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Sample records for adl process

  1. Ineffective ADL skills in women with fibromyalgia

    DEFF Research Database (Denmark)

    Von Bülow, Cecilie; Amris, Kirstine; la Cour, Karen

    2016-01-01

    BACKGROUND: Subgroups of women with fibromyalgia likely show different activity of daily living (ADL) skill deficits. Identifying ineffective ADL skills of significance in the 'typical' woman with fibromyalgia will promote the planning of targeted occupational therapy interventions aiming...... at improving ADL ability. OBJECTIVE: To identify frequently reported ADL skill deficits of significance in subgroups of women with fibromyalgia who have decreased ADL motor ability in combination with decreased or competent ADL process ability. METHOD: Women with fibromyalgia were evaluated with the Assessment...... of Motor and Process Skills (AMPS). If they demonstrated decreased ADL motor ability, the calibrated AMPS raters identified and reported ineffective ADL skills of significance. Descriptive comparisons were made between subgroups displaying either decreased or competent ADL process ability. RESULTS: Moves...

  2. A Process for the Representation of openEHR ADL Archetypes in OWL Ontologies.

    Science.gov (United States)

    Porn, Alex Mateus; Peres, Leticia Mara; Didonet Del Fabro, Marcos

    2015-01-01

    ADL is a formal language to express archetypes, independent of standards or domain. However, its specification is not precise enough in relation to the specialization and semantic of archetypes, presenting difficulties in implementation and a few available tools. Archetypes may be implemented using other languages such as XML or OWL, increasing integration with Semantic Web tools. Exchanging and transforming data can be better implemented with semantics oriented models, for example using OWL which is a language to define and instantiate Web ontologies defined by W3C. OWL permits defining significant, detailed, precise and consistent distinctions among classes, properties and relations by the user, ensuring the consistency of knowledge than using ADL techniques. This paper presents a process of an openEHR ADL archetypes representation in OWL ontologies. This process consists of ADL archetypes conversion in OWL ontologies and validation of OWL resultant ontologies using the mutation test.

  3. Differences between questionnaire-and interview-based measures of activities of daily living (ADL) ability and their association with observed ADL ability in women with rheumatoid arthritis, knee osteoarthritis, and fibromyalgia

    DEFF Research Database (Denmark)

    Wæhrens, E. E.; Bliddal, Henning; Danneskiold-Samsøe, Bente

    2012-01-01

    Objectives: Although self-report based on questionnaire is the common method to obtain information about activities of daily living (ADL) ability in rheumatic diseases, little is known about the relationship between measures of ADL ability based on questionnaire, interview, and observation. The p...... of self-reported ADL ability based on either questionnaire or interview have limited relationship to each other or to observed performance of ADL tasks....... the relationships between self-reported and observed ADL ability. Method: The 47 ADL tasks of the ADL taxonomy were used to evaluate self-reported ADL ability based on questionnaire (ADL-Q) and interview (ADL-I), and the Assessment of Motor and Process Skills (AMPS) was used to obtain measures of observed ADL......Objectives: Although self-report based on questionnaire is the common method to obtain information about activities of daily living (ADL) ability in rheumatic diseases, little is known about the relationship between measures of ADL ability based on questionnaire, interview, and observation...

  4. Trainee Occupational Therapists Scoring the Barthel ADL.

    Science.gov (United States)

    Martin, Elizabeth; Nugent, Chris; Bond, Raymond; Martin, Suzanne

    2015-09-01

    Within medical applications there are two main types of information design; paper-based and digital information [1]. As technology is constantly changing, information within healthcare management and delivery is continually being transitioned from traditional paper documents to digital and online resources. Activity of Daily Living (ADL) charts are still predominantly paper based and are therefore prone to "human error" [2]. In light of this, an investigation has taken place into the design for reducing the amount of human error, between a paper based ADL, specifically the Barthel Index, and the same ADL created digitally. The digital ADL was developed as an online platform as this offers the best method of data capture for a large group of participants all together [3]. The aim of the study was to evaluate the usability of the Barthel Index ADL in paper format and then reproduce the same ADL digitally. This paper presents the findings of a study involving 26 participants who were familiar with ADL charts, and used three scenarios requiring them to complete both a paper ADL and a digital ADL. An evaluation was undertaken to ascertain if there were any 'human errors' in completing the paper ADL and also to find similarities/differences through using the digital ADL. The results from the study indicated that 22/26 participants agreed that the digital ADL was better, if not the same as a paper based ADL. Further results indicated that participants rate highly the added benefit of the digital ADL being easy to use and also that calculation of assessment scores were performed automatically. Statistically the digital BI offered a 100 % correction rate in the total calculation, in comparison to the paper based BI where it is more common for users to make mathematical calculation errors. Therefore in order to minimise handwriting and calculation errors, the digital BI proved superior than the traditional paper based method.

  5. Self-reported and Observed Quality of ADL Task Performance in Adults with Depression

    DEFF Research Database (Denmark)

    Nielsen, Kristina Tomra; Wæhrens, Eva

    diagnosed with depression (range 19-79, median 45,5) Procedure In order to evaluate the participants’ self-reported and observed quality of ADL task performance the ADL-Interview (ADL-I) and the Assessment of Motor and Process Skills (AMPS) were chosen. Both instruments are developed to evaluate and measure...... the quality of ADL task performance. The ADL-I was conducted first and thereby formed the basis for identifying relevant tasks for the AMPS evaluation. Both evaluations were conducted on the same day by trained and calibrated occupational therapists. Results The results indicated that the participants both...

  6. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain

    DEFF Research Database (Denmark)

    Wæhrens, Eva Ejlersen; Amris, Kirstine; Fisher, Anne G

    2010-01-01

    . The investigated psychometric properties of the AMPS included discrimination between a sample of healthy women and those with chronic widespread pain, as well as stability when no intervention was provided and sensitivity to change following intervention. Data were obtained based on a repeated measures design......-report and performance-based assessment of ADL offer distinct but complementary information about ability. The present study, therefore, investigated the applicability of a performance-based measure of ADL ability, the Assessment of Motor and Process Skills (AMPS), among 50 women with chronic widespread pain...... performing AMPS evaluations twice pre- and twice post-rehabilitation. Results indicated that the ADL motor ability measures of the participants were significantly lower than those of healthy women of same age, the ADL motor and ADL process ability measures remained stable when no intervention was provided...

  7. Are there cross-cultural differences of ADL ability in children measured with the Assessment of Motor and Process Skills (AMPS)?

    Science.gov (United States)

    Peny-Dahlstrand, Marie; Gosman-Hedström, Gunilla; Krumlinde-Sundholm, Lena

    2012-01-01

    In many studies of self-care assessments for children, cultural differences in age-norm values have been shown. No study has evaluated whether there are cross-cultural differences in ADL motor and/or process skills in children when measured with the Assessment of Motor and Process Skills (AMPS). To investigate if there were systematic differences in ADL ability measured with the AMPS between children from the Nordic countries and North America and to evaluate the applicability of the existing international age-normative values for children from these two regions. Values from a total of 4 613 children, 3-15 years old, without known disabilities, from these geographical regions were compared with ANOVA. The difference in logits between each region and the mean values for each age group were calculated. No differences of relevance in age-related ADL ability measures between children from the two geographical regions were found, and the age-norm values are applicable to both regions. The AMPS may be considered free from cultural bias and useful in both clinical practice and research concerned with children in both the Nordic countries and North America.

  8. Sensitivity of different ADL measures to apraxia and motor impairments.

    Science.gov (United States)

    Donkervoort, Mireille; Dekker, Joost; Deelman, Betto G

    2002-05-01

    To determine whether specifically designed activities of daily living (ADL) observations can measure disability due to apraxia with more sensitivity than the Barthel ADL Index, a conventional functional scale. Cross-sectional study. Rehabilitation centres and nursing homes. One hundred and six left hemisphere stroke patients with apraxia, hospitalized in rehabilitation centres and nursing homes. ADL observations, Barthel ADL Index, an apraxia test, Motricity Index, Functional Motor Test. Multivariate analyses showed that the specific ADL observations were associated with severity of apraxia (and not with motor impairments). The Barthel ADL Index was associated with motor impairments (and not with severity of apraxia). The assessment of disability in stroke patients with apraxia cannot rely only on the Barthel ADL Index. In addition, the specific ADL observation procedure is needed to measure disability due to apraxia.

  9. Sensitivity of different ADL measures to apraxia and motor impairments

    OpenAIRE

    Donkervoort, M.; Dekker, J.; Deelman, B.G.

    2002-01-01

    Objective: To determine whether specifically designed activities of daily living (ADL) observations can measure disability due to apraxia with more sensitivity than the Barthel ADL Index, a conventional functional scale. Design: Cross-sectional study. Setting: Rehabilitation centres and nursing homes. Subjects: One hundred and six left hemisphere stroke patients with apraxia, hospitalized in rehabilitation centres and nursing homes. Measures: ADL observations, Barthel ADL Index, an apraxia te...

  10. [Psychometric properties of the Activities Daily Life Scale (ADL)].

    Science.gov (United States)

    Boyer, L; Murcia, A; Belzeaux, R; Loundou, A; Azorin, J-M; Chabannes, J-M; Dassa, D; Naudin, J; Samuelian, J-C; Lancon, C

    2010-10-01

    Deficits in social functioning are an important core feature of mental health. Recently in France, the Activities Daily Life (ADL) scale has been proposed by the French authorities to assess social functioning for all hospitalized patients in a psychiatric ward. The perspective is to use this scale in the financing and organization of mental health services in France. The ADL scale is a 6-item (dressing/undressing, walking/mobility, eating/drinking, using toilets, behaviour, relationships/communication) heteroquestionnaire completed by a health care professional at the beginning of each hospitalization, assessing functioning of patients suffering from mental health diseases. However, limited consensus exists on this scale. The psychometric properties of the ADL scale have not been assessed. There is a pressing need for detailed examination of its performance. The aim of this study was to explore ADL psychometric properties in a sample of hospitalized patients in a psychiatric ward. We retrospectively analyzed data for all episodes of care delivered to hospitalized patients in a psychiatric ward in our French Public Hospital from January 1, 2008 to June 30, 2008. The study involved retrospective review of administrative and medical databases. The following data were collected: age, gender, diagnoses based on the International Classification of Diseases - 10th version, ADL scale and Assessment of Social Self-Sufficiency scale (ASSS). The psychometric properties were examined using construct validity, reliability, external validity, reproducibility and sensitivity to change. Data analysis was performed using SPSS 15.0 and WINSTEP software. A total of 1066 patients completed the ADL scale. Among them, 49.7% were male, mean age was 36.5 ± 10.8, and 83.5% were single. Schizophrenia, schizotypal and delusional disorders (40.0%), mood disorders (27.9%) and mental and behavioural disorders due to psychoactive substance use (12%) were the most common diagnoses. Factor

  11. Self-reported quality of ADL task performance among patients with COPD exacerbations.

    Science.gov (United States)

    Bendixen, Hans Jørgen; Wæhrens, Eva Ejlersen; Wilcke, Jon Torgny; Sørensen, Lisbeth Villemoes

    2014-07-01

    Patients suffering from chronic obstructive pulmonary disease (COPD) experience problems in the performance of activities of daily living (ADL) tasks. The objective was to examine the self-reported quality of ADL task performance among COPD patients, and to investigate whether age, gender, and routine COPD characteristics correlate with the self-reported ADL ability. Eighty patients admitted to hospital with COPD exacerbations participated. In a cross-sectional study, the patients' self-reported ADL ability was assessed using the ADL-Interview (ADL-I) instrument. Data concerning age, gender, and routine COPD characteristics were drawn from the patients' medical records. The patients reported being inefficient to markedly inefficient when performing ADL tasks within the personal hygiene, toileting, dressing, household, mobility, and transportation domains. While more than 90% of the participants reported increased effort and/or fatigue when performing the ADL tasks, up to 88% of the participants relied on help from others in the performance of general household chores like cooking and shopping. Self-reported ADL ability did not correlate with age, gender, or routine COPD characteristics. Decreased quality of ADL task performance seemed to be extremely common among COPD patients. Therefore, addressing the problems in individually tailored pulmonary rehabilitation programmes may be advantageous.

  12. Validity and reliability of the Arabic version of Activities of Daily Living (ADL

    Directory of Open Access Journals (Sweden)

    Doumit Jacqueline

    2009-03-01

    Full Text Available Abstract Background The Activity of Daily Living (ADL is an instrument that screens elderly respondents for physical functioning and assesses whether they are dependent or independent in their daily activities. This study demonstrates a translation procedure and obtains the reliability and validity of a translated, Arabic ADL. Methods The ADL was translated to Arabic through a forward translation method followed by a committee-consensual approach. The ADL and the Arabic Mini-Mental State Examination (AMMSE were administered to an opportunistic sample of 354 Lebanese elderly living in nursing homes who did not have dementia. Results Reliability split half measures, sensitivity, and negative predictive values were high across all dimensions of the ADL with the exception of feeding. There were non-significant differences on the scored ADL between the three age groups: young age, middle age and older old. In addition, a non-significant difference was found on the scored ADL between the high and low AMMSE scores. Conclusion Overall, the translated ADL was consistent and valid measure for assessing daily activities in elderly nursing home residents. As it is quick and easy to use, the ADL in Arabic could help caregivers and doctors to prescribe appropriate physical exercise for elderly Arabic speaking patients.

  13. The Link between Cognitive Measures and ADLs and IADL Functioning in Mild Alzheimer's: What Has Gender Got to Do with It?

    Directory of Open Access Journals (Sweden)

    James R. Hall

    2011-01-01

    Full Text Available Objectives. To investigate the link between neurocognitive measures and various aspects of daily living (ADL and IADL in women and men with mild Alzheimer's disease (AD. Methods. Participants were 202 AD patients (91 male, 111 female with CDR global scores of ≤1. ADLs and IADLs ratings were obtained from caregivers. Cognitive domains were assessed with neuropsychological testing. Results. Memory and executive functioning were related to IADL scores. Executive functioning was linked to total ADL. Comparisons stratified on gender found attention predicted total ADL score in both men and women. Attention predicted bathing and eating ability in women only. Language predicted IADL functions in men (food preparation and women (driving. Conclusions. Associations between ADLs/IADLs and memory, learning, executive functioning, and language suggest that even in patients with mild AD, basic ADLs require complex cognitive processes. Gender differences in the domains of learning and memory area were found.

  14. Sensitivity of different ADL measures to apraxia and motor impairments

    NARCIS (Netherlands)

    Donkervoort, M; Dekker, Joost; Deelman, BG

    Objective: To determine whether specifically designed activities of daily living (ADL) observations can measure disability due to apraxia with more sensitivity than the Barthel ADL Index, a conventional functional scale. Design: Cross-sectional study. Setting: Rehabilitation centres and nursing

  15. Sensitivity of different ADL measures to apraxia and motor impairments

    NARCIS (Netherlands)

    Donkervoort, M.; Dekker, J.; Deelman, B.G.

    2002-01-01

    Objective: To determine whether specifically designed activities of daily living (ADL) observations can measure disability due to apraxia with more sensitivity than the Barthel ADL Index, a conventional functional scale. Design: Cross-sectional study. Setting: Rehabilitation centres and nursing

  16. Self-reported quality of ADL task performance among patients with COPD exacerbations

    DEFF Research Database (Denmark)

    Bendixen, Hans Jørgen; Wæhrens, Eva Elisabet Ejlersen; Wilcke, Jon Torgny

    2014-01-01

    OBJECTIVE: Patients suffering from chronic obstructive pulmonary disease (COPD) experience problems in the performance of activities of daily living (ADL) tasks. The objective was to examine the self-reported quality of ADL task performance among COPD patients, and to investigate whether age...... concerning age, gender, and routine COPD characteristics were drawn from the patients' medical records. RESULTS: The patients reported being inefficient to markedly inefficient when performing ADL tasks within the personal hygiene, toileting, dressing, household, mobility, and transportation domains. While...... more than 90% of the participants reported increased effort and/or fatigue when performing the ADL tasks, up to 88% of the participants relied on help from others in the performance of general household chores like cooking and shopping. Self-reported ADL ability did not correlate with age, gender...

  17. Physical performance as long-term predictor of onset of activities of daily living (ADL) disability

    DEFF Research Database (Denmark)

    Idland, Gro; Pettersen, Renate; Avlund, Kirsten

    2013-01-01

    non-disabled community-dwelling women with a mean age of 79.5 years at baseline. The baseline examinations of physical performance were: functional reach, climbing steps and comfortable walking speed. ADL disability was defined as need of personal assistance in at least one of five basic ADL items......Disability in ADL of aging women is an important public health concern. It is thus of interest to identify modifiable factors underlying onset of ADL disability. We assessed whether three physical performance-based measurements could predict ADL disability 9 years later. The participants were 113....... The participants were followed for 9 years. Logistic regression models were fitted for each of the physical performance measurements together with the covariates in relation to ADL disability. At follow-up 25.7% were disabled in ADL. All three performance measurements were significantly associated with the onset...

  18. Self-reported Quality of ADL Task Performance in Adults with Schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Kristina Tomra; Petersen, Rikke S.; Wæhrens, Eva Ejlersen

    quality of both personal ADL (PADL) and instrumental ADL (IADL). Aside from decreased independence, the participants also reported problems related to increased effort, increased use of time, and some safety issues. Although most of the participants reported to be competent in relation to PADL tasks......, how they perceive the quality of their performance in terms of effort/fatigue, use of time, safety risks, and need for assistance. The aim was to investigate the self-reported quality of ADL task performance in adults with schizophrenia. Subjects Participants were recruited from October 2013...... evaluation tool developed to describe and measure the quality of ADL task performance in terms of effort/fatigue, use of time, safety risks, and need for assistance based on self-report. Occupational therapists employed at the hospitals and trained in conducting the ADL–I were collecting data. The interviews...

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  6. File list: ALL.Adl.50.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.50.AllAg.Octopaminergic_neurons dm3 All antigens Adult Octopaminergic neurons... SRX135530,SRX135531 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.50.AllAg.Octopaminergic_neurons.bed ...

  7. File list: His.Adl.20.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.20.AllAg.Octopaminergic_neurons dm3 Histone Adult Octopaminergic neurons SR...X135531,SRX135530 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.20.AllAg.Octopaminergic_neurons.bed ...

  8. File list: His.Adl.50.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.50.AllAg.Octopaminergic_neurons dm3 Histone Adult Octopaminergic neurons SR...X135530,SRX135531 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.50.AllAg.Octopaminergic_neurons.bed ...

  9. File list: His.Adl.05.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.05.AllAg.Octopaminergic_neurons dm3 Histone Adult Octopaminergic neurons SR...X135530,SRX135531 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.05.AllAg.Octopaminergic_neurons.bed ...

  10. File list: ALL.Adl.20.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.20.AllAg.Octopaminergic_neurons dm3 All antigens Adult Octopaminergic neurons... SRX135531,SRX135530 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.20.AllAg.Octopaminergic_neurons.bed ...

  11. File list: His.Adl.10.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.10.AllAg.Octopaminergic_neurons dm3 Histone Adult Octopaminergic neurons SR...X135530,SRX135531 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.10.AllAg.Octopaminergic_neurons.bed ...

  12. File list: ALL.Adl.10.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.10.AllAg.Octopaminergic_neurons dm3 All antigens Adult Octopaminergic neurons... SRX135530,SRX135531 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.10.AllAg.Octopaminergic_neurons.bed ...

  13. Algorithm integration using ADL (Algorithm Development Library) for improving CrIMSS EDR science product quality

    Science.gov (United States)

    Das, B.; Wilson, M.; Divakarla, M. G.; Chen, W.; Barnet, C.; Wolf, W.

    2013-05-01

    Algorithm Development Library (ADL) is a framework that mimics the operational system IDPS (Interface Data Processing Segment) that is currently being used to process data from instruments aboard Suomi National Polar-orbiting Partnership (S-NPP) satellite. The satellite was launched successfully in October 2011. The Cross-track Infrared and Microwave Sounder Suite (CrIMSS) consists of the Advanced Technology Microwave Sounder (ATMS) and Cross-track Infrared Sounder (CrIS) instruments that are on-board of S-NPP. These instruments will also be on-board of JPSS (Joint Polar Satellite System) that will be launched in early 2017. The primary products of the CrIMSS Environmental Data Record (EDR) include global atmospheric vertical temperature, moisture, and pressure profiles (AVTP, AVMP and AVPP) and Ozone IP (Intermediate Product from CrIS radiances). Several algorithm updates have recently been proposed by CrIMSS scientists that include fixes to the handling of forward modeling errors, a more conservative identification of clear scenes, indexing corrections for daytime products, and relaxed constraints between surface temperature and air temperature for daytime land scenes. We have integrated these improvements into the ADL framework. This work compares the results from ADL emulation of future IDPS system incorporating all the suggested algorithm updates with the current official processing results by qualitative and quantitative evaluations. The results prove these algorithm updates improve science product quality.

  14. Muscle strength as a predictor of onset of ADL dependence in people aged 75 years

    DEFF Research Database (Denmark)

    Rantanen, Taina; Avlund, Kirsten; Suominen, Harri

    2002-01-01

    . For each muscle group tested, three equal groups were formed for men and women separately based on distributions of results. Those who reported being unable or needing help for eating, dressing, bathing, toileting, walking indoors or transferring from a bed or a chair were rated as ADL dependent....... Of the 227 initially ADL independent men, 21 (9.3%) became dependent in ADL. In women, the figures were 30 (8.8%) of 340. Multiple logistic regression models were used to predict the risk of ADL dependence in groups based on strength tertiles. After confirming that the association of muscle strength...... and incident ADL-dependence was similar in men and women, both genders were included in the same analyses adjusted for body weight and height, gender and research locality. Gender specific cut-offs were used for strength tertiles. All the strength tests predicted ADL dependence, with those being in the lowest...

  15. File list: ALL.Adl.20.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.20.AllAg.Young_adult ce10 All antigens Adult Young adult SRX331330,SRX14642...4210 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/ALL.Adl.20.AllAg.Young_adult.bed ...

  16. File list: Unc.Adl.50.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.50.AllAg.Egg_chamber dm3 Unclassified Adult Egg chamber SRX914955,SRX914951...,SRX914953 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.50.AllAg.Egg_chamber.bed ...

  17. File list: Pol.Adl.05.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.05.AllAg.Young_adult ce10 RNA polymerase Adult Young adult SRX395531,SRX331...RX043965 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.05.AllAg.Young_adult.bed ...

  18. File list: ALL.Adl.05.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.05.AllAg.Young_adult ce10 All antigens Adult Young adult SRX080072,SRX39553...2299,SRX005633 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/ALL.Adl.05.AllAg.Young_adult.bed ...

  19. File list: Pol.Adl.10.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. File list: Pol.Adl.20.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: ALL.Adl.10.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.10.AllAg.Young_adult ce10 All antigens Adult Young adult SRX395531,SRX08007...4210,SRX005633 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/ALL.Adl.10.AllAg.Young_adult.bed ...

  2. File list: Oth.Adl.50.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  3. File list: Unc.Adl.10.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  4. File list: Unc.Adl.05.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  5. File list: Unc.Adl.20.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.20.AllAg.Egg_chamber dm3 Unclassified Adult Egg chamber SRX914951,SRX914955...,SRX914953,SRX914957 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.20.AllAg.Egg_chamber.bed ...

  6. File list: ALL.Adl.50.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.50.AllAg.Adult_female dm3 All antigens Adult Adult female SRX1084165,SRX025...13111,SRX013105 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.50.AllAg.Adult_female.bed ...

  7. File list: Unc.Adl.50.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.50.AllAg.Adult_female dm3 Unclassified Adult Adult female SRX042248,SRX0130...18,SRX013048 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.50.AllAg.Adult_female.bed ...

  8. The tool in the brain: Apraxia in ADL.

    Directory of Open Access Journals (Sweden)

    Marta M. N. Bienkiewicz

    2014-04-01

    Full Text Available Humans differ from other animals in the way they can skilfully and precisely operate or invent tools to facilitate their everyday life. Tools have dominated our home, travel and work environment, becoming an integral step for our motor skills development. What happens when the part of the brain responsible for tool use is damaged in our adult life due to a cerebrovascular accident? How does daily life change when we lose the previously mastered ability to make use of the objects around us? How do patients suffering from compromised tool use cope with food preparation, personal hygiene, grooming, housework or use of home appliances? In this literature review we present a state of the art for single and multiple tool use research, with a focus on the impact that apraxia (impaired ability to perform tool-based actions and action disorganisation syndrome (impaired ability to carry our multi-step actions have on activities of daily living (ADL. Firstly, we summarise the behavioural studies investigating the impact of apraxia and other comorbidity syndromes, such as neglect or visual extinction, on ADL. We discuss the hallmarks of the compromised tool use in terms of the sequencing of action steps, conceptual errors committed, spatial motor control and temporal organisation of the movement. In addition, we present an up-to-date overview of the neuroimaging and lesion analyses studies that provide an insight into neural correlates of tool use in the human brain and functional changes in the neural organisation following a stroke, in the context of ADL. Finally we discuss the current practice in neurorehabilitation of ADL in apraxia and action disorganisation syndrome aiming at increasing patients’ independence.

  9. File list: ALL.Adl.50.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  10. File list: Oth.Adl.10.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  11. File list: Oth.Adl.20.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  12. File list: Unc.Adl.20.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  13. File list: His.Adl.05.AllAg.Adult_male [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  14. File list: His.Adl.50.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  16. File list: His.Adl.20.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  17. File list: His.Adl.10.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  18. File list: ALL.Adl.20.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  19. File list: Unc.Adl.10.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.10.AllAg.Adult_female dm3 Unclassified Adult Adult female SRX042248,SRX0130...48,SRX032119,SRX013018 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.10.AllAg.Adult_female.bed ...

  20. File list: ALL.Adl.05.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: ALL.Adl.10.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.10.AllAg.Adult_female dm3 All antigens Adult Adult female SRX013017,SRX1084...13018,SRX013111,SRX016140 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.10.AllAg.Adult_female.bed ...

  2. File list: His.Adl.20.AllAg.Adult_male [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  3. File list: His.Adl.50.AllAg.Adult_male [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.50.AllAg.Adult_male dm3 Histone Adult Adult male SRX013084,SRX013032,SRX013...033,SRX013013 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.50.AllAg.Adult_male.bed ...

  4. File list: Oth.Adl.50.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.50.AllAg.Egg_chamber dm3 TFs and others Adult Egg chamber SRX706815,SRX7068...11,SRX706814,SRX706810 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Oth.Adl.50.AllAg.Egg_chamber.bed ...

  5. File list: Oth.Adl.05.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  6. File list: Oth.Adl.10.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.10.AllAg.Egg_chamber dm3 TFs and others Adult Egg chamber SRX706814,SRX7068...10,SRX706815,SRX706811 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Oth.Adl.10.AllAg.Egg_chamber.bed ...

  7. File list: Oth.Adl.20.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  8. File list: His.Adl.50.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  9. File list: ALL.Adl.20.AllAg.Adult_male [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.20.AllAg.Adult_male dm3 All antigens Adult Adult male SRX013049,SRX013050,S...RX013084,SRX013033,SRX013032,SRX013013 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.20.AllAg.Adult_male.bed ...

  10. File list: ALL.Adl.50.AllAg.Adult_male [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.50.AllAg.Adult_male dm3 All antigens Adult Adult male SRX013049,SRX013084,S...RX013050,SRX013032,SRX013033,SRX013013 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.50.AllAg.Adult_male.bed ...

  11. File list: ALL.Adl.10.AllAg.Adult_male [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  12. File list: ALL.Adl.05.AllAg.Adult_male [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.05.AllAg.Adult_male dm3 All antigens Adult Adult male SRX013084,SRX013049,S...RX013033,SRX013050,SRX013032,SRX013013 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.05.AllAg.Adult_male.bed ...

  13. File list: InP.Adl.05.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.05.AllAg.Octopaminergic_neurons dm3 Input control Adult Octopaminergic neurons... http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.05.AllAg.Octopaminergic_neurons.bed ...

  14. File list: NoD.Adl.20.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Adl.20.AllAg.Octopaminergic_neurons dm3 No description Adult Octopaminergic neurons... http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/NoD.Adl.20.AllAg.Octopaminergic_neurons.bed ...

  15. File list: InP.Adl.20.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.20.AllAg.Octopaminergic_neurons dm3 Input control Adult Octopaminergic neurons... http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.20.AllAg.Octopaminergic_neurons.bed ...

  16. File list: InP.Adl.50.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.50.AllAg.Octopaminergic_neurons dm3 Input control Adult Octopaminergic neurons... http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.50.AllAg.Octopaminergic_neurons.bed ...

  17. File list: NoD.Adl.50.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Adl.50.AllAg.Octopaminergic_neurons dm3 No description Adult Octopaminergic neurons... http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/NoD.Adl.50.AllAg.Octopaminergic_neurons.bed ...

  18. File list: NoD.Adl.05.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available NoD.Adl.05.AllAg.Octopaminergic_neurons dm3 No description Adult Octopaminergic neurons... http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/NoD.Adl.05.AllAg.Octopaminergic_neurons.bed ...

  19. File list: NoD.Adl.10.AllAg.Octopaminergic_neurons [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. File list: Oth.Adl.50.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  1. File list: Oth.Adl.10.AllAg.Adult_female [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  2. File list: Oth.Adl.20.AllAg.Adult_female [Chip-atlas[Archive

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  3. File list: Pol.Adl.50.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.50.AllAg.Adult_male_fatbody dm3 RNA polymerase Adult Adult male fatbody htt...p://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Pol.Adl.50.AllAg.Adult_male_fatbody.bed ...

  4. File list: Pol.Adl.10.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.10.AllAg.Adult_male_fatbody dm3 RNA polymerase Adult Adult male fatbody htt...p://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Pol.Adl.10.AllAg.Adult_male_fatbody.bed ...

  5. File list: Pol.Adl.20.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.20.AllAg.Adult_male_fatbody dm3 RNA polymerase Adult Adult male fatbody htt...p://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Pol.Adl.20.AllAg.Adult_male_fatbody.bed ...

  6. File list: His.Adl.05.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.05.AllAg.Young_adult ce10 Histone Adult Young adult SRX554723,SRX1388779,SR...RX1388775,SRX554734,SRX1388768,SRX012297,SRX012298,SRX012300 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/His.Adl.05.AllAg.Young_adult.bed ...

  7. File list: His.Adl.10.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.10.AllAg.Young_adult ce10 Histone Adult Young adult SRX1388777,SRX1388779,S...SRX554724,SRX554734,SRX1388769,SRX012297,SRX012298,SRX012300 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/His.Adl.10.AllAg.Young_adult.bed ...

  8. File list: InP.Adl.50.AllAg.Ovary [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.50.AllAg.Ovary dm3 Input control Adult Ovary SRX264598,SRX1120694,SRX507393...215629,SRX507394,SRX215627,SRX215623,SRX215625,SRX507386 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.50.AllAg.Ovary.bed ...

  9. File list: Oth.Adl.20.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.20.AllAg.Adult_male_fatbody dm3 TFs and others Adult Adult male fatbody htt...p://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Oth.Adl.20.AllAg.Adult_male_fatbody.bed ...

  10. File list: Oth.Adl.05.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.05.AllAg.Adult_male_fatbody dm3 TFs and others Adult Adult male fatbody htt...p://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Oth.Adl.05.AllAg.Adult_male_fatbody.bed ...

  11. File list: Oth.Adl.10.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.10.AllAg.Adult_male_fatbody dm3 TFs and others Adult Adult male fatbody htt...p://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Oth.Adl.10.AllAg.Adult_male_fatbody.bed ...

  12. File list: InP.Adl.05.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.05.AllAg.Young_adult ce10 Input control Adult Young adult SRX005630,SRX4670...9,SRX005633 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/InP.Adl.05.AllAg.Young_adult.bed ...

  13. File list: InP.Adl.10.AllAg.Young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.10.AllAg.Young_adult ce10 Input control Adult Young adult SRX005630,SRX0056...6,SRX005633 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/InP.Adl.10.AllAg.Young_adult.bed ...

  14. File list: Pol.Adl.05.RNA_Polymerase_II.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.05.RNA_Polymerase_II.AllCell ce10 RNA polymerase RNA Polymerase II Adult SR...SRX1388757,SRX1388756 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.05.RNA_Polymerase_II.AllCell.bed ...

  15. File list: InP.Adl.20.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.20.AllAg.Egg_chamber dm3 Input control Adult Egg chamber SRX706813,SRX70681...2,SRX706816 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.20.AllAg.Egg_chamber.bed ...

  16. File list: InP.Adl.50.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.50.AllAg.Egg_chamber dm3 Input control Adult Egg chamber SRX706812,SRX70681...6,SRX706813 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.50.AllAg.Egg_chamber.bed ...

  17. File list: InP.Adl.05.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.05.AllAg.Egg_chamber dm3 Input control Adult Egg chamber SRX706813,SRX70681...2,SRX706816 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.05.AllAg.Egg_chamber.bed ...

  18. File list: InP.Adl.10.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.10.AllAg.Egg_chamber dm3 Input control Adult Egg chamber SRX706813,SRX70681...6,SRX706812 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.10.AllAg.Egg_chamber.bed ...

  19. File list: Pol.Adl.50.RNA_polymerase_III.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.50.RNA_polymerase_III.AllCell ce10 RNA polymerase RNA polymerase III Adult ...SRX331268,SRX331270,SRX395531 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.50.RNA_polymerase_III.AllCell.bed ...

  20. File list: Unc.Adl.10.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.10.AllAg.Adult_male_fatbody dm3 Unclassified Adult Adult male fatbody SRX04...2251,SRX042245,SRX042250 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.10.AllAg.Adult_male_fatbody.bed ...

  1. File list: Unc.Adl.05.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.05.AllAg.Adult_male_fatbody dm3 Unclassified Adult Adult male fatbody SRX04...2245,SRX042251,SRX042250 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.05.AllAg.Adult_male_fatbody.bed ...

  2. File list: Unc.Adl.20.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.20.AllAg.Adult_male_fatbody dm3 Unclassified Adult Adult male fatbody SRX04...2251,SRX042245,SRX042250 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.20.AllAg.Adult_male_fatbody.bed ...

  3. File list: Unc.Adl.50.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.50.AllAg.Adult_male_fatbody dm3 Unclassified Adult Adult male fatbody SRX04...2251,SRX042245,SRX042250 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/Unc.Adl.50.AllAg.Adult_male_fatbody.bed ...

  4. File list: ALL.Adl.50.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.50.AllAg.Egg_chamber dm3 All antigens Adult Egg chamber SRX914955,SRX914951...16,SRX914954,SRX914966,SRX706813,SRX914963,SRX914959,SRX706814,SRX706810,SRX914953 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.50.AllAg.Egg_chamber.bed ...

  5. QMG and MG-ADL correlations: Study of eculizumab treatment of myasthenia gravis.

    Science.gov (United States)

    Howard, James F; Freimer, Miriam; O'Brien, Fanny; Wang, Jing Jing; Collins, Stephen R; Kissel, John T

    2017-08-01

    A phase 2 study of eculizumab for treating myasthenia gravis (MG) used the quantitative myasthenia gravis score (QMG) and myasthenia gravis activities of daily living profile (MG-ADL) to evaluate baseline disease severity and treatment response. Correlations were then analyzed between these assessments. Patients were given eculizumab or placebo during the first 16-week treatment period of the crossover study, with treatment assignments reversed for the second treatment period following a 5-week washout. QMG and MG-ADL scores at baseline and endpoint of each treatment period generated correlation coefficients for baseline status and treatment response during eculizumab therapy. Correlation strength between QMG and MG-ADL scores was higher for treatment response (R = 0.726; 95% confidence interval, 0.264-0.907; P = 0.0036) than for assessing baseline disease status (R = 0.552; 95% confidence interval, -0.022-0.839; P = 0.0495). MG-ADL may be more sensitive for assessing treatment response than point-in-time disease status. Muscle Nerve 56: 328-330, 2017. © 2016 Wiley Periodicals, Inc.

  6. File list: Pol.Adl.05.RNA_polymerase_III.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.05.RNA_polymerase_III.AllCell ce10 RNA polymerase RNA polymerase III Adult ...SRX395531,SRX331268,SRX331270,SRX395532 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.05.RNA_polymerase_III.AllCell.bed ...

  7. File list: Pol.Adl.10.RNA_polymerase_III.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.10.RNA_polymerase_III.AllCell ce10 RNA polymerase RNA polymerase III Adult ...SRX395531,SRX331268,SRX331270,SRX395532 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.10.RNA_polymerase_III.AllCell.bed ...

  8. File list: ALL.Adl.20.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.20.AllAg.Adult_male_fatbody dm3 All antigens Adult Adult male fatbody SRX04...2251,SRX042245,SRX042250 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.20.AllAg.Adult_male_fatbody.bed ...

  9. File list: ALL.Adl.10.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.10.AllAg.Adult_male_fatbody dm3 All antigens Adult Adult male fatbody SRX04...2251,SRX042245,SRX042250 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.10.AllAg.Adult_male_fatbody.bed ...

  10. File list: ALL.Adl.50.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.50.AllAg.Adult_male_fatbody dm3 All antigens Adult Adult male fatbody SRX04...2251,SRX042245,SRX042250 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.50.AllAg.Adult_male_fatbody.bed ...

  11. File list: His.Adl.20.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.20.AllAg.Egg_chamber dm3 Histone Adult Egg chamber SRX914961,SRX914956,SRX9...14959,SRX914952,SRX914963,SRX914962,SRX914960,SRX914958,SRX914966,SRX914964,SRX914954 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.20.AllAg.Egg_chamber.bed ...

  12. File list: ALL.Adl.10.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.10.AllAg.Egg_chamber dm3 All antigens Adult Egg chamber SRX914951,SRX914955...58,SRX706813,SRX706815,SRX914957,SRX706816,SRX914964,SRX706811,SRX914966,SRX914954,SRX706812 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.10.AllAg.Egg_chamber.bed ...

  13. File list: ALL.Adl.20.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.20.AllAg.Egg_chamber dm3 All antigens Adult Egg chamber SRX914951,SRX914955...13,SRX914958,SRX914966,SRX914964,SRX706811,SRX914954,SRX706815,SRX706812,SRX706816,SRX706810 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/ALL.Adl.20.AllAg.Egg_chamber.bed ...

  14. File list: His.Adl.10.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.10.AllAg.Egg_chamber dm3 Histone Adult Egg chamber SRX914961,SRX914952,SRX9...14956,SRX914959,SRX914960,SRX914963,SRX914962,SRX914958,SRX914964,SRX914966,SRX914954 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.10.AllAg.Egg_chamber.bed ...

  15. File list: His.Adl.50.AllAg.Egg_chamber [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.50.AllAg.Egg_chamber dm3 Histone Adult Egg chamber SRX914961,SRX914956,SRX9...14962,SRX914952,SRX914960,SRX914958,SRX914964,SRX914954,SRX914966,SRX914963,SRX914959 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/His.Adl.50.AllAg.Egg_chamber.bed ...

  16. Arabic translation, cultural adaptation, and validation study of Knee Outcome Survey: Activities of Daily Living Scale (KOS-ADLS).

    Science.gov (United States)

    Algarni, Abdulrahman D; Alrabai, Hamza M; Al-Ahaideb, Abdulaziz; Kachanathu, Shaji John; AlShammari, Sulaiman A

    2017-09-01

    Knee complaints and their accompanying functional impairments are frequent problems encountered by healthcare practitioners worldwide. Plenty of functional scoring systems were developed and validated to give a relative estimation about the knee function. Despite the wide geographic distribution of Arabic language in the Middle East and North Africa, it is rare to find a validated knee function scale in Arabic. The present study is aimed to translate, validate, and culturally adjust the Knee Outcome Survey: Activities of Daily Living Scale (KOS-ADLS) into Arabic language for future use among Arabic-speaking patients. Permission for translation was obtained from the copyrights holder. Two different teams of high-level clinical and linguistic expertise conducted translation process blindly. Forward-backward translation technique was implemented to ensure preservation of the main conceptual content. Main study consisted of 280 subjects. Reliability was examined by test-retest pilot study. Visual Analogue Scale (VAS), Get Up and Go (GUG) Test, Ascending/Descending Stairs (A/D Stairs), and Subjective Assessment of Function (SAF) were conducted concurrently to show the validity of Arabic KOS-ADLS statistically in relation to these scales. Final translated version showed no significant discrepancies. Minor adaptive adjustment was required to fit Arabian cultural background. Internal consistency was favourable (Cronbach's alpha 0.90). Patients' scoring on Arabic KOS-ADLS appeared relatively consistent with their scoring on VAS, GUG, A/D Stairs, and SAF. A significant linear relationship was demonstrated between SAF and total KOS-ADLS scores on regression analysis (adj. R 2  = 0.548). Arabic KOS-ADLS, as its English counterpart, was found to be a simple, valid, and useful instrument for knee function evaluation. Arabic version of KOS-ADLS represents a promising candidate for unconditional use among Arabic-speaking patients with knee complaints.

  17. File list: Pol.Adl.50.RNA_polymerase_II.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.50.RNA_polymerase_II.AllCell ce10 RNA polymerase RNA polymerase II Adult SR...SRX043965,SRX005629,SRX043964,SRX554718 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.50.RNA_polymerase_II.AllCell.bed ...

  18. File list: Pol.Adl.20.RNA_polymerase_II.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.20.RNA_polymerase_II.AllCell ce10 RNA polymerase RNA polymerase II Adult SR...SRX554718,SRX043965,SRX043963,SRX043964 http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.20.RNA_polymerase_II.AllCell.bed ...

  19. File list: InP.Adl.50.Input_control.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.50.Input_control.AllCell dm3 Input control Input control Adult SRX181432,SR...15625,SRX507386,SRX390503,SRX016141 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.50.Input_control.AllCell.bed ...

  20. File list: InP.Adl.20.Input_control.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.20.Input_control.AllCell dm3 Input control Input control Adult SRX264598,SR...07394,SRX970862,SRX215623,SRX215627 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.20.Input_control.AllCell.bed ...

  1. File list: InP.Adl.05.Input_control.AllCell [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.05.Input_control.AllCell dm3 Input control Input control Adult SRX220301,SR...81442,SRX215625,SRX215627,SRX970862 http://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.05.Input_control.AllCell.bed ...

  2. File list: His.Adl.50.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.50.AllAg.Germline_containing_young_adult ce10 Histone Adult Germline containing young adult...osciencedbc.jp/kyushu-u/ce10/assembled/His.Adl.50.AllAg.Germline_containing_young_adult.bed ...

  3. File list: His.Adl.05.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.05.AllAg.Germline_containing_young_adult ce10 Histone Adult Germline containing young adult...archive.biosciencedbc.jp/kyushu-u/ce10/assembled/His.Adl.05.AllAg.Germline_containing_young_adult.bed ...

  4. File list: Oth.Adl.05.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.05.AllAg.Germline_containing_young_adult ce10 TFs and others Adult Germline containing young adult....jp/kyushu-u/ce10/assembled/Oth.Adl.05.AllAg.Germline_containing_young_adult.bed ...

  5. File list: Oth.Adl.20.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.20.AllAg.Germline_containing_young_adult ce10 TFs and others Adult Germline containing young adult....jp/kyushu-u/ce10/assembled/Oth.Adl.20.AllAg.Germline_containing_young_adult.bed ...

  6. File list: His.Adl.10.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.10.AllAg.Germline_containing_young_adult ce10 Histone Adult Germline containing young adult...archive.biosciencedbc.jp/kyushu-u/ce10/assembled/His.Adl.10.AllAg.Germline_containing_young_adult.bed ...

  7. File list: His.Adl.20.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Adl.20.AllAg.Germline_containing_young_adult ce10 Histone Adult Germline containing young adult...archive.biosciencedbc.jp/kyushu-u/ce10/assembled/His.Adl.20.AllAg.Germline_containing_young_adult.bed ...

  8. File list: Oth.Adl.10.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.10.AllAg.Germline_containing_young_adult ce10 TFs and others Adult Germline containing young adult....jp/kyushu-u/ce10/assembled/Oth.Adl.10.AllAg.Germline_containing_young_adult.bed ...

  9. File list: Oth.Adl.50.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Oth.Adl.50.AllAg.Germline_containing_young_adult ce10 TFs and others Adult Germline containing young adult....jp/kyushu-u/ce10/assembled/Oth.Adl.50.AllAg.Germline_containing_young_adult.bed ...

  10. File list: Unc.Adl.10.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.10.AllAg.Germline_containing_young_adult ce10 Unclassified Adult Germline containing young adult... http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Unc.Adl.10.AllAg.Germline_containing_young_adult.bed ...

  11. File list: Unc.Adl.20.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.20.AllAg.Germline_containing_young_adult ce10 Unclassified Adult Germline containing young adult... http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Unc.Adl.20.AllAg.Germline_containing_young_adult.bed ...

  12. File list: Unc.Adl.50.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Unc.Adl.50.AllAg.Germline_containing_young_adult ce10 Unclassified Adult Germline containing young adult... http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Unc.Adl.50.AllAg.Germline_containing_young_adult.bed ...

  13. File list: ALL.Adl.50.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Adl.50.AllAg.Germline_containing_young_adult ce10 All antigens Adult Germline containing young adult...e.biosciencedbc.jp/kyushu-u/ce10/assembled/ALL.Adl.50.AllAg.Germline_containing_young_adult.bed ...

  14. File list: InP.Adl.50.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.50.AllAg.Adult_male_fatbody dm3 Input control Adult Adult male fatbody http...://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.50.AllAg.Adult_male_fatbody.bed ...

  15. File list: InP.Adl.05.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.05.AllAg.Adult_male_fatbody dm3 Input control Adult Adult male fatbody http...://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.05.AllAg.Adult_male_fatbody.bed ...

  16. File list: InP.Adl.20.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.20.AllAg.Adult_male_fatbody dm3 Input control Adult Adult male fatbody http...://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.20.AllAg.Adult_male_fatbody.bed ...

  17. File list: InP.Adl.10.AllAg.Adult_male_fatbody [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available InP.Adl.10.AllAg.Adult_male_fatbody dm3 Input control Adult Adult male fatbody http...://dbarchive.biosciencedbc.jp/kyushu-u/dm3/assembled/InP.Adl.10.AllAg.Adult_male_fatbody.bed ...

  18. File list: Pol.Adl.20.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Pol.Adl.20.AllAg.Germline_containing_young_adult ce10 RNA polymerase Adult Germline containing young adult... http://dbarchive.biosciencedbc.jp/kyushu-u/ce10/assembled/Pol.Adl.20.AllAg.Germline_containing_young_adult.bed ...

  19. File list: Pol.Adl.50.AllAg.Germline_containing_young_adult [Chip-atlas[Archive

    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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    Lifescience Database Archive (English)

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  7. Clinical characteristics with an impact on ADL functions of PD patients with cognitive impairment indicative of dementia.

    Directory of Open Access Journals (Sweden)

    Inga Liepelt-Scarfone

    Full Text Available BACKGROUND: Dementia in Parkinson's disease (PD is defined as cognitive decline severe enough to affect activities of daily living function (ADL. The aim of our exploratory study was to compare two groups of PD patients. Both groups had cognitive deficits severe enough to justify diagnosis of dementia, but they differed according to caregivers' rating on ADL dysfunction. Parameters which differed between the two groups were interpreted to affect the caregivers' perception of ADL dysfunction in PD patients with cognitive impairment indicative of Parkinson's disease dementia. METHODOLOGY/PRINCIPAL FINDINGS: Thirty of 131 Parkinson's disease patients fulfilled the Movement Disorders Society Task Force - recommended, cognitive Level-I-criteria for dementia. According to standardized caregiver ratings, volunteers were grouped into 18 patients with (ADL- and 12 without instrumental activities of daily living dysfunction (ADL+. Caregiver activities of daily living function ratings closely correlated with self-estimates of patients and those of physician (p<0.001. ADL- patients performed worse on tests assessing visual-construction (p<0.05 and attention (p=0.03 than ADL+ patients. Moreover, the postural instability and gait disorder subtype was more frequent in ADL- patients (p=0.009. ADL- patients tended to have more communication problems (p=0.05, more anxiety (p=0.05 and showed a tendency to be treated more often with neuroleptics (p=0.049 than ADL+. CONCLUSIONS/SIGNIFICANCE: Results indicate that worse attention, visual-construction abilities, the postural instability and gait disorder subtype, communication problems, medication and presence of anxiety are related to activities of daily living dysfunctions in Parkinson's disease patients with cognitive decline indicative of dementia. Our data suggests that not only cognitive factors but also non-cognitive factors seem to be linked to the diagnosis of Parkinson's disease dementia associated with

  8. The course of apraxia and ADL functioning in left hemisphere stroke patients treated in rehabilitation centres and nursing homes.

    Science.gov (United States)

    Donkervoort, Mireille; Dekker, Joost; Deelman, Betto

    2006-12-01

    To study the course of apraxia and daily life functioning (ADL) in left hemisphere stroke patients with apraxia. Prospective cohort study. Rehabilitation centres and nursing homes. One hundred and eight left hemisphere stroke patients with apraxia, hospitalized in rehabilitation centres and nursing homes. ADL-observations, Barthel ADL Index, Apraxia Test, Motricity Index. During the study period of 20 weeks, patients showed small improvements in apraxia (standardized mean differences of 0.19 and 0.33) and medium-sized improvements in ADL functioning (standardized mean differences from 0.37 to 0.61). About 88% of the patients were still apraxic at week 20. Less improvement in apraxia was observed in initially less severe apraxic patients. Less improvement in ADL functioning was found to be associated with more severe apraxia, a more independent initial ADL score, higher age, impaired motor functioning and longer time between stroke and first assessment. Apraxia in stroke patients is a persistent disorder, which has an adverse influence on ADL recovery.

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  1. The course of apraxia and ADL functioning in left hemisphere stroke patients treated in rehabilitation centres and nursing homes.

    OpenAIRE

    Donkervoort, M.; Dekker, J.; Deelman, B.

    2006-01-01

    OBJECTIVE: To study the course of apraxia and daily life functioning (ADL) in left hemisphere stroke patients with apraxia. DESIGN: Prospective cohort study. SETTING: Rehabilitation centres and nursing homes. SUBJECTS: One hundred and eight left hemisphere stroke patients with apraxia, hospitalized in rehabilitation centres and nursing homes. MEASURES: ADL-observations, Barthel ADL Index, Apraxia Test, Motricity Index. RESULTS: During the study period of 20 weeks, patients showed small improv...

  2. Cross-cultural adaptation of the Greek version of the Knee Outcome Survey--activities of Daily Living Scale (KOS-ADLS).

    Science.gov (United States)

    Kapreli, E; Panelli, G; Strimpakos, N; Billis, E; Zacharopoulos, A; Athanasopoulos, S

    2011-12-01

    The purpose of this study was to cross-culturally adapt and validate the Greek version of Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS), a self-reported instrument used for patients with various knee pathological conditions including osteoarthritis. Ninety-four patients (57 males and 37 females) with a variety of pathological knee disorders and impairments being referred to physical therapy for evaluation and treatment were included in the study. For the crοss-cultural translation, a back-translation procedure was utilized by 3 bi-lingual translators. To assess test-retest reliability the patients were asked to complete the KOS-ADLS twice at initial visit; before and after physiotherapy treatment. To assess responsiveness, patients completed the KOS-ADLS at the end of all physiotherapy sessions and the score was compared with KOS-ADLS at initial (pre-treatment) visit. Finally, concurrent validity was measured by comparing the responses to the KOS-ADLS scores against the scores obtained from Visual Analogue Scale (VAS) and Global Rating Scale (GRS). Reliability was found satisfactory (ICC=0.97; SEM=3.03; SDD=23.05; Cronbach's alpha=0.98). Moreover, a gender subgroup analysis showed that women were more reliable than men. Minor floor/ceiling effects were detected. Concerning validity, all correlations were statistically significant, ranging from r=0.315 to r=0.741, however GRS presented higher correlations with KOS-ADLS in comparison with VAS. Finally, Greek KOS-ADLS was able to detect changes over time (standardized effect size=1.31 and standardized response mean=1.64). The Greek version of KOS-ADLS was found to be reliable, valid, responsive and comprehensible to use with patients with knee pathology. Copyright © 2010 Elsevier B.V. All rights reserved.

  3. An Evaluation of ADLs on Modeling Patterns for Software Architecture

    NARCIS (Netherlands)

    Waqas Kamal, Ahmad; Avgeriou, Paris

    2007-01-01

    Architecture patterns provide solutions to recurring design problems at the architecture level. In order to model patterns during software architecture design, one may use a number of existing Architecture Description Languages (ADLs), including the UML, a generic language but also a de facto

  4. ADL-3. Nuclear data library for activation and transmutation calculations

    International Nuclear Information System (INIS)

    Grudzevich, O.T.; Zelenetskij, A.V.; Ignatyuk, A.V.; Pashchenko, A.B.

    1995-07-01

    It is shown that the use of simplified approaches to calculate threshold neutron reaction cross-sections is not acceptable for the generation of cross-section libraries. Although rigorous models are complex and involve laborious calculations, they provide the only reliable means for evaluating cross-sections when no experimental data are available. A brief description is given of the new version of the library ADL-3 generated by the authors. It contains 18,200 excitation functions of reactions induced by neutrons of up to 20 MeV. The threshold reaction cross-sections have been calculated in the Hauser-Feshbach-Moldauer formalism with allowance for the contribution of non-equilibrium processes. The cross-sections obtained have been tested by comparison with experimental data and evaluations from other libraries. (author)

  5. [Influence of high fall-related self-efficacy on falls due to dissociation with ADL among elderly women in nursing homes].

    Science.gov (United States)

    Kato, Chikako; Ida, Kunio; Harada, Atsushi

    2009-09-01

    We examined the influence of high fall-related self-efficacy on falls due to dissociation with activities of daily living (ADL) among elderly women in nursing homes. We enrolled 72 female nursing home residents who were 70 years old or over and who scored 18 or higher on the Mini-Mental State Examination (MMSE). Subjects were classified into three groups based on the relationship between ADL and fall-related self-efficacy derived from a scattergram of the Functional Independence Measure (FIM) motor items and Falls Efficacy Scale (FES). The three groups were: group I which had low ADL and high fall-related self-efficacy (n=25); group II which had high ADL and low fall-related self-efficacy (n=30); and group III which had a correlation of ADL and fall-related self-efficacy in the 95% confidence interval (n=17). Then, we investigated the incidence of falls and the number of falls after 6 months in the three groups. The risk factor of falls was also investigated using multiple logistic regression analysis. The incidence and number of falls were significantly different in the three groups after 6 months. Moreover, the incidence of those falling was significantly different between group I and group III. The occurrence of falls was also significantly related with a past history of falls, FES, and group I which had low ADL and high fall-related self-efficacy. These findings suggest that the risk of falling increases in the presence of excessive fall-related self-efficacy dissociated from ADL.

  6. Alternate Communications Spectrum Study (ACSS) for Aviation Data Links (ADL)

    Science.gov (United States)

    Matolak, David W.

    2003-01-01

    The aim of the work was to identify the key factors involved in the use of alternate spectrum in various bands for a future integrated CNS data link. The study focused on systems and spectral bands that can deliver VDL-or-higher data rates in a two-way communication setting (including air-ground, ground-air, and air-air modes of operation), with multiple platforms (aircraft) operating in the same local environment. We begin with a review of the initial task list, and the final task list. The final task list contained a focus upon spectral availability and related systems that could be affected by the deployment of a new aviation data link (ADL) system. Most of this addresses the lower few layers of the communications protocol stack. A brief review of current related efforts in the aeronautical community is then provided, in which we describe several systems and programs of interest. Participation in some of these efforts is recommended. We also delineate several of the advantages and disadvantages of these system/efforts, in view of anticipated requirements of a new ADL. Desired attributes of a new ADL system are then discussed, and a connection with existing systems is made. The need to consider a wider set of alternative systems and technologies is described, and the beneficial aspects of a particular transmission technique- spread spectrum-are discussed. We then discuss in more detail several potential spectral regions, in terms of propagation conditions, available technology, spectrum availability, and waveform selection. Some comments on the need for standardization are also provided. We note that none of the existing systems described will likely meet the full range of desired features of a new ADL, but that several systems and spectral regions offer promise in terms of one or more characteristics. A system design and analysis approach is then provided. In this, we again focus on the lower few layers of the protocol stack, and aim to capture the main features

  7. AeroADL: applying the integration of the Suomi-NPP science algorithms with the Algorithm Development Library to the calibration and validation task

    Science.gov (United States)

    Houchin, J. S.

    2014-09-01

    A common problem for the off-line validation of the calibration algorithms and algorithm coefficients is being able to run science data through the exact same software used for on-line calibration of that data. The Joint Polar Satellite System (JPSS) program solved part of this problem by making the Algorithm Development Library (ADL) available, which allows the operational algorithm code to be compiled and run on a desktop Linux workstation using flat file input and output. However, this solved only part of the problem, as the toolkit and methods to initiate the processing of data through the algorithms were geared specifically toward the algorithm developer, not the calibration analyst. In algorithm development mode, a limited number of sets of test data are staged for the algorithm once, and then run through the algorithm over and over as the software is developed and debugged. In calibration analyst mode, we are continually running new data sets through the algorithm, which requires significant effort to stage each of those data sets for the algorithm without additional tools. AeroADL solves this second problem by providing a set of scripts that wrap the ADL tools, providing both efficient means to stage and process an input data set, to override static calibration coefficient look-up-tables (LUT) with experimental versions of those tables, and to manage a library containing multiple versions of each of the static LUT files in such a way that the correct set of LUTs required for each algorithm are automatically provided to the algorithm without analyst effort. Using AeroADL, The Aerospace Corporation's analyst team has demonstrated the ability to quickly and efficiently perform analysis tasks for both the VIIRS and OMPS sensors with minimal training on the software tools.

  8. Effect of Homoeopathic treatment on Activity of Daily Living (ADL in Knee Osteoarthritis: A prospective observational study

    Directory of Open Access Journals (Sweden)

    F F Motiwala

    2016-01-01

    Full Text Available Objectives: To investigate the effect of individualized homoeopathic medicines in improving ADL by reducing pain, stiffness and limiting the disease progress. Materials and Methods: 131 consecutive patients with OA of knee were recruited and followed up for minimum period of twelve months. Two orthopaedic surgeons diagnosed the disease based on clinical examination of the patients. Three trained homoeopathic physicians prescribed individualized homoeopathic simillimum and the patients were evaluated for pain on WOMAC Osteoarthritis Index LK3.1 (IK survey form measuring pain, stiffness and ADL. The pain was also measured on Numerical pain rating scale for confirmation. Result: Individualized homoeopathic medicines prescribed as per law of similia improved the mean ADL from 35.85 to 19.08 (p- 0.0001. Mean pain on WOMAC Osteoarthritis Index survey form improved from 10.50 to 5.48 (p-0.0001. The mean pain score on NRS improved from 6.34 to 3.77 (p-0.0001 and the mean morning stiffness also improved from 4.55 to 2.18 (p-0.0001. Conclusion: Homoeopathic medicines have potential to improve the ADL of OA patients by reducing pain and stiffness and limiting progress of the disease without any adverse systemic effects and can safely be employed as a comprehensive health care therapeutics.

  9. Advancements in Distributed Learning (ADL) Environment in Support of Transformation

    Science.gov (United States)

    2017-01-01

    take a variety of forms, including Task Groups, Workshops, Symposia, Specialists’ Meetings, Lecture Series and Technical Courses . The content of this... MySQL and PHP Apache xAPI Extensive Application Program Interface viii STO-TR-HFM-212 HFM-212 Membership List Dr. Oleksandr BUROV Institute...in Paris, France, initiated a new management infrastructure for collaboration and integration of learning courses and technologies. This ADL effort

  10. [Factors associated with activities of daily living (ADL) in independently living elderly persons in a community: a baseline examination of a large scale cohort study, Fujiwara-kyo study].

    Science.gov (United States)

    Komatsu, Masayo; Nezu, Satoko; Tomioka, Kimiko; Hazaki, Kan; Harano, Akihiro; Morikawa, Masayuki; Takagi, Masahiro; Yamada, Masahiro; Matsumoto, Yoshitaka; Iwamoto, Junko; Ishizuka, Rika; Saeki, Keigo; Okamoto, Nozomi; Kurumatani, Norio

    2013-01-01

    To investigate factors associated with activities of daily living in independently living elderly persons in a community. The potential subjects were 4,472 individuals aged 65 years and older who voluntarily participated in a large cohort study, the Fujiwara-kyo study. We used self-administered questionnaires consisting of an activities of daily living (ADL) questionnaire with the Physical Fitness Test established by the Ministry of Education, Culture, Sports, Science and Technology (12 ADL items) to determine the index of higher-level physical independence, demographics, Geriatric Depression Scale, and so on. Mini-mental state examination, measurement of physical fitness, and blood tests were also carried out. A lower ADL level was defined as having a total score of the 12 ADL items (range, 12-36 points) that was below the first quartile of a total score for all the subjects. Factors associated with a low ADL level were examined by multiple logistic regression. A total of 4,198 remained as subjects for analysis. The male, female and 5-year-old groups showed significant differences in the median score of 12 ADL items between any two groups. The highest odds ratio among factors associated with lower ADL level by multiple logistic regression with mutually adjusted independent variables was 4.49 (95%CI: 2.82-7.17) in the groups of "very sharp pain" or "strong pain" during the last month. Low physical ability, self-awareness of limb weakness, a BMI of over 25, low physical activity, cerebrovascular disorder, depression, low cognitive function, unable "to see normally", unable "to hear someone", "muscle, bone and joint pain" were independently associated with lower ADL level. Multiple factors are associated with lower ADL level assessed on the basis of the 12 ADL items.

  11. The Effects of the Green House Nursing Home Model on ADL Function Trajectory: A Retrospective Longitudinal Study

    Science.gov (United States)

    YOON, Ju Young; BROWN, Roger L.; BOWERS, Barbara J.; SHARKEY, Siobhan S.; HORN, Susan D.

    2015-01-01

    Background Growing attention in the past few decades has focused on improving care quality and quality of life for nursing home residents. Many traditional nursing homes have attempted to transform themselves to become more homelike emphasizing individualized care. This trend is referred to as nursing home culture change in the U.S. A promising culture change nursing home model, the Green House (GH) nursing home model, has shown positive psychological outcomes. However, little is known about whether the GH nursing home model has positive effects on physical function compared to traditional nursing homes. Objectives To examine the longitudinal effects of the GH nursing home model by comparing change patterns of ADL function over time between GH home residents and traditional nursing home residents. Design A retrospective longitudinal study. Settings Four GH organizations (nine GH units and four traditional units). Participants A total of 242 residents (93 GH residents and 149 traditional home residents) who had stayed in the nursing home at least six months from admission. Methods The outcome was ADL function, and the main independent variable was the facility type in which the resident stayed: a GH or traditional unit. Age, gender, comorbidity score, cognitive function, and depressive symptoms at baseline were controlled. All of these measures were from a minimum dataset. Growth curve modeling and growth mixture modeling were employed in this study for longitudinal analyses. Results The mean ADL function showed deterioration over time, and the rates of deterioration between GH and traditional home residents were not different over time. Four different ADL function trajectories were identified for 18 months, but there was no statistical difference in the likelihood of being in one of the four trajectory classes between the two groups. Conclusions Although GH nursing homes are considered to represent an innovative model changing the nursing home environment into more

  12. The effect of gamma irradiation on crude fibre NDF, ADF, and ADL of some Syrian agricultural residues

    International Nuclear Information System (INIS)

    Al-Masri, M.R.; Zarkawi, M.

    1992-07-01

    The effects of 150 KGy of gamma irradiation on crude fibre and its main components (cellulose, hemicellulose-cellulose and lignin) and on neutral detergent fibre (NDF), acid detergent lignin (ADL), and acid detergent fibre (ADF) were investigated. The results indicate that gamma irradiation decreased Cf content by 30%, 28%, 29%, and 17% for cottonwood, lentils straw, apple-tree pruning products and olive-oil cake, respectively. NDF values also decreased by 5%, 23%, 13% and 3% for, cottonwood, lentils straw, olive-oil cake and apple-tree pruning products respectively. Gamma irradiation (150 KGy) had no effects on ADF and ADL for lentils straw, apple-tree pruning products and olive-oil cake whereas, ADF decreased by 8.5% and ADL by 8.3 for cottonwood. Hemicellulose content increased by 12% for cottonwood while decreased by 54% for lentils straw and by 33% for apple-tree pruning products with no effects for olive-oil cake. Cellulose content decreased by 8.6% for cottonwood whereas no effects for the remaining residues were seen. Gamma irradiation treatment improved the nutritive value of the agriculture residues examined. The reduction in crude fibre content varies with the residue. (author). 15 refs., 5 tabs

  13. Item-level psychometrics of the ADL instrument of the Korean National Survey on persons with physical disabilities.

    Science.gov (United States)

    Hong, Ickpyo; Lee, Mi Jung; Kim, Moon Young; Park, Hae Yean

    2017-10-01

    The aim of this study is to investigate the psychometrics of the 12 items of an instrument assessing activities of daily living (ADL) using an item response theory model. A total of 648 adults with physical disabilities and having difficulties in ADLs were retrieved from the 2014 Korean National Survey on People with Disabilities. The psychometric testing included factor analysis, internal consistency, precision, and differential item functioning (DIF) across categories including sex, older age, marital status, and physical impairment area. The sample had a mean age of 69.7 years old (SD = 13.7). The majority of the sample had lower extremity impairments (62.0%) and had at least 2.1 chronic conditions. The instrument demonstrated unidimensional construct and good internal consistency (Cronbach's alpha = 0.95). The instrument precisely estimated person measures within a wide range of theta values (-2.22 logits  5.0%). Our findings indicate that the dressing item would need to be modified to improve its psychometrics. Overall, the ADL instrument demonstrates good psychometrics, and thus, it may be used as a standardized instrument for measuring disability in rehabilitation contexts. However, the findings are limited to adults with physical disabilities. Future studies should replicate psychometric testing for survey respondents with other disorders and for children.

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

    Science.gov (United States)

    Mikołajewska, Emilia

    2013-01-01

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

  15. Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes; a cross-sectional study.

    Science.gov (United States)

    Björk, Sabine; Juthberg, Christina; Lindkvist, Marie; Wimo, Anders; Sandman, Per-Olof; Winblad, Bengt; Edvardsson, David

    2016-08-22

    Earlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay. Cross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test. The results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units. The prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and

  16. Older Asian Americans and Pacific Islanders with Activities of Daily Living (ADL Limitations: Immigration and Other Factors Associated with Institutionalization

    Directory of Open Access Journals (Sweden)

    Esme Fuller-Thomson

    2012-09-01

    Full Text Available This study determined the national prevalence and profile of Asian Americans with Activities of Daily Living (ADL limitations and identified factors associated with institutionalization. Data were obtained from 2006 American Community Survey, which replaced the long-form of the US Census. The data are nationally representative of both institutionalized and community-dwelling older adults. Respondents were Vietnamese (n = 203, Korean (n = 131, Japanese (n = 193, Filipino (n = 309, Asian Indian (n = 169, Chinese (n = 404, Hawaiian/Pacific Islander (n = 54, and non-Hispanic whites (n = 55,040 aged 55 and over who all had ADL limitations. The prevalence of institutionalized among those with ADL limitations varies substantially from 4.7% of Asian Indians to 18.8% of Korean Americans with ADL limitations. Every AAPI group had a lower prevalence of institutionalization than disabled Non-Hispanic whites older adults (23.8% (p < 0.001. After adjustment for socio-demographic characteristics, Asian Indians, Vietnamese, Japanese, Filipino, and Chinese had significantly lower odds of institutionalization than non-Hispanic whites (OR = 0.29, 0.31, 0.58, 0.51, 0.70, respectively. When the sample was restricted to AAPIs, the odds of institutionalization were higher among those who were older, unmarried, cognitively impaired and those who spoke English at home. This variation suggests that aggregating data across the AAPI groups obscures meaningful differences among these subpopulations and substantial inter-group differences may have important implications in the long-term care setting.

  17. Hospital Readmission among Older Adults Who Return Home with Unmet Need for ADL Disability

    Science.gov (United States)

    DePalma, Glen; Xu, Huiping; Covinsky, Kenneth E.; Craig, Bruce A.; Stallard, Eric; Thomas, Joseph, III.; Sands, Laura P.

    2013-01-01

    Purpose: This study determined whether returning to the community from a recent hospitalization with unmet activities of daily living (ADL) need was associated with probability of readmission. Methods: A total of 584 respondents to the 1994, 1999, and/or 2004 National Long-Term Care Surveys (NLTCS) who were hospitalized within 90 days prior to the…

  18. Estimating the number of components and detecting outliers using Angle Distribution of Loading Subspaces (ADLS) in PCA analysis.

    Science.gov (United States)

    Liu, Y J; Tran, T; Postma, G; Buydens, L M C; Jansen, J

    2018-08-22

    Principal Component Analysis (PCA) is widely used in analytical chemistry, to reduce the dimensionality of a multivariate data set in a few Principal Components (PCs) that summarize the predominant patterns in the data. An accurate estimate of the number of PCs is indispensable to provide meaningful interpretations and extract useful information. We show how existing estimates for the number of PCs may fall short for datasets with considerable coherence, noise or outlier presence. We present here how Angle Distribution of the Loading Subspaces (ADLS) can be used to estimate the number of PCs based on the variability of loading subspace across bootstrap resamples. Based on comprehensive comparisons with other well-known methods applied on simulated dataset, we show that ADLS (1) may quantify the stability of a PCA model with several numbers of PCs simultaneously; (2) better estimate the appropriate number of PCs when compared with the cross-validation and scree plot methods, specifically for coherent data, and (3) facilitate integrated outlier detection, which we introduce in this manuscript. We, in addition, demonstrate how the analysis of different types of real-life spectroscopic datasets may benefit from these advantages of ADLS. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain

    DEFF Research Database (Denmark)

    Wæhrens, Eva Elisabet Ejlersen; Amris, Kirstine; Fisher, Anne G

    2010-01-01

    Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self...

  20. Long-term declines in ADLs, IADLs, and mobility among older Medicare beneficiaries

    Directory of Open Access Journals (Sweden)

    Wolinsky Fredric D

    2011-08-01

    Full Text Available Abstract Background Most prior studies have focused on short-term (≤ 2 years functional declines. But those studies cannot address aging effects inasmuch as all participants have aged the same amount. Therefore, the authors studied the extent of long-term functional decline in older Medicare beneficiaries who were followed for varying time lengths, and the authors also identified the risk factors associated with those declines. Methods The analytic sample included 5,871 self- or proxy-respondents who had complete baseline and follow-up survey data that could be linked to their Medicare claims for 1993-2007. Functional status was assessed using activities of daily living (ADLs, instrumental ADLs (IADLs, and mobility limitations, with declines defined as the development of two of more new difficulties. Multiple logistic regression analysis was used to focus on the associations involving respondent status, health lifestyle, continuity of care, managed care status, health shocks, and terminal drop. Results The average amount of time between the first and final interviews was 8.0 years. Declines were observed for 36.6% on ADL abilities, 32.3% on IADL abilities, and 30.9% on mobility abilities. Functional decline was more likely to occur when proxy-reports were used, and the effects of baseline function on decline were reduced when proxy-reports were used. Engaging in vigorous physical activity consistently and substantially protected against functional decline, whereas obesity, cigarette smoking, and alcohol consumption were only associated with mobility declines. Post-baseline hospitalizations were the most robust predictors of functional decline, exhibiting a dose-response effect such that the greater the average annual number of hospital episodes, the greater the likelihood of functional status decline. Participants whose final interview preceded their death by one year or less had substantially greater odds of functional status decline

  1. THE EFFECT OF SOIL CONDITIONERS ON CELLULOSE, HEMICELLULOSE, AND THE ADL FIBRE FRACTION CONCENTRATION IN DACTYLIS GLOMERATA AND LOLIUM PERENNE

    Directory of Open Access Journals (Sweden)

    Milena Truba

    2017-01-01

    Full Text Available Replicated three times, the research was conducted in the experimental field between 2011 and 2014. Three soil conditioners with the following trade names: UGmax, Eko-Użyźniacz, and Humus Active Papka were used in the experiment, separately or together with NPK fertilisers. They were all used on plots sown with two species of grass, Dactylis glomerata of the Bora variety and Lolium perenne of the Info variety. The plant material from both grass species was tested for the concentration of ADL fraction (% DM, cellulose (% DM, and hemicellulose (% DM. It was found that the concentration of cellulose, hemicelluloses, and the ADL fraction was significantly higher in the biomass of Dactylis glomerata than in the biomass of Lolium perenne. The grass from the plot with the UGmax soil conditioner applied had the highest amount of cellulose and hemicellulose. The lowest amount of those organic compounds was found in the grass treated with UGmax together with mineral fertilisers and in plants treated with Humus Active, together with mineral fertilisers. However, the fertilisers and conditioners did not increase the ADL content in both grass species.

  2. Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients.

    Science.gov (United States)

    Kim, Eun-Kyung; Lee, Dong-Kyu; Kim, Young-Mi

    2015-01-01

    [Purpose] This study investigated the effect of aquatic proprioceptive neuromuscular facilitation (PNF) patterns in the lower extremity on balance and activities of daily living (ADL) in stroke patients. [Subjects] Twenty poststroke participants were randomly assigned to an experimental group (n = 10) or a control group (n = 10). The experimental group performed lower extremity patterns in an aquatic environment, and the control group performed lower extremity patterns on the ground. Both exercises were conducted for 30 minutes/day, 5 days/week for 6 weeks. Balance was measured with the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Functional Reach Test (FRT), and One Leg Stand Test (OLST). Activities of daily living were measured with the Functional Independence Measure (FIM). A paired t-test was used to measure pre- and post-experiment differences, and an independent t-test was used to measure between-group differences. [Results] The experimental and control groups showed significant differences for all pre- and post-experiment variables. In the between-group comparison, the experimental group was significantly difference from the control group. [Conclusion] These results indicate that performing aquatic proprioceptive neuromuscular facilitation patterns in the lower extremity enhances balance and ADL in stroke patients.

  3. Effects of inpatient geriatric interventions in a German geriatric hospital: Impact on ADL, mobility and cognitive status.

    Science.gov (United States)

    Bordne, S; Schulz, R-J; Zank, S

    2015-06-01

    Given the demographic changes, the need for effective geriatric intervention is obvious. Geriatric care aims to maintain the highest possible level of independence and quality of life and to reduce the risk of need for care. This study investigated the benefits of geriatric care on functional performance, mobility and cognition. This study involved a retrospective analysis of clinical data from 646 patients. At hospital admission and discharge functional status was assessed using the Barthel index. Mobility was evaluated by means of the Tinetti test and cognition by the mini-mental state examination (MMSE). A follow-up was conducted on 112 patients 2-5 months after hospital discharge. Statistical analysis included t-tests including Cohen's d for effect size and multivariate regression analysis. The mean age of the study population was 81.1 ± 7.1 years including 439 women (68%) and 207 men (32%). There were significant average improvements for activities of daily living (ADL), mobility and cognition comparing discharge and admission scores. For functional and mobility status, effect sizes were medium to high. Regression analyses showed that ADL improvement was predicted by functional, mobile and cognitive status at admission. Follow-up analyses revealed a high percentage of former patients still living at home and an overall maintenance of ADL levels. Geriatric patients seem to experience long-term improvements during geriatric treatment, which appears to fulfill its aim of recovering independence. For a better understanding of relevant factors for the recreation of geriatric patients, further research is needed, e.g. with respect to the impact of the nutritional status.

  4. The impact of physical performance and cognitive status on subsequent ADL disability in low-functioning older adults

    NARCIS (Netherlands)

    Kempen, GIJM; Ormel, J

    Objectives. The purpose of this study was to examine the independent contributions of physical performance and cognitive status to subsequent levels of ADL disability in low-functioning non-institutionalized older adults. Methods. A prospective cohort study included 416 women and 141 men 57 years of

  5. Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients

    OpenAIRE

    Kim, Eun-Kyung; Lee, Dong-Kyu; Kim, Young-Mi

    2015-01-01

    [Purpose] This study investigated the effect of aquatic proprioceptive neuromuscular facilitation (PNF) patterns in the lower extremity on balance and activities of daily living (ADL) in stroke patients. [Subjects] Twenty poststroke participants were randomly assigned to an experimental group (n = 10) or a control group (n = 10). The experimental group performed lower extremity patterns in an aquatic environment, and the control group performed lower extremity patterns on the ground. Both exe...

  6. Restrictions and satisfaction with participation in patients who are ADL-independent after an aneurysmal subarachnoid hemorrhage.

    Science.gov (United States)

    Huenges Wajer, Irene M C; Visser-Meily, Johanna M A; Greebe, Paut; Post, Marcel W M; Rinkel, Gabriel J E; van Zandvoort, Martine J E

    2017-03-01

    Most survivors of an aneurysmal subarachnoid hemorrhage (aSAH) are ADL-independent, but they often experience restrictions in (social) activities and, therefore, cannot regain their pre-morbid level of participation. In this study, participation restrictions and participation satisfaction experienced after aSAH were assessed. Moreover, possible predictors of participation after aSAH were examined to identify goals for rehabilitation. Participation restrictions experienced by a series of 67 patients visiting our SAH outpatient clinic were assessed as part of standard clinical care using the Participation Restrictions and Satisfaction sections of the Utrecht Scale for Evaluation of Rehabilitation Participation (USER-Participation) 6 months after aSAH. Cognitive impairments, cognitive and emotional complaints, and symptoms of depression and anxiety, assessed 10 weeks after aSAH, were examined as possible predictors of participation by means of linear regression analysis. Although patients were ADL-independent, 64% reported one or more participation restrictions and 60% were dissatisfied in one or more participation domains. Most commonly experienced restrictions concerned housekeeping, chores in and around the house, and physical exercise. Dissatisfaction was most often reported about outdoor activities, mobility, and work/housekeeping. The main predictors of participation restrictions as well as satisfaction with participation were cognitive complaints (subjective) (β = -.30, p = .03 and β = -.40, p = .002, respectively) and anxiety (β = .32, p = .02 and β = -.34, p = .007, respectively). Almost two-thirds of the ADL-independent patients experienced problems of participation 6 months after aSAH. Cognitive complaints (subjective) and anxiety symptoms showed the strongest association with participation restrictions and satisfaction. Cognitive rehabilitation and anxiety-reducing interventions may help to optimize rehabilitation and increase

  7. Ambient and smartphone sensor assisted ADL recognition in multi-inhabitant smart environments.

    Science.gov (United States)

    Roy, Nirmalya; Misra, Archan; Cook, Diane

    2016-02-01

    Activity recognition in smart environments is an evolving research problem due to the advancement and proliferation of sensing, monitoring and actuation technologies to make it possible for large scale and real deployment. While activities in smart home are interleaved, complex and volatile; the number of inhabitants in the environment is also dynamic. A key challenge in designing robust smart home activity recognition approaches is to exploit the users' spatiotemporal behavior and location, focus on the availability of multitude of devices capable of providing different dimensions of information and fulfill the underpinning needs for scaling the system beyond a single user or a home environment. In this paper, we propose a hybrid approach for recognizing complex activities of daily living (ADL), that lie in between the two extremes of intensive use of body-worn sensors and the use of ambient sensors. Our approach harnesses the power of simple ambient sensors (e.g., motion sensors) to provide additional 'hidden' context (e.g., room-level location) of an individual, and then combines this context with smartphone-based sensing of micro-level postural/locomotive states. The major novelty is our focus on multi-inhabitant environments, where we show how the use of spatiotemporal constraints along with multitude of data sources can be used to significantly improve the accuracy and computational overhead of traditional activity recognition based approaches such as coupled-hidden Markov models. Experimental results on two separate smart home datasets demonstrate that this approach improves the accuracy of complex ADL classification by over 30 %, compared to pure smartphone-based solutions.

  8. Ambient and smartphone sensor assisted ADL recognition in multi-inhabitant smart environments

    Science.gov (United States)

    Misra, Archan; Cook, Diane

    2016-01-01

    Activity recognition in smart environments is an evolving research problem due to the advancement and proliferation of sensing, monitoring and actuation technologies to make it possible for large scale and real deployment. While activities in smart home are interleaved, complex and volatile; the number of inhabitants in the environment is also dynamic. A key challenge in designing robust smart home activity recognition approaches is to exploit the users' spatiotemporal behavior and location, focus on the availability of multitude of devices capable of providing different dimensions of information and fulfill the underpinning needs for scaling the system beyond a single user or a home environment. In this paper, we propose a hybrid approach for recognizing complex activities of daily living (ADL), that lie in between the two extremes of intensive use of body-worn sensors and the use of ambient sensors. Our approach harnesses the power of simple ambient sensors (e.g., motion sensors) to provide additional ‘hidden’ context (e.g., room-level location) of an individual, and then combines this context with smartphone-based sensing of micro-level postural/locomotive states. The major novelty is our focus on multi-inhabitant environments, where we show how the use of spatiotemporal constraints along with multitude of data sources can be used to significantly improve the accuracy and computational overhead of traditional activity recognition based approaches such as coupled-hidden Markov models. Experimental results on two separate smart home datasets demonstrate that this approach improves the accuracy of complex ADL classification by over 30 %, compared to pure smartphone-based solutions. PMID:27042240

  9. Effect of exercise on apparent total tract digestibility of nutrients and faecal recovery of ADL and TiO2 in ponies.

    Science.gov (United States)

    Schaafstra, F J W C; van Doorn, D A; Schonewille, J T; Roelfsema, E; Westermann, C M; Dansen, O; Jacobs, M; Lee, J-Y; Spronck, E A; Blok, M C; Hendriks, W H

    2018-03-07

    Exercise and physical training are known to affect gastrointestinal function and digestibility in horses and can lead to inaccurate estimates of nutrient and energy digestibility when markers are used. The effect of exercise on apparent nutrient digestibility and faecal recoveries of ADL and TiO2 was studied in six Welsh pony geldings subjected to either a low- (LI) or high-intensity (HI) exercise regime according to a cross-over design. Ponies performing LI exercise were walked once per day for 45 min in a horse walker (5 km/h) for 47 consecutive days. Ponies submitted to HI exercise were gradually trained for the same 47 days according a standardized protocol. Throughout the experiment, the ponies received a fixed level of feed and the daily rations consisted of 4.7 kg DM of grass hay and 0.95 kg DM of concentrate. The diet was supplemented with minerals, vitamins and TiO2 (3.0 g Ti/day). Total tract digestibility of DM, organic matter (OM), CP, crude fat, NDF, ADF, starch, sugar and energy was determined with the total faeces collection (TFC) method. In addition, DM and OM digestibility was estimated using internal ADL and the externally supplemented Ti as markers. Urine was collected on the final 2 days of each experimental period. Exercise did not affect apparent digestibility of CP, crude fat, starch and sugar. Digestibility of DM (DMD), OM (OMD), ADF and NDF tended to be lower and DE was decreased when ponies received the HI exercise regime. For all treatments combined, mean faecal recoveries of ADL and Ti were 87.8±1.7% and 99.3±1.7%, respectively. Ti was not detected in the urine, indicating that intestinal integrity was maintained with exercise. Dry matter digestibility estimated with the TFC, ADL and Ti for ponies subjected to LI exercise were 66.3%, 60.3% and 64.8%, respectively, while DMD for HI ponies were 64.2%, 60.3% and 65.2%, respectively. In conclusion, physical exercise has an influence on the GE digestibility of the feed in ponies provided

  10. The course of apraxia and ADL functioning in left hemisphere stroke patients treated in rehabilitation centres and nursing homes.

    NARCIS (Netherlands)

    Donkervoort, M.; Dekker, J.; Deelman, B.

    2006-01-01

    OBJECTIVE: To study the course of apraxia and daily life functioning (ADL) in left hemisphere stroke patients with apraxia. DESIGN: Prospective cohort study. SETTING: Rehabilitation centres and nursing homes. SUBJECTS: One hundred and eight left hemisphere stroke patients with apraxia, hospitalized

  11. Effects of interactive metronome training on upper extremity function, ADL and QOL in stroke patients.

    Science.gov (United States)

    Yu, Ga-Hui; Lee, Jae-Shin; Kim, Su-Kyoung; Cha, Tae-Hyun

    2017-01-01

    Rhythm and timing training is stimulation that substitutes for a damaged function controls muscular movement or temporal element, which has positive impacts on the neurological aspect and movement of the brain. This study is to assess the changes caused by rhythm and timing training using an interactive metronome (IM) on upper extremity function, ADL and QOL in stroke patients. In order to assess the effects of IM training, a group experiment was conducted on 30 stroke patients. Twelve sessions of IM training were provided for the experimental group three times a week for four weeks, while the control group was trained with a Bilateral arm Self-Exercise (BSE) for the same period. Both groups were evaluated by pre- and post-tests through MFT, MAL, K-MBI and SS-QOL. There were more statistically significant differences (<0.05) in the total score of MFT and the finger control item in the IM Group than in the BSE Group. With respect to ADL, there were more statistically significant differences (<0.05) in the total score of K-MBI and the dressing item in the IM Group than in the BSE Group. The study proposes that IM training can be applied as an occupational therapy program in patients with various diseases who need to adjust the time for performing movements as well as stroke patients.

  12. Risk Factors for Nursing Home Placement in Alzheimer's Disease: A Longitudinal Study of Cognition, ADL, Service Utilization, and Cholinesterase Inhibitor Treatment

    Science.gov (United States)

    Wattmo, Carina; Wallin, Asa K.; Londos, Elisabet; Minthon, Lennart

    2011-01-01

    Purpose of the Study: To identify risk factors for early nursing home placement (NHP) in Alzheimer's disease (AD), focusing on the impact of longitudinal change in cognition, activities of daily living (ADL), service utilization, and cholinesterase inhibitor treatment (ChEI). Design and Methods: In an open, 3-year, prospective, multicenter study…

  13. Genome-Wide Analysis of Seed Acid Detergent Lignin (ADL) and Hull Content in Rapeseed (Brassica napus L.)

    Science.gov (United States)

    Wei, Lijuan; Qu, Cunmin; Xu, Xinfu; Lu, Kun; Qian, Wei; Li, Jiana; Li, Maoteng; Liu, Liezhao

    2015-01-01

    A stable yellow-seeded variety is the breeding goal for obtaining the ideal rapeseed (Brassica napus L.) plant, and the amount of acid detergent lignin (ADL) in the seeds and the hull content (HC) are often used as yellow-seeded rapeseed screening indices. In this study, a genome-wide association analysis of 520 accessions was performed using the Q + K model with a total of 31,839 single-nucleotide polymorphism (SNP) sites. As a result, three significant associations on the B. napus chromosomes A05, A09, and C05 were detected for seed ADL content. The peak SNPs were within 9.27, 14.22, and 20.86 kb of the key genes BnaA.PAL4, BnaA.CAD2/BnaA.CAD3, and BnaC.CCR1, respectively. Further analyses were performed on the major locus of A05, which was also detected in the seed HC examination. A comparison of our genome-wide association study (GWAS) results and previous linkage mappings revealed a common chromosomal region on A09, which indicates that GWAS can be used as a powerful complementary strategy for dissecting complex traits in B. napus. Genomic selection (GS) utilizing the significant SNP markers based on the GWAS results exhibited increased predictive ability, indicating that the predictive ability of a given model can be substantially improved by using GWAS and GS. PMID:26673885

  14. Tradução, validação e adaptação cultural da escala de atividade de vida diária Translation, validation and cultural adaptation of the 'activities of daily living' scale (ADLS

    Directory of Open Access Journals (Sweden)

    Priscila Zeitune Nigri

    2007-01-01

    Full Text Available OBJETIVO: Realizar a tradução, adaptação cultural e validação do "Knee Outcome Survey- Activities of Daily Living Scale" (ADLS para a língua portuguesa, bem como verificar suas propriedades de medida, reprodutibilidade e validade, para que o mesmo possa ser usado como um instrumento específico para avaliação de sintomas em pacientes brasileiros portadores de afecções no joelho durante as atividades de vida diária. MÉTODOS: Foram realizadas 2 entrevistas,na primeira o questionário foi aplicado em conjunto ao Lysholm, SF-36 e EAV (examinador 1. Após aproximadamente 30 minutos da primeira entrevista, os mesmos pacientes responderam apenas ao ADLS (examinador 2. Após um intervalo entre 7 a 10 dias, foi realizada a terceira entrevista constituída de nova aplicação do ADLS (examinador 2. RESULTADOS: A amostra consistiu de 53 entrevistados, sendo a média de idade de 33.0566 anos e patologia mais freqüente a lesão ligamentar (56,6%. O índice de Sperman obteve um valor de 0,986 (alfa=0,05, roOBJECTIVES: To perform the translation, cultural adaptation and validation of the "Knee Outcome Survey - Activities of Daily Living Scale" (ADLS into Portuguese, as well as to check its measurement, reproducibility and validity properties in order to make it useful as a specific instrument for evaluating symptoms in Brazilian patients with knee injuries during their daily living activities. METHODS: Two interviews were performed; in the first interview, the questionnaire was applied along with Lysholm's, SF-36 and VAS (investigator 1. Approximately 30 minutes after the first interview, the same patients answered only the ADLS (investigator 2. After a break of 7 to 10 days, a third additional interview with the ADLS was applied (investigator 2. RESULTS: The sample was constituted of 53 subjects, with mean age of 33.0566 years, with the most frequent pathology being ligamentar injury (56.6%. The Spearman's index used for inter

  15. Quantifying kinematics of purposeful movements to real, imagined, or absent functional objects: implications for modelling trajectories for robot-assisted ADL tasks.

    Science.gov (United States)

    Wisneski, Kimberly J; Johnson, Michelle J

    2007-03-23

    Robotic therapy is at the forefront of stroke rehabilitation. The Activities of Daily Living Exercise Robot (ADLER) was developed to improve carryover of gains after training by combining the benefits of Activities of Daily Living (ADL) training (motivation and functional task practice with real objects), with the benefits of robot mediated therapy (repeatability and reliability). In combining these two therapy techniques, we seek to develop a new model for trajectory generation that will support functional movements to real objects during robot training. We studied natural movements to real objects and report on how initial reaching movements are affected by real objects and how these movements deviate from the straight line paths predicted by the minimum jerk model, typically used to generate trajectories in robot training environments. We highlight key issues that to be considered in modelling natural trajectories. Movement data was collected as eight normal subjects completed ADLs such as drinking and eating. Three conditions were considered: object absent, imagined, and present. This data was compared to predicted trajectories generated from implementing the minimum jerk model. The deviations in both the plane of the table (XY) and the sagittal plane of torso (XZ) were examined for both reaches to a cup and to a spoon. Velocity profiles and curvature were also quantified for all trajectories. We hypothesized that movements performed with functional task constraints and objects would deviate from the minimum jerk trajectory model more than those performed under imaginary or object absent conditions. Trajectory deviations from the predicted minimum jerk model for these reaches were shown to depend on three variables: object presence, object orientation, and plane of movement. When subjects completed the cup reach their movements were more curved than for the spoon reach. The object present condition for the cup reach showed more curvature than in the object

  16. Quantifying kinematics of purposeful movements to real, imagined, or absent functional objects: Implications for modelling trajectories for robot-assisted ADL tasks**

    Directory of Open Access Journals (Sweden)

    Wisneski Kimberly J

    2007-03-01

    Full Text Available Abstract Background Robotic therapy is at the forefront of stroke rehabilitation. The Activities of Daily Living Exercise Robot (ADLER was developed to improve carryover of gains after training by combining the benefits of Activities of Daily Living (ADL training (motivation and functional task practice with real objects, with the benefits of robot mediated therapy (repeatability and reliability. In combining these two therapy techniques, we seek to develop a new model for trajectory generation that will support functional movements to real objects during robot training. We studied natural movements to real objects and report on how initial reaching movements are affected by real objects and how these movements deviate from the straight line paths predicted by the minimum jerk model, typically used to generate trajectories in robot training environments. We highlight key issues that to be considered in modelling natural trajectories. Methods Movement data was collected as eight normal subjects completed ADLs such as drinking and eating. Three conditions were considered: object absent, imagined, and present. This data was compared to predicted trajectories generated from implementing the minimum jerk model. The deviations in both the plane of the table (XY and the saggital plane of torso (XZ were examined for both reaches to a cup and to a spoon. Velocity profiles and curvature were also quantified for all trajectories. Results We hypothesized that movements performed with functional task constraints and objects would deviate from the minimum jerk trajectory model more than those performed under imaginary or object absent conditions. Trajectory deviations from the predicted minimum jerk model for these reaches were shown to depend on three variables: object presence, object orientation, and plane of movement. When subjects completed the cup reach their movements were more curved than for the spoon reach. The object present condition for the cup

  17. Functional competency and cognitive ability in mild Alzheimer's disease: relationship between ADL assessed by a relative/ carer-rated scale and neuropsychological performance.

    Science.gov (United States)

    Matsuda, Osamu; Saito, Masahiko

    2005-06-01

    Alzheimer's disease (AD) is characterized by multiple cognitive deficits and affects functional competency to perform daily activities (ADL). As this may contribute to the patient's overall disability, it is important to identify factors that compromise competency. The relationship between different cognitive domains and functional activities in AD was studied. The functional competency of 73 Japanese AD patients, most with mild dementia, was assessed using a 27-item relative/carer-rating scale covering 7 ADL: managing finances, using transportation, taking precautions, self-care, housekeeping, communication and taking medicine. Cognitive assessment used 16 neuropsychological tests from the Japanese version of the WAIS-R and COGNISTAT, covering 9 cognitive domains: orientation, attention, episodic memory, semantic memory, language, visuoperceptual and construction abilities, computational ability, abstract thinking, and psychomotor speed. Multiple regression analysis by the stepwise method indicated that functional competency could, for the most part, be predicted from test scores for orientation, abstract thinking and psychomotor speed. The results of this study suggest that impairment of these three cognitive domains plays an important role in the functional deterioration of AD.

  18. Unravelling the potential mechanisms behind hospitalization-associated disability in older patients : the hospital-associated disability and impact on daily Life (Hospital-ADL) cohort study protocol

    NARCIS (Netherlands)

    Reichardt, Lucienne A.; Aarden, Jesse J.; van Seben, Rosanne; van der Schaaf, Marike; Engelbert, Raoul H.H.; Bosch, Jos A.; Buurman, Bianca M.

    2016-01-01

    BACKGROUND: Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the

  19. Unravelling the potential mechanisms behind hospitalization-associated disability in older patients : The Hospital-Associated Disability and impact on daily Life (Hospital-ADL) cohort study protocol

    NARCIS (Netherlands)

    Reichardt, L.A.; Aarden, J.J.; van Seben, R.; van der Schaaf, M.; Engelbert, R.H.H.; Bosch, J.A.; Buurman, B.M.

    2016-01-01

    BACKGROUND: Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the

  20. Measurement Equivalence in ADL and IADL Difficulty Across International Surveys of Aging: Findings From the HRS, SHARE, and ELSA

    Science.gov (United States)

    Kasper, Judith D.; Brandt, Jason; Pezzin, Liliana E.

    2012-01-01

    Objective. To examine the measurement equivalence of items on disability across three international surveys of aging. Method. Data for persons aged 65 and older were drawn from the Health and Retirement Survey (HRS, n = 10,905), English Longitudinal Study of Aging (ELSA, n = 5,437), and Survey of Health, Ageing and Retirement in Europe (SHARE, n = 13,408). Differential item functioning (DIF) was assessed using item response theory (IRT) methods for activities of daily living (ADL) and instrumental activities of daily living (IADL) items. Results. HRS and SHARE exhibited measurement equivalence, but 6 of 11 items in ELSA demonstrated meaningful DIF. At the scale level, this item-level DIF affected scores reflecting greater disability. IRT methods also spread out score distributions and shifted scores higher (toward greater disability). Results for mean disability differences by demographic characteristics, using original and DIF-adjusted scores, were the same overall but differed for some subgroup comparisons involving ELSA. Discussion. Testing and adjusting for DIF is one means of minimizing measurement error in cross-national survey comparisons. IRT methods were used to evaluate potential measurement bias in disability comparisons across three international surveys of aging. The analysis also suggested DIF was mitigated for scales including both ADL and IADL and that summary indexes (counts of limitations) likely underestimate mean disability in these international populations. PMID:22156662

  1. Comparisons of social interaction and activities of daily living between long-term care facility and community-dwelling stroke patients.

    Science.gov (United States)

    Yoon, Jeong-Ae; Park, Se-Gwan; Roh, Hyo-Lyun

    2015-10-01

    [Purpose] This study was conducted to compare the correlation between social interaction and activities of daily living (ADL) between community-dwelling and long-term care facility stroke patients. [Subjects and Methods] The Subjects were 65 chronic stroke patients (32 facility-residing, 33 community-dwelling). The Evaluation Social Interaction (ESI) tool was used to evaluate social interaction and the Assessment of Motor and Process Skills (AMPS) measure was used to evaluate ADL. [Results] Both social interaction and ADL were higher in community-dwelling than facility-residing stroke patients. There was a correlation between ESI and ADL for both motor and process skills among facility-residing patients, while only ADL process skills and ESI correlated among community-dwelling patients. In a partial correlation analysis using ADL motor and process skills as control variables, only process skills correlated with ESI. [Conclusion] For rehabilitation of stroke patients, an extended treatment process that combines ADL and social activities is likely to be required. Furthermore, treatment programs and institutional systems that can improve social interaction and promote health maintenance for community-dwelling and facility-residing chronic stroke patients are needed throughout the rehabilitation process.

  2. A Longitudinal Study of Changes in Asylum Seekers Ability Regarding Activities of Daily Living During Their Stay in the Asylum Center

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Amris, Kirstine; Eklund, Mona

    2015-01-01

    participated. ADL-ability was measured using Assessment of Motor and Process Skills and questionnaires about exposure to torture, self-reported mental health and pain. ADL motor and process measures, well-being and self-rated health declined from baseline to follow-up. Measures of pain and depression increased......The aim was to assess change in activities of daily living (ADL) ability amongst asylum seekers and if there were any difference between tortured and non-torture following a 10 months post-arrival period, and if self-reported health and exposure to torture were factors related to change in ADL....... Exposure to physical torture and change in ADL motor (r = 0.525) measures were associated, as well as change in current pain and change in ADL process (r = 0.525) measures. Due to preponderance of torture survivors analysis of group difference was not applicable. Health care workers should be aware of ADL...

  3. Activities of daily living (ADL) of single elderly individuals using social assistive programs in a rural community.

    Science.gov (United States)

    Yokokawa, Yoshiharu; Miyoshi, Kei; Kai, Ichiro

    2017-01-01

    Objectives The proportion of elderly individuals living alone is increasing in Japan. Matsumoto city office provides social assistive programs such as home help, lunch delivery, life advice, and safety check telephone calls. The purpose of this study was to compare the level of ADL between the elderly using social assistive programs (the use group) and those who did not (the non-use group).Methods We conducted a cross-sectional study at Shiga district of Matsumoto city in September 2014. A total of 128 elderly individuals participated in this study. Health volunteers asked these subjects to complete a questionnaire without assistance. Measurement items included lifestyle variables and social support networks. With respect to the frequency of use, we used questions that inquired about the use of the social assistive program. We included a set of instruments commonly used in the health assessment of elderly populations: functional capacity (Instrumental ADL, Intellectual Activity, Social Role), social support, nutrition (Mini Nutrition Assessment [MNA]) and depressive symptoms (Geriatric Depression Scale [GDS]).Results The use group consisted of 24 elderly individuals participating in the social support program. The non-use group consisted of 89 elderly individuals living alone without programs. The mean age of those who completed the survey was 83.9±4.2 years for the use group and 82.3±4.3 years for the non-use group. Comparisons between the two groups did not show significant difference in terms of their intellectual activity, social role, emotional social support, and MNA or GDS scores. The use group was more likely to use the public transfer service and receive instrumental social support from children and relatives.Conclusions By means of utilizing the public transfer service, and receiving family support, the elderly living alone who used social assistive programs could live independently. These findings suggest a need for improvement in the public

  4. Adrienne Rich'in "Diving into the Wreck" Adlı Şiirine Eko Feminist Bir Yaklaşım

    OpenAIRE

    ERKAN, Ayça Ülker

    2014-01-01

    Bu çalışmada Adrienne Rich\\'in şiirlerinden olan “Diving into the Wreck” (1973) adlı şiiri eko feminist eleştiri bağlamında incelenmektedir. Rich\\'in doğa şiirleri, kadın tarafsızlığını ve bilincini, ata erkil suistimalini ve önem vermeme varsayımlarını sorgular. Şiirdeki androjen (çift cinsiyetli) karakter “ben” ile birlikte Rich, dişi öznelliğine yer verebilmek için toplumsal cinsiyet ve cinsiyet sınırlarının ötesine gider. Şiirdeki karakter dişi kimliğini ve cinselliğini mecazi b...

  5. Model-based Development of Safety-critical Functions and ISO 26262 Work Products using modified EAST-ADL

    Directory of Open Access Journals (Sweden)

    Bülent Sari

    2017-07-01

    Full Text Available Safety is becoming more and more important with the ever increasing level of safety related E/E Systems built into the cars. Increasing functionality of vehicle systems through electrification of power train, in future even more by autonomous driving, leads to complexity in designing system, software and safety architecture. ISO 26262 aims to reduce the complexity and to approve the traceability of the different safety activities. This paper presents an approach about model-based development of system, software and safety architecture using Electronics Architecture and Software Technology – Architecture Description Language (EAST-ADL, being in line with the relevant standard ISO 26262. In particular, we briefly discuss how the main safety related activities, such as hazard analysis and risk assessment, developing functional and technical safety concepts and performing safety analysis can be performed model-based and how the activities can be related with system and software development. The state-of-art is also provided and compared with the proposed approach.

  6. Assistive system for people with Apraxia using a Markov decision process.

    Science.gov (United States)

    Jean-Baptiste, Emilie M D; Russell, Martin; Rothstein, Pia

    2014-01-01

    CogWatch is an assistive system to re-train stroke survivors suffering from Apraxia or Action Disorganization Syndrome (AADS) to complete activities of daily living (ADLs). This paper describes the approach to real-time planning based on a Markov Decision Process (MDP), and demonstrates its ability to improve task's performance via user simulation. The paper concludes with a discussion of the remaining challenges and future enhancements.

  7. Observation-based assessment of functional ability in patients with chronic widespread pain

    DEFF Research Database (Denmark)

    Amris, Kirstine; Wæhrens, Eva Ejlersen; Jespersen, Anders

    2011-01-01

    Knowledge about functional ability, including activities of daily living (ADL), in patients with chronic widespread pain (CWP) and fibromyalgia (FMS) is largely based on self-report. The purpose of this study was to assess functional ability by using standardised, observation-based assessment...... of ADL performance and to examine the relationship between self-reported and observation-based measures of disability. A total of 257 women with CWP, 199 (77%) fulfilling the American College of Rheumatology tender point criteria for FMS, were evaluated with the Assessment of Motor and Process Skills...... (AMPS), an observation-based assessment providing linear measures of ADL motor and ADL process skill ability (unit: logits). A cutoff for effortless and independent ADL task performance is set at 2.0 for the motor scale and 1.0 for the process scale. A total of 248 (96.5%) had ability measures below...

  8. Observation-based assessment of functional ability in patients with chronic widespread pain: A cross-sectional study

    DEFF Research Database (Denmark)

    Amris, Kirstine; Wæhrens, Eva Elisabet Ejlersen; Jespersen, Anders

    2011-01-01

    Knowledge about functional ability, including activities of daily living (ADL), in patients with chronic widespread pain (CWP) and fibromyalgia (FMS) is largely based on self-report. The purpose of this study was to assess functional ability by using standardised, observation-based assessment...... of ADL performance and to examine the relationship between self-reported and observation-based measures of disability. A total of 257 women with CWP, 199 (77%) fulfilling the American College of Rheumatology tender point criteria for FMS, were evaluated with the Assessment of Motor and Process Skills...... (AMPS), an observation-based assessment providing linear measures of ADL motor and ADL process skill ability (unit: logits). A cutoff for effortless and independent ADL task performance is set at 2.0 for the motor scale and 1.0 for the process scale. A total of 248 (96.5%) had ability measures below...

  9. Resident Choice and the Survey Process: The Need for Standardized Observation and Transparency

    Science.gov (United States)

    Schnelle, John F.; Bertrand, Rosanna; Hurd, Donna; White, Alan; Squires, David; Feuerberg, Marvin; Hickey, Kelly; Simmons, Sandra F.

    2009-01-01

    Purpose: To describe a standardized observation protocol to determine if nursing home (NH) staff offer choice to residents during 3 morning activities of daily living (ADL) and compare the observational data with deficiency statements cited by state survey staff. Design and Methods: Morning ADL care was observed in 20 NHs in 5 states by research…

  10. The Hamlet Application Design Language: introductory definition report

    NARCIS (Netherlands)

    M.R. van Steen

    1993-01-01

    textabstractThis report provides an introduction to the definition of the Hamlet Application Design Language (ADL). ADL is a graphical-based language and notation supporting the design of parallel real-time applications. Designs expressed in ADL are based on a model of processes that communicate by

  11. Ability to perform Actvities of Daily Living among patients with bipolar disorder in remission

    DEFF Research Database (Denmark)

    Decker, Lone; Träger, Conny; Miskowiak, Kamilla

    2017-01-01

    in the community. While participants reported decreased ADL ability, especially within instrumental ADL, they had a tendency towards evaluating themselves as more competent than what was observed. No relationships between measures of observed and self-reported ADL ability were found. Conclusion: Overall, patients......ABSTRACT Aims: Patients with bipolar disorder often experience disability in terms of cognitive impairments and activity limitations even in remission. However, knowledge is sparse concerning the ability to perform Activities of Daily Living (ADL) during remission. The aim of this study was to (1......) investigate the observed and self-reported ability to perform ADL tasks and (2) examine the association between observed and self-reported ability to perform ADL in patients with bipolar disorder in remission. Methods: The observed ADL ability was assessed with the Assessment of Motor and Process Skills...

  12. Occupational therapy evaluation

    DEFF Research Database (Denmark)

    Nielsen, Kristina Tomra; Wæhrens, Eva Ejlersen

    2015-01-01

    performance based on self-report and observation, respectively, and to examine the relationship between measures of self-reported and observed quality of ADL task performance. Methods: The quality of ADL task performance among 20 adults with depression was evaluated using the ADL Interview (ADL......-I) and the Assessment of Motor and Process Skills (AMPS). Results and conclusions: Results indicated that participants both reported and demonstrated increased effort and/or fatigue, increased use of time, need for assistance, and safety problems. However, little relationship was found between measures of self......-reported and observed quality of ADL task performance, supporting the use of both self-report and observation as part of the evaluation phase outlined in the OTIPM. Key words: activities of daily living, depression, assessment, interview, OTIPM, ADL-I, AMPS...

  13. Hasan Basri Çantay’ın “On Kere Kırk Hadis” Adlı Eserinde Ahkâm Hadislerine Getirdiği Fıkhî Yorumlar

    Directory of Open Access Journals (Sweden)

    Mehmet Özkan

    2015-06-01

    Full Text Available Milli mücadele yıllarının öne çıkan isimlerinden biri olan Hasan Basri Çantay yazarlık, gazetecilik, öğretmenlik ve milletvekilliği gibi birçok alanda faaliyet göstermiş, çeşitli konularda yazılar yazmış, eserler kaleme almıştır. İslami ilimler alanında da kendini yetiştiren Çantay’ın bu alandaki en önemli eseri “Kur’an-ı Hakîm ve Meal-i Kerîm” adlı Kur’an mealidir. İkinci önemli eseri, “On Kere Kırk Hadis” adlı kitabıdır. 1955-1962 yılları arasında üç cilt halinde basılan bu kitap iman, ibâdet, temizlik, ahlak, muâmelat, evlenme, boşanma, suç ve cezalar, şûra, askerlik ve cihat, savaş hukuku,  helal,  haram gibi birçok konuyla ilgili bin iki yüz hadisten oluşmaktadır. Bunların yaklaşık dört yüz yirmisi ahkâm hadisidir. Çantay, hadisleri tercüme etmekle kalmamış yeri geldikçe izahlarda da bulunmuştur. Bu çalışmada Çantay’ın yaklaşık yüz otuz ahkâm hadisine yaptığı izah ve fıkhî değerlendirmelerden örneklere yer verilecektir.

  14. The Hamlet design entry system: on the implementation of synchronous channels

    NARCIS (Netherlands)

    M.R. van Steen

    1994-01-01

    textabstractThe graphical Hamlet Application Design Language (ADL) has been developed to support the construction of parallel applications. The language is based on a notion of processes communicating by means of message-passing. One of the goals of ADL is that its implementation should allow

  15. Approach for the Development of a Framework for the Identification of Activities of Daily Living Using Sensors in Mobile Devices

    Science.gov (United States)

    Pombo, Nuno

    2018-01-01

    Sensors available on mobile devices allow the automatic identification of Activities of Daily Living (ADL). This paper describes an approach for the creation of a framework for the identification of ADL, taking into account several concepts, including data acquisition, data processing, data fusion, and pattern recognition. These concepts can be mapped onto different modules of the framework. The proposed framework should perform the identification of ADL without Internet connection, performing these tasks locally on the mobile device, taking in account the hardware and software limitations of these devices. The main purpose of this paper is to present a new approach for the creation of a framework for the recognition of ADL, analyzing the allowed sensors available in the mobile devices, and the existing methods available in the literature. PMID:29466316

  16. Approach for the Development of a Framework for the Identification of Activities of Daily Living Using Sensors in Mobile Devices.

    Science.gov (United States)

    Pires, Ivan Miguel; Garcia, Nuno M; Pombo, Nuno; Flórez-Revuelta, Francisco; Spinsante, Susanna

    2018-02-21

    Sensors available on mobile devices allow the automatic identification of Activities of Daily Living (ADL). This paper describes an approach for the creation of a framework for the identification of ADL, taking into account several concepts, including data acquisition, data processing, data fusion, and pattern recognition. These concepts can be mapped onto different modules of the framework. The proposed framework should perform the identification of ADL without Internet connection, performing these tasks locally on the mobile device, taking in account the hardware and software limitations of these devices. The main purpose of this paper is to present a new approach for the creation of a framework for the recognition of ADL, analyzing the allowed sensors available in the mobile devices, and the existing methods available in the literature.

  17. Long-term dynamic characterization of aeolian desertification in northwest Shanxi, China.

    Science.gov (United States)

    Xue, Zhanjin; Qin, Zuodong; Cheng, Fangqin; Ding, Guangwei; Li, Hongjian

    2017-07-01

    Northwest Shanxi is located on the farming-pastoral ecotone of northern China, where aeolian desertification is one of the most serious environmental and socioeconomic issues. The remote sensing image and geostatistical approach were implemented to estimate aeolian desertified land (ADL) dynamic variations from 1975 to 2015. Results showed that the ADL covered 11,685.21 km 2 (82.29%) of the study area in 2015, the majority of which was classified as a light or moderate degree. The area of ADL gradually expanded at an increasing rate of 87.37 km 2 a -1 during the 1975-2000 periods. More specifically, the area of ADL has increased by 1259.23 km 2 from 1975 to 1990 and by 924.96 km 2 from 1990 to 2000, respectively. In contrast, spatial transfer of ADL areas has dwindled by 2365.85 km 2 with a net decrease of 157.72 km 2 a -1 , and the mitigated areas of aeolian desertification were 10,602.24 km 2 between 2000 and 2015. During the past 40 years, the gravity center of ADL migrated to southeast until 2000 and moved northwest in 2000-2015. From 1975 to 2000, the migration distance of severe ADL was the largest, migrated toward the northwest by 19.03 km in 1975-1990 and by 20.16 km in 1990-2000, respectively. From 2000 to 2015, the migration distance of light ADL was the largest, 27.54 km migrated to the northwest. Aeolian desertification rapidly expanded from 1975 to 2000 under the combination of climate change and intensive human activities. Since the year of 2000, ecological engineering strategy initiated by the governments has been the dominant contributor to the aeolian desertification severity reversal. Aeolian desertification prevention is a complicated process. Both the central and local government should play a critical role in the rehabilitation of ADL in the long term.

  18. Performance of activities of daily living among hospitalized cancer patients

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Line; Hansen, Dorte Gilså; Wæhrens, Eva Ejlersen

    2015-01-01

    and characterize ADL task performance problems among a group of adult disabled hospitalized cancer patients using interview and questionnaire data. METHODS: Cross-sectional study on prevalence of ADL task performance problems experienced by disabled hospitalized cancer patients using the Activities of Daily Living...... Questionnaire (ADL-Q) (n = 118) and the Canadian Occupational Performance Measure (COPM) (n = 55). RESULTS: All 118 patients reported problems with ADL task performance. Based on the ADL-Q patients reported more problems within instrumental (I-)ADL than personal (P-)ADL. In both I-ADL and P-ADL the results......BACKGROUND: Many cancer patients report unmet rehabilitation needs. Rehabilitation may include activities of daily living (ADL) tasks, but little is known about how cancer patients perform these tasks and how they prioritize their daily activities. Hence, this study aims to identify...

  19. How Do People With COPD Value Different Activities? An Adapted Meta-Ethnography of Qualitative Research.

    Science.gov (United States)

    Lindenmeyer, Antje; Greenfield, Sheila M; Greenfield, Charlotte; Jolly, Kate

    2017-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is a long-term condition where activities of daily living (ADLs) may be very restricted; people with COPD need to prioritize what is important to them. We conducted a meta-ethnography to understand which ADLs are valued and why, systematically searching for articles including experiences of ADLs and organizing themes from the articles into five linked concepts: (a) caring for the body, (b) caring for the personal environment, (c) moving between spaces, (d) interacting with others, and (e) selfhood across time. In addition, we identified three key aspects of personal integrity: effectiveness, connectedness, and control. We found that ADLs were valued if they increased integrity; however, this process was also informed by gendered roles and social values. People whose sense of control depended on effectiveness often found accepting help very difficult to bear; therefore, redefining control as situational and relational may help enjoyment of activities that are possible. © The Author(s) 2016.

  20. Activities of daily living in children with hemiparesis: influence of cognitive abilities and motor competence.

    Science.gov (United States)

    Adler, Caroline; Rauchenzauner, Markus; Staudt, Martin; Berweck, Steffen

    2014-12-01

    The aim of the article is to investigate whether motor competence and cognitive abilities influence the quality of performance of activities of daily living (ADL) in children with hemiparesis. Patients and A total of 20 children with hemiparesis (age, 6-12 years; 11 congenital, 9 acquired during childhood) were studied. Motor competence was assessed with the Assisting Hand Assessment, cognitive abilities with the German version of the Wechsler Intelligence Scale for Children IV, and the quality of ADL performance with the Assessment of Motor and Process Skills (AMPS). The motor skills scale of the AMPS correlated with motor competence, and the process skills scale of the AMPS correlated with cognitive abilities. The quality of ADL performance is influenced not only by motor competence but also by the cognitive abilities of a hemiparetic child. This suggests that, in addition to motor-oriented training programs, an optimal therapy for hemiparetic children should also consider cognitive approaches. Georg Thieme Verlag KG Stuttgart · New York.

  1. Subgroup effects of occupational therapy-based intervention for people with advanced cancer.

    Science.gov (United States)

    Sampedro Pilegaard, Marc; Oestergaard, Lisa Gregersen; la Cour, Karen; Thit Johnsen, Anna; Brandt, Åse

    2018-03-23

    Many people with advanced cancer have decreased ability to perform activities of daily living (ADL). We recently performed a randomized, controlled trial (RCT) assessing the efficacy of an occupational therapy-based program, the 'Cancer Home-Life Intervention' in people with advanced cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences. To investigate whether subgroups of people with advanced cancer gain positive effects from the 'Cancer Home-Life Intervention' on ADL ability. An exploratory subgroup analysis including 191 participants from a RCT. The outcome was ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Subgroups were defined by age, gender, years of education, type of primary tumor, functional level, and activity problems. The 'Cancer Home-Life Intervention' had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: -0.05 to 0.64]) and gender (0.23 [95% CI: -0.11 to 0.57]) were not found. There were no subgroup effects of the 'Cancer Home-Life Intervention'on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution.

  2. Toward real time detection of the basic living activity in home using a wearable sensor and smart home sensors.

    Science.gov (United States)

    Bang, Sunlee; Kim, Minho; Song, Sa-Kwang; Park, Soo-Jun

    2008-01-01

    As the elderly people living alone are enormously increasing recently, we need the system inferring activities of daily living (ADL) for maintaining healthy life and recognizing emergency. The system should be constructed with sensors, which are used to associate with people's living while remaining as non intrusive views as possible. To do this, the proposed system use a triaxial accelerometer sensor and environment sensors indicating contact with subject in home. Particularly, in order to robustly infer ADLs, we present component ADL, which is decided with conjunction of human motion together, not just only contacted object identification. It is an important component in inferring ADL. In special, component ADL decision firstly refines misclassified initial activities, which improves the accuracy of recognizing ADL. Preliminary experiments results for proposed system provides overall recognition rate of over 97% over 8 component ADLs, which can be effectively applicable to recognize the final ADLs.

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

    Science.gov (United States)

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

    2014-01-01

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

  4. Influences of patient informed cognitive complaints on activities of daily living in patients with bipolar disorder

    DEFF Research Database (Denmark)

    Träger, Conny; Decker, Lone; Wæhrens, Eva Elisabet Ejlersen

    2017-01-01

    Many patients with bipolar disorder (BD) experience debilitating cognitive deficits, with risk of impaired occupational and psychosocial functioning. However, knowledge of how these deficits impact the patients’ ability to perform Activities of Daily Living (ADL), tasks related to self...... Complaints in Bipolar Disorder Rating Assessment questionnaire (COBRA)) were included. Objective neurocognitive function was evaluated with a short comprehensive cognitive test battery and ADL ability was evaluated with the performance-based Assessment of Motor and Process Skills (AMPS) in the homes......-care and domestic life is limited. We explored the relation between impaired cognitive function and the ability to perform ADL in patients with BD. A total of 42 outpatients (mean age 36 years (range 19.0–58.0 years), 69% women) with BD in remission and with subjective cognitive complaints (≥ 13 on the Cognitive...

  5. [Development of an activity of daily living scale for patients with COPD: the Activity of Daily Living Dyspnea scale].

    Science.gov (United States)

    Yoza, Yoshiyasu; Ariyoshi, Koya; Honda, Sumihisa; Taniguchi, Hiroyuki; Senjyu, Hideaki

    2009-10-01

    Patients with COPD often experience restriction in their activities of daily living (ADL) due to dyspnea. This type of restriction is unique to patients with COPD and cannot be adequately evaluated by the generic ADL scales. This study developed an ADL scale (the Activity of Daily Living Dyspnea scale [ADL-D scale]) for patients with COPD and investigated its validity and internal consistency. Patients with stable COPD were recruited and completed a pilot 26-item questionnaire. Patients also performed the Incremental Shuttle Walk Test (ISWT), and completed the St George's Respiratory Questionnaire (SGRQ), and Medical Research Council (MRC) dyspnea grade. There were 83 male participants who completed the pilot questionnaire. Following the pilot, 8 items that were not undertaken by the majority of subjects, and 3 items judged to be of low clinical importance by physical therapists were removed from the pilot questionnaire. The final ADL-D scale contained 15 items. Scores obtained with the ADL-D scale were significantly correlated with the MRC dyspnea grades, distance walked on the ISWT and SGRQ scores. The ADL-D scores were significantly different across the five grades of the MRC dyspnea grade. The ADL-D scale showed high consistency (Chronbach's alpha coefficient of 0.96). The ADL-D scale is a useful scale for assessing impairments in ADL in Japanese male patients with COPD.

  6. Effects of impairment in activities of daily living on predicting mortality following hip fracture surgery in studies using administrative healthcare databases

    Science.gov (United States)

    2014-01-01

    Background Impairment in activities of daily living (ADL) is an important predictor of outcomes although many administrative databases lack information on ADL function. We evaluated the impact of ADL function on predicting postoperative mortality among older adults with hip fractures in Ontario, Canada. Methods Sociodemographic and medical correlates of ADL impairment were first identified in a population of older adults with hip fractures who had ADL information available prior to hip fracture. A logistic regression model was developed to predict 360-day postoperative mortality and the predictive ability of this model were compared when ADL impairment was included or omitted from the model. Results The study sample (N = 1,329) had a mean age of 85.2 years, were 72.8% female and the majority resided in long-term care (78.5%). Overall, 36.4% of individuals died within 360 days of surgery. After controlling for age, sex, medical comorbidity and medical conditions correlated with ADL impairment, addition of ADL measures improved the logistic regression model for predicting 360 day mortality (AIC = 1706.9 vs. 1695.0; c -statistic = 0.65 vs 0.67; difference in - 2 log likelihood ratios: χ2 = 16.9, p = 0.002). Conclusions Direct measures of ADL impairment provides additional prognostic information on mortality for older adults with hip fractures even after controlling for medical comorbidity. Observational studies using administrative databases without measures of ADLs may be potentially prone to confounding and bias and case-mix adjustment for hip fracture outcomes should include ADL measures where these are available. PMID:24472282

  7. The Glittre-ADL test reflects functional performance measured by physical activities of daily living in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Manuela Karloh

    2016-01-01

    Full Text Available ABSTRACT Background The Glittre-ADL test (TGlittre is a valid and reliable test for the evaluation of functional capacity and involves multiple physical activities of daily living (PADL, which are known to be troublesome to patients with Chronic Obstructive Pulmonary Disease (COPD. However, it is still unknown if this test is also able to reflect the functional performance of patients with COPD. Objective To investigate whether the TGlittre reflects the functional performance of COPD patients and whether the necessary time to complete the TGlittre and the PADL varies according to disease severity. Method Thirty-eight patients with COPD (age 65, SD=7 years; forced expiratory volume in the first second 41.3, SD=15.2% predicted underwent anthropometric and lung function assessments and were submitted to the TGlittre and PADL measurement. Results TGlittre performance correlated significantly (p<0.05 with PADL variables, such as time sitting (r=0.50, walking (r=-0.46, number of steps taken (r=–0.53, walking movement intensity (r=–0.66, walking energy expenditure (r=-0.50, and total energy expenditure (r=–0.33. TGlittre performance was not significantly different in patients among the Global Initiative for COPD (GOLD spirometric stages, but walking and sitting time were significantly lower and greater, respectively, in severe and very severe patients compared to those with moderate disease (p<0.05. Conclusion The performance on the TGlittre correlates with walking and sitting time and other real life PADL measurements. The severity of the disease is associated with the differences in the level of physical activity in daily life more than in functional capacity.

  8. Greater Independence in Activities of Daily Living is Associated with Higher Health-Related Quality of Life Scores in Nursing Home Residents with Dementia

    Directory of Open Access Journals (Sweden)

    Charice S. Chan

    2015-06-01

    Full Text Available Health-related quality of life (HRQL for nursing home residents is important, however, the concept of quality of life is broad, encompasses many domains and is difficult to assess in people with dementia. Basic activities of daily living (ADL are measured routinely in nursing homes using the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS and Functional Independence Measure (FIM instrument. We examined the relationship between HRQL and ADL to assess the future possibility of ADL dependency level serving as a surrogate measure of HRQL in residents with dementia. To assess ADL, measures derived from the RAI-MDS and FIM data were gathered for 111 residents at the beginning of our study and at 6-month follow-up. Higher scores for independence in ADL were correlated with higher scores for a disease-specific HRQL measure, the Quality of Life—Alzheimer’s Disease Scale. Preliminary evidence suggests that FIM-assessed ADL is associated with HRQL for these residents. The associations of the dressing and toileting items with HRQL were particularly strong. This finding suggests the importance of ADL function in HRQL. The RAI-MDS ADL scales should be used with caution to evaluate HRQL.

  9. Allomyrina dichotoma (Arthropoda: Insecta Larvae Confer Resistance to Obesity in Mice Fed a High-Fat Diet

    Directory of Open Access Journals (Sweden)

    Young-Il Yoon

    2015-03-01

    Full Text Available To clarify the anti-obesity effect of Allomyrina dichotoma larvae (ADL, we previously reported that ADL block adipocyte differentiation on 3T3-L1 cell lines through downregulation of transcription factors, such as peroxisome proliferator-activated receptor-γ (PPARG and CCAAT/enhancer binding protein-α (CEBPA. In this study, we tested whether ADL prevent obesity in mice fed a high-fat diet (HFD and further investigated the mechanism underlying the effects of ADL. All mice were maintained on a normal-fat diet (NFD for 1 week and then assigned to one of five treatment groups: (1 NFD; (2 HFD; (3 HFD and 100 mg·kg−1·day−1 ADL; (4 HFD and 3000 mg·kg−1·day−1ADL; or (5 HFD and 3000 mg·kg−1·day−1 yerba mate (Ilex paraguariensis, positive control. ADL and yerba mate were administered orally daily. Mice were fed experimental diets and body weight was monitored weekly for 6 weeks. Our results indicated that ADL reduced body weight gain, organ weight and adipose tissue volume in a dose-dependent manner. Body weight gain was approximately 22.4% lower compared to mice fed only HFD, but the difference did not reach the level of statistical significance. Real-time polymerase chain reaction (PCR analysis revealed that gene expression levels of PPARG, CEBPA and lipoprotein lipase (LPL in the epididymal fat tissue of HFD-fed mice receiving 3000 mg·kg−1·day−1 ADL were reduced by 12.4-, 25.7-, and 12.3-fold, respectively, compared to mice fed HFD only. Moreover, mice administered ADL had lower serum levels of triglycerides and leptin than HFD-fed mice that did not receive ADL. Taken together our results suggest that ADL and its constituent bioactive compounds hold potential for the treatment and prevention of obesity.

  10. The effects of movement stimulation on activities of daily living performance and quality of life in nursing home residents with dementia: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Henskens M

    2018-04-01

    Full Text Available Marinda Henskens,1 Ilse M Nauta,2 Katja T Drost,3 Erik JA Scherder1 1Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; 2Department of Neurology, MS Center Amsterdam, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; 3tanteLouise, Bergen op Zoom, the Netherlands Background: Nursing home (NH residents with dementia experience a reduced quality of life (QoL, in part, due to a dependence in performing activities of daily living (ADL. Stimulating movement is associated with improvements in ADL performance. Therefore, movement stimulating interventions, such as ADL training and exercise, focus on optimizing ADL performance to improve QoL. This study aimed to evaluate the effect of three movement stimulating interventions on QoL and ADL performance in NH residents with dementia. Methods: In this 6-month double parallel randomized controlled trial, the effects of ADL training, a multicomponent aerobic and strength exercise training, and a combined ADL and exercise training were analyzed in 87 NH residents with dementia. The Global Deterioration Scale was used to classify the severity of dementia. Participants were screened at baseline using the 6 minute walk test and Mini-Mental State Examination. The Qualidem, and the Care Dependency Scale and Erlangen ADL test were evaluated at baseline, and after 3 and 6 months to measure QoL and ADL, respectively. Multilevel analyses were adjusted for baseline performance, age, and gender. Results: A 6-month ADL training positively affected overall QoL (p = 0.004 and multiple aspects of QoL, including care relationship (p = 0.004, positive self-image (p = 0.002, and feeling at home (p = 0.001, compared to care-as-usual. No benefits were observed of exercise on QoL. No benefits were observed of a combined ADL and exercise intervention on QoL. No effects were found of the three movement interventions on ADL performance. Conclusion: The results indicate

  11. Activities of daily living, depression, and quality of life in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Blake J Lawrence

    Full Text Available This study examined whether activities of daily living (ADL mediate the relationship between depression and health-related quality of life (HR-QOL in people with Parkinson's disease (PD. A cross-sectional, correlational research design examined data from 174 participants who completed the Geriatric Depression Scale (GDS-15, Parkinson's Disease Questionnaire-39 (PDQ-39, and Unified Parkinson's Disease Rating Scale-section 2 (UPDRS-section 2 [ADL]. Multiple Regression Analysis (MRA was used to examine the mediator model. Depression and ADL significantly (p<.001 predicted HR-QOL, and depression significantly (p<.001 predicted ADL. Whilst ADL did not impact on the relationship between depression and HR-QOL, there was a significant (p<.001 indirect effect of depression on HR-QOL via ADL, suggesting both direct and indirect (via ADL effects of depression on HR-QOL. The magnitude of this effect was moderate (R2 = .13. People with PD who report depression also experience greater difficulty completing ADL, which impacts upon their HR-QOL. It is recommended that clinicians adopt a multidisciplinary approach to care by combining pharmacological treatments with psycho/occupational therapy, thereby alleviating the heterogeneous impact of motor and non-motor symptoms on HR-QOL in people with PD.

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

    Directory of Open Access Journals (Sweden)

    Boström G

    2014-02-01

    Full Text Available Gustaf Boström,1 Mia Conradsson,1 Erik Rosendahl,1,2 Peter Nordström,1 Yngve Gustafson,1 Håkan Littbrand1,21Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; 2Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, SwedenBackground: This study examined associations between depressive symptoms and functional capacity, overall dependency in personal activities of daily living (ADLs, and dependency in individual ADL tasks, respectively, in people with a high mean age, large range of functional capacity, and wide spectrum of dependency in ADLs.Methods: Cross-sectional data from three studies were used. A total of 392 individuals living in community and residential care facilities were included. Mean age was 86.2 years, 72% were women, 75% were dependent in ADLs, 42% had depression, and 39% had dementia. Depressive symptoms were assessed with the 15-item Geriatric Depression Scale (GDS-15, functional capacity with the Berg Balance Scale (BBS, and ADLs with the Barthel ADL Index. Multiple linear regression analyses with comprehensive adjustments were performed between GDS-15 and BBS, GDS-15 and Barthel ADL Index, and GDS-15 and each individual ADL task, separately.Results: GDS-15 score was associated with BBS score (unstandardized b =-0.03, P=0.008, but not with Barthel ADL Index score (unstandardized b =-0.07, P=0.068. No significant interaction effects of sex, dementia, or living conditions were found in these associations. Among individual ADL tasks, dependency in transfer (unstandardized b =-1.03, P=0.007 and dressing (unstandardized b =-0.70, P=0.035 were associated with depressive symptoms.Conclusion: Functional capacity seems to be independently associated with depressive symptoms in older people living in community and residential care facilities, whereas overall ADL performance may not be associated. Dependency in the individual ADL tasks of

  13. Activities of daily living and quality of life across different stages of dementia: a UK study.

    Science.gov (United States)

    Giebel, Clarissa M; Sutcliffe, Caroline; Challis, David

    2015-01-01

    People with dementia (PwD) require an increasing degree of assistance with activities of daily living (ADLs), and dependency may negatively impact on their well-being. However, it remains unclear which activities are impaired at each stage of dementia and to what extent this is associated with variations in quality of life (QoL) across the different stages, which were the two objectives of this study. The sample comprised 122 PwD, and their carers, either living at home or recently admitted to long-term care. Measures of cognition and QoL were completed by the PwD and proxy measures of psychopathology, depression, ADLs and QoL were recorded. Using frequency, correlation and multiple regression analysis, data were analysed for the number of ADL impairments across mild, moderate and severe dementia and for the factors impacting on QoL. ADL performance deteriorates differently for individual activities, with some ADLs showing impairment in mild dementia, including dressing, whereas others only deteriorate later on, including feeding. This decline may be seen in the degree to which carers perceive ADLs to explain the QoL of the PwD, with more ADLs associated with QoL in severe dementia. RESULTS of the regression analysis showed that total ADL performance however was only impacting on QoL in moderate dementia. Knowledge about performance deterioration in different ADLs has implications for designing interventions to address specific activities at different stages of the disease. Furthermore, findings suggest that different factors are important to consider when trying to improve or maintain QoL at different stages.

  14. Retrieval cue and delay interval influence the relationship between prospective memory and activities of daily living in older adults.

    Science.gov (United States)

    Tierney, Savanna M; Bucks, Romola S; Weinborn, Michael; Hodgson, Erica; Woods, Steven Paul

    2016-01-01

    Older adults commonly experience mild declines in everyday functioning and the strategic aspects of prospective memory (PM). This study used multiprocess theory to examine whether the strategic demands of retrieval cue type (event vs. time based) and delay interval length (2 vs. 15 min) influence the relationship between PM and activities of daily living (ADLs) in older adults. Participants included 97 community-dwelling older adults recruited from the Western Australia Participant Pool. Participants were administered the Memory for Intentions Screening Test (MIST) and Prospective and Retrospective Memory Questionnaire (PRMQ) as part of a larger neurocognitive assessment. A knowledgeable informant completed the Activities of Daily Living Questionnaire (ADLQ), from which a cutpoint of ≥ 1 was used to classify participants into "ADL normal" (n = 37) or "mild ADL problems" (n = 60) groups. Repeated measures multivariate analysis of variance (MANOVA) controlling for age was conducted with ADL group as the between-subjects factor and either MIST or PRMQ cue and delay scores as the within-subjects factors. We observed a significant ADL group by PM interaction on the MIST, with pair-wise analyses showing that the mild ADL problems group performed worse than ADL normal participants on the 15-min time-based scale (p cue-delay variable differed between the two ADL groups (ps > .10). Findings indicate that decrements in strategically demanding cue monitoring and detection over longer PM delays may partly explain older adults' mild problems in everyday functioning. Findings may inform neuropsychological interventions aimed at maintaining ADL independence and enhancing quality of life in older adults.

  15. A web-based non-intrusive ambient system to measure and classify activities of daily living.

    Science.gov (United States)

    Stucki, Reto A; Urwyler, Prabitha; Rampa, Luca; Müri, René; Mosimann, Urs P; Nef, Tobias

    2014-07-21

    The number of older adults in the global population is increasing. This demographic shift leads to an increasing prevalence of age-associated disorders, such as Alzheimer's disease and other types of dementia. With the progression of the disease, the risk for institutional care increases, which contrasts with the desire of most patients to stay in their home environment. Despite doctors' and caregivers' awareness of the patient's cognitive status, they are often uncertain about its consequences on activities of daily living (ADL). To provide effective care, they need to know how patients cope with ADL, in particular, the estimation of risks associated with the cognitive decline. The occurrence, performance, and duration of different ADL are important indicators of functional ability. The patient's ability to cope with these activities is traditionally assessed with questionnaires, which has disadvantages (eg, lack of reliability and sensitivity). Several groups have proposed sensor-based systems to recognize and quantify these activities in the patient's home. Combined with Web technology, these systems can inform caregivers about their patients in real-time (e.g., via smartphone). We hypothesize that a non-intrusive system, which does not use body-mounted sensors, video-based imaging, and microphone recordings would be better suited for use in dementia patients. Since it does not require patient's attention and compliance, such a system might be well accepted by patients. We present a passive, Web-based, non-intrusive, assistive technology system that recognizes and classifies ADL. The components of this novel assistive technology system were wireless sensors distributed in every room of the participant's home and a central computer unit (CCU). The environmental data were acquired for 20 days (per participant) and then stored and processed on the CCU. In consultation with medical experts, eight ADL were classified. In this study, 10 healthy participants (6 women

  16. Causes of decreased activity of daily life in elderly patients who need daily living care.

    Science.gov (United States)

    Yoshino, Hiroshi; Sakurai, Takashi; Hasegawa, Kazuo; Yokono, Koichi

    2011-07-01

    The causes of decreased activity of daily life (ADL) in elderly patients include cerebrovascular diseases, bone fracture by falls, and dementia. The present study was conducted among elderly patients with decreased ADL who were hospitalized in nursing wards in order to investigate the causes of becoming early bedridden and to determine precautionary measures against decreased ADL. The study subjects were 224 elderly patients with decreased ADL (mean age: 83.3 ± 8.0 years) and 49 outpatients without decreased ADL (mean age: 76.8 ± 5.3 years). Current age, age at the start of ADL decrease, medical history and history of smoking were investigated. In the groups with decreased ADL, current age and the age of becoming bedridden in non-diabetic versus diabetic groups were 84.7 ± 7.9 versus 80.3 ± 7.5 and 82.7 ± 8.3 versus 77.6 ± 8.0 years, respectively, both showing significantly lower values in the diabetic group (P bedridden. Diabetic patients with smoking habit were significantly younger than diabetic and non-diabetic patients without smoking habit. Sex difference, smoking habit and presence of diabetes mellitus are independent risk factors of becoming early bedridden. Therefore, the major targets of medical care among elderly should be diabetic men with a smoking habit to lower the risks of decreased ADL. © 2011 Japan Geriatrics Society.

  17. The Impact of Leisure and Social Activities on Activities of Daily Living of Middle-Aged Adults: Evidence from a National Longitudinal Survey in Japan.

    Directory of Open Access Journals (Sweden)

    Takafumi Monma

    Full Text Available This study investigated the effects of leisure and social activities on the ability of middle-aged adults to maintain activities of daily living (ADL, and whether performing these activities alone or with others contributed to the ability to perform ADL. The study used nationally representative longitudinal data of 22,770 adults in Japan, aged 50-59 years, who did not have limitations in performing ADL at the beginning of the 5-year survey period. The study considered six activity categories: two leisure activities ("hobbies or cultural activities" and "exercise or sports" and four social activities ("community events," "support for children," "support for elderly individuals," and "other social activities". Multiple logistic regression analysis was used to examine the relation between participation in these categories at baseline and difficulties in ADL at the 5-year follow-up. The association between the extent of social interaction during these activities ("by oneself," "with others," or "both" and difficulties in ADL was also investigated. The analysis yielded significant negative correlations between "exercise or sports" and difficulties in ADL for both men and women, and between "hobbies or cultural activities" and difficulties in ADL for women. However, these significant relationships occurred only when activities were conducted "with others." The present findings might help prevent deterioration in middle-aged adults' performance of ADL in Japan.

  18. Unsupervised machine-learning method for improving the performance of ambulatory fall-detection systems

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    Yuwono Mitchell

    2012-02-01

    Full Text Available Abstract Background Falls can cause trauma, disability and death among older people. Ambulatory accelerometer devices are currently capable of detecting falls in a controlled environment. However, research suggests that most current approaches can tend to have insufficient sensitivity and specificity in non-laboratory environments, in part because impacts can be experienced as part of ordinary daily living activities. Method We used a waist-worn wireless tri-axial accelerometer combined with digital signal processing, clustering and neural network classifiers. The method includes the application of Discrete Wavelet Transform, Regrouping Particle Swarm Optimization, Gaussian Distribution of Clustered Knowledge and an ensemble of classifiers including a multilayer perceptron and Augmented Radial Basis Function (ARBF neural networks. Results Preliminary testing with 8 healthy individuals in a home environment yields 98.6% sensitivity to falls and 99.6% specificity for routine Activities of Daily Living (ADL data. Single ARB and MLP classifiers were compared with a combined classifier. The combined classifier offers the greatest sensitivity, with a slight reduction in specificity for routine ADL and an increased specificity for exercise activities. In preliminary tests, the approach achieves 100% sensitivity on in-group falls, 97.65% on out-group falls, 99.33% specificity on routine ADL, and 96.59% specificity on exercise ADL. Conclusion The pre-processing and feature-extraction steps appear to simplify the signal while successfully extracting the essential features that are required to characterize a fall. The results suggest this combination of classifiers can perform better than MLP alone. Preliminary testing suggests these methods may be useful for researchers who are attempting to improve the performance of ambulatory fall-detection systems.

  19. A "client-centred activities of daily living" intervention for persons with stroke

    DEFF Research Database (Denmark)

    Guidetti, Susanne; Ranner, Maria; Tham, Kerstin

    2015-01-01

    OBJECTIVE: To compare changes regarding perceived participation, independence in activities of daily living (ADL) and life satisfaction between 3, 6 and 12 months after inclusion in a study of a client-centred ADL intervention and usual ADL intervention after stroke. DESIGN: A multicentre...... diagnosed with dementia, and were able to understand instructions. Data collection was performed by blinded assessors. The primary outcome, perceived participation, was assessed with the Stroke Impact Scale 3.0, domain 8. The secondary outcomes, participation, independence in ADL, and life satisfaction......, were assessed with validated instruments. For statistical power, 280 participants were required. Statistical analyses were performed on an intention-to-treat basis. RESULTS: There were no differences between the groups regarding changes in perceived participation, independence in ADL, or life...

  20. Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms.

    Science.gov (United States)

    Fauth, Elizabeth B; Schwartz, Sarah; Tschanz, Joann T; Østbye, Truls; Corcoran, Christopher; Norton, Maria C

    2013-06-01

    Late-life disability in activities of daily living (ADL) is theorized to be driven by underlying cognitive and/or physical impairment, interacting with psychological and environmental factors. Although we expect that cognitive deficits would explain associations between ADL disability and dementia risk, the current study examined ADL as a predictor of future dementia after controlling for global cognitive status. The population-based Cache County Memory Study (N = 3547) assessed individuals in four triennial waves (average age 74.9 years, years of education 13.36 years; 57.9% were women). Cox proportional hazards regression models assessed whether baseline ADL disability (presence of 2+ Instrumental ADL and/or 1+ Personal ADL) predicted incident dementia after controlling for APOE status, gender, age, baseline cognitive ability (Modified Mini-mental State Exam, 3MS-R; adjusted for education level), and baseline depressive symptoms (Diagnostic Interview Schedule). Over the course of study, 571 cases of incident dementia were identified through in-depth cognitive assessment, ending in expert consensus diagnosis. Results from Cox models suggest that ADL disability is a statistically significant predictor of incident dementia (adjusted hazard ratio = 1.83, p controlling for covariates. Findings suggest that ADL disability offers unique contributions in risk for incident dementia, even after controlling for global cognitive status. We discuss how physical impairment and executive function may play important roles in this relationship, and how ADL is useful, not just a diagnostic tool at, or after dementia onset, but also as a risk factor for future dementia, even in individuals not impaired on global cognitive tests. Copyright © 2012 John Wiley & Sons, Ltd.

  1. The Impact of Leisure and Social Activities on Activities of Daily Living of Middle-Aged Adults: Evidence from a National Longitudinal Survey in Japan

    Science.gov (United States)

    Monma, Takafumi; Takeda, Fumi; Noguchi, Haruko; Takahashi, Hideto; Tamiya, Nanako

    2016-01-01

    This study investigated the effects of leisure and social activities on the ability of middle-aged adults to maintain activities of daily living (ADL), and whether performing these activities alone or with others contributed to the ability to perform ADL. The study used nationally representative longitudinal data of 22,770 adults in Japan, aged 50–59 years, who did not have limitations in performing ADL at the beginning of the 5-year survey period. The study considered six activity categories: two leisure activities (“hobbies or cultural activities” and “exercise or sports”) and four social activities (“community events,” “support for children,” “support for elderly individuals,” and “other social activities”). Multiple logistic regression analysis was used to examine the relation between participation in these categories at baseline and difficulties in ADL at the 5-year follow-up. The association between the extent of social interaction during these activities (“by oneself,” “with others,” or “both”) and difficulties in ADL was also investigated. The analysis yielded significant negative correlations between “exercise or sports” and difficulties in ADL for both men and women, and between “hobbies or cultural activities” and difficulties in ADL for women. However, these significant relationships occurred only when activities were conducted “with others.” The present findings might help prevent deterioration in middle-aged adults’ performance of ADL in Japan. PMID:27788163

  2. Vestibular Function and Activities of Daily Living

    Directory of Open Access Journals (Sweden)

    Aisha Harun MD

    2015-09-01

    Full Text Available Objective: Vestibular dysfunction increases with age and is associated with mobility difficulties and fall risk in older individuals. We evaluated whether vestibular function influences the ability to perform activities of daily living (ADLs. Method: We analyzed the 1999 to 2004 National Health and Nutrition Examination Survey of adults aged older than 40 years ( N = 5,017. Vestibular function was assessed with the Modified Romberg test. We evaluated the association between vestibular function and difficulty level in performing specific basic and instrumental ADLs, and total number of ADL impairments. Results: Vestibular dysfunction was associated with significantly higher odds of difficulty with nine ADLs, most strongly with difficulty managing finances (odds ratio [ OR ] = 2.64, 95% confidence interval [CI] = [1.18, 5.90]. In addition, vestibular dysfunction was associated with a significantly greater number of ADL impairments (β = .21, 95% CI = [0.09, 0.33]. This effect size was comparable with the influence of heavy smoking (β = .21, 95% CI = [0.06, 0.36] and hypertension (β = .10, 95% CI = [0.02, 0.18] on the number of ADL impairments. Conclusion: Vestibular dysfunction significantly influences ADL difficulty, most strongly with a cognitive rather than mobility-based task. These findings underscore the importance of vestibular inputs for both cognitive and physical daily activities.

  3. Effective detection method for falls according to the distance between two tri-axial accelerometers

    Science.gov (United States)

    Kim, Jae-Hyung; Park, Geun-Chul; Kim, Soo-Hong; Kim, Soo-Sung; Lee, Hae-Rim; Jeon, Gye-Rok

    2016-04-01

    Falls and fall-related injuries are a significant problem in the elderly population. A number of different approaches for detecting falls and activities of daily living (ADLs) have been conducted in recent years. However, distinguishing between real falls and certain fall-like ADL is often difficult. The aim of this study is to discriminate falls from fall-like ADLs such as jogging, jumping, and jumping down. The distance between two tri-axial accelerometers attached to the abdomen and the sternum was increased from 10 to 30 cm in 10-cm intervals. Experiments for falls and ADLs were performed to investigate the feasibility of the detection system for falls developed in this study. When the distances between the two tri-axial electrometers were 20 and 30 cm, fall-like ADLs were effectively distinguished from falls. The thresholds for three parameters — SVM, Diff Z, and Sum_diff_Z — were set; falls could be distinguished from ADL action sequences when the SVM value was larger than 4 g (TH1), the Diff_Z parameter was larger than 1.25 g (TH2), and the Sum_diff_Z parameter was larger than 15 m/s (TH3). In particular, when the SVM, Diff_Z, and Sum_diff_Z parameter were sequentially applied to thresholds (TH1, TH2, and TH3), fall-like ADL action sequences were accurately discriminated from falls.

  4. Both deterioration and improvement in activities of daily living are related to falls: a 6-year follow-up of the general elderly population study Good Aging in Skåne

    Directory of Open Access Journals (Sweden)

    Stenhagen M

    2014-10-01

    Full Text Available Magnus Stenhagen, Henrik Ekström, Eva Nordell, Sölve Elmståhl Department of Health Sciences, Division of Geriatric Medicine, Lund University, Skåne University Hospital, Malmö, Sweden Objectives: To determine the relationship between long-term change in activities of daily living (ADL and falls in the elderly and to identify characteristics of groups at risk for falls.Methods: This was a 6-year, prospective cohort study using data from the Good Aging in Skåne study in southern Sweden, involving 1,540 elderly subjects, including the oldest-old (age, 60–93 years. The subjects were recruited from the general population. ADL was measured at a baseline and follow-up assessment, using Sonn and Åsberg’s revised scale and the ADL staircase. Falls were recorded in a period of 6 months before the follow-up assessment. The association between falls and change in ADL was calculated using adjusted, multiple logistic regression analysis and presented in odds ratios (ORs.Results: Thirteen percent of the study population reported one or several falls in the measured period. Over the course of 6 years, one in four participants changed their ADL status, and parts of this category had an increased risk for falls compared with those who stayed independent in ADL or who had no change in the ADL staircase. Groups with different characteristics had a prominent risk for falls: those with a reduction of two to eight steps in the ADL staircase (OR, 4.05; 95% confidence interval [CI], 1.62–10.11 and those becoming independent from dependency in instrumental ADL (OR, 4.13; 95% CI, 1.89–9.00. The former group had advanced age with a greater burden of cognitive impairment, gait disability, arrhythmia, and fall risk medications. The latter group had a higher prevalence of ischemic heart disease and low walking speed. Conclusion: Both deterioration and improvement in ADL over the course of 6 years increased the risk for falls in a general elderly population

  5. Determining Nurse Aide Staffing Requirements to Provide Care Based on Resident Workload: A Discrete Event Simulation Model.

    Science.gov (United States)

    Schnelle, John F; Schroyer, L Dale; Saraf, Avantika A; Simmons, Sandra F

    2016-11-01

    Nursing aides provide most of the labor-intensive activities of daily living (ADL) care to nursing home (NH) residents. Currently, most NHs do not determine nurse aide staffing requirements based on the time to provide ADL care for their unique resident population. The lack of an objective method to determine nurse aide staffing requirements suggests that many NHs could be understaffed in their capacity to provide consistent ADL care to all residents in need. Discrete event simulation (DES) mathematically models key work parameters (eg, time to provide an episode of care and available staff) to predict the ability of the work setting to provide care over time and offers an objective method to determine nurse aide staffing needs in NHs. This study had 2 primary objectives: (1) to describe the relationship between ADL workload and the level of nurse aide staffing reported by NHs; and, (2) to use a DES model to determine the relationship between ADL workload and nurse aide staffing necessary for consistent, timely ADL care. Minimum Data Set data related to the level of dependency on staff for ADL care for residents in over 13,500 NHs nationwide were converted into 7 workload categories that captured 98% of all residents. In addition, data related to the time to provide care for the ADLs within each workload category was used to calculate a workload score for each facility. The correlation between workload and reported nurse aide staffing levels was calculated to determine the association between staffing reported by NHs and workload. Simulations to project staffing requirements necessary to provide ADL care were then conducted for 65 different workload scenarios, which included 13 different nurse aide staffing levels (ranging from 1.6 to 4.0 total hours per resident day) and 5 different workload percentiles (ranging from the 5th to the 95th percentile). The purpose of the simulation model was to determine the staffing necessary to provide care within each workload

  6. Performance evaluation of the Personal Mobility and Manipulation Appliance (PerMMA).

    Science.gov (United States)

    Wang, Hongwu; Xu, Jijie; Grindle, Garrett; Vazquez, Juan; Salatin, Ben; Kelleher, Annmarie; Ding, Dan; Collins, Diane M; Cooper, Rory A

    2013-11-01

    The Personal Mobility and Manipulation Appliance (PerMMA) is a recently developed personal assistance robot created to provide people with severe physical disabilities enhanced assistance in both mobility and manipulation. PerMMA aims to improve functional independence when a personal care attendant is not available on site. PerMMA integrates both a smart powered wheelchair and two dexterous robotic arms to assist its users in completing essential mobility and manipulation tasks during basic and instrumental activities of daily living (ADL). Two user interfaces were developed: a local control interface and a remote operator controller. This paper reports on the evaluation of PerMMA with end users completing basic ADL tasks. Participants with both lower and upper extremity impairments (N=15) were recruited to operate PerMMA and complete up to five ADL tasks in a single session of no more than two hours (to avoid fatigue or frustration of the participants). The performance of PerMMA was evaluated by participants completing ADL tasks with two different control modes: local mode and cooperative control. The users' task completion performance and answers on pre/post-evaluation questionnaires demonstrated not only the ease in learning and usefulness of PerMMA, but also their attitudes toward assistance from advanced technology like PerMMA. As a part of the iterative development process, results of this work will serve as supporting evidence to identify design criteria and other areas for improvement of PerMMA. Copyright © 2013 IPEM. All rights reserved.

  7. Cross-country differences in the association between diabetes and disability.

    Science.gov (United States)

    Assari, Shervin; Lankarani, Reza Moghani; Lankarani, Maryam Moghani

    2014-01-06

    This study tested possible cross-country differences in the associations between diabetes and activities of daily living (ADLs), and possible confounding / mediating effects of socio-economic status, obesity, and exercise. Data came from Research on Early Life and Aging Trends and Effects (RELATE). The study included a total number of 25,372 community sample of adults who were 40 years or older. We used data from community based surveys in seven countries including China, Mexico, Barbados, Brazil, Chile, Cuba, and Uruguay. Demographics (age and gender), socio-economic status (education and income), obesity, exercise, and ADL (bath, dress, toilet, transfer, heavy, shopping, meals) were measured. Self-reported data on physician diagnosis of diabetes was the independent variable. We tested if diabetes is associated with ADL, before and after adjusting for socio-economics, obesity, and exercise in each country. Based on Model I (age and gender adjusted model), diabetes was associated with limitation in at least one ADL in Mexico, Barbados, Brazil, Chile, Cuba, and Uruguay, but not China. Based on Model II that also controlled for education and income, education explained the association between diabetes and limitation in ADL in Mexico and Uruguay. Based on Model III that also controlled for exercise and obesity, in Cuba and Brazil, exercise explained the link between diabetes and limitation in performing ADLs. Thus, the link between diabetes and ADL was independent of our covariates only in Chile and Barbados. There are cross-country differences in the link between diabetes and limitation in ADL. There are also cross-country differences in how socio-economic status, obesity, and exercise explain the above association.

  8. Feeling hindered by health problems and functional capacity at 60 years and above.

    Science.gov (United States)

    Fagerström, Cecilia; Holst, Göran; Hallberg, Ingalill R

    2007-01-01

    It is common to use activities of daily living (ADL) rating scales to identify the impact of health problems such as diseases, impaired eyesight or hearing on daily life. However, for various reasons people with health problems might feel hindered in daily life before limitations in ability to perform ADL have occurred. In addition, there is sparse knowledge of what makes people feel hindered by health problems in relation to their ADL capacity. The aim was to investigate feeling hindered by health problems among 1297 people aged 60-89 living at home in relation to ADL capacity, health problems, life satisfaction, self-esteem, and social and financial resources, using a self-reported questionnaire, including questions from Older Americans' Resources and Services schedule (OARS), Rosenberg's self-esteem and Life Satisfaction Index Z (LSIZ). People feeling greatly hindered by health problems rarely had anyone who could help when they needed support, had lower life satisfaction and self-esteem than those not feeling hindered. Feeling hindered by health problems appeared to take on a different meaning depending on ADL capacity, knowledge that seems essential to include when accomplishing health promotion and rehabilitation interventions, especially at the early stages of reduced ADL capacity.

  9. Impact of a new simplified disability scoring system for adult patients with localized scleroderma.

    Science.gov (United States)

    Okiyama, Naoko; Asano, Yoshihide; Hamaguchi, Yasuhito; Jinnin, Masatoshi; Motegi, Sei-Ichiro; Koizumi, Haruka; Hasegawa, Minoru; Ishikawa, Osamu; Sato, Shinichi; Takehara, Kazuhiko; Yamamoto, Toshiyuki; Fujimoto, Manabu; Ihn, Hironobu

    2018-04-01

    Localized scleroderma (LoS) involves dermal but not internal inflammation and fibrosis. Cosmetic changes often impact quality of life (QOL), however, impairment of activities of daily living (ADL) in LoS patients has not been investigated. To determine what factor(s) are associated with ADL in adult patients with LoS, we performed a retrospective observational study in 177 Japanese adult LoS patients using a novel LoS disability score based on Barthel's indices of ADL: feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility and stairs. LoS disability scores increased in proportion to the number of affected body parts but were not correlated to age and duration of illness. The presence of leg lesions significantly impaired ADL of LoS patients compared with lesions on other body parts. Patients treated with systemic medications, who tended to have multiple lesions, presented higher LoS disability scores than those without systemic treatments. Our study proposes that physicians evaluate ADL, not only QOL, in LoS patients. Our findings using LoS disability scoring indicate that multiple affected body parts and leg lesions are risk factors for ADL impairment. © 2018 Japanese Dermatological Association.

  10. Implementation and effects of Movement-oriented Restorative Care in a nursing home - a quasi-experimental study.

    Science.gov (United States)

    Henskens, Marinda; Nauta, Ilse M; Scherder, Erik J A; Oosterveld, Frits G J; Vrijkotte, Susan

    2017-10-23

    The prevalence of dementia is expected to increase rapidly, and institutionalization is a common consequence of the disease. Dependence in activities of daily living (ADL) is a predictor for institutionalization and a determinant for the quality of life (QoL). A promising method to increase functional independence in nursing homes is a restorative care or function focused care (FFC) approach. Movement-oriented restorative care (MRC) is derived from the concept of FFC and restorative care and focuses on the integration of physical activity in the daily lives of nursing home residents with dementia using a multidisciplinary approach. The objective of this study was to assess the effectiveness of MRC in preservation of ADL independence and QoL in nursing home residents with dementia. In this quasi-experimental 12-month study, the effects of MRC were compared to care as usual in 61 nursing home residents with moderate to severe dementia. The outcome measures were ADL independence and QoL. These outcomes were measured five times (i.e. at baseline, and after 3, 6, 9, and 12 months). Additionally, data was collected regarding the degree of implementation, and the barriers to the implementation process. The effect of the intervention was analyzed using linear mixed model analyses. There was no significant overall intervention effect on ADL independence and QoL. A significant group-by-time interaction was found for the QoL subscale positive self-image: after a 12 month intervention period, the MRC group scored significantly better than the control group on positive self-image. Regarding the other subscales and the total score of the QoL, as well as ADL, no significant group-by-time interactions were found. MRC did not demonstrate significant improvements in ADL or QoL. After a 12-month intervention period, residents who received MRC showed higher scores on positive self-image compared to the control group. This study contributes to the limited research regarding the

  11. Knee pain and future self-reliance in older adults: evidence from a community-based 3-year cohort study in Japan.

    Science.gov (United States)

    Nishiwaki, Yuji; Michikawa, Takehiro; Yamada, Mutsuko; Eto, Norihito; Takebayashi, Toru

    2011-01-01

    Although knee pain is common in older persons and can cause ambulatory limitation, its impact on self-reliance has rarely been examined in Japan, particularly in a community setting. The aim of this 3-year cohort study was to investigate the association of knee pain with dependence in activities of daily living (ADL) and mortality in community-dwelling older Japanese adults. In 2005, presence of knee pain was assessed by a home visit survey of 1391 older adults aged 65 years or older (participation proportion = 97.3%). A total of 1265 participants who were ADL-independent at baseline were followed for 3 years, and information on outcomes, namely death and dependence in ADL, was collected. Participants who always had knee pain were more likely to become dependent in ADL than those who reported no knee pain (multivariate-adjusted OR, 1.98; 95% CI, 1.03-3.83); however, always having knee pain was not associated with mortality or a composite outcome of ADL dependence and death. Further analyses of each component of ADL dependence revealed that knee pain was associated with a need for assistance at home (long-term care eligibility, bathing, dressing, and transferring), but not with institutionalization. The participants were highly representative of the target population and the rate of follow-up was almost perfect (99.4%). The results suggest that knee pain is associated with future dependence in ADL, particularly a need for assistance at home.

  12. Psychosocial Well-Being Associated With Activity of Daily Living Stages Among Community-Dwelling Older Adults

    Directory of Open Access Journals (Sweden)

    Ling Na PhD

    2017-03-01

    Full Text Available Objectives: Activity of daily living (ADL stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project ( N = 3,002 were analyzed in regression models and latent factor models. Results: Although ADL stages had a nearly monotonic relationship with most mental health measures (e.g., Center for Epidemiologic Studies Depression Scale [CES-D], only the complete limitation stage (Stage IV showed significant disadvantage in the majority of social network measures. Discussion: The study may aid clinicians and policy makers to better understand the social and mental health needs of older adults at different ADL stages and provide well-planned social and mental health care.

  13. Concerned for Humanity club

    CERN Multimedia

    Concerned for humanity club

    2010-01-01

    Join the Comité International de Soutien à Adlène Hicheur Since October 8, 2009 our colleague Adlène Hicheur, a French-Algerian physicist working in LHCb has been arrested and then held in a French prison under suspicion of terrorism linked with AQMI. No material proof has been presented, only exchanges of messages on some forum sites suspected of Islamism have been mentioned. Adlène has continuously denied any link with AQMI and lives in a Kafkaesque situation since 14 mois. His lawyer has several times asked for his release and these requests have been turned down. As Adlène’s colleagues, we have been chocked by his arrest and are deeply concerned by the prolongation of his detention for his future in particle physics, even if he will be recognized innocent. Few Concerned-club members and colleagues have created an International committee to support Adlène in his defense presently having 65 members. We invite you t...

  14. Rehabilitation of limb apraxia improves daily life activities in patients with stroke.

    Science.gov (United States)

    Smania, N; Aglioti, S M; Girardi, F; Tinazzi, M; Fiaschi, A; Cosentino, A; Corato, E

    2006-12-12

    We randomly assigned 33 patients with left hemisphere stroke, limb apraxia, and aphasia to an apraxia or a control (aphasia) treatment group. Before and after each treatment, patients underwent a comprehensive neuropsychological testing battery and a caregiver evaluation of patient's activities of daily life (ADL) independence. Apraxia severity was related with ADL independence. Control (aphasia) treatment improved patients' language and intelligence performance. Apraxia treatment specifically improved praxic function and ADL.

  15. Lower frequency companions for the Advanced LIGO gravitational wave interferometric detectors: an observational opportunity?

    International Nuclear Information System (INIS)

    DeSalvo, Riccardo

    2004-01-01

    Recent x-ray and optical observations provide evidence for a population of intermediate mass black holes with masses of tens to thousands of solar masses. Dynamical braking in high stellar density regions may 'catalyze' the inspiral of heavy mass objects down to the million-year time scale. Black-hole binaries, with the masses implied by the observations, will plunge below 100 Hz. It may be technologically possible to build ground-based low frequency gravitational wave interferometric detectors optimized to detect these events and install them next to Advanced LIGO (AdL), within the existing LIGO facilities. This additional interferometer, operated coherently with AdL and Virgo, would greatly enhance the effectiveness of the existing interferometers by generating a wealth of triggers for potentially frequent but otherwise undetectable heavy mass inspirals. AdL would study, at higher frequency, the triggered, ultra-relativistic phases (merging and ringdown) of these inspirals. Comparisons are made between the expected detection performances of AdL in its proposed wide band tuning, as well as AdL in its best low frequency tuning, with a low frequency gravitational wave interferometric detector that is mechanically and optically optimized for operation at the lowest possible frequency. Finally, the synergies of tandem operation of AdL and the proposed low frequency interferometer have been considered

  16. Improved Housing Accessibility for Older People in Sweden and Germany: Short Term Costs and Long-Term Gains.

    Science.gov (United States)

    Slaug, Björn; Chiatti, Carlos; Oswald, Frank; Kaspar, Roman; Schmidt, Steven M

    2017-08-26

    The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden.

  17. Impairments in Activities of Daily Living in Older Japanese Men in Hawaii and Japan

    Directory of Open Access Journals (Sweden)

    Robert D. Abbott

    2011-01-01

    Full Text Available Introduction. Hypertension and cigarette smoking are dominant risk factors for cardiovascular disease in Japan while in westernized countries, broader effects encompass obesity, diabetes, and hypercholesterolemia. This paper examines whether different associations also appear important in the manifestation of activities of daily living (ADL in older Japanese men in Hawaii and Japan. Methods. Measures of ADL (feeding, toileting, dressing, bathing, and walking around the house were assessed from 1995 to 1999 in 1,893 men in Hawaii and 543 men in Japan. Concomitant risk factors were measured from 1990 to 1993. Results. In Hawaii, diabetes increased the odds of ≥1 ADL impairment nearly 1.5-fold (P=.020. A similar association was absent in Japan. In contrast, the odds of an ADL impairment in Japan was increased more than 5-fold in the presence of stroke (P<.001. The association in Hawaii was significantly weaker (P=.007. In both cohorts, past alcohol use was associated with a greater likelihood of ADL impairment. Conclusion. In this comparison of genetically similar samples, findings suggest that different strengths in risk factor associations with cardiovascular disease in Japan and westernized countries may also include different strengths in associations with impaired ADL.

  18. Early prediction of outcome of activities of daily living after stroke: a systematic review

    OpenAIRE

    Veerbeek, J.M.; Kwakkel, G.; Wegen, van, E.E.H.; Ket, J.C.F.; Heijmans, M.W.

    2011-01-01

    BACKGROUND AND PURPOSE-Knowledge about robust and unbiased factors that predict outcome of activities of daily living (ADL) is paramount in stroke management. This review investigates the methodological quality of prognostic studies in the early poststroke phase for final ADL to identify variables that are predictive or not predictive for outcome of ADL after stroke. METHODS-PubMed, Ebsco/Cinahl and Embase were systematically searched for prognostic studies in which stroke patients were inclu...

  19. Specific cognitive domains and symptoms of depression as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds

    Directory of Open Access Journals (Sweden)

    Jonas Jardim de Paula

    2015-07-01

    Full Text Available Cognitive functioning play an important role in the performance of activities of daily living (ADL. Although and association between this two measures are usually reported in neuropsychological studies, the results are inconsistent, especially in what aspects cognitive functioning are more or less related to each functional aspect. In addition, only a few studies investigated if depressive symptoms are associated with worse functional performance in older adults. Our objective is to investigate the role of different cognitive functions and the depressive symptoms in the performance of different groups of ADL and each activity individually. We assessed 264 older adults (96 normal aging controls, 85 patients diagnosed with mild cognitive impairment and 93 with mild probable Alzheimer’s disease dementia with low formal education (about 4 years. We used measures of ADL with different levels of complexity: Selfcare, Instrumental-Domestic and Instrumental Complex, along with composite factors of cognitive functions and the score of the Geriatric Depression Scale. Multiple linear regression analysis showed significant predictors of Instrumental-Domestic ADL (executive functions and episodic memory and Instrumental-Complex ADL (executive functions, episodic memory and language/semantic memory, with large effect sizes (22 and 28% of explained variance. Individual analysis of each Instrumental ADL shows a heterogeneous pattern of association with different cognitive factors and depressive symptoms, with effect sizes ranging from 22 to 38% of explained variance. Our results suggest that specific measures of ADL have different cognitive predictors and that depressive symptoms are associated with activities more dependent on social contact.

  20. Pulse shape analysis and position determination in segmented HPGe detectors: The AGATA detector library

    Energy Technology Data Exchange (ETDEWEB)

    Bruyneel, B. [Universitaet zu Koeln, Institut fuer Kernphysik, Koeln (Germany); Service de Physique Nucleaire, CEA Saclay, Gif-sur-Yvette (France); Birkenbach, B.; Reiter, P. [Universitaet zu Koeln, Institut fuer Kernphysik, Koeln (Germany)

    2016-03-15

    The AGATA Detector Library (ADL) was developed for the calculation of signals from highly segmented large volume high-purity germanium (HPGe) detectors. ADL basis sets comprise a huge amount of calculated position-dependent detector pulse shapes. A basis set is needed for Pulse Shape Analysis (PSA). By means of PSA the interaction position of a γ -ray inside the active detector volume is determined. Theoretical concepts of the calculations are introduced and cover the relevant aspects of signal formation in HPGe. The approximations and the realization of the computer code with its input parameters are explained in detail. ADL is a versatile and modular computer code; new detectors can be implemented in this library. Measured position resolutions of the AGATA detectors based on ADL are discussed. (orig.)

  1. The influence of exercise intervention upon quality of life and activity of daily living in elderly people who use nursing care insurance services

    OpenAIRE

    竹内, 亮

    2012-01-01

    The purpose of this study was to confirm the importance of enhancing quality of life (QOL) and activity of daily living (ADL) in elderly people, and to examine methods of exercise intervention for QOL and ADL outcomes in elderly people who use nursing care insurance services. Chapter 2 clarifies the relationship between QOL, ADL, and changes in the level of independence in elderly residents. Higher QOL outcomes (sense of well-being, satisfaction with social support, independence, and beh...

  2. Objective Analysis of Performance of Activities of Daily Living in People With Central Field Loss.

    Science.gov (United States)

    Pardhan, Shahina; Latham, Keziah; Tabrett, Daryl; Timmis, Matthew A

    2015-11-01

    People with central visual field loss (CFL) adopt various strategies to complete activities of daily living (ADL). Using objective movement analysis, we compared how three ADLs were completed by people with CFL compared with age-matched, visually healthy individuals. Fourteen participants with CFL (age 81 ± 10 years) and 10 age-matched, visually healthy (age 75 ± 5 years) participated. Three ADLs were assessed: pick up food from a plate, pour liquid from a bottle, and insert a key in a lock. Participants with CFL completed each ADL habitually (as they would in their home). Data were compared with visually healthy participants who were asked to complete the tasks as they would normally, but under specified experimental conditions. Movement kinematics were compared using three-dimension motion analysis (Vicon). Visual functions (distance and near acuities, contrast sensitivity, visual fields) were recorded. All CFL participants were able to complete each ADL. However, participants with CFL demonstrated significantly (P approach. Various kinematic indices correlated significantly to visual function parameters including visual acuity and midperipheral visual field loss.

  3. Barriers associated with reduced physical activity in COPD patients.

    Science.gov (United States)

    Amorim, Priscila Batista; Stelmach, Rafael; Carvalho, Celso Ricardo Fernandes; Fernandes, Frederico Leon Arrabal; Carvalho-Pinto, Regina Maria; Cukier, Alberto

    2014-10-01

    To evaluate the ability of COPD patients to perform activities of daily living (ADL); to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT), and an ADL limitation score. In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL) scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

  4. Do elderly people at more severe activity of daily living limitation stages fall more?

    Science.gov (United States)

    Henry-Sánchez, John T; Kurichi, Jibby E; Xie, Dawei; Pan, Qiang; Stineman, Margaret G

    2012-07-01

    The aim of this study was to explore how activity of daily living (ADL) stages and the perception of unmet needs for home accessibility features associate with a history of falling. Participants were from a nationally representative sample from the Second Longitudinal Survey of Aging conducted in 1994. The sample included 9250 community-dwelling persons 70 yrs or older. The associations of ADL stage and perception of unmet needs for home accessibility features with a history of falling within the past year (none, once, or multiple times) were explored after accounting for sociodemographic characteristics and comorbidities using a multinomial logistic regression model. The adjusted relative risk of falling more than once peaked at 4.30 (95% confidence interval, 3.29-5.61) for persons with severe limitation (ADL-III) compared those with no limitation (ADL-0) then declined for those at complete limitation (ADL-IV). The adjusted relative risks of falling once and multiple times were 1.42 (95% confidence interval, 1.07-1.87) and 1.85 (95% confidence interval, 1.44-2.36), respectively, for those lacking home accessibility features. Risk of falling appeared greatest for those whose homes lacked accessibility features and peaked at intermediate ADL limitation stages, presumably at a point when people have significant disabilities but sufficient function to remain partially active.

  5. The Relationship between Pain, Disability, and Sex in African Americans.

    Science.gov (United States)

    Walker, Janiece L; Thorpe, Roland J; Harrison, Tracie C; Baker, Tamara A; Cary, Michael; Szanton, Sarah L; Allaire, Jason C; Whitfield, Keith E

    2016-10-01

    Older African Americans consistently report diminished capacities to perform activities of daily living (ADL) compared with other racial groups. The extent to which bodily pain is related to declining abilities to perform ADL/ADL disability in African Americans remains unclear, as does whether this relationship exists to the same degree in African American men and women. For nurses to provide optimal care for older African Americans, a better understanding of the relationship between bodily pain and ADL disability and how it may differ by sex is needed. The aim of this study was to examine whether pain, age, education, income, marital status and/or comorbid conditions were associated with ADL disabilities in older African American women and men. This was a cross-sectional descriptive study. The sample included 598 participants (446 women, 152 men) from the first wave of the Baltimore Study on Black Aging. African American women (odds ratio [OR] = 4.06; 95% confidence interval [CI] 2.63-6.26) and African American men (OR = 6.44; 95% CI = 2.84-14.57) who reported bodily pain had greater ADL disability than those who did not report bodily pain. Having two or more comorbid conditions also was significantly associated with ADL disability in African American women (OR = 3.95; 95% CI: 2.09-7.47). Further work is needed to understand pain differences between older African American women and men to develop interventions that can be tailored to meet the individual pain needs of both groups. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2016-07-05

    This study's aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly. Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47-2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44-5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01-3.55) compared to having both hobbies and PIL. Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.

  7. A SIMPLE FRAILTY QUESTIONNAIRE (FRAIL) PREDICTS OUTCOMES IN MIDDLE AGED AFRICAN AMERICANS

    Science.gov (United States)

    MORLEY, J.E.; MALMSTROM, T.K.; MILLER, D.K.

    2015-01-01

    Objective To validate the FRAIL scale. Design Longitudinal study. Setting Community. Participants Representative sample of African Americans age 49 to 65 years at onset of study. Measurements The 5-item FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, & Loss of Weight), at baseline and activities of daily living (ADLs), instrumental activities of daily living (IADLs), mortality, short physical performance battery (SPPB), gait speed, one-leg stand, grip strength and injurious falls at baseline and 9 years. Blood tests for CRP, SIL6R, STNFR1, STNFR2 and 25 (OH) vitamin D at baseline. Results Cross-sectionally the FRAIL scale correlated significantly with IADL difficulties, SPPB, grip strength and one-leg stand among participants with no baseline ADL difficulties (N=703) and those outcomes plus gait speed in those with no baseline ADL dependencies (N=883). TNFR1 was increased in pre-frail and frail subjects and CRP in some subgroups. Longitudinally (N=423 with no baseline ADL difficulties or N=528 with no baseline ADL dependencies), and adjusted for the baseline value for each outcome, being pre-frail at baseline significantly predicted future ADL difficulties, worse one-leg stand scores, and mortality in both groups, plus IADL difficulties in the dependence-excluded group. Being frail at baseline significantly predicted future ADL difficulties, IADL difficulties, and mortality in both groups, plus worse SPPB in the dependence-excluded group. Conclusion This study has validated the FRAIL scale in a late middle-aged African American population. This simple 5-question scale is an excellent screening test for clinicians to identify frail persons at risk of developing disability as well as decline in health functioning and mortality. PMID:22836700

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

    Science.gov (United States)

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

    2013-04-01

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

  9. Disability associated with obesity, dynapenia and dynapenic-obesity in Chinese older adults.

    Science.gov (United States)

    Yang, Ming; Ding, Xiang; Luo, Li; Hao, Qiukui; Dong, Birong

    2014-02-01

    Whether the combination of obesity and low muscle strength (dynapenic-obesity) would cause greater impairment of the activities of daily living (ADL)/instrumental activities of daily living (IADL) than obesity alone and low muscle strength alone (dynapenia) remains unclear. The aim of this study was to reveal the possible independent and additive effects of dynapenia and obesity on ADL/IADL disability in an older Chinese population. A cross-sectional study, including 616 community-dwelling older adults, was conducted in China from 2010 to 2012. Based on the World Health Organization Asian Criteria of Obesity and handgrip strength tertiles, 4 independent groups were identified as follows: nondynapenia/nonobesity, dynapenia alone, obesity alone, and dynapenic-obesity. The Katz Index of Independence in ADL was used to assess ADL disability, whereas 6 IADL items of the Older Americans Resources and Services (OARS) multidimensional functional assessment questionnaire were used to assess IADL disability. The prevalence of ADL and IADL disability was 21.1% and 28.9% in the dynapenic-obesity group, 15.5% and 22.6% in the dynapenia alone group, 13.1% and 19.6% in the obesity alone group, and 11.9% and 12.9% in the nondynapenia/nonobesity group, respectively. After adjusting for the covariates, in comparison with the dynapenic-obesity group, the adjusted odds ratios (95% confidence interval) for ADL disability were 0.36 (0.13-0.73) in the nondynapenia/nonobesity group, 0.51 (0.20-0.78) in the dynapenia-alone group, and 0.40 (0.11-0.61) in the obesity-alone group. The corresponding data for IADL disability were 0.55 (0.20-0.93), 0.82 (0.39-0.98), and 0.61 (0.30-0.91), respectively. Dynapenia, obesity, and dynapenic-obesity were associated with an increased risk of ADL/IADL disability. Dynapenic-obesity was associated with a greater risk of ADL/IADL disability in comparison with dynapenia or obesity alone. Copyright © 2014 American Medical Directors Association, Inc

  10. Pain as a risk factor for disability or death.

    Science.gov (United States)

    Andrews, James S; Cenzer, Irena Stijacic; Yelin, Edward; Covinsky, Kenneth E

    2013-04-01

    To determine whether pain predicts future activity of daily living (ADL) disability or death in individuals aged 60 and older. Prospective cohort study. The 1998 to 2008 Health and Retirement Study (HRS), a nationally representative study of older community-living individuals. Twelve thousand six hundred thirty-one participants in the 1998 HRS aged 60 and older who did not need help in any ADL. Participants reporting that they had moderate or severe pain most of the time were defined as having significant pain. The primary outcome was time to development of ADL disability or death over 10 yrs, assessed at five successive 2-year intervals. ADL disability was defined as needing help performing any ADL: bathing, dressing, transferring, toileting, eating, or walking across a room. A discrete hazards survival model was used to examine the relationship between pain and incident disability over each 2-year interval using only participants who started the interval with no ADL disability. Several potential confounders were adjusted for at the start of each interval: demographic factors, seven chronic health conditions, and functional limitations (ADL difficulty and difficulty with five measures of mobility). At baseline, 2,283 (18%) participants had significant pain. Participants with pain were more likely (all P disability or death (58% vs 43%, unadjusted hazard ratio (HR) = 1.67, 95% confidence interval (CI) = 1.57-1.79), although after adjustment for confounders, participants with pain were not at greater risk for ADL disability or death (HR = 0.98, 95% CI = 0.91-1.07). Adjustment for functional status almost entirely explained the difference between the unadjusted and adjusted results. Although there are strong cross-sectional relationships between pain and functional limitations, individuals with pain are not at higher risk of subsequent disability or death after accounting for functional limitations. Like many geriatric syndromes, pain and disability may

  11. Chemical changes of some nutritive components in poultry litter under the influence by gamma irradiation

    International Nuclear Information System (INIS)

    Al-Masri, M.R.; Zarkawi, M.

    1996-04-01

    An experiment has been carried out to study the effect of different doses of gamma irradiation (0.50,100,150,250 and 350 KGy) on total nitrogen (N), crude fibre (CF), and on cell-wall constituents (NDF,ADF and ADL) of broiler litter. The results indicate to significant (P<0.0001) decrease in CF, NDF,ADF and ADL values as a result of gamma irradiation treatment. there was no effect on total nitrogen. The highest effect on reducing CF, ADF and ADL values was at 350 KGy which 33% for ADL and CF 24% for ADF whereas dose at 250 KGy was the best to achieve the highest reduction in NDF which reached 20%. there was no significant difference in NDF values between doses 250 and 350 KGy. (author). 21 refs. 2 tabs

  12. 76 FR 50224 - Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center...

    Science.gov (United States)

    2011-08-12

    ...] Medicare Program; Accountable Care Organization Accelerated Development Learning Sessions; Center for... (CMS). This two-day training session is the second Accelerated Development Learning Session (ADLS.... Through Accelerated Development Learning Sessions (ADLS), the Innovation Center will test whether...

  13. Relationship of Having Hobbies and a Purpose in Life With Mortality, Activities of Daily Living, and Instrumental Activities of Daily Living Among Community-Dwelling Elderly Adults

    Directory of Open Access Journals (Sweden)

    Kimiko Tomioka

    2016-07-01

    Full Text Available Background: This study’s aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai with mortality and a decline in the activities of daily living (ADL and instrumental ADL (IADL among the community-dwelling elderly. Methods: Prospective observational data from residents aged ≥65 years who were at increased risk for death (n = 1853 and developing a decline in ADL (n = 1254 and IADL (n = 1162 were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression. Results: During the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47–2.94, decline in ADL (odds ratio 2.74; 95% CI, 1.44–5.21, and decline in IADL (odds ratio 1.89; 95% CI, 1.01–3.55 compared to having both hobbies and PIL. Conclusions: Although effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.

  14. Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment

    Directory of Open Access Journals (Sweden)

    Fries Brant E

    2006-04-01

    Full Text Available Abstract Background The objective of this study was to assess the responsiveness of the Minimum Data Set Activities of Daily Living (MDS-ADL Scale to change over time by examining the change in physical function in adults with moderate to severe dementia with no comorbid illness who had been resident in a nursing home for over 90 days. Methods Longitudinal data were collected on nursing home residents with moderate (n = 7001 or severe (n = 4616 dementia in one US state from the US national Minimum Data Set (MDS. Severity of dementia was determined by the MDS Cognitive Performance Scale (CPS. Physical function was assessed by summing the seven items (bed mobility, transfer, locomotion, dressing, eating, toilet use, personal hygiene on the MDS activities of daily living (ADL Long Form scale. Mean change over time of MDS-ADL scores were estimated at three and six months for residents with moderate (CPS score of 3 and severe (CPS score of 4 or 5 dementia. Results Physical function in residents with moderate cognitive impairment deteriorated over six months by an average of 1.78 points on the MDS-ADL Long Form scale, while those with severe cognitive impairment declined by an average of 1.70 points. Approximately one quarter of residents in both groups showed some improvement in physical function over the six month period. Residents with moderate cognitive impairment experienced the greatest deterioration in early-loss and mid-loss ADL items (personal hygiene, dressing, toilet use and residents with severe cognitive impairment showed the greatest deterioration in activities related to eating, a late loss ADL. Conclusion The MDS-ADL Long Form scale detected clinically meaningful change in physical function in a large cohort of long-stay nursing home residents with moderate to severe dementia, supporting its use as a research tool in future studies.

  15. Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment

    Science.gov (United States)

    Carpenter, G Iain; Hastie, Charlotte L; Morris, John N; Fries, Brant E; Ankri, Joel

    2006-01-01

    Background The objective of this study was to assess the responsiveness of the Minimum Data Set Activities of Daily Living (MDS-ADL) Scale to change over time by examining the change in physical function in adults with moderate to severe dementia with no comorbid illness who had been resident in a nursing home for over 90 days. Methods Longitudinal data were collected on nursing home residents with moderate (n = 7001) or severe (n = 4616) dementia in one US state from the US national Minimum Data Set (MDS). Severity of dementia was determined by the MDS Cognitive Performance Scale (CPS). Physical function was assessed by summing the seven items (bed mobility, transfer, locomotion, dressing, eating, toilet use, personal hygiene) on the MDS activities of daily living (ADL) Long Form scale. Mean change over time of MDS-ADL scores were estimated at three and six months for residents with moderate (CPS score of 3) and severe (CPS score of 4 or 5) dementia. Results Physical function in residents with moderate cognitive impairment deteriorated over six months by an average of 1.78 points on the MDS-ADL Long Form scale, while those with severe cognitive impairment declined by an average of 1.70 points. Approximately one quarter of residents in both groups showed some improvement in physical function over the six month period. Residents with moderate cognitive impairment experienced the greatest deterioration in early-loss and mid-loss ADL items (personal hygiene, dressing, toilet use) and residents with severe cognitive impairment showed the greatest deterioration in activities related to eating, a late loss ADL. Conclusion The MDS-ADL Long Form scale detected clinically meaningful change in physical function in a large cohort of long-stay nursing home residents with moderate to severe dementia, supporting its use as a research tool in future studies. PMID:16584565

  16. Physiological Requirements to Perform the Glittre Activities of Daily Living Test by Subjects With Mild-to-Severe COPD.

    Science.gov (United States)

    Souza, Gérson F; Moreira, Graciane L; Tufanin, Andréa; Gazzotti, Mariana R; Castro, Antonio A; Jardim, José R; Nascimento, Oliver A

    2017-08-01

    The Glittre activities of daily living (ADL) test is supposed to evaluate the functional capacity of COPD patients. The physiological requirements of the test and the time taken to perform it by COPD patients in different disease stages are not well known. The objective of this work was to compare the metabolic, ventilatory, and cardiac requirements and the time taken to carry out the Glittre ADL test by COPD subjects with mild, moderate, and severe disease. Spirometry, Medical Research Council questionnaire, cardiopulmonary exercise test, and 2 Glittre ADL tests were evaluated in 62 COPD subjects. Oxygen uptake (V̇ O 2 ), carbon dioxide production, pulmonary ventilation, breathing frequency, heart rate, S pO 2 , and dyspnea were analyzed before and at the end of the tests. Maximum voluntary ventilation, Glittre peak V̇ O 2 /cardiopulmonary exercise test (CPET) peak V̇ O 2 , Glittre V̇ E /maximum voluntary ventilation, and Glittre peak heart rate/CPET peak heart rate ratios were calculated to analyze their reserves. Subjects carried out the Glittre ADL test with similar absolute metabolic, ventilatory, and cardiac requirements. Ventilatory reserve decreased progressively from mild to severe COPD subjects ( P reserve than the mild and moderate subjects ( P = .006 and P = .043, respectively) and significantly lower Glittre peak heart rate/CPET peak heart rate than mild subjects ( P = .01). Time taken to carry out the Glittre ADL test was similar among the groups ( P = .82 for GOLD 1 vs GOLD 2, P = .19 for GOLD 1 vs GOLD 3, and P = .45 for GOLD 2 vs GOLD 3). As the degree of air-flow obstruction progresses, the COPD subjects present significant lower ventilatory reserve to perform the Glittre ADL test. In addition, metabolic and cardiac reserves may differentiate the severe subjects. These variables may be better measures to differentiate functional performance than Glittre ADL time. Copyright © 2017 by Daedalus Enterprises.

  17. Decreased activity of daily living produced by the combination of Alzheimer's disease and lower limb fracture in elderly requiring nursing care.

    Science.gov (United States)

    Inagawa, Toshimitsu; Hamagishi, Toshio; Takaso, Yuji; Hitomi, Yoshiaki; Kambayashi, Yasuhiro; Hibino, Yuri; Shibata, Aki; Ngoc, Nguyen T M; Okochi, Jiro; Hatta, Kotaro; Takamuku, Kiyoshi; Konoshita, Tadashi; Nakamura, Hiroyuki

    2013-01-01

    Alzheimer's disease (AD) impairs cognitive functions, subsequently decreasing activity of daily living (ADL), and is frequently accompanied by lower limb fracture including hip fracture in the elderly. However, there have been few studies on what kinds of physical functions are affected or what degrees of dysfunction are produced by this combination. This study aims to clarify the relationship between decreased ADL and the combination of AD and lower limb fracture. We examined present illness and ADL in 4340 elderly aged 82.8 ± 9.36 years [average ± standard deviation (SD)] requiring nursing care and compared ADL between elderly with and without AD or lower limb fracture treated with surgery or conservatively using analysis of covariance (ANCOVA), with age and sex as covariants. We recognized that activities of cognitive function (p lower than in those without the disease, even after adjusting for sex and age. Activities of bed mobility (p fracture treated with surgery were significantly lower, which differed from the results of AD. Significant interactions of AD and fracture treated with surgery on the ADL scores for bed mobility (p fracture alone. We obtained almost the same results for fractures treated conservatively as for fractures treated with surgery. These results demonstrated that the combined effects of AD and lower limb fracture were significantly greater than expected additive effects of AD and fracture, suggesting that the combination of AD and lower limb fracture has synergistic effects on almost all types of ADL except cognitive functions.

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

    Science.gov (United States)

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

    2015-11-01

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

  19. A randomized controlled trial on early physiotherapy intervention versus usual care in acute care unit for elderly: potential benefits in light of dietary intakes.

    Science.gov (United States)

    Blanc-Bisson, C; Dechamps, A; Gouspillou, G; Dehail, P; Bourdel-Marchasson, I

    2008-01-01

    To evaluate effects of early intensive physiotherapy during acute illness on post hospitalization activity daily living autonomy (ADL). Prospective randomized controlled trial of intensive physiotherapy rehabilitation on day 1 to 2 after admission until clinical stability or usual care. acute care geriatric medicine ward. A total of 76 acutely ill patients, acutely bedridden or with reduced mobility but who were autonomous for mobility within the previous 3 months. Patients in palliative care or with limiting mobility pathology were excluded. Mean age was 85.4 (SD 6.6) years. At admission, at clinical stability and one month later: anthropometry, energy and protein intakes, hand grip strength, ADL scores, and baseline inflammatory parameters. An exploratory principal axis analysis was performed on the baseline characteristics and general linear models were used to explore the course of ADL and nutritional variables. A 4-factor solution was found explaining 71.7% of variance with a factor "nutrition", a factor "function" (18.8% of variance) for ADL, handgrip strength, bedridden state, energy and protein intakes, serum albumin and C-reactive protein concentrations; a factor "strength" and a fourth factor . During follow-up, dietary intakes, handgrip strength, and ADL scores improved but no changes occurred for anthropometric variables. Intervention was associated only with an increase in protein intake. Better improvement in ADL was found in intervention group when model was adjusted on "function" factor items. Physical intervention programs should be proposed according to nutritional intakes with the aim of preventing illness induced disability.

  20. CONTRIBUTION OF AXIAL MOTOR IMPAIRMENT TO PHYSICAL INACTIVITY IN PARKINSON'S DISEASE

    Science.gov (United States)

    Bryant, Mon S; Hou, Jyhgong Gabriel; Collins, Robert L; Protas, Elizabeth J

    2015-01-01

    Objective To investigate the relationships between motor symptoms of Parkinson’s disease (PD) and activity limitations in persons with PD. Design/Methods Cross-sectional study of persons with mild to moderate PD (N=90). Associations among axial motor features, limb motor signs, the Physical Activity Scale for Elders (PASE), the ability to perform Activities of Daily Living (ADL) and level of ADL dependency were studied. A composite score of axial motor features included the following UPDRS items: speech, rigidity of the neck, arising from chair, posture, gait and postural stability. A composite score of limb motor signs included the following UPDRS items: tremor at rest of all extremities, action tremor, rigidity of all extremities, finger taps, hand movement, rapid alternating hand movements and foot tapping. Results Axial motor features of PD were significantly correlated with physical inactivity (pphysical inactivity. After controlling for age, gender, disease duration and comorbidity, axial motor features contributed significantly to physical inactivity, decreased ADL and increase in ADL dependency, whereas the limb motor signs did not. Conclusions Axial motor impairment contributed to physical inactivity and decreased ability to perform ADLs in persons with PD. PMID:26368837

  1. Variation in Functional Independence among Stroke Survivors Having Fatigue and Depression.

    Science.gov (United States)

    Badaru, Umaru Muhammad; Ogwumike, Omoyemi Olubunmi; Adeniyi, Ade Fatai; Olowe, Olajide Olubanji

    2013-01-01

    Objective. This study evaluated variation in functional independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) among individuals with poststroke fatigue (PSF) and poststroke depression (PSD). Methods. A cross-sectional survey involved 65 consenting poststroke survivors who were purposively recruited from physiotherapy clinics of the University College Hospital, Ibadan, Adeoyo Maternity Teaching Hospital, Ibadan, and Federal Medical Center, Gusau. Participants were assessed for symptoms of PSD with short geriatric depression scale-15, PSF with fatigue severity scale, ADL with Barthel Index and IADL with Nottingham extended ADL scale. Data analysis was done using Chi-square and unpaired t-test with significance level being 0.05. Results. Participants' age ranged from 58 to 80 years. PSD alone (P = 0.002) and both PSF and PSD (P = 0.02) were significantly associated with ADL, while PSF alone was not (P = 0.233). PSD alone (P = 0.001) and both PSF and PSD (P = 0.001) significantly negatively affected IADL, while PSF alone had no significant effect (P = 0.2). Conclusions. Participants with PSD alone and those with both PSF and PSD had lower functional independence in ADL and IADL.

  2. Variation in Functional Independence among Stroke Survivors Having Fatigue and Depression

    Directory of Open Access Journals (Sweden)

    Umaru Muhammad Badaru

    2013-01-01

    Full Text Available Objective. This study evaluated variation in functional independence in activities of daily living (ADL and instrumental activities of daily living (IADL among individuals with poststroke fatigue (PSF and poststroke depression (PSD. Methods. A cross-sectional survey involved 65 consenting poststroke survivors who were purposively recruited from physiotherapy clinics of the University College Hospital, Ibadan, Adeoyo Maternity Teaching Hospital, Ibadan, and Federal Medical Center, Gusau. Participants were assessed for symptoms of PSD with short geriatric depression scale-15, PSF with fatigue severity scale, ADL with Barthel Index and IADL with Nottingham extended ADL scale. Data analysis was done using Chi-square and unpaired t-test with significance level being 0.05. Results. Participants’ age ranged from 58 to 80 years. PSD alone (P=0.002 and both PSF and PSD (P=0.02 were significantly associated with ADL, while PSF alone was not (P=0.233. PSD alone (P=0.001 and both PSF and PSD (P=0.001 significantly negatively affected IADL, while PSF alone had no significant effect (P=0.2. Conclusions. Participants with PSD alone and those with both PSF and PSD had lower functional independence in ADL and IADL.

  3. Impact of Different Lignin Fractions on Saccharification Efficiency in Diverse Species of the Bioenergy Crop Miscanthus

    NARCIS (Netherlands)

    Weijde, van der Tim; Torres Salvador, Andres Francisco; Dolstra, Oene; Dechesne, Annemarie; Visser, Richard G.F.; Trindade, Luisa M.

    2016-01-01

    Lignin is a key factor limiting saccharification of lignocellulosic feedstocks. In this comparative study, various lignin methods—including acetyl bromide lignin (ABL), acid detergent lignin (ADL), Klason lignin (KL), and modified ADL and KL determination methods—were evaluated for their

  4. Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities?

    Directory of Open Access Journals (Sweden)

    Conradsson M

    2013-11-01

    Full Text Available Mia Conradsson,1 Håkan Littbrand,1,2 Gustaf Boström,1 Nina Lindelöf,1 Yngve Gustafson,1 Erik Rosendahl1,2 1Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; 2Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden Aim: Functional capacity and dependency in activities of daily living (ADL could be important mediators for an association between physical exercise and mental health. The aim of this study was to investigate whether a change in functional capacity or dependency in ADL is associated with a change in depressive symptoms and psychological well-being among older people living in residential care facilities, and whether dementia can be a moderating factor for this association. Methods: A prospective cohort study was undertaken. Participants were 206 older people, dependent in ADL, living in residential care facilities, 115 (56% of whom had diagnosed dementia. Multivariate linear regression, with comprehensive adjustment for potential confounders, was used to investigate associations between differences over 3 months in Berg Balance Scale (BBS and Geriatric Depression Scale (GDS-15 scores, and in BBS and Philadelphia Geriatric Center Morale Scale (PGCMS scores. Associations were also investigated between differences in Barthel ADL Index and GDS-15 scores, and in Barthel ADL Index and PGCMS scores. Results: There were no significant associations between changes in scores over 3 months; the unstandardized β for associations between BBS and GDS-15 was 0.026 (P=0.31, BBS and PGCMS 0.045 (P=0.14, Barthel ADL Index and GDS-15 0.123 (P=0.06, and Barthel ADL Index and PGCMS -0.013 (P=0.86. There were no interaction effects for dementia. Conclusion: A change in functional capacity or dependency in ADL does not appear to be associated with a change in depressive symptoms or psychological well-being among older people living in residential care

  5. Preliminary Findings of Feasibility of a Wearable Soft-robotic Glove Supporting Impaired Hand Function in Daily Life

    NARCIS (Netherlands)

    Radder, Bob; Radder, B.; Prange, Grada Berendina; Prange-Lasonder, G.B.; Kottink, A.I.R.; Gaasbeek, L.; Holmberg, J.; Meyer, T.; Buurke, Jaap; Rietman, Johan Swanik

    2016-01-01

    Elderly people frequently encounter difficulties in independently performing activities of daily living (ADL) due to a reduced hand function. Robotic assistive devices have the potential to provide the assistance that is necessary to perform ADL independently without the need of personal assistance.

  6. A model-driven approach for representing clinical archetypes for Semantic Web environments.

    Science.gov (United States)

    Martínez-Costa, Catalina; Menárguez-Tortosa, Marcos; Fernández-Breis, Jesualdo Tomás; Maldonado, José Alberto

    2009-02-01

    The life-long clinical information of any person supported by electronic means configures his Electronic Health Record (EHR). This information is usually distributed among several independent and heterogeneous systems that may be syntactically or semantically incompatible. There are currently different standards for representing and exchanging EHR information among different systems. In advanced EHR approaches, clinical information is represented by means of archetypes. Most of these approaches use the Archetype Definition Language (ADL) to specify archetypes. However, ADL has some drawbacks when attempting to perform semantic activities in Semantic Web environments. In this work, Semantic Web technologies are used to specify clinical archetypes for advanced EHR architectures. The advantages of using the Ontology Web Language (OWL) instead of ADL are described and discussed in this work. Moreover, a solution combining Semantic Web and Model-driven Engineering technologies is proposed to transform ADL into OWL for the CEN EN13606 EHR architecture.

  7. Respiratory constraints during activities in daily life and the impact on health status in patients with early-stage COPD: a cross-sectional study.

    Science.gov (United States)

    van Helvoort, Hanneke Ac; Willems, Laura M; Dekhuijzen, Pn Richard; van Hees, Hieronymus Wh; Heijdra, Yvonne F

    2016-10-13

    In patients with chronic obstructive pulmonary disease (COPD), exercise capacity is reduced, resulting over time in physical inactivity and worsened health status. It is unknown whether ventilatory constraints occur during activities of daily life (ADL) in early stages of COPD. The aim of this study was to assess respiratory mechanics during ADL and to study its consequences on dyspnoea, physical activity and health status in early-stage COPD compared with healthy controls. In this cross-sectional study, 39 early-stage COPD patients (mean FEV 1 88±s.d. 12% predicted) and 20 controls performed 3 ADL: climbing stairs, vacuum cleaning and displacing groceries in a cupboard. Respiratory mechanics were measured during ADL. Physical activity was measured with accelerometry. Health status was assessed by the Nijmegen Clinical Screening Instrument. Compared with controls, COPD patients had greater ventilatory inefficiency and higher ventilatory requirements during ADL (P50% of the patients developed dynamic hyperinflation in contrast to 10-35% of the controls. Higher dyspnoea was scored by patients with dynamic hyperinflation. Physical activity was low but comparable between both groups. From the patients, 55-84% experienced mild-to-severe problems in health status compared with 5-25% of the controls. Significant ventilatory constraints already occur in early-stage COPD patients during common ADL and result in increased dyspnoea. Physical activity level is not yet reduced, but many patients already experience limitations in health status. These findings reinforce the importance of early diagnosis of COPD and assessment of more than just spirometry.

  8. Analysis of Public Datasets for Wearable Fall Detection Systems.

    Science.gov (United States)

    Casilari, Eduardo; Santoyo-Ramón, José-Antonio; Cano-García, José-Manuel

    2017-06-27

    Due to the boom of wireless handheld devices such as smartwatches and smartphones, wearable Fall Detection Systems (FDSs) have become a major focus of attention among the research community during the last years. The effectiveness of a wearable FDS must be contrasted against a wide variety of measurements obtained from inertial sensors during the occurrence of falls and Activities of Daily Living (ADLs). In this regard, the access to public databases constitutes the basis for an open and systematic assessment of fall detection techniques. This paper reviews and appraises twelve existing available data repositories containing measurements of ADLs and emulated falls envisaged for the evaluation of fall detection algorithms in wearable FDSs. The analysis of the found datasets is performed in a comprehensive way, taking into account the multiple factors involved in the definition of the testbeds deployed for the generation of the mobility samples. The study of the traces brings to light the lack of a common experimental benchmarking procedure and, consequently, the large heterogeneity of the datasets from a number of perspectives (length and number of samples, typology of the emulated falls and ADLs, characteristics of the test subjects, features and positions of the sensors, etc.). Concerning this, the statistical analysis of the samples reveals the impact of the sensor range on the reliability of the traces. In addition, the study evidences the importance of the selection of the ADLs and the need of categorizing the ADLs depending on the intensity of the movements in order to evaluate the capability of a certain detection algorithm to discriminate falls from ADLs.

  9. Extracting aerobic system dynamics during unsupervised activities of daily living using wearable sensor machine learning models.

    Science.gov (United States)

    Beltrame, Thomas; Amelard, Robert; Wong, Alexander; Hughson, Richard L

    2018-02-01

    Physical activity levels are related through algorithms to the energetic demand, with no information regarding the integrity of the multiple physiological systems involved in the energetic supply. Longitudinal analysis of the oxygen uptake (V̇o 2 ) by wearable sensors in realistic settings might permit development of a practical tool for the study of the longitudinal aerobic system dynamics (i.e., V̇o 2 kinetics). This study evaluated aerobic system dynamics based on predicted V̇o 2 data obtained from wearable sensors during unsupervised activities of daily living (μADL). Thirteen healthy men performed a laboratory-controlled moderate exercise protocol and were monitored for ≈6 h/day for 4 days (μADL data). Variables derived from hip accelerometer (ACC HIP ), heart rate monitor, and respiratory bands during μADL were extracted and processed by a validated random forest regression model to predict V̇o 2 . The aerobic system analysis was based on the frequency-domain analysis of ACC HIP and predicted V̇o 2 data obtained during μADL. Optimal samples for frequency domain analysis (constrained to ≤0.01 Hz) were selected when ACC HIP was higher than 0.05 g at a given frequency (i.e., participants were active). The temporal characteristics of predicted V̇o 2 data during μADL correlated with the temporal characteristics of measured V̇o 2 data during laboratory-controlled protocol ([Formula: see text] = 0.82, P system dynamics can be investigated during unsupervised activities of daily living by wearable sensors. Although speculative, these algorithms have the potential to be incorporated into wearable systems for early detection of changes in health status in realistic environments by detecting changes in aerobic response dynamics. NEW & NOTEWORTHY The early detection of subclinical aerobic system impairments might be indicative of impaired physiological reserves that impact the capacity for physical activity. This study is the first to use wearable

  10. Factors associated with increasing functional decline in multimorbid independently living older people

    NARCIS (Netherlands)

    Laan, W.; Bleijenberg, N.; Drubbel, I.; Numans, M.E.; De Wit, N.J.; Schuurmans, M.J.

    2013-01-01

    Objectives With increasing age the levels of activities of daily living (ADL) deteriorate. In this study we aimed to investigate which demographic characteristics and disorders are associated with ADL disabilities in multi-morbid older people. Study design We performed a cross-sectional study with

  11. Understanding implementation of comprehensive geriatric care programs: a multiple perspective approach is preferred

    NARCIS (Netherlands)

    J.B.M. Vos; J.M. Cramm (Jane); J.D.H. van Wijngaarden (Jeroen); T.J.E.M. Bakker (Ton); J.P. Mackenbach (Johan); A.P. Nieboer (Anna)

    2017-01-01

    textabstractBackground: The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital-related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older

  12. Transfer effects of a cognitive strategy training for stroke patients with apraxia

    NARCIS (Netherlands)

    Geusgens, C. A. V.; van Heugten, C. M.; Cooijmans, J. P. J.; Jolles, J.; van den Heuvel, W. J. A.

    2007-01-01

    The objective of this study was to evaluate transfer effects of cognitive strategy training for stroke patients with apraxia. During 8 weeks, 29 apraxic patients received cognitive strategy training to teach them how to perform activities of daily living (ADL) as independently as possible. ADL

  13. Aphasia and unilateral spatial neglect due to acute thalamic hemorrhage: clinical correlations and outcomes.

    Science.gov (United States)

    Osawa, Aiko; Maeshima, Shinichiro

    2016-04-01

    Thalamic hemorrhages are associated with a variety of cognitive dysfunctions, and it is well known that such cognitive changes constitute a limiting factor of recovery of the activities of daily living (ADL). The relationship between cognitive dysfunction and hematomas is unclear. In this study, we investigated the relationship between aphasia/neglect and hematoma volume, hematoma type, and the ADL. One hundred fifteen patients with thalamic hemorrhage (70 men and 45 women) were studied. Their mean age was 68.9 ± 10.3 years, and patients with both left and right lesions were included. We calculated hematoma volume and examined the presence or absence of aphasia/neglect and the relationships between these dysfunctions and hematoma volume, hematoma type, and the ADL. Fifty-nine patients were found to have aphasia and 35 were found to have neglect. Although there was no relationship between hematoma type and cognitive dysfunction, hematoma volume showed a correlation with the severity of cognitive dysfunction. The ADL score and ratio of patient discharge for patients with aphasia/neglect were lower than those for patients without aphasia/neglect. We observed a correlation between the hematoma volume in thalamic hemorrhage and cognitive dysfunction. Aphasia/neglect is found frequently in patients with acute thalamic hemorrhage and may influence the ADL.

  14. Quantitative regional cerebral blood flow study with 123I-IMP in patients with dementia and in patients with poor activities of daily living

    International Nuclear Information System (INIS)

    Iwamiya, Takashi

    1993-01-01

    N-isopropyl-p[ 123 I]iodoamphetamine ( 123 I-IMP) SPECT and quantitative regional cerebral blood flow (rCBF) studies were performed in 111 patients with cerebral disorders. Continuous arterial blood sampling method based on the microsphere model was used as a quantitative rCBF measurement. We evaluated rCBF in patients with dementia and also in patients with poor activities of daily living (ADL). Patients with dementia showed significant reduction of mean CBF in contrast to patients without dementia. Significant decrease of rCBF in the bilateral frontal cortex, parietal cortex and basal ganglia and the right temporal cortex were found in demented patients. Although patients with vascular dementia showed decreased rCBF in bilateral basal ganglia, demented patients with Parkinson's disease showed no significant reduction of rCBF in any region. Patients with poor ADL showed decreased rCBF in all brain regions. And particularly frontal and basal ganglionic defects were most pronounced. Patients with poor ADL resulting from cerebral infarction showed significant decrease of rCBF in bilateral basal ganglia. However, there was no significant correlation in Parkinson's disease between ADL and rCBF. The rCBF measurement with 123 I-IMP is useful for clinical evaluation of demented patients and patients with poor ADL. (author)

  15. Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people

    Directory of Open Access Journals (Sweden)

    Jonas J. de Paula

    2014-05-01

    Full Text Available Objective: To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs based on the Katz and Lawton indices for Alzheimer's disease (AD and mild cognitive impairment (MCI. Methods: In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years, completed the Mini Mental State Examination (MMSE and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis, reliability (internal consistency, and criterion-related validity (receiver operating characteristic analysis and logistic regression were assessed. Results: Three factors of ADL (self-care, domestic activities, and complex activities were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL. The components showed good internal consistency (> 0.800 and moderate (younger participants or high (older participants accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. Conclusion: The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD.

  16. Quantitative regional cerebral blood flow study with [sup 123]I-IMP in patients with dementia and in patients with poor activities of daily living

    Energy Technology Data Exchange (ETDEWEB)

    Iwamiya, Takashi [Tottori Univ., Yonago (Japan). School of Medicine

    1993-11-01

    N-isopropyl-p[[sup 123]I]iodoamphetamine ([sup 123]I-IMP) SPECT and quantitative regional cerebral blood flow (rCBF) studies were performed in 111 patients with cerebral disorders. Continuous arterial blood sampling method based on the microsphere model was used as a quantitative rCBF measurement. We evaluated rCBF in patients with dementia and also in patients with poor activities of daily living (ADL). Patients with dementia showed significant reduction of mean CBF in contrast to patients without dementia. Significant decrease of rCBF in the bilateral frontal cortex, parietal cortex and basal ganglia and the right temporal cortex were found in demented patients. Although patients with vascular dementia showed decreased rCBF in bilateral basal ganglia, demented patients with Parkinson's disease showed no significant reduction of rCBF in any region. Patients with poor ADL showed decreased rCBF in all brain regions. And particularly frontal and basal ganglionic defects were most pronounced. Patients with poor ADL resulting from cerebral infarction showed significant decrease of rCBF in bilateral basal ganglia. However, there was no significant correlation in Parkinson's disease between ADL and rCBF. The rCBF measurement with [sup 123]I-IMP is useful for clinical evaluation of demented patients and patients with poor ADL. (author).

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

    Science.gov (United States)

    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.

  18. The decision-making process for senior cancer patients: treatment allocation of older women with operable breast cancer in the UK

    International Nuclear Information System (INIS)

    Morgan, Jenna L.; Richards, Paul; Zaman, Osama; Ward, Sue; Collins, Karen; Robinson, Thompson; Cheung, Kwok-Leung; Audisio, Riccardo A.; Reed, Malcolm W.; Wyld, Lynda

    2015-01-01

    Up to 40% of women over 70 years with primary operable breast cancer in the UK are treated with primary endocrine therapy (PET) as an alternative to surgery. A variety of factors are important in determining treatment for older breast cancer patients. This study aimed to identify the patient and tumor factors associated with treatment allocation in this population. Prospectively collected data on treatment received (surgery vs. PET) were analysed with multivariable logistic regression using the variables age, modified Charlson Comorbidity Index (CCI), activities of daily living (ADL) score, Mini-Mental State Examination (MMSE) score, HER2 status, tumour size, grade and nodal status. Data were available for 1,122 cancers in 1,098 patients recruited between February 2013 and June 2015 from 51 UK hospitals. About 78% of the population were treated surgically, with the remainder being treated with PET. Increasing patient age at diagnosis, increasing CCI score, large tumor size (5 cm or more) and dependence in one or more ADL categories were all strongly associated with non-surgical treatment (P<0.05). Increasing comorbidity, large tumor size and reduced functional ability are associated with reduced likelihood of surgical treatment of breast cancer in older patients. However, age itself remains a significant factor for non-surgical treatment; reinforcing the need for evidence-based guidelines

  19. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability

    NARCIS (Netherlands)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I. M.; Krijnen, Wim P.; Schans, van der Cees P.; Waninge, Aly

    Background: The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and

  20. A systematic review of instruments for assessment of capacity in activities of daily living in children with developmental co-ordination disorder

    NARCIS (Netherlands)

    van der Linde, B W; van Netten, J J; Otten, E; Postema, K; Geuze, R H; Schoemaker, M M

    Children with developmental co-ordination disorder (DCD) face evident motor difficulties in activities of daily living (ADL). Assessment of their capacity in ADL is essential for diagnosis and intervention, in order to limit the daily consequences of the disorder. The aim of this study is to

  1. Allomyrina Dichotoma Larvae Regulate Food Intake and Body Weight in High Fat Diet-Induced Obese Mice Through mTOR and Mapk Signaling Pathways

    Directory of Open Access Journals (Sweden)

    Jongwan Kim

    2016-02-01

    Full Text Available Recent evidence has suggested that the Korean horn beetle (Allomyrina dichotoma has anti-hepatofibrotic, anti-neoplastic, and antibiotic effects and is recognized as a traditional medicine. In our previous works, Allomyrina dichotoma larvae (ADL inhibited differentiation of adipocytes both in vitro and in vivo. However, the anorexigenic and endoplasmic reticulum(ER stress-reducing effects of ADL in obesity has not been examined. In this study, we investigated the anorexigenic and ER stress-reducing effects of ADL in the hypothalamus of diet-induced obese (DIO mice. Intracerebroventricular (ICV administration of ethanol extract of ADL (ADE suggested that an antagonizing effect on ghrelin-induced feeding behavior through the mTOR and MAPK signaling pathways. Especially, ADE resulted in strong reduction of ER stress both in vitro and in vivo. These findings strongly suggest that ADE and its constituent bioactive compounds are available and valuable to use for treatment of various diseases driven by prolonged ER stress.

  2. Religiousness and Longitudinal Trajectories in Elders' Functional Status

    Science.gov (United States)

    Park, Nan Sook; Klemmack, David L.; Roff, Lucinda L.; Parker, Michael W.; Koenig, Harold G.; Sawyer, Patricia; Allman, Richard M.

    2010-01-01

    The purpose of this study was to examine the effects of religiousness on the trajectories of difficulties with activities of daily living (ADLs) and instrumental ADLs (IADLs) in community-dwelling older adults over a three-year period. Seven waves of data from the University of Alabama at Birmingham Study of Aging were analyzed using a hierarchical linear modeling method. The study was based on the 784 participants who completed interviews every six months between December 1999 and February 2004. Frequent religious service attendance was associated with fewer ADL difficulties and IADL difficulties at baseline. Furthermore, religious service attendance predicted slower increases for frequent churchgoers and steeper increases for less frequent churchgoers in IADL difficulties, controlling for variables related to demographics and resources. Religious service attendance was independently associated with ADL and IADL difficulties cross-sectionally. However, significant protective effects of religious service attendance were identified longitudinally only for the IADL trajectory. PMID:20485460

  3. Quality of life after carotid endarterectomy.

    Science.gov (United States)

    Abelha, Fernando José; Quevedo, Susana; Barros, Henrique

    2008-11-20

    Most studies documenting beneficial outcomes after carotid endarterectomy (CE) are limited to mortality and morbidity rates, costs, and length of hospital stay (LOS). Few have examined the dependency of patients and how they perceive their own health changes after surgery. The aim of the present study was to evaluate quality of life and independence in activities of daily living (ADL) and to study its determinants. Sixty-three patients admitted in the Post Anaesthesia Care Unit (PACU) after CE were eligible for this 14-month follow-up study. Patients were contacted 6 months after discharge to complete a Short Form-36 questionnaire (SF-36) and to have their dependency in ADL evaluated. Among 59 hospital survivors at 6 months follow-up, 43 completed the questionnaires. Sixty-three percent reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients had worse SF-36 scores for all domains except bodily pain than a general urban population, and comparison with a group of patients 6 months after surgical ICU discharge showed no differences. Six months after PACU discharge, the Lawton Instrumental Activities of ADL Scale and the Katz Index of ADL demonstrated higher dependency scores (5.9 +/- 2.2 versus 4.3 +/- 2.4 and 0.3 +/- 0.8 versus 0.6 +/- 0.9, p < 0.001 and p = 0.047). Sixty-five percent and 33% were dependent in at least one activity in instrumental and personal ADL, respectively. Patients dependent in at least one ADL task had higher Revised Cardiac Risk Index (RCRI) scores (1.0 versus 1.5, p = 0.017). After controlling for multiple comparisons, no significant differences were found. Patients undergoing CE have improved self-perception of quality of life despite being more dependent. Almost all their scores are worse than those in an urban population. We could identify no predictors of greater dependency in ADL tasks six months after PACU discharge.

  4. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability

    NARCIS (Netherlands)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I.M.; Krijnen, Wim; van der Schans, Cees; Waninge, Aly

    2015-01-01

    Background The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to the quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and

  5. Evaluation of An Activities of Daily Living Scale for Adolescents and Adults with Developmental Disabilities

    Science.gov (United States)

    Maenner, Matthew J; Smith, Leann E; Hong, Jinkuk; Makuch, Renee; Greenberg, Jan S; Mailick, Marsha R

    2012-01-01

    Background Activity limitations are an important and useful dimension of disability, but there are few validated measures of activity limitations for adolescents and adults with developmental disabilities. Objective/Hypothesis To describe the development of the Waisman Activities of Daily Living (W-ADL) Scale for adolescents and adults with developmental disabilities, and systematically evaluate its measurement properties according to an established set of criteria. Methods The W-ADL was administered among four longitudinally-studied groups of adolescents and adults with developmental disabilities: 406 with autism; 147 with fragile-X syndrome; 169 with Down syndrome, and 292 with intellectual disability of other or unknown origin. The W-ADL contains 17 activities and each is rated on a 3-point scale (0=“does not do at all”, 1=“does with help”, 2=“independent”), and a standard set of criteria were used to evaluate its measurement properties. Results Across the disability groups, Cronbach’s alphas ranged from 0.88 to 0.94, and a single-factor structure was most parsimonious. The W-ADL was reliable over time, with weighted kappas between 0.92 and 0.93. Criterion and construct validity were supported through substantial associations with the Vineland Screener, need for respite services, caregiving burden, and competitive employment. No floor or ceiling effects were present. There were significant group differences in W-ADL scores by maternally-reported level of intellectual disability (mild, moderate, severe, profound). Conclusions The W-ADL exceeded the recommended threshold for each quality criterion the authors evaluated. This freely-available tool is an efficient measure of activities of daily living for surveys and epidemiological research concerning adolescents and adults with developmental disabilities. PMID:23260606

  6. Barriers associated with reduced physical activity in COPD patients

    Directory of Open Access Journals (Sweden)

    Priscila Batista Amorim

    2014-10-01

    Full Text Available OBJECTIVE: To evaluate the ability of COPD patients to perform activities of daily living (ADL; to identify barriers that prevent these individuals from performing ADL; and to correlate those barriers with dyspnea severity, six-minute walk test (6MWT, and an ADL limitation score. METHODS: In COPD patients and healthy, age-matched controls, the number of steps, the distance walked, and walking time were recorded with a triaxial accelerometer, for seven consecutive days. A questionnaire regarding perceived barriers and the London Chest Activity of Daily Living (LCADL scale were used in order to identify the factors that prevent the performance of ADL. The severity of dyspnea was assessed with two scales, whereas submaximal exercise capacity was determined on the basis of the 6MWT. RESULTS: We evaluated 40 COPD patients and 40 controls. In comparison with the control values, the mean walk time was significantly shorter for COPD patients (68.5 ± 25.8 min/day vs. 105.2 ± 49.4 min/day; p < 0.001, as was the distance walked (3.9 ± 1.9 km/day vs. 6.4 ± 3.2 km/day; p < 0.001. The COPD patients also walked fewer steps/day. The most common self-reported barriers to performing ADL were lack of infrastructure, social influences, and lack of willpower. The 6MWT distance correlated with the results obtained with the accelerometer but not with the LCADL scale results. CONCLUSIONS: Patients with COPD are less active than are healthy adults of a comparable age. Physical inactivity and the barriers to performing ADL have immediate implications for clinical practice, calling for early intervention measures.

  7. Analysis of Public Datasets for Wearable Fall Detection Systems

    Directory of Open Access Journals (Sweden)

    Eduardo Casilari

    2017-06-01

    Full Text Available Due to the boom of wireless handheld devices such as smartwatches and smartphones, wearable Fall Detection Systems (FDSs have become a major focus of attention among the research community during the last years. The effectiveness of a wearable FDS must be contrasted against a wide variety of measurements obtained from inertial sensors during the occurrence of falls and Activities of Daily Living (ADLs. In this regard, the access to public databases constitutes the basis for an open and systematic assessment of fall detection techniques. This paper reviews and appraises twelve existing available data repositories containing measurements of ADLs and emulated falls envisaged for the evaluation of fall detection algorithms in wearable FDSs. The analysis of the found datasets is performed in a comprehensive way, taking into account the multiple factors involved in the definition of the testbeds deployed for the generation of the mobility samples. The study of the traces brings to light the lack of a common experimental benchmarking procedure and, consequently, the large heterogeneity of the datasets from a number of perspectives (length and number of samples, typology of the emulated falls and ADLs, characteristics of the test subjects, features and positions of the sensors, etc.. Concerning this, the statistical analysis of the samples reveals the impact of the sensor range on the reliability of the traces. In addition, the study evidences the importance of the selection of the ADLs and the need of categorizing the ADLs depending on the intensity of the movements in order to evaluate the capability of a certain detection algorithm to discriminate falls from ADLs.

  8. Cognitive Interventions in Mild Alzheimer's Disease: A Therapy-Evaluation Study on the Interaction of Medication and Cognitive Treatment

    Directory of Open Access Journals (Sweden)

    M. Schecker

    2013-09-01

    Full Text Available Background/Aims: Many studies have shown that not only pharmacological treatment but also cognitive stimulation in the early stages of Alzheimer's disease (AD improves language processing and (other cognitive functions, stabilizes Activities of Daily Living (ADL and Instrumental Activities of Daily Living (IADL functions and increases the subjective quality of life (wherein a combination of pharmacological intervention and cognitive stimulation could provide greater relief of clinical symptoms than either intervention given alone. Today, it is no longer the question of whether cognitive stimulation helps but rather what kind of stimulation helps more than others. Methods: A sample of 42 subjects with mild AD (all medicated with an acetylcholinesterase inhibitor and well adjusted underwent clinical and cognitive evaluation and participated in a 6-month study with 2 experimental groups (i.e. ‘client-centered' global stimulation vs. cognitive training and a control group. Since the test performance also depends on the individual test, we used a wide variety of tests; we z-transformed the results and then calculated the mean value for the global cognitive status (using the Mini-Mental State Examination as well as for the single functional areas. Results: Between-group differences were found, they were overall in favor of the experimental groups. Different functional areas led to different treatment and test patterns. Client-centered, global, cognitive therapy stimulated many cognitive functions and thus led to a better performance in language processing and ADL/IADL. The subjective quality of life increased as well. The cognitive training (of working memory improved only the ADL/IADL performance (more, however, than client-centered, global, cognitive stimulation and stabilized the level of performance in the other three functional areas.

  9. Characterization and Suppression of the Electromagnetic Interference Induced Phase Shift in the JLab FEL Photo - Injector Advanced Drive Laser System

    Energy Technology Data Exchange (ETDEWEB)

    F. G. Wilson, D. Sexton, S. Zhang

    2011-09-01

    The drive laser for the photo-cathode gun used in the JLab Free Electron Laser (FEL) facility had been experiencing various phase shifts on the order of tens of degrees (>20{sup o} at 1497 MHz or >40ps) when changing the Advanced Drive Laser (ADL) [2][3][4] micro-pulse frequencies. These phase shifts introduced multiple complications when trying to setup the accelerator for operation, ultimately inhibiting the robustness and overall performance of the FEL. Through rigorous phase measurements and systematic characterizations, we determined that the phase shifts could be attributed to electromagnetic interference (EMI) coupling into the ADL phase control loop, and subsequently resolved the issue of phase shift to within tenths of a degree (<0.5{sup o} at 1497 MHz or <1ps). The diagnostic method developed and the knowledge gained through the entire process will prove to be invaluable for future designs of similar systems.

  10. Effects of Functional-Task Training on Older Adults With Alzheimer's Disease.

    Science.gov (United States)

    Pedroso, Renata V; Ayán, Carlos; Fraga, Francisco J; da Silva, Thays M V; Cancela, José M; Santos-Galduròz, Ruth F

    2018-01-01

    The aim of this study was to verify the effects of functional-task training on cognitive function, activities of daily living (ADL) performance, and functional fitness in community-dwelling older adults with diagnosis of Alzheimer's disease (AD). A total of 57 participants (22 functional-task training group [FTG], 21 social gathering group [SGG], 14 control group [CG]) were recruited. Participants in both intervention groups carried out three 1-hr sessions per week of a functional-task program and social gathering activities for 12 weeks. Significant improvements were observed in executive functions (TMT, t-test, p = .03) in the SGG and in upper limb strength (arm curl, t-test, p = .01) in the FTG. Functional-task training has no significant effect on cognitive function, ADL, and functional fitness among people with AD, although it may contribute to slowing down the process of deterioration this illness causes.

  11. The hierarchy of the activities of daily living in the Katz index in residents of skilled nursing facilities.

    Science.gov (United States)

    Gerrard, Paul

    2013-01-01

    Nursing facility patients are a population that has not been well studied with regard to functional status and independence previously. As such, the manner in which activities of daily living (ADL) relate to one another is not well understood in this population. An understanding of ADL difficulty ordering has helped to devise systems of functional independence grading in other populations, which have value in understanding patients' global levels of independence and providing expectations regarding changes in function. This study seeks to examine the hierarchy of ADL in the nursing facility population. Data were analyzed from the 2004 National Nursing Home Survey, a cross-sectional data set of 13 507 skilled nursing facility subjects with functional independence items. The ADL difficulty hierarchy was determined using Rasch analysis. Item fit values for the Rasch model using Mean-Square infit statistics were also determined. The robustness of the hierarchy was tested for each ADL. Two grading systems were devised from the results of the item difficulty ordering. One was based on the most difficult item that he or she could perform, and the other assigned a grade based on the least difficult item that a subject could not perform. A total of 13 113 patients were included in this analysis, the majority of whom were female and white. They had an average age of 81 years. An ordered hierarchy of ADL was found with eating being the easiest and bathing the most difficult. All items in the Katz index fit the Rasch model adequately well. The majority of patients able to perform any particular ADL were also able to perform all easier ADL. Cohen's κ for the 2 grading systems was 0.73. This study is the first to show the expected hierarchy of difficulty of the 6 activities of daily proposed in the Katz index in the nursing facility population. The hierarchy found in this population matches the original hierarchy found in older adults in the community and acute care settings

  12. Mental Status as a Predictor of Daily Function in Progressive Dementia.

    Science.gov (United States)

    Reed, Bruce R.; And Others

    1989-01-01

    Compared Mini Mental Status Exam (MMSE) scores and activities of daily living (ADL) scores from 59 patients with progressive dementias. MMSE scores explained approximately one-third of variance in both instrumental and physical ADLs. Findings suggest that cognitive losses and functional impairments are 2 distinct aspects of dementia severity which…

  13. Clinical application of CT-controlled stereotactic aspiration for intracerebral hematoma

    International Nuclear Information System (INIS)

    Chen Weijian; Zhuge Qichuan; Zheng Rongyuan; Guo Xianzhong; Zhong Ming; Wu Jinsen; Qu Xuanxing

    2002-01-01

    Objective: To evaluate the clinical application of CT-controlled stereotactic aspiration for intracerebral hematoma. Methods: CT-guided stereotactic system was installed on the CT bed, and checked against a standard of the coordinate. According to controlled CT scan, the target can be adjusted at any time in the operation. 860 patients with cerebral hematoma underwent CT-controlled stereotactic aspiration. Of the 860 cases, basal ganglion hematoma was present in 408, thalamus and posterior limb of internal capsule hematoma in 136, cerebral lobe hematoma in 261, cerebellar hematoma in 5, ventricular hemorrhage in 10, midbrain and pons hemorrhage in 37, and medulla hemorrhage in 3. Results: Easy drainage of hematoma by aspiration was achieved in 586 cases, stickiness of hematoma with clearing away more than 50% was performed in 202 and less than 50% in 68. The operation duration ranged from 25 to 120 minutes (average 45 minutes). 693 cases survived and 167 cases died. According to the evaluation by active day life (ADL) after 3 months in survivors, ADL 1-2, ADL 3, ADL 4 and ADL 5 results were achieved in 378 cases, 166 cases, 107 cases, and 28 cases, respectively. In addition, 14 cases were lost beyond recall. Conclusion: CT-controlled stereotactic aspiration for intracerebral hematoma is a handy, less invasive, and safe procedure with high accuracy and curative effect, it is worth while popularizing the procedure

  14. Associations between functional ability and life satisfaction in the oldest old: results from the longitudinal population study Good Aging in Skåne

    Directory of Open Access Journals (Sweden)

    Enkvist Å

    2012-08-01

    Full Text Available Åsa Enkvist, Henrik Ekström, Sölve ElmståhlDepartment of Health Sciences, Lund University, Malmö University Hospital, Malmö, SwedenObjectives: To describe change in functional ability in the oldest-old population during 3 years and examine its relation to life satisfaction (LS. A total of 681 individuals aged 78 and older from the population-based study Good Aging in Skåne took part.Methods: Functional ability was assessed using Sonn and Åsberg's Activities of Daily Living (ADL scale and related to LS assessed by Neugarten et al's Life Satisfaction Index A (LSI-A.Results: Fifty-one percent of 87–93-year-olds reported ADL decline during 3 years. Individuals reporting impaired ADL had a mean LSI-A value of 23.0 compared to 26.4 in those unchanged. ADL decline had a stronger negative effect on LS in the younger group (78–84 years, r = 0.207, P < 0.001. In a multiple regression model, one score's decline in ADL capacity corresponded to 1.5 scores lower LS (P < 0.001.Discussion: Effort put into keeping the oldest old on a high level of functional ability has the potential to maintain the LS of this population.Keywords: life satisfaction, functional ability, longitudinal, oldest old

  15. Perceived difficulty in the use of everyday technology: relationships with everyday functioning in people with acquired brain injury with a special focus on returning to work.

    Science.gov (United States)

    Larsson Lund, Maria; Nygård, Louise; Kottorp, Anders

    2014-01-01

    The aim was to explore the relationships between difficulties in the use of everyday technology (ET) and the ability to perform activities of daily life (ADL) in the home and in society and in the workplace in people with acquired brain injury (ABI). The investigation comprises an explorative cross-sectional study of 74 people with ABI. The short version of the Everyday Technology Use Questionnaire (S-ETUQ) and a revised version of the ADL taxonomy were used to evaluate the participants. Rasch-generated person ability measures of ET use and ADL were used in correlation analyses, in group comparisons by ANOVA and in logistic regressions. Difficulty in the use of ET was significantly correlated with ADL limitations. People who worked full- or part-time had significantly higher ability to use ET than those with some type of full-time, long-term sickness compensation. The ability to use ET, ADL ability and age were significantly related to return to work. The ability to use ET is related to all areas of everyday functioning in people with ABI. Therefore, a patient's ability to use ET needs to be considered in rehabilitation strategies following an ABI to enhance the patient's performance of activities in the home and in society and to support his or her likelihood of returning to work.

  16. Did Medicare Part D Affect National Trends in Health Outcomes or Hospitalizations? A Time-Series Analysis.

    Science.gov (United States)

    Briesacher, Becky A; Madden, Jeanne M; Zhang, Fang; Fouayzi, Hassan; Ross-Degnan, Dennis; Gurwitz, Jerry H; Soumerai, Stephen B

    2015-06-16

    Medicare Part D increased economic access to medications, but its effect on population-level health outcomes and use of other medical services remains unclear. To examine changes in health outcomes and medical services in the Medicare population after implementation of Part D. Population-level longitudinal time-series analysis with generalized linear models. Community. Nationally representative sample of Medicare beneficiaries (n = 56,293 [unweighted and unique]) from 2000 to 2010. Changes in self-reported health status, limitations in activities of daily living (ADLs) (ADLs and instrumental ADLs), emergency department visits and hospital admissions (prevalence, counts, and spending), and mortality. Medicare claims data were used for confirmatory analyses. Five years after Part D implementation, no clinically or statistically significant reductions in the prevalence of fair or poor health status or limitations in ADLs or instrumental ADLs, relative to historical trends, were detected. Compared with trends before Part D, no changes in emergency department visits, hospital admissions or days, inpatient costs, or mortality after Part D were seen. Confirmatory analyses were consistent. Only total population-level outcomes were studied. Self-reported measures may lack sensitivity. Five years after implementation, and contrary to previous reports, no evidence was found of Part D's effect on a range of population-level health indicators among Medicare enrollees. Further, there was no clear evidence of gains in medical care efficiencies.

  17. Self-efficacy blandt apopleksipatienter

    DEFF Research Database (Denmark)

    Kristensen, Lola Qvist ,; Pallesen, Hanne

    2017-01-01

    Baggrund Flere og flere mennesker lever med følgerne af apopleksi, herunder fysiske og kognitive vanskeligheder, som begrænser mobilitet og ADL-evne. Studier har vist, at høj self-effi cacy (oplevet handlekompetence) er associeret med bedre mobilitet og ADL-evne samtidig med at det kan fremme liv...

  18. Controlling confounding by frailty when estimating influenza vaccine effectiveness using predictors of dependency in activities of daily living.

    Science.gov (United States)

    Zhang, Henry T; McGrath, Leah J; Wyss, Richard; Ellis, Alan R; Stürmer, Til

    2017-12-01

    To improve control of confounding by frailty when estimating the effect of influenza vaccination on all-cause mortality by controlling for a published set of claims-based predictors of dependency in activities of daily living (ADL). Using Medicare claims data, a cohort of beneficiaries >65 years of age was followed from September 1, 2007, to April 12, 2008, with covariates assessed in the 6 months before follow-up. We estimated Cox proportional hazards models of all-cause mortality, with influenza vaccination as a time-varying exposure. We controlled for common demographics, comorbidities, and health care utilization variables and then added 20 ADL dependency predictors. To gauge residual confounding, we estimated pre-influenza season hazard ratios (HRs) between September 1, 2007 and January 5, 2008, which should be 1.0 in the absence of bias. A cohort of 2 235 140 beneficiaries was created, with a median follow-up of 224 days. Overall, 52% were vaccinated and 4% died during follow-up. During the pre-influenza season period, controlling for demographics, comorbidities, and health care use resulted in a HR of 0.66 (0.64, 0.67). Adding the ADL dependency predictors moved the HR to 0.68 (0.67, 0.70). Controlling for demographics and ADL dependency predictors alone resulted in a HR of 0.68 (0.66, 0.70). Results were consistent with those in the literature, with significant uncontrolled confounding after adjustment for demographics, comorbidities, and health care use. Adding ADL dependency predictors moved HRs slightly closer to the null. Of the comorbidities, health care use variables, and ADL dependency predictors, the last set reduced confounding most. However, substantial uncontrolled confounding remained. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Recovery of activity of daily living in cases of cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Yoneyama, Kimihiro (St. Marianna Univ. School of Medicine, Kawasaki, Kanagawa (Japan))

    1983-11-01

    In 96 patients with supratentorial cerebral infarction, the recovery of activity of daily living (ADL) was studied in relation to computerized tomography (CT) findings in the acute stage. The average age was 64 and 78 out of 96 were first attack cases. The cases were divided into 3 groups on the basis of the CT findings. The N group had no low density area on CT. The S group had a small deep infarct around the basal ganglia and the L group showed a large infarct with a damaged cerebral cortex. Dilatation of the ventricles was measured by the methods of Meese and Huckman. Cortical atrophy estimated by summation of width of Sylvian fissures or parietal cortical sulci, expressed in percentages. Measurements for CT were performed in the subacute stage to exclude the effects of cerebral edema. ADL was categorized in five stages using Rankin's criteria in the first week and after the eighth week. Among the 3 groups, the L group had the worst ADL when examined eight weeks later. On the contrary, the N group showed the greatest improvement. Patients under 60 years old showed better recovery at the eight week, while in most patients aged 70 or more the improvement was less evident. Dilatation of ventricles and severity of cortical atrophy increased in proportion to age, especially in cases of cerebral infarcts. In patients with ventricular dilatation or severe cerebral atrophy. ADL improvement was lower. Recovery was low in cases with narrow cortical sulci. Recovery of ADL in reattack patients was lowest and larger dilatation of the ventricles than first attack cases was recognized. The size of cerebral infarction, ADL in the first week, the dilatation of lateral ventricles, the severity of cortical atrophy and age were found to be important factors in functional recovery.

  20. Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury.

    Science.gov (United States)

    Martínez-Moreno, J M; Sánchez-González, P; Luna, M; Roig, T; Tormos, J M; Gómez, E J

    2016-01-01

    Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine. To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments. The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation. An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures. The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current

  1. Caregivers' reported functional limitations in activities of daily living among middle-aged adults with intellectual disabilities.

    Science.gov (United States)

    Lin, Lan-Ping; Hsia, Yi-Chen; Hsu, Shang-Wei; Loh, Ching-Hui; Wu, Chia-Ling; Lin, Jin-Ding

    2013-12-01

    This study was conducted to describe the functioning of Activities of Daily Living (ADL) and to examine socio-economic effects on ADL functioning among adults with intellectual disabilities (ID) aged 45 years and older (N=480) in Taiwan. The Barthel Index (BI) was used to determine a baseline level of ADL functioning in the study participants. There are five categories of functional impairment using the following cut-off values in Taiwan: total dependence (BI score 0-20), severe (BI score 21-60), moderate (BI score 61-90), mild (BI score 91-99), and total independence (BI score 100) (Taiwan Department of Health, 2012). The results revealed that 2.3% of adults with ID were in total dependence, 11.9% were in severe dependence, 27.9% were in moderate dependence, 8.1% had a mild dependence, and 49.8% were totally independent. In the multiple linear regression model of the ADL score, we determined that educational level, comorbid Down's syndrome, and disability level are the variables able to significantly predict ADL score (R(2)=0.190) after controlling for the factors of age, marital status, and other comorbidity conditions. Those ID adults with a lower education level (primary vs. literate, β=4.780, p=0.031; intermediate vs. literate, β=6.642, p=0.030), with comorbid Down's syndrome (β=-7.135, p=0.063), and with a more severe disability condition (severe vs. mild, β=-7.650, p=0.007; profound vs. mild, β=-19.169, p<0.001) had significantly lower ADL scores. The present study highlights the need to support mobility in older adults with ID as much as possible to optimize independence in this group. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Cigarette Smoking and Activities of Daily Living in Ocular Myasthenia Gravis.

    Science.gov (United States)

    Gratton, Sean M; Herro, Angela M; Feuer, William J; Lam, Byron L

    2016-03-01

    Myasthenia gravis is an autoimmune disease of the neuromuscular junction, commonly affecting the ocular muscles. Cigarette smoking has been shown to influence many autoimmune diseases, including multiple sclerosis and rheumatoid arthritis, but its effect on myasthenia gravis has not been well studied. We sought to determine whether cigarette smoking influenced disease-related symptoms in ocular myasthenia gravis (OMG). We performed a prospective, clinic-based cross-sectional study in a single academic neuro-ophthalmology practice. All patients diagnosed with OMG between November 2006 and April 2014 were included. A prospective telephone survey was administered to determine smoking status and myasthenia gravis-related symptom severity. The main outcome measure was the myasthenia gravis-specific activities of daily living (MG-ADL) score, a well-validated marker of symptoms and quality of life in myasthenia gravis. Forty-four patients were included in the analysis. Comparison of MG-ADL ocular subscores between current smokers (3.4 ± 2.6), former smokers (1.8 ± 2.1), and never smokers (1.1 ± 1.5) revealed a statistically significant relationship (P = 0.031) where current smokers had the highest MG-ADL ocular subscores and never smokers the lowest. Comparison of MG-ADL total scores revealed the same relationship (current 5.6 ± 4.5, former 2.9 ± 3.1, never 1.4 ± 2.5, P = 0.003). There were borderline significant correlations of pack years with MG-ADL ocular subscore (r = 0.27, P = 0.074) and MG-ADL total score (r = 0.30, P = 0.051). Our findings indicate an association between cigarette smoking and symptom severity in OMG. This association suggests that smoking cessation in OMG patients may lead to improved symptom-related quality of life.

  3. Cardiac structure and function and dependency in the oldest old.

    Science.gov (United States)

    Leibowitz, David; Jacobs, Jeremy M; Stessman-Lande, Irit; Cohen, Aharon; Gilon, Dan; Ein-Mor, Eliana; Stessman, Jochanan

    2011-08-01

    To examine the association between cardiac function and activities of daily living (ADLs) in an age-homogenous, community-dwelling population born in 1920 and 1921. Cross-sectional analysis of a prospective cohort study. Community-dwelling elderly population. Participants were recruited from the Jerusalem Longitudinal Cohort Study, which has followed an age-homogenous cohort of Jerusalem residents born in 1920 and 1921. Four hundred eighty-nine of the participants (228 male, 261 female) from the most recent set of data collection in 2005 and 2006 underwent echocardiography at their place of residence in addition to structured interviews and physical examination. A home-based comprehensive assessment was performed to assess health and functional status, including performance of ADLs. Dependence was defined as needing assistance with one or more basic ADLs. Standard echocardiographic assessment of cardiac structure and function, including ejection fraction (EF) and diastolic function as assessed using early diastolic mitral annular tissue velocity measurements obtained using tissue Doppler, was performed. Of the participants with limitation in at least one ADL, significantly more had low EF (dependence in ADL had higher left ventricular mass index (LVMI) (129.3 vs 119.7 g/m²) and left atrial volume index (LAVI) (41.3 vs 36.7 mL/m²). There were no differences between the groups in percentage of participants with impaired diastolic function or average ratio of early diastolic transmitral flow velocity to early diastolic mitral annular tissue velocity (11.5 vs 11.8; P=.64). In this age-homogenous cohort of the oldest old, high LVMI and LAVI and indices of systolic but not diastolic function as assessed according to Doppler were associated with limitations in ADLs. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

  4. Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study

    Directory of Open Access Journals (Sweden)

    Langlet Ketty

    2012-10-01

    Full Text Available Abstract Background Mechanical ventilation (MV is imperative in many forms of acute respiratory failure (ARF in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL score may help to predict the outcome of these patients. Methods We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68% or failure (group B n = 8, 32%. We investigated the correlation between the ADL score and the outcome and mortality. Results The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p  Conclusion Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.

  5. Variation in the Gender Gap in Inactive and Active Life Expectancy by the Definition of Inactivity Among Older Adults.

    Science.gov (United States)

    Malhotra, Rahul; Chan, Angelique; Ajay, Shweta; Ma, Stefan; Saito, Yasuhiko

    2016-10-01

    To assess variation in gender gap (female-male) in inactive life expectancy (IALE) and active life expectancy (ALE) by definition of inactivity. Inactivity, among older Singaporeans, was defined as follows: Scenario 1-health-related difficulty in activities of daily living (ADLs); Scenario 2-health-related difficulty in ADLs/instrumental ADLs (IADLs); Scenario 3-health-related difficulty in ADLs/IADLs or non-health-related non-performance of IADLs. Multistate life tables computed IALE and ALE at age 60, testing three hypotheses: In all scenarios, life expectancy, absolute and relative IALE, and absolute ALE are higher for females (Hypothesis 1 [H1]); gender gap in absolute and relative IALE expands, and in absolute ALE, it contracts in Scenario 2 versus 1 (Hypothesis 2 [H2]); gender gap in absolute and relative IALE decreases, and in absolute ALE, it increases in Scenario 3 versus 2 (Hypothesis 3 [H3]). H1 was supported in Scenarios 1 and 3 but not Scenario 2. Both H2 and H3 were supported. Definition of inactivity influences gender gap in IALE and ALE. © The Author(s) 2016.

  6. Assessing upper extremity motor function in practice of virtual activities of daily living.

    Science.gov (United States)

    Adams, Richard J; Lichter, Matthew D; Krepkovich, Eileen T; Ellington, Allison; White, Marga; Diamond, Paul T

    2015-03-01

    A study was conducted to investigate the criterion validity of measures of upper extremity (UE) motor function derived during practice of virtual activities of daily living (ADLs). Fourteen hemiparetic stroke patients employed a Virtual Occupational Therapy Assistant (VOTA), consisting of a high-fidelity virtual world and a Kinect™ sensor, in four sessions of approximately one hour in duration. An unscented Kalman Filter-based human motion tracking algorithm estimated UE joint kinematics in real-time during performance of virtual ADL activities, enabling both animation of the user's avatar and automated generation of metrics related to speed and smoothness of motion. These metrics, aggregated over discrete sub-task elements during performance of virtual ADLs, were compared to scores from an established assessment of UE motor performance, the Wolf Motor Function Test (WMFT). Spearman's rank correlation analysis indicates a moderate correlation between VOTA-derived metrics and the time-based WMFT assessments, supporting the criterion validity of VOTA measures as a means of tracking patient progress during an UE rehabilitation program that includes practice of virtual ADLs.

  7. Water dissection technique of Toth for the treatment of hypertensive intracerebral putamen hemorrhage

    International Nuclear Information System (INIS)

    Wu Jiandong; Qian Surong; Lin Liqing; Wang Chenqiu; Wang Jianren; Wang Chen; Ying Guangzhong; Hui Guozhen

    2008-01-01

    Objective: To investige the possibility of water dissection technique of Toth for craniotomy with small bone flap through lateral fissure approach for the treatment of hypertensive intracerebral putamen hemorrhage. Methods: Twenty consecutive patients with hypertensive intracerebral putamen hemorrhage were treated by making a incision on sclap long about 6 cm across sylvian fissure, making a small bone flap about 3 cm x 3 cm, After opening dual, we injected water under microscopic control by a handheld syringe with a blunt needle applying repeated injection of physiological saline into the sylvian fissure to open it, opening the insular cortex, evacuation of intracerebral hematoma. Results: There was no further mortality. Patients who returned to ADL 1 and 2 (good recovery) after surgical treatment were 10, ADL 3 were 5, ADL 4 were 4, ADL 5 were 1. Conclusion: A method of water dissection technique of Toth for craniotomy with small bone flap through lateral fissure approach for the treatment of hypertensive intracerebral putamen hemorrhage is a method of convenient, safe, and with effective result. (authors)

  8. Life satisfaction in 6 European countries: the relationship to health, self-esteem, and social and financial resources among people (Aged 65-89) with reduced functional capacity.

    Science.gov (United States)

    Borg, Christel; Fagerström, Cecilia; Balducci, Cristian; Burholt, Vanessa; Ferring, Dieter; Weber, Germain; Wenger, Clare; Holst, Göran; Hallberg, Ingalill R

    2008-01-01

    The aim of this study was to investigate how overall health, participation in physical activities, self-esteem, and social and financial resources are related to life satisfaction among people aged 65 and older with reduced activities of daily living (ADL) capacity in 6 European countries. A subsample of the European Study of Adults' Well-Being (ESAW), consisting of 2,195 people with reduced ADL capacity from Sweden, the United Kingdom, the Netherlands, Luxembourg, Austria, and Italy, was included. The Older Americans' Resources Schedule (OARS), the Life Satisfaction Index Z, and the Self-Esteem Scale were used. In all national samples, overall health, self-esteem, and feeling worried, rather than ADL capacity, were significantly associated with life satisfaction. The findings indicate the importance of taking not only the reduction in functional capacity into account but also the individual's perception of health and self-esteem when outlining health care and nursing aimed at improving life satisfaction. The study thus suggests that personal rather than environmental factors are important for life satisfaction among people with reduced ADL capacity living in Europe.

  9. Aerobic dive limits of seals with mutant myoglobin using combined thermochemical and physiological data

    DEFF Research Database (Denmark)

    Dasmeh, Pouria; Davis, Randall W.; Kepp, Kasper Planeta

    2013-01-01

    This paper presents an integrated model of convective O2-transport, aerobic dive limits (ADL), and thermochemical data for oxygen binding to mutant myoglobin (Mb), used to quantify the impact of mutations in Mb on the dive limits of Weddell seals (Leptonychotes weddellii). We find that wild-type ...... that such conditions are mostly selected upon in seals. The model is capable of roughly quantifying the physiological impact of single-protein mutations and thus bridges an important gap between animal physiology and molecular (protein) evolution.......This paper presents an integrated model of convective O2-transport, aerobic dive limits (ADL), and thermochemical data for oxygen binding to mutant myoglobin (Mb), used to quantify the impact of mutations in Mb on the dive limits of Weddell seals (Leptonychotes weddellii). We find that wild-type Mb...... traits are only superior under specific behavioral and physiological conditions that critically prolong the ADL, action radius, and fitness of the seals. As an extreme example, the mutations in the conserved His-64 reduce ADL up to 14±2 min for routine aerobic dives, whereas many other mutations...

  10. Level of independence in daily living and cognitive plasticity in old age - Nivel de independencia en la vida diaria y plasticidad cognitiva en la vejez

    Directory of Open Access Journals (Sweden)

    Elena Navarro González

    2008-12-01

    Full Text Available Recent research provides evidence that anactive lifestyle is associated with a high level of plasticity,which in turn is related to a reduced probability of cognitivedeterioration and decline (Calero, Navarro &Muñoz, 2007. Activities of daily living (ADL constituteone of the variables currently considered to be anindicator of dependence/independence in old age andwhich is associated with cognitive and physical decline.The aim of the present study was to analyse the relationbetween ADL and cognitive plasticity in old age. Sixtythreeelderly participants were evaluated using diversemeasures of ADL levels and two techniques for evaluatinglearning potential. Results showed that a higherlevel of cognitive plasticity was associated with greaterfunctional independence in daily living.

  11. Computer versus Compensatory Calendar Training in Individuals with Mild Cognitive Impairment: Functional Impact in a Pilot Study.

    Science.gov (United States)

    Chandler, Melanie J; Locke, Dona E C; Duncan, Noah L; Hanna, Sherrie M; Cuc, Andrea V; Fields, Julie A; Hoffman Snyder, Charlene R; Lunde, Angela M; Smith, Glenn E

    2017-09-06

    This pilot study examined the functional impact of computerized versus compensatory calendar training in cognitive rehabilitation participants with mild cognitive impairment (MCI). Fifty-seven participants with amnestic MCI completed randomly assigned calendar or computer training. A standard care control group was used for comparison. Measures of adherence, memory-based activities of daily living (mADLs), and self-efficacy were completed. The calendar training group demonstrated significant improvement in mADLs compared to controls, while the computer training group did not. Calendar training may be more effective in improving mADLs than computerized intervention. However, this study highlights how behavioral trials with fewer than 30-50 participants per arm are likely underpowered, resulting in seemingly null findings.

  12. Extended Occupational Therapy Reintegration Strategies for a Woman With Guillain-Barré Syndrome: Case Report.

    Science.gov (United States)

    Tomita, Machiko R; Buckner, Kathryn; Saharan, Sumandeep; Persons, Kimberley; Liao, Sheng Hui

    2016-01-01

    This case report describes a unique long-term functional recovery process to promote successful community reintegration for a woman with Guillain-Barré syndrome (GBS), a rare autoimmune disease. Her main symptoms were very limited mobility and depressive symptoms due to the unknown cause of and cure for the illness. Holistic occupational strategies helped the client stabilize her emotional state, create a safe home environment, improve a communication method, increase physical activity, and promote social participation. Participation in a fall prevention clinical trial lowered her risk of falling; at 9 mo, she reached 75% of the maximum Social Integration score; at 13 mo, she reached near-normal level for activities of daily living (ADLs) and her fastest time for the Timed Up and Go test; and at 2 yr, she achieved a 100% score in instrumental ADLs. For community integration of clients with GBS, a comprehensive strategic self-management approach should be prescribed for long-term recovery. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  13. Association between advanced glycation end-products and functional performance in Alzheimer's disease and mixed dementia.

    Science.gov (United States)

    Drenth, Hans; Zuidema, Sytse U; Krijnen, Wim P; Bautmans, Ivan; van der Schans, Cees; Hobbelen, Hans

    2017-09-01

    People with Alzheimer's disease (AD) experience, in addition to the progressive loss of cognitive functions, a decline in functional performance such as mobility impairment and disability in activities of daily living (ADL). Functional decline in dementia is mainly linked to the progressive brain pathology. Peripheral biomechanical changes by advanced glycation end-products (AGEs) have been suggested but have yet to be thoroughly studied. A multi-center, longitudinal, one-year follow-up cohort study was conducted in 144 people with early stage AD or mixed Alzheimer's/Vascular dementia. Linear mixed model analyses was used to study associations between AGE-levels (AGE reader) and mobility (Timed Up and Go), and ADL (Groningen Activity Restriction Scale and Barthel index), respectively. A significant association between AGE levels and mobility (β = 3.57, 95%CI: 1.43-5.73) was revealed; however, no significant association between AGE levels and ADL was found. Over a one-year time span, mean AGE levels significantly increased, and mobility and ADL performance decreased. Change in AGE levels was not significantly correlated with change in mobility. This study indicates that high AGE levels could be a contributing factor to impaired mobility but lacks evidence for an association with ADL decline in people with early stage AD or mixed dementia. Future research is necessary on the reduction of functional decline in dementia regarding the effectiveness of interventions such as physical activity programs and dietary advice possibly in combination with pharmacologic strategies targeting AGE accumulation.

  14. Geriatric Assessment and Functional Decline in Older Patients with Lung Cancer.

    Science.gov (United States)

    Decoster, L; Kenis, C; Schallier, D; Vansteenkiste, J; Nackaerts, K; Vanacker, L; Vandewalle, N; Flamaing, J; Lobelle, J P; Milisen, K; De Grève, J; Wildiers, H

    2017-10-01

    Older patients with lung cancer are a heterogeneous population making treatment decisions complex. This study aims to evaluate the value of geriatric assessment (GA) as well as the evolution of functional status (FS) in older patients with lung cancer, and to identify predictors associated with functional decline and overall survival (OS). At baseline, GA was performed in patients ≥70 years with newly diagnosed lung cancer. FS measured by activities of daily living (ADL) and instrumental activities of daily living (IADL) was reassessed at follow-up to define functional decline and OS was collected. Predictors for functional decline and OS were determined. Two hundred and forty-five patients were included in this study. At baseline, GA deficiencies were present in all domains and ADL and IADL were impaired in 51 and 63% of patients, respectively. At follow-up, functional decline in ADL was observed in 23% and in IADL in 45% of patients. In multivariable analysis, radiotherapy was predictive for ADL decline. No other predictors for ADL or IADL decline were identified. Stage and baseline performance status were predictive for OS. Older patients with lung cancer present with multiple deficiencies covering all geriatric domains. During treatment, functional decline is observed in almost half of the patients. None of the specific domains of the GA were predictive for functional decline or survival, probably because of the high impact of the aggressiveness of this tumor type leading to a poor prognosis.

  15. Subgroup effects of occupational therapy-based intervention for people with advanced cancer

    DEFF Research Database (Denmark)

    Pilegaard, Marc Sampedro; Østergaard, Lisa Gregersen; la Cour, Karen

    2018-01-01

    cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences. Objective: To investigate whether subgroups of people with advanced cancer gain positive effects from the ‘Cancer Home-Life Intervention’ on ADL ability. Material....... Results: The ‘Cancer Home-Life Intervention’ had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: −0.05 to 0.64]) and gender (0.23 [95% CI: −0.11 to 0.57]) were not found. Conclusion: There were no subgroup effects of the ‘Cancer Home-Life Intervention......’on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution....

  16. Participation after acquired brain injury: Associations with everyday technology and activities in daily life.

    Science.gov (United States)

    Fallahpour, Mandana; Kottorp, Anders; Nygård, Louise; Lund, Maria Larsson

    2015-01-01

    The development of the information society has led to increased use of everyday technology and changed the conditions for participation. Enabling participation in everyday life situations is an important rehabilitation goal after acquired brain injury (ABI). Identifying factors associated with individuals' experienced participation and problems therein is therefore essential. This study aimed at exploring the relationship between perceived difficulty in everyday technology use, perceived ability in the activities of daily living (ADL), and perceived participation, and participation problems in persons with ABI. Eighty-one persons with ABI participated in the study and were assessed by the Impact on Participation and Autonomy questionnaire, the Everyday Technology Use Questionnaire, and the ADL taxonomy. Findings showed that the combined model of difficulty in everyday technology (ET) use, ADL ability, and the interaction between them explained both participation in various domains of everyday life, and also overall level of perceived participation and the perceived problems. The findings underscore the importance of evaluating individuals' ability in both ET use and ADL after ABI to increase the probability of explaining these persons' participation in desired everyday life situations and, also, for rehabilitation design.

  17. Activities of daily living and quality of life during treatment with neoadjuvant chemoradiotherapy and after surgery in patients with esophageal cancer.

    Science.gov (United States)

    Haj Mohammad, Nadia; De Rooij, Sophia; Hulshof, Maarten; Ruurda, Jelle; Wijnhoven, Bas; Erdkamp, Frans; Sosef, Meindert; Gisbertz, Suzanne; van Berge Henegouwen, Mark; Sprangers, Mirjam; van Laarhoven, Hanneke

    2016-11-01

    Neoadjuvant chemoradiation (nCRT) followed by esophagectomy is a treatment with curative intent for resectable esophageal cancer. The aim of this study was to measure activities of daily living (ADL) and quality of life (QoL), and to examine correlates of changes in ADL and QoL. A prospective study was performed with three time points (baseline, 1 week after the end of nCRT, 3-months post-surgery) together with a cross-sectional post-treatment study. ADL was measured with the Amsterdam Linear Disability Score (ALDS), and QoL with the EORTC QLQ-C30 and the OES-18. Regression analysis was performed to identify factors associated with changes in ADL and QoL. Seventy-six patients were included in the prospective study, 79 in the cross-sectional study. After nCRT, ALDS decreased from 90 to 88 (P < 0.01) and remained stable after surgery. Global QoL decreased from 75 to 61 (P < 0.01); no significant changes were observed after surgery. Only timing of the measurement of ALDS was negatively associated with non-maximum ALDS (n = 155, based on both studies) and QoL (n = 76) (P < 0.01). Patients who undergo nCRT plus surgery should be prepared to experience a short-term decline in ADL and QoL. The findings of this study can support patients and healthcare workers to guide expectations. J. Surg. Oncol. 2016;114:684-690. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Buddhist social networks and health in old age: A study in central Thailand.

    Science.gov (United States)

    Sasiwongsaroj, Kwanchit; Wada, Taizo; Okumiya, Kiyohito; Imai, Hissei; Ishimoto, Yasuko; Sakamoto, Ryota; Fujisawa, Michiko; Kimura, Yumi; Chen, Wen-ling; Fukutomi, Eriko; Matsubayashi, Kozo

    2015-11-01

    Religious social networks are well known for their capacity to improve individual health, yet the effects of friendship networks within the Buddhist context remain largely unknown. The present study aimed to compare health status and social support in community-dwelling older adults according to their level of Buddhist social network (BSN) involvement, and to examine the association between BSN involvement and functional health among older adults. A cross-sectional survey was carried out among 427 Buddhist community-dwelling older adults aged ≥60 years in Nakhon Pathom, Thailand. Data were collected from home-based personal interviews using a structured questionnaire. Health status was defined according to the measures of basic and advanced activities of daily living (ADL), the 15-item Geriatric Depression Scale and subjective quality of life. Perceived social support was assessed across the four dimensions of tangible, belonging, emotional and information support. Multiple logistic regression was used for analysis. Older adults with BSN involvement reported better functional, mental and social health status, and perceived greater social support than those without BSN involvement. In addition, BSN involvement was positively associated with independence in basic and advanced ADL. After adjusting for age, sex, education, income, morbidity and depressive symptoms, BSN showed a strong association with advanced ADL and a weak association with basic ADL. The results show that involvement in BSN could contribute positively to functional health, particularly with regard to advanced ADL. Addressing the need for involvement in these networks by older adults might help delay functional decline and save on healthcare costs. © 2014 Japan Geriatrics Society.

  19. The relationship between disease and function and perceived health in very frail elders.

    Science.gov (United States)

    Mulrow, C D; Gerety, M B; Cornell, J E; Lawrence, V A; Kanten, D N

    1994-04-01

    To study associations between disease and observed function and self-perceived health in very frail elders. Cross-sectional survey of nine nursing homes in San Antonio, TX. 194 elderly long-stay nursing home residents dependent in at least two ADLs and without severe cognitive impairment. Burden of disease (BOD) was chart abstracted using a standardized protocol that assessed types and severities of 59 categorizations of chronic and acute medical conditions. Observed function and self-perceived health status were assessed independently by the Katz Activities of Daily Living scale (ADL) and the Sickness Impact Profile (SIP), respectively. Summary BOD scores had a low, but statistically significant, univariate correlation with ADL scores (r = 0.21, P = 0.003) and no significant correlation with SIP scores (R = -0.008). Multiple linear regression analyses, including the 24 most frequent disease categories, showed that disease explained significant amounts of ADL (r2 = 0.25, P = 0.001) and borderline significant amounts of SIP (r2 = 0.16, P = 0.11). Models including both disease and sociodemographic, cognitive, and affective variables showed disease added significant incremental explantation beyond the other factors to ADL (incremental r2 = 0.14, P = 0.04), but not to SIP (incremental r2 = 0.08, P > 0.10). Disease, observed function, and self-perceived health status are separate, but interrelated entities, with disease having a stronger relationship to observed function than self-perceived health. Comprehensive assessment of frail elders may need to include all three areas, and studies that focus on one area should take into account the other two as potential important covariates.

  20. Natural History of Dependency in the Elderly: A 24-Year Population-Based Study Using a Longitudinal Item Response Theory Model.

    Science.gov (United States)

    Edjolo, Arlette; Proust-Lima, Cécile; Delva, Fleur; Dartigues, Jean-François; Pérès, Karine

    2016-02-15

    We aimed to describe the hierarchical structure of Instrumental Activities of Daily Living (IADL) and basic Activities of Daily Living (ADL) and trajectories of dependency before death in an elderly population using item response theory methodology. Data were obtained from a population-based French cohort study, the Personnes Agées QUID (PAQUID) Study, of persons aged ≥65 years at baseline in 1988 who were recruited from 75 randomly selected areas in Gironde and Dordogne. We evaluated IADL and ADL data collected at home every 2-3 years over a 24-year period (1988-2012) for 3,238 deceased participants (43.9% men). We used a longitudinal item response theory model to investigate the item sequence of 11 IADL and ADL combined into a single scale and functional trajectories adjusted for education, sex, and age at death. The findings confirmed the earliest losses in IADL (shopping, transporting, finances) at the partial limitation level, and then an overlapping of concomitant IADL and ADL, with bathing and dressing being the earliest ADL losses, and finally total losses for toileting, continence, eating, and transferring. Functional trajectories were sex-specific, with a benefit of high education that persisted until death in men but was only transient in women. An in-depth understanding of this sequence provides an early warning of functional decline for better adaptation of medical and social care in the elderly. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Factors affecting mobility milestones and activities of daily living after stroke

    International Nuclear Information System (INIS)

    Takeuchi, Masahito

    2008-01-01

    Mobility milestones are elementary movements related to activities of daily living (ADL) and have a significant influence on functional recovery after stroke. This study aimed to identify the factors affecting mobility milestones and to clarify the relationships between mobility milestones and ADL. Participants were in the acute phase after first-ever strokes (ischemic, n=77; hemorrhagic, n=84). Clinical and radiological factors within the first week were determined and their effects on mobility milestones after 4 weeks were analyzed using logistic regression analysis. After 4 weeks the patients were divided into four groups on the basis of sitting balance, standing balance, and walking ability. Then total ADL score was calculated using the Barthel index (BI), and percentage of independent patients in each 10 items of BI was transition rate of ADL for each of the four groups. Patients with ischemic stroke showed the following findings. Sitting balance was affected by severity of lower limb paralysis, consciousness level, and presence of an internal capsule lesion on computed tomography (CT) (R 2 =0.86); standing balance was influenced by severity of lower limb paralysis and consciousness level (R 2 =0.72); and walking ability was affected by severity of lower limb paralysis (R 2 =0.64). Patients with hemorrhagic stroke showed the following findings. Sitting balance was influenced by severity of lower limb paralysis, intraventricular hemorrhage on CT, blood pressure instability, and fever (R 2 =0.75); standing balance was affected by severity of lower limb paralysis, consciousness level, and presence of an internal capsule lesion (R 2 =0.58); and walking ability was influenced by severity of lower limb paralysis and presence of an internal capsule lesion (R 2 =0.70). In both types of stroke, sitting and standing balance and walking ability were directly associated with total ADL score, and sitting and standing balance became independent earlier than ADL. Severity of

  2. Improving activities of daily living for nursing home elder persons in Taiwan.

    Science.gov (United States)

    Chang, Su-Hsien; Wung, Shu-Fen; Crogan, Neva L

    2008-01-01

    Excess disability among nursing home elder persons can be prevented or remediated. Because of self-selected disuse and caregiver support of dependency, nursing home residents are likely to develop excess disability. No study was found to test a theory-based program aimed at improving elder persons' self-care abilities for Taiwanese nursing home elder persons who are at risk for developing excess disability. The purpose of this study was to test the effectiveness of a theory-based intervention program on self-care, specifically on activities of daily living (ADLs) performance among nursing home elder persons in Taiwan. A secondary aim was to determine the correlation between ADLs performance and three bliss concepts: life satisfaction, self-esteem, and motivation in health behavior. This study used a quasi-experimental, two-group, pretest-posttest design. Forty-two qualified participants were recruited from two nursing homes located in southern Taiwan and assigned to either the experimental group (n = 21) or the comparison group (n = 21). Participants in the experimental group received the Self-Care Self-Efficacy Enhancement Program (SCSEEP), and those in the comparison group received biweekly social visits for 6 weeks. Levels of ADLs performance were measured by Tappen's Refined ADL Assessment Scale. Life satisfaction was measured by Adams' Life Satisfaction Index A. Self-esteem was measured by Rosenberg's Self-Esteem Scale. Motivation in health behavior was measured by Cox's Health Self-Determinism Index. Elder persons receiving the SCSEEP had significant improvement in feeding, dressing, grooming, and washing activities. Self-esteem (p = .011) and life satisfaction (p = .033) but not motivation in health behavior (p = .282) were positively correlated with levels of ADLs performance. The SCSEEP provides a theory-based intervention model for Taiwanese nursing home elder persons aimed at improving ADLs performance. Further research with a larger sample size is

  3. [Effect of a life review process to improve quality of life for the homebound elderly in Japan].

    Science.gov (United States)

    Imuta, Hiromi; Yasumura, Seiji; Ahiko, Tadayuki

    2004-07-01

    This study examined the therapeutic effects of Life Review processes on physical and psychological functions of homebound elderly in Japan. From 1998, a cohort of people aged 65 and over living in two cities in Yamagata Prefecture has been followed. Sixty-three subjects (24 men, 39 women) were classified as rank A (homebound). Fifty-two persons completed the baseline survey in 1999 and 46 eligible persons (18 men and 28 women) were allocated to intervention and control groups whose age and sex distribution were matched. Intervention entailed giving some health information and Life Review processing for four months, twice a month on average. Each session started with provision of health information followed by the Life Review process which took an hour to finish. All subjects of both groups were assessed for dependent variables at the beginning and the end of the intervention period (pretest and post-test). Dependent variables were physical (Activities of Daily Living, Visual deficit, and others), psychological (subjective health, life satisfaction, self-efficacy scale, and others), and social (functional ability and frequency of getting out of the house). The control group received only the pretest and the post-test. Pretest scores for all physical, psychological, and social variables did not significantly differ between the two groups. The rate for improvement/no change were higher with regard to hearing deficit, ADL (eating, dressing), cognition, subjective health, ikigai and frequency of getting out of house in the intervention group than in the control group, but there were no significant differences. The developed intervention program featuring delivery of health information and structured Life Review Process had no negative influence on physical and psycho-social functions. Practicability of the intervention was suggested. But the study highlights problems such as selection of subjects, duration and method of intervention.

  4. Exploring the Predisposition of the Asian Eye to Development of Dry Eye.

    Science.gov (United States)

    Craig, Jennifer P; Wang, Michael T M; Kim, Dabin; Lee, Jung Min

    2016-07-01

    To investigate the influence of eyelid shape on tear film quality, ocular surface characteristics and dry eye symptomatology by comparing Asian and Caucasian populations. Seventy-four age-matched participants were recruited in a cross-sectional study. Participants were classified into Asian single lid (ASL), Asian double lid (ADL), and Caucasian double lid (CDL) groups. Dry eye symptomatology, ocular surface characteristics, and tear film quality were evaluated in a single clinical session. Meibomian gland dropout was significantly greater in both the ASL and ADL groups than in the CDL group (all Pdry eye symptomatology between the three groups (all P>.05). Exposed ocular surface area, lissamine green staining, and lid wiper epitheliopathy were significantly greater in the ADL group compared to the CDL group (all Pdry eye. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Antibodies Against Infliximab Are Associated with De Novo Development of Antibodies to Adalimumab and Therapeutic Failure in Infliximab-to-Adalimumab Switchers with IBD

    DEFF Research Database (Denmark)

    Frederiksen, Madeline Therese; Ainsworth, Mark Andrew; Brynskov, Jørn

    2014-01-01

    BACKGROUND: A notable proportion of patients with inflammatory bowel disease (IBD) are switched from infliximab (IFX) to adalimumab (ADL). We investigated if immunogenicity of IFX influenced immunogenicity and clinical outcomes of later ADL therapy. METHODS: Single-center cohort study including all...... patients with IBD assessed for antibodies (Abs) against IFX or ADL. RESULTS: Anti-IFX Abs were evaluated in 187 patients treated with IFX as first line anti-TNF agent. Approximately, half (49%) were positive. Detected anti-IFX Abs had functional capacity as judged by a median IFX concentration below limit...... of detection (interquartile range, 0.0-0.0 μg/mL) versus 3.8 μg/mL (IQR, 1.3-7.9) in anti-IFX Ab-negative patients, P tested positive. Patients with previous anti-IFX Ab development were...

  6. Long-Term Effects of Individually Tailored Physical Training and Activity on Physical Function, Well-Being and Cognition in Scandinavian Nursing Home Residents

    DEFF Research Database (Denmark)

    Frändin, Kerstin; Grönstedt, Helena; Helbostad, Jorunn L

    2016-01-01

    . Objective: To evaluate the long-term effects on ADL, balance function, physical activity level, physical performance, falls-related self-efficacy, well-being and cognitive function 3 months after the completion of our intervention in nursing home residents. Methods: The study was a multicenter randomized...... and 66 from Denmark. Of these, 241 [129 intervention group (IG), 112 control group (CG)] were eligible for the 6-month follow-up tests. The level of dependence in ADL, physical activity level, several dimensions of physical function, well-being, falls-related self-efficacy and cognitive function were......Background: The preservation of physical functions such as muscle strength, balance and mobility is fundamental to maintaining independence in activities of daily living (ADL). The physical activity level of most nursing home residents is very low, which implies that they are often subject...

  7. Incident Atrial Fibrillation and Disability-Free Survival in the Cardiovascular Health Study.

    Science.gov (United States)

    Wallace, Erin R; Siscovick, David S; Sitlani, Colleen M; Dublin, Sascha; Mitchell, Pamela H; Odden, Michelle C; Hirsch, Calvin H; Thielke, Stephen; Heckbert, Susan R

    2016-04-01

    To assess the associations between incident atrial fibrillation (AF) and disability-free survival and risk of disability. Prospective cohort study. Cardiovascular Health Study. Individuals aged 65 and older and enrolled in fee-for-service Medicare followed between 1991 and 2009 (MN = 4,046). Individuals with prevalent AF, activity of daily living (ADL) disability, or a history of stroke or heart failure at baseline were excluded. Incident AF was identified according to annual study electrocardiogram, hospital discharge diagnosis, or Medicare claims. Disability-free survival was defined as survival free of ADL disability (any difficulty or inability in bathing, dressing, eating, using the toilet, walking around the home, or getting out of a bed or chair). ADLs were assessed at annual study visits or in a telephone interview. Association between incident AF and disability-free survival or risk of disability was estimated using Cox proportional hazards models. Over an average of 7.0 years of follow-up, 660 individuals (16.3%) developed incident AF, and 3,112 (77%) became disabled or died. Incident AF was associated with shorter disability-free survival (hazard ratio (HR) for death or ADL disability = 1.71, 95% confidence interval (CI) = 1.55-1.90) and a higher risk of ADL disability (HR = 1.36, 95% CI = 1.18-1.58) than in individuals with no history of AF. This association persisted after adjustment for interim stroke and heart failure. These results suggest that AF is a risk factor for shorter functional longevity in older adults, independent of other risk factors and comorbid conditions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  8. Quality of life after carotid endarterectomy

    Directory of Open Access Journals (Sweden)

    Barros Henrique

    2008-11-01

    Full Text Available Abstract Background Most studies documenting beneficial outcomes after carotid endarterectomy (CE are limited to mortality and morbidity rates, costs, and length of hospital stay (LOS. Few have examined the dependency of patients and how they perceive their own health changes after surgery. The aim of the present study was to evaluate quality of life and independence in activities of daily living (ADL and to study its determinants. Methods Sixty-three patients admitted in the Post Anaesthesia Care Unit (PACU after CE were eligible for this 14-month follow-up study. Patients were contacted 6 months after discharge to complete a Short Form-36 questionnaire (SF-36 and to have their dependency in ADL evaluated. Results Among 59 hospital survivors at 6 months follow-up, 43 completed the questionnaires. Sixty-three percent reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients had worse SF-36 scores for all domains except bodily pain than a general urban population, and comparison with a group of patients 6 months after surgical ICU discharge showed no differences. Six months after PACU discharge, the Lawton Instrumental Activities of ADL Scale and the Katz Index of ADL demonstrated higher dependency scores (5.9 ± 2.2 versus 4.3 ± 2.4 and 0.3 ± 0.8 versus 0.6 ± 0.9, p Conclusion Patients undergoing CE have improved self-perception of quality of life despite being more dependent. Almost all their scores are worse than those in an urban population. We could identify no predictors of greater dependency in ADL tasks six months after PACU discharge.

  9. Pain, activities of daily living and sport function at different time points after hip arthroscopy in patients with femoroacetabular impingement: a systematic review with meta-analysis.

    Science.gov (United States)

    Kierkegaard, Signe; Langeskov-Christensen, Martin; Lund, Bent; Naal, Florian D; Mechlenburg, Inger; Dalgas, Ulrik; Casartelli, Nicola C

    2017-04-01

    To investigate pain, activities of daily living (ADL) function, sport function, quality of life and satisfaction at different time points after hip arthroscopy in patients with femoroacetabular impingement (FAI). Systematic review with meta-analysis. Weighted mean differences between preoperative and postoperative outcomes were calculated and used for meta-analysis. EMBASE, MEDLINE, SportsDiscus, CINAHL, Cochrane Library, and PEDro. Studies that evaluated hip pain, ADL function, sport function and quality of life before and after hip arthroscopy and postoperative satisfaction in patients with symptomatic FAI. Twenty-six studies (22 case series, 3 cohort studies, 1 randomised controlled trial (RCT)) were included in the systematic review and 19 in the meta-analysis. Clinically relevant pain and ADL function improvements were first reported between 3 and 6 months, and sport function improvements between 6 months and 1 year after surgery. It is not clear when quality of life improvements were first achieved. On average, residual mild pain and ADL and sport function scores lower than their healthy counterparts were reported by patients following surgery. Postoperative patient satisfaction ranged from 68% to 100%. On average, patients reported earlier pain and ADL function improvements, and slower sport function improvements after hip arthroscopy for FAI. However, average scores from patients indicate residual mild hip pain and/or hip function lower than their healthy counterparts after surgery. Owing to the current low level of evidence, future RCTs and cohort studies should investigate the effectiveness of hip arthroscopy in patients with FAI. CRD42015019649. 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/.

  10. An explorative, cross-sectional study into abnormal muscular coupling during reach in chronic stroke patients

    Directory of Open Access Journals (Sweden)

    Stienen Arno HA

    2010-03-01

    Full Text Available Abstract Background In many stroke patients arm function is limited, which can be related to an abnormal coupling between shoulder and elbow joints. The extent to which this can be translated to activities of daily life (ADL, in terms of muscle activation during ADL-like movements, is rather unknown. Therefore, the present study examined the occurrence of abnormal coupling on functional, ADL-like reaching movements of chronic stroke patients by comparison with healthy persons. Methods Upward multi-joint reaching movements (20 repetitions at a self-selected speed to resemble ADL were compared in two conditions: once facilitated by arm weight compensation and once resisted to provoke a potential abnormal coupling. Changes in movement performance (joint angles and muscle activation (amplitude of activity and co-activation between conditions were compared between healthy persons and stroke patients using a repeated measures ANOVA. Results The present study showed slight changes in joint excursion and muscle activation of stroke patients due to shoulder elevation resistance during functional reach. Remarkably, in healthy persons similar changes were observed. Even the results of a sub-group of the more impaired stroke patients did not point to an abnormal coupling between shoulder elevation and elbow flexion during functional reach. Conclusions The present findings suggest that in mildly and moderately affected chronic stroke patients ADL-like arm movements are not substantially affected by abnormal synergistic coupling. In this case, it is implied that other major contributors to limitations in functional use of the arm should be identified and targeted individually in rehabilitation, to improve use of the arm in activities of daily living.

  11. Validation of the Spanish version of the Hip Outcome Score: a multicenter study.

    Science.gov (United States)

    Seijas, Roberto; Sallent, Andrea; Ruiz-Ibán, Miguel Angel; Ares, Oscar; Marín-Peña, Oliver; Cuéllar, Ricardo; Muriel, Alfonso

    2014-05-13

    The Hip Outcome Score (HOS) is a self-reported questionnaire evaluating the outcomes of treatment interventions for hip pathologies, divided in 19 items of activities of daily life (ADL) and 9 sports' items. The aim of the present study is to translate and validate HOS into Spanish. A prospective and multicenter study with 100 patients undergoing hip arthroscopy was performed between June 2012 and January 2013. Crosscultural adaptation was used to translate HOS into Spanish. Patients completed the questionnaire before and after surgery. Feasibility, reliability, internal consistency, construct validity (correlation with Western Ontario and McMaster Universities Osteoarthritis Index), ceiling and floor effects and sensitivity to change were assessed for the present study. Mean age was 45.05 years old. 36 women and 64 men were included. Feasibility: 13% had at least one missing item within the ADL subscale and 17% within the sport subscale. Reliability: the translated version of HOS was highly reproducible with intraclass correlation coefficient of 0.95 for ADL and 0.94 for the sports subscale. Internal consistency was confirmed with Cronbach's alpha >0.90 in both subscales. Construct validity showed statistically significant correlation with WOMAC. Ceiling effect was observed in 6% and 12% for ADL and sports subscale, respectively. Floor effect was found in 3% and 37% ADL and sports subscale, respectively. Large sensitivity to change was shown in both subscales. The translated version of HOS into Spanish has shown to be feasible, reliable and sensible to changes for patients undergoing hip arthroscopy. This validated translation of HOS allows for comparisons between studies involving either Spanish- or English-speaking patients. Prognostic study, Level I.

  12. Gender differences in life expectancy with and without disability among older adults in Ecuador.

    Science.gov (United States)

    Egüez-Guevara, Pilar; Andrade, Flávia Cristina Drumond

    2015-01-01

    Knowledge on disability's impact among older women and men in Ecuador is limited. This paper provides gender-specific estimates of disability prevalence, life expectancy with and without disability, and the factors associated with gender differences in disability at older age in Ecuador (2009-2010). Data from the Health, Well-Being, and Aging Survey (SABE) Ecuador 2009 was used. Participants were 4480 men and women aged 60 and over. Life expectancy with and without disability was calculated using the Sullivan method. Logistic regression analyses were used to explore gender differences in disability prevalence. Two disability measures, indicating limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), were used. 60-year-old women in Ecuador can expect to live 16.3 years without ADL limitations compared to 16.9 years for men. Life expectancy without IADL limitations was 12.5 years for women and 15.5 years for men. At age 60, women's length of life with ADL and IADL disability was higher (7.9 years for women vs. 4.9 years for men with ADL, and 11.7 years for women vs. 6.3 years for men with IADL). After controlling for socioeconomic characteristics, chronic conditions and lifestyle factors, gender differences in ADL disability were not statistically significant. However, older women were 58% more likely (OR=1.58, 95% CI 1.27, 1.95) to report having IADL limitations than men, even after including control variables. Interventions should tackle chronic disease, physical inactivity, and socioeconomic differences to reduce women's vulnerability to disability in older age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  14. Significant Change Spotting for Periodic Human Motion Segmentation of Cleaning Tasks Using Wearable Sensors

    Directory of Open Access Journals (Sweden)

    Kai-Chun Liu

    2017-01-01

    Full Text Available The proportion of the aging population is rapidly increasing around the world, which will cause stress on society and healthcare systems. In recent years, advances in technology have created new opportunities for automatic activities of daily living (ADL monitoring to improve the quality of life and provide adequate medical service for the elderly. Such automatic ADL monitoring requires reliable ADL information on a fine-grained level, especially for the status of interaction between body gestures and the environment in the real-world. In this work, we propose a significant change spotting mechanism for periodic human motion segmentation during cleaning task performance. A novel approach is proposed based on the search for a significant change of gestures, which can manage critical technical issues in activity recognition, such as continuous data segmentation, individual variance, and category ambiguity. Three typical machine learning classification algorithms are utilized for the identification of the significant change candidate, including a Support Vector Machine (SVM, k-Nearest Neighbors (kNN, and Naive Bayesian (NB algorithm. Overall, the proposed approach achieves 96.41% in the F1-score by using the SVM classifier. The results show that the proposed approach can fulfill the requirement of fine-grained human motion segmentation for automatic ADL monitoring.

  15. Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea.

    Science.gov (United States)

    Imai, Hissei; Chen, Wen-ling; Fukutomi, Eriko; Okumiya, Kiyohito; Wada, Taizo; Sakamoto, Ryota; Fujisawa, Michiko; Ishimoto, Yasuko; Kimura, Yumi; Chang, Chia-Ming; Matsubayashi, Kozo

    2015-01-01

    The objective of this study is to investigate the cross-cultural relationship between depressive state and subjective economic status, as well as subjective quality of life (QOL) and activities of daily living (ADL) among elderly people in communities in Japan, Taiwan, and Korea. We studied 595 subjects aged 65 years or older in three Asian communities (261 subjects in T town in Japan, 164 in D town in Taiwan, and 170 in H town in Korea). The Geriatric Depression Scale-15, a self-rating questionnaire assessing ADL, subjective QOL, social situations, and past and current medical status, was used. Depression of the elderly was associated with dependence in basic ADL, subjective QOL, and subjective sense of low economic status. After adjusting for the effects of age, sex, and basic ADL, subjective sense of low economic status was closely associated with depression in community-living elderly people in all three communities in Asia. In conclusion, absolute and objective economic status is an important contributing factor to depressive state or psychosocial deterioration, however, we should pay more attention to the roles of perception of low economic status in determining depressive state in community-dwelling elderly people. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Intermonitor reliability of the GT3X+ accelerometer at hip, wrist and ankle sites during activities of daily living

    International Nuclear Information System (INIS)

    Ozemek, Cemal; Wilkerson, Brittany S; Kaminsky, Leonard A; Kirschner, Monica M; Byun, Wonwoo

    2014-01-01

    The triaxial GT3X+ accelerometer can measure activity counts in the vertical, horizontal right to left, horizontal front to back planes, and can generate a summative score of the three axes represented by vector magnitude (VM). Information on the reliability of the GT3X+ at the hip, wrist and ankle sites, over all axes and VM during activities of daily living (ADL) is lacking in the literature. Forty healthy adults (14 men and 26 women) were randomly assigned to perform 10 of 20 ADL (consisting of sedentary, housework, yard work, locomotive and recreational activities) while wearing two monitors on the hip, wrist and ankle. Subjects performed each ADL over 7 min and the mean activity counts during the last 4 min were used for analyses. Average intraclass correlations between monitors were high for the three sites for each axis and VM (hip: 0.943, 0.857, 0.864 and 0.966, respectively; wrist: 0.994, 0.963, 0.961 and 0.989, respectively; ankle: 0.977, 0.979, 0.927 and 0.986, respectively). These data suggest that GT3X+ accelerometers measurements made from the hip, wrist and ankle sites are reliable during ADL across all axes and VM. (paper)

  17. Prosthesis use in adult acquired major upper-limb amputees: patterns of wear, prosthetic skills and the actual use of prostheses in activities of daily life.

    Science.gov (United States)

    Østlie, Kristin; Lesjø, Ingrid Marie; Franklin, Rosemary Joy; Garfelt, Beate; Skjeldal, Ola Hunsbeth; Magnus, Per

    2012-11-01

    To describe patterns of prosthesis wear and perceived prosthetic usefulness in adult acquired upper-limb amputees (ULAs). To describe prosthetic skills in activities of daily life (ADL) and the actual use of prostheses in the performance of ADL tasks. To estimate the influence of prosthetic skills on actual prosthesis use and the influence of background factors on prosthetic skills and actual prosthesis use. Cross-sectional study analysing population-based questionnaire data (n = 224) and data from interviews and clinical testing in a referred/convenience sample of prosthesis-wearing ULAs (n = 50). Effects were analysed using linear regression. 80.8% wore prostheses. 90.3% reported their most worn prosthesis as useful. Prosthetic usefulness profiles varied with prosthetic type. Despite demonstrating good prosthetic skills, the amputees reported actual prosthesis use in only about half of the ADL tasks performed in everyday life. In unilateral amputees, increased actual use was associated with sufficient prosthetic training and with the use of myoelectric vs cosmetic prostheses, regardless of amputation level. Prosthetic skills did not affect actual prosthesis use. No background factors showed significant effect on prosthetic skills. Most major ULAs wear prostheses. Individualised prosthetic training and fitting of myoelectric rather than passive prostheses may increase actual prosthesis use in ADL.

  18. Reduced inflammatory and muscle damage biomarkers following oral supplementation with bioavailable curcumin

    OpenAIRE

    McFarlin, Brian K.; Venable, Adam S.; Henning, Andrea L.; Sampson, Jill N. Best; Pennel, Kathryn; Vingren, Jakob L.; Hill, David W.

    2016-01-01

    Background Exercise-Induced Muscle Damage (EIMD) and delayed onset muscle soreness (DOMS) impact subsequent training sessions and activities of daily living (ADL) even in active individuals. In sedentary or diseased individuals, EIMD and DOMS may be even more pronounced and present even in the absence of structured exercise. Methods The purpose of this study was to determine the effects of oral curcumin supplementation (Longvida? 400?mg/days) on muscle & ADL soreness, creatine kinase (CK), an...

  19. Understanding implementation of comprehensive geriatric care programs: a multiple perspective approach is preferred

    OpenAIRE

    Vos, J.B.M.; Cramm, Jane; Wijngaarden, Jeroen; Bakker, Ton; Mackenbach, Johan; Nieboer, Anna

    2017-01-01

    Summary Background The Prevention and Reactivation Care Program (PReCaP) provides a novel approach targeting hospital‐related functional decline among elderly patients. Despite the high expectations, the PReCaP was not effective in preventing functional decline (ADL and iADL) among older patients. Although elderly PReCaP patients demonstrated slightly better cognitive functioning (Mini Mental State Examination; 0.4 [95% confidence interval (CI) 0.2–0.6]), lower depression (Geriatric Depressio...

  20. Effects of Stroke on Ipsilesional End-Effector Kinematics in a Multi-Step Activity of Daily Living

    OpenAIRE

    Gulde, Philipp; Hughes, Charmayne Mary Lee; Hermsdörfer, Joachim

    2017-01-01

    Background: Stroke frequently impairs activities of daily living (ADL) and deteriorates the function of the contra- as well as the ipsilesional limbs. In order to analyze alterations of higher motor control unaffected by paresis or sensory loss, the kinematics of ipsilesional upper limb movements in patients with stroke has previously been analyzed during prehensile movements and simple tool use actions. By contrast, motion recording of multi-step ADL is rare and patient-control comparisons f...

  1. Cluster Analysis of Physical and Cognitive Ageing Patterns in Older People from Shanghai

    OpenAIRE

    Stephan Bandelow; Xin Xu; Shifu Xiao; Eef Hogervorst

    2016-01-01

    This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no p...

  2. Valor preditivo da distensão de alças intestinais em radiografias no prognóstico de enterocolite necrosante Dilatation of bowel loops on radiological images: prognostic value in necrotizing enterocolitis

    Directory of Open Access Journals (Sweden)

    Daniel Lahan Martins

    2007-10-01

    Full Text Available OBJETIVO: Avaliar o valor prognóstico da distensão de alças intestinais observada em radiografias na evolução e mortalidade de neonatos com enterocolite necrosante. MATERIAIS E MÉTODOS: Nas radiografias de abdome de 53 pacientes obtidas no momento da suspeita diagnóstica de enterocolite necrosante, foi realizada a medida do diâmetro da alça mais distendida (AD, assim como a distância entre a borda superior da primeira vértebra lombar e a borda inferior da segunda (L1-L2, a distância entre as bordas laterais dos pedículos da primeira vértebra lombar (L1, e foram estabelecidas as associações entre AD/L1-L2 e AD/L1. Esta medida foi considerada como possível determinante de potenciais complicações, intervenção cirúrgica e mortalidade. RESULTADOS: Os pacientes que necessitaram de tratamento cirúrgico, aqueles que tiveram complicações durante a evolução e aqueles que morreram da doença tiveram a relação entre AD e AD/L1-L2 maiores (p OBJECTIVE: To evaluate the prognostic value of bowel loops dilatation as a finding on radiographs in the development and mortality of neonates with necrotizing enterocolitis. MATERIALS AND METHODS: On abdominal radiographs of 53 patients for diagnostic suspicion of necrotizing enterocolitis, the major diameters of dilated bowel loops (AD were measured, as well as the distance between the upper border of the first lumbar vertebra and the lower border of the second one (L1-L2, and the distance between the lateral borders of the first lumbar vertebra (L1 pedicles, and the subsequent association between AD/L1-L2, AD/L1. This measure was considered as a possible determining factor for potential complications, surgical intervention and mortality. RESULTS: The patients who needed surgical management and who had complications during progression and died of the disease had showed increased AD and AD/L1-L2 (p < 0.05. AD/L1 values and site of the most dilated bowel loop were not different in the groups

  3. Evaluation of methodological aspects of digestibility measurements in ponies fed different haylage to concentrate ratios.

    Science.gov (United States)

    Schaafstra, F J W C; van Doorn, D A; Schonewille, J T; van Riet, M M J; Visser, P; Blok, M C; Hendriks, W H

    2017-11-01

    Methodological aspects of digestibility measurements were studied in four Welsh pony geldings consuming haylage-based diets with increasing proportions of a pelleted concentrate according to a 4×4 Latin square design experiment. Ponies were fed four experimental, iso-energetic (net energy (NE) basis) diets (i.e. 22 MJ NE/day) with increasing proportions of a pelleted concentrate (C) in relation to haylage (H). The absolute amounts of diet dry matter fed per day were 4.48 kg of H (100H), 3.36 and 0.73 kg of H and C (75H25C), 2.24 and 1.45 kg of H and C (50H50C) and 1.12 and 2.17 kg of H and C (25H75C). Diets were supplemented with minerals, vitamins and TiO2 (3.7 g Ti/day). Voluntary voided faeces were quantitatively collected daily during 10 consecutive days and analysed for moisture, ash, ADL, acid-insoluble ash (AIA) and Ti. A minimum faeces collection period of 6 consecutive days, along with a 14-day period to adapt the animals to the diets and become accustomed to the collection procedure, is recommended to obtain accurate estimations on dry matter digestibility and organic matter digestibility (OMD) in equids fed haylage-based diets supplemented with concentrate. In addition, the recovery of AIA, ADL and Ti was determined and evaluated. Mean faecal recovery over 10 consecutive days across diets for AIA, ADL and Ti was 124.9% (SEM 2.9), 108.7% (SEM 2.0) and 97.5% (SEM 0.9), respectively. Cumulative faecal recovery of AIA significantly differed between treatments, indicating that AIA is inadequate to estimate the OMD in equines. In addition, evaluation of the CV of mean cumulative faecal recoveries obtained by AIA, ADL and Ti showed greater variations in faecal excretion of AIA (9.1) and ADL (7.4) than Ti (3.7). The accuracy of prediction of OMD was higher with the use of Ti than ADL. The use of Ti is preferred as a marker in digestibility trials in equines fed haylage-based diets supplemented with increasing amounts of pelleted concentrate.

  4. Quality of life after stay in surgical intensive care unit.

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    Abelha, Fernando J; Santos, Cristina C; Maia, Paula C; Castro, Maria A; Barros, Henrique

    2007-07-24

    In addition to mortality, Health Related Quality of Life (HRQOL) has increasingly been claimed as an important outcome variable. The aim of this study was to assess HRQOL and independence in activities of daily living (ADL) six months after discharge from an Intensive Care Unit (ICU), and to study its determinants. All post-operative adult patients admitted to a surgical ICU between October 2004 and July 2005, were eligible for the study. The following variables were recorded on admission: age, gender, American Society of Anesthesiologists physical status (ASA-PS), type and magnitude of surgical procedure, ICU and hospital length of stay (LOS), mortality and Simplified Acute Physiology Score II (SAPS II). Six months after discharge, a Short Form-36 questionnaire (SF-36) and a questionnaire to assess dependency in ADL were sent to all survivors. Descriptive statistics was used to summarize data. Patient groups were compared using non-parametric tests. A logistic regression analysis was performed to identify covariate effects of each variable on dependency in personal and instrumental ADL, and for the change-in-health question of SF-36. Out of 333 hospital survivors, 226 completed the questionnaires. Fifty-nine percent reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients with greater co-morbidities (ASA-PS III/IV), had lower SF-36 scores in all domains and were more frequently dependent in instrumental and personal ADL. Logistic regression showed that SAPS II was associated with changes in general level of health (OR 1.06, 95%CI, 1.01-1.11, p = 0,016). Six months after ICU discharge, 60% and 34% of patients, respectively, were dependent in at least one activity in instrumental ADL (ADLI) and personal ADL (ADLP). ASA-PS (OR 3.00, 95%CI 1.31-6.87, p = 0.009) and age (OR 2.36, 95%CI, 1.04-5.34, p = 0.04) were associated with dependency in ADLI. For ADLP, only ASA-PS (OR 4.58, 95%CI, 1

  5. Risk of falling in patients with a recent fracture

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    Willems Gittie

    2007-06-01

    Full Text Available Abstract Background Patients with a history of a fracture have an increased risk for future fractures, even in short term. The aim of this study was to assess the number of patients with falls and to identify fall risk factors that predict the risk of falling in the first three months after a clinical fracture. Methods Prospective observational study with 3 months of follow-up in a large European academic and regional hospital. In 277 consenting women and men aged ≥ 50 years and with no dementia and not receiving treatment for osteoporosis who presented to hospital with a clinical fracture, fall risk factors were assessed according to the guidelines on fall prevention in the Netherlands. Follow-up information on falls and fractures was collected by monthly telephone interview. Incidence of falls and odds ratio's (OR, with 95% confidence intervals were calculated. Results 512 consecutive patients with a fracture were regarded for analysis, 87 were not eligible for inclusion and 137 patients were excluded. No follow-up data were available for 11 patients. Therefore full analysis was possible in 277 patients. A new fall incident was reported by 42 patients (15%, of whom five had a fracture. Of the 42 fallers, 32 had one new fall and 10 had two or more. Multivariate analysis in the total group with sex, age, ADL difficulties, urine incontinence and polypharmacy showed that sex and ADL were significant fall risk factors. Women had an OR of 3.02 (95% CI 1.13–8.06 and patients with ADL-difficulties had an OR of 2.50 (95% CI 1.27–4.93. Multivariate analysis in the female group with age, ADL difficulties, polypharmacy and presence of orthostatic hypotension indicated that polypharmacy was the predominant risk factor (OR 2.51; 95% CI: 1.19 – 5.28. The incidence of falls was 35% in women with low ADL score and polypharmacy compared to 15% in women without these risk factors (OR 3.56: CI 1.47 – 8.67. Conclusion 15% of patients reported a new fall

  6. Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

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    Hairi Noran N

    2010-08-01

    Full Text Available Abstract Background The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. Methods A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool. Data were also collected for self reported activities of daily living (ADL using the Barthel Index (ten items. To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking and five basic ADL's (eating, bathing, dressing, transferring and toileting. Results Ten, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9, 14.4% (95% CI 11.9-17.2 and 10.6% (95% CI 8.5-13.1, respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5 of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (≥ 75 years: prevalence ratio (PR 7.9; 95% CI 4.8-12.9, presence of diabetes (PR 1.8; 95% CI 1.4-2.3, stroke (PR 1.5; 95% CI 1.1-2.2, depressive symptomology (PR 1.3; 95% CI 1.1-1.8 and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6. Advancing age (≥ 75 years: PR 3.0; 95% CI 1.7-5.2 being female (PR 2.7; 95% CI 1.2-6.1, presence of arthritis (PR 1.6; 95% CI 1.2-2.1 and depressive symptomology (PR 2.0; 95% CI 1.5-2.7 were significantly associated with functional limitation. Conclusions The prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to

  7. Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country.

    Science.gov (United States)

    Hairi, Noran N; Bulgiba, Awang; Cumming, Robert G; Naganathan, Vasi; Mudla, Izzuna

    2010-08-18

    The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living (ADL) using the Barthel Index (ten items). To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking) and five basic ADL's (eating, bathing, dressing, transferring and toileting). Ten, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9), 14.4% (95% CI 11.9-17.2) and 10.6% (95% CI 8.5-13.1), respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5) of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (> or = 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), stroke (PR 1.5; 95% CI 1.1-2.2), depressive symptomology (PR 1.3; 95% CI 1.1-1.8) and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6). Advancing age (> or = 75 years: PR 3.0; 95% CI 1.7-5.2) being female (PR 2.7; 95% CI 1.2-6.1), presence of arthritis (PR 1.6; 95% CI 1.2-2.1) and depressive symptomology (PR 2.0; 95% CI 1.5-2.7) were significantly associated with functional limitation. The prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to developing countries. Associations with socio

  8. Study of polymorphism in Mazandaran and Esfahan native chicken population using microsatellite markers

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    Saeid Esmaeilkhanian

    2014-10-01

    Full Text Available In order to studying of genetic variation in Mazandaran and Esfahan native chickens, twenty microsatellite markers were evaluated. These microsatellite markers were MCW0014, MCW0081, MCW0183, MCW0067, MCW0104, MCW0123, MCW0330, MCW0165, MCW0069, MCW0020, MCW0222, LEI0094, MCW0295, MCW0034, MCW0216, ADL0268, ADL0112, ADL0278 and lEI0166. Blood samples of 90 and 150 native chickens of Mazandaran and Esfahan were randomly taken respectively. Genomic DNAs were isolated through optimized and modified salting-out procedure. The number of alleles varied from 1 to 6. In Mazandaran population one locus (MCW0216 and in Esfahan population three loci (MCW0216, MCW67 and MCW222 were monomorphic. The other loci were showed appropriate polymorphism. All the loci except MCW222 and MCW165 in Mazandaran population showed deviations from Hardy-Weinberg equilibrium (p

  9. Cognitive Rehabilitation in Alzheimer's Disease: A Controlled Intervention Trial.

    Science.gov (United States)

    Brueggen, Katharina; Kasper, Elisabeth; Ochmann, Sina; Pfaff, Henrike; Webel, Steffi; Schneider, Wolfgang; Teipel, Stefan

    2017-01-01

    Cognitive Rehabilitation for Alzheimer's disease (AD) is an integrative multimodal intervention. It aims to maintain autonomy and quality of life by enhancing the patients' abilities to compensate for decreased cognitive functioning. We evaluated the feasibility of a group-based Cognitive Rehabilitation approach in mild AD dementia and assessed its effect on activities of daily living (ADL). We included 16 patients with AD dementia in a controlled partial-randomized design. We adapted the manual-guided Cognitive Rehabilitation program (CORDIAL) to a group setting. Over the course of three months, one group received the Cognitive Rehabilitation intervention (n = 8), while the other group received a standardized Cognitive Training as an active control condition (n = 8). ADL-competence was measured as primary outcome. The secondary outcome parameters included cognitive abilities related to daily living, functional cognitive state, and non-cognitive domains, e.g., quality of life. For each scale, we assessed the interaction effect 'intervention by time', i.e., from pre-to post-intervention. We found no significant interaction effect of intervention by time on the primary outcome ADL-competence. The interaction effect was significant for quality of life (Cohen's d: -1.43), showing an increase in the intervention group compared with the control group. Our study demonstrates the feasibility of a group-based Cognitive Rehabilitation program for patients with mild AD dementia. The Cognitive Rehabilitation showed no significant effect on ADL, possibly reflecting a lack of transfer between the therapy setting and real life. However, the group setting enhanced communication skills and coping mechanisms. Effects on ADL may not have reached statistical significance due to a limited sample size. Furthermore, future studies might use an extended duration of the intervention and integrate caregivers to a greater extent to increase transfer to activities of daily living.

  10. [Frailty, disability and multi-morbidity: the relationship with quality of life and healthcare costs in elderly people].

    Science.gov (United States)

    Lutomski, Jennifer E; Baars, Maria A E; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

    2014-01-01

    To assess the independent and combined impact of frailty, multi-morbidity, and activities of daily living (ADL) limitations on self-reported quality of life and healthcare costs in elderly people. Cross-sectional, descriptive study. Data came from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS), a pooled dataset with information from 41 projects across the Netherlands from the Dutch national care for the Elderly programme. Frailty, multi-morbidity and ADL limitations, and the interactions between these domains, were used as predictors in regression analyses with quality of life and healthcare costs as outcome measures. Analyses were stratified by living situation (independent or care home). Directionality and magnitude of associations were assessed using linear mixed models. A total of 11,093 elderly people were interviewed. A substantial proportion of elderly people living independently reported frailty, multi-morbidity, and/or ADL limitations (56.4%, 88.3% and 41.4%, respectively), as did elderly people living in a care home (88.7%, 89.2% and 77,3%, respectively). One-third of elderly people living at home (31.9%) reported all three conditions compared with two-thirds of elderly people living in a care home (68.3%). In the multivariable analysis, frailty had a strong impact on outcomes independently of multi-morbidity and ADL limitations. Elderly people experiencing problems across all three domains reported the poorest quality-of-life scores and the highest healthcare costs, irrespective of their living situation. Frailty, multi-morbidity and ADL limitations are complementary measurements, which together provide a more holistic understanding of health status in elderly people. A multi-dimensional approach is important in mapping the complex relationships between these measurements on the one hand and the quality of life and healthcare costs on the other.

  11. Reproducibility, validity, and responsiveness of the hip outcome score in patients with end-stage hip osteoarthritis.

    Science.gov (United States)

    Naal, Florian D; Impellizzeri, Franco M; von Eisenhart-Rothe, Rüdiger; Mannion, Anne F; Leunig, Michael

    2012-11-01

    To evaluate reproducibility, validity, and responsiveness of the Hip Outcome Score (HOS) in patients with end-stage hip osteoarthritis. In a cohort of 157 consecutive patients (mean age 66 years; 79 women) undergoing total hip replacement, the HOS was tested for the following measurement properties: feasibility (percentage of evaluable questionnaires), reproducibility (intraclass correlation coefficient [ICC] and standard error of measurement [SEM]), construct validity (correlation with the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Oxford Hip Score [OHS], Short Form 12 health survey, and University of California, Los Angeles activity scale), internal consistency (Cronbach's alpha), factorial validity (factor analysis), floor and ceiling effects, and internal and external responsiveness at 6 months after surgery (standardized response mean and change score correlations). Missing items occurred frequently. Five percent to 6% of the HOS activities of daily living (ADL) subscales and 20-32% of the sport subscales could not be scored. ICCs were 0.92 for both subscales. SEMs were 1.8 points (ADL subscale) and 2.3 points (sport subscale). Highest correlations were found with the OHS (r = 0.81 for ADL subscale and r = 0.58 for sport subscale) and the WOMAC physical function subscale (r = 0.83 for ADL subscale and r = 0.56 for sport subscale). Cronbach's alpha was 0.93 and 0.88 for the ADL and sport subscales, respectively. Neither unidimensionality of the subscales nor the 2-factor structure was supported by factor analysis. Both subscales showed good internal and external responsiveness. The HOS is reproducible and responsive when assessing patients with end-stage hip osteoarthritis in whom the items are relevant. However, based on the large proportion of missing data and the findings of the factor analysis, we cannot recommend this questionnaire for routine use in this target group. Copyright © 2012 by the American College of Rheumatology.

  12. The impact of visual impairment on the ability to perform activities of daily living for persons with severe/profound intellectual disability.

    Science.gov (United States)

    Dijkhuizen, Annemarie; Hilgenkamp, Thessa I M; Krijnen, Wim P; van der Schans, Cees P; Waninge, Aly

    2016-01-01

    The ability to perform activities of daily living (ADL) as a component of participation is one of the factors that contribute to quality of life. The ability to perform ADL for persons experiencing severe/profound intellectual disability (ID) may be reduced due to their cognitive and physical capacities. However, until recently, the impact of the significantly prevalent visual impairments on the performance of activities of daily living has not yet been revealed within this group. The purpose of this prospective cross-sectional study was to investigate the impact of visual impairment on the performance of activities of daily living for persons with a severe/profound intellectual disability. The Barthel Index (BI) and Comfortable Walking Speed (CWS) were used to measure the ability of performing activities of daily living (ADL) in 240 persons with severe/profound ID and having Gross Motor Functioning Classification System (GMFCS) levels I, II or III; this included 120 persons with visual impairment. The impact of visual impairment on ADL was analyzed with linear regression. The results of the study demonstrated that visual impairment slightly affects the ability of performing activities of daily living (BI) for persons experiencing a severe/profound intellectual disability. GMFCS Levels II or III, profound ID level, and visual impairment each have the effect of lowering BI scores. GMFCS Levels II or III, and profound ID level each have the effect of increasing CWS scores, which indicates a lower walking speed. A main effect of visual impairment is present on CWS, but our results do show a substantive interaction effect between GMFCS level III and visual impairment on Comfortable Walking Speed in persons with a severe/profound intellectual disability. Visual impairment has a slight effect on ability to perform ADL in persons experiencing severe/profound ID. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. A Comparative Field Based Study of Katz and Barthel Indices in North Indian City of Dehradun

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    Megha Luthra

    2016-03-01

    Full Text Available Background: Elderly persons are one of the most vulnerable groups of society and have more chances of disease and disabilities (restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being. It reflects how well an individual is able to function in general areas of life. Magnitude of disability has become an important indicator in measuring disease burden along with morbidity and mortality rates. Katz and Barthel Indices have been largely used to assess disability in activities of daily living among elderly people.Aim & objectives: This community-based cross-sectional study was conducted among persons aged 60 years and above in urban field practice area of SGRRIM&HS, Dehradun, Uttarakhand with the aim of comparing these two indices in community setting. The specific objectives were to find ADL dependence by both the indices, find the factors which significantly affect ADL dependence and to find the degree of agreement which is not by chance between Katz and Barthel Indices.Material methods: An interview schedule was developed and administered to participants in Hindi, by trained investigators. Information on age, marital status, living status education, occupation and economic dependence was recorded. House-to-house visits were conducted in the selected area to collect the data. All elderly persons residing in the selected area were included in the study.Results: Prevalence of ADL dependence was 8.23% as per Katz Index and 28.45% as per Barthel Index, taking a score of less than 20 for BI and less than 6 for KI as criterion for ADL dependence. That there is a moderate degree of agreement between Katz and Barthel Scores which is not by chance was estimated by Kappa Statistic.Conclusion: Katz Index is better suited for ADL estimation in a community setting.

  14. Quality of life of nursing-home residents with dementia subject to surveillance technology versus physical restraints: an explorative study.

    Science.gov (United States)

    Te Boekhorst, S; Depla, M F I A; Francke, A L; Twisk, J W R; Zwijsen, S A; Hertogh, C M P M

    2013-04-01

    As physical restraints should only be used in exceptional cases, there is an urgent need for alternatives to restraint use. Surveillance technology could be such an alternative. This study explored whether nursing-home residents with dementia subjected to surveillance technology had better quality of life scores for mood, behavioral and societal dimensions than residents with physical restraints. Quality of life was assessed longitudinally, with three measurements in six psychogeriatric nursing homes of residents with surveillance technology (n = 170) and residents with physical restraints (n = 22). QUALIDEM subscales were used to measure five dimensions of quality of life. Multilevel longitudinal univariate and multivariate regression techniques were used to analyze the data. Because physical restraints were almost exclusively used in residents with low activities of daily living (ADL) independency (18 of the 22), we restricted the regression analyses to residents with a Barthel Index score ≤ 5 (overall n = 53). Univariate results showed that highly ADL-dependent residents with surveillance technology had significantly more positive affect than highly ADL-dependent residents with physical restraints. However, this difference proved to be no longer significant after adjustment for the confounders: age, sex and stage of dementia. Quality of life of highly ADL-dependent nursing-home residents with dementia seems to be unrelated to the use of surveillance technology as opposed to physical restraints. Copyright © 2012 John Wiley & Sons, Ltd.

  15. Recommendations service for chronic disease patient in multimodel sensors home environment.

    Science.gov (United States)

    Hussain, Maqbool; Ali, Taqdir; Khan, Wajahat Ali; Afzal, Muhammad; Lee, Sungyoung; Latif, Khalid

    2015-03-01

    With advanced technologies in hand, there exist potential applications and services built around monitoring activities of daily living (ADL) of elderly people at nursing homes. Most of the elderly people in these facilities are suffering from different chronic diseases such as dementia. Existing technologies are mainly focusing on non-medication interventions and monitoring of ADL for addressing loss of autonomy or well-being. Monitoring and managing ADL related to cognitive behaviors for non-medication intervention are very effective in improving dementia patients' conditions. However, cognitive functions of patients can be improved if appropriate recommendations of medications are delivered at a particular time. Previously we developed the Secured Wireless Sensor Network Integrated Cloud Computing for Ubiquitous-Life Care (SC(3)). SC(3) services were limited to monitoring ADL of elderly people with Alzheimer's disease and providing non-medication recommendations to the patient. In this article, we propose a system called the Smart Clinical Decision Support System (CDSS) as an integral part of the SC(3) platform. Using the Smart CDSS, patients are provided with access to medication recommendations of expert physicians. Physicians are provided with an interface to create clinical knowledge for medication recommendations and to observe the patient's condition. The clinical knowledge created by physicians as the knowledge base of the Smart CDSS produces recommendations to the caregiver for medications based on each patient's symptoms.

  16. The Impact of Fear of Falling on Functional Independence Among Older Adults Receiving Home Health Services

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    Katherine A. Lawson OTR, LMSSW, PhD

    2014-07-01

    Full Text Available Background: Falls are the fifth leading cause of death for adults aged 65 years and older. Several intrinsic and extrinsic fall risk factors have been identified, butthere is less understanding of the impact of a fear of falling on falls. Seventy percent of recent fallers and 40% percent of non-fallers report a fear of falling. Therefore, the purpose of this study was to examine the correlation between a fear of falling and a history of falls, as well as the impact on the functional independence of community-dwelling older adults receiving home health services. Methods: The participants completed the Falls Efficacy Scale, the Modified Timed Up and Go Test, self- reported fear of falling, and the KATZ ADL-staircase. The participants were primarily Hispanic females. Results: There was not a significant correlation between a fear of falling and a history of falls. Only participants' age, gender, and the number of medical diagnoses were predictive of past falls. There was a moderate correlation between impaired functional mobility and dependence with activities of daily living (ADL. Additionally, a fear of falling was associated with dependence to perform ADLs as measured objectively. Conclusion: Future studies need to examine the effectiveness of interventions that include dual-task challenges during therapeutic interventions and ADL retraining to reduce fall risk among older adults.

  17. The Relationship Between Mental State and Functional Status in Elderly Residents of Kahrizak

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    Hadi Kazemi

    2010-03-01

    Full Text Available Objectives: The current study was performed to investigate the relationship between mental impairment and each component of activity of daily living (ADL in elderly residents of the Kahrizak Charity Foundation. Methods & Materials: Standardized Iranian Mini Mental examination and Barthel index were used to assest cognitive status and ADL in 184 elderly residents of Kahrizak, respectively. Results: Data showed that 31.7% of participants had normal cognitive status and 63.3% had cognitive impairment. There was significant relationship between cognitive status and ADL after adjustment for confounding factors (P=0.01, r=0.2. By using multiple logistic regression analysis, the relation between cognitive impairment and functional status was examined (P=0.05. Odd ratio of functional disability showed an increasing trend with increasing severity of cognitive impairment [Odd Ratio (OR mild cognitive impairment: 1.13, Confidence Interval (CI: 0.54-2.37 OR moderate to severe cognitive impairment: 3.67, CI: 0.39-34.35]. Regarding the relation between Barthel components and cognitive status it was showed that there was a significant association between independent bathing and cognitive status (OR: 2.33, CI: 1.14-4.72 as well as movementability with cognitive impairment (OR: 2.96, CI: 1.30-6.75. Conclusion: Cognitive status can be a predictive factor of ADL inelderly subjects.

  18. 2,3,7,8-Tetrachlorodibenzo-p-dioxin modulates estradiol-induced aldehydic DNA lesions in human breast cancer cells through alteration of CYP1A1 and CYP1B1 expression.

    Science.gov (United States)

    Chen, Shou-Tung; Chen, Dar-Ren; Fang, Ju-Pin; Lin, Po-Hsiung

    2015-05-01

    Many genes responsible for the bioactivation of endogenous estrogen to reactive quinonoid metabolites, including cytochrome P450 (CYP) 1A1, 1A2, and 1B1, are well-known target genes of the aryl hydrocarbon receptor agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The purpose of this research was to investigate the roles of TCDD-mediated altered gene expression in the induction of aldehydic DNA lesions (ADLs) by 17β-estradiol (E2) in human MDA-MB-231 and MCF-7 breast cancer cells. We demonstrated that increases in the number of oxidant-mediated ADLs, including abasic sites and aldehydic base/sugar lesions, were detected in MDA-MB-231 cells exposed to E2. The DNA-damaging effects of E2 in MDA-MB-231 cells were prevented by pretreatment of cells with TCDD. In contrast, we did not observe statistically significant increases in the number of ADLs in MCF-7 cells exposed to E2. However, with TCDD pretreatment, an approximately twofold increase in the number of ADLs was detected in MCF-7 cells exposed to E2. TCDD pretreatment induces disparity in the disposition of E2 to reactive quinonoid metabolites and the subsequent formation of oxidative DNA lesions through alteration of CYP1A1 and CYP1B1 expression in human breast cancer cells.

  19. Effects of gamma irradiation on cell-wall constituents of some agricultural residues

    International Nuclear Information System (INIS)

    Al-Masri, M.R.; Zarkawi, M.

    1994-01-01

    The effects of 150 kilogray (kGy) of γ irradiation on cell-wall constituents of cottonwood (CW), lentils straw (LS), apple pruning products (AP) and olive cake (OC) were investigated. Samples were irradiated by γ irradiation at a dose level of 150 kGy under identical conditions of temperature and humidity and analyzed for crude fibre (CF), neutral-detergent fibre (NDF), acid detergent fibre (ADF) and acid-detergent lignin (ADL). The results indicate that γ irradiation decreased CF contents by about 29% for CW, LS and AP and by 17% for OC. NDF values were also decreased by about 4% for CW and OC, and by about 12% for LS and AP. γ irradiation treatment also decreased ADF values only for CW by 8%. ADL contents decreased by 8% for CW and 5% for OC with no effects for LS and AP. The percentage of cellulose (CL):CF ratio increased by 30, 34, 38 and 20% for CW, LS, AP and OC, respectively. Also, the percentage of hemicellulose (HCL):CF increased for 57% for CW and 16% for OC and decreased by 7% for LS and AP. The percentage of HCL:ADL increased by 22% for CW but decreased by 33% for LS and AP with no changes for OC. There were no changes in CL:ADL ratio for all residues. (Author)

  20. Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study.

    Science.gov (United States)

    Langlet, Ketty; Van Der Linden, Thierry; Launois, Claire; Fourdin, Caroline; Cabaret, Philippe; Kerkeni, Nadia; Barbe, Coralie; Lebargy, François; Deslée, Gaetan

    2012-10-18

    Mechanical ventilation (MV) is imperative in many forms of acute respiratory failure (ARF) in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL) score may help to predict the outcome of these patients. We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68%) or failure (group B n = 8, 32%). We investigated the correlation between the ADL score and the outcome and mortality. The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.

  1. Analysis of low-pass filters for approximate deconvolution closure modelling in one-dimensional decaying Burgers turbulence

    Science.gov (United States)

    San, O.

    2016-01-01

    The idea of spatial filtering is central in approximate deconvolution large-eddy simulation (AD-LES) of turbulent flows. The need for low-pass filters naturally arises in the approximate deconvolution approach which is based solely on mathematical approximations by employing repeated filtering operators. Two families of low-pass spatial filters are studied in this paper: the Butterworth filters and the Padé filters. With a selection of various filtering parameters, variants of the AD-LES are systematically applied to the decaying Burgers turbulence problem, which is a standard prototype for more complex turbulent flows. Comparing with the direct numerical simulations, it is shown that all forms of the AD-LES approaches predict significantly better results than the under-resolved simulations at the same grid resolution. However, the results highly depend on the selection of the filtering procedure and the filter design. It is concluded that a complete attenuation for the smallest scales is crucial to prevent energy accumulation at the grid cut-off.

  2. CT guided interventional therapy for hypertensive cerebral hemorrhage

    International Nuclear Information System (INIS)

    Lin Bo; Duan Bing

    2009-01-01

    Objective: To discuss the curative effect of CT-guided puncture and drainage in treating hypertensive cerebral hemorrhage. Methods: Adjusting the suitable point and direction of puncture according to the form and size of the haematoma and patient's status, the haematoma was eliminated by minimally invasive puncture and drainage guided under CT layer image in 40 cases of hypertensive cerebral hemorrhage. Results: Modality rate of treatment group was 12.5% (5/40), and is much lower than control group, which was 45% (13/30) (P<0.01). When asscess the Activities of Daily Living (ADL) after 6 months follow-up, the ADL1-ADL3 scale in treatment group was 27 cases (70%), and was much higher than that in control group, which was 29.4% (5/17), (P < 0.05). Conclusion: Minimal invasive therapy of cerebral hemorrhage has great superiority in elimination most part of the hematoma such as simple, accurate location, low cost, safe and effective, and is worthy of recommendation clinically. (authors)

  3. Activities of daily living and oral hygiene status of older Korean patients in a long-term care facility.

    Science.gov (United States)

    Seo, H-Y; Jeon, J-E; Chung, W-G; Kim, N-H

    2017-05-01

    This study investigated the relationship between oral hygiene conditions, activities of daily living (ADL) and cognitive ability in older Korean patients in long-term care facilities. Ninety older persons (65+) were randomly sampled from a possible 112 residents in a single facility. They participated in a 2-month-long survey. The Korean Modified Barthel Index was used to measure the ADL, and cognitive ability was measured using the Mini-Mental State Examination, Korean version. Oral hygiene status was measured using the Simplified Oral Hygiene Index and the Tongue Coating Index (TCI). Older participants with complete dependence manifested significantly poorer oral hygiene (P oral hygiene (P oral hygiene on tooth surfaces, while participants with partial dependence had poor tongue hygiene. In addition, dentulous older participants had poorer tongue hygiene than edentulous ones. This indicates the need to assess tooth status and provide oral care services via ADL in long-term care facilities. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Intellectual function, activities of daily living and computerized tomography of the brain in geriatric demented patients

    Energy Technology Data Exchange (ETDEWEB)

    Omura, Fumiaki; Ogura, Chikara; Kishimoto, Akira; Okubo, Masayo; Imamoto, Atsushi [Tottori Univ., Yonago (Japan). School of Medicine; Tsuchie, Harutaka; Sugihara, Kanichiro; Fujii, Shozo

    1984-09-01

    Thirty eight patients of geriatric dementia (mean age 74.9 years) were examined by computerized tomography (CT) and their intellectual functions and activities of daily living (ADL) were evaluated. CT was evaluated by both visual assessment method and direct measuring method. Intellectual function was evaluated by Jikei University dementia rating scale. ADL was evaluated by both Hasegawa's rating scale and Sengoku's rating scale. Results were as follows: significant influence by age was observed in intellectual functions and ADL of subjects above 75 years old. There were good correlations between the higher intellectual function, the better grooming and hygiene, and less needs of nursing care. The severe brain atrophy evaluated by the visual assessment method was correlated with the depressed level of intellectual function. When brain atrophy is mild despite high degree of dementia, reexamination should be made to explore somatic diseases inducing depression of mental activity. It also should be noted that sex and age difference is important in studying geriatric patients.

  5. Intellectual function, activities of daily living and computerized tomography of the brain in geriatric demented patients

    International Nuclear Information System (INIS)

    Omura, Fumiaki; Ogura, Chikara; Kishimoto, Akira; Okubo, Masayo; Imamoto, Atsushi; Tsuchie, Harutaka; Sugihara, Kanichiro; Fujii, Shozo.

    1984-01-01

    Thirty eight patients of geriatric dementia (mean age 74.9 years) were examined by computerized tomography (CT) and their intellectual functions and activities of daily living (ADL) were evaluated. CT was evaluated by both visual assessment method and direct measuring method. Intellectual function was evaluated by Jikei University dementia rating scale. ADL was evaluated by both Hasegawa's rating scale and Sengoku's rating scale. Results were as follows: significant influence by age was observed in intellectual functions and ADL of subjects above 75 years old. There were good correlations between the higher intellectual function, the better grooming and hygiene, and less needs of nursing care. The severe brain atrophy evaluated by the visual assessment method was correlated with the depressed level of intellectual function. When brain atrophy is mild despite high degree of dementia, reexamination should be made to explore somatic diseases inducing depression of mental activity. It also should be noted that sex and age difference is important in studying geriatric patients. (author)

  6. Gender differences in physical disability among older adults in underprivileged communities in Lebanon.

    Science.gov (United States)

    Zeki Al Hazzouri, Adina; Mehio Sibai, Abla; Chaaya, Monique; Mahfoud, Ziyad; Yount, Kathryn M

    2011-03-01

    To examine the role of health conditions, socioeconomic, and socioenvironmental factors in explaining gender differences in physical disability among older adults. We compared 412 women and 328 men residing in underprivileged communities in Lebanon on their activities of daily living (ADL), instrumental activities of daily living (IADL), and physical tasks (PT). Binary logistic regression analyses adjusting for possible explanatory covariates were conducted sequentially. Women showed higher prevalence rates of ADL, IADL, and PT compared to men. Gender disparities in ADL disability were explained by chronic-disease risk factors and health conditions (OR = 1.46; 95% CI = 0.94-2.25). The odds of disability in IADL and PT remained significantly higher for women compared to men after accounting for all available covariates. These results suggest underlying differences in functional status between women and men, yet, may have been influenced by the sensitivity of the measures to the social context and gendered environment surrounding daily activities.

  7. Main determinants of physical activity levels in individuals with Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Raquel de Carvalho Lana

    2016-02-01

    Full Text Available ABSTRACT This study analyzed the relationship between patient characteristics, factors associated with Parkinson’s disease (PD, and physical activity level of individuals affected by the disease. Forty-six volunteers with mild-to-moderate idiopathic PD were assessed using sections II/III of the Unified Parkinson’s Disease Rating Scale and their motor functions were classified according to the modified Hoehn and Yahr (HY scale. Data such as age, disease duration, the Human Activity Profile (HAP, the Fatigue Severity Scale were collected. Lower limb bradykinesia and clinical subtypes of PD were defined. Two models that explained 76% of the variance of the HAP were used. The first comprised age, ability to perform activities of daily living (ADL, and the HY scale; the second comprised age, ability to perform ADL, and lower limb bradykinesia. Possible modifiable factors such as the ability to perform ADL and lower limb bradykinesia were identified as predictors of physical activity level of individuals with PD.

  8. Towards a future robotic home environment: a survey.

    Science.gov (United States)

    Güttler, Jörg; Georgoulas, Christos; Linner, Thomas; Bock, Thomas

    2015-01-01

    Demographic change has resulted in an increase of elderly people, while at the same time the number of active working people is falling. In the future, there will be less caretaking, which is necessary to support the aging population. In order to enable the aged population to live in dignity, they should be able to perform activities of daily living (ADLs) as independently as possible. The aim of this paper is to describe several solutions and concepts that can support elderly people in their ADLs in a way that allows them to stay self-sufficient for as long as possible. To reach this goal, the Building Realization and Robotics Lab is researching in the field of ambient assisted living. The idea is to implement robots and sensors in the home environment so as to efficiently support the inhabitants in their ADLs and eventually increase their independence. Through embedding vital sensors into furniture and using ICT technologies, the health status of elderly people can be remotely evaluated by a physician or family members. By investigating ergonomic aspects specific to elderly people (e.g. via an age-simulation suit), it is possible to develop and test new concepts and novel applications, which will offer innovative solutions. Via the introduction of mechatronics and robotics, the home environment can be made able to seamlessly interact with the inhabitant through gestures, vocal commands, and visual recognition algorithms. Meanwhile, several solutions have been developed that address how to build a smart home environment in order to create an ambient assisted environment. This article describes how these concepts were developed. The approach for each concept, proposed in this article, was performed as follows: (1) research of needs, (2) creating definitions of requirements, (3) identification of necessary technology and processes, (4) building initial concepts, (5) experiments in a real environment, and (6) development of the final concepts. To keep these concepts

  9. Functional impairment and hospital readmission in Medicare seniors.

    Science.gov (United States)

    Greysen, S Ryan; Stijacic Cenzer, Irena; Auerbach, Andrew D; Covinsky, Kenneth E

    2015-04-01

    Medicare currently penalizes hospitals for high readmission rates for seniors but does not account for common age-related syndromes, such as functional impairment. To assess the effects of functional impairment on Medicare hospital readmissions given the high prevalence of functional impairments in community-dwelling seniors. We created a nationally representative cohort of 7854 community-dwelling seniors in the Health and Retirement Study, with 22,289 Medicare hospitalizations from January 1, 2000, through December 31, 2010. Outcome was 30-day readmission assessed by Medicare claims. The main predictor was functional impairment determined from the Health and Retirement Study interview preceding hospitalization, stratified into the following 5 levels: no functional impairments, difficulty with 1 or more instrumental activities of daily living, difficulty with 1 or more activities of daily living (ADL), dependency (need for help) in 1 to 2 ADLs, and dependency in 3 or more ADLs. Adjustment variables included age, race/ethnicity, sex, annual income, net worth, comorbid conditions (Elixhauser score from Medicare claims), and prior admission. We performed multivariable logistic regression to adjust for clustering at the patient level to characterize the association of functional impairments and readmission. Patients had a mean (SD) age of 78.5 (7.7) years (range, 65-105 years); 58.4% were female, 84.9% were white, 89.6% reported 3 or more comorbidities, and 86.0% had 1 or more hospitalizations in the previous year. Overall, 48.3% had some level of functional impairment before admission, and 15.5% of hospitalizations were followed by readmission within 30 days. We found a progressive increase in the adjusted risk of readmission as the degree of functional impairment increased: 13.5% with no functional impairment, 14.3% with difficulty with 1 or more instrumental activities of daily living (odds ratio [OR], 1.06; 95% CI, 0.94-1.20), 14.4% with difficulty with 1 or more

  10. Cross-cultural Adaptation and Validation of the Simplified Chinese Version of the Knee Outcome Survey Activities of Daily Living Scale.

    Science.gov (United States)

    Jia, Zhen-Yu; Wang, Wei; Nian, Xin-Wen; Zhang, Xiao-Xi; Huang, Zhi-Ping; Cui, Jin; Xu, Wei-Dong

    2016-10-01

    To perform a cross-cultural adaptation and translation of the original version of the Activities of Daily Living Scale of the Knee Outcome Survey into Simplified Chinese and validate of the Simplified Chinese version. The original version was translated and cross-culturally adapted into Simplified Chinese according to the guidelines and the recommendations of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 213 patients (96 male, 117 female) were selected to participate in our investigation. The inclusion criteria were as follows: 18 years of age and older, able to speak Chinese Mandarin and read Simplified Chinese, and referred to physical therapy for evaluation and treatment for a knee disorder. The exclusion criteria were as follows: patients who had disorders or impairments involving both knees, patients who had other conditions that could affect lower extremity function, patients with physical therapy related to the knee in the previous 1 month, and patients with psychological problems. Each participant was asked to complete the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS), International Knee Documentation Committee Subjective Knee Form, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form 36 forms and to provide baseline demographic data. Each participant completed the KOS-ADLS twice on 2 nonconsecutive days for reliability evaluation. A portion of the participants (n = 161) finished the KOS-ADLS a third time 4 weeks after physical treatment to test responsiveness. The original version of the KOS-ADLS was well adapted and translated into Simplified Chinese. Simplified Chinese of KOS-ADLS was shown to have good internal consistency (Cronbach's alpha = 0.855 to 0.929), great test-retest reliability (intraclass correlation coefficient = 0.935 to 0.961), high construct validity as we hypothesized (significant correlations with Short Form 36 subscales, Western Ontario and Mc

  11. Social Media and Total Joint Arthroplasty: An Analysis of Patient Utilization on Instagram.

    Science.gov (United States)

    Ramkumar, Prem N; Navarro, Sergio M; Haeberle, Heather S; Chughtai, Morad; Flynn, Megan E; Mont, Michael A

    2017-09-01

    The purpose of this study was to analyze the nature of shared content of total joint arthroplasty patients on Instagram. Specifically, we evaluated social media posts for: (1) perspective and timing; (2) tone; (3) focus (activities of daily living [ADLs], rehabilitation, return-to-work); and (4) the comparison between hip and knee arthroplasties. A search of the public Instagram domain was performed over a 6-month period. Total hip and knee arthroplasties (THA and TKA) were selected for the analysis using the following terms: "#totalhipreplacement," "#totalkneereplacement," and associated terms. 1287 individual public posts of human subjects were shared during the period. A categorical scoring system was utilized for media format (photo or video), time (preoperative, perioperative, or postoperative) period, tone (positive or negative), return-to-work, ADLs, rehabilitation, surgical site, radiograph image, satisfaction, and dissatisfaction. Ninety-one percent of the posts were shared during the postoperative period. Ninety-three percent of posts had a positive tone. Thirty-four percent of posts focused on both ADLs and 33.8% on rehabilitation. TKA patients shared more about their surgical site (14.5% vs 3.3%, P Instagram, arthroplasty patients did so with a positive tone, starting a week after surgery. TKA posts focused more on rehabilitation and wound healing than THA patients, whereas THA patients shared more posts on ADLs. The analysis of social media posts provides insight into what matters to patients after total joint arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. A multivariate fall risk assessment model for VHA nursing homes using the minimum data set.

    Science.gov (United States)

    French, Dustin D; Werner, Dennis C; Campbell, Robert R; Powell-Cope, Gail M; Nelson, Audrey L; Rubenstein, Laurence Z; Bulat, Tatjana; Spehar, Andrea M

    2007-02-01

    The purpose of this study was to develop a multivariate fall risk assessment model beyond the current fall Resident Assessment Protocol (RAP) triggers for nursing home residents using the Minimum Data Set (MDS). Retrospective, clustered secondary data analysis. National Veterans Health Administration (VHA) long-term care nursing homes (N = 136). The study population consisted of 6577 national VHA nursing home residents who had an annual assessment during FY 2005, identified from the MDS, as well as an earlier annual or admission assessment within a 1-year look-back period. A dichotomous multivariate model of nursing home residents coded with a fall on selected fall risk characteristics from the MDS, estimated with general estimation equations (GEE). There were 17 170 assessments corresponding to 6577 long-term care nursing home residents. The increased odds ratio (OR) of being classified as a faller relative to the omitted "dependent" category of activities of daily living (ADL) ranged from OR = 1.35 for "limited" ADL category up to OR = 1.57 for "extensive-2" ADL (P canes, walkers, or crutches, or the use of wheelchairs increases the odds of being a faller (OR = 1.17, P falls in long-term care settings. The model incorporated an ADL index and adjusted for case mix by including only long-term care nursing home residents. The study offers clinicians practical estimates by combining multiple univariate MDS elements in an empirically based, multivariate fall risk assessment model.

  13. Effect of a medical food on body mass index and activities of daily living in patients with Alzheimer's disease: secondary analyses from a randomized, controlled trial.

    Science.gov (United States)

    Kamphuis, P J G H; Verhey, F R J; Olde Rikkert, M G M; Twisk, J W R; Swinkels, S H N; Scheltens, P

    2011-08-01

    To investigate the effect of a medical food (Souvenaid) on body mass index (BMI) and functional abilities in patients with mild Alzheimer's disease (AD). DESIGN/SETTING/PARTICIPANTS/INTERVENTION /MEASUREMENTS: These analyses were performed on data from a 12-week, double-blind, randomized, controlled, multicenter, proof-of-concept study with a similarly designed and exploratory 12-week extension period. Patients with mild AD (Mini-Mental State Examination score of 20-26) were randomized to receive either the active product or an iso-caloric control product. While primary outcomes included measures of cognition, the 23-item Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale was included as a secondary outcome. Both ADCS-ADL and BMI were assessed at baseline and Weeks 6, 12 and 24. Data were analyzed using a repeated-measures mixed model. Overall, data suggested an increased BMI in the active versus the control group at Week 24 (ITT: p = 0.07; PP: p = 0.03), but no treatment effect on ADCS-ADL was observed. However, baseline BMI was found to be a significant treatment effect modifier (ITT: p = 0.04; PP: p = 0.05), and an increase in ADCS-ADL was observed at Week 12 in patients with a 'low' baseline BMI (ITT: p = 0.02; PP: p = 0.04). These data indicate that baseline BMI significantly impacts the effect of Souvenaid on functional abilities. In addition, there was a suggestion that Souvenaid increased BMI.

  14. Reversal of diabetic peripheral neuropathy with phototherapy (MIRE) decreases falls and the fear of falling and improves activities of daily living in seniors.

    Science.gov (United States)

    Powell, Mark W; Carnegie, Dale H; Burke, Thomas J

    2006-01-01

    to determine whether restoration of sensation, impaired due to diabetic peripheral neuropathy (DPN), would reduce the number of falls and the fear of falling and improve activities of daily living (ADL) in a Medicare-aged population. retrospective cohort study of patients with documented, monochromatic near-infrared phototherapy (MIRE)-mediated, symptomatic reversal of DPN. responses to a health status questionnaire following symptomatic reversal of DPN. 252 patients (mean age 76 years) provided health information following symptomatic reversal of diabetic neuropathy (mean duration 8.6 months). incidence of falls and fear of falling decreased within 1 month after reversal of peripheral neuropathy and remained low after 1 year. Likewise, improved ADL were evident soon after reversal of peripheral neuropathy and showed further improvement after 1 year. Overall, reversal of peripheral neuropathy in a clinician's office and subsequent use of MIRE at home was associated with a 78% reduction in falls, a 79% decrease in balance-related fear of falling and a 72% increase in ADL (P < 0.0002 for all results). reversal of peripheral neuropathy is associated with an immediate reduction in the absolute number of falls, a reduced fear of falling and improved ADL. These results suggest that symptomatic reversal of diabetic neuropathy will have a substantial favourable, long-term socioeconomic impact on patients with DPN and the Medicare system, and improve the quality of life for elderly patients with diabetes and peripheral neuropathy.

  15. Functional recovery and surgical indication in putaminal hemorrhage

    International Nuclear Information System (INIS)

    Fujitsu, Kazuhiko

    1983-01-01

    Forty-one cases of varied sized putaminal hemorrhage were classified into 4 types according to the precise localization on CT (Fig. 1). All cases with large-sized hemorrhage (more than 4-5 cm in the actual diameter) were treated surgically regardless of their types in CT classification. ADL was assessed 6 months after the onset in all 41 cases, and in 17 of these Standard Language Test of Aphasia (SLTA) was also given 1 to 3 months after the dominant hemispheric hemorrhage. Type I hemorrhage usually showed excellent ADL independently of the size of the hemorrhage (Table 3). In type II hemorrhage, the ADL is determined by the extent of the lesion and tended to deteriorate as the size of the hemorrhage increased (Table 4). Type III hemorrhage resumed less favorable ADL than the type II did (Table 5), and there was scarcely any functional recovery in Type IV hemorrhage (Table 6). On SLTA, impairment of the speaking ability was the prominant feature when the hemorrhage was primarily located in the anterior portion of the insula, while the hearing ability was more markedly impaired in the posteriorly located lesion. These location-dependent specific patterns of impairment on SLTA are schematically presented in Fig. 12. From these results described above, the author's CT classification is considered to be very useful not only in forecasting the prospects of functional recovery, but in determining the surgical indication in putaminal hemorrhage. (author)

  16. Self-Reported Decline in Everyday Function, Cognitive Symptoms, and Cognitive Function in People With HIV.

    Science.gov (United States)

    Laverick, Rosanna; Haddow, Lewis; Daskalopoulou, Marina; Lampe, Fiona; Gilson, Richard; Speakman, Andrew; Antinori, Andrea; Bruun, Tina; Vassilenko, Anna; Collins, Simon; Rodger, Alison

    2017-11-01

    We determined factors associated with self-reported decline in activities of daily living (ADLs) and symptoms of cognitive impairment in HIV positive adults in 5 European clinics. HIV+ adults underwent computerized and pen-and-paper neuropsychological tests and questionnaires of cognitive symptoms and ADLs. We considered cognitive function in 5 domains, psychosocial factors, and clinical parameters as potentially associated with symptoms. Separate regression analyses were used to determine factors associated with a decline in ADL (defined as self-reported decline affecting ≥2 ADLs and attributed to cognitive difficulties) and self-reported frequency of symptoms of cognitive impairment. We also estimated the diagnostic accuracy of both questionnaires as tests for cognitive impairment. Four hundred forty-eight patients completed the assessments [mean age 45.8 years, 84% male, 87% white, median CD4 count 550 cells/mm, median time since HIV diagnosis 9.9 years, 81% virologically suppressed (HIV-1 plasma RNA symptoms of cognitive impairment were both associated with worse performance on some cognitive tests. There were also strong associations with financial difficulties, depressive and anxiety symptoms, unemployment, and longer time since HIV diagnosis. Both questionnaires performed poorly as diagnostic tests for cognitive impairment. Patients' own assessments of everyday function and symptoms were associated with objectively measured cognitive function. However, there were strong associations with other psychosocial issues including mood and anxiety disorders and socioeconomic hardship. This should be considered when assessing HIV-associated cognitive impairment in clinical care or research studies.

  17. Visual and Motor Recovery After "Cognitive Therapeutic Exercises" in Cortical Blindness: A Case Study.

    Science.gov (United States)

    De Patre, Daniele; Van de Winckel, Ann; Panté, Franca; Rizzello, Carla; Zernitz, Marina; Mansour, Mariam; Zordan, Lara; Zeffiro, Thomas A; OʼConnor, Erin E; Bisson, Teresa; Lupi, Andrea; Perfetti, Carlo

    2017-07-01

    Spontaneous visual recovery is rare after cortical blindness. While visual rehabilitation may improve performance, no visual therapy has been widely adopted, as clinical outcomes are variable and rarely translate into improvements in activities of daily living (ADLs). We explored the potential value of a novel rehabilitation approach "cognitive therapeutic exercises" for cortical blindness. The subject of this case study was 48-year-old woman with cortical blindness and tetraplegia after cardiac arrest. Prior to the intervention, she was dependent in ADLs and poorly distinguished shapes and colors after 19 months of standard visual and motor rehabilitation. Computed tomographic images soon after symptom onset demonstrated acute infarcts in both occipital cortices. The subject underwent 8 months of intensive rehabilitation with "cognitive therapeutic exercises" consisting of discrimination exercises correlating sensory and visual information. Visual fields increased; object recognition improved; it became possible to watch television; voluntary arm movements improved in accuracy and smoothness; walking improved; and ADL independence and self-reliance increased. Subtraction of neuroimaging acquired before and after rehabilitation showed that focal glucose metabolism increases bilaterally in the occipital poles. This study demonstrates feasibility of "cognitive therapeutic exercises" in an individual with cortical blindness, who experienced impressive visual and sensorimotor recovery, with marked ADL improvement, more than 2 years after ischemic cortical damage.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A173).

  18. Effectiveness of Three Therapeutic Modalities of Bobath, Conductive Education to Parents Regarding to Activity of Daily Living in Cerebral Palcied Children

    Directory of Open Access Journals (Sweden)

    Hamid Dalvand

    2008-04-01

    Full Text Available Objective: The goal of this study was to determine effectiveness of Bobath, conductive education (CE and education to parents on activity daily living (ADL in educable children with cerebral palsy, 3-5 years old. Materials & Methods: This research was a Quasi-experimental and interventional with pre - post study design that performed on 45 children with cerebral palsy from Valyasr rehabilitation foundation clinics. They were selected by simple sampling and matched from sex, age, IQ and disorder type and were assigned to three groups by simple randomize method (15 Bobath, 15 CE, 15 education to parents. Clinical tests were goodenough and client development evaluation report (CDER. The data were analyzed by statistical tests such as Wilcoxon signed, Kruskal-Wallis and Mann-whitney U. Results: Three groups had significant improved in activity of daily living (ADL after treatment (P<0/001. There was significant difference in total function of activity of daily living between three groups after treatment (P<0/001. The most effective approach was conductive education (CE, then education to parent and Bobath There were significant relations between function difference of three groups in 13 sub tasks of 17 ADL subtasks (P<0/05. Conclusion: Bobath, conductive education (CE and education to parent’s approaches improve skills of activity of daily living, but in CE approach, group educations causes better improvement in social communication and practical educations and programs increase improvement of ADL skills.

  19. Low Hemoglobin Concentrations Are Associated With Sarcopenia, Physical Performance, and Disability in Older Australian Men in Cross-sectional and Longitudinal Analysis: The Concord Health and Ageing in Men Project.

    Science.gov (United States)

    Hirani, Vasant; Naganathan, Vasi; Blyth, Fiona; Le Couteur, David G; Seibel, Markus J; Waite, Louise M; Handelsman, David J; Hsu, Ben; Cumming, Robert G

    2016-12-01

    The objective of this study is to examine associations between Hb levels and sarcopenia, low muscle strength, functional measures, and activities of daily living (ADL) and instrumental ADL (IADL) disabilities in older Australian men. Men aged 70 years and older (2005-2007) from the Concord Health and Ageing in Men Project were assessed at baseline (n = 1,705), 2 years (n = 1,367), and 5 years (n = 958). The main outcome measurements were walking speed, muscle strength, ADL and IADL disabilities, and sarcopenia using the Foundation for the National Institutes of Health criteria (low appendicular lean mass adjusted for body mass index speed, poor grip strength, inability to perform chair stands, and ADL and IADL disabilities in unadjusted, age-adjusted, and multivariate-adjusted analysis. The highest value of the Youden Index for Hb was 14.2g/dL for sarcopenia and grip strength, 14.5g/dL for walking speed, and 14.4g/dL for all other outcomes. Declines in Hb levels over time are associated with poor functional outcomes. The risks and benefits of interventions to increase Hb among older men warrant further investigation to differentiate whether this is an active contributor to age-related debility or a passive biomarker of it. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Assessments of functional status, comorbidities, polypharmacy, nutritional status and sarcopenia in Turkish community-dwelling male elderly.

    Science.gov (United States)

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

    2013-06-01

    Functionality, comorbidities, polypharmacy, nutritional status and sarcopenia affect the prognosis of elderly excessively. These parameters are influenced by the population, living settings and age. We aimed to study these parameters in Turkish community-dwelling male elderly. We studied 274 male elderly ≥60 years of age admitted to our Geriatrics outpatient clinics. Mean age was 74.4 ± 7.1 years; 47.4% of the subjects were ≥75 years, 24.1% were ≥80 years. Mean activities-of-daily-living (ADL) and instrumental ADL (IADL) scores were 9.4 and 11.1, respectively. Patients with at least one-dependence at ADL-IADL were 22.6%-47.2%, and more than half-dependence at ADL-IADL were 2.8%-17.9%, respectively. Mean number of comorbidities were 2.6. Most common diagnosis was hypertension with 65%; mean number of drugs were 4.5; 55.3% were using ≥4 chronic drugs. Prevalences of malnutrition were 3.7%-6.9%, malnutrition risk were 23.5%-26.7% by the mini nutritional assessment test-long form and short form, respectively. Calf circumference was measured elderly may have greater prevalences of functional dependence, sarcopenia but lower rates of malnutrition and similar rates of polypharmacy compared with the western developing countries and developed countries. This study emphasized the geographical differences in and/or between the individual countries highlighting the need for studies both country- and world-wide.

  1. SIMADL: Simulated Activities of Daily Living Dataset

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    Talal Alshammari

    2018-04-01

    Full Text Available With the realisation of the Internet of Things (IoT paradigm, the analysis of the Activities of Daily Living (ADLs, in a smart home environment, is becoming an active research domain. The existence of representative datasets is a key requirement to advance the research in smart home design. Such datasets are an integral part of the visualisation of new smart home concepts as well as the validation and evaluation of emerging machine learning models. Machine learning techniques that can learn ADLs from sensor readings are used to classify, predict and detect anomalous patterns. Such techniques require data that represent relevant smart home scenarios, for training, testing and validation. However, the development of such machine learning techniques is limited by the lack of real smart home datasets, due to the excessive cost of building real smart homes. This paper provides two datasets for classification and anomaly detection. The datasets are generated using OpenSHS, (Open Smart Home Simulator, which is a simulation software for dataset generation. OpenSHS records the daily activities of a participant within a virtual environment. Seven participants simulated their ADLs for different contexts, e.g., weekdays, weekends, mornings and evenings. Eighty-four files in total were generated, representing approximately 63 days worth of activities. Forty-two files of classification of ADLs were simulated in the classification dataset and the other forty-two files are for anomaly detection problems in which anomalous patterns were simulated and injected into the anomaly detection dataset.

  2. Fractures as an independent predictor of functional decline in older people: a population-based study with an 8-year follow-up.

    Science.gov (United States)

    Piirtola, Maarit; Löppönen, Minna; Vahlberg, Tero; Isoaho, Raimo; Kivelä, Sirkka-Liisa; Räihä, Ismo

    2012-01-01

    Fractures among older people are common, but there is scant evidence about the impact of fractures on functional decline in an unselected older population. The objective of this study was to analyze the impact of lower and upper body fractures on functional performance among older adults during an 8-year follow-up. A population-based cohort of 616 Finnish persons aged 65 and over was followed for up to 8 years, and the association between fractures and the risk of short-term (0-2 years) and long-term (up to 8 years) functional decline was analyzed. Fractures were categorized according their functional influence on mobility and activities of daily living (ADL) into lower and upper body fractures. Multivariate cumulative logistic regression model was used in the analyses. During the 8-year follow-up, 112 (18%) persons sustained at least one fracture. In the multivariate analyses, lower body fractures predicted both short-term and long-term decline in mobility [cumulative odds ratio (COR) 4.7, 95% confidence interval (95% CI) 1.9-11.7 and COR 2.6, 95% CI 1.1-6.2, respectively] and in ADL performance (COR 3.1, 95% CI 1.3-7.6 and COR 4.7, 95% CI 2.0-11.4, respectively). Upper body fractures predicted decline in ADL performance during the long-term follow-up (COR 2.5, 95% CI 1.3-4.8). Pre-fracture functional decline and inactivity in leisure time physical exercise were independently associated with the risk of decline in extensive activities. Fractures have an independent influence on the development of functional decline in older persons regardless of the pre-fracture health. Prevention of falls and fractures and improvement of treatment, rehabilitation and follow-up process after fractures are needed. Copyright © 2011 S. Karger AG, Basel.

  3. Automated JPSS VIIRS GEO code change testing by using Chain Run Scripts

    Science.gov (United States)

    Chen, W.; Wang, W.; Zhao, Q.; Das, B.; Mikles, V. J.; Sprietzer, K.; Tsidulko, M.; Zhao, Y.; Dharmawardane, V.; Wolf, W.

    2015-12-01

    The Joint Polar Satellite System (JPSS) is the next generation polar-orbiting operational environmental satellite system. The first satellite in the JPSS series of satellites, J-1, is scheduled to launch in early 2017. J1 will carry similar versions of the instruments that are on board of Suomi National Polar-Orbiting Partnership (S-NPP) satellite which was launched on October 28, 2011. The center for Satellite Applications and Research Algorithm Integration Team (STAR AIT) uses the Algorithm Development Library (ADL) to run S-NPP and pre-J1 algorithms in a development and test mode. The ADL is an offline test system developed by Raytheon to mimic the operational system while enabling a development environment for plug and play algorithms. The Perl Chain Run Scripts have been developed by STAR AIT to automate the staging and processing of multiple JPSS Sensor Data Record (SDR) and Environmental Data Record (EDR) products. JPSS J1 VIIRS Day Night Band (DNB) has anomalous non-linear response at high scan angles based on prelaunch testing. The flight project has proposed multiple mitigation options through onboard aggregation, and the Option 21 has been suggested by the VIIRS SDR team as the baseline aggregation mode. VIIRS GEOlocation (GEO) code analysis results show that J1 DNB GEO product cannot be generated correctly without the software update. The modified code will support both Op21, Op21/26 and is backward compatible with SNPP. J1 GEO code change version 0 delivery package is under development for the current change request. In this presentation, we will discuss how to use the Chain Run Script to verify the code change and Lookup Tables (LUTs) update in ADL Block2.

  4. Changes for the new AMA Guides to impairment ratings, 6th Edition: implications and applications for physician disability evaluations.

    Science.gov (United States)

    Rondinelli, Robert D

    2009-07-01

    U.S. Disability Systems share a common procedural approach to the determination of disability for purposes of compensation. The structural and anatomical consequences of the injury or disease are defined and measured according to medical impairment, which is used to estimate the individual's loss in terms of their capacity to perform activities of daily living (ADLs) and, presumptively, their losses in terms of vocational and non-vocational pursuits and quality of life. The physician is traditionally empowered to rate the severity of impairment in terms of a percentage loss to the "whole person" and according to criteria specific to each disability system. Often, the impairment percentage so derived, then is directly translated into a monetary sum for purposes of compensating these losses. The AMA periodically publishes and updates a physician impairment rating guide (the AMA Guides). The 6th Edition, published in 2008, incorporates the definitions and terminology of the ICF and provides a simple means of assessment of ADLs as part of the rating process. It also has shifted the ratings criteria towards a diagnosis-based approach, ostensibly to improve inter-rater consistency and reliability. Further work is needed to refine and validate ADL-based functional assessment tools applicable to medical impairment ratings, and to demonstrate the levels of consistency and reliability of the new rating method. Of equal importance, operational standardization across systems is also needed to enable common criteria and metrics to be developed and applied when determining the non-medical aspects of disability according to vocational and non-vocational pursuits and quality of life. Impairment ratings cannot be optimally designed to serve as the singular determinant of, nor be held solely accountable for, the disability awards.

  5. Nutritive value of citrus co-products in rabbit feeding

    Directory of Open Access Journals (Sweden)

    J. Carlos de Blas

    2018-03-01

    Full Text Available Pulps from different citrus fruits are relevant agro-industrial co-products in the Mediterranean area in terms of amounts produced and availability. Moreover, part of the product is dehydrated, which increases its interest in monogastric species such as rabbits. Seventy eight samples from various Spanish producers using several types of fresh fruits (orange, tangerine, lemon and pomelo and different processing methods of orange and tangerine samples (either fresh or dried after adding Ca(OH2 were analysed for their chemical composition and in vitro digestibility. Average dry matter (DM contents of ash, neutral detergent fibre, acid detergent fibre, acid detergent lignin (ADL, soluble fibre, crude protein (CP, insoluble neutral and acid detergent CP, ether extract and gross energy were 49.0, 226, 139, 12.1, 213, 71.2, 13.1, 4.2, 30.5 g and 17.8 MJ/kg DM, respectively. Mean DM and CP in vitro digestibility were 86.7 and 95.6%, respectively. Digestible energy was estimated to be 15.1 MJ/kg DM. A high variability (coefficient of variation from 17% for CP to 60% for ADL was observed among the samples for most of the traits studied, which was partially explained by the effects of type of fruit and processing. Lemon pulps had on average higher ash and fibre but lower sugar contents than the other pulps. Dehydration processes increased ash content (almost double than for fresh pulp due to lime addition. As regards the current results, citrus pulp has potential for use in rabbit diets as a source of energy and soluble fibre.

  6. DEVELOPMENT OF WEARABLE HUMAN FALL DETECTION SYSTEM USING MULTILAYER PERCEPTRON NEURAL NETWORK

    Directory of Open Access Journals (Sweden)

    Hamideh Kerdegari

    2013-02-01

    Full Text Available This paper presents an accurate wearable fall detection system which can identify the occurrence of falls among elderly population. A waist worn tri-axial accelerometer was used to capture the movement signals of human body. A set of laboratory-based falls and activities of daily living (ADL were performed by volunteers with different physical characteristics. The collected acceleration patterns were classified precisely to fall and ADL using multilayer perceptron (MLP neural network. This work was resulted to a high accuracy wearable fall-detection system with the accuracy of 91.6%.

  7. [Application of spaced retrieval training on patients with dementia].

    Science.gov (United States)

    Wu, Hua-Shan; Lin, Li-Chan

    2012-10-01

    Dementia causes semantic and episodic memory impairments that limit patients' activities of daily living (ADL) and increase caregiver burden. Spaced retrieval training uses repetitive retrieval to strengthen cognitive and motor skills intuitively in mild / moderate dementia patients who retain preserved implicit / non-declarative memory. This article describes and discusses the operative mechanism, influencing variables, and practical applications of spaced retrieval training. We hope this article increases professional understanding and application of this training approach to improve dementia patient ADL and improve quality of life for both caregivers and patients.

  8. Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia.

    Science.gov (United States)

    Toots, Annika; Littbrand, Håkan; Lindelöf, Nina; Wiklund, Robert; Holmberg, Henrik; Nordström, Peter; Lundin-Olsson, Lillemor; Gustafson, Yngve; Rosendahl, Erik

    2016-01-01

    To investigate the effects of a high-intensity functional exercise program on independence in activities of daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. Residential care facilities, Umeå, Sweden. Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N=186). Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=-1.6-4.3; BI=0.6, 95% CI=-0.2-1.4) or 7 (FIM=0.8, 95% CI=-2.2-3.8; BI=0.6, 95% CI=-0.3-1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8-6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

  9. Psychometric Evaluation of the Lower Extremity Computerized Adaptive Test, the Modified Harris Hip Score, and the Hip Outcome Score.

    Science.gov (United States)

    Hung, Man; Hon, Shirley D; Cheng, Christine; Franklin, Jeremy D; Aoki, Stephen K; Anderson, Mike B; Kapron, Ashley L; Peters, Christopher L; Pelt, Christopher E

    2014-12-01

    The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood. To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision. Cohort study (diagnosis); Level of evidence, 2. Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index. All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good. The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior in all psychometric aspects examined in this study. Future

  10. Effect of fiber source on cell wall digestibility and rate of passage in rabbits.

    Science.gov (United States)

    García, J; Carabaño, R; de Blas, J C

    1999-04-01

    The influence of fiber source on fiber digestion and mean retention time was investigated. Six fibrous feedstuffs with wide differences in chemical composition and particle size were selected: paprika meal, olive leaves, alfalfa hay, soybean hulls, sodium hydroxide-treated barley straw, and sunflower hulls. Six diets were formulated to contain one of these ingredients as the sole source of fiber. To avoid nutrient imbalances, fiber sources were supplemented with different proportions of a concentrate free of fiber based on soy protein isolate, wheat flour, lard, and a vitamin and mineral mix to obtain diets containing at least 18.5% CP and 5% starch. Fecal apparent digestibility of nonstarch polysaccharides (NSPd) and its monomers, NDF, NDF-ADL, and ADF-ADL, were determined using four New Zealand White x California growing rabbits per diet. Total, ileorectal, and cecal mean retention times (tMRT, i-rMRT, and cMRT, respectively) were determined for diets based on paprika meal, olive leaves, soybean hulls, and sunflower hulls in 16 does (four per diet) fitted with T-cannulas at the terminal ileum. In both trials, DMI was negatively correlated with the proportion of fine particles (FP: 1.25 mm) (P lignification of NDF, considering lignin as the difference between ADL and acid detergent cutin, was only included as the third variable for the model of NDF digestibility. Digestibility of NSP was positively correlated with those of NDF, NDF-ADL, and ADF-ADL (r = .82, .87 and .85, respectively, P < .001); the latter was also highly correlated with the digestibility of the glucose included in the NSP fraction (r = .86; P < .001). Cecal mean retention time accounted for 63% of average tMRT, for most of the variability in tMRT (r = .99; P < .001), and was positively related to NSPd (r = .89; P < .001). From these results, we conclude that particle size is a major factor affecting fiber digestion efficiency, rate of passage, and feed intake in rabbits.

  11. Associations and impact factors between living arrangements and functional disability among older Chinese adults.

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    Hui Wang

    Full Text Available OBJECTIVES: To examine the association of living arrangements with functional disability among older persons and explore the mediation of impact factors on the relationship. DESIGN: Cross-sectional analysis using data from Healthy Aging study in Zhejiang Province. PARTICIPANTS: Analyzed sample was drawn from a representative rural population of older persons in Wuyi County, Zhejiang Province, including 1542 participants aged 60 and over in the second wave of the study. MEASUREMENTS: Living arrangements, background, functional disability, self-rated health, number of diseases, along with contemporaneous circumstances including income, social support (physical assistance and emotional support. Instrument was Activities of Daily Living (ADL scale, including Basic Activities Daily Living (BADL and Instrumental Activities of Daily Living (IADL. RESULTS: Living arrangements were significantly associated with BADL, IADL and ADL disability. Married persons living with or without children were more advantaged on all three dimensions of functional disability. Unmarried older adults living with children only had the worst functional status, even after controlling for background, social support, income and health status variables (compared with the unmarried living alone, ß for BADL: -1.262, ß for IADL: -2.112, ß for ADL: -3.388; compared with the married living with children only, ß for BADL: -1.166, ß for IADL: -2.723, ß for ADL: -3.902. In addition, older adults without difficulty in receiving emotional support, in excellent health and with advanced age had significantly better BADL, IADL and ADL function. However, a statistically significant association between physical assistance and functional disability was not found. CONCLUSION: Functional disabilities vary by living arrangements with different patterns and other factors. Our results highlight the association of unmarried elders living with children only and functioning decline comparing with

  12. Are the effects of a non-drug multimodal activation therapy of dementia sustainable? Follow-up study 10 months after completion of a randomised controlled trial

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    Luttenberger Katharina

    2012-12-01

    Full Text Available Abstract Background Little is known about the long-term success of non-drug therapies for treating dementia, especially whether the effects are sustained after therapy ends. Here, we examined the effects of a one-year multimodal therapy 10 months after patients completed the therapy. Methods This randomised, controlled, single-blind, longitudinal trial involved 61 patients (catamnesis: n = 52 with primary degenerative dementia in five nursing homes in Bavaria, Germany. The highly standardised intervention, MAKS, consisted of motor stimulation, practice of activities of daily living (ADLs, and cognitive stimulation. Each group of 10 patients was treated for 2 h, 6 days a week for 12 months. Control patients received standard nursing home care. At baseline, at the end of therapy (month 12, and 10 months thereafter (month 22, cognitive functioning was assessed using the cognitive subscale of the Alzheimer’s Disease Assessment Scale, and the ability to perform ADLs was assessed using the Erlangen Test of Activities of Daily Living. Results During the therapy phase, the MAKS patients maintained their cognitive function and ability to carry out ADLs. After the end of therapy, both the control and the MAKS groups deteriorated in both their cognitive function (control, p = 0.02; MAKS, p 0: βMAKS + βMAKS month 22 = 0; χ2 = 3.8568, p = 0.0496. Cohen’s d for the difference between the two groups in ADLs and cognitive abilities 10 months after the end of therapy was 0.40 and 0.22, respectively. Conclusions A multimodal non-drug therapy of dementia resulted in stabilisation of the ability to perform ADLs, even beyond the end of therapy. To prevent functional decline for as long as possible, therapy should be performed continuously until the benefit for the patient ends. Follow-up studies on larger numbers of patients are needed to definitively confirm these results. Trial registration http://www.isrctn.com Identifier: ISRCTN

  13. Faruk Nafiz Çamlıbel’in Suda Halkalar Adlı Eserinde Su İmajları ve Benzetmeler Water Images and Metaphors in Suda Halkalar Which Faruk Nafiz Çamlıbel’s Work

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    Hüseyin DOĞRAMACIOĞLU

    2012-09-01

    Full Text Available Suda Halkalar (Circles in Water which the poetry book of Faruk Nafiz Çamlıbel, has not been translated into the Latin alphabet to the present day. The images of the water and metaphors which used in this work brought new connotations and approaches to the Turkish poetry. The images of the water in the poetry book are used instead of the poet's soul and dreams sometimes. These images are thought with poet’s darling and sometimes are used as a background. The poetformed the images of the water in his poem sadly. There are the poetand his darling in these tables. The images of the water and thedreams of the poet form the background of the poem. The backgroundsin this poem are repeated as a leitmotiv. Visuality and individualitybecomes important feature in these tables created by the poet. Themetaphors in the work created differently from classical Turkish poetry.These metaphors brought a new meaning to the poem. The poem basedon the intellectual grounds via metaphors. This can be considered asone of the significant achievements of Turkish poetry. We can see thatthe past remembered and desired both in poetry and metaphors bypessimistic feeling. In this respect the past affects the poet's dreamscombining with a sense of mourning, water images and metaphors inpoetry. The metaphors can be grouped as imaginary, visual andstrongly poetic ground. The feelings of pessimism and sadness arepredominant in these metaphors. The images and metaphors used bythe poet can be considered as an improvement for Turkish poetry. It isthe first research done on Suda Halkalar (Circles in Water will help tobetter understand and identify Çamlıbel’s aspect of poetry and literaryline. Faruk Nafiz Çamlıbel’in Suda Halkalar adlı şiir kitabı günümüze kadar Latin harflerine aktarılmamıştır. Bu eserde kullanılan su imajları ve benzetmeler Türk şiirine yeni yaklaşımlar ve çağrışımlar getirmiştir. Eserdeki su imajları bazen şairin ruhu ve hayalleri

  14. Non-pharmacological interventions for perceptual disorders following stroke and other adult-acquired, non-progressive brain injury.

    Science.gov (United States)

    Bowen, Audrey; Knapp, Peter; Gillespie, David; Nicolson, Donald J; Vail, Andy

    2011-04-13

    Stroke and other adult-acquired brain injury may impair perception leading to distress and increased dependence on others. Perceptual rehabilitation includes functional training, sensory stimulation, strategy training and task repetition. To examine the evidence for improvement in activities of daily living (ADL) six months post randomisation for active intervention versus placebo or no treatment. We searched the trials registers of the Cochrane Stroke Group and the Cochrane Infectious Diseases Group (May 2009) but not the Injuries Group, the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to August 2009), EMBASE (1980 to August 2009), CINAHL (1982 to August 2009), PsycINFO (1974 to August 2009), REHABDATA and PsycBITE (May to June 2009). We also searched trials and research registers, handsearched journals, searched reference lists and contacted authors. Randomised controlled trials of adult stroke or acquired brain injury. Our definition of perception excluded visual field deficits, neglect/inattention and apraxia. One review author assessed titles, abstracts and keywords for eligibility. At least two review authors independently extracted data. We requested unclear or missing information from corresponding authors. We included six single-site trials in rehabilitation settings, involving 338 participants. Four trials included people with only stroke. All studies provided sensory stimulation, sometimes with another intervention. Sensory stimulation typically involved practising tasks that required visuo-perceptual processing with occupational therapist assistance. Repetition was never used and only one study included functional training. No trials provided data on longer term improvement in ADL scores. Only three trials provided any data suitable for analysis. Two of these trials compared active to placebo intervention. There was no evidence of a difference in ADL scores at the scheduled end of intervention: mean

  15. Predictive factors associated with death of elderly in nursing homes.

    Science.gov (United States)

    Sung, Kiwol

    2014-06-01

    An increasing elderly population reflects a great need for readily accessible, clinically useful methods to identify mortality-related factors in nursing home residents. The purpose of this study was to identify factors associated with the deaths of nursing home residents. Data was collected from a Minimal Data Set of 195 elderly nursing home residents, followed by analysis of demographic factors, disease and nursing condition factors, Activities of Daily Living (ADL), cognitive function, behavioral patterns, and dysfunctional status. Major factors associated with death among nursing home residents were identified as dyspnea (odds ratio [OR] = 4.88), problematic behaviors (OR = 3.95), and ADL (OR = 3.61). These variables accounted for 31.1% of the variance in death. Dyspnea, problematic behaviors, and ADL data were identified as the key factors associated with death among nursing home residents. Future plans for the prediction of death among nursing home residents can be made by nursing staff, factoring in these identified variables, to ensure more comfortable conditions and more responsive care. Copyright © 2014. Published by Elsevier B.V.

  16. Impact of Balance Confidence on Daily Living Activities of Older People with Knee Osteoarthritis with Regard to Balance, Physical Function, Pain, and Quality of Life - A Preliminary Report.

    Science.gov (United States)

    Bobić Lucić, Lana; Grazio, Simeon

    2018-01-01

    The objective of this study was to explore the impact of balance confidence on different activities of daily living (ADL) in older people with knee osteoarthritis (OA). Forty-seven consecutive participants with knee OA were included in this cross-sectional study. They were divided according to the results of the Activities-specific Balance Confidence (ABC) Scale into a group with a low level of confidence in physical functioning (ABC balance measurements. Older people with knee OA who were less confident in their daily physical activities had more physical difficulties and a greater effect of pain on ADL, lower quality of life, and a higher physician's global assessment, but no differences were obtained in balance tests. In people with knee OA, decreased balance confidence is associated with more physical difficulties, an increased effect of pain on ADL, and lower quality of life. An improved awareness of decreased balance confidence may lead to more effective management of older people with knee OA by improving their mobility and QOL through rehabilitation. Furthermore, future research in that direction is warranted.

  17. The evaluation of daily living activities, pressure sores and risk factors.

    Science.gov (United States)

    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 pressure sores (p 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.

  18. The effects of rehabilitation on intellectually-disabled people – a systematic review

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    Ernest J. Sechoaro

    2014-08-01

    Objective: To synthesise critically and summarise the best available evidence of the effects of rehabilitation on intellectually-disabled people. Method: Literature searches of different electronic databases and manual searches were conducted using selected keywords. Studies on the effects of rehabilitation on intellectually-disabled people were selected systematically, appraised critically for methodological quality and summarised. Results: Rehabilitation interventions indicated good outcomes with regard to intellectually-disabled people. Findings showed that people with mild to moderate intellectual disabilities improved in terms of activities of daily living (ADL after rehabilitation. Improvement was noted in ADL, self-care skills, communication skills and cognitive achievements. Conclusion: Findings demonstrated positive rehabilitation effects on intellectually-disabled people. This study contributes to the comprehensive nursing care of intellectually-disabled people by endorsement of the effectiveness of rehabilitation in terms of ADL, self-care skills, communication skills and cognitive achievements. The collected evidence of this study may contribute to the education of more effective nurse practitioners involved in the daily care and rehabilitation of intellectually-disabled people.

  19. Acid detergent lignin, lodging resistance index, and expression of the caffeic acid O-methyltransferase gene in brown midrib-12 sudangrass.

    Science.gov (United States)

    Li, Yuan; Liu, Guibo; Li, Jun; You, Yongliang; Zhao, Haiming; Liang, Huan; Mao, Peisheng

    2015-09-01

    Understanding the relationship between acid detergent lignin (ADL) and lodging resistance index (LRI) is essential for breeding new varieties of brown midrib (bmr) sudangrass (Sorghum sudanense (Piper) Stapf.). In this study, bmr-12 near isogenic lines and their wild-types obtained by back cross breeding were used to compare relevant forage yield and quality traits, and to analyze expression of the caffeic acid O-methyltransferase (COMT) gene using quantitative real time-PCR. The research showed that the mean ADL content of bmr-12 mutants (20.94 g kg(-1)) was significantly (P bmr-12 mutants (0.29) was significantly (P bmr-12 materials (r = -0.44, P > 0.05). Sequence comparison of the COMT gene revealed two point mutations present in bmr-12 but not in the wild-type, the second mutation changed amino acid 129 of the protein from Gln (CAG) to a stop codon (UAG). The relative expression level of COMT gene was significantly reduced, which likely led to the decreased ADL content observed in the bmr-12 mutant.

  20. Garment-based detection of falls and activities of daily living using 3-axis MEMS accelerometer

    International Nuclear Information System (INIS)

    Nyan, M N; Tay, Francis E H; Manimaran, M; Seah, K H W

    2006-01-01

    This paper studied the detection of falls and activities of daily living (ADL) with two objectives: (1) minimum number of sensors for a broad range of activities and (2) maximize the comfort of the wearer for long term use. We used a garment to provide long term comfort for the wearer, with a 3-axis MEMS accelerometer on the shoulder position, as a wearable platform. ADL were detected in time-frequency domain and summation of absolute peak values of 3-D acceleration signals was used as feature in fall detection. 6 male and female subjects performed approximately five-hour long experiment. Sensitivity of 94.98% and specificity of 98.83% for altogether 1495 activities were achieved. Our garment-based detection system fulfilled the objective of providing the comfort of the wearer in long term monitoring of falls and ADL with high sensitivity. In fall detection, our device can summon medical assistances via SMS (Short Message Service). This detection system can raise fall alarm (fall SMS) automatically to individuals to get a shortened interval of the arrival of assistance

  1. Cognitive and functional assessment about elderly people users of health public service

    Directory of Open Access Journals (Sweden)

    Beatriz Rodrigues de Souza Melo

    2017-08-01

    Full Text Available Abstract Objective: To evaluate the functional capacity, cognition and mood in three different care models for older adults. Method: A cross-sectional study conducted in 2014 with 140 older adults (37 institutionalized, 53 hospitalized and 50 outpatients. The MMSE, Clock Drawing Test (CDT, Activities of Daily Living Scale - ADLs (Katz, Lawton and the Geriatric Depression Scale (GDS were applied. Results: Of those institutionalized, the majority were totally dependent for ADLs and 100% presented cognitive decline. Of those hospitalized and the outpatients, the majority were independent for ADLs, with 62.3% and 48.0% presenting cognitive decline, respectively. The minority presented depressive symptoms. The results indicated that age was a predictor of cognitive decline and the likelihood of prevalence in hospitalized and outpatient older adults increased by 8.7% for each year of life. Conclusion: It is important to pay attention to the cognitive and functional performance of older adults with the aim of preventing their decline, which is so frequent in the public health services in Brazil.

  2. Efficacy and safety of nimodipine in treatment of vascular dementia: a systematic review

    Directory of Open Access Journals (Sweden)

    Tao CHEN

    2015-07-01

    Full Text Available Objective To systematically evaluate the clinical efficacy and safety of nimodipine in treating vascular dementia (VaD.  Methods Taking "nimodipine AND vascular dementia" as search terms, retrieve in databases such as PubMed, Cochrane Library, EMBASE/SCOPUS, Science Citation Index (SCI, China National Knowledge Infrastructure (CNKI, VIP and Wanfang Data (January 1995-March 2015. Annual searching was applied to retrieve partial periodical literatures and unpublished studies. Google Scholar was used for randomized controlled trials (RCTs about nimodipine in treating VaD. Jadad scale was used to evaluate the quality of literature, and Meta-analyses were performed by using RevMan 5.3 software.  Results Eleven literatures met inclusion criteria, including 10 clinical studies (1333 patients. All 10 studies were RCTs, including 4 nimodipine vs placebo, 5 nimodipine vs donepezil and one nimodipne vs hydergine, but only 2 described randomization methods. The results of Meta-analysis showed: nimodipine had better Mini-Mental State Examination (MMSE score than before treatment and placebo group (3 studies, MD = 0.270, 95%CI: 0.070—0.460, P = 0.007; one study of blank control, MD = 2.950, 95% CI: 1.670—4.200, P = 0.000. Patients treated with nimodipne had no significantly improved Activities of Daily Living (ADL score than placebo group [one study of ADL, MD = 5.800, 95%CI: 2.480—9.120, P = 0.000; one study of ADL Index, MD = -0.040, 95%CI: -0.110—0.030, P = 0.230; one study of instrumental ADL (IADL, MD = -0.080, 95%CI: -0.110—0.000, P = 0.060]. Both nimodipine and donepezil can improve MMSE and ADL scores, but the efficacy of nimodipine was not superior to donepezil [4 studies of MMSE (12-week observation, MD = -4.400, 95% CI: -4.870— -3.920, P = 0.000; one study of MMSE (24-week observation, MD = -8.800, 95% CI: -8.970— -7.430, P = 0.000; 2 studies of ADL, MD = 1.800, 95% CI: 1.360—2.230, P = 0.000]. Compared with hydergine

  3. The mobility gap between older men and women: the embodiment of gender.

    Science.gov (United States)

    Zunzunegui, M V; Alvarado, B E; Guerra, R; Gómez, J F; Ylli, A; Guralnik, J M

    2015-01-01

    To present the study design and baseline results of the longitudinal International Mobility in Aging Study (IMIAS) on gender differences in physical performance and mobility disability prevalence in five diverse societies. Data are from surveys on random samples of people aged 65-74 years at Canadian (Kingston, Ontario; Saint-Hyacinthe, Quebec), Mediterranean (Tirana, Albania) and Latin American sites (Natal, Brazil; Manizales, Colombia) (N=1995). Mobility disability was defined as reporting difficulty in walking 400m or climbing stairs. Activities of daily living (ADL) disability was based on any self-reported difficulty in five mobility-related ADLs. The short physical performance battery (SPPB) was used to assess physical performance. Poisson regression models were fitted to estimate prevalence ratios. Age-adjusted prevalence of low SPPB, mobility disability and ADL disability were higher in women than in men in all sites except for Kingston. After adjustment for education and income, gender differences in SPPB and ADL disability attenuated or disappeared in Saint-Hyacinthe and Manizales but remained large in Tirana and Natal and mobility disability remained more frequent in women than in men at all sites except Kingston. After further adjustment by chronic conditions and depressive symptoms, gender differences in mobility remained large at all sites except Kingston but only in Tirana did women have significantly poorer physical performance than men. Results provide evidence for gender as a risk factor to explain poorer physical function in women and suggest that moving toward gender equality could attenuate the gender gap in physical function in old age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Transcranial direct current stimulation (tDCS) for improving capacity in activities and arm function after stroke: a network meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Elsner, Bernhard; Kwakkel, Gert; Kugler, Joachim; Mehrholz, Jan

    2017-09-13

    Transcranial Direct Current Stimulation (tDCS) is an emerging approach for improving capacity in activities of daily living (ADL) and upper limb function after stroke. However, it remains unclear what type of tDCS stimulation is most effective. Our aim was to give an overview of the evidence network regarding the efficacy and safety of tDCS and to estimate the effectiveness of the different stimulation types. We performed a systematic review of randomised trials using network meta-analysis (NMA), searching the following databases until 5 July 2016: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, Web of Science, and four other databases. We included studies with adult people with stroke. We compared any kind of active tDCS (anodal, cathodal, or dual, that is applying anodal and cathodal tDCS concurrently) regarding improvement of our primary outcome of ADL capacity, versus control, after stroke. CRD42016042055. We included 26 studies with 754 participants. Our NMA showed evidence of an effect of cathodal tDCS in improving our primary outcome, that of ADL capacity (standardized mean difference, SMD = 0.42; 95% CI 0.14 to 0.70). tDCS did not improve our secondary outcome, that of arm function, measured by the Fugl-Meyer upper extremity assessment (FM-UE). There was no difference in safety between tDCS and its control interventions, measured by the number of dropouts and adverse events. Comparing different forms of tDCS shows that cathodal tDCS is the most promising treatment option to improve ADL capacity in people with stroke.

  5. Physical Exercise with Music Maintains Activities of Daily Living in Patients with Dementia: Mihama-Kiho Project Part 21.

    Science.gov (United States)

    Satoh, Masayuki; Ogawa, Jun-Ichi; Tokita, Tomoko; Nakaguchi, Noriko; Nakao, Koji; Kida, Hirotaka; Tomimoto, Hidekazu

    2017-01-01

    Recent studies suggest that combined non-pharmacological interventions are more beneficial than single interventions for primary and secondary prevention of dementia. We previously reported enhanced effects of physical exercise with music (ExM) on cognitive function in normal elderly people compared to exercise alone. To identify if ExM improves cognitive function and activities of daily livings (ADLs) in dementia patients over cognitive stimulation (CS). We enrolled 85 patients with mild to moderate dementia. Forty-three subjects performed ExM developed by the Yamaha Music Foundation, and 42 subjects performed cognitive stimulation using portable game consoles and drills involving easy calculations, mazes, and mistake-searching in pictures. Interventions were performed once a week for 40 minutes. Before and after the six-month intervention, patients were assessed using neuropsychological batteries, and ADLs were assessed by patients' caregivers using the functional independence measure (FIM). Voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used to assess medial temporal lobe atrophy. Twenty-three subjects dropped out during the intervention. Thirty-one patients from each group were analyzed. Post-intervention, both groups showed significantly improved visuospatial function. Significant benefits were observed in psychomotor speed or memory in the ExM or CS groups, respectively. FIM scores, reflecting ADLs, and VSRAD scores were significantly preserved in the ExM group, but significantly worsened in the CS group. ExM produced greater positive effects on cognitive function and ADLs in patients with mild to moderate dementia than CS, excluding memory. Optimal interventions for dementia will likely be achieved by combining ExMand CS.

  6. Functional status and all-cause mortality in serious mental illness.

    Directory of Open Access Journals (Sweden)

    Richard D Hayes

    Full Text Available Serious mental illness can affect many aspects of an individual's ability to function in daily life. The aim of this investigation was to determine if the environmental and functional status of people with serious mental illness contribute to the high mortality risk observed in this patient group.We identified cases of schizophrenia, schizoaffective and bipolar disorder aged ≥ 15 years in a large secondary mental healthcare case register linked to national mortality tracing. We modelled the effect of activities of daily living (ADLs, living conditions, occupational and recreational activities and relationship factors (Health of the Nation Outcome Scale [HoNOS] subscales on all-cause mortality over a 4-year observation period (2007-10 using Cox regression.We identified 6,880 SMI cases (242 deaths in the observation period. ADL impairment was associated with an increased risk of all-cause mortality (adjusted HR 1.9; 95% CI 1.3-2.8; p = 0.001, p for trend across ADL categories = 0.001 after controlling for a broad range of covariates (including demographic factors, physical health, mental health symptoms and behaviours, socio-economic status and mental health service contact. No associations were found for the other three exposures. Stratification by age indicated that ADLs were most strongly associated with mortality in the youngest (15 to <35 years and oldest (≥ 55 years groups.Functional impairment in people with serious mental illness diagnoses is a marker of increased mortality risk, possibly in younger age groups as a marker of negative symptomatology.

  7. Cardiac structure and function predicts functional decline in the oldest old.

    Science.gov (United States)

    Leibowitz, David; Jacobs, Jeremy M; Lande-Stessman, Irit; Gilon, Dan; Stessman, Jochanan

    2018-02-01

    Background This study examined the association between cardiac structure and function and the deterioration in activities of daily living (ADLs) in an age-homogenous, community-dwelling population of patients born in 1920-1921 over a five-year follow-up period. Design Longitudinal cohort study. Methods Patients were recruited from the Jerusalem Longitudinal Cohort Study, which has followed an age-homogenous cohort of Jerusalem residents born in 1920-1921. Patients underwent home echocardiography and were followed up for five years. Dependence was defined as needing assistance with one or more basic ADL. Standard echocardiographic assessment of cardiac structure and function, including systolic and diastolic function, was performed. Reassessment of ADLs was performed at the five-year follow-up. Results A total of 459 patients were included in the study. Of these, 362 (79%) showed a deterioration in at least one ADL at follow-up. Patients with functional deterioration had a significantly higher left ventricular mass index and left atrial volume with a lower ejection fraction. There was no significant difference between the diastolic parameters the groups in examined. When the data were examined categorically, a significantly larger percentage of patients with functional decline had an abnormal left ventricular ejection fraction and left ventricular hypertrophy. The association between left ventricular mass index and functional decline remained significant in all multivariate models. Conclusions In this cohort of the oldest old, an elevated left ventricular mass index, higher left atrial volumes and systolic, but not diastolic dysfunction, were predictive of functional disability.

  8. Comparing the loss of functional independence of older adults in the U.S. and China.

    Science.gov (United States)

    Fong, Joelle H; Feng, Jun

    2018-01-01

    Functional loss among older adults is known to follow a hierarchical sequence, but little is known about whether such sequences differ across socio-cultural contexts. The aim of this study is to construct activities of daily livings (ADL) scales for oldest-old adults in the United States and China so as to compare their functional loss sequences. We use data from the Asset and Health Dynamics of the Oldest Old (n=1607) and Chinese Longitudinal Healthy Longevity Survey (n=5570) for years 1998-2008. ADL items are calibrated within a scale using the Rasch measurement model. Rasch scores are averaged across survey waves to identify the ADL loss sequence for each study population. We also assess scale stability over measurement periods. Factor analyses confirm that the ADL items in each study population can be combined meaningfully to form a hierarchical sequence. Internal consistency assessed by Cronbach's alpha is high (0.81 to 0.95). We find that bathing is the first activity that both older Americans and Chinese have difficulty with, while eating is the last activity. There are, however, differences in the rank order for toileting (ranked more challenging in the Chinese sample) and dressing (ranked more challenging in the U.S. sample). Item orderings are stable over time. The results highlight the relative importance of bathing in the functional loss sequence for older adults, regardless of socio-cultural context. Health interventions are needed to address deficits in the bathroom environment, especially in developing countries like China. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Predicting activities of daily living for cancer patients using an ontology-guided machine learning methodology.

    Science.gov (United States)

    Min, Hua; Mobahi, Hedyeh; Irvin, Katherine; Avramovic, Sanja; Wojtusiak, Janusz

    2017-09-16

    Bio-ontologies are becoming increasingly important in knowledge representation and in the machine learning (ML) fields. This paper presents a ML approach that incorporates bio-ontologies and its application to the SEER-MHOS dataset to discover patterns of patient characteristics that impact the ability to perform activities of daily living (ADLs). Bio-ontologies are used to provide computable knowledge for ML methods to "understand" biomedical data. This retrospective study included 723 cancer patients from the SEER-MHOS dataset. Two ML methods were applied to create predictive models for ADL disabilities for the first year after a patient's cancer diagnosis. The first method is a standard rule learning algorithm; the second is that same algorithm additionally equipped with methods for reasoning with ontologies. The models showed that a patient's race, ethnicity, smoking preference, treatment plan and tumor characteristics including histology, staging, cancer site, and morphology were predictors for ADL performance levels one year after cancer diagnosis. The ontology-guided ML method was more accurate at predicting ADL performance levels (P ontologies. This study demonstrated that bio-ontologies can be harnessed to provide medical knowledge for ML algorithms. The presented method demonstrates that encoding specific types of hierarchical relationships to guide rule learning is possible, and can be extended to other types of semantic relationships present in biomedical ontologies. The ontology-guided ML method achieved better performance than the method without ontologies. The presented method can also be used to promote the effectiveness and efficiency of ML in healthcare, in which use of background knowledge and consistency with existing clinical expertise is critical.

  10. Estudo eletromiográfico dos músculos adutor longo e vasto medial (fibras oblíquas), durante exercícios de agachamento com e sem a adução do quadril

    OpenAIRE

    Fabio de Faro Passos

    2006-01-01

    INTRODUÇÃO: os músculos adutor longo (ADL) e vasto medial (VM), incluindo suas fibras oblíquas (VMO), possuem relações anatômicas e funcionais. O músculo VMO é estabilizador da patela, portanto inúmeros trabalhos EMG procuram determinar exercícios que aumentem a atividade deste músculo. Este estudo teve como objetivo relacionar a atividade do músculo VMO com a adução do quadril e com a contração do músculo ADL em exercícios de agachamento com e sem apoio dorsal para ambos os sexos. CASUÍSTICA...

  11. Digestibility and composition of broiler litter, as affected by gamma irradiation

    International Nuclear Information System (INIS)

    Al-Masri, M.R.; Zarkawi, M.

    1999-01-01

    An experiment has been carried out to study the effect of 6 doses of gamma irradiation (0-350 kilo Gray, kGy) on in vitro organic matter digestibility (IVOMD), digestible energy, gross energy (GE), total nitrogen (N), crude fibre (CF), neutral-detergent fibre (NDF), acid-detergent fibre (ADF) and acid-detergent lignin (ADL) in broiler litter. The results indicate that gamma irradiation increased the IVOMD and IVDE, except the dose of 50 kGy, and decreased the values of CF, NDF, ADF and ADL significantly (P 0.05) effect of irradiation on GE and N. (author)

  12. A comparison of home care clients and nursing home residents: can community based care keep the elderly and disabled at home?

    Science.gov (United States)

    Shugarman, L R; Fries, B E; James, M

    1999-01-01

    Admission cohorts from the Michigan Medicaid Home and Community-Based Waiver program and Ohio nursing homes were compared on measures of resource utilization including a modified Resource Utilization Groups (RUG-III) system, Activities of Daily Living (ADLs), and overall case mix. We found that, contrary to previous research, the two samples were remarkably similar across RUG-III categories. However, the nursing home sample was more functionally impaired on measures of ADL functioning and overall case mix. Results of this study may inform policymakers and providers of the potential for maintaining the appropriate population in the home with government-funded home care.

  13. Halveti-Şâbânî Şeyhi Mustafa Kemâleddîn Bekrî ve Hediyyetü’l-Ahbâb Adlı Eseri

    Directory of Open Access Journals (Sweden)

    Halim Gül

    2013-03-01

    Full Text Available AbstractThis article studies the life and woks of Kemaleddin Bekrî, who affiliated himself to Khalvati-Shabani Sheikh Abdullatîf b. Hüsameddîn el-Halebî, and who was growed up under Abd al-Ghani al-Nabulsi’s control. His work “Hadiyyat al-Ahbab fi ma li’l-Khalveti min al-Şuruti va’l-Adab”, which explains the conditions and rules of “khalvet” was also studied. The work consists of preface, eight parts and an epilogue and all parts examined in detail.ÖzetBu makalede, Abdülganî Nablusî’nin (ö.1143/1730 gözetiminde yetişen, halvetî-Şabânî şeyhi Abdullatîf b. Hüsameddîn el-Halebî’ye intisap eden Mustafa Kemaleddin Bekrî’nin hayatı ve eserleri incelenmiştir. Bu çerçevede onun tasavvufi bir kavram olan halvetin âdab ve şartlarını izah eden “Hediyyetü’l ahbâb fî mâ li’l-halveti mine’ş-şurûti ve’l-âdâb” adlı risalesinin incelenmesi ve değerlendirmesi üzerinde durulmuştur. Söz konusu eser, mukaddime sekiz bölüm ve bir hatimeden oluşmaktadır.Le Shaykh Khalwatî-Sha‘bânî Mustafâ Kamâl al-Dîn Bakrî et son Traité qui s’intitule Hadiyya al-ahbâbRésuméDans cet article, on va étudier d’abord la vie et les œuvres du Shaykh Khalwatî-Sha‘bânî Mustafâ Kamâl al-Dîn Bakrî qui a été éduqué par le célèbre soufi ‘Abd al-Ghanî Nablûsî (m. 1143/1730 et a été initié par ‘Abd al-Latîf b. Husâm al-Dîn al-Halabî. Puis, plus particulièrement, on va analyser son traité qui s’intitule ‘Hadiyya al-ahbâb fî mâ li’l-khalwatî min al-shurût wa’l-âdâb’. Ce traité – qui a été composé de dix-huit chapitres et d’une conclusion – étudie les convenances et les conditions de la retraite spirituelle, khalwa, une des notions soufies importantes

  14. Sensor Data Acquisition and Processing Parameters for Human Activity Classification

    Directory of Open Access Journals (Sweden)

    Sebastian D. Bersch

    2014-03-01

    Full Text Available It is known that parameter selection for data sampling frequency and segmentation techniques (including different methods and window sizes has an impact on the classification accuracy. For Ambient Assisted Living (AAL, no clear information to select these parameters exists, hence a wide variety and inconsistency across today’s literature is observed. This paper presents the empirical investigation of different data sampling rates, segmentation techniques and segmentation window sizes and their effect on the accuracy of Activity of Daily Living (ADL event classification and computational load for two different accelerometer sensor datasets. The study is conducted using an ANalysis Of VAriance (ANOVA based on 32 different window sizes, three different segmentation algorithm (with and without overlap, totaling in six different parameters and six sampling frequencies for nine common classification algorithms. The classification accuracy is based on a feature vector consisting of Root Mean Square (RMS, Mean, Signal Magnitude Area (SMA, Signal Vector Magnitude (here SMV, Energy, Entropy, FFTPeak, Standard Deviation (STD. The results are presented alongside recommendations for the parameter selection on the basis of the best performing parameter combinations that are identified by means of the corresponding Pareto curve.

  15. Radiation pasteurised oil palm empty fruit bunch fermented with Pleurotus sajor-caju as feed supplement to ruminants

    Science.gov (United States)

    Awang, Mat Rasol; Mutaat, Hassan Hamdani; Mahmud, Mohd. Shukri; Wan Husain, Wan Badrin; Osman, Tajuddin; Bakar, Khomsaton Abu; Kassim, Asmahwati; Wan Mahmud, Zal U'yun; Manaf, Ishak; Kume, Tamikazu; Hashimoto, Shoji

    1993-10-01

    In solid state fermentation, Pleurotus sajor-caju has been found to be able to degrade at least 30% oil palm empty Fruit Bunch (EFB) fibre leaving 70 % useful materials. Conditions under which fermentation carried out were investigated. It was found that, in the temperature range between 25- 28 °C, relative ph between 6-8, moisture between 60-70 % and medium composition of CaCO 3: rice bran 2 %: 5 % were the optimum conditions. The results showed in fermented products that, there were substantial reduction in cellulosic component such as Crude Fiber (CF, 18 %); Acid Detergent Fibre (ADF, 45 %), Neutral Detergent Fibre (NDF, 61 %) and Acid Detergent Lignin (ADL, 14 %). However, Crude Protein (CP, 10%) increased resulted from single cell protein enrichment of mycelial microbial mass. The mass reductions of substrate in fermentation process corresponds to the CO 2 released during fermentation. Hence, attributable to the decreased in content of CF, ADF, NDF, and ADL. The digestibility study has also been carried out to determine the useful level of this product to ruminant. Aflatoxin content was detected low in both the initial substrates and products. Based on nutritional value and low content of aflatoxin, the product is useful as a source of roughage to ruminant.

  16. AMEM-ADL Polymer Migration Estimation Model User's Guide

    Science.gov (United States)

    The user's guide of the Arthur D. Little Polymer Migration Estimation Model (AMEM) provides the information on how the model estimates the fraction of a chemical additive that diffuses through polymeric matrices.

  17. Adlî Tıpta Giysi İncelemesinin Yeri

    Directory of Open Access Journals (Sweden)

    Muhammet Can

    2005-08-01

    Full Text Available Fiziksel deliller, adli olayın aydınlatılmasında ve orijin tayininde çok önemli bir yere sahiptir. Ateşli silahlar ve çeşitli aletler (kesici, kesici-delici, delici vb. ile yaralanma ve öldürme olaylarında, ölen ve/veya yaralananın olay anında üzerinde bulunan giysilerin fiziksel ve kimyasal incelemesi, olayın adli ve tıbbi sonuçları açısından önemlidir. Çalışmamızda 1995-1999 yılları arasında Adli Tıp Kurumu-Fizik İncelemeler İhtisas Dairesi’nde giysi incelemesi ile ilgili olarak düzenlenen raporlar yapılandırılmış bir değerlendirme formuna göre taranmıştır. İnceleme için gönderilen 1172 adet dosyanın %6 Tinde atış mesafesi, %18’inde giysi tetkiki, %4’ünde aletin türü ile ilgili soruların fiziksel delil elde etmek yönünde öne çıktığı görülmüştür. Giysilerin elde ediliş ve gönderilişi sırasında aksaklıklar saptanmış, bazı dosyalarda incelemesi istenen giysilerin dosya ve otopsi raporu bulunmadan gönderildiği tespit edilmiştir. Sonuç olarak, giysi incelemesi istenen dosyalarda, her aşamada uygun prosedürlerin uygulanması gerekliliği ortaya konmuştur. Anahtar kelimeler: Adli tıp, fiziksel delil, giysi incelemesi, atış mesafesi, aletin türü.

  18. Personalized Hydration Strategy Attenuates the Rise in Heart Rate and in Skin Temperature Without Altering Cycling Capacity in the Heat

    Directory of Open Access Journals (Sweden)

    Denise de Melo-Marins

    2018-04-01

    Full Text Available The optimal hydration plan [i.e., drink to thirst, ad libitum (ADL, or personalized plan] to be adopted during exercise in recreational athletes has recently been a matter of debate and, due to conflicting results, consensus does not exist. In the present investigation, we tested whether a personalized hydration strategy based on sweat rate would affect cardiovascular and thermoregulatory responses and exercise capacity in the heat. Eleven recreational male cyclists underwent two familiarization cycling sessions in the heat (34°C, 40% RH where sweat rate was also determined. A fan was used to enhance sweat evaporation. Participants then performed three randomized time-to-exhaustion (TTE trials in the heat with different hydration strategies: personalized volume (PVO, where water was consumed, based on individual sweat rate, every 10 min; ADL, where free access to water was allowed; and a control (CON trial with no fluids. Blood osmolality and urine-specific gravity were measured before each trial. Heart rate (HR, rectal, and skin temperatures were monitored throughout trials. Time to exhaustion at 70% of maximal workload was used to define exercise capacity in the heat, which was similar in all trials (p = 0.801. Body mass decreased after ADL (p = 0.008 and CON (p < 0.001 and was maintained in PVO trials (p = 0.171. Participants consumed 0 ml in CON, 166 ± 167 ml in ADL, and 1,080 ± 166 ml in PVO trials. The increase in mean body temperature was similar among trials despite a lower increase in skin temperature during PVO trial in comparison with CON (2.1 ± 0.6 vs. 2.9 ± 0.5°C, p = 0.0038. HR was lower toward the end of TTE in PVO (162 ± 8 bpm in comparison with ADL (168 ± 12 bpm and CON (167 ± 10 bpm, p < 0.001. In conclusion, a personalized hydration strategy can reduce HR during a moderate to high intensity exercise session in the heat and halt the increase in skin

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

    Directory of Open Access Journals (Sweden)

    Shah Raj C

    2012-10-01

    Full Text Available Abstract 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

  20. Effects of primary caregiver participation in vestibular rehabilitation for unilateral neglect patients with right hemispheric stroke: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Dai CY

    2013-04-01

    Full Text Available Chin-Ying Dai,1,2 Yu-Hui Huang,3,4 Li-Wei Chou,5,6 Shiao-Chi Wu,7 Ray-Yau Wang,8 Li-Chan Lin9 1School of Nursing, National Yang Ming University, Taipei, Taiwan; 2Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan; 3Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan; 4School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 6School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 7Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; 8Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan; 9Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan, Republic of China Introduction: The current study aims to investigate the effects of primary caregiver participation in vestibular rehabilitation (VR on improving the measures of neglect, activities of daily living (ADL, balance, and falls of unilateral neglect (UN patients. Methods: This study is a single-blind randomized controlled trial. Both experimental (n = 24 and control groups (n = 24 received conventional rehabilitation. The experimental group undertook VR for a month. During the first and second weeks, a registered nurse trained the experimental group in VR. The primary caregivers in the experimental group supervised and guided their patients in VR during the third and fourth weeks. The outcome measures were neglect, ADL, balance, and falls. Results: The two groups of UN patients showed a significant improvement in neglect, ADL, and balance over time. Based on the generalized estimating equations model, an interaction was observed between groups and times. Significant interactions were observed between the VR group

  1. PROMIS Pain Interference and Physical Function Scores Correlate With the Foot and Ankle Ability Measure (FAAM) in Patients With Hallux Valgus.

    Science.gov (United States)

    Nixon, Devon C; McCormick, Jeremy J; Johnson, Jeffrey E; Klein, Sandra E

    2017-11-01

    Traditional patient-reported outcome instruments like the Foot and Ankle Ability Measure (FAAM) quantify patient disability but often are limited by responder burden and incomplete questionnaires. The Patient-Reported Outcome Measurement Information System (PROMIS) overcomes such obstacles through computer-adaptive technology and can capture outcome data from various domains including physical and psychosocial function. Prior work has compared the FAAM with PROMIS physical function; however, there is little evidence comparing the association between foot and ankle-specific tools like the FAAM with more general outcomes measures of PROMIS pain interference and depression in foot and ankle conditions. (1) We asked whether there was a relationship between FAAM Activities of Daily Living (ADL) scores with PROMIS physical function, pain interference, and depression in patients with hallux valgus. (2) Additionally, we asked if we could identify specific factors that are associated with variance in FAAM and PROMIS physical function scores in patients with hallux valgus. Eighty-five new patients with either a primary or secondary diagnosis of hallux valgus based on clinic billing codes from July 2015 to February 2016 were retrospectively identified. Patients completed FAAM ADL paper-based surveys and electronic PROMIS questionnaires for physical function, pain interference, and depression from new patient visits at a single time. Spearman rho correlations were performed between FAAM ADL and PROMIS scores. Analyses then were used to identify differences in FAAM ADL and PROMIS physical function measures based on demographic variables. Stepwise linear regressions then determined which demographic and/or outcome variable(s) accounted for the variance in FAAM ADL and PROMIS physical function scores. FAAM scores correlated strongly with PROMIS physical function (r = 0.70, p hallux valgus. PROMIS tools allow for more-efficient data collection across multiple domains and, moving

  2. The Functional Dysphagia Scale Is a Useful Tool for Predicting Aspiration Pneumonia in Patients With Parkinson Disease.

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    Lee, Jong Hwa; Lee, Kyeong Woo; Kim, Sang Beom; Lee, Sook Joung; Chun, Sang Myung; Jung, Sung Moon

    2016-06-01

    To describe the correlation between the functional dysphagia scale and aspiration pneumonia and which characteristics influence the occurrence of aspiration pneumonia in patients with idiopathic Parkinson disease. Fifty-three patients with idiopathic Parkinson disease were prospectively evaluated in this study. Disease severity and functional status were measured by modified Hoehn and Yahr (H&Y) staging, Schwab and England activities of daily living (S-E ADL) scale and Korean version of Mini-Mental State Examination (K-MMSE). Swallowing function was evaluated by the functional dysphagia scale (FDS) and the penetration-aspiration scale (PAS) based on a videofluoroscopic swallowing study. The patients were followed up for 3 months and divided into two groups according to the occurrence of aspiration pneumonia. The correlation between the variables and aspiration pneumonia was analyzed. Eight patients of the 53 patients were allocated to the aspiration pneumonia group and 45 patients to the non-aspiration pneumonia group. The patients in the aspiration pneumonia group had significantly higher H&Y staging, and scored lower on S-E ADL scale and K-MMSE. The patients in the aspiration pneumonia group had significantly higher scores on FDS and PAS. A multiple logistic regression analysis showed that the S-E ADL scale and the FDS were associated with the occurrence of aspiration pneumonia in the patients with Parkinson disease. Given that the FDS can quantitatively assess the functional problems associated with dysphagia, it can be clinically effective in predicting the occurrence of aspiration pneumonia, and the FDS and the S-E ADL scale could be predictive variables for aspiration pneumonia in patients with Parkinson disease.

  3. Neuropsychological rehabilitation of memory deficits and activities of daily living in patients with Alzheimer's disease: a pilot study

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    Ávila R.

    2004-01-01

    Full Text Available Patients with Alzheimer's disease (AD gradually lose their cognitive competence, particularly memory, and the ability to perform daily life tasks. Neuropsychological rehabilitation is used to improve cognitive functions by facilitating memory performance through the use of external aids and internal strategies. The effect of neuropsychological rehabilitation through memory training - motor movements, verbal association, and categorization - and activities of daily living (ADL training was tested in a sample of 5 elderly out-patients (mean age: 77.4 ± 2.88 years, with mild AD (Mini-Mental State Examination score: 22.20 ± 2.17 and their caregivers. All patients had been taking rivastigmine (6-12 mg/day for at least 3 months before being assigned to the rehabilitation sessions, and they continued to take the medication during the whole program. Just before and after the 14-week neuropsychological rehabilitation program all patients were assessed by interviewers that did not participate in the cognitive training, using the Mini-Mental State Examination, Montgomery-Alsberg Depression Rating Scale, Hamilton Anxiety Scale, Interview to Determine Deterioration in Functioning in Dementia, Functional Test, Memory Questionnaire of Daily Living for patient and caregiver, Quality of Life Questionnaire for patient and caregiver, and a neuropsychological battery. The results showed a statistically significant improvement in ADL measured by Functional Test (P = 0.04, and only a small improvement in memory and psychiatric symptoms. Our results support the view that weekly stimulation of memory and training of ADL is believed to be of great value in AD treatment, not only delaying the progress of the disease, but also improving some cognitive functions and ADL, even though AD is a progressively degenerative disease.

  4. The relationship between sarcopenia,undernutrition, physical mobility and basic activities of daily living in a group of elderly women of Mexico City.

    Science.gov (United States)

    Velázquez Alva, María del Consuelo; Irigoyen Camacho, Maria Esther; Delgadillo Velázquez, Jaime; Lazarevich, Irina

    2013-01-01

    Sarcopenia is a geriatric syndrome, which affects the functional status and mobility of individuals. To identify the prevalence of sarcopenia and undernutrition, and to assess the association between sarcopenia and mobility, and sarcopenia and basic activities of daily living (ADL) in a group of elderly women. A cross-sectional study was performed in patients attending a geriatric service at a government hospital in Mexico City. Sarcopenia was identified applying Baumgartner's equation by obtaining skeletal muscle mass index (SMI) and undernutrition was diagnosed using mini-nutritional assessment instrument (MNA). The SENECA questionnaire and Katz index were used to evaluate mobility and ADL, respectively. lineal regression models were constructed fitting SMI as a dependent variable and SENECA, and ADL scores as independent variables, adjusted for age. 90 women with a mean age of 78.2 (± 6.8) were studied. Undernutrition was identified in 15.5% of the patients. The prevalence of sarcopenia was 41.1%. Patients with sarcopenia presented a high prevalence of undernutrition (p Sarcopenia was associated with difficulty in climbing stairs (OR = 2.63, p = 0.03), adjusted for age. The mobility score was associated with sarcopenia, in the group without sarcopenia the mean score was 16.3, and with sarcopenia it was 18.3, (p = 0.04). Regarding ADL, 64.9% of the patients with intermediate independence and dependence had sarcopenia, while 35.1% with total independence presented sarcopenia (p elder women with sarcopenia had a higher prevalence of undernutrition. Sarcopenia was associated with difficulties in mobility, particularly difficulties in climbing stairs. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  5. Nutritional Improvement and Energy Intake Are Associated with Functional Recovery in Patients after Cerebrovascular Disorders.

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    Nii, Maria; Maeda, Keisuke; Wakabayashi, Hidetaka; Nishioka, Shinta; Tanaka, Atsuko

    2016-01-01

    Malnutrition affects the activities of daily living (ADLs) in convalescent patients with cerebrovascular disorders. We investigated the relationship between nutritional improvement, energy intake at admission, and recovery of ADLs. We evaluated 67 patients with cerebrovascular disorders admitted to our rehabilitation hospital between April 2013 and April 2015. These patients received interventions from the rehabilitation nutritional support team according to the following criteria: weight loss of 2 kg or more and body mass index of 19 kg/m(2) or lower. Exclusion criteria included a body mass index of 25 kg/m(2) or higher, duration of intervention of less than 14 days, or transfer to an acute care hospital because of clinical deterioration. We assessed nutritional status using the Geriatric Nutritional Risk Index (GNRI) and ADL using the Functional Independence Measure (FIM) score, FIM gain, and FIM efficiency. The mean age of the patients was 78.7 ± 8.0 years. The numbers of patients in each category of cerebrovascular disorder were 39 with cerebral infarction, 16 with intracerebral hemorrhage, 8 with subarachnoid hemorrhage, and 4 others. Compared with the counterpart group, the group with an improvement in GNRI had a greater gain in FIM (median 17 and 20, respectively; P = .036) and a higher FIM efficiency (.14 and .22, respectively; P = .020). Multivariate stepwise regression analysis showed that an improvement in GNRI, increasing energy intake at admission, and intracerebral hemorrhage were associated independently with greater FIM efficiency. This study suggested that nutritional improvement and energy intake at admission are associated with recovery of ADL after cerebrovascular disorders. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Functional Impairment: An Unmeasured Marker of Medicare Costs for Postacute Care of Older Adults.

    Science.gov (United States)

    Greysen, S Ryan; Stijacic Cenzer, Irena; Boscardin, W John; Covinsky, Kenneth E

    2017-09-01

    To assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge. Longitudinal cohort study. Health and Retirement Study (HRS). Nationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data. The main predictor was functional impairment (level of difficulty or dependence in activities of daily living (ADLs)), determined from HRS interview preceding hospitalization. Multivariable linear regression was performed, adjusted for age, race, sex, income, net worth, and comorbidities, with clustering at the individual level to characterize the association between functional impairment and costs of postacute care. Unadjusted mean Medicare costs for 1 year after discharge increased with severity of impairment in a dose-response fashion (P < .001 for trend); 68% had no functional impairment ($25,931), 17% had difficulty with one ADL ($32,501), 7% had dependency in one ADL ($39,928), and 8% had dependency in two or more ADLs ($45,895). The most severely impaired participants cost 77% more than those with no impairment; adjusted analyses showed attenuated effect size (33% more) but no change in trend. Considering costs attributable to comorbidities, only three conditions were more expensive than severe functional impairment (lymphoma, metastatic cancer, paralysis). Functional impairment is associated with greater Medicare costs for postacute care and may be an unmeasured but important marker of long-term costs that cuts across conditions. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  7. Dexamphetamine improves upper extremity outcome during rehabilitation after stroke: a pilot randomized controlled trial.

    Science.gov (United States)

    Schuster, Corina; Maunz, Gerd; Lutz, Karin; Kischka, Udo; Sturzenegger, Rolf; Ettlin, Thierry

    2011-10-01

    For early inpatient stroke rehabilitation, the effectiveness of amphetamine combined with physiotherapy varies across studies. To investigate whether the recovery of activities of daily living (ADL, primary outcome) and motor function (secondary outcome) can be improved by dexamphetamine added to physiotherapy. In a double-blind, placebo-controlled trial, 16 patients, from 918 who were screened, were randomized to the experimental group (EG, dexamphetamine + physiotherapy) or control group (CG, placebo + physiotherapy). Both groups received multidisciplinary inpatient rehabilitation. Dexamphetamine (10 mg oral) or placebo was administered 2 days per week before physiotherapy. ADL and motor function were measured using the Chedoke-McMaster Stroke Assessment (CMSA) twice during baseline, every week during the 5-week treatment period, and at follow-up 1 week, 6 months, and 12 months after intervention. The majority of ineligible patients had too little paresis, were on anticoagulants, or had a stroke >60 days prior to entry. Participants (EG, n = 7, age 70.3 ± 10 years, 5 women, 37.9 ± 9 days after stroke; CG, n = 9, age 65.2 ± 17 years, 3 women, 40.3 ± 9 days after stroke) did not differ at baseline except for the leg subscale. Analysis of variance from baseline to 1 week follow-up revealed significant improvements in favor of EG for subscales ADL (P = .023) and arm function (P = .020) at end of treatment. No adverse events were detected. In this small trial that was based on prior positive trials, significant gains in ADL and arm function suggest that the dose and timing of dexamphetamine can augment physiotherapy. Effect size calculation suggests inclusion of at least 25 patients per group in future studies.

  8. Prevalence of self-reported stroke and disability in the French adult population: a transversal study.

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    Schnitzler, Alexis; Woimant, France; Tuppin, Philippe; de Peretti, Christine

    2014-01-01

    In France, the prevalence of stroke and the level of disability of stroke survivors are little known. The aim of this study was to evaluate functional limitations in adults at home and in institutions, with and without self-reported stroke. A survey named "the Disability Health survey" was carried out in people's homes (DHH) and in institutions (DHI). Medical history and functional level (activities-of-daily-living, ADL and instrumented-activities-of-daily-living IADL) were collected through interviews. The modified Rankin score (mRS) and the level of dependence and disability were compared between participants with and without stroke. 33896 subjects responded. The overall prevalence of stroke was 1.6% (CI95% [1.4%-1.7%]). The mRS was over 2 for 34.4% of participants with stroke (28.7% of participants at home and 87.8% of participants in institutions) versus respectively 3.9%, 3.1% and 71.6% without stroke. Difficulty washing was the most frequently reported ADL for those with stroke (30.6% versus 3% for those without stroke). Difficulty with ADL and IADL increased with age but the relative risk was higher below the age of 60 (17 to 25) than over 85 years (1.5 to 2.2), depending on the ADL. In the overall population, 22.6% of those confined to bed or chair reported a history of stroke. These results thus demonstrate a high national prevalence of stroke. Older people are highly dependent, irrespective of stroke history and the relative risk of dependence in young subjects with a history of stroke is high compared with those without.

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

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    Ivan Miguel Pires

    2018-01-01

    Full Text Available 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.

  10. Obesity and intensive staffing needs of nursing home residents.

    Science.gov (United States)

    Harris, John Alexander; Engberg, John; Castle, Nicholas George

    2018-06-05

    The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (BMI < 18.5 kg/m 2 ) to obesity Class IIIB (≥50 kg/m 2 ). Logistic regression models estimated the odds of nursing home-reported need for extensive (≥2 staff member) assistance needed for ADLs. The adjusted odds increased from 1.07 (95% Confidence Interval (95%CI) 1.06-1.08) for Class I, 1.16 (95%CI 1.14-1.17) for Class II, 1.33 (95%CI 1.31-1.35) for Class IIIA, and 1.90 (95%CI 1.86-1.95) for Class IIIB obesity residents compared to residents of normal weight. As a nursing home resident's BMI increases, especially for BMI ≥40 kg/m 2 , the need for extensive staffing assistance with ADLs also increases substantially. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Development of a Proxy-Free Objective Assessment Tool of Instrumental Activities of Daily Living in Mild Cognitive Impairment Using Smart Home Technologies.

    Science.gov (United States)

    Jekel, Katrin; Damian, Marinella; Storf, Holger; Hausner, Lucrezia; Frölich, Lutz

    2016-01-01

    The assessment of activities of daily living (ADL) is essential for dementia diagnostics. Even in mild cognitive impairment (MCI), subtle deficits in instrumental ADL (IADL) may occur and signal a higher risk of conversion to dementia. Thus, sensitive and reliable ADL assessment tools are important. Smart homes equipped with sensor technology and video cameras may provide a proxy-free assessment tool for the detection of IADL deficits. The aim of this paper is to investigate the potential of a smart home environment for the assessment of IADL in MCI. The smart home consisted of a two-room flat equipped with activity sensors and video cameras. Participants with either MCI or healthy controls (HC) had to solve a standardized set of six tasks, e.g., meal preparation, telephone use, and finding objects in the flat. MCI participants needed more time (1384 versus 938 seconds, p smart home technologies offer the chance for an objective and ecologically valid assessment of IADL. It can be analyzed not only whether a task is successfully completed but also how it is completed. Future studies should concentrate on the development of automated detection of IADL deficits.

  12. Factors Affecting Quality of Life of the Homebound Elderly Hemiparetic Stroke Patients

    Science.gov (United States)

    Takemasa, Seiichi; Nakagoshi, Ryoma; Murakami, Masahito; Uesugi, Masayuki; Inoue, Yuri; Gotou, Makoto; Koeda, Hideki; Naruse, Susumu

    2014-01-01

    [Purpose] This study examined the quality of life (QOL) of homebound elderly hemiparetic stroke patients and factors that affect it. [Subjects] The subjects of the study were 21 homebound elderly hemiparetic stroke patients who were 65 years old or over and required care for daily living (12 males and 9 females, average age: 79.3 ± 8.4 years old). Their physical and psychological conditions, QOL, and other characteristics were researched. [Methods] The Functional Independence Measure (FIM) was used for the activities of daily living (ADL) assessment, and the MOS 36-Item Short-Form Health Survey (SF-36, Japanese version 1.2) was used for the QOL assessment. [Results] No correlations were observed between the QOL of homebound elderly hemiparetic stroke patients and their age and gender. However, the results showed that their QOL was affected by their independence in ADL, bedridden degree, and care-need level. [Conclusion] These results suggest that in order to improve the QOL of homebound elderly hemiparetic stroke patients, ongoing rehabilitation to improve independence in ADL and lower the bedridden degree and care-need level is required. PMID:24648653

  13. Impact of neuropsychological rehabilitation on activities of daily living and community reintegration of patients with traumatic brain injury.

    Science.gov (United States)

    Kanchan, Amrita; Singh, Amool Ranjan; Khan, Nawab Akhtar; Jahan, Masroor; Raman, Rajesh; Sathyanarayana Rao, T S

    2018-01-01

    The present study was targeted to observe the impact of neuropsychological rehabilitation on activities of daily living (ADL) and community reintegration of patients with traumatic brain injury (TBI). Based on purposive sampling technique, ten patients with TBI falling in the age range of 20-40 years and fulfilling the inclusion and exclusion criteria were chosen from All India Institute of Speech and Hearing, Mysuru, India. A quasi-experimental design, i.e., nonequivalent control group design was chosen for the study. Patients were assessed on Luria-Nebraska Neuropsychological Battery for Adults, Cognitive Symptoms Checklist, and Community Integration Questionnaire. Patients in experimental group were given neuropsychological rehabilitation for 6 months. Brainwave-R and Talking Pen were used as rehabilitative tools. Patients with TBI have significant neuropsychological deficits observed in memory, visuo-spatial organization, arithmetic, spelling, writing, fine motor coordination, and executive functioning. Neuropsychological deficits have a major impact on ADL and community reintegration. Neuropsychological rehabilitation is effective in rehabilitating neuropsychological deficits, which in turn leads to improvement in ADL and community reintegration. Neuropsychological rehabilitation should be one of the major goals in rehabilitation procedures for patients with TBI in order to bring overall improvement in them.

  14. Occupational Therapy and the amazon riverside child victim of scalping by motor boat shaft

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    Paula Dayse Braga Santos

    2015-03-01

    Full Text Available Although scalping is a recurrentaccident innorthern Brazil, there are still few studies on the subject. The aim of the present work was to report the occupational therapy procedure on the minimization of the occupational performance impairment of two riverside children that were victims of scalping by unprotected motor boat shaft, through the evaluation of occupational performance and exposure of the intervention performed. This is a case study with two scalped riverside girls hospitalized between April and June, 2013. The application of evaluation protocols verified changes in the areas of occupational performance, where activities of daily living (ADL such as dependence for bathing and ambulationare inserted; changesin the performance context, verified in the anxiety to be discharged from hospital; and changesin the performance component, with decreased self-esteem because of the change on their self-image. Reassessment after intervention showed improvement in the performance of ADL and self-image perceptionof both patients. Thereby it is believed that the development of the research allowed the contact with a theme that is so typical in the Braziliannorth region, stressing the importance of Occupational Therapy assistance, providing greater independence in the performance of ADL that are meaningful to each child.

  15. The effects of Snoezelen (multi-sensory behavior therapy) and psychiatric care on agitation, apathy, and activities of daily living in dementia patients on a short term geriatric psychiatric inpatient unit.

    Science.gov (United States)

    Staal, Jason A; Sacks, Amanda; Matheis, Robert; Collier, Lesley; Calia, Tina; Hanif, Henry; Kofman, Eugene S

    2007-01-01

    A randomized, controlled, single-blinded, between group study of 24 participants with moderate to severe dementia was conducted on a geriatric psychiatric unit. All participants received pharmacological therapy, occupational therapy, structured hospital environment, and were randomized to receive multi sensory behavior therapy (MSBT) or a structured activity session. Greater independence in activities of daily living (ADLs) was observed for the group treated with MSBT and standard psychiatric inpatient care on the Katz Index of Activities of Daily Living (KI-ADL; P = 0.05) than standard psychiatric inpatient care alone. The combination treatment of MSBT and standard psychiatric care also reduced agitation and apathy greater than standard psychiatric inpatient care alone as measured with the Pittsburgh Agitation Scale and the Scale for the Assessment of Negative Symptoms in Alzheimer's Disease (P = 0.05). Multiple regression analysis predicted that within the multi-sensory group, activities of daily living (KI-ADL) increased as apathy and agitation reduced (R2 = 0.42; p = 0.03). These data suggest that utilizing MSBT with standard psychiatric inpatient care may reduce apathy and agitation and additionally improve activities of daily living in hospitalized people with moderate to severe dementia more than standard care alone.

  16. Falls in the community-dwelling elderly with a history of cancer.

    Science.gov (United States)

    Spoelstra, Sandra; Given, Barbara; von Eye, Alexander; Given, Charles

    2010-01-01

    Falls place older adults at risk for injuries, resulting in functional decline, hospitalization, institutionalization, higher healthcare costs, and decreased quality of life. This study examined community-dwelling elderly to identify if individuals with a history of cancer fall at a higher rate than those without cancer, and if the occurrence of falls was influenced by individual characteristics, symptoms, or function. This was a retrospective, cross-sectional study, in 2007, examining 7,448 community-dwelling elderly 65 years or older in a state in the Midwest. Fallers were identified based on a diagnosis of cancer, age, sex, race and ethnicity, poor vision, reduced activities of daily living (ADLs), instrumental ADLs, cognition, incontinence, pain, or depression. Findings indicated that 2,125 (28.5%) had at least 1 fall. Of those who fell, 967 (13.0%) had cancer, and 363 (4.9%) with cancer had a fall. Predictors of falls in this population included race, sex, ADLs, incontinence, depression, and pain, all with P falls in this study. This study found a high frequency of falls and suggests a predictive model for fall risk in the vulnerable, community-dwelling elderly and will be used to inform future studies.

  17. Effect of urea and urea-gamma treatments on cellulose degradation of Thai rice straw and corn stalk

    International Nuclear Information System (INIS)

    Banchorndhevakul, Siriwattana

    2002-01-01

    Cellulose degradation of 20% urea treated and 20% urea-10 kGy gamma treated Thai rice straw and corn stalk showed that combination effect of urea and gamma radiation gave a higher % decrease in neutral detergent fiber (NDF), acid detergent fiber (ADF), acid detergent lignin (ADL), cellulose, hemicellulose, and lignin and cutin in comparison with urea effect only for both room temperature storage and room temperature +258 K storage. The results also indicated that cellulose degradation proceeded with time, even at 258 K. A drastic drop to less than half of the original contents in NDF, ADF, and ADL could not be obtained in this study

  18. Effect of urea and urea-gamma treatments on cellulose degradation of Thai rice straw and corn stalk

    Science.gov (United States)

    Banchorndhevakul, Siriwattana

    2002-08-01

    Cellulose degradation of 20% urea treated and 20% urea-10 kGy gamma treated Thai rice straw and corn stalk showed that combination effect of urea and gamma radiation gave a higher % decrease in neutral detergent fiber (NDF), acid detergent fiber (ADF), acid detergent lignin (ADL), cellulose, hemicellulose, and lignin and cutin in comparison with urea effect only for both room temperature storage and room temperature +258 K storage. The results also indicated that cellulose degradation proceeded with time, even at 258 K. A drastic drop to less than half of the original contents in NDF, ADF, and ADL could not be obtained in this study.

  19. [Muscle and bone health as a risk factor of fall among the elderly. An approach to identify high-risk fallers by risk assessment].

    Science.gov (United States)

    Kikuchi, Reiko; Kozaki, Koichi; Nakamura, Tetsuro; Toba, Kenji

    2008-06-01

    Fall-induced hip fracture is one of the major causes rendering the elderly to be in a low ADL or bed-ridden status. Fall is not only the cause for fractures, but it lowers elderly peoples'ADL. History of fall, age, decline of motor function, orthostatic hypotension, balance deficit, dementia, drug and environmental factors were raised as possible risk factor for falls. We created a fall predicting score which consist of 21 risk factors and a history of falls. We found that the score is useful to identify high-risk fallers. It would be necessary to identify high-risk fallers early and give an appropriate individual approach.

  20. White Matter Hyperintensity in Elderly Patients with Diabetes Mellitus Is Associated with Cognitive Impairment, Functional Disability, and a High Glycoalbumin/Glycohemoglobin Ratio

    Directory of Open Access Journals (Sweden)

    Yoshiaki Tamura

    2017-07-01

    Full Text Available Aims: Although evidence has accumulated that white matter hyperintensity (WMH is associated with the deterioration of cognitive function and impairment of activities of daily living (ADL, the clinical relevance of WMH in elderly patients with diabetes mellitus (DM is not still clear. The aim of this study was to examine whether WMH volume is associated with ADL and cognitive function and whether glucose control and glucose variability can affect WMH volume in these patients.Methods: This cross-sectional study investigated the associations of WMH with cognitive function and instrumental ADL (IADL, as well as metabolic and vascular risk factors in a total of 178 elderly patients with diabetes. The study assessed WMH volumes and the functional status of cognition and IADL. WMH volumes were evaluated by obtaining axial T2-weighted and fluid-attenuated inversion recovery sequence images on brain magnetic resonance imaging and assessing the images using Software for Neuro-Image Processing in Experimental Research.Results: We found a significant association between WMH volumes and Mini-Mental State Examination (MMSE scores (p = 0.039 and between WMH and IADL status (p = 0.006. Furthermore, we found significant relations of large WMH volumes with a high glycoalbumin/glycohemoglobin ratio (GA/HbA1c (p < 0.001. Large WMH volumes were also found to be associated with a low body mass index (p = 0.014 and a low diastolic blood pressure (p = 0.024, but not with HbA1c. Multiple regression analysis showed that high GA/HbA1c, which reflects high glucose variability, was a significant determining factor for large WMH volumes. We also found that GA/HbA1c was negatively associated with both MMSE (p = 0.036 and IADL (p < 0.001.Conclusion: GA/HbA1c, which is a marker of glucose variability, was independently associated with WMH volumes, which could lead to the decline of cognition and IADL in elderly patients with DM.

  1. Relationship Between Visual Constructive Abilities and Activity of Daily Living in Home Dwelling Elderly Population

    Directory of Open Access Journals (Sweden)

    Negin Chehrehnegar

    2016-07-01

    Full Text Available Objectives: Increasing life expectancy and decreasing birthrates have significantly contributed to an increased aging population throughout the world. This sudden change is a global phenomenon often resulting in biological changes that may have various consequences, such as reduced life power and coping skills in the elderly population. Cognitive deficits are one of the most severe impairments in the elderly people. Deficits in cognitive abilities, especially visual constructive skills, can have a considerable impact on the independency of the daily living skills of the elderly people. Self-care by individuals to maintain their life and wellbeing is a key element for their independency. The activity of daily living (ADL can support personal life independency, and is considered as a morbidity index. In the present cross-sectional study, we assessed the visual abilities and ADL in older subjects to determine whether cognitive impairment is associated with changes in self-care behavior. Methods & Materials: This study employed random sampling technique to select and recruit forty seven individuals aged between 60 to 80 years from Jahandidegan club in Shiraz, Iran. They were evaluated through "visual constructive ability" sub-scale from Loewenstein Occupational Therapy Cognitive Assessment (LOTCA battery and "Katz Index", which were used to assess their associated skill and ADL, respectively. Data was collected through observation and interviews. Data analysis was performed through Pearson's correlation test using SPSS. Results: The mean age of the participants (9 women and 38 men was 69.94±4.66 years. Lower scores in cognitive domains predicted functional decline in some scales. There was a significant correlation between visual constructive ability and eating; however, no significant correlation was found between this sub-scale with bathing, moving, toileting, and bowel control. Conclusion: In summary, a significant correlation was noted

  2. Activity Limitation Stages Are Associated With Risk of Hospitalization Among Medicare Beneficiaries.

    Science.gov (United States)

    Na, Ling; Pan, Qiang; Xie, Dawei; Kurichi, Jibby E; Streim, Joel E; Bogner, Hillary R; Saliba, Debra; Hennessy, Sean

    2017-05-01

    Activity limitation stages based on activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are associated with 3-year mortality in elderly Medicare beneficiaries, yet their associations with hospitalization risk in this population have not been studied. To examine the independent association of activity limitation stages with risk of hospitalization within a year among Medicare beneficiaries aged 65 years and older. Cohort study. Community. A total of 9447 community-dwelling elderly Medicare beneficiaries from the Medicare Current Beneficiary Survey for years 2005-2009. Stages were derived for ADLs and IADLs separately. Associations of stages with time to first hospitalization and time to recurrent hospitalizations within a year were assessed with Cox proportional hazards models, with which we accounted for baseline sociodemographics, smoking status, comorbidities, and the year of survey entry. Time to first hospitalization and time to recurrent hospitalizations within 1 year. The adjusted risk of first hospitalization increased with greater activity limitation stages (except stage III). The hazard ratios (95% confidence intervals) for ADL stages I-IV compared with stage 0 (no limitations) were 1.49 (1.36-1.63), 1.61 (1.44-1.80), 1.54 (1.35-1.76), and 2.06 (1.61-2.63), respectively. The pattern for IADL stages was similar. For recurrent hospitalizations, activity limitation stages were associated with the risk of the first hospitalization but not with subsequent hospitalizations. Activity limitation stages are associated with the risk of first hospitalization in the subsequent year among elderly Medicare beneficiaries. Stages capture clinically interpretable profiles of ADL and IADL functionality and describe preserved functions and activity limitation in an aggregated measure. Stage can inform interventions to ameliorate disability and thus reduce the risk of a subsequent hospitalization in this population. IV. Copyright © 2017

  3. Standard assessments of frailty are validated predictors of mortality in hospitalized patients with cirrhosis.

    LENUS (Irish Health Repository)

    Tapper, Elliot B

    2015-04-04

    The risk of morbidity and mortality for hospitalized patients with cirrhosis is high and incompletely captured by conventional indices. We sought to evaluate the predictive role of frailty in an observational cohort study of inpatients with decompensated cirrhosis between 2010 and 2013. The primary outcome was 90-day mortality. Secondary outcomes included discharge to a rehabilitation hospital, 30-day readmission, and length of stay. Frailty was assessed with three metrics: activities of daily living (ADL), the Braden Scale, and the Morse fall risk score. A predictive model was validated by randomly dividing the population into training and validation cohorts: 734 patients were admitted 1358 times in the study period. The overall 90-day mortality was 18.3%. The 30-day readmission rate was 26.6%, and the rate of discharge to a rehabilitation facility was 14.3%. Adjusting for sex, age, Model for End-Stage Liver Disease, sodium, and Charlson index, the odds ratio for the effect of an ADL score of less than 12 of 15 on mortality is 1.83 (95% confidence interval [CI] 1.05-3.20). A predictive model for 90-day mortality including ADL and Braden Scale yielded C statistics of 0.83 (95% CI 0.80-0.86) and 0.77 (95% CI 0.71-0.83) in the derivation and validation cohorts, respectively. Discharge to a rehabilitation hospital is predicted by both the ADL (<12) and Braden Scale (<16), with respective adjusted odds ratios of 3.78 (95% CI 1.97-7.29) and 6.23 (95% CI 2.53-15.4). Length of stay was associated with the Braden Scale (<16) (hazard ratio = 0.63, 95% CI 0.44-0.91). No frailty measure was associated with 30-day readmission.

  4. Comprehensive rehabilitation measure treatment on spinal cord injury central pain of clinical observation%综合康复措施治疗脊髓损伤中枢性疼痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    肖登; 夏新蜀

    2011-01-01

    目的:探讨综合康复治疗措施对脊髓损伤后中枢性疼痛的治疗效果.方法:对31例脊髓损伤后中枢性疼痛患者采用阿米替林、按摩、心理治疗及经皮神经电刺激(TENS)进行治疗.采用McGill疼痛问卷(McGill pain questionnaire,MPQ)、疼痛视觉模拟评分法(Visual Analogous Score,VAS)于治疗前和治疗1疗程后对疼痛和日常生活活动(activities of daily living,ADL)能力进评定.结果:治疗后患者疼痛的各项评分均有明显降低(PADL)能力明显提高(P<0.01).结论:综合康复措施治疗脊髓损伤后中枢性疼痛效果明显.%Objective: To observe the effects of multidisciplinary therapy on central pain of patients with spinal cord injury. Methods: 31 cases of spinal cord injury with central pain were treated with amitriptyline, psychotherapy and transcutaneous electric nerve stimulation ( TENS ), and the effects were assessed by McGill Pain Questionnaire (MPQ), Visual Analogous Score (VAS) and activities of daily living (ADL). Results:The scores of pain of all patients significantly decreased and the scores of ADL highly increased after treatment ( P < 0.01 ). Conclusion: Multidisciplinary therapy is effective on central pain in patients with spinal cord injury.

  5. Work ability as a determinant of old age disability severity: evidence from the 28-year Finnish Longitudinal Study on Municipal Employees.

    Science.gov (United States)

    von Bonsdorff, Mikaela B; Seitsamo, Jorma; Ilmarinen, Juhani; Nygård, Clas-Håkan; von Bonsdorff, Monika E; Rantanen, Taina

    2012-08-01

    Lower occupational class correlates with a higher disability risk later in life. However, it is not clear whether the demands made by mental and physical work relative to individual resources in midlife predict well-being in old age. This study investigated prospectively whether work ability in midlife predicts disability severity in activities of everyday living in old age. Data come from the population-based 28-year follow-up called Finnish Longitudinal Study of Municipal Employees. A total of 2879 occupationally active persons aged 44-58 years answered a questionnaire on work ability at baseline in 1981 and activities of daily living in 2009. At baseline, perceived work ability relative to lifetime best was categorized into excellent, moderate, and poor work ability. At follow-up, disability scales were constructed based on the severity and frequency of difficulties reported in self-care activities of daily living (ADL) and instrumental activities of daily living (IADL). There was a graded prevalence of ADL and IADL disability severity, according to excellent, moderate and poor midlife work ability (pwork ability had an 11 to 20% higher mean ADL or IADL disability severity score, compared with those with excellent midlife work ability (reference), incidence rate ratios (IRR) ranging from 1.11 (95% CI 1.01-1.22) to 1.20 (95% CI 1.10-1.30). Those with poor midlife work ability had a mean ADL or IADL disability severity score 27 to 38% higher than the referent, IRRs ranging from 1.27 (95% CI 1.09-1.47) to 1.38 (95% CI 1.25-1.53). Adjusting for socio-economics, lifestyle factors and chronic diseases only slightly attenuated the associations. Work ability, an indicator of the de- mands made by mental and physical work relative to individuals' mental and physical resources, predicted disability severity 28 years later among middle-aged municipal employees.

  6. Health Promotion Behaviours and Level of Activities of Daily Living and Instrumental Activities of Daily Living Among Elderly People in West Region of Tehran: A Cross-Sectional Survey

    Directory of Open Access Journals (Sweden)

    Aghil Habibi Sola

    2007-10-01

    Full Text Available Objectives: As individuals live longer, health promotion behaviors get even more important, particularly with regard to maintaining functional independence and improving quality of life. The purpose of this study was to explore the relationship between health promotion behaviors and level of Activities of Daily Living (ADL and Instrumental Activities of Daily Living (IADL among elderly people in west region of Tehran. Methods & Materials: This was a descriptive-correlational study. A multi-stage sample of 410 community residents who were over 60 years old were selected from west region of Tehran. Participants who consented to participate in the study were interviewed with a structured questionnaire. The questionnaire consisted of 2-part; Health Promotion Behavior Checklist and questions related to status of physical functioning, which includes activities of daily living (ADLs and instrumental activities of daily living (IADLs. Descriptive statistics and T-test were used to data analysis. Results: The results of the study showed that there were significant relations between ADLs and ' exercise or walking', 'drinking milk, eating dairy and meat', 'eating vegetables and fruits', 'low salt diet' and 'low fat diet' (P<0.05. Furthermore there were significant relations between the IADLs and 'smoking cessation', 'alcohol abstinence', 'exercise or walking', 'drinking milk, eating dairy and meat', 'eating vegetables and fruits', 'low salt diet' and 'low fat diet' (P<0.05. Conclusion: Study showed, health promotion behaviors and level of ADL and IADL are related meaningfully. Health care professionals should enhance the physical functioning in elderly people by facilitating health promotion behaviors through formal health promotion programs which focus on regular diet, exercise, and regular physical check-ups which will maintain and increase a healthy and active life.

  7. Effect of fall-related concerns on physical, mental, and social function in community-dwelling older adults: a prospective cohort study.

    Science.gov (United States)

    van der Meulen, Erik; Zijlstra, G A Rixt; Ambergen, Ton; Kempen, Gertrudis I J M

    2014-12-01

    To determine the effect of fall-related concerns on physical, mental, and social function. Community-based prospective cohort study (secondary analysis using control group data from a randomized controlled trial). Two municipalities in the south of the Netherlands. Community-dwelling older adults (N = 260). Two groups were created using Modified Falls Efficacy Scale scores (high and low levels of fall-related concerns). Five outcome measures representing physical, mental, and social function were included: activities of daily living (ADLs), symptoms of depression, feelings of anxiety, social participation, and social support interactions. Outcomes were measured at baseline and at 2, 8, and 14 months. Data were analyzed using analysis of covariance and mixed-effect regression models for longitudinal data, adjusting for age, sex, living status (alone or with another person), educational level, cognitive status, self-perceived health, and falls history at baseline. At baseline, significantly more limitations in ADLs and social participation were found for older persons with high levels of fall-related concerns than for those with low levels of concern. These differences persisted over 14 months of follow-up and were consistent over time. No significant differences were found for symptoms of depression, feelings of anxiety, or social support interactions, except for feelings of anxiety at 14 months. Older persons with higher levels of fall-related concerns reported up to 14 months poorer ADL and social participation for up to 14 months than those with lower levels of fall-related concerns. From a clinical point of view, the clear relationship between fall-related concerns and ADL dysfunction and social participation may help to target groups who are at risk of developing adverse consequences of concerns about falls. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  8. The Effects of Quality of Life and Ability to Perform Activities of Daily Living on Mild Cognitive Impairment in Older People Living in Publicly Managed Congregate Housing.

    Science.gov (United States)

    Chang, Chun-Feng; Yang, Rea-Jeng; Chang, Shu-Fang; Chou, Yuan Hwa; Huang, Ean-Wen

    2017-06-01

    Mild cognitive impairment (MCI) is characterized by a decrease in cognitive abilities that does not affect the ability to perform activities of daily living (ADLs). Therefore, this condition is easily overlooked. The prevalence and factors of influence for MCI in older people living in publicly managed congregate housing are currently unknown. This study investigated the prevalence and distribution of MCI in older people living in publicly managed congregate housing and assessed the correlations among quality of life (QoL), ADL, and MCI. This study applied a correlational study design. The participants were older people who met the study criteria and who lived in public housing in Wanhua District, Taipei City, Taiwan. One-on-one interviews were conducted to measure the cognitive abilities of the participants, and 299 valid samples were collected. The prevalence of MCI in older people living in publicly managed congregate housing was 16.1%. The χ test was employed to evaluate the distribution of MCI prevalence and indicated that the group with higher MCI prevalence exhibited the following characteristics: older than 81 years; married; lived in public housing for more than 20 years; cohabiting; had a history of drinking; and exhibited severe memory regression, physical disabilities, psychological distress, and low QoL. The difference between the groups achieved statistical significance (p < .05). After performing logistical regression analysis to control demographic variables, we found that QoL and ADL were critical for predicting MCI. This study confirmed that QoL and ADL correlate significantly with MCI in older people. Maintaining an open and supportive community enables older people to maintain sufficient mental activity, which has been shown to reduce MCI. These findings may provide an important reference for policy makers, educators, researchers, and community practitioners in their development of service strategies for older people.

  9. The Myosuit: Bi-articular Anti-gravity Exosuit That Reduces Hip Extensor Activity in Sitting Transfers.

    Science.gov (United States)

    Schmidt, Kai; Duarte, Jaime E; Grimmer, Martin; Sancho-Puchades, Alejandro; Wei, Haiqi; Easthope, Chris S; Riener, Robert

    2017-01-01

    Muscle weakness-which can result from neurological injuries, genetic disorders, or typical aging-can affect a person's mobility and quality of life. For many people with muscle weakness, assistive devices provide the means to regain mobility and independence. These devices range from well-established technology, such as wheelchairs, to newer technologies, such as exoskeletons and exosuits. For assistive devices to be used in everyday life, they must provide assistance across activities of daily living (ADLs) in an unobtrusive manner. This article introduces the Myosuit, a soft, wearable device designed to provide continuous assistance at the hip and knee joint when working with and against gravity in ADLs. This robotic device combines active and passive elements with a closed-loop force controller designed to behave like an external muscle (exomuscle) and deliver gravity compensation to the user. At 4.1 kg (4.6 kg with batteries), the Myosuit is one of the lightest untethered devices capable of delivering gravity support to the user's knee and hip joints. This article presents the design and control principles of the Myosuit. It describes the textile interface, tendon actuators, and a bi-articular, synergy-based approach for continuous assistance. The assistive controller, based on bi-articular force assistance, was tested with a single subject who performed sitting transfers, one of the most gravity-intensive ADLs. The results show that the control concept can successfully identify changes in the posture and assist hip and knee extension with up to 26% of the natural knee moment and up to 35% of the knee power. We conclude that the Myosuit's novel approach to assistance using a bi-articular architecture, in combination with the posture-based force controller, can effectively assist its users in gravity-intensive ADLs, such as sitting transfers.

  10. Outcome and quality of life of patients with acute kidney injury after major surgery.

    Science.gov (United States)

    Abelha, F J; Botelho, M; Fernandes, V; Barros, H

    2009-01-01

    In postoperative critically-ill patients who develop Acute Kidney Injury (AKI) it is important to focus on survival and quality of life beyond hospital discharge. The aim of the study was to evaluate outcome and quality of life in patients that develop AKI after major surgery. This retrospective study was carried out in a Post-Anaesthesia Care Unit with five intensive care beds during 2 years. Patients were followed for the development of AKI. Preoperative characteristics, intra-operative management and outcome were evaluated. Six months after discharge, these patients were contacted to complete a Short Form-36 questionnaire (SF-36) and to have their dependency in ADL evaluated. Chi-square or Fischer's exact test were used to compare proportions between groups. A "t test" and a paired "t test" for independent groups was used for comparisons. Of 1584 patients admitted to the PACU, 1200 patients met the inclusion criteria. One hundred-fourteen patients (9.6%) met AKI criteria. Patients with AKI were more severely ill, stayed longer at the PACU. Among 71 hospital survivors at 6 months follow-up, 50 completed the questionnaires. Fifty-two percent of patients reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients that met AKI criteria after surgery had worse SF-36 scores for physical function, role physical and role emotional domains. Six months after PACU discharge, patients that met AKI criteria were more dependent in I-ADL but not in P-ADL. Patients that develop AKI improved self-perception of quality of life despite having high rate of dependency in ADL tasks. For physical function and role physical domains they had worse scores than PACU patients that did not develop AKI.

  11. Quality of life and mortality assessment in patients with major cardiac events in the postoperative period.

    Science.gov (United States)

    Abelha, Fernando José; Botelho, Miguela; Fernandes, Vera; Barros, Henrique

    2010-01-01

    Cardiovascular complications in the postoperative period are associated with high mortality and morbidity. Few studies have assessed the degree of dependence in these patients and their perception of health. The objective of this study was to assess the mortality and the quality of life in patients who developed major cardiac events (MCE) in the postoperative period. Retrospective study carried out in a Surgical Intensive Care Unit (SICU), between March 2006 and March 2008. The patients were assessed regarding the occurrence of CE. Six months after the hospital discharge, the Short-Form-36 (SF-36) questionnaire was filled out and dependence was assessed in relation to activities of daily living (ADL). The comparisons between independent groups of patients were carried out using Student's t test. The comparison between each variable and the occurrence of CE was carried out by logistic regression and included all patients. Of the 1,280 patients that met the inclusion criteria, 26 (2%) developed MCE. The univariate analysis identified as independent determinants for the development of major cardiac events: ASA physical status, hypertension, ischemic heart disease, congestive heart disease and score of the Revised Cardiac Risk Index (RCRI). The six-month mortality after the SICU discharge was 35%. Of the 17 surviving patients, 13 completed the questionnaires. Thirty-one percent of them reported that their general health was better on the day they answered the questionnaire, when compared to 12 months before. Sixty-nine percent of the patients were dependent in instrumental ADL e 15% in personal ADL. The development of MCE has a significant impact on the duration of hospital stay and mortality rates. Six months after the discharge from the SICU, more than 50% of the patients were dependent in at least one instrumental ADL. Copyright 2010 Elsevier Editora Ltda. All rights reserved.

  12. Utilisation of formal and informal care and services at home among persons with dementia: a cross-sectional study.

    Science.gov (United States)

    Bökberg, Christina; Ahlström, Gerd; Karlsson, Staffan

    2017-09-04

    The progression of dementia disease implies increasing needs for both informal and formal care and services but also risk of institutionalisation. To better adjust care and services in the phase preceding institutionalisation it is important to find out whether utilisation of formal and informal care and services is determined by increased needs and by who meets the needs. The aim was to compare persons with dementia (65+) with different levels of cognitive impairment, regarding utilisation of formal and informal care and service at home. The participants consisted of 177 persons with dementia ≥65 years old and at risk of nursing home admission, divided into groups according to their cognitive function. Structured interviews were conducted based on questionnaires about type and amount of formal and informal care utilised, as well as questions regarding cognitive impairment, dependency in activities of daily living (ADLs) and neuropsychiatric symptoms. To analyse the data, descriptive and comparative statistics were used. The findings revealed that the group with severe dementia used significantly more help with ADLs and supervision in terms of time (number of hours and days) provided by the informal caregiver, compared with the group with moderate dementia. Utilisation of formal care and services was highest in the group with the most severe cognitive impairments (Standardized Mini-Mental State Examination score of <9). The group with severe dementia were more dependent in ADLs and had more neuropsychiatric symptoms (hallucinations and motor disturbances). They were younger and more often cohabitated with the informal caregiver, compared with the group with moderate dementia. This study shows that in the phase preceding institutionalisation the ADL and supervision needs due to progression of dementia appear to tend to be met first and foremost by the informal caregivers. © 2017 Nordic College of Caring Science.

  13. The Myosuit: Bi-articular Anti-gravity Exosuit That Reduces Hip Extensor Activity in Sitting Transfers

    Directory of Open Access Journals (Sweden)

    Kai Schmidt

    2017-10-01

    Full Text Available Muscle weakness—which can result from neurological injuries, genetic disorders, or typical aging—can affect a person's mobility and quality of life. For many people with muscle weakness, assistive devices provide the means to regain mobility and independence. These devices range from well-established technology, such as wheelchairs, to newer technologies, such as exoskeletons and exosuits. For assistive devices to be used in everyday life, they must provide assistance across activities of daily living (ADLs in an unobtrusive manner. This article introduces the Myosuit, a soft, wearable device designed to provide continuous assistance at the hip and knee joint when working with and against gravity in ADLs. This robotic device combines active and passive elements with a closed-loop force controller designed to behave like an external muscle (exomuscle and deliver gravity compensation to the user. At 4.1 kg (4.6 kg with batteries, the Myosuit is one of the lightest untethered devices capable of delivering gravity support to the user's knee and hip joints. This article presents the design and control principles of the Myosuit. It describes the textile interface, tendon actuators, and a bi-articular, synergy-based approach for continuous assistance. The assistive controller, based on bi-articular force assistance, was tested with a single subject who performed sitting transfers, one of the most gravity-intensive ADLs. The results show that the control concept can successfully identify changes in the posture and assist hip and knee extension with up to 26% of the natural knee moment and up to 35% of the knee power. We conclude that the Myosuit's novel approach to assistance using a bi-articular architecture, in combination with the posture-based force controller, can effectively assist its users in gravity-intensive ADLs, such as sitting transfers.

  14. Patient Satisfaction and Perceived Quality of Care Among Older Adults According to Activity Limitation Stages

    Science.gov (United States)

    Bogner, Hillary R.; de Vries McClintock, Heather F.; Hennessy, Sean; Kurichi, Jibby E.; Streim, Joel E.; Xie, Dawei; Pezzin, Liliana E.; Kwong, Pui L.; Stineman, Margaret G.

    2016-01-01

    OBJECTIVE To examine whether patient satisfaction and perceived quality of medical care was related to stages of activity limitations among older adults. DESIGN Cross-sectional study. SETTING Medicare Current Beneficiary Survey (MCBS) for calendar years 2001-2011. PARTICIPANTS A population-based sample (n= 42,584) of persons 65 years of age and older living in the community. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) MCBS questions were categorized under 5 patient satisfaction and perceived quality dimensions: care coordination and quality, access barriers, technical skills of primary care physicians, interpersonal skills of primary care physicians, and quality of information provided by primary care physicians. Persons were classified into a stage of activity limitation (0-IV) derived from self-reported difficulty levels performing activities of daily living (ADLs) and instrumental activities of daily living (IADLs). RESULTS Compared to older beneficiaries with no limitations at ADL Stage 0, the adjusted odds ratios (OR) (95% confidence intervals (CI)) for Stage I (mild) to Stage III (severe) for satisfaction with care coordination and quality ranged from OR = 0.85 (95% CI: 0.80-0.92) to OR = 0.79 (95% CI: 0.70-0.89). Compared to ADL Stage 0, satisfaction with access barriers ranged from OR = 0.81 (95% CI: 0.76-0.87) at Stage I (mild) to a minimum of OR = 0.67 (95% CI: 0.59-0.76) at Stage III (severe). Similarly, compared to older beneficiaries at ADL Stage 0, perceived quality of the technical skills of their primary care physician ranged from OR = 0.87 (95% CI: 0.82-0.94) at Stage I (mild) to a minimum of OR = 0.81 (95% CI: 0.72-0.91) at Stage III (severe). CONCLUSIONS Medicare beneficiaries at higher stages of activity limitation although not necessarily the highest stage of activity limitation reported less satisfaction with medical care. PMID:26119464

  15. A designated centre for people with disabilities operated by Daughters of Charity Disability Support Services Ltd., Limerick

    LENUS (Irish Health Repository)

    Tapper, Elliot B

    2015-04-04

    The risk of morbidity and mortality for hospitalized patients with cirrhosis is high and incompletely captured by conventional indices. We sought to evaluate the predictive role of frailty in an observational cohort study of inpatients with decompensated cirrhosis between 2010 and 2013. The primary outcome was 90-day mortality. Secondary outcomes included discharge to a rehabilitation hospital, 30-day readmission, and length of stay. Frailty was assessed with three metrics: activities of daily living (ADL), the Braden Scale, and the Morse fall risk score. A predictive model was validated by randomly dividing the population into training and validation cohorts: 734 patients were admitted 1358 times in the study period. The overall 90-day mortality was 18.3%. The 30-day readmission rate was 26.6%, and the rate of discharge to a rehabilitation facility was 14.3%. Adjusting for sex, age, Model for End-Stage Liver Disease, sodium, and Charlson index, the odds ratio for the effect of an ADL score of less than 12 of 15 on mortality is 1.83 (95% confidence interval [CI] 1.05-3.20). A predictive model for 90-day mortality including ADL and Braden Scale yielded C statistics of 0.83 (95% CI 0.80-0.86) and 0.77 (95% CI 0.71-0.83) in the derivation and validation cohorts, respectively. Discharge to a rehabilitation hospital is predicted by both the ADL (<12) and Braden Scale (<16), with respective adjusted odds ratios of 3.78 (95% CI 1.97-7.29) and 6.23 (95% CI 2.53-15.4). Length of stay was associated with the Braden Scale (<16) (hazard ratio = 0.63, 95% CI 0.44-0.91). No frailty measure was associated with 30-day readmission.

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

    Science.gov (United States)

    Maeda, Keisuke; Koga, Takayuki; Akagi, Junji

    2018-01-01

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

  17. Predictors of sustained response to rivastigmine in patients with Alzheimer's disease: a retrospective analysis.

    Science.gov (United States)

    Sadowsky, Carl H; Grossberg, George T; Somogyi, Monique; Meng, Xiangyi

    2011-01-01

    The cholinesterase inhibitor rivastigmine is approved for the treatment of mild to moderate Alzheimer's disease. However, it is not possible to predict which individuals will benefit from treatment. This retrospective analysis of an international, 24-week, randomized, double-blind trial aimed to identify the percentage of persons with Alzheimer's disease who have a sustained response with rivastigmine patch, rivastigmine capsules, or placebo; to determine the magnitude of the sustained treatment response; and to investigate baseline patient characteristics predictive of the observed sustained response. Patients who improved on the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Alzheimer's Disease Cooperative Study-Activities of Daily Living scale (ADCS-ADL) at week 16 and maintained at least the week 16 improvement at week 24 were identified as sustained responders. Treatment differences and baseline predictive factors were assessed in patients demonstrating a 1-, 2-, 3-, 4-, or 5-point sustained improvement. The first patient was screened in November 2003 and the last patient completed the study in January 2006. More persons with Alzheimer's disease had sustained improvements on the ADAS-cog and ADCS-ADL with rivastigmine versus placebo. Sustained improvements of 4 or 5 points on the ADAS-cog or ADCS-ADL were demonstrated in the 9.5-mg/24-h rivastigmine patch (24% and 36% of patients, respectively) and 12-mg/d capsule groups (28% on both outcome measures). Factors predictive of a sustained response to treatment included baseline Mini-Mental State Examination, ADAS-cog, and ADCS-ADL scores and treatment, country of treatment, and time since first symptom was diagnosed by a physician. Understanding factors predictive of sustained cholinesterase inhibitor treatment response should help to optimize Alzheimer's disease management and encourage compliance by allowing more realistic expectations of treatment effects.

  18. Functional Independence in Late-Life: Maintaining Physical Functioning in Older Adulthood Predicts Daily Life Function after Age 80.

    Science.gov (United States)

    Vaughan, Leslie; Leng, Xiaoyan; La Monte, Michael J; Tindle, Hilary A; Cochrane, Barbara B; Shumaker, Sally A

    2016-03-01

    We examined physical functioning (PF) trajectories (maintaining, slowly declining, and rapidly declining) spanning 15 years in older women aged 65-80 and protective factors that predicted better current levels and less decline in functional independence outcomes after age 80. Women's Health Initiative extension participants who met criteria (enrolled in either the clinical trial or observational study cohort, >80 years at the data release cutoff, PF survey data from initial enrollment to age 80, and functional independence survey data after age 80) were included in these analyses (mean [SD] age = 84.0 [1.4] years; N = 10,478). PF was measured with the SF-36 (mean = 4.9 occasions). Functional independence was measured by self-reported level of dependence in basic and instrumental activities of daily living (ADLs and IADLs) (mean = 3.4 and 3.3 occasions). Maintaining consistent PF in older adulthood extends functional independence in ADL and IADL in late-life. Protective factors shared by ADL and IADL include maintaining PF over time, self-reported excellent or very good health, no history of hip fracture after age 55, and no history of cardiovascular disease. Better IADL function is uniquely predicted by a body mass index less than 25 and no depression. Less ADL and IADL decline is predicted by better self-reported health, and less IADL decline is uniquely predicted by having no history of hip fracture after age 55. Maintaining or improving PF and preventing injury and disease in older adulthood (ages 65-80) has far-reaching implications for improving late-life (after age 80) functional independence. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Transcranial direct current stimulation (tDCS) for improving function and activities of daily living in patients after stroke.

    Science.gov (United States)

    Elsner, Bernhard; Kugler, Joachim; Pohl, Marcus; Mehrholz, Jan

    2013-11-15

    Stroke is one of the leading causes of disability worldwide. Functional impairment resulting in poor performance in activities of daily living (ADLs) among stroke survivors is common. Current rehabilitation approaches have limited effectiveness in improving ADL performance and function after stroke, but a possible adjunct to stroke rehabilitation might be non-invasive brain stimulation by transcranial direct current stimulation (tDCS) to modulate cortical excitability and hence to improve ADL performance and function. To assess the effects of tDCS on generic activities of daily living (ADLs) and motor function in people with stroke. We searched the Cochrane Stroke Group Trials Register (March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, May 2013), MEDLINE (1948 to May 2013), EMBASE (1980 to May 2013), CINAHL (1982 to May 2013), AMED (1985 to May 2013), Science Citation Index (1899 to May 2013) and four additional databases. In an effort to identify further published, unpublished and ongoing trials, we searched trials registers and reference lists, handsearched conference proceedings and contacted authors and equipment manufacturers. We included only randomised controlled trials (RCTs) and randomised controlled cross-over trials (from which we analysed only the first period as a parallel-group design) that compared tDCS versus control in adults with stroke for improving ADL performance and function. Two review authors independently assessed trial quality (JM and MP) and extracted data (BE and JM). If necessary, we contacted study authors to ask for additional information. We collected information on dropouts and adverse events from the trial reports. We included 15 studies involving a total of 455 participants. Analysis of six studies involving 326 participants regarding our primary outcome, ADL, showed no evidence of an effect in favour of tDCS at the end of the intervention phase (mean difference (MD) 5.31 Barthel

  20. Development and simulation of a passive upper extremity orthosis for amyoplasia

    DEFF Research Database (Denmark)

    Jensen, Erik Føge; Raunsbæk, Joakim; Lund, Jan Nørgaard

    2018-01-01

    Introduction People who are born with arthrogryposis multiplex congenita are typically not able to perform activities of daily living (ADL) due to decreased muscle mass, joint contractures and unnatural upper extremity positioning. They are, therefore, potential users of an assistive device capable....... Results For a given configuration using a mono- and a bi-articular spring, the simulations showed that spring stiffnesses of 400?Nm?1 and of 1029?Nm?1, respectively, were able to lower the maximal muscle activity estimated by the musculoskeletal model to a level in which the 10 postures can be realized....... Conclusion By augmenting residual muscle strength with a partially gravity-balanced passive orthosis, ADLs may be achievable for people with arthrogryposis multiplex congenita....