functional exercise capacity and daily physical activity in patients with mild to moderate COPD recruited and assessed in primary care. We conclude that these variables represent two different concepts. Our results reinforce the importance of measuring daily physical activity in order to fine-tune treatment (i.e. focusing on enhancement of exercise capacity or behavioural change, or both).

Particulate air pollution and daily mortality in Detroit.

PubMed

Schwartz, J

1991-12-01

Particulate air pollution has been associated with increased mortality during episodes of high pollution concentrations. The relationship at lower concentrations has been more controversial, as has the relative role of particles and sulfur dioxide. Replication has been difficult because suspended particle concentrations are usually measured only every sixth day in the U.S. This study used concurrent measurements of total suspended particulates (TSP) and airport visibility from every sixth day sampling for 10 years to fit a predictive model for TSP. Predicted daily TSP concentrations were then correlated with daily mortality counts in Poisson regression models controlling for season, weather, time trends, overdispersion, and serial correlation. A significant correlation (P less than 0.0001) was found between predicted TSP and daily mortality. This correlation was independent of sulfur dioxide, but not vice versa. The magnitude of the effect was very similar to results recently reported from Steubenville, Ohio (using actual TSP measurements), with each 100 micrograms/m3 increase in TSP resulting in a 6% increase in mortality. Graphical analysis indicated a dose-response relationship with no evidence of a threshold down to concentrations below half of the National Ambient Air Quality Standards for particulate matter.

Achieving the daily step goal of 10,000 steps: the experience of a Canadian family attached to pedometers.

PubMed

Choi, Bernard C K; Pak, Anita W P; Choi, Jerome C L; Choi, Elaine C L

2007-01-01

Health experts recommend daily step goals of 10,000 steps for adults and 12,000 steps for youths to achieve a healthy active living. This article reports the findings of a Canadian family project to investigate whether the recommended daily step goals are achievable in a real life setting, and suggests ways to increase the daily steps to meet the goal. The family project also provides an example to encourage more Canadians to conduct family projects on healthy living. This is a pilot feasibility study. A Canadian family was recruited for the study, with 4 volunteers (father, mother, son and daughter). Each volunteer was asked to wear a pedometer and to record daily steps for three time periods of each day during a 2-month period. Both minimal routine steps, and additional steps from special non-routine activities, were recorded at work, school and home. The mean number of daily steps from routine minimal daily activities for the family was 6685 steps in a day (16 hr, approx 400 steps/hr). There was thus a mean deficit of 4315 steps per day, or approximately 30,000 steps per week, from the goal (10,000 steps for adults; 12,000 steps for youths). Special activities that were found to effectively increase the steps above the routine level include: walking at brisk pace, grocery shopping, window shopping in a mall, going to an entertainment centre, and attending parties (such as to celebrate the holiday season and birthdays). To increase our daily steps to meet the daily step goal, a new culture is recommended: "get off the chair". By definition, sitting on a chair precludes the opportunity to walk. We encourage people to get off the chair, to go shopping, and to go partying, as a practical and fun way to increase the daily steps. This paper is a call for increased physical activity to meet the daily step goal.

The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients.

PubMed

Park, Jin-Young; Chang, Moonyoung; Kim, Kyeong-Mi; Kim, Hee-Jung

2015-06-01

The purpose of this study was to examine the effects of mirror therapy on upper-extremity function and activities of daily living in chronic stroke patients. [Subjects and Methods] Fifteen subjects were each assigned to a mirror therapy group and a sham therapy group. The Fugl-Meyer Motor Function Assessment and the Box and Block Test were performed to compare paretic upper-extremity function and hand coordination abilities. The functional independence measurement was conducted to compare abilities to perform activities of daily living. [Results] Paretic upper-extremity function and hand coordination abilities were significantly different between the mirror therapy and sham therapy groups. Intervention in the mirror therapy group was more effective than in the sham therapy group for improving the ability to perform activities of daily living. Self-care showed statistically significant differences between the two groups. [Conclusion] Mirror therapy is effective in improving paretic upper-extremity function and activities of daily living in chronic stroke patients.

Digital Daily Cycles of Individuals

NASA Astrophysics Data System (ADS)

Aledavood, Talayeh; Lehmann, Sune; Saramäki, Jari

2015-10-01

Humans, like almost all animals, are phase-locked to the diurnal cycle. Most of us sleep at night and are active through the day. Because we have evolved to function with this cycle, the circadian rhythm is deeply ingrained and even detectable at the biochemical level. However, within the broader day-night pattern, there are individual differences: e.g., some of us are intrinsically morning-active, while others prefer evenings. In this article, we look at digital daily cycles: circadian patterns of activity viewed through the lens of auto-recorded data of communication and online activity. We begin at the aggregate level, discuss earlier results, and illustrate differences between population-level daily rhythms in different media. Then we move on to the individual level, and show that there is a strong individual-level variation beyond averages: individuals typically have their distinctive daily pattern that persists in time. We conclude by discussing the driving forces behind these signature daily patterns, from personal traits (morningness/eveningness) to variation in activity level and external constraints, and outline possibilities for future research.

The effect of mirror therapy on upper-extremity function and activities of daily living in stroke patients

PubMed Central

Park, Jin-Young; Chang, Moonyoung; Kim, Kyeong-Mi; Kim, Hee-Jung

2015-01-01

The purpose of this study was to examine the effects of mirror therapy on upper-extremity function and activities of daily living in chronic stroke patients. [Subjects and Methods] Fifteen subjects were each assigned to a mirror therapy group and a sham therapy group. The Fugl-Meyer Motor Function Assessment and the Box and Block Test were performed to compare paretic upper-extremity function and hand coordination abilities. The functional independence measurement was conducted to compare abilities to perform activities of daily living. [Results] Paretic upper-extremity function and hand coordination abilities were significantly different between the mirror therapy and sham therapy groups. Intervention in the mirror therapy group was more effective than in the sham therapy group for improving the ability to perform activities of daily living. Self-care showed statistically significant differences between the two groups. [Conclusion] Mirror therapy is effective in improving paretic upper-extremity function and activities of daily living in chronic stroke patients. PMID:26180297

Daily associations between partner responses and sexual and relationship satisfaction in couples coping with provoked vestibulodynia.

PubMed

Rosen, Natalie O; Muise, Amy; Bergeron, Sophie; Delisle, Isabelle; Baxter, Mary Lou

2015-04-01

Women with provoked vestibulodynia (PVD) experience a recurrent vulvo-vaginal pain triggered primarily during sexual intercourse. Although affected couples report adverse effects on their sexual and global romantic relationships, few studies have examined interpersonal factors that may influence their sexual and relationship satisfaction. Cross-sectional studies have shown that greater partner solicitous and negative responses and lower facilitative responses are associated with poorer sexual and relationship satisfaction in women with PVD. The aim of this study was to investigate the within-person associations between partner responses to painful intercourse and the sexual and relationship satisfaction of affected couples. In a dyadic daily experience study, 69 women (M(age) = 28.46, SD = 6.66) diagnosed with PVD and their cohabitating male partners (M(age) = 30.29, SD = 8.13) reported on male partner responses, as well as sexual and relationship satisfaction on sexual intercourse days (M = 6.81; SD = 5.40) over 8 weeks. Dependent measures were the (i) Kansas Marital Satisfaction Scale and (ii) Global Measure of Sexual Satisfaction Scale. On sexual intercourse days when women perceived more facilitative partner responses than usual and on days when they perceived lower negative partner responses than usual, they reported higher sexual and relationship satisfaction. On sexual intercourse days when men reported more solicitous responses than usual, both they and their female partners reported lower sexual satisfaction. Interventions aimed at improving the day-to-day sexual and relationship satisfaction of couples with PVD should target increasing facilitative and decreasing negative and solicitous partner responses. © 2015 International Society for Sexual Medicine.

[Survey on the use of electronic cigarettes and tobacco among children in middle and high school].

PubMed

Stenger, N; Chailleux, E

2016-01-01

To estimate the prevalence of electronic cigarette use among teenagers and its connection with the consumption of tobacco. In 2014 we conducted a survey of 3319 middle and high school students. Among the students, 56% had tried an electronic cigarette at least once (boys: 59.9%, girls: 49.3%; ranging from 31.3% for the 8th grade students to 66.1% for the 12th grades). However, only 3.4% reported that they used electronic cigarettes every day. Initiation of e-cigarette use in these teenagers was principally due to use by friends or triggered by curiosity and they usually choose fruit or sweet flavours initially. The majority could not give the concentration of nicotine in e-cigarettes that they used. Moreover, 61.5% of the students had ever tried tobacco and 22.3% were daily smokers. Our study found a strong link between vaping and smoking. 80% of the students who had ever tried conventional cigarettes (94% for the daily smokers) had also tried an electronic cigarette, versus 16% of the student who have never smoked. Few students (6.2%) used electronic cigarettes without smoking tobacco too. Usually, they have tried tobacco before trying an electronic cigarette. Only tobacco smokers seem to smoke electronic cigarettes with nicotine. Although our study shows that teenagers frequently try electronic cigarettes, it does not prove, for the moment, that vaping itself usually leads to nicotine addiction. However, as most of the teenagers are unable to tell if the electronic cigarette they are testing contains nicotine, it raises the possibility that they could be vulnerable to manipulation by the tobacco industry. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

A case-control study of the effectiveness of tissue plasminogen activator on 6 month patients--reported outcomes and health care utilization.

PubMed

Lang, Catherine E; Bland, Marghuretta D; Cheng, Nuo; Corbetta, Maurizio; Lee, Jin-Moo

2014-01-01

We examined the benefit of tissue plasminogen activator (tPA), delivered as part of usual stroke management, on patient-reported outcomes and health care utilization. Using a case control design, patients who received tPA as part of usual stroke management were compared with patients who would have received tPA had they arrived to the hospital within the therapeutic time window. Data were collected from surveys 6 months after stroke using standardized patient-reported outcome measures and questions about health care utilization. Demographic and medical data were acquired from hospital records. Patients were matched on stroke severity, age, race, and gender. Matching was done with 1:2 ratio of tPA to controls. Results were compared between groups with 1-tailed tests because of a directionally specific hypothesis in favor of the tPA group. The tPA (n = 78) and control (n = 156) groups were matched across variables, except for stroke severity, which was better in the control group; subsequent analyses controlled for this mismatch. The tPA group reported better physical function, communication, cognitive ability, depressive symptomatology, and quality of life/participation compared with the control group. Fewer people in the tPA group reported skilled nursing facility stays, emergency department visits, and rehospitalizations after their stroke compared with controls. Reports of other postacute services were not different between groups. Although it is known that tPA reduces disability, this is the first study to demonstrate the effectiveness of tPA in improving meaningful, patient-reported outcomes. Thus, use of tPA provides a large benefit to the daily lives of people with ischemic stroke. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Menopausal Quality of Life: A RCT of Yoga, Exercise and Omega-3 Supplements

PubMed Central

REED, Susan D; GUTHRIE, Katherine A; NEWTON, Katherine M; ANDERSON, Garnet L; BOOTH-LAFORCE, Cathryn; CAAN, Bette; CARPENTER, Janet S; COHEN, Lee S; DUNN, Andrea L; ENSRUD, Kristine E; FREEMAN, Ellen W; HUNT, Julie R; JOFFE, Hadine; LARSON, Joseph C; LEARMAN, Lee A; ROTHENBERG, Robin; SEGUIN, Rebecca A; SHERMAN, Karen J; STERNFELD, Barbara S; LACROIX, Andrea Z

2014-01-01

Objective Determine efficacy of three non-hormonal therapies for improving menopause-related quality of life (QOL) in women with vasomotor symptoms (VMS). Methods 12-week 3×2 randomized, controlled, factorial design trial. Peri- and postmenopausal women, ages 40-62 years, were randomized to yoga (n=107), exercise (n=106), or usual activity (n=142), and also randomized to double-blind comparison of omega-3 (n=177) or placebo (n=178) capsules. Interventions: 1) weekly 90-minute yoga classes with daily at-home practice; 2) individualized facility-based aerobic exercise training 3 times/week; and 3) 0.615 gram omega-3 supplement, 3 times/day. Outcomes: Menopausal Quality of Life Questionnaire (MENQOL) total and domain (VMS, psychosocial, physical and sexual) scores. Results Among 355 randomized women, average age 54.7 years, 338 (95%) completed 12-week assessments. Mean baseline VMS frequency was 7.6/day and mean baseline total MENQOL score was 3.8 (range 1-8 from better to worse) with no between-group differences. For yoga compared to usual activity, baseline to 12-week improvements were seen for MENQOL total -0.3 (95% CI -0.6 to 0.0, p=0.02), and VMS (p=0.02) and sexuality (p=0.03) domain scores. For exercise and omega-3 compared to controls, improvements in baseline to 12-week total MENQOL scores were not observed. Exercise showed benefit in the MENQOL physical domain score at 12-weeks (p=0.02). Conclusion All women become menopausal and many seek medical advice on ways to improve quality of life; little evidence-based information exists. We found, among healthy sedentary menopausal women, yoga appears to improve menopausal QOL - the clinical significance of our finding is uncertain due to modest effect. PMID:24215858

The effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength among community-based older people.

PubMed

Lin, Shu-Fen; Sung, Huei-Chuan; Li, Tzai-Li; Hsieh, Tsung-Cheng; Lan, Hsiao-Chin; Perng, Shoa-Jen; Smith, Graeme D

2015-05-01

The aim of this study was to investigate the effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength in community-based older people. Tai-Chi is known to improve functional fitness in older people. Tai-Chi is usually performed with free hands without resistance training and usually focuses on training lower limbs. To date, no study has examined the use of Tai-Chi in conjunction with thera-band resistance exercise in this population. Cluster randomised trial design. Older people at six senior day care centres in Taiwan were assigned to thera-band resistance exercise or control group using a cluster randomisation. The thera-band resistance exercise group (n = 48) received sixty minute thera-band resistance exercise twice weekly for a period of 16 weeks. The control group (n = 47) underwent routine activities in the day care centre, receiving no Tai-Chi or resistance exercise. After receiving the thera-band resistance exercise, intervention participants displayed a significant increase in muscle strength of upper and lower extremities. Significant improvements were recorded on most measures of the Senior Fitness Test, with the exception of the chair-stand and back-scratch test. Thera-band resistance exercise has the potential to improve functional fitness and muscle strength in community-based older people. Thera-band resistance exercise potentially offers a safe and appropriate form of physical activity that nursing staff can easily incorporate into the daily routine of older people in day care centres, potentially improving functional performance and muscle strength. © 2015 John Wiley & Sons Ltd.

[Experimental and clinical studies of flomoxef in the field of obstetrics and gynecology. Representative Committee Members of the Research Team for Infections in the Field of Obstetrics and Gynecology].

PubMed

Matsuda, S; Okada, H; Ninomiya, K; Shimizu, T; Noda, K; Deguchi, K

1988-12-01

Flomoxef (FMOX) has a broad antibacterial spectrum against Gram-positive and Gram-negative bacteria; especially its potent antibacterial activity against Staphylococcus aureus is a significant advantage that may not be found with other cephem compounds. In our determination of its antibacterial potency against various clinical isolates obtained from clinical materials (amniotic fluid, intrauterine secretions, exudates of the pelvic dead space) of patients with various infections, we obtained results representing specific features of this drug. From the results, the drug may be expected to produce an excellent effect in the treatment of various infections. Our study on drug concentrations in body fluids and genital tissues demonstrated a good transfer of this drug into various tissues; in every tissue examined, the drug administered by the usual method in the usual dose yielded a concentration exceeding MIC for principal pathogens, thus promising a good clinical response. Indeed a high clinical efficacy rate of 90.1% (good to very good responses) was obtained in a clinical trial involving 222 cases. Administration of the drug in 2 g quantity daily produced a high response rate of 92.8%. It was especially noteworthy that a good response was obtained in 30 of 32 cases (93.8%) in which other cephem compounds had failed. In evaluation of the bacteriological effect, furthermore, the drug showed an excellent rate of bacterial elimination. In conclusion, this drug is expected to be greatly useful in the light of its good transfer into genital tissues and its strong antibacterial activities against Gram-positive cocci, Gram-negative bacteria and anaerobes as well as against multiple bacterial infections predominating among women with genital infections.

Usefulness of the University of California San Diego Performance-Based Skills Assessment for the evaluation of cognitive function and activities of daily living function in patients with cognitive impairment.

PubMed

Jeon, Dong-Wook; Ju, Hyun-Bin; Jung, Do-Un; Kim, Sung-Jin; Shim, Joo-Cheol; Moon, Jung-Joon; Kim, You-Na

2017-10-25

To assess the usefulness of the University of California San Diego Performance-Based Skills Assessment (UPSA) as a new diagnostic method and tool for the assessment of cognitive function and activities of daily living function in patients with cognitive impairment. In total, 35 patients with cognitive impairment and 35 healthy controls were recruited for this study. The Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Global Deterioration Scale (GDS) were used for the evaluation of cognitive function, while the Barthel Activities of Daily Living Index (BADL), Instrumental Activities of Daily Living Index (IADL), and UPSA were used for the evaluation of activities of daily living function. UPSA scores were significantly lower in patients with cognitive impairment than in controls. The UPSA total score was significantly correlated with MMSE, CDR, GDS, and IADL scores. With regard to the detection of cognitive impairment, UPSA exhibited a greater determination power (R 2 = 0.593) compared with BADL (R 2 = 0.149) and IADL (R 2 = 0.423) and higher sensitivity and specificity compared with IADL. Our results suggest that UPSA is a useful tool for the evaluation of cognitive function and activities of daily living function in patients with cognitive impairment.

Accelerometer-measured daily physical activity related to aerobic fitness in children and adolescents.

PubMed

Dencker, Magnus; Andersen, Lars B

2011-06-01

Maximum oxygen uptake (VO(2PEAK)) is generally considered to be the best single marker for aerobic fitness. While a positive relationship between daily physical activity and aerobic fitness has been established in adults, the relationship appears less clear in children and adolescents. The purpose of this paper is to summarise recently published data on the relationship between daily physical activity, as measured by accelerometers, and VO(2PEAK) in children and adolescents. A PubMed search was performed on 29 October 2010 to identify relevant articles. Studies were considered relevant if they included measurement of daily physical activity by accelerometry and related to a VO(2PEAK) either measured directly at a maximal exercise test or estimated from maximal power output. A total of nine studies were identified, with a total number of 6116 children and adolescents investigated. Most studies reported a low-to-moderate relationship (r = 0.10-0.45) between objectively measured daily physical activity and VO(2PEAK). No conclusive evidence exists that physical activity of higher intensities are more closely related to VO(2PEAK), than lower intensities.

Feel the Fatigue and Be Active Anyway: Physical Activity on High-Fatigue Days Protects Adults With Arthritis From Decrements in Same-Day Positive Mood.

PubMed

Hegarty, Rosisin S M; Conner, Tamlin S; Stebbings, Simon; Treharne, Gareth J

2015-09-01

The present study examined whether daily physical activity moderated the within-person relationship between daily fatigue and positive or negative mood in patients with rheumatoid arthritis (RA) or osteoarthritis (OA). Participants were 142 patients, 70 with RA and 72 with OA (67.6% women). Participants completed daily diaries during 4 fixed time windows per day for 7 days. Each diary assessed fatigue, pain, and positive and negative mood. Participants wore pedometers throughout each day and recorded pedometer readings at the end of each day. Physical activity buffered the same-day relationship between daily fatigue and positive mood for both RA and OA participants. On high-fatigue days, large decrements in mood were noted, but this was mitigated on days when participants were more physically active. Being more physically active on high-fatigue days buffered the negative effect of fatigue on positive mood among adults with both OA and RA. These findings have implications for understanding the daily variations in fatigue and inform potential clinical interventions. © 2015, American College of Rheumatology.

Chemotherapy-related neuropathic symptom management: a randomized trial of an automated symptom-monitoring system paired with nurse practitioner follow-up.

PubMed

Kolb, Noah Allan; Smith, Albert Gordon; Singleton, John Robinson; Beck, Susan L; Howard, Diantha; Dittus, Kim; Karafiath, Summer; Mooney, Kathi

2018-05-01

The purpose of this study was to evaluate a new care model to reduce chemotherapy-induced neuropathic symptoms. Neuropathic symptom usual care was prospectively compared to an automated symptom-monitoring and coaching system, SymptomCare@Home (SCH), which included nurse practitioner follow-up triggered by moderate to severe symptoms. Patients beginning chemotherapy were randomized to usual care (UC) or to the SCH intervention. This sub-analysis included only taxane/platin therapies. Participants called the automated telephone symptom-monitoring system daily to report numbness and tingling. The monitoring system recorded patient-reported neuropathic symptom severity, distress, and activity interference on a 0-10 scale. UC participants were instructed to call their oncologist for symptom management. SCH participants with symptom severity of ≥ 4 received automated self-care strategies, and a nurse practitioner (NP) provided guideline-based care. There were 252 participants, 78.6% of which were female. Mean age was 55.1 years. Mean follow-up was 90.2 ± 39.9 days (81.1 ± 40.3 calls). SCH participants had fewer days of moderate (1.8 ± 4.0 vs. 8.6 ± 17.3, p < 0.001) and severe chemotherapy-induced peripheral neuropathy symptoms (0.3 ± 1.0 vs. 1.1 ± 5.2, p = 0.006). SCH participants had fewer days with moderate and severe symptom-related distress (1.4 ± 3.7 vs. 6.9 ± 15.0, p < 0.001; 0.2 ± 0.9 vs. 1.5 ± 6.1, p = 0.001) and trended towards less activity interference (3.3 ± 1.9 vs. 3.8 ± 2.1, p = 0.08). Other neuropathic symptoms were addressed in 5.8-15.4% of SCH follow-up calls. The SCH system effectively identified neuropathic symptoms and their severity and, paired with NP follow-up, reduced symptom prevalence, severity, and distress compared to usual care.

Patient-directed music therapy reduces anxiety and sedation exposure in mechanically-ventilated patients: a research critique.

PubMed

Gullick, Janice G; Kwan, Xiu Xian

2015-05-01

This research appraisal, guided by the CASP Randomised Controlled Trial Checklist, critiques a randomised, controlled trial of patient-directed music therapy compared to either noise-cancelling headphones or usual care. This study recruited 373 alert, mechanically-ventilated patients across five intensive care units in the United States. The Music Assessment Tool, administered by a music therapist, facilitated music selection by participants in the intervention group. Anxiety was measured using the VAS-A scale. Sedation exposure was measured by both sedation frequency and by sedation intensity using a daily sedation intensity score. Context for the data was supported by an environmental scan form recording unit activity and by written comments from nurses about the patient's responses to the protocol. Patient-directed music therapy allowed a significant reduction in sedation frequency compared to noise-cancelling headphones and usual care participants. Patient-directed music therapy led to significantly lower anxiety and sedation intensity compared to usual care, but not compared to noise-cancelling headphones. This is a robust study with clear aims and a detailed description of research methods and follow-up. While no participants were lost to follow-up, not all were included in the analysis: 37% did not have the minimum of two anxiety assessments for comparison and 23% were not included in sedation analysis. While some participants utilised the intervention or active control for many hours-per-day, half the music therapy participants listened for 12min or less per day and half of the noise-cancelling headphone participants did not appear to use them. While the results suggest that patient-directed music therapy and noise-cancelling headphones may be useful and cost-effective interventions that lead to an overall improvement in anxiety and sedation exposure, these may appeal to a subset of ICU patients. The self-directed use of music therapy and noise-cancelling headphones means these findings may not transfer to sedated or cognitively-impaired patients. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Menstruation disturbances: prevalence, characteristics, and effects on the activities of daily living among adolescent girls from Brazil.

PubMed

Pitangui, Ana Carolina R; Gomes, Mayra Ruana de A; Lima, Alaine Souza; Schwingel, Paulo Adriano; Albuquerque, Ana Paula dos S; de Araújo, Rodrigo Cappato

2013-06-01

To determine the prevalence, characteristics and effects on the activities of daily living of menstruation disturbances among adolescent girls. Descriptive, cross-sectional study. A public school in the city of Petrolina, Brazil. 218 female adolescents of ages between 12 and 17 years. We used a structured questionnaire addressing the socio-demographic and menstrual characteristics of the adolescents. The intensity of menstrual pain and its effect on the activities of daily living were measured using an 11-point numeric rating scale. The mean age of adolescent girls was 13.7 ± 1.5 years. The menstrual cycles of 67% were regular, while 33% were irregular. Dysmenorrhea had a prevalence of 73%, and school absenteeism was observed among 31% of the adolescents. In addition, 66% of the participants considered that dysmenorrhea affected their activities of daily living. Associations were found between the intensity of pain and the variables: school absenteeism; affected activities of daily living; need to use medications; and between affected activities of daily living and school absenteeism (P < .05). Among the menstrual disturbances observed dysmenorrhea stood out due to its high prevalence among adolescents with a negative effect on adolescents' activities of daily living. Early diagnosis and knowledge about menstrual disturbances are essential because in addition to reiterating the importance of implementing health education actions, they also help to choose appropriate treatments, thus minimizing the negative effects of these disturbances on the lives of adolescents. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Physical Behavior in Older Persons during Daily Life: Insights from Instrumented Shoes.

PubMed

Moufawad El Achkar, Christopher; Lenoble-Hoskovec, Constanze; Paraschiv-Ionescu, Anisoara; Major, Kristof; Büla, Christophe; Aminian, Kamiar

2016-08-03

Activity level and gait parameters during daily life are important indicators for clinicians because they can provide critical insights into modifications of mobility and function over time. Wearable activity monitoring has been gaining momentum in daily life health assessment. Consequently, this study seeks to validate an algorithm for the classification of daily life activities and to provide a detailed gait analysis in older adults. A system consisting of an inertial sensor combined with a pressure sensing insole has been developed. Using an algorithm that we previously validated during a semi structured protocol, activities in 10 healthy elderly participants were recorded and compared to a wearable reference system over a 4 h recording period at home. Detailed gait parameters were calculated from inertial sensors. Dynamics of physical behavior were characterized using barcodes that express the measure of behavioral complexity. Activity classification based on the algorithm led to a 93% accuracy in classifying basic activities of daily life, i.e., sitting, standing, and walking. Gait analysis emphasizes the importance of metrics such as foot clearance in daily life assessment. Results also underline that measures of physical behavior and gait performance are complementary, especially since gait parameters were not correlated to complexity. Participants gave positive feedback regarding the use of the instrumented shoes. These results extend previous observations in showing the concurrent validity of the instrumented shoes compared to a body-worn reference system for daily-life physical behavior monitoring in older adults.

Promoting toddlers' positive social-emotional outcomes in low-income families: a play-based experimental study.

PubMed

Kochanska, Grazyna; Kim, Sanghag; Boldt, Lea J; Nordling, Jamie Koenig

2013-01-01

This multimethod study of mothers and toddlers (a) examined the effectiveness of a play-based intervention (child-oriented play vs. play-as-usual) on children's cooperation with their mothers and socioemotional competence; (b) introduced a robust new measure of maternal engagement in the intervention, reflected in the dose of child-oriented play the mother delivered to the child; and (c) examined ecological factors that predicted maternal engagement, and the effect of engagement on the outcomes. Low-income mothers (N = 186, 11% Latino, 27% minority) were randomized into child-oriented play group or play-as-usual group, participated in 8 play sessions, and played daily with their children for 10 weeks. Microscopic coding of mothers' behavior in play sessions assessed the dose of child-oriented play delivered to children; mothers' diaries assessed time in daily play. Children's cooperation with maternal control, observed in the laboratory, and mother-rated competence were measured before randomization (Pretest), after play sessions (Posttest 1), and 6 months later (Posttest 2). Children in both groups made significant gains in both outcomes. The gains in cooperation appeared longer lasting in child-oriented play group. Both groups made significantly greater gains than a "historical community control" group, an unrelated longitudinal study without any intervention. Structural equation analyses revealed that married mothers and those with fewer children delivered higher doses of child-oriented play, and those doses predicted children's higher cooperation and competence, with the effects of earlier scores covaried. The dose of time spent in daily play had no effect. Child-oriented play may be a promising, effective, and inexpensive means of promoting toddlers' positive development.

Promoting Toddlers’ Positive Social-Emotional Outcomes in Low-Income Families: A Play-Based Experimental Study

PubMed Central

Kochanska, Grazyna; Kim, Sanghag; Boldt, Lea J.; Nordling, Jamie Koenig

2013-01-01

Objectives This multi-method study of mothers and toddlers (a) examined the effectiveness of a play-based intervention (child-oriented play versus play-as-usual) on children’s cooperation with their mothers and socioemotional competence, (b) introduced a robust new measure of maternal engagement in the intervention, reflected in the dose of child-oriented play the mother delivered to the child, (c) examined ecological factors that predicted maternal engagement, and the effect of engagement on the outcomes. Methods Low-income mothers (N=186, 11% Latino, 27% minority) were randomized into Child-Oriented Play group or Play-as-Usual group, and participated in 8 play sessions and played daily with their children for 10 weeks. Microscopic coding of mothers’ behavior in play sessions assessed the dose of child-oriented play delivered to children; mothers’ diaries assessed time in daily play. Children’s cooperation with maternal control, observed in the laboratory, and mother-rated competence were measured before randomization (Pretest), after play sessions (Posttest 1), and 6 months later (Posttest 2). Results Children in both groups made significant gains in both outcomes. The gains in cooperation appeared longer lasting in Child-Oriented Play group. Both groups made significantly greater gains than a “historical community control” group, an unrelated longitudinal study without any intervention. Structural Equation Analyses revealed that married mothers, and those with fewer children delivered higher doses of child-oriented play, and those doses predicted children’s higher cooperation and competence, with the effects of earlier scores covaried. The dose of time spent in daily play had no effect. Conclusion Child-oriented play may be a promising, effective, and inexpensive means of promoting toddlers’ positive development. PMID:23557253

Recognition of Daily Activity in Living Space based on Indoor Ambient Atmosphere and Acquiring Localized Information for Improvement of Recognition Accuracy

NASA Astrophysics Data System (ADS)

Hirasawa, Kazuki; Sawada, Shinya; Saitoh, Atsushi

The system watching over elder's life is very important in a super-aged society Japan. In this paper, we describe a method to recognize resident's daily activities by means of using the information of indoor ambient atmosphere changes. The measuring targets of environmental changes are of gas and smell, temperature, humidity, and brightness. Those changes have much relation with resident's daily activities. The measurement system with 7 sensors (4 gas sensors, a thermistor, humidity sensor, and CdS light sensor) was developed for getting indoor ambient atmosphere changes. Some measurements were done in a one-room type residential space. 21 dimensional activity vectors were composed for each daily activity from acquired data. Those vectors were classified into 9 categories that were main activities by using Self-Organizing Map (SOM) method. From the result, it was found that the recognition of main daily activities based on information on indoor ambient atmosphere changes is possible. Moreover, we also describe the method for getting information of local gas and smell environmental changes. Gas and smell environmental changes are related with daily activities, especially very important action, eating and drinking. And, local information enables the relation of the place and the activity. For such a purpose, a gas sensing module with the operation function that synchronizes with human detection signal was developed and evaluated. From the result, the sensor module had the ability to acquire and to emphasize local gas environment changes caused by the person's activity.

Perceived ability to perform daily hand activities after stroke and associated factors: a cross-sectional study.

PubMed

Ekstrand, Elisabeth; Rylander, Lars; Lexell, Jan; Brogårdh, Christina

2016-11-02

Despite that disability of the upper extremity is common after stroke, there is limited knowledge how it influences self-perceived ability to perform daily hand activities. The aim of this study was to describe which daily hand activities that persons with mild to moderate impairments of the upper extremity after stroke perceive difficult to perform and to evaluate how several potential factors are associated with the self-perceived performance. Seventy-five persons (72 % male) with mild to moderate impairments of the upper extremity after stroke (4 to 116 months) participated. Self-perceived ability to perform daily hand activities was rated with the ABILHAND Questionnaire. The perceived ability to perform daily hand activities and the potentially associated factors (age, gender, social and vocational situation, affected hand, upper extremity pain, spasticity, grip strength, somatosensation of the hand, manual dexterity, perceived participation and life satisfaction) were evaluated by linear regression models. The activities that were perceived difficult or impossible for a majority of the participants were bimanual tasks that required fine manual dexterity of the more affected hand. The factor that had the strongest association with perceived ability to perform daily hand activities was dexterity (p < 0.001), which together with perceived participation (p = 0.002) explained 48 % of the variance in the final multivariate model. Persons with mild to moderate impairments of the upper extremity after stroke perceive that bimanual activities requiring fine manual dexterity are the most difficult to perform. Dexterity and perceived participation are factors specifically important to consider in the rehabilitation of the upper extremity after stroke in order to improve the ability to use the hands in daily life.

Occupational therapy for patients with problems in personal activities of daily living after stroke: systematic review of randomised trials

PubMed Central

Drummond, Avril; Leonardi-Bee, Jo; Gladman, J R F; Donkervoort, Mireille; Edmans, Judi; Gilbertson, Louise; Jongbloed, Lyn; Logan, Pip; Sackley, Catherine; Walker, Marion; Langhorne, Peter

2007-01-01

Objective To determine whether occupational therapy focused specifically on personal activities of daily living improves recovery for patients after stroke. Design Systematic review and meta-analysis. Data sources The Cochrane stroke group trials register, the Cochrane central register of controlled trials, Medline, Embase, CINAHL, PsycLIT, AMED, Wilson Social Sciences Abstracts, Science Citation Index, Social Science Citation, Arts and Humanities Citation Index, Dissertations Abstracts register, Occupational Therapy Research Index, scanning reference lists, personal communication with authors, and hand searching. Review methods Trials were included if they evaluated the effect of occupational therapy focused on practice of personal activities of daily living or where performance in such activities was the target of the occupational therapy intervention in a stroke population. Original data were sought from trialists. Two reviewers independently reviewed each trial for methodological quality. Disagreements were resolved by consensus. Results Nine randomised controlled trials including 1258 participants met the inclusion criteria. Occupational therapy delivered to patients after stroke and targeted towards personal activities of daily living increased performance scores (standardised mean difference 0.18, 95% confidence interval 0.04 to 0.32, P=0.01) and reduced the risk of poor outcome (death, deterioration or dependency in personal activities of daily living) (odds ratio 0.67, 95% confidence interval 0.51 to 0.87, P=0.003). For every 100 people who received occupational therapy focused on personal activities of daily living, 11 (95% confidence interval 7 to 30) would be spared a poor outcome. Conclusions Occupational therapy focused on improving personal activities of daily living after stroke can improve performance and reduce the risk of deterioration in these abilities. Focused occupational therapy should be available to everyone who has had a stroke. PMID:17901469

School-day and overall physical activity among youth.

PubMed

Long, Michael W; Sobol, Arthur M; Cradock, Angie L; Subramanian, S V; Blendon, Robert J; Gortmaker, Steven L

2013-08-01

Increasing school-day physical activity through policy and programs is commonly suggested to prevent obesity and improve overall child health. However, strategies that focus on school-day physical activity may not increase total physical activity if youth compensate by reducing physical activity outside of school. Objectively measured, nationally representative physical activity data were used to test the hypothesis that higher school-day physical activity is associated with higher overall daily physical activity in youth. Accelerometer data from 2003-2004/2005-2006 National Health and Nutrition Examination Surveys were analyzed in 2012 to estimate physical activity levels during the school day (8AM-3PM) among youth aged 6-19 years (n=2548). Fixed-effects regressions were used to estimate the impact of changes in school-day minutes of moderate-to-vigorous physical activity (MVPA) on changes in total daily MVPA. Each additional minute of school-day MVPA was associated with an additional 1.14 minutes (95% CI=1.04, 1.24; p<0.001) of total daily MVPA, or 0.14 additional minutes (95% CI=0.04, 0.24; p=0.008) outside the school day, controlling for total daily accelerometer wear time and age, gender, race/ethnicity, and other non-time varying covariates. There were no differences in the effect of school-day MVPA on total MVPA by age group, gender, race/ethnicity, poverty status, or degree of change in MVPA. Higher school-day MVPA was associated with higher daily MVPA among U.S. youth with no evidence for same-day "compensation." Increasing school-based physical activity is a promising approach that can improve total daily physical activity levels of youth. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Barriers to physical activity between adults with stroke and their care partners.

PubMed

Zalewski, Kathryn R; Dvorak, Leah

2011-10-01

Healthy living includes meeting daily physical activity guidelines. This study compares daily physical activity rates and barriers to physical activity for people with stroke and their partners (spouse or significant other). Physical abilities, energy expenditure, daily steps, and barriers to physical activity are evaluated in people who have completed stroke rehabilitation and their partners. Twenty pairs of adults (mean age 69.7 years) participated. Participants with stroke were classified as sedentary, averaging 2,990 (± 2,488) steps per day. Their partners are classified as low active, averaging 6,378 (± 2,149) steps per day. For stroke survivors, physical abilities were positively correlated to daily activity rates. The number of steps walked per day was moderately correlated to 6-minute walk tests (r = 0.550, P < .05), comfortable gait speeds (r = 0.588, P < .05), and fast gait speeds (r = 0.677, P < .01). For care partners, physical abilities were not correlated to daily physical activity. People with stroke report lack of skill as a primary barrier; their partners report lack of time. The relationship between physical ability and physical activity is reinforced with this study. The impact of stroke on the family, particularly on time demands of the primary caregiver, suggests the needs of the care partner may not be adequately addressed in the rehabilitation process.

Delaying cognitive and physical decline through multidomain interventions for residents with mild-to-moderate dementia in dementia care units in Taiwan: A prospective cohort study.

PubMed

Liang, Chih-Kuang; Chou, Ming-Yueh; Chen, Liang-Yu; Wang, Kuei-Yu; Lin, Shih-Yi; Chen, Liang-Kung; Lin, Yu-Te; Liu, Tsung-Yun; Loh, Ching-Hui

2017-04-01

To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic). All residents in Jia-Li Veterans Home received comprehensive intervention, including Multi-disciplinary team consultation and intervention, Multi-component non-pharmacological management, geriatric syndromes survey and intervention by CGA, and a dementia friendly medical Green channel Approach (2MCGA). The decline of cognitive and physical function are determined by the change of Mini-Mental State Examination score, CDR and the sum of CDR box, as well as activities of daily living based on the Barthel Index. We also screened geriatric syndromes at baseline and 1 year later. Participants in the intervention group were older and had a lower educational level, lower body mass index, poor baseline activities of daily living function, lower visual impairment, and higher rates of hearing impairment, polypharmacy and risk of malnutrition. The residents receiving 2MCGA had lower baseline Mini-Mental State Examination scores, and higher CDR. For residents in Jia-Li Veterans Home, all cognitive measurements except Mini-Mental State Examination were significantly associated with delaying the decline of cognition after analyzing by multiple linear regression, and multivariate logistic regression also showed that patients living in the community was independently associated with a higher odds ratio for activities of daily living decline (3.180, 95% CI 1.384-7.308, P = 0.006). There are also more improvement in their baseline geriatric syndromes and suffered less from new geriatric syndromes, including falls, urinary incontinence, and risk of malnutrition. The 2MCGA intervention shows strong delays in the decline of cognition and physical function for older residents with mild-to-moderate dementia. Furthermore, this strategy can also improve or prevent the onset of new geriatric syndromes, especially fall episodes, urinary incontinence and risk of malnutrition. Geriatr Gerontol Int 2017; 17 (Suppl. 1): 36-43. © 2017 Japan Geriatrics Society.

A randomized-controlled trial of intensive case management emphasizing the recovery model among patients with severe and enduring mental illness.

PubMed

O'Brien, S; McFarland, J; Kealy, B; Pullela, A; Saunders, J; Cullen, W; Meagher, D

2012-09-01

There is increasing interest in the application of recovery principles in mental health services. We studied the implementation of a programme of intensive case management (ICM) emphasizing recovery principles in a community mental health service in Ireland. Eighty service attenders with severe and enduring illness characterized by significant ongoing disability were randomized into (1) a group receiving a programme of ICM and (2) a group receiving treatment as usual (TAU). Groups were compared before and after the programme for general psychopathology using the Brief Psychiatric Rating Scale (BPRS) (clinician rated) and How are You? scale (self-rated). The Functional Analysis of Care Environments (FACE) scale provided assessment of multiple functional domains. The overall group (mean age 44.5 ± 13.2 years; 60% male) had mean total Health of the Nation Outcome Scale (HoNOS) scale scores of 10.5 ± 4.6, with problems in social functioning especially prominent (mean social subscale score 5.0 ± 2.7). The ICM group were younger (p < 0.01) with higher baseline scores on the HoNOS social subscale and BPRS (p < 0.05). An analysis of covariance, controlling for these baseline differences, indicated greater improvement in BPRS scores (p = 0.001), How are You? scores (p = 0.02) and FACE domains for cognition, symptoms and interpersonal relationships (all p < 0.001) in the ICM group. The ICM group underwent greater changes in structured daily activities that were linked to improved BPRS scores (p = 0.01). A programme of ICM emphasizing recovery principles resulted in significant improvement across psychopathological and functional domains. Improvements were linked to enhanced engagement with structured daily activities. Recovery-oriented practices can be integrated into existing mental health services and provided alongside traditional models of care.

Do patients diagnosed with Alzheimer's disease benefit from a psycho-educational programme for family caregivers? A randomised controlled study.

PubMed

de Rotrou, Jocelyne; Cantegreil, Inge; Faucounau, Véronique; Wenisch, Emilie; Chausson, Catherine; Jegou, David; Grabar, Sophie; Rigaud, Anne-Sophie

2011-08-01

The Aide dans la Maladie d'Alzheimer (AIDMA) study was conducted to determine whether a psycho-educational programme (PEP) for primary caregivers in addition to standard anti-dementia drugs for patients improves caregivers' psychological condition and patients' activities of daily life. Multicentre randomised controlled intervention trial. One hundred and sixty-seven dyads 'patient-caregiver' were recruited from 15 French memory clinics and randomised in two parallel groups. The intervention group was offered the PEP in 12 group sessions for 3 months. The control group had usual care. Patients in both groups with mild to moderate Alzheimer's disease (AD) were diagnosed and treated with pharmacotherapy. Patients' primary efficacy variable was functional status assessed with the Disability Assessment Scale for Dementia (DAD) scale. Alzheimer Disease Assessment Scale (ADAS-Cog) and Neuropsychiatric Inventory (NPI) were secondary criteria. Caregivers' first outcome measure was depressive symptoms assessed with the Montgomery and Asberg Depression Rating Scale (MADRS) scale. Zarit scale, Sense of Competence Questionnaire (SCQ) and Visual Analogue Scales (VAS) were secondary criteria. Assessment was done at baseline, 3 months (M3, end of intervention) and 6 months (M6). Patients' stabilisation was observed in both groups. In caregivers, significant improvement in disease understanding at M3 (p = 0.007) and M6 (p = 0.0001) and in ability to cope with care-recipients' disease at M6 (0.02) was evidenced. The PEP had no additional impact on patients but carers developed more effective disease understanding and ability of coping. Results support the idea that the PEP although improving caregivers' condition is not sufficient to improve patients' activities in daily life which requires additional individually tailored interventions provided by professionals. Copyright © 2010 John Wiley & Sons, Ltd.

[Quality of life in institutionalized elderly people of Medellín].

PubMed

Estrada, Alejandro; Cardona, Doris; Segura, Angela María; Chavarriaga, Lina Marcela; Ordóñez, Jaime; Osorio, Jorge Julián

2011-01-01

Many factors contribute to the deteriorating quality of life of elderly people living in care institutions. Some of these problems are a consequence of few contacts with relatives and friends, and being alone with a feeling of isolation. The conditions of quality of life are explored for elderly people living in care institutions. In a cross sectional study, 276 subjects were selected from 39 long term institutions located in the city of Medellín, Colombia. The sex ratio was female: male 60:40% with a mean age of 79.2 ± 8.0. Elderly subjects with cognitive problems or not living in the institution were excluded. The World Health Organization Quality of Life of Older Adults (WHOQOL-OLD) questionnaire was applied; in additional, capacity and cognitive functional scales of Pfeffer, the anxiety scale of Goldberg, and the Geriatric Depression Scale of Yesavage were administered. Mininutritional assessment scales and complementary questionnaires about demographics, health perception, social support system were also included. The information was analyzed using the Mann Whitney U test, Kruskal Wallis test, Pearson correlation and multiple linear regression method. Most (71%) considered themselves autonomous for undertaking daily, habitual activities. Other statistics included the following: 45.7% with depression, 33.0% with anxiety, 28.3% with functional problems, and 54.3% at risk of malnutrition. A negative quality-of-life assessment was associated with the following factors: female, diabetes, depression, anxiety and high functional capacity. A positive quality-of-life assessment was associated with individuals who voluntarily came to the institution. Quality of life for elderly people living in care institutions can become deteriorated when they are not capable to do the usual activities necessary for daily living. Exacerbating factors included sex, symptoms of depression, anxiety, or perceived mistreatment by their families.

Keeping it in the family: caregiving in Australian-Greek families.

PubMed

Morse, C A; Messimeri-Kianidis, V

2001-01-01

Family-based caregiving refers to the daily provision of help to a co-resident family relative with the usual activities of daily living, custody and protection of a dependent relative at risk of self-injury, and support of a person with physical, developmental and/or mental disability or frailty due to ageing. Many reports from western studies refer to the caregiving burdens, stress and strains. A common view of migrant peoples is that they 'look after their own' to a greater extent than do English-speaking groups and that their closer connections with ethno-specific community organisations and with their extended family networks provides more opportunities for assistance and support so that caregiving is shared and the burdens are reduced. A study was carried out with 300 Australian-Greek families in Melbourne where 150 were providing family-based caregiving, and these were age and gender matched with friends or acquaintances who had no such duties. Most care was provided by women, although almost 20% of carers were men. A wide range of disabilities and illnesses were receiving help and care in the caregiving families among care recipients aged from childhood to advanced old age. Distinct evidence of caregiving burden was found to a significant degree. Gender differences were apparent in the type of disorders managed, in the perceived severity of caregiving duties provided and in the total range of activities engaged in. The ethno-specific community organisations and extended family networks played little part in providing assistance to caregivers which challenges the myths of a close-knit migrant community looking after its own. Qualitative reports of concerns for future caregiving were expressed and the implications for future service needs are discussed.

The Comprehensive Geriatric Assessment and the multidimensional approach. A new look at the older patient with gastroenterological disorders.

PubMed

Pilotto, Alberto; Addante, Filomena; D'Onofrio, Grazia; Sancarlo, Daniele; Ferrucci, Luigi

2009-01-01

The Comprehensive Geriatric Assessment (CGA) is a multidimensional, usually interdisciplinary, diagnostic process intended to determine an elderly person's medical, psychosocial, and functional capacity and problems with the objective of developing an overall plan for treatment and short- and long-term follow-up. The potential usefulness of the CGA in evaluating treatment and follow-up of older patients with gastroenterological disorders is unknown. In the paper we reported the efficacy of a Multidimensional-Prognostic Index (MPI), calculated from information collected by a standardized CGA, in predicting mortality risk in older patients hospitalized with upper gastrointestinal bleeding and liver cirrhosis. Patients underwent a CGA that included six standardized scales, i.e. Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Short-Portable Mental Status Questionnaire (SPMSQ), Mini-Nutritional Assessment (MNA), Exton-Smith Score (ESS) and Comorbity Index Rating Scale (CIRS), as well as information on medication history and cohabitation, for a total of 63 items. The MPI was calculated from the integrated total scores and expressed as MPI 1=low risk, MPI 2=moderate risk and MPI 3=severe risk of mortality. Higher MPI values were significantly associated with higher short- and long-term mortality in older patients with both upper gastrointestinal bleeding and liver cirrhosis. A close agreement was found between the estimated mortality by MPI and the observed mortality. Moreover, MPI seems to have a greater discriminatory power than organ-specific prognostic indices such as Rockall and Blatchford scores (in upper gastrointestinal bleeding patients) and Child-Plugh score (in liver cirrhosis patients). All these findings support the concept that a multidimensional approach may be appropriate for the evaluation of older patients with gastroenterological disorders, like it has been reported for patients with other pathological conditions.

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

PubMed

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

2012-01-01

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

Executive Functions and Motor Ability Contribute to Children's Participation in Daily Activities

ERIC Educational Resources Information Center

Rosenberg, Limor; Jacobi, Shani; Bart, Orit

2017-01-01

Executive functions are crucial for efficient daily functioning. However, the contribution of executive functions to the participation in daily life activities of children, have been inadequately studied. The study aimed to examine the unique contribution of executive functions, beyond motor ability, to the diversity and independence of children's…

Daily Variation in Adolescents' Sleep, Activities, and Psychological Well-Being

ERIC Educational Resources Information Center

Fuligni, Andrew J.; Hardway, Christina

2006-01-01

The daily diary method was used to examine the daily dynamics of adolescent sleep time, activities, and psychological well-being among an ethnically diverse sample of over 750 adolescents approximately 14-15 years of age. Studying and stressful demands during the day were modestly but consistently associated with less sleep that evening. Receiving…

The importance of body weight and weight management for military personnel.

PubMed

Naghii, Mohammad Reza

2006-06-01

Weight or fat reduction and maintenance among military personnel and attainment of desired body composition and physical appearance are considered important. A high level of body fat has been shown to have an adverse effect on performance in a number of military activities. The effect of rapid weight loss on performance appears to depend on the method of weight loss, the magnitude of weight loss, and the type of exercise or activity performance test used. Personnel who undertake imprudent weight-loss strategies, that is, personnel who try to change their usual body size by chronically restricting their food and fluid intake, may suffer a number of problems. Overweight personnel and their military coaches are just as susceptible to false ideas about weight loss and dieting as the rest of the community. Inappropriate weight loss causes a loss of lean tissue and can reduce, rather than enhance, performance. The understanding and promotion of safe, effective, appropriate weight-loss and weight-maintenance strategies represent important functions of the military system and officials. The greatest likelihood of success requires an integrated program, both during and after the weight-loss phase, in which assessment, increased energy expenditure through exercise and other daily activities, energy intake reduction, nutrition education, lifestyle changes, environmental changes, and psychological support are all components.

Unrecognized Sleep Loss Accumulated in Daily Life Can Promote Brain Hyperreactivity to Food Cue.

PubMed

Katsunuma, Ruri; Oba, Kentaro; Kitamura, Shingo; Motomura, Yuki; Terasawa, Yuri; Nakazaki, Kyoko; Hida, Akiko; Moriguchi, Yoshiya; Mishima, Kazuo

2017-10-01

Epidemiological studies have shown that sleep debt increases the risk of obesity. Experimental total sleep deprivation (TSD) has been reported to activate the reward system in response to food stimuli, but food-related responses in everyday sleep habits, which could lead to obesity, have not been addressed. Here, we report that habitual sleep time at home among volunteers without any sleep concerns was shorter than their optimal sleep time estimated by the 9-day extended sleep intervention, which indicates that participants had already been in sleep debt in their usual sleep habits. The amygdala and anterior insula, which are responsible for both affective responses and reward prediction, were found to exhibit significantly lowered activity in the optimal sleep condition. Additionally, a subsequent one-night period of TSD reactivated the right anterior insula in response to food images; however, the activity level of amygdala remained lowered. These findings indicate that (1) our brain is at risk of hyperactivation to food triggers in everyday life, which could be a risk factor for obesity and lifestyle diseases, and (2) optimal sleep appears to reduce this hypersensitivity to food stimuli. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

The impact of a short-term iyengar yoga program on the health and well-being of physically inactive older adults.

PubMed

Vogler, Juliane; O'Hara, Lily; Gregg, Jane; Burnell, Fiona

2011-01-01

With the current challenge of rapidly aging populations, practices such as yoga may help older adults stay physically active, healthy, and fulfilled. The impact of an 8-week Iyengar yoga program on the holistic health and well-being of physically inactive people aged 55 years and over was assessed. Thirty-eight older adults (mean age 73.21±8.38 years; 19 intervention, 19 control) engaged in either twice-weekly yoga classes or continued their usual daily routines. Physical health measures were muscle strength, active range of motion, respiratory function (FEV1), resting blood pressure, and immune function (salivary IgA and lysozyme). Self-perceived general, physical, mental, spiritual, and social health and well-being were assessed with the Life's Odyssey Questionnaire and the SF12v2™ Health Survey. Muscle strength, active range of motion, physical well-being, and aspects of mental well-being (emotional well-being and self-care) improved significantly in the yoga group (p<.05). Median changes in most of these variables were also significantly different from those in the control group. Participation in Iyengar yoga programs by older people is beneficial for health and well-being, and greater availability of such programs could improve quality of life.

Prevalence and Clinical Characteristics of Itch in Vitiligo and Its Clinical Significance.

PubMed

Vachiramon, Vasanop; Onprasert, Woranit; Harnchoowong, Sarawin; Chanprapaph, Kumutnart

2017-01-01

Vitiligo usually presented as asymptomatic depigmented macules and patches. Little is known regarding itch in vitiligo. This study aimed to evaluate the prevalence and characteristics of itch in vitiligo patients. A cross-sectional study was conducted on vitiligo patients. Itch character and intensity were determined through questionnaires. Evaluation was also made by dermatologists to define vitiligo subtype, body surface area, Koebner phenomenon (KP), and so on. Data were assessed by computer software. Results were considered statistically significant if p < 0.05. Among 402 patients, itch on vitiliginous lesion presented in 20.2%. Prevalence of itch was most common in focal vitiligo (29.4%), followed by segmental vitiligo (20.3%) and nonsegmental vitiligo (19.6%), respectively. Tingling sensation was the most common itch-related symptom (82.7%). The median itch intensity is 5 by 10-point visual analog scale. Daily activity and sleep disturbance were observed in 60.5% and 39.5% of patients who experience itch. Itch occurred approximately 3 days prior to the development of lesions in 48.1% of patients. Thirty-two patients (78.1%) with both itch and KP type IIb had active disease. Itch in vitiligo is not uncommon. The presence of itch with KP type IIb may warrant the active vitiligo.

Trial Protocol: Randomised controlled trial of the effects of very low calorie diet, modest dietary restriction, and sequential behavioural programme on hunger, urges to smoke, abstinence and weight gain in overweight smokers stopping smoking

PubMed Central

2010-01-01

Background Weight gain accompanies smoking cessation, but dieting during quitting is controversial as hunger may increase urges to smoke. This is a feasibility trial for the investigation of a very low calorie diet (VLCD), individual modest energy restriction, and usual advice on hunger, ketosis, urges to smoke, abstinence and weight gain in overweight smokers trying to quit. Methods This is a 3 armed, unblinded, randomized controlled trial in overweight (BMI > 25 kg/m2), daily smokers (CO > 10 ppm); with at least 30 participants in each group. Each group receives identical behavioural support and NRT patches (25 mg(8 weeks),15 mg(2 weeks),10 mg(2 weeks)). The VLCD group receive a 429-559 kcal/day liquid formula beginning 1 week before quitting and continuing for 4 weeks afterwards. The modest energy restricted group (termed individual dietary and activity planning(IDAP)) engage in goal-setting and receive an energy prescription based on individual basal metabolic rate(BMR) aiming for daily reduction of 600 kcal. The control group receive usual dietary advice that accompanies smoking cessation i.e. avoiding feeling hungry but eating healthy snacks. After this, the VLCD participants receive IDAP to provide support for changing eating habits in the longer term; the IDAP group continues receiving this support. The control group receive IDAP 8 weeks after quitting. This allows us to compare IDAP following a successful quit attempt with dieting concurrently during quitting. It also aims to prevent attrition in the unblinded, control group by meeting their need for weight management. Follow-up occurs at 6 and 12 months. Outcome measures include participant acceptability, measured qualitatively by semi-structured interviewing and quantitatively by recruitment and attrition rates. Feasibility of running the trial within primary care is measured by interview and questionnaire of the treatment providers. Adherence to the VLCD is verified by the presence of urinary ketones measured weekly. Daily urges to smoke, hunger and withdrawal are measured using the Mood and Physical Symptoms Scale-Combined (MPSS-C) and a Hunger Craving Score (HCS). 24 hour, 7 day point prevalence and 4-week prolonged abstinence (Russell Standard) is confirmed by CO < 10 ppm. Weight, waist and hip circumference and percentage body fat are measured at each visit. Trial Registration Current controlled trials ISRCTN83865809 PMID:20929584

Systematic recover of long high-resolution rainfall time series recorded by pluviographs during the 20th century.

NASA Astrophysics Data System (ADS)

Delitala, Alessandro M. S.; Deidda, Roberto; Mascaro, Giuseppe; Piga, Enrico; Querzoli, Giorgio

2010-05-01

During most of the 20th century, precipitation has been continuously measured by means of the so-called "pluviographs", i.e. rain gauges including a mechanical apparatus for continuously recording the depth of water from precipitation on specific strip charts, usually on a weekly basis. The signal recorded on such strips was visually examined by trained personnel on a regular basis, in order to extract the daily precipitation totals and the maximum precipitation intensities over short periods (from a few minutes to hours). The rest of the high-resolution information contained in the signal was usually not extracted, except for specific cases. A systematic recovering of the entire information at high temporal resolution contained in these precipitation signals would provide a fundamental database to improve the characterization of historical rainfall climatology during the previous century. The Department of Land Engineering of the University of Cagliari has recently developed and tested an automatic software, based on image analysis techniques, which is able to acquire the scanned images of the pluviograph strip charts, to automatically digitise the signal and to produce a digital database of continuous precipitation records at the highest possible temporal resolution, i.e. 5 to 10 minutes. Along with that, a significant amount of daily precipitation totals from the late 19th and the 20th century, either elaborated from pluviograph strip charts or simply derived from bucket rain gauges, still exists in paper form, but it has never been digitalized. Within a project partly-funded by the Operational Programme of the European Union "Italia-Francia Marittimo", the Regional Environmental Protection Agency of Sardinia and the University of Cagliari will recover both the high-resolution rainfall signals and the older time series of daily totals recorded by a large number of pluviographs belonging to the historical monitoring networks of the island of Sardinia. Such data will then be used to construct the high-resolution climatology of precipitation over Sardinia, both assuming stationary climate and slowly varying climate. Specific attention will be devoted to a set of critical hydrological basins, often affected by intense precipitation and flash floods. All information will then be made available to researchers, regional officers, technicians (e.g. hydraulic engineers) and the greater public interested into such information. The present poster describes the general scope of the E.U. project and the specific activities in the field of climatology of Sardinia rainfall that will be conducted as well as the expected results. A section will be dedicated to show how the pluviograph strips are automatically digitized.

These Shoes Are Made for Walking: Sensitivity Performance Evaluation of Commercial Activity Monitors under the Expected Conditions and Circumstances Required to Achieve the International Daily Step Goal of 10,000 Steps

PubMed Central

O’Connell, Sandra; ÓLaighin, Gearóid; Kelly, Lisa; Murphy, Elaine; Beirne, Sorcha; Burke, Niall; Kilgannon, Orlaith; Quinlan, Leo R.

2016-01-01

Introduction Physical activity is a vitally important part of a healthy lifestyle, and is of major benefit to both physical and mental health. A daily step count of 10,000 steps is recommended globally to achieve an appropriate level of physical activity. Accurate quantification of physical activity during conditions reflecting those needed to achieve the recommended daily step count of 10,000 steps is essential. As such, we aimed to assess four commercial activity monitors for their sensitivity/accuracy in a prescribed walking route that reflects a range of surfaces that would typically be used to achieve the recommended daily step count, in two types of footwear expected to be used throughout the day when aiming to achieve the recommended daily step count, and in a timeframe required to do so. Methods Four commercial activity monitors were worn simultaneously by participants (n = 15) during a prescribed walking route reflective of surfaces typically encountered while achieving the daily recommended 10,000 steps. Activity monitors tested were the Garmin Vivofit ™, New Lifestyles’ NL-2000 ™ pedometer, Withings Smart Activity Monitor Tracker (Pulse O2) ™, and Fitbit One ™. Results All activity monitors tested were accurate in their step detection over the variety of different surfaces tested (natural lawn grass, gravel, ceramic tile, tarmacadam/asphalt, linoleum), when wearing both running shoes and hard-soled dress shoes. Conclusion All activity monitors tested were accurate in their step detection sensitivity and are valid monitors for physical activity quantification over the variety of different surfaces tested, when wearing both running shoes and hard-soled dress shoes, and over a timeframe necessary for accumulating the recommended daily step count of 10,000 steps. However, it is important to consider the accuracy of activity monitors, particularly when physical activity in the form of stepping activities is prescribed as an intervention in the treatment or prevention of a disease state. PMID:27167121

Physical Activity and Bone Density in Women

NASA Technical Reports Server (NTRS)

Bowley, Susan M.; Whalen, R. T.

2000-01-01

A mathematical model of bone density regulation as a function of the daily tissue "effective" stress has been derived. Using the model, the influence of daily activity in the form of a daily loading history has been related to bone density of the calcaneus. The theory incorporates a stress exponent m to account for differences in the importance of magnitude and number of load cycles experienced during daily activity. We have derived a parameter from the model, the "Bone Density Index" (BDI). We have developed a method of collecting daily habitual loading histories using an insole force sensor interfaced to a portable digital data logger carried in a fanny pack. Our goal for this study was to determine a stress exponent, m, relating GRFz history to Calcaneal Bone Mineral Density (CBMD).

Posttraumatic syringomyelia associated with heavy weightlifting exercises: case report.

PubMed

Balmaseda, M T; Wunder, J A; Gordon, C; Cannell, C D

1988-11-01

Posttraumatic syringomyelia is a well-recognized late sequel to spinal trauma occurring in 1% to 3.2% of spinal cord injured patients. Its clinical presentation is usually marked by pain, ascending sensory loss, increased muscle weakness, and depressed deep tendon reflexes. The case of a 25-year-old man with C8 complete quadriplegia, who developed a syrinx five years after his initial injury, is presented. This patient kept a log of his daily physical workout which consisted of lifting weights of 50 to 60 pounds with his neck extensors and biceps. The diagnosis was made clinically and confirmed by magnetic resonance imaging. Repeated valsalva maneuvers from daily heavy weightlifting exercises most likely predisposed this patient to the development and extension of his syringomyelia. Dramatic improvement followed surgical placement of a subarachnoid shunt.

Unexpected paracetamol (acetaminophen) hepatotoxicity at standard dosage in two older patients: time to rethink 1 g four times daily?

PubMed

Ging, Patricia; Mikulich, Olga; O'Reilly, Katherine M A

2016-07-01

We present two cases of acute hepatotoxicity associated with elevated paracetamol (acetaminophen) levels in older patients. Both patients were receiving a standard European dose of oral paracetamol (2 × 500 mg QDS) with no risk factors for slowed metabolism (weight <50 kg, interacting medications, hepatic enzyme inducers, history of liver disease). Significantly, both patients had recently had a dose escalation from 'as needed' dosing to 4 g daily, and the medication was being administered by nursing staff. Our experience shows that even when prescribed appropriately at the usual therapeutic dosage, paracetamol can be hepatotoxic. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Extreme-volatility dynamics in crude oil markets

NASA Astrophysics Data System (ADS)

Jiang, Xiong-Fei; Zheng, Bo; Qiu, Tian; Ren, Fei

2017-02-01

Based on concepts and methods from statistical physics, we investigate extreme-volatility dynamics in the crude oil markets, using the high-frequency data from 2006 to 2010 and the daily data from 1986 to 2016. The dynamic relaxation of extreme volatilities is described by a power law, whose exponents usually depend on the magnitude of extreme volatilities. In particular, the relaxation before and after extreme volatilities is time-reversal symmetric at the high-frequency time scale, but time-reversal asymmetric at the daily time scale. This time-reversal asymmetry is mainly induced by exogenous events. However, the dynamic relaxation after exogenous events exhibits the same characteristics as that after endogenous events. An interacting herding model both with and without exogenous driving forces could qualitatively describe the extreme-volatility dynamics.

A 12-Week Physical and Cognitive Exercise Program Can Improve Cognitive Function and Neural Efficiency in Community-Dwelling Older Adults: A Randomized Controlled Trial.

PubMed

Nishiguchi, Shu; Yamada, Minoru; Tanigawa, Takanori; Sekiyama, Kaoru; Kawagoe, Toshikazu; Suzuki, Maki; Yoshikawa, Sakiko; Abe, Nobuhito; Otsuka, Yuki; Nakai, Ryusuke; Aoyama, Tomoki; Tsuboyama, Tadao

2015-07-01

To investigate whether a 12-week physical and cognitive exercise program can improve cognitive function and brain activation efficiency in community-dwelling older adults. Randomized controlled trial. Kyoto, Japan. Community-dwelling older adults (N = 48) were randomized into an exercise group (n = 24) and a control group (n = 24). Exercise group participants received a weekly dual task-based multimodal exercise class in combination with pedometer-based daily walking exercise during the 12-week intervention phase. Control group participants did not receive any intervention and were instructed to spend their time as usual during the intervention phase. The outcome measures were global cognitive function, memory function, executive function, and brain activation (measured using functional magnetic resonance imaging) associated with visual short-term memory. Exercise group participants had significantly greater postintervention improvement in memory and executive functions than the control group (P < .05). In addition, after the intervention, less activation was found in several brain regions associated with visual short-term memory, including the prefrontal cortex, in the exercise group (P < .001, uncorrected). A 12-week physical and cognitive exercise program can improve the efficiency of brain activation during cognitive tasks in older adults, which is associated with improvements in memory and executive function. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Sleep Time Monitoring by Accelerometer in Two Subjects for 1 Year

NASA Astrophysics Data System (ADS)

KAWADA, T.; KUROIWA, M.; SASAZAWA, Y.; SUZUKI, S.; TAMURA, Y.

2002-02-01

The authors conducted sleep time monitoring using an activity-detecting device on a married couple. The subjects were a 39-year-old man and a 36-year-old woman. They were continuously monitored for 1 year or a half-year from 1998 to 1999. Their daily activities were not limited. The male works in an office 5 days a week and stays at home on weekends. The female is a farmer and works in the field when the weather is clear. They usually went to bed at 10-11 p.m. and got up around 6 a.m. the next morning on weekdays. The activity-monitoring device, Actiwatch®, was installed on the wrists of their non-dominant arms. The number of body movements was calculated by the summation of the active electricity number. There was no significant monthly difference in the mean nightly total sleep time (TST) by analysis of variance in either the husband or the wife. When nocturnal and diurnal sleep were combined for the analysis, the mean value in April or May, 1999, was significantly larger than the values in July, August, December or October, although only in the husband. The sleep time for Saturday or Sunday was significantly extended as compared to that of a weekday. Power spectrum analysis showed the TST cycle to predominate on all 7 days in the week in both subjects.

Impact of Dry Eye Symptoms and Daily Activities in a Modern Office.

PubMed

van Tilborg, Mirjam M; Murphy, Paul J; Evans, Katharine S

2017-06-01

Modern offices and the use of electronic devices are increasing factors in work-related eye symptoms. However, symptoms of eye fatigue or dry eye sensation can be mixed and confusing. This study surveys the eye symptoms reported during a working day at modern offices to investigate the possible inhibition on daily work activities. Two online digital surveys were sent to three different work locations, by direct e-mail. Survey A consisted of 14 questions that investigated eye symptoms experienced during daily activities at work and the impact on daily activities. Survey B consisted of four general questions, the Dutch Ocular Surface Disease Index, the Work Productivity and Activity Index, and the Illness Perception Questionnaire. A total of 505 participants completed survey A, and 213 completed survey B. The participants reported that a high proportion of their day was spent working on a computer (60%). The majority experienced an air draft (79.1%) and had no adjustable light (81.5%) at their workspace. Dry eye-related symptoms were reported at a significantly higher frequency at work than at home (P < .001). Up to 70% experienced some inhibition of daily activity at work due to eye symptoms, with more than 5% experiencing symptoms most or all of the time. Indoor environment, work environment, and general health were perceived as the main reasons for developing dry eye. Compared with males, females showed a statistically significant higher Ocular Surface Disease Index score (P < .001) and experienced more inhibition and adverse effects on daily life and work productivity. This investigation shows that dry eye symptoms have a negative impact on daily activities at work. These findings suggest that multidisciplinary understanding of the negative impact of dry eye by a range of specialists will be of help in managing work-related dry eye.

The relationships among Muslim Uyghur and Kazakh disabled elders' life satisfaction, activity of daily living, and informal family caregiver's burden, depression, and life satisfaction in far western China: A structural equation model.

PubMed

Wang, Wen Ting; He, Bin; Wang, Yu Huan; Wang, Mei Yan; Chen, Xue Feng; Wu, Fu Chen; Yang, Xue

2017-04-01

1 Hypothesis Disabled elders' activities of daily living, caregiver burden, caregiver depression, and caregivers' life satisfaction are significantly related to the life satisfaction of elderly people with disability. 2 Hypothesis There are direct and indirect effects between the life satisfaction of elders, disabled elders' activities of daily living, and family caregivers' factors. This study explored the interrelationships of disabled elders' life satisfaction and activities of daily living, caregivers' factors (burden, depression, and life satisfaction) through a structural equation model. In total, 621 dyads of disabled elders and informal family caregivers completed questionnaires during face-to-face interviews in Xinjiang Uyghur Autonomous Region from September 2013 to January 2014. Activity of daily living exerted a direct effect on life satisfaction of disabled elders and 30.4% indirect effect through caregivers' factors. Caregiver burden had a 60.0% direct effect on life satisfaction of disabled elders and a 40.0% indirect effect through the caregiver depression. Caregiver depression showed 76% direct effect on life satisfaction of disabled elders and 24% indirect effect through caregivers' life satisfaction. Direct relationships between activity of daily living and caregiver burden, caregiver burden and caregiver depression, and caregiver depression and caregivers' life satisfaction were observed. Activity of daily living had a 91.3% indirect effect on caregiver depression mediated by caregiver burden; caregiver burden had a 40.0% indirect effect on caregivers' life satisfaction mediated by caregiver depression. Results provide useful information for nurses and policymakers and shed light on the need to consider caregivers' factors in improving care recipients' life satisfaction. © 2017 John Wiley & Sons Australia, Ltd.

78 FR 2397 - Agency Information Collection Activities: Announcement of Board Approval Under Delegated...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

...--Division of Research and Statistics, Board of Governors of the Federal Reserve System, Washington, DC 20551... Report of Specific Issues (FR 2004SI), Daily Report of Specific Issues (FR 2004SD), Supplement to the Daily Report of Specific Issues (FR 2004SD ad hoc), and Daily Report of Dealer Activity in Treasury...

What is the relation between fear of falling and physical activity in older adults?

PubMed

Hornyak, Victoria; Brach, Jennifer S; Wert, David M; Hile, Elizabeth; Studenski, Stephanie; Vanswearingen, Jessie M

2013-12-01

To describe the association between fear of falling (FOF) and total daily activity in older adults. Cross-sectional observational study. Ambulatory clinical research training center. Community-dwelling older adults aged ≥64 years (N=78), who were independent in ambulation with or without an assistive device. Not applicable. FOF was defined by self-reported fear ratings using the Survey of Activities and Fear of Falling in the Elderly and self-reported fear status determined by response to the following question: Are you afraid of falling? Physical function was assessed using the Late Life Function and Disability Instrument. Physical activity was recorded using an accelerometer worn on the waist for 7 consecutive days, and mean daily counts of activity per minute were averaged over the 7-day period. Fear ratings were related to total daily activity (r=-.26, P=.02). The relation was not as strong as the relation of function and physical activity (r=.45, P<.001). When stratified by exercise status or functional status, fear was no longer related to total daily activity. Physical function explained 19% of the variance in physical activity, whereas the addition of fear status did not add to the explained variance in physical activity. FOF is related to total daily physical activity; however, FOF was not independently associated with physical activity when accounting for physical function. Some FOF may be reported as a limitation in function. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Daily insufficient sleep and active duty status.

PubMed

Chapman, Daniel P; Liu, Yong; McKnight-Eily, Lela R; Croft, Janet B; Holt, James B; Balkin, Thomas J; Giles, Wayne H

2015-01-01

We assessed the relationship between active duty status and daily insufficient sleep in a telephone survey. U.S. military service status (recent defined as past 12 months and past defined as >12 months ago) and daily insufficient sleep in the past 30 days were assessed among 566,861 adults aged 18 to 64 years and 271,202 adults aged ≥ 65 years in the 2009 to 2010 Behavioral Risk Factor Surveillance System surveys. Among ages 18 to 64 years, 1.1% reported recent active duty and 7.1% had past service; among ages ≥ 65 years, 0.6% reported recent and 24.6% had past service. Among ages 18 to 64 years, prevalence of daily insufficient sleep was 13.7% among those reporting recent duty, 12.6% for those with past service, and 11.2% for those with no service. Insufficient sleep did not vary significantly with active duty status among ages ≥ 65 years. After adjustment for sociodemographic characteristics, health behaviors, and frequent mental distress in multivariate logistic regression models, respondents aged 18 to 64 years with recent active duty were 34% more likely and those with past service were 23% more likely to report daily insufficient sleep than those with no service (p < 0.05, both). Adults with either recent or past active duty have a greater risk for daily insufficient sleep. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Satisfaction with daily occupations amongst asylum seekers in Denmark.

PubMed

Morville, Anne-Le; Erlandsson, Lena-Karin; Danneskiold-Samsøe, Bente; Amris, Kirstine; Eklund, Mona

2015-05-01

The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related to their satisfaction with daily occupations and activity level. A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social information were used as well as Assessment of Motor and Process Skills. The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow-up. Associations between AMPS process skills--education, worst pain and activity level--were present at baseline, as was a relationship between AMPS process skills and satisfaction. At follow-up, associations between WHO-5 and satisfaction and activity level and between MDI scores and activity level were found. Asylum seekers experience a low level of satisfaction with daily occupations, both at arrival and after 10 months in an asylum centre. There is a need for further research and development of occupation-focused rehabilitation methods for the asylum seeker population.

The evaluation of daily living activities, pressure sores and risk factors.

PubMed

Aydın, Gökçen; Mucuk, Salime

2015-01-01

This study was conducted to assess daily living activities, pressure sores and risk factors. This was a descriptive study. The study was conducted at a rehabilitation center with 188 individuals participating in the study. Data were collected with a questionnaire form, Activities of Daily Living Scale (ADLS), Instrumental Activities of Daily Living Scale (IADLS) and Braden Risk Assessment Scale (BRAS). Among the participants, 48.9% were dependent according to activities of daily living and 71.8% were dependent on instrumental activities of daily living. It was noted that 4.8% had pressure sores and 38.8% were at high risk. A strong and positive correlation was found among ADLS, IADLS, and BRAS scores (p < .001). Participants who had a low body mass index, had lived at the rehabilitation center for a long time, and were fed on regime 1 or 2, had a higher risk of developing pressure sores (p < .001). Individuals who were dependent according to ADLS and IADLS were at increased risk for the development of pressure sores. Individuals who are treated at rehabilitation centers should be periodically assessed in terms of risk. Pressure sore development can be prevented with appropriate nursing interventions. To reduce the risk of developing pressure sores, nurses should describe the individual's degree of dependency according to ADLS and IADLS and initiate preventive nursing care. © 2014 Association of Rehabilitation Nurses.

Effects of photophase illuminance on locomotor activity, urine production and urinary 6-sulfatoxymelatonin in nocturnal and diurnal South African rodents.

PubMed

van der Merwe, Ingrid; Oosthuizen, Maria K; Ganswindt, Andre; Haim, Abraham; Bennett, Nigel C

2017-05-01

Effects of photophase illuminance (1, 10, 100 and 330 lx of white incandescent lighting) on daily rhythms of locomotor activity, urine production and 6-sulfatoxymelatonin (6-SMT; 10 versus 330 lx) were studied in nocturnal Namaqua rock mice ( Micaelamys namaquensis ) and diurnal four-striped field mice ( Rhabdomys pumilio ). Micaelamys namaquensis was consistently nocturnal (∼90-94% nocturnal activity), whereas considerable individual variation marked activity profiles in R. pumilio , but with activity mostly pronounced around twilight (∼55-66% diurnal activity). The amplitude of daily activity was distinctly affected by light intensity and this effect was greater in M. namaquensis than in R. pumilio Only M. namaquensis displayed a distinctive daily rhythm of urine production, which correlated with its activity rhythm. Mean daily urine production appeared to be attenuated under dim photophase conditions, particularly in R. pumilio The results suggest that the circadian regulation of locomotor activity and urine production possesses separate sensitivity thresholds to photophase illuminance. Micaelamys namaquensis expressed a significant daily 6-SMT rhythm that peaked during the late night, but the rhythm was attenuated by the brighter photophase cycle (330 lx). Rhabdomys pumilio appeared to express an ultradian 6-SMT rhythm under both lighting regimes with comparable mean daily 6-SMT values, but with different temporal patterns. It is widely known that a natural dark phase which is undisturbed by artificial light is essential for optimal circadian function. Here, we show that light intensity during the photophase also plays a key role in maintaining circadian rhythms in rodents, irrespective of their temporal activity rhythm. © 2017. Published by The Company of Biologists Ltd.

Active travel and adults' health: The 2007-to-2011 Canadian Health Measures Surveys.

PubMed

Larouche, Richard; Faulkner, Guy; Tremblay, Mark S

2016-04-01

Active travel may be a means of integrating physical activity into an individual's routine. This analysis investigates the relationship between utilitarian walking and cycling and objectively measured physical activity and health-related outcomes in a nationally representative sample of Canadian adults. Adults aged 20 to 79 who participated in the 2007-to-2011 Canadian Health Measures Surveys (N = 7,160) reported the weekly time spent in utilitarian walking and cycling and wore an Actical accelerometer for seven days. They underwent a series of tests to measure physical fitness, body composition, blood pressure, and biomarkers. Differences in physical activity and health-related outcomes across levels of utilitarian walking and cycling were assessed with ANCOVA analyses adjusted for age, sex, education, household income, self-reported usual daily physical activity, and the complex survey design. Utilitarian walking and cycling were associated with moderate-to-vigorous physical activity in a graded manner. Compared with respondents who reported walking 1 to 5 hours a week, those who walked more than 5 hours a week had lower skinfold thickness. Respondents who reported cycling 1 or more hours a week had greater aerobic fitness and lower BMI, waist circumference, total cholesterol/HDL ratio, glycohemoglobin, C-reactive protein, and triglycerides than did those who did not cycle. They also had higher aerobic fitness and lower BMI and waist circumference than those who reported cycling less than an hour a week. Cycling at least an hour a week is associated with improved fitness and reduced cardiovascular disease risk factors. Both utilitarian walking and cycling may be means of increasing adults' moderate-to-vigorous physical activity.

Graded activity for low back pain in occupational health care: a randomized, controlled trial.

PubMed

Staal, J Bart; Hlobil, Hynek; Twisk, Jos W R; Smid, Tjabe; Köke, Albère J A; van Mechelen, Willem

2004-01-20

Low back pain is a common medical and social problem frequently associated with disability and absence from work. However, data on effective return to work after interventions for low back pain are scarce. To determine the effectiveness of a behavior-oriented graded activity program compared with usual care. Randomized, controlled trial. Occupational health services department of an airline company in the Netherlands. 134 workers who were absent from work because of low back pain were randomly assigned to either graded activity (n = 67) or usual care (n = 67). Graded activity, a physical exercise program based on operant-conditioning behavioral principles, to stimulate a rapid return to work. Outcomes were the number of days of absence from work because of low back pain, functional status (Roland Disability Questionnaire), and severity of pain (11-point numerical scale). The median number of days of absence from work over 6 months of follow-up was 58 days in the graded activity group and 87 days in the usual care group. From randomization onward, graded activity was effective after 50 days of absence from work (hazard ratio, 1.9 [95% CI, 1.2 to 3.2]; P = 0.009). The graded activity group was more effective in improving functional status and pain than the usual care group. The effects, however, were small and not statistically significant. Graded activity was more effective than usual care in reducing the number of days of absence from work because of low back pain.

Factors in daily physical activity related to calcaneal mineral density in men.

PubMed

Hutchinson, T M; Whalen, R T; Cleek, T M; Vogel, J M; Arnaud, S B

1995-05-01

To determine the factors in daily physical activity that influence the mineral density of the calcaneus, we recorded walking steps and the type and duration of exercise in 43 healthy 26-to 51-yr-old men. Areal (g.cm-2) calcaneal bone mineral density (CBMD) was measured by single energy x-ray densitometry (SXA, Osteon, Inc., Wahiawa, HI). Subjects walked a mean (+/- SD) of 7902 (+/- 2534) steps per day or approximately 3.9 (+/- 1.2) miles daily. Eight subjects reported no exercise activities. The remaining 35 subjects spent 143 (2-772) (median and range) min.wk-1 exercising. Twenty-eight men engaged in exercise activities that generate single leg peak vertical ground reaction forces (GRFz) of 2 or more body weights (high loaders, HL), and 15 reported exercise or daily activities that typically generate GRFz less than 1.5 body weights (low loaders, LL). CBMD was 12% higher in HL than LL (0.668 +/- 0.074 g.cm-2 vs 0.597 +/- 0.062 g.cm-2, P < 0.004). In the HL group, CBMD correlated to reported minutes of high load exercise (r = 0.41, P < 0.03). CBMD was not related to the number of daily walking steps (N = 43, r = 0.03, NS). The results of this study support the concept that the dominant factor in daily physical activity relating to bone mineral density is the participation in site specific high loading activities, i.e., for the calcaneus, high calcaneal loads.

Factors in Daily Physical Activity Related to Calcaneal Mineral Density in Men

NASA Technical Reports Server (NTRS)

Hutchinson, Teresa M.; Whalen, Robert T.; Cleek, Tammy M.; Vogel, John M.; Arnaud, Sara B.

1995-01-01

To determine the factors in daily physical activity that influence the mineral density of the calcaneus, we recorded walking steps and the type and duration of exercise in 43 healthy 26-to 51-yr-old men. Areal (g/sq cm) calcaneal bone mineral density (CBMD) was measured by single energy x-ray densitometry. Subjects walked a mean (+/- SD) of 7902(+/-2534) steps per day or approximately 3.9(+/-1.2) miles daily. Eight subjects reported no exercise activities. The remaining 35 subjects spent 143(2-772) (median and range) min/wk exercising. Twenty-eight men engaged in exercise activities that generate single leg peak vertical ground reaction forces (GRF(sub z)) of 2 or more body weights (high loaders, HL), and 15 reported exercise or daily activities that typically generate GRF(sub z) less than 1.5 body weights (low loaders, LL). CBMD was 12% higher in HL than LL (0.668 +/- 0.074 g/sq cm vs 0.597 +/- 0.062 g/sq cm, P less than 0.004). In the HL group, CBMD correlated to reported minutes of high load exercise (r = 0.41, P less than 0.03). CBMD was not related to the number of daily walking steps (N = 43, r = 0.03, NS). The results of this study support the concept that the dominant factor in daily physical activity relating to bone mineral density is the participation in site specific high loading activities, i.e., for the calcaneus, high calcaneal loads.

[The development and effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention].

PubMed

Son, Youn-Jung

2008-04-01

This study was conducted to develop and to determine the effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention. Subjects consisted of 58 CAD patients (experimental group: 30, control group: 28). The experimental group participated in an integrated symptom management program for 6 months which was composed of tailored education, stress management, exercise, diet, deep breathing, music therapy, periodical telephone monitoring and a daily log. The control group received the usual care. The experimental group significantly decreased symptom experiences and the level of LDL compared to the control group. The experimental group significantly increased self care activity and quality of life compared to the control group. Although no significant difference was found in cardiac recurrence, the experimental group had fewer recurrences. These results suggest that an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention can improve symptom aggravation, recurrent rate, self care activity and quality of life. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented in the overall transition period.

Driving: a road to unhealthy lifestyles and poor health outcomes.

PubMed

Ding, Ding; Gebel, Klaus; Phongsavan, Philayrath; Bauman, Adrian E; Merom, Dafna

2014-01-01

Driving is a common part of modern society, but its potential effects on health are not well understood. The present cross-sectional study (n = 37,570) examined the associations of driving time with a series of health behaviors and outcomes in a large population sample of middle-aged and older adults using data from the Social, Economic, and Environmental Factor Study conducted in New South Wales, Australia, in 2010. Multiple logistic regression was used in 2013 to examine the associations of usual daily driving time with health-related behaviors (smoking, alcohol use, diet, physical activity, sedentary behavior, sleep) and outcomes (obesity, general health, quality of life, psychological distress, time stress, social functioning), adjusted for socio-demographic characteristics. Findings suggested that longer driving time was associated with higher odds for smoking, insufficient physical activity, short sleep, obesity, and worse physical and mental health. The associations consistently showed a dose-response pattern and more than 120 minutes of driving per day had the strongest and most consistent associations with the majority of outcomes. This study highlights driving as a potential lifestyle risk factor for public health. More population-level multidisciplinary research is needed to understand the mechanism of how driving affects health.

Strength and ability to implement the activities of daily living in elderly resident in rural areas.

PubMed

Vasconcelos Rocha, Saulo; Souza Dos Santos, Samara; Carneiro Vasconcelos, Lélia Renata; Alves Dos Santos, Clarice

2016-09-30

To examine the association between muscle strength and the ability to perform basic and instrumental activities of daily living in elderly resident in rural areas of Jequie, Brazil. We performed a cross-sectional design study with a population of 104 individuals aged sixty or older, registered in the Family Health Unit of the district of Itajuru, Jequie-Brazil. Data collection was performed using a standardized instrument used as an interview, followed by the application of tests (bending arm with dumbbell and rising from a chair 30 sec). The basic and instrumental activities of daily living were investigated through the Katz and Lawton scales, respectively. The chi-square test with p ≤0.05 was used as a measure of statistical significance for bivariate analyzes between muscle strength and ability to perform daily activities. The results showed a significant association between muscle strength and dynamic ability to perform activities of daily living. Reduced muscle strength is an important predictor of the functional ability of the elderly. Accordingly, it is recommended to observe muscle strength in actions directed at the elderly.

Cancer-related fatigue and physical activity among premenopausal cervical and endometrial cancer survivors in Japan.

PubMed

Obama, Kyoko; Maru, Mitsue; Maeda, Rumi; Kubota, Toshiro

2015-09-30

To examine the relationship between cancer-related fatigue (CRF) and physical activity in daily living in premenopausal disease-free cervical and endometrial cancer survivors. A physical activity monitor was used to collect objective data on daily physical activity. CRF and related variables were measured using self-report scales in a cross-sectional manner. The average age was 44.9 years among 64 women. The higher CRF group comprised 22 women (34%), 10% of whom had severe fatigue. The participants had higher physical activity levels compared with the findings in previous studies, and reported an average of 40 min/day of moderate to vigorous activity. Moderate to vigorous levels of physical activity were derived from essential social activities rather than leisure time exercise. There were no significant differences in physical activity levels between the lower and higher CRF groups. Our study results suggested that the higher level of physical activity in daily living itself had no relationship with decreasing CRF among premenopausal cervical and endometrial cancer survivors. It would be better to focus on cognitive and psychological factors before introducing physical activity programs and be careful of the characteristics of the participants' physical activity among this population in daily basis.

Self-reported taste preference can be a proxy for daily sodium intake in middle-aged Japanese adults.

PubMed

Takachi, Ribeka; Ishihara, Junko; Iwasaki, Motoki; Ishii, Yuri; Tsugane, Shoichiro

2014-05-01

Reducing dietary salt intake remains a challenging issue in the management of chronic disease. Taste preference is suspected to be an important proxy index of daily sodium consumption. This study examined the difference in daily sodium intake according to self-reported taste preference for miso soup as representative of homemade cooking in middle-aged urban Japanese adults. Among 896 candidates randomly selected from examinees of cancer screening provided by the National Cancer Center, Japan, 143 men and women participated in this cross-sectional study. During the period from May 2007 through April 2008, participants provided a food frequency questionnaire, which included information on taste preference and dietary behaviors, a weighed food record over 4 consecutive days, a simultaneous 24-hour urine collection, and a sample of miso soup as it is usually prepared in the home. Mean 24-hour urinary sodium excretion and daily sodium intake were compared according to the self-reported taste preference for miso soup. Taste preference was significantly associated with both 24-hour urinary sodium excretion (trend P<0.01) and daily sodium intake (trend P=0.01), with a corresponding regression coefficient per 1 rank preference increment of 403 mg and 315 mg/day, respectively. The observed association between preference and urinary excretion was attenuated by further adjustment for discretionary salt-related behaviors. These findings suggest that self-reported taste preference for homemade cooking is a defining feature of daily sodium intake through discretionary salt-related dietary behaviors. A reduction in daily sodium consumption per 1 rank light preference was estimated to equate to approximately 1 g salt/day. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

A cluster randomised controlled trial evaluating the effectiveness and cost-effectiveness of the daily mile on childhood obesity and wellbeing; the Birmingham daily mile protocol.

PubMed

Breheny, Katie; Adab, Peymane; Passmore, Sandra; Martin, James; Lancashire, Emma; Hemming, Karla; Frew, Emma

2018-01-11

Childhood obesity prevention is a public health priority. Children spend a large proportion of their waking time in school; therefore this is an appropriate setting to implement obesity prevention initiatives. Anecdotal reports suggest that implementing The Daily Mile in schools has had positive effects on childhood obesity, academic attainment and wellbeing. This trial aims to measure the effectiveness of The Daily Mile for improving health and wellbeing. This protocol describes a cluster randomised controlled trial (RCT) in 40 primary schools located in Birmingham, UK. Eligible participants are children in years 3 (aged 7-8) and 5 (aged 9-10). The study compares The Daily Mile (intervention) to usual practice (control) in relation to health and wellbeing. The Daily Mile intervention involves an additional 15 min of running or walking integrated into the school day, throughout a 12 month study period. The primary clinical outcome is body mass index (BMI) z-scores at 12 months following introduction of the intervention. The cost per Quality Adjusted Life Year (QALY) is the primary outcome of the economic evaluation. Secondary outcomes include wellbeing, physical fitness and teacher reported academic attainment. This study is the first RCT investigating the clinical and cost-effectiveness of The Daily Mile. A range of outcomes will be measured to evaluate the broader wellbeing and academic benefits in addition to clinical outcomes typically measured in childhood obesity prevention trials. The intervention is simple and low-cost, therefore if the benefits are demonstrated it has enormous potential to influence future policy. ISRCTN: 12698269 . Date protocol registered 27th October 2016.

The Relationship between Activities of Daily Living and Life Satisfaction in the Elderly: Active Engagement as Compared to Passive Participation.

ERIC Educational Resources Information Center

Iannuzzelli, Jena; England, Eileen M.

Daily activities and social contact were studied as influences on the life satisfaction of elderly people. It was considered that all activities might not be equal and that individuals who participate in more active activities and who have more active social contacts would score higher in life satisfaction than those who engage in inactive…

Time Use as Cause and Consequence of Youth Development

PubMed Central

Lam, Chun Bun; McHale, Susan M.

2014-01-01

From an ecological perspective, daily activities are both causes and consequences of youth development. As causes, daily activities represent distinct sets of socialization experiences that afford opportunities to acquire new competencies and behavioral patterns. As consequences, daily activities reflect youth’s force and resource characteristics, including developmental status, temperament and motivation, and pre-existing levels of adjustment. An ecological perspective also highlights the role of the larger sociocultural context in shaping and conditioning the links between daily activities and youth development. In this article, we draw on research with children and adolescents to consider how an ecological perspective can provide a flexible framework for studying time use as a developmental phenomenon. We also discuss methodological issues and suggest research that should be conducted in this broad area. PMID:25821514

Examination of Children's Recess Physical Activity Patterns Using the Activities for Daily Living-Playground Participation (ADL-PP) Instrument

ERIC Educational Resources Information Center

Stellino, Megan Babkes; Sinclair, Christina

2014-01-01

Thorough assessment of children's physical activity is essential to efficacious interventions to reduce childhood obesity prevalence. The purpose of this study was to examine children's recess physical activity (RPA) patterns of behavior using the Activities of Daily Living-Playground Participation (ADL-PP: Watkinson et al., 2001) instrument.…

Maternally-derived antibodies in pups and protection from canine parvovirus infection.

PubMed

Decaro, Nicola; Campolo, Marco; Desario, Costantina; Elia, Gabriella; Martella, Vito; Lorusso, Eleonora; Buonavoglia, Canio

2005-12-01

The interaction between maternally-derived antibodies (MDA) and canine parvovirus (CPV) infection was evaluated in five groups of pups with a wide range of haemagglutination inhibiting (HI) titres of MDA (from < 10 to 320). The pups were inoculated with a field CPV strain and monitored daily to evaluate their clinical condition and viral shedding in the faeces. Serum samples were collected weekly to evaluate antibody response. Clinical signs were observed in dogs with HI titres up to 80. Active CPV replication was demonstrated in dogs with HI titres up to 160, although slightly delayed, at lower titres and for a shorter period compared to seronegative dogs. The successful infection of dogs with HI titres of 80 and 160 was also confirmed by seroconversion, evaluated at day 14 postinfection. These findings are in contrast with the MDA titre (HI > or = 80) usually considered fully protective for CPV infection, and suggest the need for revision of current vaccination programmes for pups.

The Vespid Allergy Quality of Life Questionnaire - cultural adaptation and translation to Portuguese.

PubMed

Silva, D; Pereira, A M; Santos, N; Amaral, L; Delgado, L; Oude Elberink, J N; Coimbra, A

2017-05-01

A cross-cultural translation of the Vespid Allergy Quality of Life Questionnaire (VQLQ) to the Portuguese population (VQLQ-P) was performed, assessing its applicability in wasp and in non-beekeeper bee venom allergic patients. Additionally, we evaluated a Visual Analogue Scale (VAS) to estimate hymenoptera allergy interference with daily life. Methods. Cross-cultural translation was performed according to recommendations. The final VQLQ-P version, the Expectation of Outcome questionnaire (EoQ), EQ-5D and VAS were applied to wasp (n = 19) and non-beekeeper bee venom allergic patients (n = 30). Results. VQLQ-P significantly correlated with EoQ, (r = 0.76, p < 0.01), EQ-5D (usual activities and anxiety / depression dimensions) and VAS, with a good internal consistency (Cronbach α = 0.88) in wasp allergic individuals. VQLQ-P and EoQ correlation was also high (r = 0.67, p < 0.01) in bee allergy. Conclusion. The VQLQ-P is a valuable tool to evaluate quality of life impairment in Portuguese hymenoptera venom allergic individuals.

Does Posting Facebook Status Updates Increase or Decrease Loneliness? An Online Social Networking Experiment

PubMed Central

Deters, Fenne große; Mehl, Matthias R.

2013-01-01

Online social networking is a pervasive but empirically understudied phenomenon. Strong public opinions on its consequences exist but are backed up by little empirical evidence and almost no causally-conclusive, experimental research. The current study tested the psychological effects of posting status updates on Facebook using an experimental design. For one week, participants in the experimental condition were asked to post more than they usually do, whereas participants in the control condition received no instructions. Participants added a lab “Research Profile” as a Facebook friend allowing for the objective documentation of protocol compliance, participants’ status updates, and friends’ responses. Results revealed (1) that the experimentally-induced increase in status updating activity reduced loneliness, (2) that the decrease in loneliness was due to participants feeling more connected to their friends on a daily basis and (3) that the effect of posting on loneliness was independent of direct social feedback (i.e. responses) by friends. PMID:24224070

Recurrent abdominal pain in childhood.

PubMed

Chiou, Fang Kuan; How, Choon How; Ong, Christina

2013-04-01

Recurrent abdominal pain in childhood is common, and continues to be a diagnostic and therapeutic challenge. It is usually attributed to a functional gastrointestinal disorder rather than an organic disease. In most cases, a comprehensive history and physical examination should enable one to make a positive diagnosis of functional disorder. The presence of alarm symptoms and signs, such as weight loss, gastrointestinal bleeding and chronic severe diarrhoea, warrants further investigations and referral to a paediatric gastrointestinal specialist. The mainstay of therapy in functional abdominal pain is education, reassurance and avoidance of triggering factors. While symptom-based pharmacological therapy may be helpful in patients who do not respond to simple management, it is best used on a time-limited basis due to the lack of good evidence of its efficacy. The primary goal of therapy is a return to normal daily activities rather than complete elimination of pain. In recalcitrant cases, psychological interventions such as cognitive behaviour therapy and relaxation training have proven to be efficacious.

Lumbar spinal mobility changes among adults with advancing age

PubMed Central

Saidu, Ismaila Adamu; Maduagwu, Stanley Monday; Abbas, Abdullahi Digil; Adetunji, Omotayo O.; Jajere, Abdurahman Mohammed

2011-01-01

Background: Limitations in spinal mobility can interfere with the attainment of important functional skills and activities of daily living and restrictions in spinal mobility are usually the earliest and reliable indicator of diseases. Objective: The aim of this study was to determine the differences of lumbar spinal mobility among healthy adults with advancing age. Materials and Methods: The modified Schober's method was used to measure anterior flexion. The guideline of the American Academy of Orthopaedic Surgeons was adapted to measure lateral flexion and extension. Results: The results of this study indicate that spinal mobility decreases with advancing age. The most significant (P < 0.05) differences occurred between the two youngest and the two oldest age categories. Conclusion: Using these data, we developed normative values of spinal mobility for each sex and age group. This study helps the clinicians to understand and correlate the restrictions of lumbar spinal mobility due to age and differentiate the limitations due to disease. PMID:22408334

A qualitative study on trainees' and supervisors' perceptions of assessment for learning in postgraduate medical education.

PubMed

Dijksterhuis, Marja G K; Schuwirth, Lambert W T; Braat, Didi D M; Teunissen, Pim W; Scheele, Fedde

2013-08-01

Recent changes in postgraduate medical training curricula usually encompass a shift towards more formative assessment, or assessment for learning. However, though theoretically well suited to postgraduate training, evidence is emerging that engaging in formative assessment in daily clinical practice is complex. We aimed to explore trainees' and supervisors' perceptions of what factors determine active engagement in formative assessment. Focus group study with postgraduate trainees and supervisors in obstetrics and gynaecology. Three higher order themes emerged: individual perspectives on feedback, supportiveness of the learning environment and the credibility of feedback and/or feedback giver. Engaging in formative assessment with a genuine impact on learning is complex and quite a challenge to both trainees and supervisors. Individual perspectives on feedback, a supportive learning environment and credibility of feedback are all important in this process. Every one of these should be taken into account when the utility of formative assessment in postgraduate medical training is evaluated.

Verification of space weather forecasts at the UK Met Office

NASA Astrophysics Data System (ADS)

Bingham, S.; Sharpe, M.; Jackson, D.; Murray, S.

2017-12-01

The UK Met Office Space Weather Operations Centre (MOSWOC) has produced space weather guidance twice a day since its official opening in 2014. Guidance includes 4-day probabilistic forecasts of X-ray flares, geomagnetic storms, high-energy electron events and high-energy proton events. Evaluation of such forecasts is important to forecasters, stakeholders, model developers and users to understand the performance of these forecasts and also strengths and weaknesses to enable further development. Met Office terrestrial near real-time verification systems have been adapted to provide verification of X-ray flare and geomagnetic storm forecasts. Verification is updated daily to produce Relative Operating Characteristic (ROC) curves and Reliability diagrams, and rolling Ranked Probability Skill Scores (RPSSs) thus providing understanding of forecast performance and skill. Results suggest that the MOSWOC issued X-ray flare forecasts are usually not statistically significantly better than a benchmark climatological forecast (where the climatology is based on observations from the previous few months). By contrast, the issued geomagnetic storm activity forecast typically performs better against this climatological benchmark.

[Post-polio syndrome. A case report].

PubMed

Bartman, Wojciech; Biernawska, Jolanta; ŁAbuz-Roszak, Beata; Kumor, Klaudiusz; Pierzchała, Krystyna

2004-01-01

Certain acute anterior poliomyelitis survivors express complaints of abnormal fatigue, weakness and muscular atrophy many years after acute onset. These are basic clinical symptoms of so-called post-polio syndrome (PPS). PPS is characterized by a relatively slow, but progressive pathological muscular process, in some cases leading to functional impairment of daily living and professional activity. Breathing, speaking and swallowing impairment are common but not severe medical problems of post-polio patients. Diagnosis is usually based on a typical medical history, electromyographic investigation and exclusion of other diseases presenting similar features. We report a case of PPS in a 49-year-old woman diagnosed in the Neurological Department in Zabrze. Thirty six years after acute anterior poliomyelitis with partial recovery, new symptoms of fatigue, muscular atrophy, exertional dyspnea, walking impairment and joint pain developed. Electromyography revealed features of coexisting spinal denervation and reinnervation in tested muscles. The differential diagnosis excluded other neuromuscular diseases. The patient fulfilled clinical and electromyographic criteria of PPS.

Surgical Management of Ruptured Isolated Aneurysm of Artery of Adamkiewicz: Interesting Report and Overview of Literature.

PubMed

Aljuboori, Zaid; Sharma, Mayur; Simpson, Jessica; Altstadt, Thomas

2018-03-01

Spinal subarachnoid hemorrhage due to rupture of an isolated spinal aneurysm is extremely rare. Patients usually present with symptoms and signs resulting from spinal cord compression. No standard guidelines are available for the treatment of this condition. In this report we present the case of a 78-year-old Caucasian male who presented with sudden-onset back pain and bilateral lower extremity weakness. Spinal angiogram revealed an isolated aneurysm of the artery of Adamkiewicz. The aneurysm was successfully managed by surgical clipping, and the patient recovered well with rehabilitation. At 46 months' follow-up, the patient was able to ambulate and perform activities of daily living independently. Our case is the first description of surgical clipping of a ruptured isolated spinal aneurysm of the artery of Adamkiewicz with a long-term successful outcome and shows that it is a safe and feasible option in carefully selected patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Daily torpor and hibernation in birds and mammals

PubMed Central

RUF, THOMAS; GEISER, FRITZ

2014-01-01

Many birds and mammals drastically reduce their energy expenditure during times of cold exposure, food shortage, or drought, by temporarily abandoning euthermia, i.e., the maintenance of high body temperatures. Traditionally, two different types of heterothermy, i.e., hypometabolic states associated with low body temperatures (torpor), have been distinguished: Daily torpor, which lasts less than 24 h and is accompanied by continued foraging, versus hibernation, with torpor bouts lasting consecutive days to several weeks in animals that usually do not forage but rely on energy stores, either food caches or body energy reserves. This classification of torpor types has been challenged however, suggesting that these phenotypes may merely represent the extremes in a continuum of traits. Here, we investigate whether variables of torpor in 214 species, 43 birds and 171 mammals form a continuum or a bimodal distribution. We use Gaussian-mixture cluster analysis as well as phylogenetically informed regressions to quantitatively assess the distinction between hibernation and daily torpor and to evaluate the impact of body mass and geographical distribution of species on torpor traits. Cluster analysis clearly confirmed the classical distinction between daily torpor and hibernation. Overall, heterothermic endotherms are small on average, but hibernators are significantly heavier than daily heterotherms and also are distributed at higher average latitudes (~35°) than daily heterotherms (~25°). Variables of torpor for an average 30-g heterotherm differed significantly between daily heterotherms and hibernators. Average maximum torpor bout duration was >30-fold longer, and mean torpor bout duration >25-fold longer in hibernators. Mean minimum body temperature differed by ~13°C, and the mean minimum torpor metabolic rate was ~35% of the BMR in daily heterotherms but only 6% of basal metabolic rate in hibernators. Consequently, our analysis strongly supports the view that hibernators and daily heterotherms are functionally distinct groups that probably have been subject to disruptive selection. Arguably, the primary physiological difference between daily torpor and hibernation, which leads to a variety of derived further distinct characteristics, is the temporal control of entry into and arousal from torpor, which is governed by the circadian clock in daily heterotherms, but apparently not in hibernators. PMID:25123049

Time to pay attention: attentional performance time-stamped prefrontal cholinergic activation, diurnality and performance

PubMed Central

Paolone, Giovanna; Lee, Theresa M.; Sarter, Martin

2012-01-01

Although the impairments in cognitive performance that result from shifting or disrupting daily rhythms have been demonstrated, the neuronal mechanisms that optimize fixed time daily performance are poorly understood. We previously demonstrated that daily practice of a sustained attention task (SAT) evokes a diurnal activity pattern in rats. Here we report that SAT practice at a fixed time produced practice time-stamped increases in prefrontal cholinergic neurotransmission that persisted after SAT practice was terminated and in a different environment. SAT time-stamped cholinergic activation occurred irrespective of whether the SAT was practiced during the light or dark phase or in constant light conditions. In contrast, prior daily practice of an operant schedule of reinforcement, albeit generating more rewards and lever presses per session than the SAT, neither activated the cholinergic system nor affected the animals' nocturnal activity pattern. Likewise, food-restricted animals exhibited strong food anticipatory activity (FAA) and attenuated activity during the dark period but FAA was not associated with increases in prefrontal cholinergic activity. Removal of cholinergic neurons impaired SAT performance and facilitated the reemergence of nocturnality. Shifting SAT practice away from a fixed time resulted in significantly lower performance. In conclusion, these experiments demonstrated that fixed time, daily practice of a task assessing attention generates a precisely practice time-stamped activation of the cortical cholinergic input system. Time-stamped cholinergic activation benefits fixed time performance and, if practiced during the light phase, contributes to a diurnal activity pattern. PMID:22933795

Time to pay attention: attentional performance time-stamped prefrontal cholinergic activation, diurnality, and performance.

PubMed

Paolone, Giovanna; Lee, Theresa M; Sarter, Martin

2012-08-29

Although the impairments in cognitive performance that result from shifting or disrupting daily rhythms have been demonstrated, the neuronal mechanisms that optimize fixed-time daily performance are poorly understood. We previously demonstrated that daily practice of a sustained attention task (SAT) evokes a diurnal activity pattern in rats. Here, we report that SAT practice at a fixed time produced practice time-stamped increases in prefrontal cholinergic neurotransmission that persisted after SAT practice was terminated and in a different environment. SAT time-stamped cholinergic activation occurred regardless of whether the SAT was practiced during the light or dark phase or in constant-light conditions. In contrast, prior daily practice of an operant schedule of reinforcement, albeit generating more rewards and lever presses per session than the SAT, neither activated the cholinergic system nor affected the animals' nocturnal activity pattern. Likewise, food-restricted animals exhibited strong food anticipatory activity (FAA) and attenuated activity during the dark phase but FAA was not associated with increases in prefrontal cholinergic activity. Removal of cholinergic neurons impaired SAT performance and facilitated the reemergence of nocturnality. Shifting SAT practice away from a fixed time resulted in significantly lower performance. In conclusion, these experiments demonstrated that fixed-time, daily practice of a task assessing attention generates a precisely practice time-stamped activation of the cortical cholinergic input system. Time-stamped cholinergic activation benefits fixed-time performance and, if practiced during the light phase, contributes to a diurnal activity pattern.

Counting Steps in Activities of Daily Living in People With a Chronic Disease Using Nine Commercially Available Fitness Trackers: Cross-Sectional Validity Study

PubMed Central

Beekman, Emmylou; Theunissen, Kyra; Braun, Susy; Beurskens, Anna J

2018-01-01

Background Measuring physical activity with commercially available activity trackers is gaining popularity. People with a chronic disease can especially benefit from knowledge about their physical activity pattern in everyday life since sufficient physical activity can contribute to wellbeing and quality of life. However, no validity data are available for this population during activities of daily living. Objective The aim of this study was to investigate the validity of 9 commercially available activity trackers for measuring step count during activities of daily living in people with a chronic disease receiving physiotherapy. Methods The selected activity trackers were Accupedo (Corusen LLC), Activ8 (Remedy Distribution Ltd), Digi-Walker CW-700 (Yamax), Fitbit Flex (Fitbit inc), Lumoback (Lumo Bodytech), Moves (ProtoGeo Oy), Fitbit One (Fitbit inc), UP24 (Jawbone), and Walking Style X (Omron Healthcare Europe BV). In total, 130 persons with chronic diseases performed standardized activity protocols based on activities of daily living that were recorded on video camera and analyzed for step count (gold standard). The validity of the trackers’ step count was assessed by correlation coefficients, t tests, scatterplots, and Bland-Altman plots. Results The correlations between the number of steps counted by the activity trackers and the gold standard were low (range: –.02 to .33). For all activity trackers except for Fitbit One, a significant systematic difference with the gold standard was found for step count. Plots showed a wide range in scores for all activity trackers; Activ8 showed an average overestimation and the other 8 trackers showed underestimations. Conclusions This study showed that the validity of 9 commercially available activity trackers is low measuring steps while individuals with chronic diseases receiving physiotherapy engage in activities of daily living. PMID:29610110