WorldWideScience

Sample records for daily home measurements

  1. Daily home measurements of exhaled nitric oxide in asthmatic children during natural birch pollen exposure

    DEFF Research Database (Denmark)

    Vahlkvist, Signe; Sinding, Marianne; Skamstrup, Kirsten

    2006-01-01

    the feasibility, repeatability, accuracy, sensitivity, and biologic plausibility of new handheld equipment for FENO measurements. We studied day-to-day home measurements of FENO during the birch pollen season in children with allergy to birch pollen and a history of mild asthma and rhinoconjunctivitis during...... this season, as well as in nonatopic children. METHODS: Eleven children with mild asthma and allergy to birch pollen, performed daily home measurements of FENO for 6 weeks before and during the birch pollen season by using a handheld FENO monitor (NIOX MINO). Additionally, FENO (chemiluminescence equipment...... of FENO to a wider group of asthma clinics and even home measurements....

  2. 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.

  3. 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

  4. Measurements of Daily Energy Intake and Total Energy Expenditure in People with Dementia in Care Homes: The Use of Wearable Technology.

    Science.gov (United States)

    Murphy, J; Holmes, J; Brooks, C

    2017-01-01

    To estimate daily total energy expenditure (TEE) using a physical activity monitor, combined with dietary assessment of energy intake to assess the relationship between daily energy expenditure and patterns of activity with energy intake in people with dementia living in care homes. A cross-sectional study in care homes in the UK. Twenty residents with confirmed dementia diagnosis were recruited from two care homes that specialised in dementia care. A physical activity monitor (SensewearTM Armband, Body Media, Pittsburgh, PA) was employed to objectively determine total energy expenditure, sleep duration and physical activity. The armband was placed around the left upper triceps for up to 7 days. Energy intake was determined by weighing all food and drink items over 4 days (3 weekdays and 1 weekend day) including measurements of food wastage. The mean age was 78.7 (SD ± 11.8) years, Body Mass Index (BMI) 23.0 (SD ± 4.2) kg/m2; 50% were women. Energy intake (mean 7.4; SD ± 2.6) MJ/d) was correlated with TEE (mean 7.6; SD ± 1.8 MJ/d; r=0.49, p<0.05). Duration of sleeping ranged from 0.4-12.5 (mean 6.1) hrs/d and time spent lying down was 1.3-16.0 (8.3) hrs/d. On average residents spent 17.9 (6.3-23.4) hrs/d undertaking sedentary activity. TEE was correlated with BMI (r=0.52, p<0.05) and body weight (r=0.81, p<0.001) but inversely related to sleep duration (r=-0.59, p<0.01) and time lying down (r=-0.62, p<0.01). Multiple linear regression analysis revealed that after taking BMI, sleep duration and time spent lying down into account, TEE was no longer correlated with energy intake. The results show the extent to which body mass, variable activity and sleep patterns may be contributing to TEE and together with reduced energy intake, energy requirements were not satisfied. Thus wearable technology has the potential to offer real-time monitoring to provide appropriate nutrition management that is more person-centred to prevent weight loss in dementia.

  5. Eldercare at Home: Problems of Daily Living

    Science.gov (United States)

    ... suggestions and provide education or other support. A social worker with the home health agency may make a few visits to discuss options ... carry out needed medical procedures. They often have social workers and ... When home health agency staff are visiting the home because of physical ...

  6. Unsupervised daily routine and activity discovery in smart homes.

    Science.gov (United States)

    Jie Yin; Qing Zhang; Karunanithi, Mohan

    2015-08-01

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

  7. Home geriatric physiological measurements.

    Science.gov (United States)

    Tamura, Toshiyo

    2012-10-01

    In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the 'smart-house' project. This review concludes by discussing future challenges of the future aged society.

  8. Home geriatric physiological measurements

    International Nuclear Information System (INIS)

    Tamura, Toshiyo

    2012-01-01

    In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the ‘smart-house’ project. This review concludes by discussing future challenges of the future aged society. (topical review)

  9. The daily commute from work to home: examining employees' experiences in relation to their recovery status.

    Science.gov (United States)

    van Hooff, Madelon L M

    2015-04-01

    Sufficient recovery after daily effort expenditure at work is important to protect employee health and well-being. However, the role of commuting in the daily effort-recovery process is still not very well understood. The present study aimed to advance insight in this respect by examining if relaxation, detachment, mastery and stressful delays experienced during the commute from work to home affect employees' recovery status after returning home from work and at the end of the evening. Daily job demands were expected to moderate these effects. Serenity and (low) anxiety were included as indicators of employees' recovery status. Data were collected by means of a 5-day daily diary study (three measurements daily) among 76 participants from various industries. Multilevel analyses showed that relaxation was positively and stressful delays were negatively related to employees' recovery status after returning home from work but not to indicators of recovery at the end of the evening. For detachment, similar relations were found but only on days with high job demands. Mastery was not related to employees' recovery status. These findings enhance our insight in the daily effort-recovery cycle and underline the importance of promoting detachment (on demanding workdays) and relaxation on the way home from work. Copyright © 2013 John Wiley & Sons, Ltd.

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

    OpenAIRE

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

    2016-01-01

    Despite the benefits of smartphones, many adverse effects have emerged. However, to date, there was no particular approach to treat or prevent smartphone addiction. The aim of this study was to evaluate the therapeutic effectiveness of a home-based daily journal of smartphone use (HDJ-S) in Korean adolescents. Three hundred thirty five middle school students participated in this study. The severity of smartphone addiction was measured using the Korean Smartphone Addiction Proneness Scale. The...

  11. Achieving Improvement Through Nursing Home Quality Measurement

    OpenAIRE

    Harris, Yael; Clauser, Steven B.

    2002-01-01

    CMS has initiated the Nursing Home Quality Initiative (NHQI) to improve the quality of nursing home care. Central to the NHQI is the public reporting of nursing home quality measures that serve as the basis for the Initiative's communication and quality improvement program. This article provides an overview of the NHQI, focusing on the role of nursing home quality measures in achieving improvements in nursing home care. We also describe the evolution of quality measurement in nursing homes, a...

  12. Incremental short daily home hemodialysis: a case series.

    Science.gov (United States)

    Toth-Manikowski, Stephanie M; Mullangi, Surekha; Hwang, Seungyoung; Shafi, Tariq

    2017-07-05

    Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. From 2011 to 2015, we initiated 5 incident hemodialysis patients on an incremental home hemodialysis regimen. The biochemical parameters of all patients remained stable on the incremental hemodialysis regimen and they consistently achieved standard Kt/Vurea targets. Of the two patients with follow-up >6 months, residual kidney function was preserved for ≥2 years. Importantly, the patients were able to transition to home hemodialysis without automatically requiring 5 sessions per week at the outset and gradually increased the number of treatments and/or dialysate volume as the residual kidney function declined. An incremental home hemodialysis regimen can be safely prescribed and may improve acceptability of home hemodialysis. Reducing hemodialysis frequency by even one treatment per week can reduce the number of fistula or graft cannulations or catheter connections by >100 per year, an important consideration for patient well-being, access longevity, and access-related infections. The incremental hemodialysis approach, supported by national guidelines, can be considered for all home hemodialysis patients with residual kidney function.

  13. The dynamic relationship between daily activities, home environment, and identity when living with advanced cancer

    DEFF Research Database (Denmark)

    Mærsk, Jesper Larsen

    The importance of daily activities and home to identity when living with advanced cancer Introduction Research within occupational science and gerontology has documented that being engaged in daily activities and having relational bonds to home are important to identity formation. For people living...... with advanced cancer in Denmark it is of priority to be able to live at home for as long as possible. For approximately 80% their home is the preferred place to die. Studies indicate home is the place where people with advanced cancer spent most of their day and are engaged in most of their daily activities...... with advanced cancer in Denmark may experience challenges to how they can form and express their identity through what they do and where they live. Objectives The purpose of this study is to generate knowledge about how people with advanced cancer through their words and actions express: • The importance...

  14. Oral temperatures of the elderly in nursing homes in summer and winter in relation to activities of daily living

    Science.gov (United States)

    Nakamura, K.; Tanaka, Masatoshi; Motohashi, Yutaka; Maeda, Akira

    This study was conducted to clarify the seasonal difference in body temperature in summer and winter, and to document the thermal environment of the elderly living in nursing homes. The subjects were 57 healthy elderly people aged >=63 years living in two nursing homes in Japan. One of the homes was characterized by subjects with low levels of activities of daily living (ADL). Oral temperatures were measured in the morning and afternoon, with simultaneous recording of ambient temperature and relative humidity. Oral temperatures in summer were higher than in winter, with statistically significant differences (Pchanges in ambient temperature.

  15. Sensor monitoring to measure and support daily functioning for independently living older people: a systematic review and road map for further development

    NARCIS (Netherlands)

    Pol, Margriet C.; Poerbodipoero, Soemitro; Robben, Saskia; Daams, Joost; van Hartingsveldt, Margo; de Vos, Rien; de Rooij, Sophia E.; Kröse, Ben; Buurman, Bianca M.

    2013-01-01

    To study sensor monitoring (use of a sensor network placed in the home environment to observe individuals' daily functioning (activities of daily living and instrumental activities of daily living)) as a method to measure and support daily functioning for older people living independently at home.

  16. Incremental short daily home hemodialysis: a case series

    OpenAIRE

    Toth-Manikowski, Stephanie M.; Mullangi, Surekha; Hwang, Seungyoung; Shafi, Tariq

    2017-01-01

    Background Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients? residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. Case presentation From 2011 to 2015, we initiated 5 incident hemodialysis patients on an ...

  17. Solute kinetics with short-daily home hemodialysis using slow dialysate flow rate.

    Science.gov (United States)

    Kohn, Orly F; Coe, Fredric L; Ing, Todd S

    2010-01-01

    "NxStage System One()" is increasingly used for daily home hemodialysis. The ultrapure dialysate volumes are typically between 15 L and 30 L per dialysis, substantially smaller than the volumes used in conventional dialysis. In this study, the impact of the use of low dialysate volumes on the removal rates of solutes of different molecular weights and volumes of distribution was evaluated. Serum measurements before and after dialysis and total dialysate collection were performed over 30 times in 5 functionally anephric patients undergoing short-daily home hemodialysis (6 d/wk) over the course of 8 to 16 months. Measured solutes included beta(2) microglobulin (beta(2)M), phosphorus, urea nitrogen, and potassium. The average spent dialysate volume (dialysate plus ultrafiltrate) was 25.4+/-4.7 L and the dialysis duration was 175+/-15 min. beta(2) microglobulin clearance of the polyethersulfone dialyzer averaged 53+/-14 mL/min. Total beta(2)M recovered in the dialysate was 106+/-42 mg per treatment (n=38). Predialysis serum beta(2)M levels remained stable over the observation period. Phosphorus removal averaged 694+/-343 mg per treatment with a mean predialysis serum phosphorus of 5.2+/-1.8 mg/dL (n=34). Standard Kt/V averaged 2.5+/-0.3 per week and correlated with the dialysate-based weekly Kt/V. Weekly beta(2)M, phosphorus, and urea nitrogen removal in patients dialyzing 6 d/wk with these relatively low dialysate volumes compared favorably with values published for thrice weekly conventional and with short-daily hemodialysis performed with machines using much higher dialysate flow rates. Results of the present study were achieved, however, with an average of 17.5 hours of dialysis per week.

  18. 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

  19. Daily Home Spirometry: An Effective Tool for Detecting Progression in Idiopathic Pulmonary Fibrosis.

    Science.gov (United States)

    Russell, Anne-Marie; Adamali, Huzaifa; Molyneaux, Philip L; Lukey, Pauline T; Marshall, Richard P; Renzoni, Elisabetta A; Wells, Athol U; Maher, Toby M

    2016-10-15

    Recent clinical trial successes have created an urgent need for earlier and more sensitive endpoints of disease progression in idiopathic pulmonary fibrosis (IPF). Domiciliary spirometry permits more frequent measurement of FVC than does hospital-based assessment, which therefore affords the opportunity for a more granular insight into changes in IPF progression. To determine the feasibility and reliability of measuring daily FVC in individuals with IPF. Subjects with IPF were given handheld spirometers and instruction on how to self-administer spirometry. Subjects recorded daily FEV 1 and FVC for up to 490 days. Clinical assessment and hospital-based spirometry was undertaken at 6 and 12 months, and outcome data were collected for 3 years. Daily spirometry was recorded by 50 subjects for a median period of 279 days (range, 13-490 d). There were 18 deaths during the active study period. Home spirometry showed excellent correlation with hospital-obtained readings. The rate of decline in FVC was highly predictive of outcome and subsequent mortality when measured at 3 months (hazard ratio [HR], 1.040; 95% confidence interval [CI], 1.021-1.062; P ≤ 0.001), 6 months (HR, 1.024; 95% CI, 1.014-1.033; P spirometry in patients with IPF is highly clinically informative and is feasible to perform for most of these patients. The relationship between mortality and rate of change of FVC at 3 months suggests that daily FVC may be of value as a primary endpoint in short proof-of-concept IPF studies.

  20. Systems Health Care: daily measurement and lifestyle change

    Science.gov (United States)

    Nakajima, Hiroshi; Tsuchiya, Naoki; Shiga, Toshikazu; Hata, Yutaka

    2012-06-01

    Health is quite important to be realized in our daily life. However, its idea covers wide area and has individual dependency. Activities in health care have been widely developed by medical, drag, insurance, food, and other types of industries mainly centering diseases. In this article, systems approach named Systems Health Care is introduced and discussed to generate new and precious values based on measurements in daily life to change lifestyle habits for realizing each health. Firstly, issues related to health such as its definitions are introduced and discussed by centering health rather than disease. In response to the discussions on health, Home and Medical Care is continuously introduced to point out the important role causality between life style and vital signal such as exercise and blood pressure based on detailed sampling time. Systems approaches of Systems Health Care are discussed from various points of views. Real applications of devices and services are used to make the studies and discussions deeper on the subjects of the article.

  1. Home Accidents and Assistance in Daily Activities of Older Women in Turkey

    Science.gov (United States)

    Erkal, Sibel; Sahin, Hande

    2010-01-01

    This study analyzed the relation between incidents of at-home accidents and the assistance in daily activities of women age of 65+ living in the area of Dikmen Akpinar Health Care Unit in Ankara-Turkey. Of the women, 49.2% had experienced a home accident in the last 12 months. More than half of these accidents were caused by falling. Women over…

  2. Health smart home for elders - a tool for automatic recognition of activities of daily living.

    Science.gov (United States)

    Le, Xuan Hoa Binh; Di Mascolo, Maria; Gouin, Alexia; Noury, Norbert

    2008-01-01

    Elders live preferently in their own home, but with aging comes the loss of autonomy and associated risks. In order to help them live longer in safe conditions, we need a tool to automatically detect their loss of autonomy by assessing the degree of performance of activities of daily living. This article presents an approach enabling the activities recognition of an elder living alone in a home equipped with noninvasive sensors.

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

    Science.gov (United States)

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

    2016-01-01

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

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  5. How does older people’s drinking appear in the daily work of home care professionals?

    Directory of Open Access Journals (Sweden)

    Koivula Riitta

    2016-12-01

    Full Text Available AIMS - In this article the authors ask how the alcohol use of elderly home care clients affects the daily work of home care professionals and how the professionals act to support the drinking client. METHODS - Semi-structured interviews with 10 home care professionals were conducted from December 2014 to February 2015 in the Helsinki metropolitan area of Finland. Everyday situations during home visits related to the clients’ alcohol use were analysed according to modalities of agency of the home care professionals. RESULTS - The results focus on three themes raised in the interviews: supporting life management of the client, the lack of qualifications in tackling clients’ drinking and the need for multi-professional collaboration. Intoxicated clients complicated the home care nurses’ work and obstructed the implementation of recommendations set out to guide the professionals’ operations. Care work with alcohol-using clients was particularly demanding, and the professionals were concerned about not having enough training in how to encounter elderly clients’ drinking. Multi-professional collaboration with substance abuse services and emergency department personnel was called for to remedy this problem. CONCLUSIONS - More extensive and detailed research is needed for a better picture of how clients’ drinking influences home care nurses’ working conditions and what kind of skills nurses need in different alcohol-related situations. Such research would have the potential to benefit clients and improve the well-being of the employees.

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

    Science.gov (United States)

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-05-01

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

  8. Sensor monitoring to measure and support daily functioning for independently living older people: A systematic review and road map for further development

    NARCIS (Netherlands)

    Pol, M.C.; Poerbodipoero, S.; Robben, S.; Daams, J.; van Hartingsveldt, M.; de Vos, R.; de Rooij, S.E.; Kröse, B.; Buurman, B.M.

    2013-01-01

    Objectives To study sensor monitoring (use of a sensor network placed in the home environment to observe individuals' daily functioning (activities of daily living and instrumental activities of daily living)) as a method to measure and support daily functioning for older people living independently

  9. Detection of Early Morning Daily Activities with Static Home and Wearable Wireless Sensors

    Directory of Open Access Journals (Sweden)

    David Vanderpool

    2007-10-01

    Full Text Available This paper describes a flexible, cost-effective, wireless in-home activity monitoring system for assisting patients with cognitive impairments due to traumatic brain injury (TBI. The system locates the subject with fixed home sensors and classifies early morning bathroom activities of daily living with a wearable wireless accelerometer. The system extracts time- and frequency-domain features from the accelerometer data and classifies these features with a hybrid classifier that combines Gaussian mixture models and a finite state machine. In particular, the paper establishes that despite similarities between early morning bathroom activities of daily living, it is possible to detect and classify these activities with high accuracy. It also discusses system training and provides data to show that with proper feature selection, accurate detection and classification are possible for any subject with no subject specific training.

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

    Directory of Open Access Journals (Sweden)

    Rodriguez-Roisin R

    2016-08-01

    Full Text Available Roberto Rodriguez-Roisin,1 Kay Tetzlaff,2,3 Henrik Watz,4 Emiel FM Wouters,5 Bernd Disse,2 Helen Finnigan,6 Helgo Magnussen,4 Peter MA Calverley7 1Respiratory Institute, Servei de Pneumologia, Hospital Clínic IDIBAPS-CIBERES, Universitat de Barcelona, Barcelona, Spain; 2Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany; 3Department of Sports Medicine, University of Tübingen, Tübingen, Germany; 4Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany; 5Department of Respiratory Medicine, University Hospital Maastricht, Maastricht University, Maastricht, the Netherlands; 6Department of Biostatistics and Data Sciences, Boehringer Ingelheim, Bracknell, UK; 7Institute of Ageing and Chronic Disease, Aintree University Hospital, Liverpool, UK Abstract: The WISDOM study (NCT00975195 reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measurements in addition to undergoing periodic in-clinic spirometric testing throughout the study duration. We subsequently determined the validity of home-based spirometry for detecting changes in lung function by comparing in-clinic and home-based forced expiratory volume in 1 second in patients who underwent stepwise fluticasone propionate withdrawal over 12 weeks versus patients remaining on fluticasone propionate for 52 weeks. Bland–Altman analysis of these data confirmed good agreement between in-clinic and home-based measurements, both across all visits and at the individual visits at study weeks 6, 12, 18, and 52. There was a measurable difference between the forced expiratory volume

  11. Impact of continuous in-home rehabilitation on quality of life and activities of daily living in elderly clients over 1 year.

    Science.gov (United States)

    Imanishi, Miyuki; Tomohisa, Hisao; Higaki, Kazuo

    2017-11-01

    To verify the effect of in-home rehabilitation on quality of life and activities of daily living in elderly clients. In this non-randomized controlled intervention trial, elderly participants were separated into a rehabilitation or a non-rehabilitation group (n = 100 each). The non-rehabilitation group received basic in-home nursing care, including assistance with cooking, cleaning, toileting, meals and medication. The rehabilitation group received a physical treatment program provided by a licensed professional once a week and basic nursing care in the home. For each group, quality of life and activities of daily living were assessed approximately every 3 months over a 1-year period. Quality of life was evaluated using the Philadelphia Geriatric Center Morale Scale, and activities of daily living were evaluated based on the Functional Independence Measure. The rehabilitation group showed statistically significant improvements in both quality of life and activities of daily living. In contrast, the non-rehabilitation group, although showing slight improvement in quality of life at 9 months, showed almost no effects at the other time-points and no significant changes in activities of daily living over the course of the study. The results of the present study suggest that long-term continuous in-home rehabilitation might improve quality of life and activities of daily living in elderly clients. Geriatr Gerontol Int 2017; 17: 1866-1872. © 2017 Japan Geriatrics Society.

  12. Hospitalization in daily home hemodialysis and matched thrice-weekly in-center hemodialysis patients.

    Science.gov (United States)

    Weinhandl, Eric D; Nieman, Kimberly M; Gilbertson, David T; Collins, Allan J

    2015-01-01

    Cardiovascular disease is a common cause of hospitalization in dialysis patients. Daily hemodialysis improves some parameters of cardiovascular function, but whether it associates with lower hospitalization risk is unclear. Observational cohort study using US Renal Data System data. Medicare-enrolled daily (5 or 6 sessions weekly) home hemodialysis (HHD) patients initiating NxStage System One use from January 1, 2006, through December 31, 2009, and contemporary thrice-weekly in-center hemodialysis patients, matched 5 to 1. Daily HHD or thrice-weekly in-center hemodialysis. All-cause and cause-specific hospital admissions, hospital readmissions, and hospital days assessed from Medicare Part A claims. For 3,480 daily HHD and 17,400 thrice-weekly in-center hemodialysis patients in intention-to-treat analysis, the HR of all-cause admission for daily HHD versus in-center hemodialysis was 1.01 (95%CI, 0.98-1.03). Cause-specific admission HRs were 0.89 (95%CI, 0.86-0.93) for cardiovascular disease, 1.18 (95%CI, 1.13-1.23) for infection, 1.01 (95%CI, 0.93-1.09) for vascular access dysfunction, and 1.02 (95%CI, 0.99-1.06) for other morbidity. Regarding cardiovascular disease, first admission and readmission HRs for daily HHD versus in-center hemodialysis were 0.91 and 0.87, respectively. Regarding infection, first admission and readmission HRs were 1.35 and 1.03, respectively. Protective associations of daily HHD with heart failure and hypertensive disease were most pronounced, as were adverse associations of daily HHD with bacteremia/sepsis, cardiac infection, osteomyelitis, and vascular access infection. Results may be confounded by unmeasured factors, including vascular access type; information about dialysis frequency, duration, and dose was lacking; causes of admission may be misclassified; results may not apply to patients without Medicare coverage. All-cause hospitalization risk was similar in daily HHD and thrice-weekly in-center hemodialysis patients. However

  13. Measuring safety climate in elderly homes.

    Science.gov (United States)

    Yeung, Koon-Chuen; Chan, Charles C

    2012-02-01

    Provision of a valid and reliable safety climate dimension brings enormous benefits to the elderly home sector. The aim of the present study was to make use of the safety climate instrument developed by OSHC to measure the safety perceptions of employees in elderly homes such that the factor structure of the safety climate dimensions of elderly homes could be explored. In 2010, surveys by mustering on site method were administered in 27 elderly homes that had participated in the "Hong Kong Safe and Healthy Residential Care Home Accreditation Scheme" organized by the Occupational Safety and Health Council. Six hundred and fifty-one surveys were returned with a response rate of 54.3%. To examine the factor structure of safety climate dimensions in our study, an exploratory factor analysis (EFA) using principal components analysis method was conducted to identify the underlying factors. The results of the modified seven-factor's safety climate structure extracted from 35 items better reflected the safety climate dimensions of elderly homes. The Cronbach alpha range for this study (0.655 to 0.851) indicated good internal consistency among the seven-factor structure. Responses from managerial level, supervisory and professional level, and front-line staff were analyzed to come up with the suggestion on effective ways of improving the safety culture of elderly homes. The overall results showed that managers generally gave positive responses in the factors evaluated, such as "management commitment and concern to safety," "perception of work risks and some contributory influences," "safety communication and awareness," and "safe working attitude and participation." Supervisors / professionals, and frontline level staff on the other hand, have less positive responses. The result of the lowest score in the factors - "perception of safety rules and procedures" underlined the importance of the relevance and practicability of safety rules and procedures. The modified OSHC

  14. Daily spillover from family to work: A test of the work-home resources model.

    Science.gov (United States)

    Du, Danyang; Derks, Daantje; Bakker, Arnold B

    2018-04-01

    The present study examines a mediated moderation model of the day-level effects of family hassles and family-work spillover (affect and cognition) on the relationship between job resources and employees' flourishing at work. Based on the work-home resources model, the authors hypothesized that demands from one domain (family) induce repetitive thoughts or negative feelings about those problems, so that individuals are not able to function optimally and to make full use of contextual resources in the other domain (work). Multilevel analyses of 108 Chinese working parents' 366 daily surveys revealed that the relationship between morning job resources and afternoon flourishing was significantly positive when previous day family hassles were low; the relationship became nonsignificant when previous day family hassles were high. In addition, as predicted, daily rumination also attenuated the relationship between morning job resources and afternoon flourishing, whereas daily affect did not. Finally, the moderating effect of previous day family hassles was mediated by daily rumination. The findings contribute to spillover theories by revealing the roles of affective and cognitive spillover from family to work. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  15. Energy Savings Measure Packages. Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Casey, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Booten, Chuck [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2011-11-01

    This document presents the most cost effective Energy Savings Measure Packages (ESMP) for existing mixed-fuel and all electric homes to achieve 15% and 30% savings for each BetterBuildings grantee location across the United States. These packages are optimized for minimum cost to homeowners for source energy savings given the local climate and prevalent building characteristics (i.e. foundation types). Maximum cost savings are typically found between 30% and 50% energy savings over the reference home; this typically amounts to $300 - $700/year.

  16. A time series based sequence prediction algorithm to detect activities of daily living in smart home.

    Science.gov (United States)

    Marufuzzaman, M; Reaz, M B I; Ali, M A M; Rahman, L F

    2015-01-01

    The goal of smart homes is to create an intelligent environment adapting the inhabitants need and assisting the person who needs special care and safety in their daily life. This can be reached by collecting the ADL (activities of daily living) data and further analysis within existing computing elements. In this research, a very recent algorithm named sequence prediction via enhanced episode discovery (SPEED) is modified and in order to improve accuracy time component is included. The modified SPEED or M-SPEED is a sequence prediction algorithm, which modified the previous SPEED algorithm by using time duration of appliance's ON-OFF states to decide the next state. M-SPEED discovered periodic episodes of inhabitant behavior, trained it with learned episodes, and made decisions based on the obtained knowledge. The results showed that M-SPEED achieves 96.8% prediction accuracy, which is better than other time prediction algorithms like PUBS, ALZ with temporal rules and the previous SPEED. Since human behavior shows natural temporal patterns, duration times can be used to predict future events more accurately. This inhabitant activity prediction system will certainly improve the smart homes by ensuring safety and better care for elderly and handicapped people.

  17. A Context-Aware System Infrastructure for Monitoring Activities of Daily Living in Smart Home

    Directory of Open Access Journals (Sweden)

    Qin Ni

    2016-01-01

    Full Text Available We propose a three-layered context-aware architecture for monitoring activities of daily life in smart home. This architecture provides for the inclusion of functionalities that range from low-level data collection to high-level context knowledge extraction. We have also devised an upper-level ontology to model the context in which the activities take place. This enables having a common activity-related context representation, on which to infer and share knowledge. Furthermore, we have begun to implement a platform that realizes our architecture and ontology, making use of Microsoft’s Lab of Things (LoT platform, being the preliminary results on this task also described in the paper.

  18. Low-cost measurement techniques to characterize the influence of home heating fuel on carbon monoxide in Navajo homes.

    Science.gov (United States)

    Casey, Joanna Gordon; Ortega, John; Coffey, Evan; Hannigan, Michael

    2018-06-01

    A large fraction of the global population relies on the inefficient combustion of solid fuels for cooking and home heating, resulting in household exposure to combustion byproducts. In the southwestern United States, unhealthy air quality has been observed in some homes that use solid fuels as a primary source of heat on the Navajo Nation. In order to better understand how home heating fuel choice can influence indoor air quality in this region, we used recently developed low-cost electrochemical sensors to measure carbon monoxide (CO) air mole fractions continuously inside and outside 41 homes in two communities on the Navajo Nation. Using low-cost sensors in this study, which don't require extensive training to operate, enabled collaboration with local Diné College students and faculty in the planning and implementation of home deployments. Households used natural gas, propane, pellets, wood, and/or coal for heating. We developed quantification methods that included uncertainty estimation for Alphasense CO-B4 sensors, for measurements both inside and outside homes. CO concentrations elevated above background were observed in homes in each heating fuel group, but the highest hourly concentrations were observed in wood and coal burning homes, some of which exceeded World Health Organization Guidelines on both an hourly and eight-hourly basis. In order to probe the many factors that can influence indoor pollutant concentrations, we developed and implemented methods that employ CO emission and decay time periods observed in homes during everyday activities to estimate air exchange rates as well as CO emission rates on the basis of a given well-mixed volume of air. The air quality measurement tools and methods demonstrated in this study can be readily extended to indoor air quality studies in other communities around the world to inform how home heating and cooking practices are influencing indoor air quality during normal daily activities. Copyright © 2018 Elsevier

  19. Evaluating the Feasibility and Intercorrelation of Measurements on the Functioning of Residents Living in Scandinavian Nursing Homes

    DEFF Research Database (Denmark)

    Andresen, Mette; Frändin, Kerstin; Grönstedt, Helena

    2010-01-01

    Background. The purpose of this study is to investigate the feasibility of measurements of muscle strength, balance, cognitive function, mobility, activities of daily living (ADL), and physical activity for use in a Scandinavian nursing home population and to examine intercorrelations between the......, functional independence measure, physiotherapy clinical outcome variables, and the Nursing Home Life Space...

  20. A comparison of center-based vs. home-based daily hemodialysis for patients with end-stage renal disease.

    Science.gov (United States)

    Kraus, Michael; Burkart, John; Hegeman, Rebecca; Solomon, Richard; Coplon, Norman; Moran, John

    2007-10-01

    Home hemodialysis has been a therapeutic option for almost 4 decades. The complexity of dialysis equipment has been a factor-limiting adoption of this modality. We performed a feasibility study to demonstrate the safety of center-based vs. home-based daily hemodialysis with the NxStage System One portable hemodialysis device. We also performed a retrospective analysis to determine if clinical effects previously associated with short-daily dialysis were also seen using this novel device. We conducted a prospective, 2-treatment, 2-period, open-label, crossover study of in-center hemodialysis vs. home hemodialysis in 32 patients treated at 6 U.S. centers. The 8-week In-Center Phase (6 days/week) was followed by a 2-week transition period and then followed by the 8-week Home Phase (6 days/week). We retrospectively collected data on hemodialysis treatment parameters immediately preceding the study in a subset of patients. Twenty-six out of 32 patients (81%) successfully completed the study. Successful delivery of at least 90% of prescribed fluid volume (primary endpoint) was achieved in 98.5% of treatments in-center and 97.3% at home. Total effluent volume as a percentage of prescribed volume was between 94% and 100% for all study weeks. The composite rate of intradialytic and interdialytic adverse events per 100 treatments was significantly higher for the In-Center Phase (5.30) compared with the Home Phase (2.10; p=0.007). Compared with the period immediately preceding the study, there were reductions in blood pressure, antihypertensive medications, and interdialytic weight gain. Daily home hemodialysis with a small, easy-to-use hemodialysis device is a viable dialysis option for end-stage renal disease patients capable of self/partner-administered dialysis.

  1. What Is Nursing Home Quality and How Is It Measured?

    Science.gov (United States)

    Castle, Nicholas G.; Ferguson, Jamie C.

    2010-01-01

    Purpose: In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. Design and Methods: A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO)…

  2. Sensorized toys for measuring manipulation capabilities of infants at home.

    Science.gov (United States)

    Passetti, Giovanni; Cecchi, Francesca; Baldoli, Ilaria; Sgandurra, Giuseppina; Beani, Elena; Cioni, Giovanni; Laschi, Cecilia; Dario, Paolo

    2015-01-01

    Preterm infants, i.e. babies born after a gestation period shorter than 37 weeks, spend less time exploring objects. The quantitative measurement of grasping actions and forces in infants can give insights on their typical or atypical motor development. The aim of this work was to test a new tool, a kit of sensorized toys, to longitudinally measure, monitor and promote preterm infants manipulation capabilities with a purposive training in an ecological environment. This study presents preliminary analysis of grasping activity. Three preterm infants performed 4 weeks of daily training at home. Sensorized toys with embedded pressure sensors were used as part of the training to allow quantitative analysis of grasping (pressure and acceleration applied to toys while playing). Each toy was placed on the midline, while the infant was in supine position. Preliminary data show differences in the grasping parameters in relation to infants age and the performed daily training. Ongoing clinical trial will allow a full validation of this new tool for promoting object exploration in preterm infants.

  3. 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

  4. Wintertime pollution level, size distribution and personal daily exposure to particulate matters in the northern and southern rural Chinese homes and variation in different household fuels.

    Science.gov (United States)

    Du, Wei; Shen, Guofeng; Chen, Yuanchen; Zhuo, Shaojie; Xu, Yang; Li, Xinyue; Pan, Xuelian; Cheng, Hefa; Wang, Xilong; Tao, Shu

    2017-12-01

    This study investigated and compared wintertime air pollution and personal exposure in the rural northern and southern Chinese homes. Daily indoor and outdoor particle samples were simultaneously collected by using stationary samplers, and personal exposure was directly measured using portable carried samplers. The daily average concentrations of indoor and outdoor PM 2.5 were 521 ± 234 and 365 ± 185 μg/m 3 in the northern village, that were about 2.3-2.7 times of 188 ± 104 and 150 ± 29 μg/m 3 in indoor and outdoor air in the southern villages. Particle size distribution was similar between indoor and outdoor air, and had relatively smaller difference between the two sites, relative to the particle mass concentration difference. PM 2.5 contributed to ∼80% of the TSP mass, and in PM 2.5 , near 90% were PM 1.0 . In homes using electricity in the southern villages, outdoor air pollution could explain 70-80% of the variation in indoor air pollution. The daily exposure to PM 2.5 measured using personal carried samplers were 451 ± 301 μg/m 3 in the northern villages with traditional solid fuels used for daily cooking and heating, and in the southern villages without heating, the exposure to PM 2.5 were 184 ± 83 and 166 ± 45 μg/m 3 , respectively, for the population using wood and electricity for daily cooking. Time-weighted daily average exposure estimated from area concentration and time spent indoor and outdoor was generally correlated the directly measured exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Depression is associated with poor functioning in activities of daily living among nursing home residents without cognitive impairment.

    Science.gov (United States)

    Drageset, Jorunn; Eide, Geir E; Ranhoff, Anette H

    2011-11-01

    To explore depressive symptoms among nursing home residents without cognitive impairment and the relationship between their depressive symptoms and dependence on activities of daily living, comorbidity and sociodemographic variables. Depression has become a major health care concern among older people, but depression and its association with functioning in activities of daily living among nursing home residents without cognitive impairment has previously not been studied in Norway. A cross-sectional comparative design. The sample comprised older residents (age 65-102 years; n = 227) from 30 nursing homes with at least six months of residence. All nursing home residents had a Clinical Dementia Rating scale score ≤0·5 and were capable of conversation. Scores on the Geriatric Depression Scale (15 items) and demographic variables were collected during face-to-face interviews. The activities of daily living were assessed using the Katz Index based on nurses' observation, and medical diagnoses were obtained from the patient records. Pearson's chi-square test and ordinal logistic regression were used to identify possible associations between activities of daily living and depression. After adjustment for age, sex, marital status, length of stay per year and education, more dependence on activities of daily living was associated with depression [odds ratio (OR): 1·18; 95% confidence interval (CI): 1·04-1·37; p = 0·02]. Higher age was associated with less depression (OR: 0·64; 95% CI: 0·43-0·94; p = 0·02), that is, the odds of depression declined by 36% for each 10-year increase in age. Our results suggest that depression symptoms are a major health problem among nursing home residents without cognitive impairment and that younger residents are more prone to having depressive symptoms. Nursing home staff should communicate with and observe residents closely for signs of depression, especially younger residents with high dependence on activities of daily living

  6. Vitamin D supplementation in nursing home patients: randomized controlled trial of standard daily dose versus individualized loading dose regimen.

    Science.gov (United States)

    Wijnen, Hugo; Salemink, Dayenne; Roovers, Lian; Taekema, Diana; de Boer, Hans

    2015-05-01

    Supplementation of cholecalciferol 800 IU daily appears to be insufficient to raise vitamin D levels to >75 nmol/l in nursing home (NH) patients. Our objective was to compare the efficacy of an individualized cholecalciferol loading dose (LD) regimen and a daily dose (DD) regimen of cholecalciferol 800 IU in reaching 25-OH vitamin D (25OHD) levels >75 nmol/l. A total of 30 NH patients with 25OHD levels 50 nmol/l were included. Patients were randomized using the minimization method in the LD or DD group. The cholecalciferol LD, calculated with an algorithm based on serum 25OHD level and body weight, was administered in divided doses of 50,000 IU twice a week, followed by a monthly maintenance dose of either 50,000 or 25,000 IU. The DD regimen consisted of cholecalciferol 800 IU daily for 26 weeks. Serum 25OHD, calcium, creatinine, phosphate, and parathyroid hormone were measured, and 2-minute walking test, handgrip strength, and timed get up and go test were assessed at baseline (T 0), after 5 weeks (T 5), 12 weeks (T 12), and 26 weeks (T 26). The primary endpoint was the percentage of patients with 25OHD levels >75 nmol/l at T 5. Secondary endpoints were the proportion of patients with 25OHD levels >75 nmol/l at T 26, safety of LD regimen, and improvement of performance tests with normalization of vitamin D levels. Median baseline 25OHD levels (interquartile range) were comparable between the 14 DD and 16 LD patients: 20.9 (15.9-29.6) and 21.7 (16.4-32.8) nmol/l, respectively. Levels of 25OHD >75 nmol/l at T 5 were reached in 79 % of the 14 LD patients, but in none of the 13 DD patients (p 75 nmol/l were reached in 83 % of the 12 LD patients and in 30 % of the ten DD patients (p tests was observed. In NH patients with severe 25OHD deficiency, an individualized calculated cholecalciferol LD is likely to be superior to a DD of cholecalciferol 800 IU in terms of the ability to rapidly normalize vitamin D levels.

  7. MedMinify: An Advice-giving System for Simplifying the Schedules of Daily Home Medication Regimens Used to Treat Chronic Conditions.

    Science.gov (United States)

    Flynn, Allen J; Klasnja, Predrag; Friedman, Charles P

    2014-01-01

    For those with high blood pressure, diabetes, or high cholesterol, adherence to a home medication regimen is important for health. Reductions in the number of daily medication-taking events or daily pill burden improve adherence. A novel advice-giving computer application was developed using the SMART platform to generate advice on how to potentially simplify home medication regimens. MedMinify generated advice for 41.3% of 1,500 home medication regimens for adults age 60 years and older with chronic medical conditions. If the advice given by MedMinify were implemented, 320 regimen changes would have reduced daily medication-taking events while an additional 295 changes would have decreased the daily pill burden. The application identified four serious drug-drug interactions and so advised against taking two pairs of medications simultaneously. MedMinify can give advice to change home medication regimens that could result in simpler home medication-taking schedules.

  8. Measuring and Assuring the Quality of Home Health Care

    Science.gov (United States)

    Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.

    1994-01-01

    The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157

  9. Use of Clinical Health Information Technology in Nursing Homes: Nursing Home Characteristics and Quality Measures

    Science.gov (United States)

    Spinelli-Moraski, Carla

    2014-01-01

    This study compares quality measures among nursing homes that have adopted different levels of clinical health information technology (HIT) and examines the perceived barriers and benefits of the adoption of electronic health records as reported by Nursing Home Administrators and Directors of Nursing. A cross-sectional survey distributed online to…

  10. The daily commute from work to home: Examining employees' experiences in relation to their recovery status

    NARCIS (Netherlands)

    Hooff, M.L.M. van

    2015-01-01

    Sufficient recovery after daily effort expenditure at work is important to protect employee health and well-being. However, the role of commuting in the daily effort-recovery process is still not very well understood. The present study aimed to advance insight in this respect by examining if

  11. Gender Regimes in Ontario Nursing Homes: Organization, Daily Work, and Bodies.

    Science.gov (United States)

    Storm, Palle; Braedley, Susan; Chivers, Sally

    2017-06-01

    Today more men work in the long-term care sector, but men are still in the minority. Little is known about men's experiences in care work, and the dilemmas and opportunities they face because of their gender. This article focuses on men care workers' integration into the organization and flow of nursing home work as perceived by these workers and staff members. Using a rapid ethnography method in two Ontario nursing homes, we found work organization affected interpretations of gender and race, and that workers' scope for discretion affected the integration and acceptance of men as care workers. In a nursing home with a rigid work organization and little worker discretion, women workers perceived men workers as a problem, whereas at a nursing home with a more flexible work organization that stressed relational care, both women and men workers perceived men workers as a resource in the organization.

  12. Adaptação de instrumento para dimensionar horas diárias de assistência de enfermagem residencial Adaptacion de instrumento para medir horas diarias de atención de enfermería domiciliaria Adaptation of an instrument for the measurement of daily hours for nursing care at patient's home

    Directory of Open Access Journals (Sweden)

    Luiza Watanabe Dal Ben

    2004-03-01

    Full Text Available O Therapeutic Intervention Scoring System Intermediate: TISS-Intermediário foi traduzido para a língua portuguesa e adaptado para estabelecer horas diárias de assistência domiciliar. O processo de modificação do instrumento, desenvolvido através da Técnica Delphi, teve como participantes 16 enfermeiros, que atuam em empresas de assistência domiciliar e determinam horas diárias de assistência de enfermagem para pacientes na residência, após a hospitalização. Ao término do estudo obteve-se um instrumento com 104 itens, para ser no futuro validado clinicamente. Tal instrumento ajudará enfermeiros a estender cuidados de enfermagem a pacientes em casa, após a alta hospitalar, especialmente na tomada de decisões relativas à avaliação dos pacientes.El Therapeutic Intervention Scoring System Intermediate: TISS-Intermedio, fue traducido para el idioma portugués y adaptado para establecer las horas diarias de asistencia en el domicilio. Dieciséis enfermeros participaron del proceso de modificación del instrumento desarrollado a través de la Técnica Delphi. Esos enfermeros actúan en empresas de atención a domicilio y determinan las horas diarias de atención de enfermería a los pacientes en su domicilio después del alta. Al término del estudio se obtuvo un instrumento con 104 items para ser validado clínicamente.Tal instrumento ayudará a los enfermeros a extender sus cuidados de enfermería a pacientes que se encuentran en casa, después del alta hospitalario, especialmente en la toma de decisiones relacionadas con la evaluación de los pacientes.The Therapeutic Intervention Scoring System Intermediate: TISS-Intermediate, was translated into Portuguese and adapted to establish the number of hours daily of home care. The adaptation process of the instrument, developed with the Delphi Technique, used 16 nurses, who work in home care service providers and helped in calculating the number of nursing care hours for patients at

  13. Relations between mothers' daily work, home, and relationship stress with characteristics of mother-child conflict interactions.

    Science.gov (United States)

    Nelson, Jackie A; Boyer, Brittany P; Villarreal, Deyaun L; Smith, Olivia A

    2017-06-01

    This study examined whether daily variations in levels of mothers' work, home, and relationship stress were related to collaborative and oppositional qualities of mother-child conflict interactions across 1 week. Mothers reported on 1 specific conflict interaction with their 5- to 8-year-old child and their work, home, and relationship stress through online surveys each day for 7 consecutive days. Diary data from 142 mothers were analyzed in 6 multilevel models, each including within- and between-family levels of a stressor predicting collaborative or oppositional conflict qualities. Results suggested that families in the sample differed from each other, and also varied during the week, in collaborative and oppositional conflict qualities as well as stress in all 3 domains. Mothers reported a greater degree of oppositional conflict qualities on days characterized by higher perceptions of home chaos. Additionally, mothers who reported higher average levels of negativity in romantic relationships endorsed oppositional conflict qualities to a greater extent than mothers with lower relationship negativity. Two multilevel models including all 3 stressors in relation to collaborative and oppositional conflict revealed that for mothers managing multiple roles, average romantic relationship stress was the most important unique contributor to mother-child conflict qualities and daily relationship stress was particularly influential among mothers with sons compared to those with daughters. Results support the spillover hypothesis of stress within the family system and are discussed in terms of mothers' coping mechanisms and emotional engagement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. A New Measure of Home Exercise Benefits and Barriers

    Science.gov (United States)

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

    2016-01-01

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

  15. Association between stairs in the home and instrumental activities of daily living among community-dwelling older adults.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2018-06-04

    There is insufficient evidence regarding the relationship of home environment with functional capacity among community-dwelling older people without disabilities. We conducted a population-based longitudinal cohort study and examined whether stairs in the home were associated with capability to perform instrumental activities of daily living (IADL) in community-dwelling high-functioning older adults. The target population was individuals aged 65 years or older living in two municipalities in Nara Prefecture in Japan. At the baseline survey, residents who were independent in IADL (n = 6722) were included as survey subjects. Subjects were divided into three groups according to their home type; one-storey residences, walk-up residences, or residences with an elevator. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Multiple logistic regression analyses stratified by gender were used to calculate the odds ratio (OR) and a 95% confidence interval (CI) for a decline in IADL, with one-storey residences as a reference. Age, studied area, marital status, working status, self-perceived economic status, body mass index, chronic diseases, smoking, drinking, eating habits, basic activities of daily living, cognitive functioning, depression, self-rated health, and social participation were used as covariates. During the 3-year follow-up, 11.6% of the subjects showed a decline in IADL. After adjusting for covariates, women who lived in walk-up residences had a lower risk for IADL decline (adjusted OR = 0.72, 95% CI = 0.52-0.99), while living in a home with an elevator was not associated with IADL decline (adjusted OR = 0.94, 95% CI = 0.49-1.77). In contrast, there was no association between home type and IADL decline in men (walk-up residences, adjusted OR = 0.90, 95% CI = 0.71-1.14; residences with an elevator, adjusted OR = 0.82, 95% CI = 0.39-1.72). The presence of stairs in the home was

  16. Keeping pace with the ebbs and flows in daily nursing home operations

    NARCIS (Netherlands)

    Bekker, René; Moeke, Dennis; Schmidt, Bas

    2018-01-01

    Nursing homes are challenged to develop staffing strategies that enable them to efficiently meet the healthcare demand of their residents. In this study, we investigate how demand for care and support fluctuates over time and during the course of a day, using demand data from three independent

  17. Out-of-home activities, daily travel, and subjective well-being

    NARCIS (Netherlands)

    Ettema, D.F.; Gärling, T.; Olsson, L.E.; Friman, M.

    2010-01-01

    It is argued that utility theory that underpins current cost-benefit analyses of daily travel needs to be complemented. An alternative theoretical framework is to this end proposed which applies subjective well-being (SWB) to travel behaviour analysis. It is posited in this theoretical framework

  18. Comparative Measurements of Indoor Radon in Homes and Floating Houses

    International Nuclear Information System (INIS)

    Changmuang, Wirote; Tantawiroon, Malulee; Polphong, Pornsri

    2003-06-01

    A survey of the radon ( 222 Rn) concentrations in 318 homes and 152 floating houses (1410 samples) in Phitsanulok province, using a passive 222 Rn charcoal canister and measurement by gamma spectrometry. Floating houses showed significant lower mean levels (8.22 Bqm -3 ) than homes (21.56 Bqm -3 ) (p 222 Rn concentrations indicated that concrete homes had a higher level than wooden homes and homes lying on ground had a higher level than those built at 1 meter or more above ground. The estimated annual mean effective dose equivalent 0.35 mSvy -1 and the annual lung dose equivalent of 5.94 mSvy -1 were only one-third of the world mean estimates

  19. Environmental Consciousness in Daily Activities Measured by Negative Prompts

    Directory of Open Access Journals (Sweden)

    Ai Hiramatsu

    2015-12-01

    Full Text Available The gap between people’s attitude and action as regards environmental issues has been pointed out even while surveys registered an increase in people’s environmental awareness. Among the possible reasons is that people tend to automatically answer “yes”, as most surveys on environmental consciousness use positively-phrased questions or prompts. To remove the “yes-bias” in previous surveys, this present study conducted in Japan a large-scale questionnaire survey on environmental consciousness using negative prompts and free-answered prompts on which behaviors people feel good/bad/uncertain for the environment. This study also investigated peoples’ psychological factors and concrete pro-environmental behaviors (PEBs in daily life. The results of the questionnaire with negative prompts showed that the rate of people’s consciousness to the environment was lower compared with other surveys. Through factor analysis, five psychological factors were extracted as the explanatory factors of environmental attitude. Demographic effects on the consciousness and PEBs were also observed. Comparison of free-answers on concrete daily behaviors among five different environmentally conscious groups showed there were certain phases in the perception of PEBs based on consciousness level. Similar common behaviors were highly ranked as both PEB and doubtful behaviors, indicating that people were worried about actions that involve a trade-off relationship from diversified standpoints.

  20. SVM-based multimodal classification of activities of daily living in Health Smart Homes: sensors, algorithms, and first experimental results.

    Science.gov (United States)

    Fleury, Anthony; Vacher, Michel; Noury, Norbert

    2010-03-01

    By 2050, about one third of the French population will be over 65. Our laboratory's current research focuses on the monitoring of elderly people at home, to detect a loss of autonomy as early as possible. Our aim is to quantify criteria such as the international activities of daily living (ADL) or the French Autonomie Gerontologie Groupes Iso-Ressources (AGGIR) scales, by automatically classifying the different ADL performed by the subject during the day. A Health Smart Home is used for this. Our Health Smart Home includes, in a real flat, infrared presence sensors (location), door contacts (to control the use of some facilities), temperature and hygrometry sensor in the bathroom, and microphones (sound classification and speech recognition). A wearable kinematic sensor also informs postural transitions (using pattern recognition) and walk periods (frequency analysis). This data collected from the various sensors are then used to classify each temporal frame into one of the ADL that was previously acquired (seven activities: hygiene, toilet use, eating, resting, sleeping, communication, and dressing/undressing). This is done using support vector machines. We performed a 1-h experimentation with 13 young and healthy subjects to determine the models of the different activities, and then we tested the classification algorithm (cross validation) with real data.

  1. 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.

  2. [Home Daily Hemodialysis with NxStage System One: monocentric italian casistic results].

    Science.gov (United States)

    Brunati, Chiara; Cassaro, Franca; Cretti, Laura; Izzo, Michela; Pegoraro, Marisa; Negri, Daniela; Gervasi, Francesca; Colussi, Giacomo

    2017-09-28

    NxStage System One is a new dialytic technology based on easy setup, simplicity of use and reduced dimensions, which is increasingly in use worldwide for home hemodialysis treatments. The system utilizes a low amount of dialysate, usually 15-30 liters according to anthropometric patients' values. The dialysate is supplied at very low flux, generally about 1/3 of blood flow, in order to obtain an elevated saturation of dialysate for solutes. In these conditions the clearance of urea will be almost equal to dialysate flow rate. In order to achieve an obptimal weekly clearance evaluated by Std Kt/V the dialysis sessions are repeated six times a week. In this way a good control of blood voleme can be reached. In this paper we report our experience of treatment with NxStage System One in 12 patients from May 2011 to Dicember 2016. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  3. Evaluation of Three State-of-the-Art Classifiers for Recognition of Activities of Daily Living from Smart Home Ambient Data.

    Science.gov (United States)

    Nef, Tobias; Urwyler, Prabitha; Büchler, Marcel; Tarnanas, Ioannis; Stucki, Reto; Cazzoli, Dario; Müri, René; Mosimann, Urs

    2015-05-21

    Smart homes for the aging population have recently started attracting the attention of the research community. The "health state" of smart homes is comprised of many different levels; starting with the physical health of citizens, it also includes longer-term health norms and outcomes, as well as the arena of positive behavior changes. One of the problems of interest is to monitor the activities of daily living (ADL) of the elderly, aiming at their protection and well-being. For this purpose, we installed passive infrared (PIR) sensors to detect motion in a specific area inside a smart apartment and used them to collect a set of ADL. In a novel approach, we describe a technology that allows the ground truth collected in one smart home to train activity recognition systems for other smart homes. We asked the users to label all instances of all ADL only once and subsequently applied data mining techniques to cluster in-home sensor firings. Each cluster would therefore represent the instances of the same activity. Once the clusters were associated to their corresponding activities, our system was able to recognize future activities. To improve the activity recognition accuracy, our system preprocessed raw sensor data by identifying overlapping activities. To evaluate the recognition performance from a 200-day dataset, we implemented three different active learning classification algorithms and compared their performance: naive Bayesian (NB), support vector machine (SVM) and random forest (RF). Based on our results, the RF classifier recognized activities with an average specificity of 96.53%, a sensitivity of 68.49%, a precision of 74.41% and an F-measure of 71.33%, outperforming both the NB and SVM classifiers. Further clustering markedly improved the results of the RF classifier. An activity recognition system based on PIR sensors in conjunction with a clustering classification approach was able to detect ADL from datasets collected from different homes. Thus, our

  4. Evaluation of Three State-of-the-Art Classifiers for Recognition of Activities of Daily Living from Smart Home Ambient Data

    Directory of Open Access Journals (Sweden)

    Tobias Nef

    2015-05-01

    Full Text Available Smart homes for the aging population have recently started attracting the attention of the research community. The “health state” of smart homes is comprised of many different levels; starting with the physical health of citizens, it also includes longer-term health norms and outcomes, as well as the arena of positive behavior changes. One of the problems of interest is to monitor the activities of daily living (ADL of the elderly, aiming at their protection and well-being. For this purpose, we installed passive infrared (PIR sensors to detect motion in a specific area inside a smart apartment and used them to collect a set of ADL. In a novel approach, we describe a technology that allows the ground truth collected in one smart home to train activity recognition systems for other smart homes. We asked the users to label all instances of all ADL only once and subsequently applied data mining techniques to cluster in-home sensor firings. Each cluster would therefore represent the instances of the same activity. Once the clusters were associated to their corresponding activities, our system was able to recognize future activities. To improve the activity recognition accuracy, our system preprocessed raw sensor data by identifying overlapping activities. To evaluate the recognition performance from a 200-day dataset, we implemented three different active learning classification algorithms and compared their performance: naive Bayesian (NB, support vector machine (SVM and random forest (RF. Based on our results, the RF classifier recognized activities with an average specificity of 96.53%, a sensitivity of 68.49%, a precision of 74.41% and an F-measure of 71.33%, outperforming both the NB and SVM classifiers. Further clustering markedly improved the results of the RF classifier. An activity recognition system based on PIR sensors in conjunction with a clustering classification approach was able to detect ADL from datasets collected from different

  5. Daily living with distress and enrichment: the moral experience of families with ventilator-assisted children at home.

    Science.gov (United States)

    Carnevale, Franco A; Alexander, Eren; Davis, Michael; Rennick, Janet; Troini, Rita

    2006-01-01

    principal themes were (1) confronting parental responsibility: parental responsibility was described as stressful and sometimes overwhelming. Parents needed to devote extraordinary care and attention to their children's needs. They struggled with the significant emotional strain, physical and psychological dependence of the child, impact on family relationships, living with the daily threat of death, and feeling that there was "no free choice" in the matter: they could not have chosen to let their child die. (2) Seeking normality: all of the families devoted significant efforts toward normalizing their experiences. They created common routines so that their lives could resemble those of "normal" families. These efforts seemed motivated by a fundamental striving for a stable family and home life. This "striving for stability" was sometimes undermined by limitations in family finances, family cohesion, and unpredictability of the child's condition. (3) Conflicting social values: families were offended by the reactions that they faced in their everyday community. They believe that the child's life is devalued, frequently referred to as a life not worth maintaining. They felt like strangers in their own communities, sometimes needing to seclude themselves within their homes. (4) Living in isolation: families reported a deep sense of isolation. In light of the complex medical needs of these children, neither the extended families nor the medical system could support the families' respite needs. (5) What about the voice of the child? The children in this study (patients and siblings) were generally silent when asked to talk about their experience. Some children described their ventilators as good things. They helped them breathe and feel better. Some siblings expressed resentment toward the increased attention that their ventilated sibling was receiving. (6) Questioning the moral order: most families questioned the "moral order" of their lives. They contemplated how "good things

  6. Evaluating the Feasibility and Intercorrelation of Measurements on the Functioning of Residents Living in Scandinavian Nursing Homes

    DEFF Research Database (Denmark)

    Andresen, Mette; Frändin, Kerstin; Grönstedt, Helena

    2010-01-01

    Background. The purpose of this study is to investigate the feasibility of measurements of muscle strength, balance, cognitive function, mobility, activities of daily living (ADL), and physical activity for use in a Scandinavian nursing home population and to examine intercorrelations between...

  7. Daily consumption of foods and nutrients from institutional and home sources among young children attending two contrasting day-care centers in Guatemala City.

    Science.gov (United States)

    Vossenaar, M; Jaramillo, P M; Soto-Méndez, M-J; Panday, B; Hamelinck, V; Bermúdez, O I; Doak, C M; Mathias, P; Solomons, N W

    2012-12-01

    Adequate nutrition is critical to child development and institutions such as day-care centers could potentially complement children's diets to achieve optimal daily intakes. The aim of the study was to describe the full-day diet of children, examining and contrasting the relative contribution of home-derived versus institutional energy and nutrient sources. The present comparison should be considered in the domain of a case-study format. The diets of 33, 3-6 y old children attending low-income day-care centers serving either 3 or a single meal were examined. The home-diet was assessed by means of 3 non-consecutive 24-hr recalls. Estimated energy and nutrient intakes at the centers and at home were assessed and related to Recommended Nutrient Intakes (RNI). Nutrient densities, critical densities and main sources of nutrients were computed. We observed that in children attending the day-care center serving three meals, home-foods contributed less than half the daily energy (47.7%) and between 29.9% and 53.5% of daily nutrients. In children receiving only lunch outside the home, energy contribution from the home was 83.9% and 304 kcal lower than for children receiving 3 meals. Furthermore, between 59.0% and 94.8% of daily nutrients were provided at home. Daily energy, nutrient intakes and nutrient densities were well above the nutrient requirements for this age group, and particularly high for vitamin A. The overall dietary variety was superior in the situation of greater contribution of home fare, but overall the nutrient density and adequacy of the aggregate intakes did not differ in any important manner.

  8. 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

  9. Pyrethroids in chicken eggs from commercial farms and home production in Rio de Janeiro: Estimated daily intake and diastereomeric selectivity.

    Science.gov (United States)

    Parente, Cláudio E T; Lestayo, Julliana; Guida, Yago S; Azevedo-Silva, Claudio E; Torres, João Paulo M; Meire, Rodrigo O; Malm, Olaf

    2017-10-01

    In this study, pyrethroids were determined in chicken eggs from commercial farm (n = 60) and home egg production (n = 30). These pyrethroids were investigated: bifenthrin, phenothrin, permethrin, cyfluthrin, cypermethrin and fenvalerate, including most diastereomers. Quantification was done using GC-MS in a negative chemical ionization mode. Pyrethroids residues were found in 79% of the analyzed samples. Cypermethrin presented the highest occurrence, being quantified in 62 samples (69%) in concentrations (lipid weight - l w.) varying between 0.29 and 6408 ng g -1 , followed by phenothrin (24%), 21-3910 ng g -1 , permethrin (14%), 2.96-328 ng g -1 , and bifenthrin (11%), 3.77-16.7 ng g -1 . Cyfluthrin and fenvalerate were not detected. Home-produced eggs had a higher occurrence of pyrethroids (97%), with a greater predominance of phenothrin. In commercial production, 70% of the samples presented pyrethroid residues (predominantly cypermethrin). This is the first report about the presence of pyrethroids in home-produced eggs and the first description of a selectivity pattern with the predominance of cis diastereomers in chicken eggs. In general, estimated daily intake does not present a risk to human consumption, according to Brazilian and international standards (FAO/WHO). However, one third of the samples (30 eggs) had concentrations above the maximum residue limits (MRLs). The maximum cypermethrin concentration was 66 times the MRL, while the maximum phenothrin concentration was 11 times the limit. Further studies about transfer dynamics, bioaccumulation and metabolic degradation of stereoisomers are required, as well as determining if this selectivity pattern in food can increase consumer's health risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Daily home gardening improved survival for older people with mobility limitations: an 11-year follow-up study in Taiwan.

    Science.gov (United States)

    Lêng, Chhian Hūi; Wang, Jung-Der

    2016-01-01

    To test the hypothesis that gardening is beneficial for survival after taking time-dependent comorbidities, mobility, and depression into account in a longitudinal middle-aged (50-64 years) and older (≥65 years) cohort in Taiwan. The cohort contained 5,058 nationally sampled adults ≥50 years old from the Taiwan Longitudinal Study on Aging (1996-2007). Gardening was defined as growing flowers, gardening, or cultivating potted plants for pleasure with five different frequencies. We calculated hazard ratios for the mortality risks of gardening and adjusted the analysis for socioeconomic status, health behaviors and conditions, depression, mobility limitations, and comorbidities. Survival models also examined time-dependent effects and risks in each stratum contingent upon baseline mobility and depression. Sensitivity analyses used imputation methods for missing values. Daily home gardening was associated with a high survival rate (hazard ratio: 0.82; 95% confidence interval: 0.71-0.94). The benefits were robust for those with mobility limitations, but without depression at baseline (hazard ratio: 0.64, 95% confidence interval: 0.48-0.87) when adjusted for time-dependent comorbidities, mobility limitations, and depression. Chronic or relapsed depression weakened the protection of gardening. For those without mobility limitations and not depressed at baseline, gardening had no effect. Sensitivity analyses using different imputation methods yielded similar results and corroborated the hypothesis. Daily gardening for pleasure was associated with reduced mortality for Taiwanese >50 years old with mobility limitations but without depression.

  11. Analysis of Illinois Home Performance with ENERGY STAR® Measure Packages

    Energy Technology Data Exchange (ETDEWEB)

    Baker, J. [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Yee, S. [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States); Brand, L. [Partnership for Advanced Residential Retrofit (PARR), Chicago, IL (United States)

    2013-09-01

    Through the Chicagoland Single Family Housing Characterization and Retrofit Prioritization report, the Partnership for Advanced Residential Retrofit research team characterized 15 housing types in the Chicagoland region based on assessor data, utility billing history, and available data from prior energy efficiency programs. Within these 15 groups, a subset showed the greatest opportunity for energy savings based on BEopt Version 1.1 modeling of potential energy efficiency package options and the percent of the housing stock represented by each group. In this project, collected field data from a whole-home program in Illinois are utilized to compare marketplace-installed measures to the energy saving optimal packages previously developed for the 15 housing types. Housing type, conditions, energy efficiency measures installed, and retrofit cost information were collected from 19 homes that participated in the Illinois Home Performance with ENERGY STAR program in 2012, representing eight of the characterized housing groups. Two were selected for further case study analysis to provide an illustration of the differences between optimal and actually installed measures. Taken together, these homes are representative of 34.8% of the Chicagoland residential building stock. In one instance, actual installed measures closely matched optimal recommended measures.

  12. Effects of individually tailored physical and daily activities in nursing home residents on activities of daily living, physical performance and physical activity level

    DEFF Research Database (Denmark)

    Andresen, Mette; Frändin, Kerstin; Bergland, Astrid

    2012-01-01

    , evidence for the benefit of rehabilitation in nursing home residents is conflicting and inconclusive. Objective: To evaluate the effect of an individually tailored intervention program of 3 months, for nursing home residents, on ADL, balance, physical activity level, mobility and muscle strength. Methods...

  13. Intraindividual change and variability in daily stress processes: Findings from two measurement-burst diary studies

    Science.gov (United States)

    Sliwinski, Martin J.; Almeida, David M.; Smyth, Joshua; Stawski, Robert S.

    2010-01-01

    There is little longitudinal information on aging-related changes in emotional responses to negative events. The present manuscript examined intraindividual change and variability in the within-person coupling of daily stress and negative affect (NA) using data from two-measurement burst daily diary studies. Three main findings emerged. First, average reactivity to daily stress increased longitudinally, and this increase was evident across most the adult lifespan. Second, individual differences in emotional reactivity to daily stress exhibited long-term temporal stability, but this stability was greatest in midlife and decreased in old age. And third, reactivity to daily stress varied reliably within-persons (across-time), with individual exhibiting higher levels of reactivity during times when reporting high levels of global subject stress in previous month. Taken together, the present results emphasize the importance of modeling dynamic psychosocial and aging processes that operate across different time scales for understanding age-related changes in daily stress processes. PMID:20025399

  14. Health-related aspects of objectively measured daily physical activity in children

    DEFF Research Database (Denmark)

    Dencker, Magnus; Andersen, Lars Bo

    2008-01-01

    It is well established that physical inactivity in adults is associated with increased mortality and morbidity. Whether daily physical activity level is related to risk factors for cardiovascular disease (CVD) in children has been debated. Furthermore, objective data on the habitual daily physica...... activity. This review summarizes recently published studies that have used accelerometers to measure daily physical activity in children and related activity data to known risk factors for CVD.......It is well established that physical inactivity in adults is associated with increased mortality and morbidity. Whether daily physical activity level is related to risk factors for cardiovascular disease (CVD) in children has been debated. Furthermore, objective data on the habitual daily physical...... activity in children have at large been scarce in the literature. The main reason for this is the fact that daily physical activity is very difficult to measure in children. In recent years, a new device, the accelerometer, has emerged as a frequently used instrument for the measurement of daily physical...

  15. Parent Perceptions and Observations of Their Children with Autism Age 14-to-26 Concerning Generalization of Daily Living Skills at Home and in the Community

    Science.gov (United States)

    Crosby, Patrick H.

    2009-01-01

    The purpose of this sequential mixed methods study was to determine if students with autism from 19-to-26 years of age who receive instruction in Daily Living Skills (DLS) class sustain, improve, or decline in their ability to generalize DLS at home and in the community. Research regarding how well students with autism from 19-to-26 years of age…

  16. The effect of a daily application of a 0.05% chlorhexidine oral rinse solution on the incidence of aspiration pneumonia in nursing home residents: a multicenter study.

    NARCIS (Netherlands)

    Hollaar, V.R.Y.; Putten, G.J. van der; Maarel-Wierink, C.D. van der; Bronkhorst, E.M.; Swart, B.J.M. de; Creugers, N.H.J.

    2017-01-01

    BACKGROUND: Dysphagia and potential respiratory pathogens in the oral biofilm are risk factors for aspiration pneumonia in nursing home residents. The aim of the study was to examine if the daily application of 0.05% chlorhexidine oral rinse solution is effective in reducing the incidence of

  17. Home and Office Blood Pressure Control among Treated Hypertensive Patients in Japan: Findings from the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME Study

    Directory of Open Access Journals (Sweden)

    Nariyasu Mano

    2010-02-01

    Full Text Available Appropriate control of blood pressure (BP is essential for prevention of future cardiovascular events. However, BP control among treated hypertensive patients has been insufficient. Recently, the usefulness of self-measured BP at home (home BP measurement for the management of hypertension has been reported in many studies. We evaluated BP control both at home and in the office among treated hypertensive patients in primary care settings in Japan (the J-HOME study. We found poor control of home and office BPs and clarified some factors affecting control. We also examined factors associated with the magnitude of the white-coat effect, the morning–evening BP difference, and home heart rate in this J-HOME study.

  18. When can employees have a family life? The effects of daily workload and affect on work-family conflict and social behaviors at home.

    Science.gov (United States)

    Ilies, Remus; Schwind, Kelly M; Wagner, David T; Johnson, Michael D; DeRue, D Scott; Ilgen, Daniel R

    2007-09-01

    This article presents a longitudinal examination of antecedents and outcomes of work-to-family conflict. A total of 106 employees participating in an experience-sampling study were asked to respond to daily surveys both at work and at home, and their spouses were interviewed daily via telephone for a period of 2 weeks. Intraindividual analyses revealed that employees' perceptions of workload predicted work-to-family conflict over time, even when controlling for the number of hours spent at work. Workload also influenced affect at work, which in turn influenced affect at home. Finally, perhaps the most interesting finding in this study was that employees' behaviors in the family domain (reported by spouses) were predicted by the employees' perceptions of work-to-family conflict and their positive affect at home. (c) 2007 APA.

  19. Measures of emergency preparedness contributing to nursing home resilience.

    Science.gov (United States)

    Lane, Sandi J; McGrady, Elizabeth

    2017-12-13

    Resilience approaches have been successfully applied in crisis management, disaster response, and high reliability organizations and have the potential to enhance existing systems of nursing home disaster preparedness. This study's purpose was to determine how the Center for Medicare and Medicaid Services (CMS) "Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning" contributes to organizational resilience by identifying the benchmark resilience items addressed by the CMS Emergency Preparedness Checklist and items not addressed by the CMS Emergency Preparedness Checklist, and to recommend tools and processes to improve resilience for nursing homes. The CMS Emergency Preparedness Checklist items were compared to the Resilience Benchmark Tool items; similar items were considered matches. Resilience Benchmark Tool items with no CMS Emergency Preparedness Checklist item matches were considered breaches in nursing home resilience. The findings suggest that the CMS Emergency Preparedness Checklist can be used to measure some aspects of resilience, however, there were many resilience factors not addressed. For nursing homes to prepare and respond to crisis situations, organizations need to embrace a culture that promotes individual resilience-related competencies that when aggregated enable the organization to improve its resiliency. Social workers have the skills and experience to facilitate this change.

  20. The Sickness Impact Profile as a measure of the health status of noncognitively impaired nursing home residents.

    Science.gov (United States)

    Rothman, M L; Hedrick, S; Inui, T

    1989-03-01

    The Sickness Impact Profile (SIP) is a multidimensional, behaviorally based measure of the health status that has been successfully used in a wide range of applications. The characteristics of this measure have not been assessed with nursing home residents. The purpose of this study was to assess the feasibility, reliability (internal consistency), validity, and comprehensiveness of the SIP as a measure of the health status of a selected group of nursing home residents. One hundred sixty-eight veterans residing in community and VA nursing homes responded to a questionnaire consisting of the SIP, Index of Activities of Daily Living, Barthel Index, Life Satisfaction Index Z, and the Philadelphia Geriatric Center Morale Scale. In general, the respondents correctly interpreted instructions; reliability and validity were supported; and the SIP was found to provide a comprehensive assessment of physical function. Adding a measure of psychologic well-being to a study protocol involving this population may, however, provide additional useful information regarding this construct.

  1. Relationship between mean daily energy intake and frequency of consumption of out-of-home meals in the UK National Diet and Nutrition Survey.

    Science.gov (United States)

    Goffe, Louis; Rushton, Stephen; White, Martin; Adamson, Ashley; Adams, Jean

    2017-09-22

    Out-of-home meals have been characterised as delivering excessively large portions that can lead to high energy intake. Regular consumption is linked to weight gain and diet related diseases. Consumption of out-of-home meals is associated with socio-demographic and anthropometric factors, but the relationship between habitual consumption of such meals and mean daily energy intake has not been studied in both adults and children in the UK. We analysed adult and child data from waves 1-4 of the UK National Diet and Nutrition Survey using generalized linear modelling. We investigated whether individuals who report a higher habitual consumption of meals out in a restaurant or café, or takeaway meals at home had a higher mean daily energy intake, as estimated by a four-day food diary, whilst adjusting for key socio-demographic and anthropometric variables. Adults who ate meals out at least weekly had a higher mean daily energy intake consuming 75-104 kcal more per day than those who ate these meals rarely. The equivalent figures for takeaway meals at home were 63-87 kcal. There was no association between energy intake and frequency of consumption of meals out in children. Children who ate takeaway meals at home at least weekly consumed 55-168 kcal more per day than those who ate these meals rarely. Additionally, in children, there was an interaction with socio-economic position, where greater frequency of consumption of takeaway meals was associated with higher mean daily energy intake in those from less affluent households than those from more affluent households. Higher habitual consumption of out-of-home meals is associated with greater mean daily energy intake in the UK. More frequent takeaway meal consumption in adults and children is associated with greater daily energy intake and this effect is greater in children from less affluent households. Interventions seeking to reduce energy content through reformulation or reduction of portion sizes in restaurants

  2. Blood Pressure Measurement: Clinic, Home, Ambulatory, and Beyond

    Science.gov (United States)

    Drawz, Paul E.; Abdalla, Mohamed; Rahman, Mahboob

    2014-01-01

    Blood pressure has traditionally been measured in the clinic setting using the auscultory method and a mercury sphygmomanometer. Technological advances have led to improvements in measuring clinic blood pressure and allowed for measuring blood pressures outside the clinic. This review outlines various methods for evaluating blood pressure and the clinical utility of each type of measurement. Home blood pressures and 24 hour ambulatory blood pressures have improved our ability to evaluate risk for target organ damage and hypertension related morbidity and mortality. Measuring home blood pressures may lead to more active participation in health care by patients and has the potential to improve blood pressure control. Ambulatory blood pressure monitoring enables the measuring nighttime blood pressures and diurnal changes, which may be the most accurate predictors of risk associated with elevated blood pressure. Additionally, reducing nighttime blood pressure is feasible and may be an important component of effective antihypertensive therapy. Finally, estimating central aortic pressures and pulse wave velocity are two of the newer methods for assessing blood pressure and hypertension related target organ damage. PMID:22521624

  3. Can the care transitions measure predict rehospitalization risk or home health nursing use of home healthcare patients?

    Science.gov (United States)

    Ryvicker, Miriam; McDonald, Margaret V; Trachtenberg, Melissa; Peng, Timothy R; Sridharan, Sridevi; Feldman, Penny H

    2013-01-01

    The Care Transitions Measure (CTM) was designed to assess the quality of patient transitions from the hospital. Many hospitals are using the measure to inform their efforts to improve transitional care. We sought to determine if the measure would have utility for home healthcare providers by predicting newly admitted patients at heightened risk for emergency department use, rehospitalization, or increased home health nursing visits. The CTM was administered to 495 home healthcare patients shortly after hospital discharge and home healthcare admission. Follow-up interviews were completed 30 and 60 days post hospital discharge. Interview data were supplemented with agency assessment and service use data. We did not find evidence that the CTM could predict home healthcare patients having an elevated risk for emergent care, rehospitalization, or higher home health nursing use. Because Medicare/Medicaid-certified home healthcare providers already use a comprehensive, mandated start of care assessment, the CTM may not provide them additional crucial information. Process and outcome measurement is increasingly becoming part of usual care. Selection of measures appropriate for each service setting requires thorough site-specific evaluation. In light of our findings, we cannot recommend the CTM as an additional measure in the home healthcare setting. © 2013 National Association for Healthcare Quality.

  4. Investigating the relationship between two home numeracy measures: A questionnaire and observations during Lego building and book reading.

    Science.gov (United States)

    Mutaf Yildiz, Belde; Sasanguie, Delphine; De Smedt, Bert; Reynvoet, Bert

    2018-06-01

    Home numeracy has been defined as the parent-child interactions that include experiences with numerical content in daily-life settings. Previous studies have commonly operationalized home numeracy either via questionnaires or via observational methods. These studies have shown that both types of measures are positively related to variability in children's mathematical skills. This study investigated whether these distinctive data collection methods index the same aspect of home numeracy. The frequencies of home numeracy activities and parents' opinions about their children's mathematics education were assessed via a questionnaire. The amount of home numeracy talk was observed via two semi-structured videotaped parent-child activity sessions (Lego building and book reading). Children's mathematical skills were examined with two calculation subtests. We observed that parents' reports and number of observed numeracy interactions were not related to each other. Interestingly, parents' reports of numeracy activities were positively related to children's calculation abilities, whereas the observed home numeracy talk was negatively related to children's calculation abilities. These results indicate that these two methods tap on different aspects of home numeracy. Statement of contribution What is already known on this subject? Home numeracy, that is, parent-child interactions that include experiences with numerical content, is supposed to have a positive impact on calculation or mathematical ability in general. Despite many positive results, some studies have failed to find such an association. Home numeracy has been assessed with questionnaires on the frequency of numerical experiences and observations of parent-child interactions; however, those two measures of home numeracy have never been compared directly. What does this study add? This study assessed home numeracy through questionnaires and observations in the 44 parent-child dyads and showed that home numeracy

  5. Measurement of time processing ability and daily time management in children with disabilities.

    Science.gov (United States)

    Janeslätt, Gunnel; Granlund, Mats; Kottorp, Anders

    2009-01-01

    Improvement is needed in methods for planning and evaluating interventions designed to facilitate daily time management for children with intellectual disability, Asperger syndrome, or other developmental disorders. The aim of this study was to empirically investigate the hypothesized relation between children's time processing ability (TPA), daily time management, and self-rated autonomy. Such a relationship between daily time management and TPA may support the idea that TPA is important for daily time management and that children with difficulties in TPA might benefit from intervention aimed at improving daily time management. Participants were children aged 6 to 11 years with dysfunctions such as attention-deficit/hyperactivity disorder, autism, or physical or intellectual disabilities (N = 118). TPA was measured with the instrument KaTid. All data were transformed to interval measures using applications of Rasch models and then further analysed with correlation and regression analysis. The results demonstrate a moderate significant relation between the parents' ratings of daily time management and TPA of the children, and between the self-rating of autonomy and TPA. There was also a significant relation between self-ratings of autonomy and the parents' rating of the children's daily time management. Parents' ratings of their children's daily time management explain 25% of the variation in TPA, age of the children explains 22%, while the child's self-rating of autonomy can explain 9% of the variation in TPA. The three variables together explain 38% of the variation in TPA. The results indicate the viability of the instrument for assessing TPA also in children with disabilities and that the ability measured by KaTid is relevant for daily time management. TPA seems to be a factor for children's daily time management that needs to be taken into consideration when planning and evaluating interventions designed to facilitate everyday functioning for children with

  6. Nursing Homes

    Science.gov (United States)

    ... Home › Aging & Health A to Z › Nursing Homes Font size A A A Print Share Glossary Basic ... Reason For Living in A Nursing Home Some type of disability with activities of daily living (ADLs) ...

  7. On the Disambiguation of Passively Measured In-home Gait Velocities from Multi-person Smart Homes.

    Science.gov (United States)

    Austin, Daniel; Hayes, Tamara L; Kaye, Jeffrey; Mattek, Nora; Pavel, Misha

    2011-01-01

    In-home monitoring of gait velocity with passive PIR sensors in a smart home has been shown to be an effective method of continuously and unobtrusively measuring this important predictor of cognitive function and mobility. However, passive measurements of velocity are nonspecific with regard to who generated each measurement or walking event. As a result, this method is not suitable for multi-person homes without additional information to aid in the disambiguation of gait velocities. In this paper we propose a method based on Gaussian mixture models (GMMs) combined with infrequent clinical assessments of gait velocity to model in-home walking speeds of two or more residents. Modeling the gait parameters directly allows us to avoid the more difficult problem of assigning each measured velocity individually to the correct resident. We show that if the clinically measured gait velocities of residents are separated by at least 15 cm/s a GMM can be accurately fit to the in-home gait velocity data. We demonstrate the accuracy of this method by showing that the correlation between the means of the GMMs and the clinically measured gait velocities is 0.877 (p value < 0.0001) with bootstrapped 95% confidence intervals of (0.79, 0.94) for 54 measurements of 20 subjects living in multi-person homes. Example applications of using this method to track in-home mean velocities over time are also given.

  8. 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

  9. TREATMENT OF HYPERTENSION USING TELEMEDICAL HOME BLOOD PRESSURE MEASUREMENTS

    DEFF Research Database (Denmark)

    Hoffmann-Petersen, N; Lauritzen, T; Bech, J N

    2015-01-01

    OBJECTIVE: Telemonitoring of home blood pressure measurements (TBPM) is a new and promising supplement to diagnosis, control and treatment of hypertension. We wanted to compare the outcome of antihypertensive treatment based on TBPM and conventional monitoring of blood pressure. DESIGN AND METHOD...... of the measurements and subsequent communication by telephone or E-mail. In the control group, patients received usual care. Primary outcome was reduction in daytime ambulatory blood pressure measurements (ABPM) from baseline to 3 months' follow-up. RESULTS: In both groups, daytime ABPM decreased significantly....../181), p = 0.34. Blood pressure reduction in the TBPM group varied with the different practices. CONCLUSIONS: No further reduction in ABPM or number of patients reaching blood pressure targets was observed when electronic transmission of TBPM was applied in the treatment of hypertension by GPs. Thus...

  10. Daily snow depth measurements from 195 stations in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Allison, L.J. [ed.] [Oak Ridge National Lab., TN (United States). Carbon Dioxide Information Analysis Center; Easterling, D.R.; Jamason, P.; Bowman, D.P.; Hughes, P.Y.; Mason, E.H. [National Oceanic and Atmospheric Administration, Asheville, NC (United States). National Climatic Data Center

    1997-02-01

    This document describes a database containing daily measurements of snow depth at 195 National Weather Service (NWS) first-order climatological stations in the United States. The data have been assembled and made available by the National Climatic Data Center (NCDC) in Asheville, North Carolina. The 195 stations encompass 388 unique sampling locations in 48 of the 50 states; no observations from Delaware or Hawaii are included in the database. Station selection criteria emphasized the quality and length of station records while seeking to provide a network with good geographic coverage. Snow depth at the 388 locations was measured once per day on ground open to the sky. The daily snow depth is the total depth of the snow on the ground at measurement time. The time period covered by the database is 1893--1992; however, not all station records encompass the complete period. While a station record ideally should contain daily data for at least the seven winter months (January through April and October through December), not all stations have complete records. Each logical record in the snow depth database contains one station`s daily data values for a period of one month, including data source, measurement, and quality flags.

  11. Inner power, physical strength and existential well-being in daily life: relatives' experiences of receiving soft tissue massage in palliative home care.

    Science.gov (United States)

    Cronfalk, Berit Seiger; Strang, Peter; Ternestedt, Britt-Marie

    2009-08-01

    This article explores relatives' experiences of receiving soft tissue massage as a support supplement while caring for a dying family member at home. In palliative home care, relatives play an important role as carers to seriously ill and dying family members. To improve their quality of life, different support strategies are of importance. Complementary methods, such as soft tissue massage have become an appreciated supplement for these patients. However, only few studies focus on relatives experiences of receiving soft tissue massage as a supplemental support. Qualitative design Nineteen relatives received soft tissue massage (hand or foot) nine times (25 minutes) in their homes. Open-ended semi-structured tape-recorded interviews were conducted once per relative after the nine times of massage, using qualitative content analysis. Soft tissue massage gave the relatives' feelings of 'being cared for', 'body vitality' and 'peace of mind'. For a while, they put worries of daily life aside as they just experienced 'being'. During massage, it became apparent that body and mind is constituted of an indestructible completeness. The overarching theme was 'inner power, physical strength and existential well-being in their daily lives'. All relatives experienced soft tissue massage positively, although they were under considerable stress. Soft tissue massage could be an option to comfort and support relatives in palliative home care. In palliative nursing care, soft tissue massage could present a worthy supplement in supporting caring relatives.

  12. Constructing a Measure of Private-pay Nursing Home Days.

    Science.gov (United States)

    Thomas, Kali S; Silver, Benjamin; Gozalo, Pedro L; Dosa, David; Grabowski, David C; Makineni, Rajesh; Mor, Vincent

    2018-05-01

    Nursing home (NH) care is financed through multiple sources. Although Medicaid is the predominant payer for NH care, over 20% of residents pay out-of-pocket for their care. Despite this large percentage, an accepted measure of private-pay NH occupancy has not been established and little is known about the types of facilities and the long-term care markets that cater to this population. To describe 2 novel measures of private-pay utilization in the NH setting, including the proportion of privately financed residents and resident days, and examine their construct validity. Retrospective descriptive analysis of US NHs in 2007-2009. We used Medicare claims, Medicare Enrollment records, and the Minimum Data Set to create measures of private-pay resident prevalence and proportion of privately financed NH days. We compared our estimates of private-pay utilization to payer data collected in the NH annual certification survey and evaluated the relationships of our measures with facility characteristics. Our measures of private-pay resident prevalence and private-pay days are highly correlated (r=0.83, Ppay residents and days in higher quality facilities. This new methodology provides estimates of private-pay resident prevalence and resident days. These measures were correlated with estimates using other data sources and validated against measures of facility quality. These data set the stage for additional work to examine questions related to NH payment, quality of care, and responses to changes in the long-term care market.

  13. Single-Camera-Based Method for Step Length Symmetry Measurement in Unconstrained Elderly Home Monitoring.

    Science.gov (United States)

    Cai, Xi; Han, Guang; Song, Xin; Wang, Jinkuan

    2017-11-01

    single-camera-based gait monitoring is unobtrusive, inexpensive, and easy-to-use to monitor daily gait of seniors in their homes. However, most studies require subjects to walk perpendicularly to camera's optical axis or along some specified routes, which limits its application in elderly home monitoring. To build unconstrained monitoring environments, we propose a method to measure step length symmetry ratio (a useful gait parameter representing gait symmetry without significant relationship with age) from unconstrained straight walking using a single camera, without strict restrictions on walking directions or routes. according to projective geometry theory, we first develop a calculation formula of step length ratio for the case of unconstrained straight-line walking. Then, to adapt to general cases, we propose to modify noncollinear footprints, and accordingly provide general procedure for step length ratio extraction from unconstrained straight walking. Our method achieves a mean absolute percentage error (MAPE) of 1.9547% for 15 subjects' normal and abnormal side-view gaits, and also obtains satisfactory MAPEs for non-side-view gaits (2.4026% for 45°-view gaits and 3.9721% for 30°-view gaits). The performance is much better than a well-established monocular gait measurement system suitable only for side-view gaits with a MAPE of 3.5538%. Independently of walking directions, our method can accurately estimate step length ratios from unconstrained straight walking. This demonstrates our method is applicable for elders' daily gait monitoring to provide valuable information for elderly health care, such as abnormal gait recognition, fall risk assessment, etc. single-camera-based gait monitoring is unobtrusive, inexpensive, and easy-to-use to monitor daily gait of seniors in their homes. However, most studies require subjects to walk perpendicularly to camera's optical axis or along some specified routes, which limits its application in elderly home monitoring

  14. Errorless (re)learning of daily living routines by a woman with impaired memory and initiation: transferrable to a new home?

    Science.gov (United States)

    Ferland, Mark B; Larente, Johanne; Rowland, Julia; Davidson, Patrick S R

    2013-01-01

    To use errorless learning to train a memory- and initiation-impaired woman on two activities of daily living routines and then to transfer these routines to a new home. Single case quasi-experimental. Over 9 months, a young woman with an anterior cerebral haemorrhagic stroke (secondary to a ruptured arteriovenous malformation) was trained on routines of morning self-care and diabetes management, involving extensive practice on a structured series of steps with intervention as needed to prevent errors. Once routines were established, family members were trained in the supervision and rating of the routines at home. Following discharge, caregivers continued to monitor the routines daily for 3 months. Errorless learning of self-care and diabetes routines was successful. The routines were transferred to a new home environment and maintained at a near perfect level over a 3-month follow-up period. The patient remained severely memory-impaired, indicating that her functional gains were not attributable to any recovery of her memory abilities over time. This case offers evidence that even people with severe memory and initiation impairments can be trained on new routines using errorless learning and that, once learned, these routines can be carried out in novel contexts.

  15. Automated home cage observations as a tool to measure the effects of wheel running on cage floor locomotion.

    Science.gov (United States)

    de Visser, Leonie; van den Bos, Ruud; Spruijt, Berry M

    2005-05-28

    This paper introduces automated observations in a modular home cage system as a tool to measure the effects of wheel running on the time distribution and daily organization of cage floor locomotor activity in female C57BL/6 mice. Mice (n = 16) were placed in the home cage system for 6 consecutive days. Fifty percent of the subjects had free access to a running wheel that was integrated in the home cage. Overall activity levels in terms of duration of movement were increased by wheel running, while time spent inside a sheltering box was decreased. Wheel running affected the hourly pattern of movement during the animals' active period of the day. Mice without a running wheel, in contrast to mice with a running wheel, showed a clear differentiation between novelty-induced and baseline levels of locomotion as reflected by a decrease after the first day of introduction to the home cage. The results are discussed in the light of the use of running wheels as a tool to measure general activity and as an object for environmental enrichment. Furthermore, the possibilities of using automated home cage observations for e.g. behavioural phenotyping are discussed.

  16. Daily time spent indoors in German homes--baseline data for the assessment of indoor exposure of German occupants.

    Science.gov (United States)

    Brasche, Sabine; Bischof, Wolfgang

    2005-01-01

    Comprehensive time-activity studies, for use as a basis for estimates of personal exposure, are not readily available in Germany. This analysis of time spent indoors at home is based on data from "Dampness and mould in homes" (2000/ 2001)--a study of about 12,000 persons living in 5530 randomly selected apartments and houses in Germany. The results show the mean times per day people in Germany spend in their homes, classified by gender, age group, building location, city size, region, building type, owner-occupier status, number of people at home, smoking and ventilation habits, moisture emission and ill health factors such as asthma, allergy and number of acute respiratory infections per year. The overall mean time spent at home, 15.7 h per, is in accordance with results from US-American (15.6 h/day) and Canadian (15.8 h/day) human activity surveys carried out in the nineties, as well as being consistent with the German Environmental Survey (1990/92) and a small German study in 1987.

  17. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, Robb [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-02-01

    This document addresses adding -or improving - mechanical ventilation systems to existing homes. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including some discussion of relevant codes and standards. Advantages, disadvantages, and approximate costs of various system types are presented along with general guidelines for implementing the systems in homes. CARB intends for this document to be useful to decision makers and contractors implementing ventilation systems in homes. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors. It is the intent of this document to assist contractors in making more informed decisions when selecting systems. Ventilation is an integral part of a high-performance home. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability.

  18. 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.

  19. Measurement of farm level efficiency of home gardens in Uyo ...

    African Journals Online (AJOL)

    To investigate the farm level efficiency of home vegetable gardens in Uyo, a stochastic production function which incorporates a model for the technical inefficiency effects was used. Using farm-level data from 80 home gardeners obtained through structured questionnaire, the parameters were estimated simultaneously with ...

  20. A study of depression, perceived loneliness, cognitive function and independence in daily activities in home and institution based older people: A cross sectional comparative study

    Directory of Open Access Journals (Sweden)

    Riddhi Desai

    2016-01-01

    Full Text Available Context: Old age homes are on the rise in India. Older people staying in such institutions have specific psychosocial issues that may affect their cognitive performance and daily living. Materials and Methods: 71 older people, 39 institution based and 32 community-based were recruited with serial sampling after screening on mini-mental state examination and were evaluated with geriatric depression scale, University of California, Los Angeles scale, Lawton′s instrumental activities of daily living scale and montreal cognitive assessment scale. Results: Prevalence of depression was significantly higher in older people who were institution based, widowers and females. The severity of perceived loneliness was higher in females, institution based and depressed older people. The severity of depression correlated with independence in daily activities, cognition, and perceived loneliness only in institution based older people. Discussion: Older people in institutions have a higher psychosocial burden than the community-based older people. Family support prevents the attrition effect of depression on cognition and independence in daily activities in the community-based older people.

  1. 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

  2. Home

    Science.gov (United States)

    AF Branding & Trademark Licensing Join the Air Force Home About Us The Air Force Symbol Display Resources Document Library TM Connect Search AF Branding and Trademark Licensing Program: important links Legal Documents 10 U.S.C. § 2260 15 U.S.C. § 167;167; 1114-1125 DODI 5535.12, DoD Branding and

  3. Home

    Science.gov (United States)

    intersect as Attack Wing leaders change roles The 112th COS postured as cyber shield for Pa. infrastructure 111th Attack Wing 111th Attack Wing 21st Century Guard Airmen Home News Photos Art Video Resources - The Balance Search 111th Attack Wing: COMMUNITY/ENVIRO May 16, 2018; Pa. Department of Health update

  4. Adaptation and Validation of the HOME-SF as a Caregiver-Report Home Environment Measure for Use in the Taiwan Birth Cohort Study (TBCS)

    Science.gov (United States)

    Wu, Jennifer Chun-Li; Chiang, Tung-liang; Bradley, Robert H.

    2011-01-01

    This study aimed to develop a brief caregiver-report instrument for measuring the home environment of children aged three and under, as part of the Taiwan Birth Cohort Study (TBCS). Instrument development was conducted by translating and adapting the Home Observation for the Measurement of Environment Inventory-Short Form (HOME-SF) which comprises…

  5. An in-depth, longitudinal examination of the daily physical activity of a patient with heart failure using a Nintendo Wii at home: a case report.

    Science.gov (United States)

    Klompstra, Leonie Verheijden; Jaarsma, Tiny; Strömberg, Anna

    2013-06-01

    To explore the influence of the Nintendo Wii on the daily physical activity of a patient with chronic heart failure at home. A 74-year-old Swedish patient with heart failure had access to a Nintendo Wii at home for 12 weeks. Exercise motivation, exercise self-efficacy and exercise capacity were assessed before and after the intervention. Data on perceived physical effort, global well-being and expended energy were collected every day during the intervention. During the 12 weeks of access to the Nintendo Wii, daily physical activity increased by 200% on weekdays and 57% on weekends, compared with baseline. The patient's exercise motivation and exercise self-efficacy increased during the study, whereas perceived physical effort and global well-being did not change. The patient had no difficulties in using the system and did not suffer any major harm. The results of this case study suggest that providing patients with heart failure access to a Nintendo Wii is a promising and safe intervention. The energy expended by the patient per day increased, as did exercise capacity. Playing the Nintendo Wii did not increase the perceived physical effort, but increased motivation to exercise and decreased barriers to exercising.

  6. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2014-02-01

    This report, developed by Building America research team CARB, addresses adding or improving mechanical ventilation systems to existing homes. The goal of this report is to assist decision makers and contractors in making informed decisions when selecting ventilation systems for homes. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including examination of relevant codes and standards. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors.

  7. Calculation of new snow densities from sub-daily automated snow measurements

    Science.gov (United States)

    Helfricht, Kay; Hartl, Lea; Koch, Roland; Marty, Christoph; Lehning, Michael; Olefs, Marc

    2017-04-01

    In mountain regions there is an increasing demand for high-quality analysis, nowcasting and short-range forecasts of the spatial distribution of snowfall. Operational services, such as for avalanche warning, road maintenance and hydrology, as well as hydropower companies and ski resorts need reliable information on the depth of new snow (HN) and the corresponding water equivalent (HNW). However, the ratio of HNW to HN can vary from 1:3 to 1:30 because of the high variability of new snow density with respect to meteorological conditions. In the past, attempts were made to calculate new snow densities from meteorological parameters mainly using daily values of temperature and wind. Further complex statistical relationships have been used to calculate new snow densities on hourly to sub-hourly time intervals to drive multi-layer snow cover models. However, only a few long-term in-situ measurements of new snow density exist for sub-daily time intervals. Settling processes within the new snow due to loading and metamorphism need to be considered when computing new snow density. As the effect of these processes is more pronounced for long time intervals, a high temporal resolution of measurements is desirable. Within the pluSnow project data of several automatic weather stations with simultaneous measurements of precipitation (pluviometers), snow water equivalent (SWE) using snow pillows and snow depth (HS) measurements using ultrasonic rangers were analysed. New snow densities were calculated for a set of data filtered on the basis of meteorological thresholds. The calculated new snow densities were compared to results from existing new snow density parameterizations. To account for effects of settling of the snow cover, a case study based on a multi-year data set using the snow cover model SNOWPACK at Weissfluhjoch was performed. Measured median values of hourly new snow densities at the different stations range from 54 to 83 kgm-3. This is considerably lower than a 1

  8. Outcome-driven thresholds for home blood pressure measurement: international database of home blood pressure in relation to cardiovascular outcome.

    Science.gov (United States)

    Niiranen, Teemu J; Asayama, Kei; Thijs, Lutgarde; Johansson, Jouni K; Ohkubo, Takayoshi; Kikuya, Masahiro; Boggia, José; Hozawa, Atsushi; Sandoya, Edgardo; Stergiou, George S; Tsuji, Ichiro; Jula, Antti M; Imai, Yutaka; Staessen, Jan A

    2013-01-01

    The lack of outcome-driven operational thresholds limits the clinical application of home blood pressure (BP) measurement. Our objective was to determine an outcome-driven reference frame for home BP measurement. We measured home and clinic BP in 6470 participants (mean age, 59.3 years; 56.9% women; 22.4% on antihypertensive treatment) recruited in Ohasama, Japan (n=2520); Montevideo, Uruguay (n=399); Tsurugaya, Japan (n=811); Didima, Greece (n=665); and nationwide in Finland (n=2075). In multivariable-adjusted analyses of individual subject data, we determined home BP thresholds, which yielded 10-year cardiovascular risks similar to those associated with stages 1 (120/80 mm Hg) and 2 (130/85 mm Hg) prehypertension, and stages 1 (140/90 mm Hg) and 2 (160/100 mm Hg) hypertension on clinic measurement. During 8.3 years of follow-up (median), 716 cardiovascular end points, 294 cardiovascular deaths, 393 strokes, and 336 cardiac events occurred in the whole cohort; in untreated participants these numbers were 414, 158, 225, and 194, respectively. In the whole cohort, outcome-driven systolic/diastolic thresholds for the home BP corresponding with stages 1 and 2 prehypertension and stages 1 and 2 hypertension were 121.4/77.7, 127.4/79.9, 133.4/82.2, and 145.4/86.8 mm Hg; in 5018 untreated participants, these thresholds were 118.5/76.9, 125.2/79.7, 131.9/82.4, and 145.3/87.9 mm Hg, respectively. Rounded thresholds for stages 1 and 2 prehypertension and stages 1 and 2 hypertension amounted to 120/75, 125/80, 130/85, and 145/90 mm Hg, respectively. Population-based outcome-driven thresholds for home BP are slightly lower than those currently proposed in hypertension guidelines. Our current findings could inform guidelines and help clinicians in diagnosing and managing patients.

  9. Where should Momma go? Current nursing home performance measurement strategies and a less ambitious approach

    Directory of Open Access Journals (Sweden)

    Lieberman Trudy

    2007-06-01

    Full Text Available Abstract Background Nursing home performance measurement systems are practically ubiquitous. The vast majority of these systems aspire to rank order all nursing homes based on quantitative measures of quality. However, the ability of such systems to identify homes differing in quality is hampered by the multidimensional nature of nursing homes and their residents. As a result, the authors doubt the ability of many nursing home performance systems to truly help consumers differentiate among homes providing different levels of quality. We also argue that, for consumers, performance measurement models are better at identifying problem facilities than potentially good homes. Discussion In response to these concerns we present a proposal for a less ambitious approach to nursing home performance measurement than previously used. We believe consumers can make better informed choice using a simpler system designed to pinpoint poor-quality nursing homes, rather than one designed to rank hundreds of facilities based on differences in quality-of-care indicators that are of questionable importance. The suggested performance model is based on five principles used in the development of the Consumers Union 2006 Nursing Home Quality Monitor. Summary We can best serve policy-makers and consumers by eschewing nursing home reporting systems that present information about all the facilities in a city, a state, or the nation on a website or in a report. We argue for greater modesty in our efforts and a focus on identifying only the potentially poorest or best homes. In the end, however, it is important to remember that information from any performance measurement website or report is no substitute for multiple visits to a home at different times of the day to personally assess quality.

  10. High prevalence of subtle and severe menstrual disturbances in exercising women: confirmation using daily hormone measures.

    Science.gov (United States)

    De Souza, M J; Toombs, R J; Scheid, J L; O'Donnell, E; West, S L; Williams, N I

    2010-02-01

    The identification of subtle menstrual cycle disturbances requires daily hormone assessments. In contrast, the identification of severe menstrual disturbances, such as amenorrhea and oligomenorrhea, can be established by clinical observation. The primary purpose of this study was to determine the frequency of subtle menstrual disturbances, defined as luteal phase defects (LPD) or anovulation, in exercising women, with menstrual cycles of 26-35 days, who engage in a variety of sports, both recreational and competitive. Secondly, the prevalence of oligomenorrhea and amenorrhea was also determined via measurement of daily urinary ovarian steroids rather than self report alone. Menstrual status was documented by daily measurements of estrone and pregnanediol glucuronide and luteinizing hormone across two to three consecutive cycles and subsequently categorized as ovulatory (Ovul), LPD, anovulatory (Anov), oligomenorrheic (Oligo) and amenorrheic (Amen) in sedentary (Sed) and exercising (Ex) women. Sed (n = 20) and Ex women (n = 67) were of similar (P > 0.05) age (26.3 +/- 0.8 years), weight (59.3 +/- 1.8 kg), body mass index (22.0 +/- 0.6 kg/m2), age of menarche (12.8 +/- 0.3 years) and gynecological maturity (13.4 +/- 0.9 years). The Sed group exercised less (P exercising women experience subtle menstrual disturbances, i.e. LPD and anovulation, and that one third of exercising women may be amenorrheic. Estimates of the prevalence of subtle menstrual disturbances in exercising women determined by the presence or absence of short or long cycles does not identify these disturbances. In light of known clinical consequences of menstrual disturbances, these findings underscore the lack of reliability of normal menstrual intervals and self report to infer menstrual status.

  11. Home Circadian Phase Assessments with Measures of Compliance Yield Accurate Dim Light Melatonin Onsets.

    Science.gov (United States)

    Burgess, Helen J; Wyatt, James K; Park, Margaret; Fogg, Louis F

    2015-06-01

    There is a need for the accurate assessment of circadian phase outside of the clinic/laboratory, particularly with the gold standard dim light melatonin onset (DLMO). We tested a novel kit designed to assist in saliva sampling at home for later determination of the DLMO. The home kit includes objective measures of compliance to the requirements for dim light and half-hourly saliva sampling. Participants were randomized to one of two 10-day protocols. Each protocol consisted of two back-to-back home and laboratory phase assessments in counterbalanced order, separated by a 5-day break. Laboratory or participants' homes. Thirty-five healthy adults, age 21-62 y. N/A. Most participants received at least one 30-sec epoch of light > 50 lux during the home phase assessments (average light intensity 4.5 lux), but on average for light > 50 lux or sampling errors. There was no significant difference between the home and laboratory DLMOs (P > 0.05); on average the home DLMOs occurred 9.6 min before the laboratory DLMOs. The home DLMOs were highly correlated with the laboratory DLMOs (r = 0.91, P dim light melatonin onsets (DLMOs) demonstrates that including objective measures of light exposure and sample timing during home saliva sampling can lead to accurate home DLMOs. Circadian Phase Assessments at Home, http://clinicaltrials.gov/show/NCT01487252, NCT01487252. © 2015 Associated Professional Sleep Societies, LLC.

  12. Factors influencing older people's experiences of participation in autonomous decisions concerning their daily care in their own homes

    DEFF Research Database (Denmark)

    Morville, Annette; Fjordside, Solveig

    2016-01-01

    -being. Little is known about factors that facilitate or hinder older peoples autonomous decision-making in their own homes. Methods. The study has been carried out as a literature review. The following databases were used: CINAHL, PubMed, PsykInfo, Cochrane, SweMed, Embase. Research studies range from 2009....... A framework for systematic ethical discussions among carers may improve awareness about factors that facilitate or hinder good personalised care. The organisation of nursing care needs to be shaped in line with best practice for older people....

  13. Predicted versus measured resting energy expenditure in patients requiring home parenteral nutrition.

    Science.gov (United States)

    Ławiński, Michał; Singer, Pierre; Gradowski, Łukasz; Gradowska, Aleksandra; Bzikowska, Agnieszka; Majewska, Krystyna

    2015-01-01

    Guidelines from the European Society for Clinical Nutrition and Metabolism (ESPEN) recommend between 20 and 35 kcal/kg daily for patients requiring home parenteral nutrition (PN). Other guidelines use predictive equations. However, these equations have not been validated. Indirect calorimetry is recommended as the gold standard for determining resting energy expenditure (REE). The aim of this study was to compare the frequently used equations with measured REE. Seventy-six hospitalized patients suffering from intestinal failure (ages 21-85 y) were enrolled between January 2012 and May 2014. They were eligible for implementation of home parenteral nutrition (HPN) due to short bowel syndrome (54%), intestinal fistulae (24%), cancer obstruction (16%), and radiation-induced intestinal injury (6%). REE measurements were compared with predictive equations by Harris and Benedict (HB), Owen, Ireton-Jones, and Mifflin, as well as recommendations from ESPEN. In all, 152 calorimetry measurements (two per patient) were performed in 76 patients, after total PN administrations. An average result of REE measurement by indirect calorimetry was 1181 ± 322 kcal/d. Variability in momentary energy expenditure (MEE) from one measurement to the other was 8% ± 7%. Bland-Altman analysis showed a mean bias of -192 ± 300 kcal/d between MEE and estimated energy expenditure using the HB equation, which means that the equation increased the score on average by 192 ± 300 kcal/d. Limits of agreement (LoA) between the two methods was -780 to +396 kcal/d. Estimation energy expenditure using the Ireton-Jones equation gave a mean bias of -359 ± 335 kcal/d. LoA between the two methods was -1015 to +297 kcal/d. For Owen equation, Bland-Altman analysis showed a mean bias of -208 ± 313 kcal/d and the LoA between the two methods was -822 to +406 kcal/d. Using the Mifflin equation, estimation energy expenditure gave a mean bias of -172 ± 312 kcal/d and the LoA between the

  14. Objectively measured daily physical activity related to aerobic fitness in young children

    DEFF Research Database (Denmark)

    Dencker, Magnus; Bugge, Anna; Hermansen, Bianca

    2010-01-01

    The purpose of this study was to investigate by direct measurement the cross-sectional relationship between accelerometer-measured physical activity and peak oxygen uptake (VO(2peak): ml x min(-1) x kg(-1)), in a population-based cohort of young children, since such data are scarce. The study...... analyses indicated that the various physical activity variables explained between 2 and 8% of the variance in VO(2peak) in boys. In this population-based cohort, most daily activity variables were positively related to aerobic fitness in boys, whereas less clear relationships were observed in girls. Our...... finding that physical activity was only uniformly related to aerobic fitness in boys partly contradicts previous studies in older children and adolescents....

  15. Obtaining sub-daily new snow density from automated measurements in high mountain regions

    Science.gov (United States)

    Helfricht, Kay; Hartl, Lea; Koch, Roland; Marty, Christoph; Olefs, Marc

    2018-05-01

    The density of new snow is operationally monitored by meteorological or hydrological services at daily time intervals, or occasionally measured in local field studies. However, meteorological conditions and thus settling of the freshly deposited snow rapidly alter the new snow density until measurement. Physically based snow models and nowcasting applications make use of hourly weather data to determine the water equivalent of the snowfall and snow depth. In previous studies, a number of empirical parameterizations were developed to approximate the new snow density by meteorological parameters. These parameterizations are largely based on new snow measurements derived from local in situ measurements. In this study a data set of automated snow measurements at four stations located in the European Alps is analysed for several winter seasons. Hourly new snow densities are calculated from the height of new snow and the water equivalent of snowfall. Considering the settling of the new snow and the old snowpack, the average hourly new snow density is 68 kg m-3, with a standard deviation of 9 kg m-3. Seven existing parameterizations for estimating new snow densities were tested against these data, and most calculations overestimate the hourly automated measurements. Two of the tested parameterizations were capable of simulating low new snow densities observed at sheltered inner-alpine stations. The observed variability in new snow density from the automated measurements could not be described with satisfactory statistical significance by any of the investigated parameterizations. Applying simple linear regressions between new snow density and wet bulb temperature based on the measurements' data resulted in significant relationships (r2 > 0.5 and p ≤ 0.05) for single periods at individual stations only. Higher new snow density was calculated for the highest elevated and most wind-exposed station location. Whereas snow measurements using ultrasonic devices and snow

  16. Field Measurements of Heating Efficiency of Electric Forced-Air Furnaces in Six Manufactured Homes.

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Bob; Palmiter, Larry S.; Siegel, Jeff

    1994-07-26

    This report presents the results of field measurements of heating efficiency for six manufactured homes in the Pacific Northwest heated with electric forced-air systems. This is the first in a series of regional and national efforts to measure in detail the heating efficiency of manufactured homes. Only six homes were included in this study because of budgetary constraints; therefore this is not a representative sample. These investigations do provide some useful information on the heating efficiency of these homes. Useful comparisons can be drawn between these study homes and site-built heating efficiencies measured with a similar protocol. The protocol used to test these homes is very similar to another Ecotope protocol used in the study conducted in 1992 and 1993 for the Bonneville Power Administration to test the heating efficiency of 24 homes. This protocol combined real-time power measurements of furnace energy usage with energy usage during co-heat periods. Accessory data such as house and duct tightness measurements and tracer gas measurements were used to describe these homes and their heating system efficiency. Ensuring that manufactured housing is constructed in an energy and resource efficient manner is of increasing concern to manufactured home builders and consumers. No comparable work has been done to measure the heating system efficiency of MCS manufactured homes, although some co-heat tests have been performed on manufactured homes heated with natural gas to validate HUD thermal standards. It is expected that later in 1994 more research of this kind will be conducted, and perhaps a less costly and less time-consuming method for testing efficiencies will be develops.

  17. Concordance of In-Home "Smart" Scale Measurement with Body Weight Measured In-Person.

    Science.gov (United States)

    Ross, Kathryn M; Wing, Rena R

    2016-06-01

    Newer "smart" scales that transmit participants' body weights directly to data collection centers offer the opportunity to simplify weight assessment in weight management research; however, little data exist on the concordance of these data compared to weights measured at in-person assessments. We compared the weights of 58 participants (mean±SD BMI = 31.6±4.8, age = 52.1±9.7 years, 86.2% White, 65.5% Female) measured by study staff at an in-person assessment visit to weights measured on the same day at home using BodyTrace "smart" scales. These measures occurred after 3 months of an internet-based weight management intervention. Weight (mean±SD) measured at the 3-month in-person assessment visit was 81.5±14.7kg compared to 80.4±14.5kg measured on the same day using in-home body weight scales; mean bias =1.1±0.8kg, 95% limits of agreement = -0.5 to 2.6. Two outliers in the data suggest that there may be greater variability between measurements for participants weighing above 110 kg. Results suggest good concordance between the measurements and support the use of the BodyTrace smart scale in weight management research. Future trials using BodyTrace scales for outcome assessment should clearly define protocols for measurement and associated instructions to participants (e.g., instruct individuals to weigh at the same time of day, similarly clothed). Finally, measure concordance should be investigated in a group of individuals weighing more than 110kg.

  18. Comparison of several databases of downward solar daily irradiation data at ocean surface with PIRATA measurements

    Science.gov (United States)

    Trolliet, Mélodie; Wald, Lucien

    2017-04-01

    The solar radiation impinging at sea surface is an essential variable in climate system. There are several means to assess the daily irradiation at surface, such as pyranometers aboard ship or on buoys, meteorological re-analyses and satellite-derived databases. Among the latter, assessments made from the series of geostationary Meteosat satellites offer synoptic views of the tropical and equatorial Atlantic Ocean every 15 min with a spatial resolution of approximately 5 km. Such Meteosat-derived databases are fairly recent and the quality of the estimates of the daily irradiation must be established. Efforts have been made for the land masses and must be repeated for the Atlantic Ocean. The Prediction and Research Moored Array in the Tropical Atlantic (PIRATA) network of moorings in the Tropical Atlantic Ocean is considered as a reference for oceanographic data. It consists in 17 long-term Autonomous Temperature Line Acquisition System (ATLAS) buoys equipped with sensors to measure near-surface meteorological and subsurface oceanic parameters, including downward solar irradiation. Corrected downward solar daily irradiation from PIRATA were downloaded from the NOAA web site and were compared to several databases: CAMS RAD, HelioClim-1, HelioClim-3 v4 and HelioClim-3 v5. CAMS-RAD, the CAMS radiation service, combines products of the Copernicus Atmosphere Monitoring Service (CAMS) on gaseous content and aerosols in the atmosphere together with cloud optical properties deduced every 15 min from Meteosat imagery to supply estimates of the solar irradiation. Part of this service is the McClear clear sky model that provides estimates of the solar irradiation that should be observed in cloud-free conditions. The second and third databases are HelioClim-1 and HelioClim-3 v4 that are derived from Meteosat images using the Heliosat-2 method and the ESRA clear sky model, based on the Linke turbidity factor. HelioClim-3 v5 is the fourth database and differs from v4 by the

  19. [Do you measure gait speed in your daily clinical practice? A review].

    Science.gov (United States)

    Inzitari, Marco; Calle, Alicia; Esteve, Anna; Casas, Álvaro; Torrents, Núria; Martínez, Nicolás

    Gait speed (GS), measured at usual pace, is an easy, quick, reliable, non-expensive and informative measurement. With a standard chronometer, like those that currently found in mobile phones, and with two marks on the floor, trained health professionals obtain a more objective and quick measurement compared with many geriatric scales used in daily practice. GS is one of the pillars of the frailty phenotype, and is closely related to sarcopenia. It is a powerful marker of falls incidence, disability and death, mostly useful in the screening of older adults that live in the community. In recent years, the evidence is reinforcing the usefulness of GS in acute care and post-surgical patients. Its use in patients with cognitive impairment is suggested, due to the strong link between cognitive and physical function. Although GS meets the criteria for a good geriatric screening tool, it is not much used in clinical practice. Why? This review has different aims: (i)disentangling the relationship between GS and frailty; (ii)reviewing the protocols to measure GS and the reference values; (iii)reviewing the evidence in different clinical groups (older adults with frailty, with cognitive impairment, with cancer or other pathologies), and in different settings (community, acute care, rehabilitation), and (iv)speculating about the reasons for its poor use in clinical practice and about the gaps to be filled. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. How the perspectives of nursing assistants and frail elderly residents on their daily interaction in nursing homes affect their interaction: a qualitative study.

    Science.gov (United States)

    Lung, Chi-Chi; Liu, Justina Yat Wa

    2016-01-14

    Good support from and positive relations with institutional staff can enhance the psychosocial wellbeing of residents admitted to a nursing home. Nursing assistants (NAs) interact most frequently with residents and play an important role in developing good rapport with them. Most studies have described the daily interactions between NAs and residents as task oriented. Only few have attempted to explore the perspectives of NAs and residents on their daily interactions. Therefore, the aim of this study was to identify the types of daily interactions perceived by NAs and residents. We also investigated those intentions/beliefs held by NAs and residents that might direct their interactive behaviors. A descriptive, exploratory, qualitative approach was used to explore the perspectives of 18 NAs (mean age: 51) and 15 residents (mean age: 84.4) on their daily interactions. Unstructured in-depth interviews were used to collect data. All of the interviews were conducted from July to December 2013. The collected data were transcribed verbatim and analyzed by content analysis. Three types of interactions were found that described the NAs' and residents' perspectives on their daily interactions: (1) physiologically-oriented daily interactions; (2) cordial interactions intended to maintain a harmonious atmosphere; and (3) reciprocal social interactions intended to develop closer rapport. One or more themes reflecting the participants' intentions or beliefs were identified from each group to support each type of interaction. An over-emphasis on the formal caring relationship and over-concern about maintaining a harmonious atmosphere contributed to a superficial and distant relationship between the two parties. Building close rapport takes time and involves repeated reciprocal social interactions. The findings showed that with good intentions to establish closer rapport, both NAs and residents did favors for each other. All of those favors were easily integrated in the care

  1. In connection with the aged who have need help to perform all daily chores on general care ward in Hiroshima Survivors Home

    International Nuclear Information System (INIS)

    Shimizu, Kiyoshi; Hirata, Takeshi; Sugiura, Fusako

    1978-01-01

    The aged who are admitted to general care ward of Hiroshima Survivors Home and need help to perform all daily chores as of January 1978 are 3 of 18 aged 60 - 69 years old (16.7%), 18 of 69 ones 70 - 79 years old (26.1%), 21 of 52 ones 80 - 89 years old (40.4%), and 6 of 7 ones more than 90 years old (85.7%), which are 48 of total 146 (32.9%). This phenomenon is recognized more frequently in women than in men. Occurrence of this phenomenon was high in a short-distance group and a group who entered city after the explosion. It was also high in the aged who stayed at this home for more than 7 years. Most diseases from which they suffered are those of bone and joints (19%) and arteriosclerosis (18.7%). Eight of 13 aged with eye diseases suffered from cataract. As advancement of senility with aging and exacerbation lead to increase of care for them, it is necessary to change their general care to special one. The ability of such aged, who are admitted to general ward and need help to perform all daily chores, to act independently was the same as that of those admitted to Yokufukai special care ward. At the present when beds for special care are filled to capacity, treatment of the aged who need special care (30% of those who need general care), personnel management, and health management of staffs are important. (Tsunoda, M.)

  2. Variability in Measured Space Temperatures in 60 Homes

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, D.; Lay, K.

    2013-03-01

    This report discusses the observed variability in indoor space temperature in a set of 60 homes located in Florida, New York, Oregon, and Washington. Temperature data were collected at 15-minute intervals for an entire year, including living room, master bedroom, and outdoor air temperature (Arena, et. al). The data were examined to establish the average living room temperature for the set of homes for the heating and cooling seasons, the variability of living room temperature depending on climate, and the variability of indoor space temperature within the homes. The accuracy of software-based energy analysis depends on the accuracy of input values. Thermostat set point is one of the most influential inputs for building energy simulation. Several industry standards exist that recommend differing default thermostat settings for heating and cooling seasons. These standards were compared to the values calculated for this analysis. The data examined for this report show that there is a definite difference between the climates and that the data do not agree well with any particular standard.

  3. Proportion and characteristics of patients who measure their blood pressure at home: Nationwide survey in Slovenia

    Directory of Open Access Journals (Sweden)

    Petek-Šter Marija

    2009-01-01

    Full Text Available Introduction. Home blood pressure monitoring has several advantages over blood pressure monitoring at a physician's office, and has become a useful instrument in the management of hypertension. Objective. To explore the rate and characteristics of patients who measure their blood pressure at home. Methods. A sample of 2,752 patients with diagnosis of essential arterial hypertension was selected from 12596 consecutive office visitors. Data of 2,639 patients was appropriate for analysis. The data concerning home blood pressure measurement and patients' characteristics were obtained from the patients' case histories. Results 1,835 (69.5% out of 2,639 patients measured their blood pressure at home. 1,284 (70.0% of home blood pressure patients had their own blood pressure measurement device. There were some important differences between these two groups: home blood pressure patients were more frequently male, of younger age, better educated, from urban area, mostly non-smokers, more likely to have diabetes mellitus and ischemic heart disease and had higher number of co-morbidities and were on other drugs beside antihypertensive medication. Using the logistic regression analysis we found that the most powerful predictors of home blood pressure monitoring had higher education level than primary school OR=1.80 (95% CI 1.37-2.37, non-smoking OR=2.16 (95% CI 1.40-3.33 and having a physician in urban area OR=1.32 (95% CI 1.02-1.71. Conclusion. Home blood pressure monitoring is popular in Slovenia. Patients who measured blood pressure at home were different from patients who did not. Younger age, higher education, non-smoking, having a physician in urban area and longer duration of hypertension were predictors of home blood pressure monitoring.

  4. The effectiveness of radon preventive and remedial measures in Irish homes

    International Nuclear Information System (INIS)

    Long, S; Fenton, D; Cremin, M; Morgan, A

    2013-01-01

    It is estimated that approximately 100 000 Irish homes have radon concentrations above the reference level of 200 Bq m −3 . To minimise the number of new homes with this problem, building regulations require that all new homes built since July 1998 in high radon areas are installed with radon barriers during construction. Measurements on local authority homes in a number of high radon areas have allowed the impact of these new regulations to be assessed. In County Cork a reduction of up to 70% in the mean radon concentration was observed in homes built since 1998 relative to those built before this date. A reduction in both the number of homes exceeding the reference level and the maximum concentration measured in homes was also measured. Homes exceeding the reference level were remediated with the use of an active sump. The results of this remedial work are also presented and show that the mean reduction in radon concentration achieved was 92%. (paper)

  5. Home outdoor models for traffic-related air pollutants do not represent personal exposure measurements in Southern California

    International Nuclear Information System (INIS)

    Ducret-Stich, R; Gemperli, A; Ineichen, A; Phuleria, H C; Delfino, R J; Tjoa, T; Wu, J; Liu, L-J S

    2009-01-01

    Recent studies have used measurements or estimates of traffic-related air pollutants at home or school locations to link associations between exposure and health. However, little is known about the validity of these outdoor concentrations as an estimate for personal exposure to traffic. This paper compares modelled outdoor concentrations at home with personal exposure to traffic air pollution of 63 children in two areas in Los Angeles in 2003/2004. Exposure monitoring consisted of sixteen 10-day monitoring runs, with each run monitoring 4 subjects concurrently with the active personal DataRAM for particulate matter 25 ), elemental carbon (EC) and organic carbon (OC). One child per run had concurrent indoor/outdoor home monitoring. Measurements at central sites (24-hr PM 25 , EC, OC) were taken daily and concentrations of PM 25 , EC, and OC from traffic sources were calculated using the CALINE4 model for individual residences. We modelled outdoor concentrations of PM 2 5 , EC and OC with multilinear regression including GIS and meteorological parameters and adjusted for auto-correlation between repeated measurements. The model fit (R 2 ) for home outdoor estimates was 0.94, 0.74 and 0.80 for PM 25 , EC and OC, respectively. Comparisons between these outdoor estimates and the personal measurements showed a good agreement for PM 25 (R 2 =0.65-0.70) with a mean bias of -0.7±11.8|ag for the smog receptor area, and 18.9±16.2|ag for the traffic impacted area. However the outdoor estimates were not related to personal exposure for EC (R 2 =0.01-0.29) and OC (R 2 =0.03- 0.14). Conclusions: Predictions of outdoor concentrations can be used as approximations of personal exposure to PM 25 . However, they are not appropriate for estimating personal exposure to traffic-related air pollutants including EC and OC in studies of acute exposure-response relationships.

  6. Validity of parent-reported weight and height of preschool children measured at home or estimated without home measurement: a validation study

    Directory of Open Access Journals (Sweden)

    Cox Bianca

    2011-07-01

    Full Text Available Abstract Background Parental reports are often used in large-scale surveys to assess children's body mass index (BMI. Therefore, it is important to know to what extent these parental reports are valid and whether it makes a difference if the parents measured their children's weight and height at home or whether they simply estimated these values. The aim of this study is to compare the validity of parent-reported height, weight and BMI values of preschool children (3-7 y-old, when measured at home or estimated by parents without actual measurement. Methods The subjects were 297 Belgian preschool children (52.9% male. Participation rate was 73%. A questionnaire including questions about height and weight of the children was completed by the parents. Nurses measured height and weight following standardised procedures. International age- and sex-specific BMI cut-off values were employed to determine categories of weight status and obesity. Results On the group level, no important differences in accuracy of reported height, weight and BMI were identified between parent-measured or estimated values. However, for all 3 parameters, the correlations between parental reports and nurse measurements were higher in the group of children whose body dimensions were measured by the parents. Sensitivity for underweight and overweight/obesity were respectively 73% and 47% when parents measured their child's height and weight, and 55% and 47% when parents estimated values without measurement. Specificity for underweight and overweight/obesity were respectively 82% and 97% when parents measured the children, and 75% and 93% with parent estimations. Conclusions Diagnostic measures were more accurate when parents measured their child's weight and height at home than when those dimensions were based on parental judgements. When parent-reported data on an individual level is used, the accuracy could be improved by encouraging the parents to measure weight and height

  7. Reproducibility of wrist home blood pressure measurement with position sensor and automatic data storage

    Directory of Open Access Journals (Sweden)

    Nickenig Georg

    2009-05-01

    Full Text Available Abstract Background Wrist blood pressure (BP devices have physiological limits with regards to accuracy, therefore they were not preferred for home BP monitoring. However some wrist devices have been successfully validated using etablished validation protocols. Therefore this study assessed the reproducibility of wrist home BP measurement with position sensor and automatic data storage. Methods To compare the reproducibility of three different(BP measurement methods: 1 office BP, 2 home BP (Omron wrist device HEM- 637 IT with position sensor, 3 24-hour ambulatory BP(24-h ABPM (ABPM-04, Meditech, Hunconventional sphygmomanometric office BP was measured on study days 1 and 7, 24-h ABPM on study days 7 and 14 and home BP between study days 1 and 7 and between study days 8 and 14 in 69 hypertensive and 28 normotensive subjects. The correlation coeffcient of each BP measurement method with echocardiographic left ventricular mass index was analyzed. The schedule of home readings was performed according to recently published European Society of Hypertension (ESH- guidelines. Results The reproducibility of home BP measurement analyzed by the standard deviation as well as the squared differeces of mean individual differences between the respective BP measurements was significantly higher than the reproducibility of office BP (p Conclusion The short-term reproducibility of home BP measurement with the Omron HEM-637 IT wrist device was superior to the reproducibility of office BP and 24- h ABPM measurement. Furthermore, home BP with the wrist device showed similar correlations to targed organ damage as recently reported for upper arm devices. Although wrist devices have to be used cautious and with defined limitations, the use of validated devices with position sensor according to recently recommended measurement schedules might have the potential to be used for therapy monitoring.

  8. Objectively measured daily physical activity and postural changes as related to positive and negative affect using ambulatory monitoring assessments

    OpenAIRE

    Aggio, D; Wallace, K; Boreham, N; Shankar, A; Steptoe, A; Hamer, M

    2017-01-01

    ABSTRACT Objective The aim of the study was to determine whether objectively measured daily physical activity and posture of sitting, standing, and sit-to-stand transitions are associated with daily assessments of affect. Methods Participants (N = 51, 49% female) wore ActivPal accelerometers for 24 h/d for seven consecutive days. Time spent sitting, standing, and being physically active and sit-to-stand transitions were derived for each day. Participants also completed a mood inventory each e...

  9. Objectively Measured Daily Physical Activity and Postural Changes as Related to Positive and Negative Affect Using Ambulatory Monitoring Assessments

    OpenAIRE

    Aggio, D.; Wallace, K.; Boreham, N.; Shankar, A.; Steptoe, A.; Hamer, M.

    2017-01-01

    OBJECTIVE: The aim of the study was to determine whether objectively measured daily physical activity and posture of sitting, standing, and sit-to-stand transitions are associated with daily assessments of affect. METHODS: Participants (N = 51, 49% female) wore ActivPal accelerometers for 24 h/d for seven consecutive days. Time spent sitting, standing, and being physically active and sit-to-stand transitions were derived for each day. Participants also completed a mood inventory each evening....

  10. POEM a core instrument to measure symptoms in clinical trials: a HOME statement

    OpenAIRE

    Spuls, Ph.I.; Gerbens, L.A.A.; Simpson, E.; Apfelbacher, C.J.; Chalmers, J.R.; Thomas, K.S.; Prinsen, C.A.C.; Kobyletzki, L.B. von; Singh, J.A.; Williams, Hywel C.; Schmitt, J.

    2016-01-01

    Background: The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and longterm control. Objectives: The aim of this paper is to report on the consensus process that was used to select the core instrument to consistently assess symptoms in all future AE trials. Methods: Following the HOME roa...

  11. Participation needs of older adults having disabilities and receiving home care: met needs mainly concern daily activities, while unmet needs mostly involve social activities.

    Science.gov (United States)

    Turcotte, Pier-Luc; Larivière, Nadine; Desrosiers, Johanne; Voyer, Philippe; Champoux, Nathalie; Carbonneau, Hélène; Carrier, Annie; Levasseur, Mélanie

    2015-08-01

    Participation is a key determinant of successful aging and enables older adults to stay in their homes and be integrated into the community. Assessing participation needs involves identifying restrictions in the accomplishment of daily and social activities. Although meeting participation needs involves older adults, their caregivers and healthcare providers, little is known about their respective viewpoints. This study thus explored the participation needs of older adults having disabilities as perceived by the older adults themselves, their caregivers and healthcare providers. A qualitative multiple case study consisted of conducting 33 semi-structured interviews in eleven triads, each composed of an older adult, his/her caregiver and a healthcare provider recruited in a Health and Social Services Centre (HSSC) in Québec, Canada. Interview transcripts and reviews of clinical records were analyzed using content analysis and descriptive statistics based on thematic saliency analysis methods. Aged 66 to 88 years, five older adults had physical disabilities, five had mild cognitive impairment and one had psychological problems, leading to moderate to severe functional decline. Caregivers and healthcare providers were mainly women, respectively retired spouses and various professionals with four to 32 years of clinical experience. Participation needs reported by each triad included all domains of participation. Needs related to daily activities, such as personal care, nutrition, and housing, were generally met. Regarding social activities, few needs were met by various resources in the community and were generally limited to personal responsibilities, including making decisions and managing budgets, and some community life activities, such as going shopping. Unmet needs were mainly related to social activities, involving leisure, other community life activities and interpersonal relationships, and some daily activities, including fitness and mobility. This study

  12. 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.

  13. Effects of diurnal emission patterns and sampling frequency on precision of measurement methods for daily ammonia emissions from animal houses

    NARCIS (Netherlands)

    Estelles, F.; Calvet, S.; Ogink, N.W.M.

    2010-01-01

    Ammonia concentrations and airflow rates are the main parameters needed to determine ammonia emissions from animal houses. It is possible to classify their measurement methods into two main groups according to the sampling frequency: semi-continuous and daily average measurements. In the first

  14. Daily energy expenditure and physical activity measured in Parkinson's disease patients with and without weight loss

    Science.gov (United States)

    Patients with Parkinson's disease (PD) commonly exhibit weight loss, which investigators attribute to various factors, including elevated resting energy expenditure. We tested the hypothesis that daily energy expenditure (DEE) and its components, resting energy expenditure (REF) and physical activit...

  15. [Home health resource utilization measures using a case-mix adjustor model].

    Science.gov (United States)

    You, Sun-Ju; Chang, Hyun-Sook

    2005-08-01

    The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.

  16. Home dim light melatonin onsets with measures of compliance in delayed sleep phase disorder.

    Science.gov (United States)

    Burgess, Helen J; Park, Margaret; Wyatt, James K; Fogg, Louis F

    2016-06-01

    The dim light melatonin onset (DLMO) assists with the diagnosis and treatment of circadian rhythm sleep disorders. Home DLMOs are attractive for cost savings and convenience, but can be confounded by home lighting and sample timing errors. We developed a home saliva collection kit with objective measures of light exposure and sample timing. We report on our first test of the kit in a clinical population. Thirty-two participants with delayed sleep phase disorder (DSPD; 17 women, aged 18-52 years) participated in two back-to-back home and laboratory phase assessments. Most participants (66%) received at least one 30-s epoch of light >50 lux during the home phase assessments, but for only 1.5% of the time. Most participants (56%) collected every saliva sample within 5 min of the scheduled time. Eighty-three per cent of home DLMOs were not affected by light or sampling errors. The home DLMOs occurred, on average, 10.2 min before the laboratory DLMOs, and were correlated highly with the laboratory DLMOs (r = 0.93, P light exposure and sample timing, can assist in identifying accurate home DLMOs. © 2016 European Sleep Research Society.

  17. Measurement-Based Evaluation of Installed Filtration System Performance in Single-Family Homes

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Wanyu Rengie; Singer, Brett C.

    2014-04-03

    This guide discusses important study design issues to consider when conducting an on-site evaluation of filtration system performance. The two most important dichotomies to consider in developing a study protocol are (1) whether systems are being evaluated in occupied or unoccupied homes and (2) whether different systems are being compared in the same homes or if the comparison is between systems installed in different homes. This document provides perspective and recommendations about a suite of implementation issues including the choice of particle measurement devices, selection of sampling locations, ways to control and/or monitor factors and processes that can impact particle concentrations, and data analysis approaches.

  18. Influence of staff infection control training on infection-related quality measures in US nursing homes.

    Science.gov (United States)

    Kaur, Jasjit; Stone, Patricia W; Travers, Jasmine L; Cohen, Catherine C; Herzig, Carolyn T A

    2017-09-01

    Health care-associated infections are a leading cause of morbidity and mortality in US nursing home residents. Ongoing training of nursing home staff is vital to the implementation of infection prevention and control processes. Our aim was to describe associations between methods, frequency, and timing of staff infection prevention and control training and infection-related quality measures. In this national survey of nursing homes, timing of staff infection prevention and control training was associated with reduced indwelling urinary catheter use. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Daily actions, challenges, and needs among Dutch parents while supporting the participation of their child with a physical disability at home, at school, and in the community : a qualitative diary study

    NARCIS (Netherlands)

    Piškur, Barbara; Beurskens, Anna J H M; Ketelaar, Marjolijn; Jongmans, Marian; Casparie, Barbara M; Smeets, Rob J E M

    2017-01-01

    BACKGROUND: Parents have a vital influence on the participation of their child with a physical disability. The aim of this study is to gain insight into parents' own daily actions, challenges, and needs while supporting their child with a physical disability at home, at school, and in the community.

  20. Daily actions, challenges, and needs among Dutch parents while supporting the participation of their child with a physical disability at home, at school, and in the community : A qualitative diary study

    NARCIS (Netherlands)

    Piškur, Barbara; Beurskens, Anna J H M; Ketelaar, Marjolijn; Jongmans, Marian J.; Casparie, Barbara M.; Smeets, Rob J E M

    2017-01-01

    Background: Parents have a vital influence on the participation of their child with a physical disability. The aim of this study is to gain insight into parents' own daily actions, challenges, and needs while supporting their child with a physical disability at home, at school, and in the community.

  1. Estimation of daily global solar irradiation by coupling ground measurements of bright sunshine hours to satellite imagery

    International Nuclear Information System (INIS)

    Ener Rusen, Selmin; Hammer, Annette; Akinoglu, Bulent G.

    2013-01-01

    In this work, the current version of the satellite-based HELIOSAT method and ground-based linear Ångström–Prescott type relations are used in combination. The first approach is based on the use of a correlation between daily bright sunshine hours (s) and cloud index (n). In the second approach a new correlation is proposed between daily solar irradiation and daily data of s and n which is based on a physical parameterization. The performances of the proposed two combined models are tested against conventional methods. We test the use of obtained correlation coefficients for nearby locations. Our results show that the use of sunshine duration together with the cloud index is quite satisfactory in the estimation of daily horizontal global solar irradiation. We propose to use the new approaches to estimate daily global irradiation when the bright sunshine hours data is available for the location of interest, provided that some regression coefficients are determined using the data of a nearby station. In addition, if surface data for a close location does not exist then it is recommended to use satellite models like HELIOSAT or the new approaches instead the Ångström type models. - Highlights: • Satellite imagery together with surface measurements in solar radiation estimation. • The new coupled and conventional models (satellite and ground-based) are analyzed. • New models result in highly accurate estimation of daily global solar irradiation

  2. Feasibility of Measuring Tobacco Smoke Air Pollution in Homes: Report from a Pilot Study

    Directory of Open Access Journals (Sweden)

    Laura Rosen

    2015-11-01

    Full Text Available Tobacco smoke air pollution (TSAP measurement may persuade parents to adopt smoke-free homes and thereby reduce harm to children from tobacco smoke in the home. In a pilot study involving 29 smoking families, a Sidepak was used to continuously monitor home PM2.5 during an 8-h period, Sidepak and/or Dylos monitors provided real-time feedback, and passive nicotine monitors were used to measure home air nicotine for one week. Feedback was provided to participants in the context of motivational interviews. Home PM2.5 levels recorded by continuous monitoring were not well-accepted by participants because of the noise level. Also, graphs from continuous monitoring showed unexplained peaks, often associated with sources unrelated to indoor smoking, such as cooking, construction, or outdoor sources. This hampered delivery of a persuasive message about the relationship between home smoking and TSAP. By contrast, immediate real-time PM2.5 feedback (with Sidepak or Dylos monitor was feasible and provided unambiguous information; the Dylos had the additional advantages of being more economical and quieter. Air nicotine sampling was complicated by the time-lag for feedback and questions regarding shelf-life. Improvement in the science of TSAP measurement in the home environment is needed to encourage and help maintain smoke-free homes and protect vulnerable children. Recent advances in the use of mobile devices for real-time feedback are promising and warrant further development, as do accurate methods for real-time air nicotine air monitoring.

  3. Reproducibility of wrist home blood pressure measurement with position sensor and automatic data storage

    Science.gov (United States)

    Uen, Sakir; Fimmers, Rolf; Brieger, Miriam; Nickenig, Georg; Mengden, Thomas

    2009-01-01

    Background Wrist blood pressure (BP) devices have physiological limits with regards to accuracy, therefore they were not preferred for home BP monitoring. However some wrist devices have been successfully validated using etablished validation protocols. Therefore this study assessed the reproducibility of wrist home BP measurement with position sensor and automatic data storage. Methods To compare the reproducibility of three different(BP) measurement methods: 1) office BP, 2) home BP (Omron wrist device HEM- 637 IT with position sensor), 3) 24-hour ambulatory BP(24-h ABPM) (ABPM-04, Meditech, Hun)conventional sphygmomanometric office BP was measured on study days 1 and 7, 24-h ABPM on study days 7 and 14 and home BP between study days 1 and 7 and between study days 8 and 14 in 69 hypertensive and 28 normotensive subjects. The correlation coeffcient of each BP measurement method with echocardiographic left ventricular mass index was analyzed. The schedule of home readings was performed according to recently published European Society of Hypertension (ESH)- guidelines. Results The reproducibility of home BP measurement analyzed by the standard deviation as well as the squared differeces of mean individual differences between the respective BP measurements was significantly higher than the reproducibility of office BP (p ABPM (p ABPM was not significantly different (p = 0.80 systolic BP, p = 0.1 diastolic BP). The correlation coefficient of 24-h ABMP (r = 0.52) with left ventricular mass index was significantly higher than with office BP (r = 0.31). The difference between 24-h ABPM and home BP (r = 0.46) was not significant. Conclusion The short-term reproducibility of home BP measurement with the Omron HEM-637 IT wrist device was superior to the reproducibility of office BP and 24- h ABPM measurement. Furthermore, home BP with the wrist device showed similar correlations to targed organ damage as recently reported for upper arm devices. Although wrist devices have

  4. SU-G-TeP2-01: Can EPID Based Measurement Replace Traditional Daily Output QA On Megavoltage Linac?

    International Nuclear Information System (INIS)

    Saleh, Z; Tang, X; Song, Y; Obcemea, C; Beeban, N; Chan, M; Li, X; Tang, G; Lim, S; Lovelock, D; LoSasso, T; Mechalakos, J; Both, S

    2016-01-01

    Purpose: To investigate the long term stability and viability of using EPID-based daily output QA via in-house and vendor driven protocol, to replace conventional QA tools and improve QA efficiency. Methods: Two Varian TrueBeam machines (TB1&TB2) equipped with electronic portal imaging devices (EPID) were employed in this study. Both machines were calibrated per TG-51 and used clinically since Oct 2014. Daily output measurement for 6/15 MV beams were obtained using SunNuclear DailyQA3 device as part of morning QA. In addition, in-house protocol was implemented for EPID output measurement (10×10 cm fields, 100 MU, 100cm SID, output defined over an ROI of 2×2 cm around central axis). Moreover, the Varian Machine Performance Check (MPC) was used on both machines to measure machine output. The EPID and DailyQA3 based measurements of the relative machine output were compared and cross-correlated with monthly machine output as measured by an A12 Exradin 0.65cc Ion Chamber (IC) serving as ground truth. The results were correlated using Pearson test. Results: The correlations among DailyQA3, in-house EPID and Varian MPC output measurements, with the IC for 6/15 MV were similar for TB1 (0.83–0.95) and TB2 (0.55–0.67). The machine output for the 6/15MV beams on both machines showed a similar trend, namely an increase over time as indicated by all measurements, requiring a machine recalibration after 6 months. This drift is due to a known issue with pressurized monitor chamber which tends to leak over time. MPC failed occasionally but passed when repeated. Conclusion: The results indicate that the use of EPID for daily output measurements has the potential to become a viable and efficient tool for daily routine LINAC QA, thus eliminating weather (T,P) and human setup variability and increasing efficiency of the QA process.

  5. SU-G-TeP2-01: Can EPID Based Measurement Replace Traditional Daily Output QA On Megavoltage Linac?

    Energy Technology Data Exchange (ETDEWEB)

    Saleh, Z; Tang, X; Song, Y; Obcemea, C; Beeban, N; Chan, M; Li, X; Tang, G; Lim, S; Lovelock, D; LoSasso, T; Mechalakos, J; Both, S [Memorial Sloan-Kettering Cancer Center, NY (United States)

    2016-06-15

    Purpose: To investigate the long term stability and viability of using EPID-based daily output QA via in-house and vendor driven protocol, to replace conventional QA tools and improve QA efficiency. Methods: Two Varian TrueBeam machines (TB1&TB2) equipped with electronic portal imaging devices (EPID) were employed in this study. Both machines were calibrated per TG-51 and used clinically since Oct 2014. Daily output measurement for 6/15 MV beams were obtained using SunNuclear DailyQA3 device as part of morning QA. In addition, in-house protocol was implemented for EPID output measurement (10×10 cm fields, 100 MU, 100cm SID, output defined over an ROI of 2×2 cm around central axis). Moreover, the Varian Machine Performance Check (MPC) was used on both machines to measure machine output. The EPID and DailyQA3 based measurements of the relative machine output were compared and cross-correlated with monthly machine output as measured by an A12 Exradin 0.65cc Ion Chamber (IC) serving as ground truth. The results were correlated using Pearson test. Results: The correlations among DailyQA3, in-house EPID and Varian MPC output measurements, with the IC for 6/15 MV were similar for TB1 (0.83–0.95) and TB2 (0.55–0.67). The machine output for the 6/15MV beams on both machines showed a similar trend, namely an increase over time as indicated by all measurements, requiring a machine recalibration after 6 months. This drift is due to a known issue with pressurized monitor chamber which tends to leak over time. MPC failed occasionally but passed when repeated. Conclusion: The results indicate that the use of EPID for daily output measurements has the potential to become a viable and efficient tool for daily routine LINAC QA, thus eliminating weather (T,P) and human setup variability and increasing efficiency of the QA process.

  6. Optimal replacement policies for dairy cows based on daily yield measurements

    DEFF Research Database (Denmark)

    Nielsen, Lars Relund; Jørgensen, Erik; Kristensen, Anders Ringgaard

    2010-01-01

    describes the first step of developing an MDP model that can be integrated into a modern herd management system. A hierarchical MDP was formulated for the dairy cow replacement problem with stage lengths of 1 d. It can be used to assist the farmer in replacement decisions on a daily basis and is based...

  7. Accelerometer-measured daily physical activity related to aerobic fitness in children and adolescents

    DEFF Research Database (Denmark)

    Dencker, Magnus; Andersen, Lars Bo

    2011-01-01

    Maximum oxygen uptake ([Vdot]O(2PEAK)) is generally considered to be the best single marker for aerobic fitness. While a positive relationship between daily physical activity and aerobic fitness has been established in adults, the relationship appears less clear in children and adolescents...

  8. Measurements of Capture Efficiency of Range Hoods in Homes

    DEFF Research Database (Denmark)

    Simone, Angela; Sherman, Max H.; Walker, Iain S.

    2015-01-01

    mapped the pollution distribution in the room, and showed that the pollutants escape more at the sides of the cooktop. These preliminary results suggest that more measurements should be conducted investigating the capture efficiency at different pollutant source temperature, size and location...... want a range hood to use little energy and have high capture efficiency to minimize the required air flow to capture the cooking pollutants. Currently there are no standards for rating range hoods for capture efficiency In this study, measurements of range hood capture efficiency were made a tight...... kitchen-room built in a laboratory chamber, and a methodology for standardizing measurement of capture efficiency was developed. The results for a wall mounted range hood, showed that up to half of the cooking pollutants were not captured at a flow rate of 230 m3/h. A more detailed set of measurements...

  9. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F.; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-01-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  10. Towards global consensus on outcome measures for atopic eczema research : Results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  11. Influence of daily setup measurements and corrections on the estimated delivered dose during IMRT treatment of prostate cancer patients

    International Nuclear Information System (INIS)

    Haaren, Paul M.A. van; Bel, Arjan; Hofman, Pieter; Vulpen, Marco van; Kotte, Alexis N.T.J.; Heide, Uulke A. van der

    2009-01-01

    Purpose: To evaluate the impact of marker-based position verification, using daily imaging and an off-line correction protocol, by calculating the delivered dose to prostate, rectum and bladder. Methods: Prostate cancer patients (n = 217) were treated with IMRT, receiving 35 daily fractions. Plans with five beams were optimized taking target coverage (CTV, boost) and organs-at-risk (rectum and bladder) into account. PTV margins were 8 mm. Prostate position was verified daily using implanted fiducial gold markers by imaging the first segment of all the five beams on an EPID. Setup deviations were corrected off-line using an adapted shrinking-action-level protocol. The estimated delivered dose, including daily organ movements, was calculated using a version of PLATO's dose engine, enabling batch processing of large numbers of patients. The dose was calculated ± inclusion of setup corrections, and was evaluated relative to the original static plan. The marker-based measurements were considered representative for all organs. Results: Daily organ movements would result in an underdosage of 2-3 Gy to CTV and boost volume relative to the original plan, which was prevented by daily setup corrections. The dose to rectum and bladder was on average unchanged, but a large spread was introduced by organ movements, which was reduced by including setup corrections. Conclusions: Without position verification and setup corrections, margins of 8mm would be insufficient to account for position uncertainties during IMRT of prostate cancer. With the daily off-line correction protocol, the remaining variations are accommodated adequately

  12. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

    Science.gov (United States)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-09-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

  13. A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers.

    Science.gov (United States)

    Moor, C C; Wapenaar, M; Miedema, J R; Geelhoed, J J M; Chandoesing, P P; Wijsenbeek, M S

    2018-05-29

    In idiopathic pulmonary fibrosis (IPF), home monitoring experiences are limited, not yet real-time available nor implemented in daily care. We evaluated feasibility and potential barriers of a new home monitoring program with real-time wireless home spirometry in IPF. Ten patients with IPF were asked to test this home monitoring program, including daily home spirometry, for four weeks. Measurements of home and hospital spirometry showed good agreement. All patients considered real-time wireless spirometry useful and highly feasible. Both patients and researchers suggested relatively easy solutions for the identified potential barriers regarding real-time home monitoring in IPF.

  14. Assessing Virtue: Measurement in Moral Education at Home and Abroad

    Science.gov (United States)

    Alexander, Hanan A.

    2016-01-01

    How should we assess programs dedicated to education in virtue? One influential answer draws on quantitative research designs. By measuring the inputs and processes that produce the highest levels of virtue among participants according to some reasonable criterion, in this view, we can determine which programs engender the most desired results.…

  15. Objectively Measured Daily Physical Activity and Postural Changes as Related to Positive and Negative Affect Using Ambulatory Monitoring Assessments.

    Science.gov (United States)

    Aggio, Daniel; Wallace, Karen; Boreham, Nicola; Shankar, Aparna; Steptoe, Andrew; Hamer, Mark

    2017-09-01

    The aim of the study was to determine whether objectively measured daily physical activity and posture of sitting, standing, and sit-to-stand transitions are associated with daily assessments of affect. Participants (N = 51, 49% female) wore ActivPal accelerometers for 24 h/d for seven consecutive days. Time spent sitting, standing, and being physically active and sit-to-stand transitions were derived for each day. Participants also completed a mood inventory each evening. Multilevel models examined within- and between-person associations of daily physical activity with positive and negative affect, adjusting for age, sex, body mass index, education, and sleep duration. Within-person associations showed that a 1-hour increase in daily physical activity was associated with a decrease in negative affect over the same day (B = -0.11, 95% confidence interval [CI], -0.21 to -0.01). Between-person associations indicated a borderline significant association between higher average daily physical activity levels and higher positive affect (B = 1.85, 95% CI = -0.25 to 3.94). There were no between- or within-person associations between sitting, standing, and sit-to-stand transitions with affect. Promoting physical activity may be a potential intervention strategy to acutely suppress negative affective states.

  16. Poor Reliability of Wrist Blood Pressure Self-Measurement at Home: A Population-Based Study.

    Science.gov (United States)

    Casiglia, Edoardo; Tikhonoff, Valérie; Albertini, Federica; Palatini, Paolo

    2016-10-01

    The reliability of blood pressure measurement with wrist devices, which has not previously been assessed under real-life circumstances in general population, is dependent on correct positioning of the wrist device at heart level. We determined whether an error was present when blood pressure was self-measured at the wrist in 721 unselected subjects from the general population. After training, blood pressure was measured in the office and self-measured at home with an upper-arm device (the UA-767 Plus) and a wrist device (the UB-542, not provided with a position sensor). The upper-arm-wrist blood pressure difference detected in the office was used as the reference measurement. The discrepancy between office and home differences was the home measurement error. In the office, systolic blood pressure was 2.5% lower at wrist than at arm (P=0.002), whereas at home, systolic and diastolic blood pressures were higher at wrist than at arm (+5.6% and +5.4%, respectively; Pblood pressure values likely because of a poor memory and rendition of the instructions, leading to the wrong position of the wrist. © 2016 American Heart Association, Inc.

  17. Quality-of-life measures for use within care homes: a systematic review of their measurement properties.

    Science.gov (United States)

    Aspden, Trefor; Bradshaw, Siobhan A; Playford, E Diane; Riazi, Afsane

    2014-09-01

    the aims of this review were (i) to identify quality-of-life (QoL) measures which have had their measurement properties validated in people residing in care homes or nursing homes, and to critically compare and summarise these instruments and (ii) to make recommendations for measurement instruments. bibliographic databases PsycINFO, PubMed, Cochrane, CINAHL and Embase were searched for articles evaluating measurement properties of QoL instruments in people residing in care homes. Methodological quality of studies was assessed using the consensus-based standards for the selection of health measurement instruments checklist. Measurement properties of instruments were appraised using a systematic checklist. the search strategy resulted in 3252 unique citations, of which 15 articles were included in this review. These articles assessed 13 instruments, 8 of which were dementia or Alzheimer specific instruments. The QUALIDEM, a dementia-specific observational instrument, had the widest array of information available on its measurement properties, which were mostly satisfactory. Most measurement instruments lacked information on hypotheses testing and content validity. Information on responsiveness and measurement error was not available for any instrument. for people with dementia living in care homes, the QUALIDEM is recommended for measuring QoL. For residents without dementia, we recommend Kane et al.'s Psychosocial Quality of Life Domains questionnaire. Studies of higher methodological quality, assessing a wider range of measurement properties are needed to allow a more fully informed choice of QoL instrument. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Analysis of Illinois Home Performance with ENERGY STAR(R) Measure Packages

    Energy Technology Data Exchange (ETDEWEB)

    Baker, J.; Yee, S.; Brand, L.

    2013-09-01

    Through the Chicagoland Single Family Housing Characterization and Retrofit Prioritization report, the Partnership for Advanced Residential Retrofit characterized 15 housing types in the Chicagoland region based on assessor data, utility billing history, and available data from prior energy efficiency programs. Within these 15 groups, a subset showed the greatest opportunity for energy savings based on BEopt Version 1.1 modeling of potential energy efficiency package options and the percent of the housing stock represented by each group. In this project, collected field data from a whole-home program in Illinois are utilized to compare marketplace-installed measures to the energy saving optimal packages previously developed for the 15 housing types. Housing type, conditions, energy efficiency measures installed, and retrofit cost information were collected from 19 homes that participated in the Illinois Home Performance with ENERGY STAR program in 2012, representing eight of the characterized housing groups. Two were selected for further case study analysis to provide an illustration of the differences between optimal and actually installed measures. Taken together, these homes are representative of 34.8% of the Chicagoland residential building stock. In one instance, actual installed measures closely matched optimal recommended measures.

  19. Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment.

    Science.gov (United States)

    Chen, Hui-Mei; Lin, Hsiu-Fen; Huang, Mei-Feng; Chang, Chun-Wei; Yeh, Yi-Chun; Lo, Yi-Ching; Yen, Cheng-Fang; Chen, Cheng-Sheng

    2016-01-01

    Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants' reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), for vascular cognitive impairment (VCI) by examining its psychometric properties and diagnostic accuracy. Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD), 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE), Lawton-IADL and Barthel Index (BI), were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined. Cronbach's alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = -0.587, p cognitive domain of Lawton IADL (r = -0.663) than with physical domain of Lawton IADL (r = -0.541). The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812-0.965) to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%. The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD.

  20. Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL, a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment.

    Directory of Open Access Journals (Sweden)

    Hui-Mei Chen

    Full Text Available Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants' reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL, for vascular cognitive impairment (VCI by examining its psychometric properties and diagnostic accuracy.Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD, 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE, Lawton-IADL and Barthel Index (BI, were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined.Cronbach's alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = -0.587, p <0.01. Notably, the TPIADL had a higher correlation coefficient with the cognitive domain of Lawton IADL (r = -0.663 than with physical domain of Lawton IADL (r = -0.541. The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812-0.965 to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%.The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD.

  1. Measuring limitations in activities of daily living: a population-based validation of a short questionnaire.

    Science.gov (United States)

    Elfering, Achim; Cronenberg, Sonja; Grebner, Simone; Tamcan, Oezguer; Müller, Urs

    2017-12-01

    A newly developed questionnaire assessing limitations in activity of daily living (LADL-Q) that should improve assessment of LADL is tested in a large population-based validation study. This survey was paper-based. Overall, 16,634 individuals who were representative of the working population in the German-speaking part of Switzerland participated in the study. Item analysis was used the final version of the LADL-Q to four items per subscale that correspond to potential problems in three body regions (back and neck, upper extremities, lower extremities). Analysis included tests for reliability, internal consistency, dimensionality and convergent validity. Test-retest reliability coefficients after 2 weeks ranged from 0.82 to 0.99 (Mdn = 0.87), with no item having a coefficient below 0.60. The median item-total coefficients ranged between moderate and good. Correlation coefficients between LADL-Q subscales and three validated clinical instruments (Western Ontario and McMaster Universities osteoarthritis index, shoulder pain disability index, Oswestry) ranged from 0.63 to 0.81. In structural equation modeling the three subscales were significantly related with two important outcomes in occupational rehabilitation: self-reported general health and daily task performance. The new LADL-Q is a brief, reliable and valid tool for assessment of LADL in studies on musculoskeletal health.

  2. Consumer preferences and brand equity measurement of Spanish national daily newspapers: a conjoint analysis approach.

    Science.gov (United States)

    Varela Mallou, J; Rial Boubeta, A; Braña Tobío, T

    2001-05-01

    Brand is a product attribute that, for many types of goods or services, makes a major contribution to consumer preferences. Conjoint analysis is a useful technique for the assessment of brand values for a given consumer or group of consumers. In this paper, an application of conjoint analysis to the estimation of brand values in the Spanish daily newspaper market is reported. Four newspaper attributes were considered: brand (i.e., newspaper name), price (0.60, 1.05, or 1.50 euros), Sunday supplement (yes/no), and daily pullout (yes/no). A total of 510 regular readers of the national press, stratified by age and sex, were asked to rank 16 profiles representing an orthogonal fraction of the possible attribute-level combinations. Brand was by far the most important attribute, whereas price had negligible effect. More generally, the results confirm the utility of conjoint analysis for assessing brand equity in the newspaper market and for estimating the relative importance of the various attributes to different subgroups of consumers.

  3. Pilot study of methods and equipment for in-home noise level measurements.

    Science.gov (United States)

    Neitzel, Richard L; Heikkinen, Maire S A; Williams, Christopher C; Viet, Susan Marie; Dellarco, Michael

    2015-01-15

    Knowledge of the auditory and non-auditory effects of noise has increased dramatically over the past decade, but indoor noise exposure measurement methods have not advanced appreciably, despite the introduction of applicable new technologies. This study evaluated various conventional and smart devices for exposure assessment in the National Children's Study. Three devices were tested: a sound level meter (SLM), a dosimeter, and a smart device with a noise measurement application installed. Instrument performance was evaluated in a series of semi-controlled tests in office environments over 96-hour periods, followed by measurements made continuously in two rooms (a child's bedroom and a most used room) in nine participating homes over a 7-day period with subsequent computation of a range of noise metrics. The SLMs and dosimeters yielded similar A-weighted average noise levels. Levels measured by the smart devices often differed substantially (showing both positive and negative bias, depending on the metric) from those measured via SLM and dosimeter, and demonstrated attenuation in some frequency bands in spectral analysis compared to SLM results. Virtually all measurements exceeded the Environmental Protection Agency's 45 dBA day-night limit for indoor residential exposures. The measurement protocol developed here can be employed in homes, demonstrates the possibility of measuring long-term noise exposures in homes with technologies beyond traditional SLMs, and highlights potential pitfalls associated with measurements made by smart devices.

  4. Quantitative gait measurement with pulse-Doppler radar for passive in-home gait assessment.

    Science.gov (United States)

    Wang, Fang; Skubic, Marjorie; Rantz, Marilyn; Cuddihy, Paul E

    2014-09-01

    In this paper, we propose a pulse-Doppler radar system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed and step time using Doppler radar. The gait parameters have been validated with a Vicon motion capture system in the lab with 13 participants and 158 test runs. The study revealed that for an optimal step recognition and walking speed estimation, a dual radar set up with one radar placed at foot level and the other at torso level is necessary. An excellent absolute agreement with intraclass correlation coefficients of 0.97 was found for step time estimation with the foot level radar. For walking speed, although both radars show excellent consistency they all have a system offset compared to the ground truth due to walking direction with respect to the radar beam. The torso level radar has a better performance (9% offset on average) in the speed estimation compared to the foot level radar (13%-18% offset). Quantitative analysis has been performed to compute the angles causing the systematic error. These lab results demonstrate the capability of the system to be used as a daily gait assessment tool in home environments, useful for fall risk assessment and other health care applications. The system is currently being tested in an unstructured home environment.

  5. Science at Home: Measuring a Thermophysical Property of Water with a Microwave Oven

    Science.gov (United States)

    Levine, Zachary H.

    2018-01-01

    An attempt to calibrate a conventional oven led to making a measurement of a thermophysical property of water using items found in the author's home. Specifically, the ratio of the energy required to heat water from the melting point to boiling to the energy required to completely boil away the water is found to be 5.7. This may be compared to the…

  6. The association of Nursing Home Compare quality measures with market competition and occupancy rates.

    Science.gov (United States)

    Castle, Nicholas G; Liu, Darren; Engberg, John

    2008-01-01

    Since 2002, the Centers for Medicare and Medicaid Services have reported quality measures on the Nursing Home Compare Web site. It has been assumed that nursing homes are able to make improvements on these measures. In this study researchers examined nursing homes to see whether they have improved their quality scores, after accounting for regression to the mean. Researchers also examined whether gains varied according to market competition or market occupancy rates. They identified some regression to the mean for the quality measure scores over time; nevertheless, they also determined that some nursing homes had indeed made small improvements in their quality measure scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, the greatest improvements occurred in the most competitive markets and in those with the Lowest average occupancy rates. As policies to promote more competition in Long-term care proceed, further reducing occupancy rates, further, albeit small, quality gains will likely be made in the future.

  7. Social well-being and its measurement in the nursing home, the SWON-scale

    NARCIS (Netherlands)

    Gerritsen, Debby L.; Steverink, Nardi; Frijters, Dinnus H. M.; Ooms, Marcel E.; Ribbe, Miel W.

    Aims and objectives. The aim of this study was to develop an observational scale to measure the social well-being of nursing home residents, by assessing not only the social behaviour of the resident towards others, but also the behaviour of others towards the resident. Background. Traditionally,

  8. Very low energy homes in the United States: Perspectives on performance from measured data

    Energy Technology Data Exchange (ETDEWEB)

    Parker, Danny S. [Florida Solar Energy Center, 1679 Clearlake Rd., Cocoa, FL 32922 (United States)

    2009-05-15

    We present measured annual performance data from a dozen recent-vintage very low energy homes in North America. Many of the designs combine greater energy efficiency with solar electric photovoltaic power in an attempt to create Zero Energy Homes (ZEH). We also provide measured data from the first home constructed to the German Passivhaus standard in the United States. Several projects either exceeded or come very close to true net zero energy when evaluated over a year. The data indicate that very low energy use buildings can very readily be achieved in North America. Annual energy use half that or less than standard housing can be achieved for an equivalent cost of $0.10/kWh from the efficiency investment. In general, the better cost effectiveness seen from energy efficiency measures indicates that greater investment in conservation should be a prerequisite to installation of solar water heating and solar electricity in Zero Energy Homes. However, over emphasis in efficiency is also possible. This suggests that optimization tools such as BEopt and EGUSA, which characterize both renewable resource performance and that also of specific combinations of energy efficiency measures, will best guide designers to locate the most economically favorable mix to reach an energy neutral level. (author)

  9. Measuring Students' Self-Perceived Competence in Home Economics Core Areas.

    Science.gov (United States)

    Smith, Frances M.

    1990-01-01

    Using the self-efficacy concept from Bandura's social learning theory, researchers developed an instrument to measure students' self-perceived competence in home economics core areas. Administration to all graduate students at a midwestern university during 1982-88 verified eight original competence areas and added a ninth. (SK)

  10. Objectively Measured Daily Steps and Subsequent Long Term All-Cause Mortality: The Tasped Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Terence Dwyer

    Full Text Available Self-reported physical activity has been inversely associated with mortality but the effect of objectively measured step activity on mortality has never been evaluated. The objective is to determine the prospective association of daily step activity on mortality among free-living adults.Cohort study of free-living adults residing in Tasmania, Australia between 2000 and 2005 who participated in one of three cohort studies (n = 2 576 total participants. Daily step activity by pedometer at baseline at a mean of 58.8 years of age, and for a subset, repeated monitoring was available 3.7 (SD 1.3 years later (n = 1 679. All-cause mortality (n = 219 deaths was ascertained by record-linkage to the Australian National Death Index; 90% of participants were followed-up over ten years, until June 2011. Higher daily step count at baseline was linearly associated with lower all-cause mortality (adjusted hazard ratio AHR, 0.94; 95% CI, 0.90 to 0.98 per 1 000 steps; P = 0.004. Risk was altered little by removing deaths occurring in the first two years. Increasing baseline daily steps from sedentary to 10 000 steps a day was associated with a 46% (95% CI, 18% to 65%; P = 0.004 lower risk of mortality in the decade of follow-up. In addition, those who increased their daily steps over the monitoring period had a substantial reduction in mortality risk, after adjusting for baseline daily step count (AHR, 0.39; 95% CI, 0.22 to 0.72; P = 0.002, or other factors (AHR, 0.38; 95% CI, 0.21-0.70; P = 0.002.Higher daily step count was linearly associated with subsequent long term mortality among free living adults. These data are the first to quantify mortality reductions using an objective measure of physical activity in a free living population. They strongly underscore the importance of physical inactivity as a major public health problem.

  11. Daily measure of the constancy of rotation in the evaluation of geometric and dosimetric parameters of the tomotherapy

    International Nuclear Information System (INIS)

    Erzilbengoa, M.; Moral, S.; Bragado, L.; Guisasola, M. A.

    2011-01-01

    The daily test performance called ''Rotating Constancia'', based on the methodology developed by Balog ''Helical tomotherapy dynamic quality assurance'' (2006), has allowed us over these 2 years to assess the response to TomoTherapy machine parameters given dose, travel speed table offset of the same, position of the green lasers, field size, rotation time and energy index of the beam parameters can be measured without intensity modulation.

  12. Forecasting Daily Variability of the S and P 100 Stock Index using Historical, Realised and Implied Volatility Measurements

    OpenAIRE

    Koopman, Siem Jan; Jungbacker, Borus; Hol, Eugenie

    2004-01-01

    The increasing availability of financial market data at intraday frequencies has not only led to the development of improved volatility measurements but has also inspired research into their potential value as an information source for volatility forecasting. In this paper we explore the forecasting value of historical volatility (extracted from daily return series), of implied volatility (extracted from option pricing data) and of realised volatility (computed as the sum of squared high freq...

  13. Forecasting Daily Variability of the S&P 100 Stock Index using Historical, Realised and Implied Volatility Measurements

    OpenAIRE

    Koopman, Siem Jan; Jungbacker, Borus; Hol, Eugenie

    2004-01-01

    This discussion paper resulted in an article in the Journal of Empirical Finance (2005). Vol. 12, issue 3, pages 445-475. The increasing availability of financial market data at intraday frequencies has not only led to the development of improved volatility measurements but has also inspired research into their potential value as an information source for volatility forecasting. In this paper we explore the forecasting value of historical volatility (extracted from daily return series), of im...

  14. Experiments to Evaluate and Implement Passive Tracer Gas Methods to Measure Ventilation Rates in Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lunden, Melissa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faulkner, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Heredia, Elizabeth [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cohn, Sebastian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dickerhoff, Darryl [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Noris, Federico [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Logue, Jennifer [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hotchi, Toshifumi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-10-01

    This report documents experiments performed in three homes to assess the methodology used to determine air exchange rates using passive tracer techniques. The experiments used four different tracer gases emitted simultaneously but implemented with different spatial coverage in the home. Two different tracer gas sampling methods were used. The results characterize the factors of the execution and analysis of the passive tracer technique that affect the uncertainty in the calculated air exchange rates. These factors include uncertainties in tracer gas emission rates, differences in measured concentrations for different tracer gases, temporal and spatial variability of the concentrations, the comparison between different gas sampling methods, and the effect of different ventilation conditions.

  15. Measurements of seasonal and daily radon daughter concentration fluctuations in National Park Service caves

    International Nuclear Information System (INIS)

    Yarborough, K.A.

    1977-01-01

    The National Park Service (NPS) is studying levels of airborne alpha radiation from radon and thoron in all NPS administered caves in which tours for visitors are regularly conducted. The NPS research has the dual but complementary objectives of safeguarding health at the NPS administered caves, and to develop data on alpha radiation levels and on natural airflows in NPS caves. The results reported here for NPS caves describe concepts hypothesized for the objectives. In addition the data can be used by various agencies to clarify health standards for exposures to low airborne alpha radiation levels in cave environments. These results show daily and seasonal trends and the influence of natural ventilation by air circulation for each cave investigated

  16. The use of EORTC measures in daily clinical practice-A synopsis of a newly developed manual.

    Science.gov (United States)

    Wintner, Lisa M; Sztankay, Monika; Aaronson, Neil; Bottomley, Andrew; Giesinger, Johannes M; Groenvold, Mogens; Petersen, Morten Aa; van de Poll-Franse, Lonneke; Velikova, Galina; Verdonck-de Leeuw, Irma; Holzner, Bernhard

    2016-11-01

    Cancer has increasingly become a chronic condition and the routine collection of patient-reported outcomes (PROs) like quality of life is widely recommended for clinical practice. Nonetheless, the successful implementation of PROs is still a major challenge, although common barriers to and facilitators of their beneficial use are well known. To support health care professionals and other stakeholders in the implementation of the EORTC PRO measures, the EORTC Quality of Life Group provides guidance on issues considered important for their use in daily clinical practice. Herein, we present an outline of the newly developed "'Manual for the use of EORTC measures in daily clinical practice", covering the following issues: * a rationale for using EORTC measures in routine care *selection of EORTC measures, timing of assessments, scoring and presentation of results * aspects of a strategic implementation * electronic data assessment and telemonitoring, and * further use of EORTC measures and ethical considerations. Next to an extensive overview of currently available literature, the manual specifically focuses on knowledge about EORTC measures to give evidence-based recommendations whenever possible and to encourage readers and end-users of EORTC measures to contribute to further needed high-quality research. The manual will be accessible on the EORTC Quality of Life Group website's homepage and will be periodically updated to take into account any new knowledge due to medical, technical, regulatory and scientific advances. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Measured Cooling Performance and Potential for Buried Duct Condensation in a 1991 Central Florida Retrofit Home

    Energy Technology Data Exchange (ETDEWEB)

    Chasar, Dave [Building America Partership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Withers, Charles R. [Building America Partership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States)

    2013-02-01

    FSEC conducted energy performance monitoring of two existing residences in Central Florida that were undergoing various retrofits. These homes were occupied by FSEC researchers and were fully instrumented to provide detailed energy, temperature, and humidity measurements. The data provided feedback about the performance of two levels of retrofit in two types of homes in a hot-humid climate. This report covers a moderate-level retrofit and includes two years of pre-retrofit data to characterize the impact of improvements. The other home is a 'deep energy retrofit' (detailed in a separate report) that has performed at near zero energy with a photovoltaic (PV) system and extensive envelope improvements.

  18. Measuring the Impact of Cognitive Prosthetics on the Daily Life of People with Dementia and Their Carers

    Science.gov (United States)

    Meiland, Franka; Dröes, Rose-Marie; Sävenstedt, Stefan

    Assistive technologies to support persons with dementia and their carers are used increasingly often. However, little is known about the effectiveness of most assistive devices. Much technology is put on the market without having been properly tested with potential end-users. To increase the chance that an assistive device is well accepted and useful for the target group, it is important, especially in the case of disabled persons, to involve potential users in the development process and to evaluate the impact of using the device on them before implementing it in the daily care and support. When evaluating the impact, decisions have to be made regarding the selection of measuring instruments. Important considerations in the selection process are the underlying domains to be addressed by the assistive technology, the target group and the availability of standardized instruments with good psychometric properties. In this chapter the COGKNOW project is used as a case example to explain how the impact of cognitive prosthetics on the daily lives of people with dementia and their carers can be measured. In COGKNOW a cognitive prosthetic device is being developed to improve the quality of life and autonomy of persons with dementia and to help them to remember and remind, to have social contact, to perform daily activities and to enhance feelings of safety. For all these areas, potential measuring instruments are described. Besides (standardized) measuring instruments, other data collection methods are used as well, such as semi-structured interviews and observations, diaries and in situ measurement. Within the COGKNOW project a first uncontrolled small-scale impact measurement takes place during the development process of the assistive device. However, it is recommended to perform a larger randomized controlled study as soon as the final product is ready to evaluate the impact of the device on persons with dementia and carers before it is released on the market.

  19. Do daily ward interviews improve measurement of hospital quality and safety indicators? A prospective observational study.

    Science.gov (United States)

    Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Mitchell, Deb; O'Brien, Lisa; May, Kerry; Ghaly, Marcelle; Ho, Melissa; Haines, Terry P

    2016-10-01

    The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under-reporting of hospital quality and safety indicators in incident reporting systems. A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub-acute and acute medical assessment unit. An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% (n = 72), pressure injuries by 21.7% (n = 48) and rapid response medical team calls by 12.7% (n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday (P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday (P = 0.01). Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under-reported in incident reporting systems, with variability in under-reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety

  20. Probabilistic global maps of the CO2 column at daily and monthly scales from sparse satellite measurements

    Science.gov (United States)

    Chevallier, Frédéric; Broquet, Grégoire; Pierangelo, Clémence; Crisp, David

    2017-07-01

    The column-average dry air-mole fraction of carbon dioxide in the atmosphere (XCO2) is measured by scattered satellite measurements like those from the Orbiting Carbon Observatory (OCO-2). We show that global continuous maps of XCO2 (corresponding to level 3 of the satellite data) at daily or coarser temporal resolution can be inferred from these data with a Kalman filter built on a model of persistence. Our application of this approach on 2 years of OCO-2 retrievals indicates that the filter provides better information than a climatology of XCO2 at both daily and monthly scales. Provided that the assigned observation uncertainty statistics are tuned in each grid cell of the XCO2 maps from an objective method (based on consistency diagnostics), the errors predicted by the filter at daily and monthly scales represent the true error statistics reasonably well, except for a bias in the high latitudes of the winter hemisphere and a lack of resolution (i.e., a too small discrimination skill) of the predicted error standard deviations. Due to the sparse satellite sampling, the broad-scale patterns of XCO2 described by the filter seem to lag behind the real signals by a few weeks. Finally, the filter offers interesting insights into the quality of the retrievals, both in terms of random and systematic errors.

  1. Longitudinal Study of a Novel, Performance-based Measure of Daily Function

    Science.gov (United States)

    2016-06-01

    have functional impairments, and healthy age matched controls on the UPSA, as well as measures of cognition (e.g., episodic memory , semantic memory ...controls on the UPSA, as well as measures of cognition (e.g., episodic memory , semantic memory , executive function, speed). We found that patients with...diagnosis have functional impairments, and healthy age matched controls on the UPSA, as well as measures of cognition (e.g., episodic memory , semantic

  2. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    NARCIS (Netherlands)

    Chalmers, J. R.; Schmitt, J.; Apfelbacher, C.; Dohil, M.; Eichenfield, L. F.; Simpson, E. L.; Singh, J.; Spuls, P.; Thomas, K. S.; Admani, S.; Aoki, V.; Ardeleanu, M.; Barbarot, S.; Berger, T.; Bergman, J. N.; Block, J.; Borok, N.; Burton, T.; Chamlin, S. L.; Deckert, S.; DeKlotz, C. C.; Graff, L. B.; Hanifin, J. M.; Hebert, A. A.; Humphreys, R.; Katoh, N.; Kisa, R. M.; Margolis, D. J.; Merhand, S.; Minnillo, R.; Mizutani, H.; Nankervis, H.; Ohya, Y.; Rodgers, P.; Schram, M. E.; Stalder, J. F.; Svensson, A.; Takaoka, R.; Teper, A.; Tom, W. L.; von Kobyletzki, L.; Weisshaar, E.; Zelt, S.; Williams, H. C.

    2014-01-01

    This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6-7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial:

  3. Objective measurements of daily physical activity patterns and sedentary behaviour in older adults

    DEFF Research Database (Denmark)

    Arnardottir, Nanna Yr; Koster, Annemarie; Van Domelen, Dane R

    2013-01-01

    objectively measured population physical activity (PA) data from older persons is lacking. The aim of this study was to describe free-living PA patterns and sedentary behaviours in Icelandic older men and women using accelerometer.......objectively measured population physical activity (PA) data from older persons is lacking. The aim of this study was to describe free-living PA patterns and sedentary behaviours in Icelandic older men and women using accelerometer....

  4. Measurement of Fall Prevention Awareness and Behaviours among Older Adults at Home.

    Science.gov (United States)

    Russell, Katherine; Taing, Darcie; Roy, Jacqueline

    2017-12-01

    This study surveyed awareness of, and adherence to, six national fall prevention recommendations among community-dwelling older adults (n = 1050) in Ottawa. Although 76 per cent of respondents agreed falling is a concern and preventable, fewer perceived susceptibility to falling (63%). Respondents had high awareness that home modifications and physical activity can prevent falls. Reported modifications included grab bars (50%), night lights (44%), and raised toilet seats (19%). Half met aerobic activity recommendations; 38 per cent met strength recommendations. Respondents had lower awareness that an annual medication review, annual eye and physical examination, and daily vitamin D supplementation could reduce fall risk. However, reported annual medication review (79%) and eye examination (75%) was high. Nearly half met recommendations for vitamin D intake. These findings suggest a gap in knowledge of awareness and adherence to national recommendations, highlighting the ones that may require attention from those who work to prevent falls.

  5. Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

    NARCIS (Netherlands)

    Spuls, P. I.; Gerbens, L. A. A.; Simpson, E.; Apfelbacher, C. J.; Chalmers, J. R.; Thomas, K. S.; Prinsen, C. A. C.; von Kobyletzki, L. B.; Singh, J. A.; Williams, H. C.; Schmitt, J.

    2017-01-01

    The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and long-term control. The aim of this paper is

  6. Psychometric evaluation of a daily gastro-oesophageal reflux disease symptom measure

    DEFF Research Database (Denmark)

    Bytzer, Peter; Reimer, Christina; Smith, Gary

    2017-01-01

    was demonstrated by moderate to high correlations with ReQuest™ change scores and time with symptoms. An HRDQ cut-off value of 0.70 for definition of ‘bad day’ was also evaluated. Conclusions: Based on existing evidence, the HRDQ is a valid and reliable measure of GORD symptoms that can be used as a study outcome...... (Cronbach’s alpha range.83–.88) and test–retest reliability (intraclass correlation coefficient range.71–.90). Convergent and discriminant validity were supported by high correlations with ReQuest™ and ability to differentiate between groups based on ReQuest™ cut-off values. Responsiveness of HRDQ......Objective: The objective of this study was to evaluate the validity of the Heartburn Reflux Dyspepsia Questionnaire (HRDQ), a newly developed measure of gastro-oesophageal reflux disease (GORD) symptoms. Specifically, the HRDQ was developed for patients, who still experience symptoms with proton...

  7. The use of EORTC measures in daily clinical practice: A synopsis of a newly developed manual.

    OpenAIRE

    Wintner, L.M.; Sztankay, M.; Aaronson, N.; Bottomley, A.; Giesinger, J.M.; Groenvold, M.; Petersen, M.A.; van de Poll-Franse, L.; Velikova, G.; Verdonck-de Leeuw, I.; Holzner, B.

    2016-01-01

    Cancer has increasingly become a chronic condition and the routine collection of patient-reported outcomes (PROs) like quality of life is widely recommended for clinical practice. Nonetheless, the successful implementation of PROs is still a major challenge, although common barriers to and facilitators of their beneficial use are well known. To support health care professionals and other stakeholders in the implementation of the EORTC PRO measures, the EORTC Quality of Life Group provides gui...

  8. Automated measurement of office, home and ambulatory blood pressure in atrial fibrillation.

    Science.gov (United States)

    Kollias, Anastasios; Stergiou, George S

    2014-01-01

    1. Hypertension and atrial fibrillation (AF) often coexist and are strong risk factors for stroke. Current guidelines for blood pressure (BP) measurement in AF recommend repeated measurements using the auscultatory method, whereas the accuracy of the automated devices is regarded as questionable. This review presents the current evidence on the feasibility and accuracy of automated BP measurement in the presence of AF and the potential for automated detection of undiagnosed AF during such measurements. 2. Studies evaluating the use of automated BP monitors in AF are limited and have significant heterogeneity in methodology and protocols. Overall, the oscillometric method is feasible for static (office or home) and ambulatory use and appears to be more accurate for systolic than diastolic BP measurement. 3. Given that systolic hypertension is particularly common and important in the elderly, the automated BP measurement method may be acceptable for self-home and ambulatory monitoring, but not for professional office or clinic measurement. 4. An embedded algorithm for the detection of asymptomatic AF during routine automated BP measurement with high diagnostic accuracy has been developed and appears to be a useful screening tool for elderly hypertensives. © 2013 Wiley Publishing Asia Pty Ltd.

  9. Validation of daily urinary creatinine excretion measurement by muscle-creatinine equivalence.

    Science.gov (United States)

    Iacone, Roberto; D'Elia, Lanfranco; Guida, Bruna; Barbato, Antonio; Scanzano, Clelia; Strazzullo, Pasquale

    2018-02-09

    Twenty-four-hour urinary creatinine excretion (24hUCrE) is strongly correlated with skeletal muscle mass (SMM). This study suggests how to exploit the power of the SMM-24hUCrE correlation to assess the accuracy of 24hUCrE measurement. Four hundred and sixty-six men, a subgroup of participants in the 2002-2004 follow-up examination of the Olivetti Heart Study, performed a 24-h urine collection to measure 24hUCrE and underwent bioelectrical impedance analysis to evaluate SMM. Linear regression analysis between 24hUCrE and SMM was used to calculate the muscle-creatinine equivalence and to develop an equation to predict the 24hUCrE depending on SMM. The accuracy of the 24hUCrE measurement was assessed using the change in the SMM-24hUCrE correlation coefficient upon variation in the percentage deviation (%D) between the measured and predicted 24hUCrE. The calculated muscle-creatinine equivalence was 1 g of 24hUCrE = 22.73 kg of SMM. The %Ds and the corresponding SMM-24hUCrE correlation coefficients were as follows: %D = 3.0, r = .997; %D = 4.7, r = .989; %D = 8.1, r = .963; %D = 10.5, r = .940; %D = 12.6, r = .909; %D = 18.9, r = .825; %D = 25.8, r = .707; %D = 33.5, r = .595; %D = 41.4, r = .453. The increase in %D corresponds to a reduced correlation between muscle mass and creatinine excretion, which indicated a poor performance in the measurement of the 24hUCrE. For studies on single individuals, where small variations in 24hUCrE could be significant, a %D up to 12.6% is suggested; on the other hand, a wider %D interval could be acceptable for population studies. © 2018 Wiley Periodicals, Inc.

  10. Patient-Oriented Eczema Measure (POEM), a core instrument to measure symptoms in clinical trials: a Harmonising Outcome Measures for Eczema (HOME) statement

    OpenAIRE

    Spuls, Ph.I.; Gerbens, L.A.A.; Simpson, E.; Apfelbacher, C.J.; Chalmers, J.R.; Thomas, K.S.; Prinsen, C.A.C.; Kobyletzki, L.B. von; Singh, J.A.; Williams, Hywel C.; Schmitt, J.

    2017-01-01

    Background: The Harmonising Outcome Measures for Eczema (HOME) initiative has defined four core outcome domains for a core outcome set (COS) to be measured in all atopic eczema (AE) trials to ensure cross-trial comparison: clinical signs, symptoms, quality of life and longterm control.\\ud Objectives: The aim of this paper is to report on the consensus process that was used to select the core instrument to consistently assess symptoms in all future AE trials.\\ud Methods: Following the HOME roa...

  11. Objectively measured daily physical activity related to cardiac size in young children

    DEFF Research Database (Denmark)

    Dencker, M; Thorsson, O; Karlsson, M K

    2009-01-01

    Training studies in children have suggested that endurance training can give enlargement of cardiac dimensions. This relationship has not been studied on a population-based level in young children with objective methods. A cross-sectional study was made of 248 children (140 boys and 108 girls...... activity per day (VPA) was calculated. Acceptable accelerometer and echocardiography measurements were obtained in 228 children (boys=127, girls=101). Univariate correlations between VPA and LVDD were indexed for BSA in boys (r=0.27, Pgirls (r=0.10, NS). Multiple regression analysis showed...

  12. Evaluation on the implementation of respiratory protection measures in old age homes

    Directory of Open Access Journals (Sweden)

    Lee DT

    2017-09-01

    Full Text Available Diana TF Lee,1 Doris Yu,1 Margaret Ip,2 Jennifer YM Tang3 1The Nethersole School of Nursing, The Chinese University of Hong Kong, 2Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, 3Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong Purpose: Old age homes (OAHs represent a vulnerable community for influenza outbreaks. Effective implementation of respiratory protection measures has been identified as an effective prevention measure to reduce mortality and morbidity caused by such outbreaks. Yet, relatively little is known about this aspect in these homes. This study evaluated the implementation of respiratory protection measures among infection control officers (ICOs and health care workers (HCWs in these homes in Hong Kong.Patients and methods: A territory-wide, cross-sectional survey was conducted in 87 OAHs. A total of 87 ICOs and 1,763 HCWs (including nurses, health workers, care workers, allied HCWs and assistants completed the questionnaires that evaluated the implementation at the organizational level and individual level, respectively. Generalized estimating equations with unstructured working correlation matrix were used to analyze the simultaneous influence of organizational and individual factors on the implementation.Results: At the organizational level, all homes had a policy on respiratory protection and implementation of such measures was generally adequate. Basic resources such as paper towels/hand dryers and equipment disinfectants, however, were rated as most inadequate by HCWs. Training opportunities were also identified as grossly inadequate. Only less than half of the ICOs and HCWs participated in training on infection control either at the initiation of employment or on a regular basis. Twenty-five percent of HCWs even indicated that they had never participated in any infection control training. At the individual level, hand hygiene, among other

  13. Psychometric evaluation of a daily gastro-oesophageal reflux disease symptom measure.

    Science.gov (United States)

    Bytzer, Peter; Reimer, Christina; Smith, Gary; Anatchkova, Milena D; Hsieh, Ray; Wilkinson, Joanne; Thomas, S Jane; Lenderking, William R

    2017-03-01

    The objective of this study was to evaluate the validity of the Heartburn Reflux Dyspepsia Questionnaire (HRDQ), a newly developed measure of gastro-oesophageal reflux disease (GORD) symptoms. Specifically, the HRDQ was developed for patients, who still experience symptoms with proton pump inhibitor (PPI) treatment. The psychometric properties of HRDQ were evaluated based on data from two clinical trials of patients with GORD with a partial response to PPIs, one from the UK and one from Denmark and Germany. The HRDQ had good internal consistency (Cronbach's alpha range .83-.88) and test-retest reliability (intraclass correlation coefficient range .71-.90). Convergent and discriminant validity were supported by high correlations with ReQuest™ and ability to differentiate between groups based on ReQuest™ cut-off values. Responsiveness of HRDQ was demonstrated by moderate to high correlations with ReQuest™ change scores and time with symptoms. An HRDQ cut-off value of 0.70 for definition of 'bad day' was also evaluated. Based on existing evidence, the HRDQ is a valid and reliable measure of GORD symptoms that can be used as a study outcome in clinical trials.

  14. 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

  15. Methods and strategy for modeling daily global solar radiation with measured meteorological data - A case study in Nanchang station, China

    International Nuclear Information System (INIS)

    Wu, Guofeng; Liu, Yaolin; Wang, Tiejun

    2007-01-01

    Solar radiation is a primary driver for many physical, chemical and biological processes on the earth's surface, and complete and accurate solar radiation data at a specific region are quite indispensable to the solar energy related researches. This study, with Nanchang station, China, as a case study, aimed to calibrate existing models and develop new models for estimating missing global solar radiation data using commonly measured meteorological data and to propose a strategy for selecting the optimal models under different situations of available meteorological data. Using daily global radiation, sunshine hours, temperature, total precipitation and dew point data covering the years from 1994 to 2005, we calibrated or developed and evaluated seven existing models and two new models. Validation criteria included intercept, slope, coefficient of determination, mean bias error and root mean square error. The best result (R 2 = 0.93) was derived from Chen model 2, which uses sunshine hours and temperature as predictors. The Bahel model, which only uses sunshine hours, was almost as good, explaining 92% of the solar radiation variance. Temperature based models (Bristow and Campbell, Allen, Hargreaves and Chen 1 models) provided less accurate results, of which the best one (R 2 = 0.69) is the Bristow and Campbell model. The temperature based models were improved by adding other variables (daily mean total precipitation and mean dew point). Two such models could explain 77% (Wu model 1) and 80% (Wu model 2) of the solar radiation variance. We, thus, propose a strategy for selecting an optimal method for calculating missing daily values of global solar radiation: (1) when sunshine hour and temperature data are available, use Chen model 2; (2) when only sunshine hour data are available, use Bahel model; (3) when temperature, total precipitation and dew point data are available but not sunshine hours, use Wu model 2; (4) when only temperature and total precipitation are

  16. 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.

  17. Using quantitative wastewater analysis to measure daily usage of conventional and emerging illicit drugs at an annual music festival.

    Science.gov (United States)

    Lai, Foon Yin; Thai, Phong K; O'Brien, Jake; Gartner, Coral; Bruno, Raimondo; Kele, Benjamin; Ort, Christoph; Prichard, Jeremy; Kirkbride, Paul; Hall, Wayne; Carter, Steve; Mueller, Jochen F

    2013-11-01

    Wastewater analysis provides a non-intrusive way of measuring drug use within a population. We used this approach to determine daily use of conventional illicit drugs [cannabis, cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA)] and emerging illicit psychostimulants (benzylpiperazine, mephedrone and methylone) in two consecutive years (2010 and 2011) at an annual music festival. Daily composite wastewater samples, representative of the festival, were collected from the on-site wastewater treatment plant and analysed for drug metabolites. Data over 2 years were compared using Wilcoxon matched-pair test. Data from 2010 festival were compared with data collected at the same time from a nearby urban community using equivalent methods. Conventional illicit drugs were detected in all samples whereas emerging illicit psychostimulants were found only on specific days. The estimated per capita consumption of MDMA, cocaine and cannabis was similar between the two festival years. Statistically significant (P popularity in music settings. Our study demonstrated that wastewater analysis can objectively capture changes in substance use at a music setting without raising major ethical issues. It would potentially allow effective assessments of drug prevention strategies in such settings in the future. © 2013 Australasian Professional Society on Alcohol and other Drugs.

  18. Daily river flow prediction based on Two-Phase Constructive Fuzzy Systems Modeling: A case of hydrological - meteorological measurements asymmetry

    Science.gov (United States)

    Bou-Fakhreddine, Bassam; Mougharbel, Imad; Faye, Alain; Abou Chakra, Sara; Pollet, Yann

    2018-03-01

    Accurate daily river flow forecast is essential in many applications of water resources such as hydropower operation, agricultural planning and flood control. This paper presents a forecasting approach to deal with a newly addressed situation where hydrological data exist for a period longer than that of meteorological data (measurements asymmetry). In fact, one of the potential solutions to resolve measurements asymmetry issue is data re-sampling. It is a matter of either considering only the hydrological data or the balanced part of the hydro-meteorological data set during the forecasting process. However, the main disadvantage is that we may lose potentially relevant information from the left-out data. In this research, the key output is a Two-Phase Constructive Fuzzy inference hybrid model that is implemented over the non re-sampled data. The introduced modeling approach must be capable of exploiting the available data efficiently with higher prediction efficiency relative to Constructive Fuzzy model trained over re-sampled data set. The study was applied to Litani River in the Bekaa Valley - Lebanon by using 4 years of rainfall and 24 years of river flow daily measurements. A Constructive Fuzzy System Model (C-FSM) and a Two-Phase Constructive Fuzzy System Model (TPC-FSM) are trained. Upon validating, the second model has shown a primarily competitive performance and accuracy with the ability to preserve a higher day-to-day variability for 1, 3 and 6 days ahead. In fact, for the longest lead period, the C-FSM and TPC-FSM were able of explaining respectively 84.6% and 86.5% of the actual river flow variation. Overall, the results indicate that TPC-FSM model has provided a better tool to capture extreme flows in the process of streamflow prediction.

  19. A precipitation database of station-based daily and monthly measurements for West Africa: Overview, quality control and harmonization

    Science.gov (United States)

    Bliefernicht, Jan; Waongo, Moussa; Annor, Thompson; Laux, Patrick; Lorenz, Manuel; Salack, Seyni; Kunstmann, Harald

    2017-04-01

    West Africa is a data sparse region. High quality and long-term precipitation data are often not readily available for applications in hydrology, agriculture, meteorology and other needs. To close this gap, we use multiple data sources to develop a precipitation database with long-term daily and monthly time series. This database was compiled from 16 archives including global databases e.g. from the Global Historical Climatology Network (GHCN), databases from research projects (e.g. the AMMA database) and databases of the national meteorological services of some West African countries. The collection consists of more than 2000 precipitation gauges with measurements dating from 1850 to 2015. Due to erroneous measurements (e.g. temporal offsets, unit conversion errors), missing values and inconsistent meta-data, the merging of this precipitation dataset is not straightforward and requires a thorough quality control and harmonization. To this end, we developed geostatistical-based algorithms for quality control of individual databases and harmonization to a joint database. The algorithms are based on a pairwise comparison of the correspondence of precipitation time series in dependence to the distance between stations. They were tested for precipitation time series from gages located in a rectangular domain covering Burkina Faso, Ghana, Benin and Togo. This harmonized and quality controlled precipitation database was recently used for several applications such as the validation of a high resolution regional climate model and the bias correction of precipitation projections provided the Coordinated Regional Climate Downscaling Experiment (CORDEX). In this presentation, we will give an overview of the novel daily and monthly precipitation database and the algorithms used for quality control and harmonization. We will also highlight the quality of global and regional archives (e.g. GHCN, GSOD, AMMA database) in comparison to the precipitation databases provided by the

  20. Identification of fall risk predictors in daily life measurements: gait characteristics' reliability and association with self-reported fall history.

    Science.gov (United States)

    Rispens, Sietse M; van Schooten, Kimberley S; Pijnappels, Mirjam; Daffertshofer, Andreas; Beek, Peter J; van Dieën, Jaap H

    2015-01-01

    Background. Gait characteristics extracted from trunk accelerations during daily life locomotion are complementary to questionnaire- or laboratory-based gait and balance assessments and may help to improve fall risk prediction. Objective. The aim of this study was to identify gait characteristics that are associated with self-reported fall history and that can be reliably assessed based on ambulatory data collected during a single week. Methods. We analyzed 2 weeks of trunk acceleration data (DynaPort MoveMonitor, McRoberts) collected among 113 older adults (age range, 65-97 years). During episodes of locomotion, various gait characteristics were determined, including local dynamic stability, interstride variability, and several spectral features. For each characteristic, we performed a negative binomial regression analysis with the participants' self-reported number of falls in the preceding year as outcome. Reliability of gait characteristics was assessed in terms of intraclass correlations between both measurement weeks. Results. The percentages of spectral power below 0.7 Hz along the vertical and anteroposterior axes and below 10 Hz along the mediolateral axis, as well as local dynamic stability, local dynamic stability per stride, gait smoothness, and the amplitude and slope of the dominant frequency along the vertical axis, were associated with the number of falls in the preceding year and could be reliably assessed (all P 0.75). Conclusions. Daily life gait characteristics are associated with fall history in older adults and can be reliably estimated from a week of ambulatory trunk acceleration measurements. © The Author(s) 2014.

  1. Science at Home: Measuring a Thermophysical Property of Water with a Microwave Oven

    Science.gov (United States)

    Levine, Zachary H.

    2018-02-01

    An attempt to calibrate a conventional oven led to making a measurement of a thermophysical property of water using items found in the author's home. Specifically, the ratio of the energy required to heat water from the melting point to boiling to the energy required to completely boil away the water is found to be 5.7. This may be compared to the standard value of 5.5. The close agreement is not representative of the actual uncertainties in this simple experiment (Fig. 1). Heating water in a microwave oven can let a student apply the techniques of quantitative science based on questions generated by his or her scientific curiosity.

  2. Measurement of activity-weighted size distributions of radon decay products in a normally occupied home

    International Nuclear Information System (INIS)

    Hopke, P.K.; Wasiolek, P.; Montassier, N.; Cavallo, A.; Gadsby, K.; Socolow, R.

    1992-01-01

    In order to assess the exposure of individuals to the presence of indoor radioactivity arising from the decay of radon, an automated, semicontinuous graded screen array system was developed to permit the measurement of the activity-weighted size distributions of the radon progeny in homes. The system has been modified so that the electronics and sampling heads can be separated from the pump by approximately 15 m. The system was placed in the living room of a one-storey house with basement in Princeton, NJ and operated for 2 weeks while the house was occupied by the home owners in their normal manner. One of the house occupants was a cigarette smoker. Radon and potential alpha energy concentration (PAEC) measurements were also made, but condensation nuclei counts were not performed. PAEC values ranged from 23.4 to 461.6 mWL. In the measured activity size distributions, the amount of activity in the 0.5-1.5 nm size range can be considered to be the unattached fraction. The mean value for the 218 Po unattached fraction is 0.217 with a range of 0.054-0.549. The median value for the unattached fraction of PAEC is 0.077 with a range of 0.022-0.178. (author)

  3. MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

    Science.gov (United States)

    Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

    2018-05-04

    In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

  4. Which indicators for measuring the daily physical activity? An overview on the challenges and technology limits for Telehealth applications.

    Science.gov (United States)

    Tagliente, Irene; Solvoll, Terje; Trieste, Leopoldo; De Cecco, Carlo N; Murgia, Fabrizio; Bella, Sergio

    2016-09-14

    Obesity is one of the biggest drivers of preventable chronic diseases and healthcare costs in Worldwide. Different prevention activities are suggested. By monitoring daily energy expenditure (EE) could be possible make personalized diets and programming physical activity. In this, physical inactivity is one of the most important public health problems. Some studies refer the effort of the international community in promoting physical activities. Physical activity can be promoted only by increasing citizens' empowerment on taking care of their health, and it passes from the improving of individual information. Technology can offer solutions and metrics for monitoring and measuring daily activity by interacting with individuals, sharing information and feedbacks. In this study we review indicators of total energy expenditure and weaknesses of available devices in assessing these parameters. Literature review and technology testing EuNetHta core model. For the clinical aspects, it is fundamental to take into account all the factor that can influence the personal energy expenditure as: heart rate, blood pressure and thermoregulation (influenced by the body temperature). In this study we focused the attention on the importance of tools to encourage the physical activity. We made an analysis of the factor that can influence the right analysis of energy expenditure and at the same time the energy regime. A punctual monitoring of the exercise regime could be helpful in Telemedicine application as Telemonitorig. More study are needed to value the impact of physical activity tracker in Telemonitorig protocols. On the assessment of the energy expenditure, critical issues are related to the physiological data acquisition. Sensors connected with mobile devices could be important tools for disease prevention and interventions affecting health behaviors. New devices applications are potential useful for telemedicine assistance, but security of data and the related communication

  5. Cigarettes vs. e-cigarettes: Passive exposure at home measured by means of airborne marker and biomarkers

    Energy Technology Data Exchange (ETDEWEB)

    Ballbè, Montse [Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d' Oncologia, L’Hospitalet de Llobregat, Barcelona (Spain); Catalan Network of Smoke-free Hospitals, L' Hospitalet de Llobregat, Barcelona (Spain); Cancer Prevention and Control Group, Institut d' Investigació Biomèdica de Bellvitge – IDIBELL, L’Hospitalet de Llobregat, Barcelona (Spain); Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona – IDIBAPS, Barcelona (Spain); Department of Clinical Sciences, Universitat de Barcelona, Barcelona (Spain); Martínez-Sánchez, Jose M., E-mail: jmmartinez@iconcologia.net [Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d' Oncologia, L’Hospitalet de Llobregat, Barcelona (Spain); Cancer Prevention and Control Group, Institut d' Investigació Biomèdica de Bellvitge – IDIBELL, L’Hospitalet de Llobregat, Barcelona (Spain); Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona (Spain); Sureda, Xisca; Fu, Marcela [Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d' Oncologia, L’Hospitalet de Llobregat, Barcelona (Spain); Cancer Prevention and Control Group, Institut d' Investigació Biomèdica de Bellvitge – IDIBELL, L’Hospitalet de Llobregat, Barcelona (Spain); Department of Clinical Sciences, Universitat de Barcelona, Barcelona (Spain); and others

    2014-11-15

    Background: There is scarce evidence about passive exposure to the vapour released or exhaled from electronic cigarettes (e-cigarettes) under real conditions. The aim of this study is to characterise passive exposure to nicotine from e-cigarettes' vapour and conventional cigarettes' smoke at home among non-smokers under real-use conditions. Methods: We conducted an observational study with 54 non-smoker volunteers from different homes: 25 living at home with conventional smokers, 5 living with nicotine e-cigarette users, and 24 from control homes (not using conventional cigarettes neither e-cigarettes). We measured airborne nicotine at home and biomarkers (cotinine in saliva and urine). We calculated geometric mean (GM) and geometric standard deviations (GSD). We also performed ANOVA and Student's t tests for the log-transformed data. We used Bonferroni-corrected t-tests to control the family error rate for multiple comparisons at 5%. Results: The GMs of airborne nicotine were 0.74 μg/m{sup 3} (GSD=4.05) in the smokers’ homes, 0.13 μg/m{sup 3} (GSD=2.4) in the e-cigarettes users’ homes, and 0.02 μg/m{sup 3} (GSD=3.51) in the control homes. The GMs of salivary cotinine were 0.38 ng/ml (GSD=2.34) in the smokers’ homes, 0.19 ng/ml (GSD=2.17) in the e-cigarettes users’ homes, and 0.07 ng/ml (GSD=1.79) in the control homes. Salivary cotinine concentrations of the non-smokers exposed to e-cigarette's vapour at home (all exposed ≥2 h/day) were statistically significant different that those found in non-smokers exposed to second-hand smoke ≥2 h/day and in non-smokers from control homes. Conclusions: The airborne markers were statistically higher in conventional cigarette homes than in e-cigarettes homes (5.7 times higher). However, concentrations of both biomarkers among non-smokers exposed to conventional cigarettes and e-cigarettes’ vapour were statistically similar (only 2 and 1.4 times higher, respectively). The levels of airborne

  6. Cigarettes vs. e-cigarettes: Passive exposure at home measured by means of airborne marker and biomarkers

    International Nuclear Information System (INIS)

    Ballbè, Montse; Martínez-Sánchez, Jose M.; Sureda, Xisca; Fu, Marcela

    2014-01-01

    Background: There is scarce evidence about passive exposure to the vapour released or exhaled from electronic cigarettes (e-cigarettes) under real conditions. The aim of this study is to characterise passive exposure to nicotine from e-cigarettes' vapour and conventional cigarettes' smoke at home among non-smokers under real-use conditions. Methods: We conducted an observational study with 54 non-smoker volunteers from different homes: 25 living at home with conventional smokers, 5 living with nicotine e-cigarette users, and 24 from control homes (not using conventional cigarettes neither e-cigarettes). We measured airborne nicotine at home and biomarkers (cotinine in saliva and urine). We calculated geometric mean (GM) and geometric standard deviations (GSD). We also performed ANOVA and Student's t tests for the log-transformed data. We used Bonferroni-corrected t-tests to control the family error rate for multiple comparisons at 5%. Results: The GMs of airborne nicotine were 0.74 μg/m 3 (GSD=4.05) in the smokers’ homes, 0.13 μg/m 3 (GSD=2.4) in the e-cigarettes users’ homes, and 0.02 μg/m 3 (GSD=3.51) in the control homes. The GMs of salivary cotinine were 0.38 ng/ml (GSD=2.34) in the smokers’ homes, 0.19 ng/ml (GSD=2.17) in the e-cigarettes users’ homes, and 0.07 ng/ml (GSD=1.79) in the control homes. Salivary cotinine concentrations of the non-smokers exposed to e-cigarette's vapour at home (all exposed ≥2 h/day) were statistically significant different that those found in non-smokers exposed to second-hand smoke ≥2 h/day and in non-smokers from control homes. Conclusions: The airborne markers were statistically higher in conventional cigarette homes than in e-cigarettes homes (5.7 times higher). However, concentrations of both biomarkers among non-smokers exposed to conventional cigarettes and e-cigarettes’ vapour were statistically similar (only 2 and 1.4 times higher, respectively). The levels of airborne nicotine and

  7. Health management and pattern analysis of daily living activities of people with dementia using in-home sensors and machine learning techniques.

    Directory of Open Access Journals (Sweden)

    Shirin Enshaeifar

    Full Text Available The number of people diagnosed with dementia is expected to rise in the coming years. Given that there is currently no definite cure for dementia and the cost of care for this condition soars dramatically, slowing the decline and maintaining independent living are important goals for supporting people with dementia. This paper discusses a study that is called Technology Integrated Health Management (TIHM. TIHM is a technology assisted monitoring system that uses Internet of Things (IoT enabled solutions for continuous monitoring of people with dementia in their own homes. We have developed machine learning algorithms to analyse the correlation between environmental data collected by IoT technologies in TIHM in order to monitor and facilitate the physical well-being of people with dementia. The algorithms are developed with different temporal granularity to process the data for long-term and short-term analysis. We extract higher-level activity patterns which are then used to detect any change in patients' routines. We have also developed a hierarchical information fusion approach for detecting agitation, irritability and aggression. We have conducted evaluations using sensory data collected from homes of people with dementia. The proposed techniques are able to recognise agitation and unusual patterns with an accuracy of up to 80%.

  8. Psychometric testing of an instrument to measure the experience of home.

    Science.gov (United States)

    Molony, Sheila L; McDonald, Deborah Dillon; Palmisano-Mills, Christine

    2007-10-01

    Research related to quality of life in long-term care has been hampered by a paucity of measurement tools sensitive to environmental interventions. The primary aim of this study was to test the psychometric properties of a new instrument, the Experience of Home (EOH) Scale, designed to measure the strength of the experience of meaningful person-environment transaction. The instrument was administered to 200 older adults in diverse dwelling types. Principal components analysis provided support for construct validity, eliciting a three-factor solution accounting for 63.18% of variance in scores. Internal consistency reliability was supported with Cronbach's alpha of .96 for the entire scale. The EOH Scale is a unique research tool to evaluate interventions to improve quality of living in residential environments.

  9. Measurement of concentration and size distribution of radon decay products in homes using air cleaners

    International Nuclear Information System (INIS)

    Montassier, N.; Hopke, P.K.; Shi, Y.; McCallum, B.

    1992-01-01

    By removing particles, air cleaners can also eliminate radon decay products. However, by removing the particles, the open-quotes unattachedclose quotes fraction of the radon progeny is increased leading to a higher dose per unit exposure. Thus, both the concentration and size distributions of the radon decay products are needed to evaluate air cleaners. Three types of room air cleaners, NO-RAD Radon Removal System, Electronic Air Cleaner and PUREFLOW Air Treatment System were tested in a single family home in Arnprior, Ontario (Canada). Semi-continuous measurements of radon gas concentration and radon decay product activity weighted size distribution were performed in the kitchen/dining room under real living conditions. The effects of air cleaners on both the concentration and size distribution of the radon decay products were measured, and their impact on the dose of radiation given to the lung tissue were examined

  10. A home-made system for IPCE measurement of standard and dye-sensitized solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Palma, Giuseppina; Cozzarini, Luca; Capria, Ennio [Organic OptoElectronics Laboratory, Sincrotrone Trieste SCpA—SS 14.5, km 163.5, 34149 Basovizza (TS) (Italy); Fraleoni-Morgera, Alessandro, E-mail: alessandro.fraleoni@elettra.trieste.it, E-mail: afraleoni@units.it [Organic OptoElectronics Laboratory, Sincrotrone Trieste SCpA—SS 14.5, km 163.5, 34149 Basovizza (TS) (Italy); Flextronics Laboratory, Department of Engineering and Architecture, University of Trieste. V. Valerio 10, 34100 Trieste (TS) (Italy)

    2015-01-15

    A home-made system for incident photon-to-electron conversion efficiency (IPCE) characterization, based on a double-beam UV-Vis spectrophotometer, has been set up. In addition to its low cost (compared to the commercially available apparatuses), the double-beam configuration gives the advantage to measure, autonomously and with no need for supplementary equipment, the lamp power in real time, compensating possible variations of the spectral emission intensity and quality, thus reducing measurement times. To manage the optical and electronic components of the system, a custom software has been developed. Validations carried out on a common silicon-based photodiode and on a dye-sensitized solar cell confirm the possibility to adopt this system for determining the IPCE of solar cells, including dye-sensitized ones.

  11. A home-made system for IPCE measurement of standard and dye-sensitized solar cells.

    Science.gov (United States)

    Palma, Giuseppina; Cozzarini, Luca; Capria, Ennio; Fraleoni-Morgera, Alessandro

    2015-01-01

    A home-made system for incident photon-to-electron conversion efficiency (IPCE) characterization, based on a double-beam UV-Vis spectrophotometer, has been set up. In addition to its low cost (compared to the commercially available apparatuses), the double-beam configuration gives the advantage to measure, autonomously and with no need for supplementary equipment, the lamp power in real time, compensating possible variations of the spectral emission intensity and quality, thus reducing measurement times. To manage the optical and electronic components of the system, a custom software has been developed. Validations carried out on a common silicon-based photodiode and on a dye-sensitized solar cell confirm the possibility to adopt this system for determining the IPCE of solar cells, including dye-sensitized ones.

  12. Psychometric properties of the Canadian Occupational Performance Measure in home-dwelling older adults

    Science.gov (United States)

    Tuntland, Hanne; Aaslund, Mona Kristin; Langeland, Eva; Espehaug, Birgitte; Kjeken, Ingvild

    2016-01-01

    Background The Canadian Occupational Performance Measure (COPM) is an occupational therapy instrument designed to help participants identify, prioritize, and evaluate performance of important occupations. Objective To investigate the validity, responsiveness, interpretability, and feasibility of the COPM when used by various health professions in home-dwelling older adults receiving reablement. Reablement is a new form of multidisciplinary home-based rehabilitation for older adults experiencing functional decline. Participants and methods The sample of 225 participants, mean age 80.8 years, who were in need of rehabilitation for various health conditions were included in the study. Data collection was conducted at baseline and at 10 weeks follow-up. The COSMIN guidelines and recommendations for evaluating methodological quality were followed. Results Content validity, construct validity, and feasibility were found to be adequate. Responsiveness, however, was moderate. Functional mobility was the most frequently prioritized occupational category of all. Regarding interpretability, the minimal important change was 3.0 points and 3.2 points for performance and satisfaction, respectively. The older adults reported that COPM was a useful and manageable instrument. The majority of the occupational therapists, physiotherapists, and nurses reported that they had the required expertise to conduct the COPM assessments. Conclusion The results support the multidisciplinary use of the COPM in clinical practice and research in a home-dwelling, heterogeneous population of older adults. Based on the findings, 3 points are recommended as a cutoff point to distinguish between older adults who have a minimal important change in COPM performance and COPM satisfaction and those who have not. PMID:27621647

  13. Use of outcome measures in stroke rehabilitation in the transition from hospital to home-based rehabilitation

    DEFF Research Database (Denmark)

    Maribo, Thomas; Nielsen, Claus Vinther

    Relevance: Stroke is one of the major chronic diseases leading to long-term disability. Stroke treatment has improved and in-hospital stays have been reduced, leading to increasing emphasis on home-based rehabilitation. The transition from hospital to home-based rehabilitation is critical, as vital...... are vague. Purpose: The purpose was to examine the use of outcome measures used in clinical practice in the transition from hospital to home-based rehabilitation. Methods/Analysis: A questionnaire were sent to the heads of 26 hospitals discharging patients with stroke and 52 municipalities' health services...... rehabilitation, especially in the transition between hospital and home-based rehabilitation. A nationwide, interprofessional and intersectional group is currently discussing recommendations for the use of outcome measures in stroke rehabilitation. Results from this group will be presented at the conference...

  14. Diagnostic Accuracy of the Barthel Index for Measuring Activities of Daily Living Outcome After Ischemic Hemispheric Stroke Does Early Poststroke Timing of Assessment Matter?

    OpenAIRE

    Kwakkel, G.; Veerbeek, J.M.; Harmeling-van der Wel, B.C.; Wegen, van, E.E.H.; Kollen, B.J.

    2011-01-01

    Background and Purpose- This study investigated the diagnostic accuracy of the Barthel Index (BI) in 206 stroke patients, measured within 72 hours, for activities of daily living at 6 months and determined whether the timing of BI assessment during the first days affects the accuracy of predicting activities of daily living outcome at 6 months. Methods- Receiver operating characteristic curves were constructed to determine the area under the curve and optimal cutoff points for BI at Days 2, 5...

  15. Weatherization and Indoor Air Quality: Measured Impacts in Single Family Homes Under the Weatherization Assistance Program

    Energy Technology Data Exchange (ETDEWEB)

    Pigg, Scott [Energy Center of Wisconsin, Madison, WI (United States); Cautley, Dan [Energy Center of Wisconsin, Madison, WI (United States); Francisco, Paul [Univ. of Illinois, Urbana-Champaign, IL (United States); Hawkins, Beth A [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brennan, Terry M [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-09-01

    This report summarizes findings from a national field study of indoor air quality parameters in homes treated under the Weatherization Assistance Program (WAP). The study involved testing and monitoring in 514 single-family homes (including mobile homes) located in 35 states and served by 88 local weatherization agencies.

  16. Have Nursing Home Compare quality measure scores changed over time in response to competition?

    Science.gov (United States)

    Castle, Nicholas G; Engberg, John; Liu, Darren

    2007-06-01

    Currently, the Centers for Medicare and Medicaid Services report on 15 Quality Measures (QMs) on the Nursing Home Compare (NHC) website. It is assumed that nursing homes are able to make improvements on these QMs, and in doing so they will attract more residents. In this investigation, we examine changes in QM scores, and whether competition and/or excess demand have influenced these change scores over a period of 1 year. Data come from NHC and the On-line Survey Certification And Recording (OSCAR) system. QM change scores are calculated using values from January 2003 to January 2004. A series of regression analyses are used to examine the association of competition and excess demand on QM scores. Eight QMs show an average decrease in scores (ie, better quality) and six QMs show an average increase in scores (ie, worse quality). However, for 13 of the 14 QMs these average changes averaged less than 1%. The regression analyses show an association between higher competition and improving QM scores and an association between lower occupancy and improving QM scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, we show that it is in the most competitive markets and those with the lowest average occupancy rates that improvements in the QM scores are more likely.

  17. Formaldehyde and acetaldehyde exposure mitigation in US residences: In-home measurements of ventilation control and source control

    Energy Technology Data Exchange (ETDEWEB)

    Hult, Erin L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Willem, Henry [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Price, Phillip N. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hotchi, Toshifumi [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Russell, Marion L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-10-01

    Measurements were taken in new US residences to assess the extent to which ventilation and source control can mitigate formaldehyde exposure. Increasing ventilation consistently lowered indoor formaldehyde concentrations. However, at a reference air exchange rate of 0.35 h-1, increasing ventilation was up to 60% less effective than would be predicted if the emission rate were constant. This is consistent with formaldehyde emission rates decreasing as air concentrations increase, as observed in chamber studies. In contrast, measurements suggest acetaldehyde emission was independent of ventilation rate. To evaluate the effectiveness of source control, formaldehyde concentrations were measured in Leadership in Energy and Environmental Design (LEED) certified/Indoor airPLUS homes constructed with materials certified to have low emission rates of volatile organic compounds (VOC). At a reference air exchange rate of 0.35 h-1, and adjusting for home age, temperature and relative humidity, formaldehyde concentrations in homes built with low-VOC materials were 42% lower on average than in reference new homes with conventional building materials. Without adjustment, concentrations were 27% lower in the low-VOC homes. The mean and standard deviation of formaldehyde concentration were 33 μg m-3 and 22 μg m-3 for low-VOC homes and 45 μg m-3 and 30 μg m-3 for conventional.

  18. At Home Photography-Based Method for Measuring Wrist Range of Motion.

    Science.gov (United States)

    Trehan, Samir K; Rancy, Schneider K; Johnsen, Parker H; Hillstrom, Howard J; Lee, Steve K; Wolfe, Scott W

    2017-11-01

    Purpose  To determine the reliability of wrist range of motion (WROM) measurements based on digital photographs taken by patients at home compared with traditional measurements done in the office with a goniometer. Methods  Sixty-nine postoperative patients were enrolled in this study at least 3 months postoperatively. Active and passive wrist flexion/extension and radial/ulnar deviation were recorded by one of the two attending surgeons with a 1-degree resolution goniometer at the last postoperative office visit. Patients were provided an illustrated instruction sheet detailing how to take digital photographic images at home in six wrist positions (active and passive flexion/extension, and radial/ulnar deviation). Wrist position was measured from digital images by both the attending surgeons in a randomized, blinded fashion on two separate occasions greater than 2 weeks apart using the same goniometer. Reliability analysis was performed using the intraclass correlation coefficient to assess agreement between clinical and photography-based goniometry, as well as intra- and interobserver agreement. Results  Out of 69 enrolled patients, 30 (43%) patients sent digital images. Of the 180 digital photographs, only 9 (5%) were missing or deemed inadequate for WROM measurements. Agreement between clinical and photography-based measurements was "almost perfect" for passive wrist flexion/extension and "substantial" for active wrist flexion/extension and radial/ulnar deviation. Inter- and intraobserver agreement for the attending surgeons was "almost perfect" for all measurements. Discussion  This study validates a photography-based goniometry protocol allowing accurate and reliable WROM measurements without direct physician contact. Passive WROM was more accurately measured from photographs than active WROM. This study builds on previous photography-based goniometry literature by validating a protocol in which patients or their families take and submit their own

  19. Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study

    Directory of Open Access Journals (Sweden)

    Fries Brant E

    2005-01-01

    Full Text Available Abstract Background The objective of this study was to examine the Minimum Data Set (MDS and Geriatric Depression Scale (GDS as measures of depression among nursing home residents. Methods The data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1 a sum of the MDS Depression items; (2 the MDS Depression Rating Scale; (3 the 15-item GDS; and (4 the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant across cognitive impairment strata. Results The GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demonstrated adequate internal consistency reliability. The MDS suggested greater depression among those with cognitive impairment, whereas the GDS suggested a more severe depression among those with better cognitive functioning. The GDS was limited by missing data; the DRS by a larger floor effect. The DRS was more strongly correlated with conspicuous depression, but only among those with cognitive impairment. Conclusions The MDS Depression items and GDS identify different elements of depression. This may be due to differences in the manifest symptom content and/or the self-report nature of the GDS versus the observer-rated MDS. Our findings suggest that the GDS and the MDS are not interchangeable measures of depression.

  20. Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study

    Science.gov (United States)

    Koehler, Melissa; Rabinowitz, Terry; Hirdes, John; Stones, Michael; Carpenter, G Iain; Fries, Brant E; Morris, John N; Jones, Richard N

    2005-01-01

    Background The objective of this study was to examine the Minimum Data Set (MDS) and Geriatric Depression Scale (GDS) as measures of depression among nursing home residents. Methods The data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1) a sum of the MDS Depression items; (2) the MDS Depression Rating Scale; (3) the 15-item GDS; and (4) the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant) across cognitive impairment strata. Results The GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demonstrated adequate internal consistency reliability. The MDS suggested greater depression among those with cognitive impairment, whereas the GDS suggested a more severe depression among those with better cognitive functioning. The GDS was limited by missing data; the DRS by a larger floor effect. The DRS was more strongly correlated with conspicuous depression, but only among those with cognitive impairment. Conclusions The MDS Depression items and GDS identify different elements of depression. This may be due to differences in the manifest symptom content and/or the self-report nature of the GDS versus the observer-rated MDS. Our findings suggest that the GDS and the MDS are not interchangeable measures of depression. PMID:15627403

  1. Home-based Constraint Induced Movement Therapy Poststroke

    OpenAIRE

    Stephen Isbel HScD; Christine Chapparo PhD; David McConnell PhD; Judy Ranka PhD

    2014-01-01

    Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors. Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity L...

  2. A methodology for the measure of secondary homes tourist flows at municipal level

    Directory of Open Access Journals (Sweden)

    Andrea Guizzardi

    2007-10-01

    Full Text Available The present public statistical system does not provide information concerning second houses touristic flows at sub-regional level. The lack limits local administrations' capabilities to take decisions about either: environmental, territorial and productive development, as well as regional governments in fair allocation of public financing. In the work, this information lack is overcome by proposing an indirect estimation methodology. Municipalities electric power consumption is proposed as an indicator of the stays on secondary homes. The indicator is connected to tourism flows considering both measurement errors and factors, modifying the local power demand. The application to Emilia-Romagna regional case allow to verify results’ coherence with officials statistics, as weel as to assess municipalities’ tourist vocation.

  3. Automated health alerts from Kinect-based in-home gait measurements.

    Science.gov (United States)

    Stone, Erik E; Skubic, Marjorie; Back, Jessica

    2014-01-01

    A method for automatically generating alerts to clinicians in response to changes in in-home gait parameters is investigated. Kinect-based gait measurement systems were installed in apartments in a senior living facility. The systems continuously monitored the walking speed, stride time, and stride length of apartment residents. A framework for modeling uncertainty in the residents' gait parameter estimates, which is critical for robust change detection, is developed; along with an algorithm for detecting changes that may be clinically relevant. Three retrospective case studies, of individuals who had their gait monitored for periods ranging from 12 to 29 months, are presented to illustrate use of the alert method. Evidence suggests that clinicians could be alerted to health changes at an early stage, while they are still small and interventions may be most successful. Additional potential uses are also discussed.

  4. Agreement Between Home-Based Measurement of Stool Calprotectin and ELISA Results for Monitoring Inflammatory Bowel Disease Activity

    NARCIS (Netherlands)

    Heida, Anke; Knol, Mariska; Kobold, Anneke Muller; Bootsman, Josette; Dijkstra, Gerard; van Rheenen, Patrick F

    2017-01-01

    BACKGROUND & AIMS: An increasing number of physicians use repeated measurements of stool calprotectin to monitor intestinal inflammation in patients with inflammatory bowel diseases (IBDs). A lateral flow-based rapid test allows patients to measure their own stool calprotectin values at home. The

  5. Measurement of overall quality of life in nursing homes through self report : the role of cognitive impairment

    NARCIS (Netherlands)

    Gerritsen, Debby Lydia; Steverink, Nardi; Ooms, Marcel E.; de Vet, Henrica C. W.; Ribbe, Miel W.

    Measuring quality of life is a necessity for adequate interventions. This paper concerns the usefulness of six self-report measures for overall quality of life for nursing home residents with various levels of cognitive impairment. It was investigated which proportion of residents from four

  6. SU-E-J-53: A Phantom Design to Assist Patient Position Verification System in Daily Image-Guided RT and Comprehensive QA Measurements

    International Nuclear Information System (INIS)

    Syh, J; Wu, H

    2015-01-01

    Purpose This study is to implement a homemade novel device with surface locking couch index to check daily radiograph (DR) function of adaPTInsight™, stereoscopic image guided system (SIGS), for proton therapy. The comprehensive daily QA checks of proton pencil beam output, field size, flatness and symmetry of spots and energy layers will be followed by using MatriXX dosimetry device. Methods The iBa MatriXX device was used to perform daily dosimetry which is also used to perform SIGS checks. A set of markers were attached to surface of MatriXX device in alignment of DRR of reconstructed CT images and daily DR. The novel device allows MatriXX to be fit into the cradle which was locked by couch index bars on couch surface. This will keep the MatriXX at same XY plane daily with exact coordinates. Couch height Z will be adjusted according to imaging to check isocenter-laser coincidence accuracy. Results adaPTInsight™ provides robotic couch to move in 6-degree coordinate system to align the dosimetry device to be within 1.0 mm / 1.0°. The daily constancy was tightened to be ± 0.5 mm / 0.3° compared to 1.0 mm / 1.0° before. For gantry at 0° and couch all 0° angles (@ Rt ARM 0 setting), offsets measured of the couch systems were ≤ 0.5° in roll, yaw and pitch dimensions. Conclusion Simplicity of novel device made daily image guided QA consistent with accuracy. The offset of the MatriXX isocenter-laser coincident was reproducible. Such easy task not only speeds up the setup, but it increases confidence level in detailed daily comprehensive measurements. The total SIGS alignment time has been shortened with less setup error. This device will enhance our experiences for the future QA when cone beam CT imaging modality becomes available at proton therapy center

  7. The impact of obstructive sleep apnea variability measured in-lab versus in-home on sample size calculations

    Directory of Open Access Journals (Sweden)

    Levendowski Daniel

    2009-01-01

    Full Text Available Abstract Background When conducting a treatment intervention, it is assumed that variability associated with measurement of the disease can be controlled sufficiently to reasonably assess the outcome. In this study we investigate the variability of Apnea-Hypopnea Index obtained by polysomnography and by in-home portable recording in untreated mild to moderate obstructive sleep apnea (OSA patients at a four- to six-month interval. Methods Thirty-seven adult patients serving as placebo controls underwent a baseline polysomnography and in-home sleep study followed by a second set of studies under the same conditions. The polysomnography studies were acquired and scored at three independent American Academy of Sleep Medicine accredited sleep laboratories. The in-home studies were acquired by the patient and scored using validated auto-scoring algorithms. The initial in-home study was conducted on average two months prior to the first polysomnography, the follow-up polysomnography and in-home studies were conducted approximately five to six months after the initial polysomnography. Results When comparing the test-retest Apnea-hypopnea Index (AHI and apnea index (AI, the in-home results were more highly correlated (r = 0.65 and 0.68 than the comparable PSG results (r = 0.56 and 0.58. The in-home results provided approximately 50% less test-retest variability than the comparable polysomnography AHI and AI values. Both the overall polysomnography AHI and AI showed a substantial bias toward increased severity upon retest (8 and 6 events/hr respectively while the in-home bias was essentially zero. The in-home percentage of time supine showed a better correlation compared to polysomnography (r = 0.72 vs. 0.43. Patients biased toward more time supine during the initial polysomnography; no trends in time supine for in-home studies were noted. Conclusion Night-to-night variability in sleep-disordered breathing can be a confounding factor in assessing

  8. Tiredness in daily activities: a subjective measure for the identification of frailty among non-disabled community-living older adults

    DEFF Research Database (Denmark)

    Schultz-Larsen, Kirsten; Avlund, Kirsten

    2006-01-01

    The objective of this study was to determine whether the responses to questions about tiredness in daily activities is an early subjective sign of frailty indicating older community-living adults at increased risk for disability and mortality. Tiredness in daily activities as measured by the Mob......-T Scale, maximal power in sustained work, and comorbid diseases were assessed together with sociodemographic variables in a sample of 705 non-disabled, 70-year old men and women surveyed in 1984. Vital status of members was determined prospectively over the next 15 years. Onset of disability was measured...

  9. Psychometric properties of the Canadian Occupational Performance Measure in home-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Tuntl

    2016-09-01

    Full Text Available Hanne Tuntland,1,2 Mona Kristin Aaslund,1 Eva Langeland,2 Birgitte Espehaug,3 Ingvild Kjeken4,5 1Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; 2Centre for Care Research Western Norway, Bergen University College, Bergen, Norway; 3Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway; 4National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Bergen, Norway; 5Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences,Oslo, Norway Background: The Canadian Occupational Performance Measure (COPM is an occupational therapy instrument designed to help participants identify, prioritize, and evaluate performance of important occupations.Objective: To investigate the validity, responsiveness, interpretability, and feasibility of the COPM when used by various health professions in home-dwelling older adults receiving reablement. Reablement is a new form of multidisciplinary home-based rehabilitation for older adults experiencing functional decline.Participants and methods: The sample of 225 participants, mean age 80.8 years, who were in need of rehabilitation for various health conditions were included in the study. Data collection was conducted at baseline and at 10 weeks follow-up. The COSMIN guidelines and recommendations for evaluating methodological quality were followed.Results: Content validity, construct validity, and feasibility were found to be adequate. Responsiveness, however, was moderate. Functional mobility was the most frequently prioritized occupational category of all. Regarding interpretability, the minimal important change was 3.0 points and 3.2 points for performance and satisfaction, respectively. The older adults reported that COPM was a useful and manageable instrument. The majority of the occupational therapists

  10. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    OpenAIRE

    Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN

    2014-01-01

    Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6?7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting par...

  11. Using alternative or direct anthropometric measurements to assess risk for malnutrition in nursing homes.

    Science.gov (United States)

    Lorini, Chiara; Collini, Francesca; Castagnoli, Mariangela; Di Bari, Mauro; Cavallini, Maria Chiara; Zaffarana, Nicoletta; Pepe, Pasquale; Lucenteforte, Ersilia; Vannacci, Alfredo; Bonaccorsi, Guglielmo

    2014-10-01

    The aim of this study was to use the Malnutrition Universal Screening Tool (MUST) to assess the applicability of alternative versus direct anthropometric measurements for evaluating the risk for malnutrition in older individuals living in nursing homes (NHs). We conducted a cross-sectional survey in 67 NHs in Tuscany, Italy. We measured the weight, standing height (SH), knee height (KH), ulna length (UL), and middle-upper-arm circumference of 641 NH residents. Correlations between the different methods for calculating body mass index (BMI; using direct or alternative measurements) were evaluated by the intraclass correlation coefficient and the Bland-Altman method; agreement in the allocation of participants to the same risk category was assessed by squared weighted kappa statistic and indicators of internal relative validity. The intraclass correlation coefficient for BMI calculated using KH was 0.839 (0.815-0.861), whereas those calculated by UL were 0.890 (0.872-0.905). The limits of agreement were ±6.13 kg/m(2) using KH and ±4.66 kg/m(2) using UL. For BMI calculated using SH, 79.9% of the patients were at low risk, 8.1% at medium risk, and 12.2% at high risk for malnutrition. The agreement between this classification and that obtained using BMI calculated by alternative measurements was "fair-good." When it is not possible to determine risk category by using SH, we suggest using the alternative measurements (primarily UL, due to its highest sensitivity) to predict the height and to compare these evaluations with those obtained by using middle-upper-arm-circumference to predict the BMI. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Noninvasive measurement of physiological signals on a modified home bathroom scale.

    Science.gov (United States)

    Inan, O T; Dookun Park; Giovangrandi, L; Kovacs, G T A

    2012-08-01

    A commercial bathroom scale with both handlebar and footpad electrodes was modified to enable measurement of four physiological signals: the ballistocardiogram (BCG), electrocardiogram (ECG), lower body impedance plethysmogram (IPG), and lower body electromyogram (EMG). The BCG, which describes the reaction of the body to cardiac ejection of blood, was measured using the strain gauges in the scale. The ECG was detected using handlebar electrodes with a two-electrode amplifier. For the lower body IPG, the two electrodes under the subject's toes were driven with an ac current stimulus, and the resulting differential voltage across the heels was measured and demodulated synchronously with the source. The voltage signal from the same two footpad electrodes under the heels was passed through a passive low-pass filter network into another amplifier, and the output was the lower body EMG signal. The signals were measured from nine healthy subjects, and the average signal-to-noise ratio (SNR) while the subjects were standing still was estimated for the four signals as follows: BCG, 7.6 dB; ECG, 15.8 dB; IPG, 10.7 dB. During periods of motion, the decrease in SNR for the BCG signal was found to be correlated to the increase in rms power for the lower body EMG (r = 0.89, p <; 0.01). The EMG could, thus, be used to flag noise-corrupted segments of the BCG, increasing the measurement robustness. This setup could be used for monitoring the cardiovascular health of patients at home.

  13. Indoor radon in selected homes in Aburi Municipality: measurement uncertainty, decision analysis and remediation strategy

    International Nuclear Information System (INIS)

    Yeboah, M. S.

    2014-07-01

    The main source of natural internal irradiation of man is radon and its decay products. In this study, the radon concentration levels in selected homes in Aburi of the Akuapim North Municipal Assembly in Eastern Region, Ghana were estimated using time-intergrated passive radon detector; LR-115 Type II solid state nuclear track detector (SSNTD) technique. The primary objective of the study was to measure radon levels in 30 selected homes in the Aburi municipality and determine the uncertainties associated with the measured radon concentrations in order to take a decision on remedial actions to be adopted in case of any abnormality using simple qualitative decision analysis method. Measurements were carried out from December, 2013 to March, 2014. After each month of exposure for a period of three months, the detectors were subjected to chemical etching in a 2.5M analytical grade of sodium hydroxide solution at (60 ± I )OC, for 90mins in a constant temperature water bath to enlarge the latent tracks produced by alpha particles from the decay of radon. The etched tracks were magnified using the microfiche reader and counted with a tally counter. The results obtained from the study revealed that concentration of radon in most of the selected homes in the Aburi municipality is low and it is within the internationally accepted action level of 100Bqm-3 set by WHO (2009). The analysis of the results established that the average radon concentrations vary in the range 23.72- 92.24Bqm -3 , 19.07-124.36 Bqm -3 and 31.63-123.87 Bqm -3 for month I, month 2 and month 3 respectively. The corresponding mean values are 46.77, 45.92 and 56.66 Bqm -3 respectively with standard deviations of ±2.18. ±2.38 and ±2.76. These gave a mean of 49.78 ± 12.50 for the three months. Two (2) of the rooms investigated had values above 20 % of the remedial action level of 100Bqm -3 in two of the months but with their average values slightly lower than the remedial action level. From the

  14. Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

    Science.gov (United States)

    Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

    2015-05-01

    Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

  15. A comparison of daily water use estimates derived from constant-heat sap-flow probe values and gravimetric measurements in pot-grown saplings.

    Science.gov (United States)

    K.A. McCulloh; K. Winter; F.C. Meinzer; M. Garcia; J. Aranda; Lachenbruch B.

    2007-01-01

    The use of Granier-style heat dissipation sensors to measure sap flow is common in plant physiology, ecology, and hydrology. There has been concern that any change to the original Granier design invalidates the empirical relationship between sap flux density and the temperature difference between the probes. We compared daily water use estimates from gravimetric...

  16. Reliability and construct validity of the Instrument to Measure the Impact of Valve Heart Disease on the Patient's Daily Life.

    Science.gov (United States)

    Anjos, Daniela Brianne Martins Dos; Rodrigues, Roberta Cunha Matheus; Padilha, Kátia Melissa; Pedrosa, Rafaela Batista Dos Santos; Gallani, Maria Cecília Bueno Jayme

    2016-12-19

    evaluate the practicality, acceptability and the floor and ceiling effects, estimate the reliability and verify the convergent construct's validity with the instrument called the Heart Valve Disease Impact on daily life (IDCV) of the valve disease in patients with mitral and or aortic heart valve disease. data was obtained from 86 heart valve disease patients through 3 phases: a face to face interview for a socio-demographic and clinic characterization and then other two done through phone calls of the interviewed patients for application of the instrument (test and repeat test). as for the practicality and acceptability, the instrument was applied with an average time of 9,9 minutes and with 110% of responses, respectively. Ceiling and floor effects observed for all domains, especially floor effect. Reliability was tested using the test - repeating pattern to give evidence of temporal stability of the measurement. Significant negative correlations with moderate to strong magnitude were found between the score of the generic question about the impact of the disease and the scores of IDCV, which points to the validity of the instrument convergent construct. the instrument to measure the impact of valve heart disease on the patient's daily life showed evidence of reliability and validity when applied to patients with heart valve disease. avaliar a praticabilidade, aceitabilidade e os efeitos teto e chão, estimar a confiabilidade e verificar a validade de construto convergente do Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata em pacientes com valvopatia mitral e/ou aórtica. dados foram obtidos junto a 86 pacientes valvopatas por meio de três etapas: uma entrevista presencial para caracterização sociodemográfica e clínica e as duas outras realizadas por meio de contato telefônico para as aplicações do instrumento (Teste e teste de repetição). quanto à praticabilidade e aceitabilidade, o instrumento foi aplicado com tempo m

  17. Measuring In-Home Walking Speed using Wall-Mounted RF Transceiver Arrays

    Science.gov (United States)

    Jacobs, Peter G.; Wan, Eric A.; Schafermeer, Erich; Adenwala, Fatema; Paul, Anindya S.; Preiser, Nick; Kaye, Jeffrey

    2014-01-01

    In this paper we present a new method for passively measuring walking speed using a small array of radio transceivers positioned on the walls of a hallway within a home. As a person walks between a radio transmitter and a receiver, the received signal strength (RSS) detected by the receiver changes in a repeatable pattern that may be used to estimate walking speed without the need for the person to wear any monitoring device. The transceivers are arranged as an array of 4 with a known distance between the array elements. Walking past the first pair of transceivers will cause a peak followed by a second peak when the person passes the second pair of transceivers. The time difference between these peaks is used to estimate walking speed directly. We further show that it is possible to estimate the walking speed by correlating the shape of the signal using a single pair of transceivers positioned across from each other in a hallway or doorframe. RMSE performance was less than 15 cm/s using a 2-element array, and less than 8 cm/s using a 4-element array relative to a gait mat used for ground truth. PMID:25570108

  18. Using a measure of person-perception skills to identify outstanding home care workers.

    Science.gov (United States)

    Grosch, Kerry; Medvene, Louis; Walker, Diane

    2011-01-01

    This study involved university-community collaboration with an international home care company for the purpose of developing a tool to identify talented caregivers. Tested was the hypothesis that workers' ability to provide care in person-centered ways would be positively associated with their ability to describe others in complex ways--that is, their person-perception skills. Company coordinators functioning as supervisors used an innovative 10-item instrument to screen 554 home health aides for their person centeredness. The most and least person-centered workers were evaluated for their person-perception skills. Person centeredness was positively associated with the complexity of home care workers' descriptions of others.

  19. Pentachlorophenol measurements in body fluids of people in log homes and workplaces

    Energy Technology Data Exchange (ETDEWEB)

    Cline, R.E.; Hill, R.H. Jr.; Phillips, D.L.; Needham, L.L.

    1989-07-01

    Human exposure to pentachlorophenol (PCP) was evaluated in the normal population (controls), residents of PCP-treated log homes, and persons exposed primarily in the workplace. Blood and urine samples were analyzed by gas chromatography after extraction and acetylation. For 34 controls, serum PCP values ranged from 15-75 ppb with a mean of 40 ppb. For 123 residents of log homes, serum levels ranged from 69-1,340 ppb with a mean of 420 ppb. In such homes, serum levels for children were significantly higher than those for parents, averaging 1.8 times greater. Serum and urine values for workers varied widely, depending on the workplace, with serum levels ranging from 26 to 84,900 ppb of PCP. Urinary concentrations when corrected for creatinine values correlated well (r = 0.92) with serum concentrations. Coating PCP-treated logs of home interiors with a sealant reduced serum PCP levels in the residents.

  20. Measure Guideline: Heat Pump Water Heaters in New and Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Shapiro, C.; Puttagunta, S.; Owens, D.

    2012-02-01

    This Building America Measure Guideline is intended for builders, contractors, homeowners, and policy-makers. This document is intended to explore the issues surrounding heat pump water heaters (HPWHs) to ensure that homeowners and contractors have the tools needed to appropriately and efficiently install HPWHs. Heat pump water heaters (HPWHs) promise to significantly reduce energy consumption for domestic hot water (DHW) over standard electric resistance water heaters (ERWHs). While ERWHs perform with energy factors (EFs) around 0.9, new HPWHs boast EFs upwards of 2.0. High energy factors in HPWHs are achieved by combining a vapor compression system, which extracts heat from the surrounding air at high efficiencies, with electric resistance element(s), which are better suited to meet large hot water demands. Swapping ERWHs with HPWHs could result in roughly 50% reduction in water heating energy consumption for 35.6% of all U.S. households. This Building America Measure Guideline is intended for builders, contractors, homeowners, and policy-makers. While HPWHs promise to significantly reduce energy use for DHW, proper installation, selection, and maintenance of HPWHs is required to ensure high operating efficiency and reliability. This document is intended to explore the issues surrounding HPWHs to ensure that homeowners and contractors have the tools needed to appropriately and efficiently install HPWHs. Section 1 of this guideline provides a brief description of HPWHs and their operation. Section 2 highlights the cost and energy savings of HPWHs as well as the variables that affect HPWH performance, reliability, and efficiency. Section 3 gives guidelines for proper installation and maintenance of HPWHs, selection criteria for locating HPWHs, and highlights of important differences between ERWH and HPWH installations. Throughout this document, CARB has included results from the evaluation of 14 heat pump water heaters (including three recently released HPWH

  1. Measured Whole-House Performance of TaC Studios Test Home

    Energy Technology Data Exchange (ETDEWEB)

    Butler, T. [Southface Energy Institute, Upper Marlboro, MD (United States); Curtis, O. [Southface Energy Institute, Upper Marlboro, MD (United States); Stephenson, R. [Southface Energy Institute, Upper Marlboro, MD (United States)

    2013-12-01

    As part of the NAHB Research Center Industry Partnership, Southface partnered with TaC Studios, an Atlanta-based architecture firm specializing in residential and light commercial design, on the construction of a new test home in Atlanta, GA, in the mixed humid climate. This home serves as a residence and home office for the firm's owners, as well as a demonstration of their design approach to potential and current clients. Southface believes the home demonstrates current best practices for the mixed-humid climate, including a building envelope featuring advanced air sealing details and low density spray foam insulation, glazing that exceeds ENERGY STAR requirements, and a high performance heating and cooling system. Construction quality and execution was a high priority for TaC Studios and was ensured by a third party review process. Post-construction testing showed that the project met stated goals for envelope performance, an air infiltration rate of 2.15 ACH50. The homeowners wished to further validate whole house energy savings through the project's involvement with Building America and this long-term monitoring effort. As a Building America test home, this home was evaluated to detail whole house energy use, end use loads, and the efficiency and operation of the ground source heat pump and associated systems. Given that the home includes many non-typical end use loads including a home office, pool, landscape water feature, and other luxury features not accounted for in Building America modeling tools, these end uses were separately monitored to determine their impact on overall energy consumption.

  2. Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services

    Directory of Open Access Journals (Sweden)

    Margaret K Danilovich

    2015-11-01

    Full Text Available Objectives: This study used validated physical performance measures to examine function, risk of adverse health outcomes, and the relationship with allocated hours of weekly caregiving assistance among older adults receiving home and community-based services through a Medicaid waiver program. Methods: Older adults (n = 42 completed physical performance measures including grip strength, 30-s chair rise, Timed Up and Go, and gait speed. Demographic information including age, gender, and allocated hours of weekly caregiving assistance were also collected. Results: A majority, 72% of females and 86% of males, had weak grip strength, 57% met criteria for fall risk based on their Timed Up and Go score, 83% had lower extremity strength impairments, and 98% were unable to ambulate more than 1.0 m/s. Frailty was prevalent in the sample with 72% of clients meeting Fried’s frailty criteria. The most significant predictors of allocated hours of weekly caregiving assistance approved for clients were race and gait speed. Conclusion: Based on scores on physical performance measures, clients are at risk of falls, hospitalization, and mortality, and scores indicate an urgent need to assess performance in addition to self-reported activities of daily living limitations for this population. Performance measures associated with quantifiable risk of adverse outcomes can be critical indicators for referrals and services needed to enhance the safety and improve care outcomes for homebound older adults.

  3. Self-Report Measures of the Home Learning Environment in Large Scale Research: Measurement Properties and Associations with Key Developmental Outcomes

    Science.gov (United States)

    Niklas, Frank; Nguyen, Cuc; Cloney, Daniel S.; Tayler, Collette; Adams, Raymond

    2016-01-01

    Favourable home learning environments (HLEs) support children's literacy, numeracy and social development. In large-scale research, HLE is typically measured by self-report survey, but there is little consistency between studies and many different items and latent constructs are observed. Little is known about the stability of these items and…

  4. Remote sensing of potential and actual daily transpiration of plant canopies based on spectral reflectance and infrared thermal measurements: Concept with preliminary test

    International Nuclear Information System (INIS)

    Inoue, Y.; Moran, M.S.; Pinter, P.J.Jr.

    1994-01-01

    A new concept for estimating potential and actual values of daily transpiration rate of vegetation canopies is presented along with results of an initial test. The method is based on a physical foundation of spectral radiation balance for a vegetation canopy, the key inputs to the model being the remotely sensed spectral reflectance and the surface temperature of the plant canopy. The radiation interception or absorptance is estimated more directly from remotely sensed spectral data than it is from the leaf area index. The potential daily transpiration is defined as a linear function of the absorbed solar radiation, which can be estimated using a linear relationship between the fraction absorptance of solar radiation and the remotely sensed Soil Adjusted Vegetation Index for the canopy. The actual daily transpiration rate is estimated by combining this concept with the Jackson-Idso Crop Water Stress Index, which also can be calculated from remotely sensed plant leaf temperatures measured by infrared thermometry. An initial demonstration with data sets from an alfalfa crop and a rangeland suggests that the method may give reasonable estimates of potential and actual values of daily transpiration rate over diverse vegetation area based on simple remote sensing measurements and basic meteorological parameters

  5. The effects of humor therapy on nursing home residents measured using observational methods: the SMILE cluster randomized trial.

    Science.gov (United States)

    Low, Lee-Fay; Goodenough, Belinda; Fletcher, Jennifer; Xu, Kenny; Casey, Anne-Nicole; Chenoweth, Lynn; Fleming, Richard; Spitzer, Peter; Bell, Jean-Paul; Brodaty, Henry

    2014-08-01

    To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment. Single-blind cluster randomized controlled trial. A total of 35 Sydney nursing homes. All eligible residents within geographically defined areas within each nursing home were invited to participate. Professional "ElderClowns" provided 9 to 12 weekly humor therapy sessions, augmented by resident engagement by trained staff "LaughterBosses." Controls received usual care. The Behavior Engagement Affect Measure (BEAM) touchpad observational tool was used to capture real-time behavioral data. The tool assesses the duration in seconds of agitation, positive behavior toward others, engagement, and affect (angry, anxious, happy, neutral, sad). Seventeen nursing homes (189 residents) received the intervention and 18 homes (209 residents) received usual care. Over 26 weeks, in comparison with controls, the humor therapy group decreased in duration of high agitation (effect size = 0.168 and 0.129 at 13 and 26 weeks, respectively) and increased in duration of happiness (effect size = 0.4 and 0.236 at 13 and 26 weeks, respectively). We confirmed that humor therapy decreases agitation and also showed that it increases happiness. Researchers may consider evaluating impacts of nonpharmaceutical interventions on positive outcomes. Computer-assisted observational measures should be considered, particularly for residents with dementia and when the reliability of staff is uncertain. Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Activities of daily living measured by the Harvard Automated Phone Task track with cognitive decline over time in non-demented elderly

    Science.gov (United States)

    Marshall, Gad A.; Aghjayan, Sarah L.; Dekhtyar, Maria; Locascio, Joseph J.; Jethwani, Kamal; Amariglio, Rebecca E.; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2017-01-01

    Background Impairment in activities of daily living is a major burden to both patients and caregivers. Mild impairment in instrumental activities of daily living is often seen at the stage of mild cognitive impairment. The field of Alzheimer’s disease is moving toward earlier diagnosis and intervention and more sensitive and ecologically valid assessments of instrumental or complex activities of daily living are needed. The Harvard Automated Phone Task, a novel performance-based activities of daily living instrument, has the potential to fill this gap. Objective To further validate the Harvard Automated Phone Task by assessing its longitudinal relationship to global cognition and specific cognitive domains in clinically normal elderly and individuals with mild cognitive impairment. Design In a longitudinal study, the Harvard Automated Phone Task was associated with cognitive measures using mixed effects models. The Harvard Automated Phone Task’s ability to discriminate across diagnostic groups at baseline was also assessed. Setting Academic clinical research center. Participants Two hundred and seven participants (45 young normal, 141 clinically normal elderly, and 21 mild cognitive impairment) were recruited from the community and the memory disorders clinics at Brigham and Women’s Hospital and Massachusetts General Hospital. Measurements Participants performed the three tasks of the Harvard Automated Phone Task, which consist of navigating an interactive voice response system to refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and make a bank account transfer and payment (APT-Bank). The 3 tasks were scored based on time, errors, repetitions, and correct completion of the task. The primary outcome measure used for each of the tasks was total time adjusted for correct completion. Results The Harvard Automated Phone Task discriminated well between young normal, clinically normal elderly, and mild cognitive impairment

  7. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    NARCIS (Netherlands)

    Chalmers, J. R.; Simpson, E.; Apfelbacher, C. J.; Thomas, K. S.; von Kobyletzki, L.; Schmitt, J.; Singh, J. A.; Svensson, Å; Williams, H. C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T. L.; Block, J.; Bragg, A.; Burton, T.; Bjerring Clemmensen, K. K.; Creswell-Melville, A.; Dinesen, M.; Drucker, A.; Eckert, L.; Flohr, C.; Garg, M.; Gerbens, L. A. A.; Graff, A. L. B.; Hanifin, J.; Heinl, D.; Humphreys, R.; Ishii, H. A.; Kataoka, Y.; Leshem, Y. A.; Marquort, B.; Massuel, M.-A.; Merhand, S.; Mizutani, H.; Murota, H.; Murrell, D. F.; Nakahara, T.; Nasr, I.; Nograles, K.; Ohya, Y.; Osterloh, I.; Pander, J.; Prinsen, C.; Purkins, L.; Ridd, M.; Sach, T.; Schuttelaar, M.-L. A.; Shindo, S.; Smirnova, J.; Sulzer, A.; Synnøve Gjerde, E.; Takaoka, R.; Vestby Talmo, H.; Tauber, M.; Torchet, F.; Volke, A.; Wahlgren, C.-F.; Weidinger, S.; Weisshaar, E.; Wollenberg, A.; Yamaga, K.; Zhao, C. Y.; Spuls, P. I.

    2016-01-01

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and

  8. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    NARCIS (Netherlands)

    Chalmers, J. R.; Simpson, E.; Apfelbacher, C. J.; Thomas, K. S.; von Kobyletzki, L.; Schmitt, J.; Singh, J. A.; Svensson, A.; Williams, H. C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T. L.; Block, J.; Bragg, A.; Burton, T.; Clemmensen, K. K. Bjerring; Creswell-Melville, A.; Dinesen, M.; Drucker, A.; Eckert, L.; Flohr, C.; Garg, M.; Gerbens, L. A. A.; Graff, A. L. B.; Hanifin, J.; Heinl, D.; Humphreys, R.; Ishii, H. A.; Kataoka, Y.; Leshem, Y. A.; Marquort, B.; Massuel, M. -A.; Merhand, S.; Mizutani, H.; Murota, H.; Murrell, D. F.; Nakahara, T.; Nasr, I.; Nograles, K.; Ohya, Y.; Osterloh, I.; Pander, Jan; Prinsen, C.; Purkins, L.; Ridd, M.; Sach, T.; Schuttelaar, M. -L. A.; Shindo, S.; Smirnova, J.; Sulzer, A.; Gjerde, E. Synnove; Takaoka, R.; Talmo, H. Vestby; Tauber, M.; Torchet, F.; Volke, A.; Wahlgren, C. -F.; Weidinger, S.; Weisshaar, E.; Wollenberg, A.; Yamaga, K.; Zhao, C. Y.; Spuls, P. I.

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmo, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and

  9. Measured Whole-House Performance of TaC Studios Test Home

    Energy Technology Data Exchange (ETDEWEB)

    Butler, T. [Partnership for Home Innovation (PHI), Upper Marlboro, MD (United States). Southface Energy Inst.; Curtis, O. [Partnership for Home Innovation (PHI), Upper Marlboro, MD (United States). Southface Energy Inst.; Stephenson, R. [Partnership for Home Innovation (PHI), Upper Marlboro, MD (United States). Southface Energy Inst.

    2013-12-01

    As part of the NAHB Research Center Industry Partnership, Southface partnered with TaC Studios, an Atlanta-based architecture firm specializing in residential and light commercial design, on the construction of a new test home in Atlanta, GA in the mixed humid climate. This home serves as a residence and home office for the firm's owners, as well as a demonstration of their design approach topotential and current clients. Southface believes the home demonstrates current best practices for the mixed-humid climate, including a building envelope featuring advanced air sealing details and low density spray foam insulation, glazing that exceeds ENERGY STAR requirements, and a high performance heating and cooling system. Construction quality and execution was a high priority for TaCStudios and was ensured by a third party review process. Post-construction testing showed that the project met stated goals for envelope performance, an air infiltration rate of 2.15 ACH50. The homeowners wished to further validate whole house energy savings through the project's involvement with Building America and this long-term monitoring effort. As a Building America test home, this homewas evaluated to detail whole house energy use, end use loads, and the efficiency and operation of the ground source heat pump and associated systems. Given that the home includes many non-typical end use loads including a home office, pool, landscape water feature, and other luxury features not accounted for in Building America modeling tools, these end uses were separately monitored todetermine their impact on overall energy consumption.

  10. Home readings of blood pressure in assessment of hypertensive subjects

    DEFF Research Database (Denmark)

    Nielsen, P.E.; Myschetzky, P; Andersen, A R

    1986-01-01

    Out-patient clinic blood pressure (OPC-BP) was compared to home blood pressure (Home-BP) measured three times daily during a two week period in 122 consecutively referred hypertensive subjects. A semi-automatic device (TM-101) including a microphone for detection of Korotkoff-sounds, self......-deflation of cuff pressure and digital display of blood pressure was used. Mean difference between OPC-BP and Home-BP was systolic +13 mm Hg (range -21 - +100 mg Hg) and diastolic +5 mm Hg (range -27 - +36 mm Hg). Although a significant correlation could be demonstrated between Home-BP and OPC-BP, the inter...

  11. Daily Emotional and Physical Reactivity to Stressors Among Widowed and Married Older Adults

    Science.gov (United States)

    2014-01-01

    Objectives. Widowhood may result in declines in health and potentially stressful changes to daily routines. However, little research has examined how daily stressors contribute to physical and emotional well-being in widowhood. The objectives of the current study were to examine daily stressor exposure and reactivity in widowed versus married older adults. Method. Participants included all 100 widowed and 342 married adults aged 65 and older from the National Study of Daily Experiences, a daily diary study from the second wave of the Midlife in the United States. Daily stressors were measured using the Daily Inventory of Stressful Events; multilevel modeling assessed daily reactivity to stressors using daily negative affect (emotional reactivity) and daily physical symptoms (physical reactivity) as outcomes. Results. Married participants reported more stressors in general, and specifically more interpersonal stressors (e.g., arguments). Both married and widowed participants were reactive to daily stressors. Married participants were physically and emotionally reactive to interpersonal stressors. Widowed participants were more physically reactive to home-related stressors. Discussion. Attention to the types of daily stressors that widowed older adults experience in daily life and the potential physical effects of daily stressors during widowhood may help to alleviate some of the physical distress that widowed older adults may experience. PMID:23685921

  12. Daily emotional and physical reactivity to stressors among widowed and married older adults.

    Science.gov (United States)

    Hahn, Elizabeth A; Cichy, Kelly E; Small, Brent J; Almeida, David M

    2014-01-01

    Widowhood may result in declines in health and potentially stressful changes to daily routines. However, little research has examined how daily stressors contribute to physical and emotional well-being in widowhood. The objectives of the current study were to examine daily stressor exposure and reactivity in widowed versus married older adults. Participants included all 100 widowed and 342 married adults aged 65 and older from the National Study of Daily Experiences, a daily diary study from the second wave of the Midlife in the United States. Daily stressors were measured using the Daily Inventory of Stressful Events; multilevel modeling assessed daily reactivity to stressors using daily negative affect (emotional reactivity) and daily physical symptoms (physical reactivity) as outcomes. Married participants reported more stressors in general, and specifically more interpersonal stressors (e.g., arguments). Both married and widowed participants were reactive to daily stressors. Married participants were physically and emotionally reactive to interpersonal stressors. Widowed participants were more physically reactive to home-related stressors. Attention to the types of daily stressors that widowed older adults experience in daily life and the potential physical effects of daily stressors during widowhood may help to alleviate some of the physical distress that widowed older adults may experience.

  13. Modelling nitrous oxide emissions from mown-grass and grain-cropping systems: Testing and sensitivity analysis of DailyDayCent using high frequency measurements.

    Science.gov (United States)

    Senapati, Nimai; Chabbi, Abad; Giostri, André Faé; Yeluripati, Jagadeesh B; Smith, Pete

    2016-12-01

    The DailyDayCent biogeochemical model was used to simulate nitrous oxide (N 2 O) emissions from two contrasting agro-ecosystems viz. a mown-grassland and a grain-cropping system in France. Model performance was tested using high frequency measurements over three years; additionally a local sensitivity analysis was performed. Annual N 2 O emissions of 1.97 and 1.24kgNha -1 year -1 were simulated from mown-grassland and grain-cropland, respectively. Measured and simulated water filled pore space (r=0.86, ME=-2.5%) and soil temperature (r=0.96, ME=-0.63°C) at 10cm soil depth matched well in mown-grassland. The model predicted cumulative hay and crop production effectively. The model simulated soil mineral nitrogen (N) concentrations, particularly ammonium (NH 4 + ), reasonably, but the model significantly underestimated soil nitrate (NO 3 - ) concentration under both systems. In general, the model effectively simulated the dynamics and the magnitude of daily N 2 O flux over the whole experimental period in grain-cropland (r=0.16, ME=-0.81gNha -1 day -1 ), with reasonable agreement between measured and modelled N 2 O fluxes for the mown-grassland (r=0.63, ME=-0.65gNha -1 day -1 ). Our results indicate that DailyDayCent has potential for use as a tool for predicting overall N 2 O emissions in the study region. However, in-depth analysis shows some systematic discrepancies between measured and simulated N 2 O fluxes on a daily basis. The current exercise suggests that the DailyDayCent may need improvement, particularly the sub-module responsible for N transformations, for better simulating soil mineral N, especially soil NO 3 - concentration, and N 2 O flux on a daily basis. The sensitivity analysis shows that many factors such as climate change, N-fertilizer use, input uncertainty and parameter value could influence the simulation of N 2 O emissions. Sensitivity estimation also helped to identify critical parameters, which need careful estimation or site

  14. Comparison of Central, Ambulatory, Home and Office Blood Pressure Measurement as Risk Markers for Mild Cognitive Impairment in Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Teodora Yaneva-Sirakova

    2017-08-01

    Full Text Available Aims: We compared the role of central blood pressure (BP, ambulatory BP monitoring (ABPM, home-measured BP (HMBP and office BP measurement as risk markers for the development of mild cognitive impairment (MCI. Methods: 70 hypertensive patients on combination medical therapy were studied. Their mean age was 64.97 ± 8.88 years. Eighteen (25.71% were males and 52 (74.28% females. All of the patients underwent full physical examination, laboratory screening, echocardiography, and office, ambulatory, home and central BP measurement. The neuropsychological tests used were: Mini Mental State Examination (MMSE and Montreal Cognitive Assessment (MoCA. SPSS 19 was used for the statistical analysis with a level of significance of 0.05. Results: The mean central pulse pressure values of patients with MCI were significantly (p = 0.016 higher than those of the patients without MCI. There was a weak negative correlation between central pulse pressure and the results from the MoCA and MMSE (r = –0.283, p = 0.017 and r = –0.241, p = 0.044, respectively. There was a correlation between ABPM and MCI as well as between HMBP and MCI. Conclusions: The correlation of central BP with target organ damage (MCI is as good as for the other types of measurements of BP (home and ambulatory. Office BP seems to be the poorest marker for the assessment of target organ damage.

  15. Method for determining the wedge angle from the daily measurements made with the measurement enabled devices DC6; Metodo para la determinacion del angulo de cuna a partir de las medidas diarias realizadas con el dispositio de medida QC6

    Energy Technology Data Exchange (ETDEWEB)

    Marques Fraguela, E.; Suero Rodrigo, M. A.

    2011-07-01

    The aim of this paper is to present a method for determining the angle of the wedges virtual electron linear accelerator (ALE) Siemens Primus, from the daily measurements made with the measurement system PTW-QC6Plus and found to be sufficiently sensitive to determine variations of {+-} 1 of this parameter. In addition, we study the behavior statistically CUFLE angle over a year.

  16. Reporting the national antimicrobial consumption in Danish pigs: influence of assigned daily dosage values and population measurement

    DEFF Research Database (Denmark)

    Dupont, Nana Hee; Fertner, Mette Ely; Kristensen, Charlotte Sonne

    2016-01-01

    Transparent calculation methods are crucial when investigating trends in antimicrobial consumption over time and between populations. Until 2011, one single standardized method was applied when quantifying the Danish pig antimicrobial consumption with the unit "Animal Daily Dose" (ADD). However...... assignment methods, Denmark has also experienced a shift in the production pattern, towards a larger export of live pigs. The aims of this paper were to (1) describe previous and current ADD assignment methods used by the major Danish institutions and (2) to illustrate how ADD assignment method and choice...... DANMAP and DVFA were only identical for 48 % of antimicrobial products approved for use in pigs. From 2007 to 2013, the total number of ADDs per year increased by 9 % when using the new DVFA ADD-values, but decreased by 2 and 7 % when using the new DANMAP ADD-values or the old VetStat ADD...

  17. 'I try not to bother the residents too much' - the use of capillary blood glucose measurements in nursing homes.

    Science.gov (United States)

    Andreassen, Lillan Mo; Granas, Anne Gerd; Sølvik, Una Ørvim; Kjome, Reidun Lisbet Skeide

    2016-01-01

    Capillary blood glucose measurements are regularly used for nursing home residents with diabetes. The usefulness of these measurements relies on clear indications for use, correct measurement techniques, proper documentation and clinical use of the resulting blood glucose values. The use of a regular, invasive procedure may also entail additional challenges in a population of older, multimorbid patients who often suffer from cognitive impairment or dementia. The aim of this study was to explore the perspectives of physicians, registered nurses and auxiliary nurses on the use, usefulness and potential challenges of using capillary blood glucose measurements in nursing homes, and the procedures for doing so. This was a qualitative study that used three profession-specific focus group interviews. Interviews were transcribed in modified verbatim form and analysed in accordance with Malterud's principles of systematic text condensation. Five physicians, four registered nurses and three auxiliary nurses participated in the focus groups. All professional groups regarded capillary blood glucose measurements as a necessity in the management of diabetes, the physicians to ensure that the treatment is appropriate, and the nurses to be certain and assured about their caring decisions. Strict glycaemic control and excessive measurements were avoided in order to promote the well-being and safety of the residents. Sufficient knowledge of diabetes symptoms, equivalent practices for glucose measurement, and unambiguous documentation and communication of results were determined to be most helpful. However, all professional groups seldom involved the residents in managing their own measurements and stated that guidelines and training had been inconsistent or lacking. Inadequate procedures and training in diabetes care may compromise the rationale for capillary blood glucose measurements in nursing homes, and hence the residents' safety. These concerns should be addressed together

  18. Radon water to air transfer measured in a bathroom in an energy-efficient home with a private well

    International Nuclear Information System (INIS)

    Harley, Naomi H.; Chittaporn, Passaporn; Cook, Gordon B.; Fisenne, Isabel M.

    2014-01-01

    Monthly measurements of radon in kitchen and bath tap water along with indoor air concentrations were made from 1994 to 1996 in an energy-efficient home with a private well. The well supplies all water to the home. The radon in cold and hot kitchen water averaged 69±2 and 52±2 Bq l -1 , respectively. Radon in cold and hot water from the bath/shower room shower head averaged 60±1 and 38±2 Bq l -1 , respectively, whereas hot water collected in the shower at the tub base averaged 5±1 Bq l -1 or a 92 % radon loss to air. While the calculated transfer factor of 1/10 000, i.e. radon concentration in air to radon in water, conventionally applies to the whole house, measurements for the specific water release during showering in a bathroom exhibit a larger transfer factor of 1/2300, due to smaller room volume. (authors)

  19. Measure Guideline: Wall Air Sealing and Insulation Methods in Existing Homes; An Overview of Opportunity and Process

    Energy Technology Data Exchange (ETDEWEB)

    Roberts, S.; Stephenson, R.

    2012-09-01

    This guide provides renovators and retrofit contractors an overview of considerations when including wall air sealing and insulation in an energy retrofit project. It also outlines the potential project risks, various materials for insulating, possible field inspections needed, installation procedures, as well as the benefits and drawbacks. The purpose of this document is to provide the outline of the overview and process of insulating and air sealing walls so that home retrofit professionals can identify approaches to air sealing and insulation measures.

  20. Spanish Home Language Use and English Proficiency as Differential Measures of Language Maintenance and Shift.

    Science.gov (United States)

    Bills, Garland D.; Hudson, Alan; Chavez, Eduardo Hernandez

    1999-01-01

    Examines 1990 Census data for a large sample of the Hispanic-origin population in the Southwest, exploring two possible indices of language maintenance--Spanish home language claiming and English proficiency--as these are influenced by nativity, time, and age of immigration, citizenship status of the foreign born, education, and income.…

  1. Offices for living in : An instrument for measuring the potential for transforming offices into homes

    NARCIS (Netherlands)

    Geraedts, Rob P.; van der Voordt, Theo

    2003-01-01

    A large number of office premises seem difficult to rent out because they no longer meet the demands of the market. A solution must be found for these premises and also for office buildings that have been empty for longer periods. Reallocation or transformation to other functions such as homes can

  2. Small and Home-Based Businesses: Measures of Success and the Contribution of Local Development Services

    Science.gov (United States)

    Brooks, Lara; Whitacre, Brian; Shideler, Dave; Muske, Glenn; Woods, Mike

    2012-01-01

    Small and home-based businesses have long been identified by Extension educators as an important component of economic development, particularly in rural areas. The services available to these businesses can take many forms, including management training, accessibility of local funding, providing incubation facilities, or setting up mentoring…

  3. Measuring Attitude towards RE: Factoring Pupil Experience and Home Faith Background into Assessment

    Science.gov (United States)

    Thanissaro, Phra Nicholas

    2012-01-01

    Recent studies have increasingly favoured contextualisation of religious education (RE) to pupils' home faith background in spite of current assessment methods that might hinder this. For a multi-religious, multi-ethnic sample of 369 London school pupils aged from 13 to 15 years, this study found that the participatory, transformative and…

  4. Home blood pressure measurement in elderly patients with cognitive impairment: comparison of agreement between relative-measured blood pressure and automated blood pressure measurement.

    Science.gov (United States)

    Plichart, Matthieu; Seux, Marie-Laure; Caillard, Laure; Chaussade, Edouard; Vidal, Jean-Sébastien; Boully, Clémence; Hanon, Olivier

    2013-08-01

    Home blood pressure measurement (HBPM) is recommended by guidelines for hypertension management. However, this method might be difficult to use in elderly individuals with cognitive disorders. Our aim was to assess the agreement and the feasibility of HBPM by a relative as compared with 24-h ambulatory blood pressure monitoring (ABPM) in elderly patients with dementia. Sixty outpatients with dementia aged 75 years and older with office hypertension (≥140/90 mmHg) were subjected successively to HBPM by a trained relative and 24-h ABPM. The order of the two methods was randomized. Current guidelines' thresholds for the diagnosis of hypertension were used. The mean (SD) age of the patients was 80.8 (6.1) years (55% women) and the mean (SD) mini-mental state examination score was 20.1 (6.9). The feasibility of relative-HBPM was very high, with a 97% success rate (defined by ≥12/18 measurements reported). The blood pressure measurements were highly correlated between the two methods (r=0.75 and 0.64 for systolic blood pressure and diastolic blood pressure, respectively; Pmethods for the diagnosis of sustained hypertension and white-coat hypertension was excellent (overall agreement, 92%; κ coefficient, 0.81; 95% CI, 0.61-0.93). Similar results were found for daytime-ABPM. In cognitively impaired elderly patients, HBPM by a relative using an automated device was a good alternative to 24-h ABPM.

  5. A Secondary Analysis of Longitudinal Prevalence Data to Determine the Use of Pressure Ulcer Preventive Measures in Dutch Nursing Homes, 2005-2014.

    Science.gov (United States)

    van Leen, Martin Wf; Schols, Joseph Mga; Hovius, Steven Er; Halfens, Ruud Jg

    2017-09-01

    Pressure ulcers (PUs) are an important and distressing problem in Dutch nursing homes. A secondary analysis of longitudinal data from the Dutch National Prevalence Measurement of Care Problems (LPZ) - an annual, multicenter, point-prevalence survey - was conducted for the years 2005-2014 to determine the use of specific recommended PU preventive measures from the European Pressure Ulcer Advisory Panel 1998, the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel 2009, and the 2002 and 2011 Dutch PU guidelines. Preventive care was investigated among nursing home residents at risk for PUs and included skin care (moisturization); nutritional and hydration status assessment and optimization; and pressure redistribution involving mattresses, cushions, and heel pressure-relieving strategies and devices. Following abstraction from the study database, data for 3 at-risk groups were distinguished: 1) residents with a Braden score of 17, 18, or 19; 2) residents with a Braden score below 17; and 3) residents with a PU. Data were aggregated at the institutional level. Differences were tested with multiple regression analyses. The mean number of residents over the study period was 5435, the mean age was 82.8 years, and the mean Braden score was 15.3. None of the recommended preventive measures from the guidelines consulted was applied 100% of the time: preventive skin care measures were used in 25.1% to 63.8% of cases and dehydration and/or malnutrition were identified and managed in 27.8% to 65.6% of patients. Pressure redistribution with special types of mattresses was used in 85.2% of patients, cushions in (wheel)chairs were used in 64.8% of patients, and heels were offloaded in 57.8% of patients. The results regarding repositioning for the 3 groups, respectively, showed a maximum use of 9.7%, 30.3%, and 65.6%; the higher the PU risk, the more preventive measures were used. Although the results show a decrease in the percent of category 2 through

  6. Evaluation of the Use of Home Blood Pressure Measurement Using Mobile Phone-Assisted Technology: The iVitality Proof-of-Principle Study.

    Science.gov (United States)

    Wijsman, Liselotte W; Richard, Edo; Cachucho, Ricardo; de Craen, Anton Jm; Jongstra, Susan; Mooijaart, Simon P

    2016-06-13

    Mobile phone-assisted technologies provide the opportunity to optimize the feasibility of long-term blood pressure (BP) monitoring at home, with the potential of large-scale data collection. In this proof-of-principle study, we evaluated the feasibility of home BP monitoring using mobile phone-assisted technology, by investigating (1) the association between study center and home BP measurements; (2) adherence to reminders on the mobile phone to perform home BP measurements; and (3) referrals, treatment consequences and BP reduction after a raised home BP was diagnosed. We used iVitality, a research platform that comprises a Website, a mobile phone-based app, and health sensors, to measure BP and several other health characteristics during a 6-month period. BP was measured twice at baseline at the study center. Home BP was measured on 4 days during the first week, and thereafter, at semimonthly or monthly intervals, for which participants received reminders on their mobile phone. In the monthly protocol, measurements were performed during 2 consecutive days. In the semimonthly protocol, BP was measured at 1 day. We included 151 participants (mean age [standard deviation] 57.3 [5.3] years). BP measured at the study center was systematically higher when compared with home BP measurements (mean difference systolic BP [standard error] 8.72 [1.08] and diastolic BP 5.81 [0.68] mm Hg, respectively). Correlation of study center and home measurements of BP was high (R=0.72 for systolic BP and 0.72 for diastolic BP, both PMobile phone-assisted technology is a reliable and promising method with good adherence to measure BP at home during a 6-month period. This provides a possibility for implementation in large-scale studies and can potentially contribute to BP reduction.

  7. Exploration of Energy Metabolism in the Mouse Using Indirect Calorimetry: Measurement of Daily Energy Expenditure (DEE) and Basal Metabolic Rate (BMR).

    Science.gov (United States)

    Meyer, Carola W; Reitmeir, Peter; Tschöp, Matthias H

    2015-09-01

    Current comprehensive mouse metabolic phenotyping involves studying energy balance in cohorts of mice via indirect calorimetry, which determines heat release from changes in respiratory air composition. Here, we describe the measurement of daily energy expenditure (DEE) and basal metabolic rate (BMR) in mice. These well-defined metabolic descriptors serve as meaningful first-line read-outs for metabolic phenotyping and should be reported when exploring energy expenditure in mice. For further guidance, the issue of appropriate sample sizes and the frequency of sampling of metabolic measurements is also discussed. Copyright © 2015 John Wiley & Sons, Inc.

  8. Family's difficulty scale in end-of-life home care: a new measure of the family's difficulties in caring for patients with cancer at the end of life at home from bereaved family's perspective.

    Science.gov (United States)

    Ishii, Yoko; Miyashita, Mitsunori; Sato, Kazuki; Ozawa, Taketoshi

    2012-02-01

    The aim of this study was to develop a tool to measure the family's difficulties in caring for cancer patients at the end of life at home: Family's Difficulty Scale in end-of-life home care (FDS). The draft of the FDS was derived from a pilot interview survey and literature reviews. The questionnaires were sent to 395 bereaved family caregivers whose family members were patients with terminal cancer receiving home service. We obtained 306 responses (response rate, 81%). Factor analysis resulted in 29 items and 8 factors: Burden of Care, Concerns about Home Care Doctor, Balance of Work and Care, Patient's Pain and Condition, Concerns about Visiting Nurse, Concerns about Home Care Service, Relationship between Family Caregivers and their Families, and Funeral Preparations. The cumulative rate of contribution was 71.8%. Cronbach coefficient α for the FDS was 0.73-0.75; the intraclass correlation coefficient in the test-retest examination was 0.75-0.85. Evidence for construct validity was confirmed by convergent and divergent validity. Concurrent validity was confirmed by significant correlations between identified factors and concurrent measures. The validity and reliability of this new instrument were confirmed. This scale should help home care providers to assess and focus on family difficulties and provide individualized care for the family who cares for a patient with terminal cancer at home.

  9. Airborne protein concentration: a key metric for type 1 allergy risk assessment-in home measurement challenges and considerations.

    Science.gov (United States)

    Tulum, Liz; Deag, Zoë; Brown, Matthew; Furniss, Annette; Meech, Lynn; Lalljie, Anja; Cochrane, Stella

    2018-01-01

    Exposure to airborne proteins can be associated with the development of immediate, IgE-mediated respiratory allergies, with genetic, epigenetic and environmental factors also playing a role in determining the likelihood that sensitisation will be induced. The main objective of this study was to determine whether airborne concentrations of selected common aeroallergens could be quantified in the air of homes using easily deployable, commercially available equipment and analytical methods, at low levels relevant to risk assessment of the potential to develop respiratory allergies. Additionally, air and dust sampling were compared and the influence of factors such as different filter types on allergen quantification explored. Low volume air sampling pumps and DUSTREAM ® dust samplers were used to sample 20 homes and allergen levels were quantified using a MARIA ® immunoassay. It proved possible to detect a range of common aeroallergens in the home with sufficient sensitivity to quantify airborne concentrations in ranges relevant to risk assessment (Limits of Detection of 0.005-0.03 ng/m 3 ). The methodology discriminates between homes related to pet ownership and there were clear advantages to sampling air over dust which are described in this paper. Furthermore, in an adsorption-extraction study, PTFE (polytetrafluoroethylene) filters gave higher and more consistent recovery values than glass fibre (grade A) filters for the range of aeroallergens studied. Very low airborne concentrations of allergenic proteins in home settings can be successfully quantified using commercially available pumps and immunoassays. Considering the greater relevance of air sampling to human exposure of the respiratory tract and its other advantages, wider use of standardised, sensitive techniques to measure low airborne protein concentrations and how they influence development of allergic sensitisation and symptoms could accelerate our understanding of human dose-response relationships

  10. Effect of Caffeine on Attention and Alertness Measured in a Home-Setting, Using Web-Based Cognition Tests.

    Science.gov (United States)

    Pasman, Wilrike J; Boessen, Ruud; Donner, Yoni; Clabbers, Nard; Boorsma, André

    2017-09-07

    There is an increasing interest among nutritional researchers to perform lifestyle and nutritional intervention studies in a home setting instead of testing subjects in a clinical unit. The term used in other disciplines is 'ecological validity' stressing a realistic situation. This becomes more and more feasible because devices and self-tests that enable such studies are more commonly available. Here, we present such a study in which we reproduced the effect of caffeine on attention and alertness in an at-home setting. The study was aimed to reproduce the effect of caffeine on attention and alertness using a Web-based study environment of subjects, at home, performing different Web-based cognition tests. The study was designed as a randomized, placebo-controlled, double-blind, crossover study. Subjects were provided with coffee sachets (2 with and 2 without caffeine). They were also provided with a written instruction of the test days. Healthy volunteers consumed a cup of coffee after an overnight fast. Each intervention was repeated once. Before and 1 hour after coffee consumption subjects performed Web-based cognitive performance tests at home, which measured alertness and attention, established by 3 computerized tests provided by QuantifiedMind. Each test was performed for 5 minutes. Web-based recruitment was fast and efficient. Within 2 weeks, 102 subjects applied, of whom 70 were eligible. Of the 66 subjects who started the study, 53 completed all 4 test sessions (80%), indicating that they were able to perform the do it yourself tests, at home, correctly. The Go-No Go cognition test performed at home showed the same significant improvement in reaction time with caffeine as found in controlled studies in a metabolic ward (P=.02). For coding and N-back the second block was performed approximately 10% faster. No effect was seen on correctness. The study showed that the effects of caffeine consumption on a cognition test in an at-home setting revealed similar

  11. The reliability of in-home measures of height and weight in large cohort studies: Evidence from Add Health

    Directory of Open Access Journals (Sweden)

    Jon Hussey

    2015-05-01

    Full Text Available Background: With the emergence of obesity as a global health issue, an increasing number of major demographic surveys are collecting measured anthropometric data. Yet little is known about the characteristics and reliability of these data. Objective: We evaluate the accuracy and reliability of anthropometric data collected in the home during Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health, compare our estimates to national standard, clinic-based estimates from the National Health and Nutrition Examination Survey (NHANES and, using both sources, provide a detailed anthropometric description of young adults in the United States. Methods: The reliability of Add Health in-home anthropometric measures was estimated from repeat examinations of a random subsample of study participants. A digit preference analysis evaluated the quality of anthropometric data recorded by field interviewers. The adjusted odds of obesity and central obesity in Add Health vs. NHANES were estimated with logistic regression. Results: Short-term reliabilities of in-home measures of height, weight, waist and arm circumference - as well as derived body mass index (BMI, kg/m2 - were excellent. Prevalence of obesity (37Š vs. 29Š and central obesity (47Š vs. 38Š was higher in Add Health than in NHANES, while socio-demographic patterns of obesity and central obesity were comparable in the two studies. Conclusions: Properly trained non-medical field interviewers can collect reliable anthropometric data in a nationwide, home visit study. This national cohort of young adults in the United States faces a high risk of early-onset chronic disease and premature mortality.

  12. High Prevalence of Hypertension in a Danish Population Telemedical Home Measurement of Blood Pressure in Citizens Aged 55–64 Years in Holstebro County

    Science.gov (United States)

    Lauritzen, Torsten; Bech, Jesper Nørgaard; Pedersen, Erling Bjerregaard

    2016-01-01

    BACKGROUND Home blood pressure (HBP) is prognostically superior to office BP (OBP) and similar to ambulatory BP measurements. We determined the prevalence of hypertension using HBP with telemedical data transmission in the municipality of Holstebro, Denmark (57,000 citizens). METHODS Using the Civil Registration System, we invited citizens aged 55–64 years to have their OBP and HBP measured using telemedical data transmission. Elevated OBP was defined as ≥140/90mm Hg. HBP was measured 3 times daily on 3 consecutive days with 3 measurements on each occasion. HBP was the mean of all measurements on day 1 and 3, and hypertension was defined as ≥135/85mm Hg. RESULTS We included 3,102 citizens who had performed at least 12 HBP measurements during day 2 and 3. Group 1: (n = 1,464, 47%) had both normal OBP and HBP. Group 2: (n = 838, 27%) had both elevated OBP and HBP indicating persistent hypertension. Group 3: (n = 560, 18%) had elevated OBP and normal HBP indicating white coat hypertension (WCH). Group 4: (n = 240, 8%) had normal OBP and elevated HBP indicating masked hypertension (MH). Thus, 1,078 (35%, groups 2 and 4) were untreated or insufficiently treated. Awareness of hypertension was registered in 950 patients (31%) and of these 49% had a normal HBP. CONCLUSIONS This is the first large-scale study to eliminate completely reporting bias by using telemedical transmission of BP data. One third of citizens in the age group 55–64 years had an abnormally high HBP, and one fourth either had WCH or MH. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov identification number: NCT02355392 PMID:26208671

  13. Measuring cannabis consumption: Psychometric properties of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU).

    Science.gov (United States)

    Cuttler, Carrie; Spradlin, Alexander

    2017-01-01

    We created the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU) because the current lack of psychometrically sound inventories for measuring these dimensions of cannabis use has impeded research on the effects of cannabis in humans. A sample of 2,062 cannabis users completed the DFAQ-CU and was used to assess the DFAQ-CU's factor structure and reliability. To assess validity, a subsample of 645 participants completed additional measures of cannabis dependence and problems (Marijuana Smoking History Questionnaire [MSHQ], Timeline Followback [TLFB], Cannabis Abuse Screening Test [CAST], Cannabis Use Disorders Identification Test Revised [CUDIT-R], Cannabis Use Problems Identification Test [CUPIT], and Alcohol Use Disorder Identification Test [AUDIT]). A six-factor structure was revealed, with factors measuring: daily sessions, frequency, age of onset, marijuana quantity, cannabis concentrate quantity, and edibles quantity. The factors were reliable, with Cronbach's alpha coefficients ranging from .69 (daily sessions) to .95 (frequency). Results further provided evidence for the factors' convergent (MSHQ, TLFB), predictive (CAST, CUDIT-R, CUPIT), and discriminant validity (AUDIT). The DFAQ-CU is the first psychometrically sound inventory for measuring frequency, age of onset, and quantity of cannabis use. It contains pictures of marijuana to facilitate the measurement of quantity of marijuana used, as well as questions to assess the use of different forms of cannabis (e.g., concentrates, edibles), methods of administering cannabis (e.g., joints, hand pipes, vaporizers), and typical THC levels. As such, the DFAQ-CU should help facilitate research on frequency, quantity, and age of onset of cannabis use.

  14. Measuring cannabis consumption: Psychometric properties of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU.

    Directory of Open Access Journals (Sweden)

    Carrie Cuttler

    Full Text Available We created the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU because the current lack of psychometrically sound inventories for measuring these dimensions of cannabis use has impeded research on the effects of cannabis in humans.A sample of 2,062 cannabis users completed the DFAQ-CU and was used to assess the DFAQ-CU's factor structure and reliability. To assess validity, a subsample of 645 participants completed additional measures of cannabis dependence and problems (Marijuana Smoking History Questionnaire [MSHQ], Timeline Followback [TLFB], Cannabis Abuse Screening Test [CAST], Cannabis Use Disorders Identification Test Revised [CUDIT-R], Cannabis Use Problems Identification Test [CUPIT], and Alcohol Use Disorder Identification Test [AUDIT].A six-factor structure was revealed, with factors measuring: daily sessions, frequency, age of onset, marijuana quantity, cannabis concentrate quantity, and edibles quantity. The factors were reliable, with Cronbach's alpha coefficients ranging from .69 (daily sessions to .95 (frequency. Results further provided evidence for the factors' convergent (MSHQ, TLFB, predictive (CAST, CUDIT-R, CUPIT, and discriminant validity (AUDIT.The DFAQ-CU is the first psychometrically sound inventory for measuring frequency, age of onset, and quantity of cannabis use. It contains pictures of marijuana to facilitate the measurement of quantity of marijuana used, as well as questions to assess the use of different forms of cannabis (e.g., concentrates, edibles, methods of administering cannabis (e.g., joints, hand pipes, vaporizers, and typical THC levels. As such, the DFAQ-CU should help facilitate research on frequency, quantity, and age of onset of cannabis use.

  15. Low-E Storm Windows Gain Acceptance as a Home Weatherization Measure

    Energy Technology Data Exchange (ETDEWEB)

    Gilbride, Theresa L.; Cort, Katherine A.

    2016-05-16

    This article for Home Energy Magazine describes work by the U.S. Department of Energy to develop low-emissivity storm windows as an energy efficiency-retrofit option for existing homes. The article describes the low-emissivity invisible silver metal coatings on the glass, which reflect heat back into the home in winter or back outside in summer and the benefits of low-e storm windows including insulation, air sealing, noise blocking, protection of antique windows, etc. The article also describes Pacific Northwest National Laboratory's efforts on behalf of DOE to overcome market barriers to adoption of the technology, including performance validation studies in the PNNL Lab Homes, cost effectiveness analysis, production of reports, brochures, how-to guides on low-e storm window installation for the Building America Solution Center, and a video posted on YouTube. PNNL's efforts were reviewed by the Pacific Northwest Regional Technical Forum (RTF), which serves as the advisory board to the Pacific Northwest Electric Power Planning Council and Bonneville Power Administration. In late July 2015, the RTF approved the low-e storm window measure’s savings and specifications, a critical step in integrating low-e storm windows into energy-efficiency planning and utility weatherization and incentive programs. PNNL estimates that more than 90 million homes in the United States with single-pane or low-performing double-pane windows would benefit from the technology. Low-e storm windows are suitable not only for private residences but also for small commercial buildings, historic properties, and facilities that house residents, such as nursing homes, dormitories, and in-patient facilities. To further assist in the market transformation of low-e storm windows and other high-efficiency window attachments, DOE helped found the window Attachment Energy Rating Council (AERC) in 2015. AERC is an independent, public interest, non-profit organization whose mission is to rate

  16. Daily actions, challenges, and needs among Dutch parents while supporting the participation of their child with a physical disability at home, at school, and in the community: a qualitative diary study.

    Science.gov (United States)

    Piškur, Barbara; Beurskens, Anna J H M; Ketelaar, Marjolijn; Jongmans, Marian J; Casparie, Barbara M; Smeets, Rob J E M

    2017-01-11

    Parents have a vital influence on the participation of their child with a physical disability. The aim of this study is to gain insight into parents' own daily actions, challenges, and needs while supporting their child with a physical disability at home, at school, and in the community. An additional objective of this study is to refine the preliminary thematic framework previously identified in a scoping review. A qualitative research inquiry was performed based on using a diary over a 7-day period to gather data. To systematically organise data into a structured format, content analysis has been applied using both inductive and deductive reasoning guided by the existing preliminary thematic framework. Analysis of the eligible diaries shows that the actions mentioned by the 47 parents describe several efforts to enhance participation of their children with a physical disability by using, enabling, or changing the social and physical environment, or by supporting their child to perform or engage in meaningful activities. Those parents' actions are primarily a result of challenges caused by restrictions in social and physical environments. Parental responses highlighted, above all, the need for environments designed for all people. Based on the findings a redefined thematic framework is presented. Parents' actions, challenges, and needs are mainly directed towards the social or/and physical environment. The presented thematic framework can offer practitioners knowledge to support parents. More work is necessary to provide tailored approaches. Paediatric rehabilitation may need to address the importance of the environment on the participation of a child with a physical disability.

  17. Limited english proficiency, primary language at home, and disparities in children's health care: how language barriers are measured matters.

    Science.gov (United States)

    Flores, Glenn; Abreu, Milagros; Tomany-Korman, Sandra C

    2005-01-01

    Approximately 3.5 million U.S. schoolchildren are limited in English proficiency (LEP). Disparities in children's health and health care are associated with both LEP and speaking a language other than English at home, but prior research has not examined which of these two measures of language barriers is most useful in examining health care disparities. Our objectives were to compare primary language spoken at home vs. parental LEP and their associations with health status, access to care, and use of health services in children. We surveyed parents at urban community sites in Boston, asking 74 questions on children's health status, access to health care, and use of health services. Some 98% of the 1,100 participating children and families were of non-white race/ethnicity, 72% of parents were LEP, and 13 different primary languages were spoken at home. "Dose-response" relationships were observed between parental English proficiency and several child and parental sociodemographic features, including children's insurance coverage, parental educational attainment, citizenship and employment, and family income. Similar "dose-response" relationships were noted between the primary language spoken at home and many but not all of the same sociodemographic features. In multivariate analyses, LEP parents were associated with triple the odds of a child having fair/poor health status, double the odds of the child spending at least one day in bed for illness in the past year, and significantly greater odds of children not being brought in for needed medical care for six of nine access barriers to care. None of these findings were observed in analyses of the primary language spoken at home. Individual parental LEP categories were associated with different risks of adverse health status and outcomes. Parental LEP is superior to the primary language spoken at home as a measure of the impact of language barriers on children's health and health care. Individual parental LEP

  18. Insuring quality during implementation of a SPEDT method of regional cerebral blood flow measurements into daily routine

    International Nuclear Information System (INIS)

    Mathiassen, B.; Landsfeldt, U.S.; Broechner-Mortensen, J.; Andersen, A.R.; Pedersen, B.; Roedbro, P.

    1995-01-01

    The present aim was to describe a method for quality insurance when a previously experimental technique is implemented for daily clinical use. Regional cerebral blood flow (rCBF) was studied in 24 patients with medically intractable complex partial epilepsy using SPECT of the Tc99m-HMPAO distribution. The colour-coded rCBF images were evaluated visually four times by four observers who classified each data set into one of four ranked classes (normal, slightly - , median - or severely abnormal). The visual analysis was compared to the results obtained by an expert (the standard). After two evaluation rounds a teaching session of image interpretation was performed with emphasis on the most difficult problem cases. The results of the primary evaluation and the yield of the teaching round was assessed by error-points depending on the magnitude of the misinterpretation of each data set. Interobserver discrepancies was analyzed by Friedman's test of variance, while intra-observer variability was evaluated by Wilcoxon's paired non-parametric test. The teaching round improved the performance of the four observers significantly (p=0.0004), but not to the wanted quality standard for all observers. The reproducibility was improved in all, but not significantly. The insurance of quality during implementation of a new diagnostic method can thus be performed in a simple way providing the steering team with identification of problems, as well as inspiration to solution of critical problems. The presented quality insurance method can easily be performed when other imaging modalities are started or when quality control of a routine method is needed. (au)

  19. GLOBE Observer: A new tool to bring science activities and measurements home

    Science.gov (United States)

    Riebeek Kohl, H.; Murphy, T.

    2016-12-01

    The Global Learning and Observations to Benefit the Environment (GLOBE) Program is an international science and education program that provides students and the public worldwide with the opportunity to participate in data collection and the scientific process, and contribute meaningfully to our understanding of the Earth system and global environment. For more than 20 years, GLOBE-trained teachers have been leading environmental data collection and student research in the classroom. In 2016, GLOBE expanded to invite data collection from citizen scientists of all ages through a simple smart phone app. The app makes it possible for students to take GLOBE data (environmental observations) outside of school with their families. It enables a museum, park, youth organization, or other informal institution to provide a simple take-home activity that will keep patrons engaged in environmental science from home. This presentation will provide a demonstration of the app and will provide examples of its use in informal settings.

  20. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes.

    Directory of Open Access Journals (Sweden)

    Kayoko Ichikawa

    Full Text Available Birth outcomes, such as preterm birth, low birth weight (LBW, and small for gestational age (SGA, are crucial indicators of child development and health.To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes.In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14-19 years old, women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964, which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311 and included in the analysis. Data were analyzed between January and June 2014.In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98 and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92 compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5.Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA.

  1. The Effect of Daily Self-Measurement of Pressure Pain Sensitivity Followed by Acupressure on Depression and Quality of Life versus Treatment as Usual in Ischemic Heart Disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Bech, Per

    2014-01-01

    -measurement of PPS twice daily followed by acupressure as mandatory action, aiming at a reduction in PPS. Primary endpoint: change in depressive symptoms as measured by Major depression inventory (MDI). Other endpoints: changes in PPS, Well-being (WHO-5) and mental and physical QOL (SF-36). RESULTS: At 3 months PPS......BACKGROUND: Depressive symptoms and reduced quality of life (QOL) are parts of the chronic stress syndrome and predictive of adverse outcome in patients with ischemic heart disease (IHD). Chronic stress is associated with increased sensitivity for pain, which can be measured by algometry...... as Pressure Pain Sensitivity (PPS) on the sternum. AIM: To evaluate if stress focus by self-measurement of PPS, followed by stress reducing actions including acupressure, can decrease depressive symptoms and increase psychological well-being in people with stable IHD. DESIGN: Observer blinded randomized...

  2. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    Science.gov (United States)

    Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN; Block, J; Borok, N; Burton, T; Chamlin, SL; Deckert, S; DeKlotz, CC; Graff, LB; Hanifin, JM; Hebert, AA; Humphreys, R; Katoh, N; Kisa, RM; Margolis, DJ; Merhand, S; Minnillo, R; Mizutani, H; Nankervis, H; Ohya, Y; Rodgers, P; Schram, ME; Stalder, JF; Svensson, A; Takaoka, R; Teper, A; Tom, WL; von Kobyletzki, L; Weisshaar, E; Zelt, S; Williams, HC

    2014-01-01

    Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6–7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure. What's already known about this topic? Many different scales have been used to measure eczema, making it difficult to compare trials in meta-analyses and hampering improvements in clinical practice. HOME core outcome measures must pass the OMERACT (Outcome Measures in Rheumatology) filter of truth (validity), discrimination (sensitivity to change and responsiveness) and feasibility (ease of use, costs, time to perform and interpret). It has been previously agreed as part of the consensus process that four domains should be measured by the core outcomes: clinical signs, patient

  3. Review of water, lighting, and cooling energy efficiency measures for low-income homes located in warm climates

    Energy Technology Data Exchange (ETDEWEB)

    Martin, M.A.; Gettings, M.B.

    1998-02-01

    In support of the U.S. Department of Energy`s Weatherization Assistance Program, Oak Ridge National Laboratory has performed a literature review of weatherization measures applicable for homes located in warm climate regions. Sources for this information included: (1) documented engineering estimates, (2) vendor information, (3) reported performance from research and field tests, and (4) direct discussions with researchers, vendors, and field reporters. Estimated savings are extrapolated from reported energy savings and applied to the end-use energy consumption for low-income homes reported by the Energy Information Administration. Additionally, installation costs, savings-to-investment ratios, and parameters indicating performance sensitivity to issues such as occupancy, construction, client education, and maintenance requirements are presented. The report is comprised of two sections: (1) an overview of measure performance, and (2) an appendix. The overview of measures is in a tabular format, which allows for quick reference. More detailed discussions and references for each measure are presented in the Appendix and it is highly recommended that these be reviewed prior to measure selection.

  4. In vivo measurements of daily UV exposure of human anterior teeth using CaF{sub 2}:Tb,Sm as a thermoluminescence dosimeter

    Energy Technology Data Exchange (ETDEWEB)

    Saito, W., E-mail: saito-wataru@tsurumi-u.ac.j [Department of Operative Dentistry, Tsurumi University, School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama (Japan); Ikejima, I. [Department of Operative Dentistry, Tsurumi University, School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama (Japan); Fukuda, Y. [Department of Urban Environment, Faculty of Human Environment, Osaka Sangyo University, 3-1-1, Nakagaito, Daito, Osaka (Japan); Momoi, Y. [Department of Operative Dentistry, Tsurumi University, School of Dental Medicine, 2-1-3, Tsurumi, Tsurumi-ku, Yokohama (Japan)

    2011-03-15

    Ultraviolet radiation (UV) has been indicated as one of the causes of discoloration of dental materials yet the standard requires that dental polymers be irradiated with light from a xenon lamp, which includes UV, to evaluate their color stability. It is doubtful that dental polymers in the mouth are exposed to large energy of UV on a daily basis, but there have been no reports concerning exposure. In the present study, we used thermoluminescence (TL) from sintered CaF{sub 2}:Tb,Sm, which is highly sensitive to UV, to measure the daily energy of UV exposure to the labial surface of the maxillary anterior teeth, which are regarded as receiving the maximum exposure among oral tissues. We produced disks of CaF{sub 2} co-doped with Tb{sub 4}O{sub 7} and Sm{sub 2}O{sub 3} (sintered CaF{sub 2}:Tb,Sm) that were 5 mm in diameter and 1 mm thick, and placed them inside glass cases that had a 7-mm external diameter, 3-mm height, and 1-mm thickness of glass made of synthetic silica with {>=}90% UV transmittance. These glass cases were fixed in dental mouthpieces in a position corresponding to the central maxillary incisors. These mouthpieces were worn by 11 subjects and UV measurements were carried out over a 24-h period in a uniform environment. The results of these TL measurements showed a TL glow peak in the region of 430 K. This was the same as that seen with irradiation from a xenon lamp as basic illumination. The daily UV radiant energy was 72.2 mJ/cm{sup 2} (32.7-143.8 mJ/cm{sup 2}), calculated from the relationship between TL intensity and UV radiant energy. This corresponded to 0.02% of the UV radiant energy contained in the light irradiation specified by ISO 4049.

  5. Measurement Properties of the Psoriasis Symptom Inventory Electronic Daily Diary in Patients with Moderate to Severe Plaque Psoriasis.

    Science.gov (United States)

    Viswanathan, Hema N; Mutebi, Alex; Milmont, Cassandra E; Gordon, Kenneth; Wilson, Hilary; Zhang, Hao; Klekotka, Paul A; Revicki, Dennis A; Augustin, Matthias; Kricorian, Gregory; Nirula, Ajay; Strober, Bruce

    2017-09-01

    The Psoriasis Symptom Inventory (PSI) is a patient-reported outcome instrument that measures the severity of psoriasis signs and symptoms. This study evaluated measurement properties of the PSI in patients with moderate to severe plaque psoriasis. This secondary analysis used pooled data from a phase 3 brodalumab clinical trial (AMAGINE-1). Outcome measures included the PSI, Psoriasis Area and Severity Index (PASI), static Physician's Global Assessment (sPGA), psoriasis-affected body surface area, 36-item Short-Form Health Survey version 2, and the Dermatology Life Quality Index (DLQI). The PSI was evaluated for dimensionality, item performance, reliability (internal consistency and test-retest), construct validity, ability to detect change, and agreement between PSI response and response measures based on the PASI, sPGA, and DLQI. Results supported unidimensionality, good item fit, ordered responses, and PSI scoring. The PSI demonstrated reliability: baseline Cronbach's alpha ≥ 0.92 and intraclass correlation coefficients ≥ 0.95. Correlations between PSI total score and DLQI item 1 (r = 0.86), DLQI symptoms and feelings (r = 0.87), and 36-item Short-Form Health Survey version 2 bodily pain (r = -0.61) supported convergent validity. PSI scores differed significantly (P 10%), and DLQI (≤ 5/> 5) at weeks 8 and 12. At week 12, the PSI detected significant changes in severity based on PASI responses (psoriasis signs and symptoms. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. The short-term effects of effort-reward imbalance : Daily and within-day psychological and physiological measurements

    NARCIS (Netherlands)

    Hanson, E.K.S.

    2000-01-01

    In the present thesis, the short-term effects of Effort-Reward Imbalance (ERI) are studied by measuring indices of vagal control, hypothalamo-pituitary-adrenocortical (HPAC) activity and affect. The studies provide an illustration of recent developments in the field. Primarily, Ecological Momentary

  7. The use of EORTC measures in daily clinical practice—A synopsis of a newly developed manual

    DEFF Research Database (Denmark)

    Wintner, Lisa M; Sztankay, Monika; Aaronson, Neil

    2016-01-01

    possible and to encourage readers and end-users of EORTC measures to contribute to further needed high-quality research. The manual will be accessible on the EORTC Quality of Life Group website's homepage and will be periodically updated to take into account any new knowledge due to medical, technical...

  8. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity

    NARCIS (Netherlands)

    L.M. van Bortel (Luc); S. Laurent (Stephane); P. Boutouyrie (Pierre); P. Chowienczyk (Phil); J.K. Cruickshank (Kennedy); T.L.M. de Backer (Tine); J. Filipovsky (Jan); S. Huybrechts (Sofie); F.U.S. Mattace Raso (Francesco); A.D. Protogerou (Athanase); G. Schillaci (Giuseppe); P. Segers (Patrick); S. Vermeersch (Steve); T. Weber (Thomas)

    2012-01-01

    textabstractStiffness of elastic arteries like the aorta predicts cardiovascular risk. By directly reflecting arterial stiffness, having the best predictive value for cardiovascular outcome and the ease of its measurement, carotid-femoral pulse wave velocity is now considered the gold standard for

  9. Forecasting Daily Variability of the S and P 100 Stock Index using Historical, Realised and Implied Volatility Measurements

    NARCIS (Netherlands)

    Koopman, Siem Jan; Jungbacker, Borus; Hol, Eugenie

    2004-01-01

    The increasing availability of financial market data at intraday frequencies has not only led to the development of improved volatility measurements but has also inspired research into their potential value as an information source for volatility forecasting. In this paper we explore the forecasting

  10. Forecasting daily variability of the S&P 100 stock index using historical, realised and implied volatility measurements

    NARCIS (Netherlands)

    Koopman, S.J.; Jungbacker, B.M.J.P.; Hol, E.

    2005-01-01

    The increasing availability of financial market data at intraday frequencies has not only led to the development of improved volatility measurements but has also inspired research into their potential value as an information source for volatility forecasting. In this paper, we explore the

  11. Does school physical education really contribute to accelerometer-measured daily physical activity and non sedentary behaviour in high school students?

    Science.gov (United States)

    Mayorga-Vega, Daniel; Martínez-Baena, Alejandro; Viciana, Jesús

    2018-01-11

    Physical education has been highlighted as an important environment for physical activity promotion, however, to our knowledge there are no previous studies examining the contribution of physical education to daily accelerometer-measured physical activity and non sedentary behaviour. The purpose was to compare the accelerometer-measured physical activity and sedentary behaviour between physical education, non-physical education and weekend days in adolescents. Of the 394 students from a Spanish high school that were invited to participate, 158 students (83 boys and 75 girls) aged 13-16 years were analyzed (wear time ≥ 600 min). Participants' physical activity and sedentary behaviour were objectively-measured by GT3X+ accelerometers during physical education (one session), non-physical education and weekend days. Results indicated that overall adolescents had statistically significant greater physical activity levels and lower values of sedentary behaviour on physical education days than on non-physical education and weekend days (e.g., moderate-to-vigorous physical activity = 71, 54 and 57 min; sedentary = 710, 740 and 723 min) (p education contributes significantly to reducing students' daily physical inactivity and sedentary behaviour. Increasing the number of physical education classes seems to be an effective strategy to reduce the high current prevalence of physical inactivity and sedentary behaviour in adolescence.

  12. The light spot test: Measuring anxiety in mice in an automated home-cage environment.

    Science.gov (United States)

    Aarts, Emmeke; Maroteaux, Gregoire; Loos, Maarten; Koopmans, Bastijn; Kovačević, Jovana; Smit, August B; Verhage, Matthijs; Sluis, Sophie van der

    2015-11-01

    Behavioral tests of animals in a controlled experimental setting provide a valuable tool to advance understanding of genotype-phenotype relations, and to study the effects of genetic and environmental manipulations. To optimally benefit from the increasing numbers of genetically engineered mice, reliable high-throughput methods for comprehensive behavioral phenotyping of mice lines have become a necessity. Here, we describe the development and validation of an anxiety test, the light spot test, that allows for unsupervised, automated, high-throughput testing of mice in a home-cage system. This automated behavioral test circumvents bias introduced by pretest handling, and enables recording both baseline behavior and the behavioral test response over a prolonged period of time. We demonstrate that the light spot test induces a behavioral response in C57BL/6J mice. This behavior reverts to baseline when the aversive stimulus is switched off, and is blunted by treatment with the anxiolytic drug Diazepam, demonstrating predictive validity of the assay, and indicating that the observed behavioral response has a significant anxiety component. Also, we investigated the effectiveness of the light spot test as part of sequential testing for different behavioral aspects in the home-cage. Two learning tests, administered prior to the light spot test, affected the light spot test parameters. The light spot test is a novel, automated assay for anxiety-related high-throughput testing of mice in an automated home-cage environment, allowing for both comprehensive behavioral phenotyping of mice, and rapid screening of pharmacological compounds. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Quantitative Gait Measurement With Pulse-Doppler Radar for Passive In-Home Gait Assessment

    OpenAIRE

    Wang, Fang; Skubic, Marjorie; Rantz, Marilyn; Cuddihy, Paul E.

    2014-01-01

    In this paper, we propose a pulse-Doppler radar system for in-home gait assessment of older adults. A methodology has been developed to extract gait parameters including walking speed and step time using Doppler radar. The gait parameters have been validated with a Vicon motion capture system in the lab with 13 participants and 158 test runs. The study revealed that for an optimal step recognition and walking speed estimation, a dual radar set up with one radar placed at foot level and the ot...

  14. Measuring the Cost of the Patient-Centered Medical Home: A Cost-Accounting Approach.

    Science.gov (United States)

    Lieberthal, Robert D; Payton, Colleen; Sarfaty, Mona; Valko, George

    To explore the cost for individual practices to become more patient-centered, we inventoried and calculated the cost of costly activities involved in implementing the Patient-Centered Medical Home (PCMH) as defined by the National Committee for Quality Assurance. There were 3 key findings. The cost of each PCMH-related clinical activity can be classified in 1 of 3 major categories. Cost offsets can be used to defray part of the cost recognition. The cost of PCMH transformation varied by practice with no clear level or pattern of costs. Our study suggests that small- and medium-sized practices may experience difficulty with the financial burden of PCMH recognition.

  15. Monitoring of ovarian activity by measurement of urinary excretion rates of estrone glucuronide and pregnanediol glucuronide using the Ovarian Monitor, Part II: reliability of home testing.

    Science.gov (United States)

    Blackwell, Leonard F; Vigil, Pilar; Gross, Barbara; d'Arcangues, Catherine; Cooke, Delwyn G; Brown, James B

    2012-02-01

    The UNDP/WHO/World Bank/Special Programme of Research, Development and Research Training in Human Reproduction (Geneva) set up a study to determine whether it is feasible for women to monitor their ovarian activity reliably by home testing. Daily self-monitoring of urinary hormone metabolites for menstrual cycle assessment was evaluated by comparison of results obtained with the Home Ovarian Monitor by untrained users both at home and in study centres. Women collected daily data for urinary estrone glucuronide (E1G) and pregnanediol glucuronide (PdG) for two cycles, then the procedure was repeated in the women's local centre (in Chile, Australia or New Zealand) giving a total of 113 duplicate cycles. The tests were performed without the benefit of replicates or quality controls. The home and centre cycles were normalized and compared to identify assay errors, and the resulting home and centre menstrual cycle profiles were averaged. Reliable mean cycle profiles were obtained with the home and centre excretion rates agreeing to within 36 ± 21 nmol/24 h for E1G and 0.77 ± 0.28 µmol/24 h for baseline PdG values (1-5 µmol/24 h). The cycles had a mean length of 28.1 ± 3.1 days (n = 112; 5th and 95th percentiles: 24 and 35 days, respectively), a mean follicular phase of 14.8 ± 3.1 days (n = 107; 5th and 95th percentiles: 11 and 21 days) and a mean luteal phase length of 13.3 ± 1.5 days (n = 106; 5th and 95th percentiles: 11 and 17 days), calculated from the day of the LH peak. The study confirmed that the Ovarian Monitor pre-coated assay tubes worked well even in the hands of lay users, without standard curves, quality controls or replicates. Point-of-care monitoring to give reliable fertility data is feasible.

  16. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    OpenAIRE

    Chalmers, J.R.; Simpson, E.; Apfelbacher, C.J.; Thomas, K.S.; von Kobyletzki, L.; Schmitt, J.; Singh, J.A.; Svensson, Å.; Williams, H.C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T.L.

    2016-01-01

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23–24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group a...

  17. Evaluation of Candidate Measures for Home-Based Screening of Sleep Disordered Breathing in Taiwanese Bus Drivers

    Directory of Open Access Journals (Sweden)

    Hua Ting

    2014-05-01

    Full Text Available Background: Sleepiness-at-the-wheel has been identified as a major cause of highway accidents. The aim of our study is identifying the candidate measures for home-based screening of sleep disordered breathing in Taiwanese bus drivers, instead of polysomnography. Methods: Overnight polysomnography accompanied with simultaneous measurements of alternative screening devices (pulse oximetry, ApneaLink, and Actigraphy, heart rate variability, wake-up systolic blood pressure and questionnaires were completed by 151 eligible participants who were long-haul bus drivers with a duty period of more than 12 h a day and duty shifting. Results: 63.6% of professional bus drivers were diagnosed as having sleep disordered breathing and had a higher body mass index, neck circumference, systolic blood pressure, arousal index and desaturation index than those professional bus drivers without evidence of sleep disordered breathing. Simple home-based candidate measures: (1 Pulse oximetry, oxygen-desaturation indices by ≥3% and 4% (r = 0.87~0.92; (2 Pulse oximetry, pulse-rising indices by ≥7% and 8% from a baseline (r = 0.61~0.89; and (3 ApneaLink airflow detection, apnea-hypopnea indices (r = 0.70~0.70, based on recording-time or Actigraphy-corrected total sleep time were all significantly correlated with, and had high agreement with, corresponding polysomnographic apnea-hypopnea indices [(1 94.5%~96.6%, (2 93.8%~97.2%, (3 91.1%~91.3%, respectively]. Conversely, no validities of SDB screening were found in the multi-variables apnea prediction questionnaire, Epworth Sleepiness Scale, night-sleep heart rate variability, wake-up systolic blood pressure and anthropometric variables. Conclusions: The indices of pulse oximetry and apnea flow detection are eligible criteria for home-based screening of sleep disordered breathing, specifically for professional drivers.

  18. Adding delayed recall to the ADAS-cog improves measurement precision in mild Alzheimer's disease: Implications for predicting instrumental activities of daily living.

    Science.gov (United States)

    Lowe, Deborah A; Balsis, Steve; Benge, Jared F; Doody, Rachelle S

    2015-12-01

    As research increasingly focuses on preclinical stages of Alzheimer's disease (AD), instruments must be retooled to identify early cognitive markers of AD. A supplemental delayed recall subtest for the Alzheimer's Disease Assessment Scale-cognitive (ADAS-cog; Mohs, Rosen, & Davis, 1983; Rosen, Mohs, & Davis, 1984) is commonly implemented, but it is not known precisely where along the spectrum of cognitive dysfunction this subtest yields incremental information beyond what is gained from the standard ADAS-cog, or whether it can improve prediction of functional outcomes. An item response theory approach can analyze this in a psychometrically rigorous way. Seven hundred eighty-eight patients with AD or amnestic complaints or impairment completed a battery including the ADAS-cog and 2 activities of daily living measures. The delayed recall subtest slightly improved the ADAS-cog's measurement precision in the mild range of cognitive dysfunction and increased prediction of instrumental activities of daily living for individuals with subjective memory impairment. (c) 2015 APA, all rights reserved).

  19. Daily personal exposure to black carbon: A pilot study

    Science.gov (United States)

    Williams, Ryan D.; Knibbs, Luke D.

    2016-05-01

    Continuous personal monitoring is the benchmark for air pollution exposure assessment. Black carbon (BC) is a strong marker of primary combustion like vehicle and biomass emissions. There have been few studies that quantified daily personal BC exposure and the contribution that different microenvironments make to it. In this pilot study, we used a portable aethalometer to measure BC concentrations in an individual's breathing zone at 30-s intervals while he performed his usual daily activities. We used a GPS and time-activity diary to track where he spent his time. We performed twenty 24-h measurements, and observed an arithmetic mean daily exposure concentration of 603 ng/m3. We estimated that changing commute modes from bus to train reduced the 24-h mean BC exposure concentration by 29%. Switching from open windows to closed windows and recirculated air in a car led to a reduction of 32%. Living in a home without a wood-fired heater caused a reduction of 50% compared with a wood-heated home. Our preliminary findings highlight the potential utility of simple approaches to reduce a person's daily BC exposure.

  20. Daily physical activity and screen time, but not other sedentary activities, are associated with measures of obesity during childhood.

    Science.gov (United States)

    Lee, Shoo Thien; Wong, Jyh Eiin; Shanita, Safii Nik; Ismail, Mohd Noor; Deurenberg, Paul; Poh, Bee Koon

    2014-12-23

    Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI), BMI-for-age Z-score (BAZ), body fatness (%BF) and waist circumference (WC). A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ) in all children and by pedometers in a subsample (n = 514). PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours.

  1. Daily Physical Activity and Screen Time, but Not Other Sedentary Activities, Are Associated with Measures of Obesity during Childhood

    Science.gov (United States)

    Lee, Shoo Thien; Wong, Jyh Eiin; Nik Shanita, Safii; Ismail, Mohd Noor; Deurenberg, Paul; Poh, Bee Koon

    2014-01-01

    Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI), BMI-for-age Z-score (BAZ), body fatness (%BF) and waist circumference (WC). A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF) was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ) in all children and by pedometers in a subsample (n = 514). PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours. PMID:25546277

  2. Daily Physical Activity and Screen Time, but Not Other Sedentary Activities, Are Associated with Measures of Obesity during Childhood

    Directory of Open Access Journals (Sweden)

    Shoo Thien Lee

    2014-12-01

    Full Text Available Childhood obesity is related to low physical activity level and a sedentary lifestyle. The aim of this study was to assess the physical activity level and sedentary behaviour of Malaysian children aged 7 to 12 years and to examine their association with body mass index (BMI, BMI-for-age Z-score (BAZ, body fatness (%BF and waist circumference (WC. A total of 1736 children, representing all ethnic groups were recruited from six regions of Malaysia. Anthropometric measurements included body weight, height and waist circumference. Body fat percentage (%BF was assessed using bioelectrical impedance. Physical activity was assessed by a physical activity questionnaire (PAQ in all children and by pedometers in a subsample (n = 514. PAQ score and pedometer step counts were negatively associated with BMI, BAZ, %BF and WC after adjusting for covariates. Screen time was positively associated with BAZ and WC. However, other sedentary activities were not significantly related with any anthropometric indicators. Strategies to promote active living among children in Malaysia should focus not only on increasing physical activity but also emphasise reduction in sedentary behaviours.

  3. Chronic and Daily Stressors Along With Negative Affect Interact to Predict Daily Tiredness.

    Science.gov (United States)

    Hartsell, Elizabeth N; Neupert, Shevaun D

    2017-11-01

    The present study examines the within-person relationship of daily stressors and tiredness and whether this depends on daily negative affect and individual differences in chronic stress. One hundred sixteen older adult participants were recruited via Amazon's Mechanical Turk for a 9-day daily diary study. Daily tiredness, daily stressors, and negative affect were measured each day, and chronic stress was measured at baseline. Daily stressors, daily negative affect, and chronic stress interacted to predict daily tiredness. People with high chronic stress who experienced an increase in daily negative affect were the most reactive to daily stressors in terms of experiencing an increase in daily tiredness. We also found that people with low levels of chronic stress were the most reactive to daily stressors when they experienced low levels of daily negative affect. Our results highlight the need for individualized and contextualized approaches to combating daily tiredness in older adults.

  4. The Daily Physical Activity (DPA) policy in Ontario: is it working? an examination using accelerometry-measured physical activity data.

    Science.gov (United States)

    Stone, Michelle R; Faulkner, Guy E J; Zeglen-Hunt, Laura; Bonne, Jennifer Cowie

    2012-01-01

    In 2005, the Ontario Ministry of Education announced a policy requiring that all elementary students be provided with opportunities to participate in a minimum of 20 minutes of sustained moderate-to-vigorous physical activity (MVPA) each school day during instructional time. To the authors' knowledge, this policy has never been formally evaluated. In a form of natural experiment with Project BEAT, we explored within 16 Toronto District School Board schools the proportion of children who participate in DPA, and the proportion who achieve sustained MVPA within these sessions; these are the objectives of this article. Consent was given by 1027 parents/guardians for their children to participate (boys, n=478; girls, n=549). Physical activity (PA) was measured using accelerometry and classroom schedules collected to identify sessions of DPA. The frequency of DPA and number and duration of sustained bouts of MVPA (> or =5 min) were computed and explored relative to PA levels and health outcomes. Fewer than half of the participating children were provided with DPA every day and not a single child engaged in sustained MVPA for > or =20 minutes. On the more positive side, children who engaged in DPA every day were significantly more active than their peers. Those accumulating at least 1 bout of MVPA were more active and likely to meet PA guidelines, and fewer of these children were overweight. The majority of schools are not meeting the DPA policy. However, as the frequency and intensity of DPA increases, so do positive health outcomes. This paper provides supporting evidence that when this policy is implemented, the intended health benefits are achievable.

  5. Patients with coronary stenosis and a fractional flow reserve of ≥0.75 measured in daily practice at the VU University Medical Center

    Science.gov (United States)

    Oud, N.; Marques, K.M.; Bronzwaer, J.G.F.; Brinckman, S.; Allaart, C.P.; de Cock, C.C.; Appelman, Y.

    2010-01-01

    Objectives. The aim of this study was to analyse the rate of major adverse clinical events in patients with coronary artery disease and a fractional flow reserve (FFR) of ≥0.75 and deferred for coronary intervention in daily practice. Methods. From 1 January to 31 December 2006, FFR measurement was initiated in 122 patients (5%) out of 2444 patients referred for coronary angiography. In two patients FFR measurement failed and in one patient the FFR value could no longer be traced in the documents. Thus, 119 patients (84 men, 64 years, range 41-85) were included in the evaluation (145 lesions). Major adverse clinical events (death, myocardial infarction, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG)) and the presence of angina were evaluated at follow-up. Furthermore a cost-effectiveness analysis was performed. Results. In 93 patients (76%) the FFR value was ≥0.75. Seventy of these 93 patients (76%) were treated with medication alone or underwent PCI for a different lesion (medical treatment group). Average duration of follow-up of all 119 patients was 22 months (range 4 days to 30 months). In the medical treatment group seven patients (10%) experienced a major adverse clinical event related to the FFR-evaluated lesion during follow-up. In this study population, the use of FFR measurement is cost-reducing provided that at least 65% of the patients in the medical treatment group has had a PCI with stent implantation when the use of FFR measurement is impossible. In this case, the decision to use PCI with stent implantation is purely based on the angiogram. Conclusions. In patients with a coronary stenosis based on visual assessment and an FFR of ≥0.75 deferral of PCI or CABG is safe in daily clinical practice and saves money. (Neth Heart J 2010;18:402–7.) PMID:20862234

  6. Multidimensional measures validated for home health needs of older persons: A systematic review.

    Science.gov (United States)

    de Rossi Figueiredo, Daniela; Paes, Lucilene Gama; Warmling, Alessandra Martins; Erdmann, Alacoque Lorenzini; de Mello, Ana Lúcia Schaefer Ferreira

    2018-01-01

    To conduct a systematic review of the literature on valid and reliable multidimensional instruments to assess home health needs of older persons. Systematic review. Electronic databases, PubMed/Medline, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, Scientific Electronic Library Online and the Latin American and Caribbean Health Sciences Information. All English, Portuguese and Spanish literature which included studies of reliability and validity of instruments that assessed at least two dimensions: physical, psychological, social support and functional independence, self-rated health behaviors and contextual environment and if such instruments proposed interventions after evaluation and/or monitoring changes over a period of time. Older persons aged 60 years or older. Of the 2397 studies identified, 32 were considered eligible. Two-thirds of the instruments proposed the physical, psychological, social support and functional independence dimensions. Inter-observer and intra-observer reliability and internal consistency values were 0.7 or above. More than two-thirds of the studies included validity (n=26) and more than one validity was tested in 15% (n=4) of these. Only 7% (n=2) proposed interventions after evaluation and/or monitoring changes over a period of time. Although the multidimensional assessment was performed, and the reliability values of the reviewed studies were satisfactory, different validity tests were not present in several studies. A gap at the instrument conception was observed related to interventions after evaluation and/or monitoring changes over a period of time. Further studies with this purpose are necessary for home health needs of the older persons. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Home Care Services: Questions to Ask

    Science.gov (United States)

    Healthy Lifestyle Healthy aging Home care services range from medical care to help with daily household chores. If ... 12, 2017 Original article: http://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/home-care-services/art- ...

  8. Meals in nursing homes

    DEFF Research Database (Denmark)

    Kofod, Jens Erik; Birkemose, A.

    2004-01-01

    Undernutrition is present among 33% of nursing home residents in Denmark. Hence, it is relevant to examine the meal situation at nursing homes to single out factors that may increase or reduce the residents' food intake. in the ongoing Danish nursing home debate it is claimed that a new type...... of nursing home improves the residents' meal situation with a positive effect on nutrition. The aim of this work is to test the general hypothesis that (i) residents appreciate the meal situation in these nursing homes and (ii) nutritional status of the residents is improved in this type of nursing home....... This study was carried out in four Danish nursing homes at various locations in Denmark. The methods used are qualitative interviews and observations at four nursing homes in combination with measurement of body mass index (BMI) at two of the four nursing homes. Undernutrition is defined as a BMI below 20...

  9. Development and validation of a condition-specific diary to measure severity, bothersomeness and impact on daily activities for patients with acute urinary tract infection in primary care

    DEFF Research Database (Denmark)

    Holm, Anne; Cordoba, Gloria; Siersma, Volkert

    2017-01-01

    Background: Urinary tract infection (UTI) is a common condition in primary care. Patient-reported outcome measures (PROMs) are crucial in the evaluation of interventions to improve diagnosis, treatment and prognosis of UTI. The aim of this study was to identify an existing condition-specific PROM...... for polytomous items in a cohort of 451 women participating in two studies regarding UTI. Results: No existing PROM fulfilled the inclusion criteria. Content validation resulted in one domain concerning symptom severity (18 items), one concerning bothersomeness (18 items), and one concerning impact on daily...... activities (7 items). Psychometrical validation resulted in four dimensions in each of the first two domains and one dimension in the third domain. Conclusions: Domains were not unidimensional, which meant that we identified dimensions of patient-experienced UTI that differed substantially from those...

  10. 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.

  11. Walking Behavior of Zoo Elephants: Associations between GPS-Measured Daily Walking Distances and Environmental Factors, Social Factors, and Welfare Indicators.

    Directory of Open Access Journals (Sweden)

    Matthew R Holdgate

    Full Text Available Research with humans and other animals suggests that walking benefits physical health. Perhaps because these links have been demonstrated in other species, it has been suggested that walking is important to elephant welfare, and that zoo elephant exhibits should be designed to allow for more walking. Our study is the first to address this suggestion empirically by measuring the mean daily walking distance of elephants in North American zoos, determining the factors that are associated with variations in walking distance, and testing for associations between walking and welfare indicators. We used anklets equipped with GPS data loggers to measure outdoor daily walking distance in 56 adult female African (n = 33 and Asian (n = 23 elephants housed in 30 North American zoos. We collected 259 days of data and determined associations between distance walked and social, housing, management, and demographic factors. Elephants walked an average of 5.3 km/day with no significant difference between species. In our multivariable model, more diverse feeding regimens were correlated with increased walking, and elephants who were fed on a temporally unpredictable feeding schedule walked 1.29 km/day more than elephants fed on a predictable schedule. Distance walked was also positively correlated with an increase in the number of social groupings and negatively correlated with age. We found a small but significant negative correlation between distance walked and nighttime Space Experience, but no other associations between walking distances and exhibit size were found. Finally, distance walked was not related to health or behavioral outcomes including foot health, joint health, body condition, and the performance of stereotypic behavior, suggesting that more research is necessary to determine explicitly how differences in walking may impact elephant welfare.

  12. Validity of Garmin Vívofit and Polar Loop for measuring daily step counts in free-living conditions in adults

    Directory of Open Access Journals (Sweden)

    Adam Šimůnek

    2016-09-01

    Full Text Available Background: Wrist activity trackers (WATs are becoming popular and widely used for the monitoring of physical activity. However, the validity of many WATs in measuring steps remains unknown. Objective: To determine the validity of the following WATs: Garmin Vívofit (Vívofit and Polar Loop (Loop, by comparing them with well-validated devices, Yamax Digiwalker SW-701 pedometer (Yamax and hip-mounted ActiGraph GT3X+ accelerometer (ActiGraph, in healthy adults. Methods: In free-living conditions, adult volunteers (N = 20 aged 25 to 52 years wore two WATs (Vívofit and Loop with Yamax and ActiGraph simultaneously over a 7 day period. The validity of Vívofit and Loop was assessed by comparing each device with the Yamax and ActiGraph, using a paired samples t-test, mean absolute percentage errors, intraclass correlation coefficients (ICC and Bland-Altman plots. Results: The differences between average steps per day were significant for all devices, except the difference between Vívofit and Yamax (p = .06; d = 0.2. Compared with Yamax and ActiGraph, the mean absolute percentage errors of Vívofit were -4.0% and 12.5%, respectively. For Loop the mean absolute percentage error was 8.9% compared with Yamax and 28.0% compared with ActiGraph. Vívofit showed a very strong correlation with both Yamax and ActiGraph (ICC = .89. Loop showed a very strong correlation with Yamax (ICC = .89 and a strong correlation with ActiGraph (ICC = .70. Conclusions: Vívofit showed higher validity than Loop in measuring daily step counts in free-living conditions. Loop appears to overestimate the daily number of steps in individuals who take more steps during a day.

  13. Walking Behavior of Zoo Elephants: Associations between GPS-Measured Daily Walking Distances and Environmental Factors, Social Factors, and Welfare Indicators.

    Science.gov (United States)

    Holdgate, Matthew R; Meehan, Cheryl L; Hogan, Jennifer N; Miller, Lance J; Soltis, Joseph; Andrews, Jeff; Shepherdson, David J

    2016-01-01

    Research with humans and other animals suggests that walking benefits physical health. Perhaps because these links have been demonstrated in other species, it has been suggested that walking is important to elephant welfare, and that zoo elephant exhibits should be designed to allow for more walking. Our study is the first to address this suggestion empirically by measuring the mean daily walking distance of elephants in North American zoos, determining the factors that are associated with variations in walking distance, and testing for associations between walking and welfare indicators. We used anklets equipped with GPS data loggers to measure outdoor daily walking distance in 56 adult female African (n = 33) and Asian (n = 23) elephants housed in 30 North American zoos. We collected 259 days of data and determined associations between distance walked and social, housing, management, and demographic factors. Elephants walked an average of 5.3 km/day with no significant difference between species. In our multivariable model, more diverse feeding regimens were correlated with increased walking, and elephants who were fed on a temporally unpredictable feeding schedule walked 1.29 km/day more than elephants fed on a predictable schedule. Distance walked was also positively correlated with an increase in the number of social groupings and negatively correlated with age. We found a small but significant negative correlation between distance walked and nighttime Space Experience, but no other associations between walking distances and exhibit size were found. Finally, distance walked was not related to health or behavioral outcomes including foot health, joint health, body condition, and the performance of stereotypic behavior, suggesting that more research is necessary to determine explicitly how differences in walking may impact elephant welfare.

  14. Daily Course of CO2 Fluxes in the Atmosphere-Water System and Variable Fluorescence of Phytoplankton during the Open-Water Period for Lake Baikal according to Long-Term Measurements

    Science.gov (United States)

    Zavoruev, V. V.; Domysheva, V. M.; Pestunov, D. A.; Sakirko, M. V.; Panchenko, M. V.

    2018-04-01

    The process of gas exchange of CO2 in the atmosphere-water system and its relation to the daily course of variable fluorescence of phytoplankton is studied on the basis of long-term (2004-2014) measurements during the open water period for Lake Baikal. It is found that the decrease in photosynthetic activity of plankton is almost synchronous to the increase in the CO2 flux from atmosphere to water. It follows from comparison of the spring and summer data with December measurements that the daily decrease in variable fluorescence of phytoplankton is caused by the internal daily rhythm of the photosynthetic activity of plankton.

  15. Contribution of various microenvironments to the daily personal exposure to ultrafine particles: Personal monitoring coupled with GPS tracking

    Science.gov (United States)

    Bekö, Gabriel; Kjeldsen, Birthe Uldahl; Olsen, Yulia; Schipperijn, Jasper; Wierzbicka, Aneta; Karottki, Dorina Gabriela; Toftum, Jørn; Loft, Steffen; Clausen, Geo

    2015-06-01

    Exposure to ultrafine particles (UFP) may have adverse health effects. Central monitoring stations do not represent the personal exposure to UFP accurately. Few studies have previously focused on personal exposure to UFP. Sixty non-smoking residents living in Copenhagen, Denmark were asked to carry a backpack equipped with a portable monitor, continuously recording particle number concentrations (PN), in order to measure the real-time individual exposure over a period of ˜48 h. A GPS logger was carried along with the particle monitor and allowed us to estimate the contribution of UFP exposure occurring in various microenvironments (residence, during active and passive transport, other indoor and outdoor environments) to the total daily exposure. On average, the fractional contribution of each microenvironment to the daily integrated personal exposure roughly corresponded to the fractions of the day the subjects spent in each microenvironment. The home environment accounted for 50% of the daily personal exposure. Indoor environments other than home or vehicles contributed with ˜40%. The highest median UFP concentration was obtained during passive transport (vehicles). However, being in transit or outdoors contributed 5% or less to the daily exposure. Additionally, the subjects recorded in a diary the periods when they were at home. With this approach, 66% of the total daily exposure was attributable to the home environment. The subjects spent 28% more time at home according to the diary, compared to the GPS. These results may indicate limitations of using diaries, but also possible inaccuracy and miss-classification in the GPS data.

  16. Quality of care in one Italian nursing home measured by ACOVE process indicators.

    Directory of Open Access Journals (Sweden)

    Claudia Pileggi

    Full Text Available To adapt the Assessing Care of Vulnerable Elders Quality Indicators (ACOVE QIs for use in Italy, to assess the adherence to these indicators as reported in the medical records of residents in a nursing home (NH, to compare this adherence for general medical and geriatric conditions, and eventually, to identify the relationships between patients' characteristics and reported processes of care.Two physicians collected the data by reviewing medical records of all NH residents in the previous 5 years, for a period of one year. Patients aged <65 years were excluded. A total of 245 patients were reviewed during the study period. The ACOVE QIs set, developed for NH processes of care, was used to assess the quality of care. Multivariate analysis was performed to identify and to assess the role of patients' characteristics on quality of processes of care by several domains of care in general medical and geriatric conditions.With the exception of diabetes management, quality of processes of care for general medical conditions approached adequate adherence. Care falls substantially short of acceptable levels for geriatric conditions (pressure ulcers, falls, dementia. On the contrary, the recommended interventions for urinary incontinence were commonly performed. Adherence to indicators varied for the different domains of care and was proven worse for the screening and prevention indicators both for geriatric and general medical conditions. Statistical analysis showed disparities in provision of appropriate processes of care associated with gender, age, co-morbidities, level of function and mobility, length of stay and modality of discharge by NHs.Adherence to recommended processes of care delivered in NH is inadequate. Substantial work lies ahead for the improvement of care. Efforts should focus particularly on management of geriatric conditions and on preventive healthcare.

  17. Home built equipment for measuring Hall coefficient and charge carrier concentration, mobility and resistivity

    DEFF Research Database (Denmark)

    Borup, Kasper Andersen; Christensen, Mogens; Blichfeld, Anders Bank

    2011-01-01

    der Pauw method. The commercial availability of these systems is limited and they are usually not optimized for measurements on samples which show properties characteristic of thermoelectric materials. We give an assessment of the reliability of the measurements and a comparison with a commercial...

  18. Mining the Home Environment

    Science.gov (United States)

    Cook, Diane J.; Krishnan, Narayanan

    2014-01-01

    Individuals spend a majority of their time in their home or workplace and for many, these places are our sanctuaries. As society and technology advance there is a growing interest in improving the intelligence of the environments in which we live and work. By filling home environments with sensors and collecting data during daily routines, researchers can gain insights on human daily behavior and the impact of behavior on the residents and their environments. In this article we provide an overview of the data mining opportunities and challenges that smart environments provide for researchers and offer some suggestions for future work in this area. PMID:25506128

  19. Mining the Home Environment.

    Science.gov (United States)

    Cook, Diane J; Krishnan, Narayanan

    2014-12-01

    Individuals spend a majority of their time in their home or workplace and for many, these places are our sanctuaries. As society and technology advance there is a growing interest in improving the intelligence of the environments in which we live and work. By filling home environments with sensors and collecting data during daily routines, researchers can gain insights on human daily behavior and the impact of behavior on the residents and their environments. In this article we provide an overview of the data mining opportunities and challenges that smart environments provide for researchers and offer some suggestions for future work in this area.

  20. OPPORTUNISTIC ASPERGILLUS PATHOGENS MEASURED IN HOME AND HOSPITAL TAP WATER BY MOLD SPECIFIC QUANTITATIVE PCR (MSQPCR)

    Science.gov (United States)

    Opportunistic fungal pathogens are a concern because of the increasing number of immunocompromised patients. The goal of this research was to test a simple extraction method and rapid quantitative PCR (QPCR) measurement of the occurrence of potential pathogens, Aspergillus fumiga...

  1. Infiltration and air quality in well-insulated homes: 3. measurement and modeling of pollutant levels

    International Nuclear Information System (INIS)

    Koontz, M.D.; Nagda, N.L.

    1984-01-01

    Indoor pollutant levels in well-insulated houses are being investigated in a 2-year theoretical and experimental study involving the simultaneous measurement of meteorological variables, air exchange and circulation, and energy consumption. This paper describes concentrations of radon, radon progeny, formaldehyde, carbon monoxide, and nitrogen oxides observed in two houses over two seasons, summer and fall 1983. Two companion papers provide a perspective on the problem and the study design, and present results of energy use and infiltration measurements. (Author)

  2. Long-term measurements of respirable sulfates and particulates inside and outside homes

    Energy Technology Data Exchange (ETDEWEB)

    Spengler, J D; Dockery, D W; Turner, W A; Wolfson, J M; Ferris, B G

    1981-01-01

    To better understand the health effects of air pollution, the results of extensive indoor and outdoor measurements of mass respirable particulates and water-soluble respirable particulates are analyzed. The measurements were taken in six U.S. citiesPortage, Wis./ Topeka, Kans./ Kingston/Harriman, Tenn./ Watertown, Mass./ St. Louis, Mo./ and Steubenville, Ohio. Results indicated that the major source of indoor air pollution is cigarette smoke, which contributes about 20

  3. Cosmic ray research in Hanoi: The Auger experiment and measurements made at home

    International Nuclear Information System (INIS)

    Pham Ngoc Dinh; Nguyen Tien Dung; Bui Duc Hieu; Nguyen Phuc; Pham Trung Phuong; Darriulat, Pierre; Dang Quang Thieu; Thuan Vo Van

    2003-01-01

    The VATLY is a new laboratory in Hanoi dedicated to research in the field of comic ray physics. Its various activities are briefly reviewed. The vertical cosmic muon flux has been measured using a segmented scintillator hodoscope and the results have been published in Ref. [1]. An orientable scintillation telescope has been constructed for measurement of the zenith angle dependence of the muon flux, of which preliminary results are reported here. They are in good agreement with the predictions of air shower model

  4. Cosmic ray research in Hanoi: The Auger experiment and measurements made at home

    Energy Technology Data Exchange (ETDEWEB)

    Pham Ngoc Dinh; Nguyen Tien Dung; Bui Duc Hieu; Nguyen Phuc; Pham Trung Phuong; Darriulat, Pierre; Dang Quang Thieu; Thuan Vo Van

    2003-07-14

    The VATLY is a new laboratory in Hanoi dedicated to research in the field of comic ray physics. Its various activities are briefly reviewed. The vertical cosmic muon flux has been measured using a segmented scintillator hodoscope and the results have been published in Ref. [1]. An orientable scintillation telescope has been constructed for measurement of the zenith angle dependence of the muon flux, of which preliminary results are reported here. They are in good agreement with the predictions of air shower model.

  5. Daily Patterns of Preschoolers’ Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study

    Directory of Open Access Journals (Sweden)

    Vicky Van Stappen

    2018-02-01

    Full Text Available This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain, aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers’ step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4 was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs (p < 0.01 and clearly reflected the kindergartens’ daily schedules, except for Germany. For example, low numbers of steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers.

  6. Development and Examination of a Family Triadic Measure to Examine Quality of Life Family Congruence in Nursing Home Residents and Two Family Members.

    Science.gov (United States)

    Aalgaard Kelly, Gina

    2015-01-01

    Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes . Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC).

  7. Testing objective measures of motor impairment in early Parkinson's disease: Feasibility study of an at-home testing device.

    Science.gov (United States)

    Goetz, Christopher G; Stebbins, Glenn T; Wolff, David; DeLeeuw, William; Bronte-Stewart, Helen; Elble, Rodger; Hallett, Mark; Nutt, John; Ramig, Lorraine; Sanger, Terence; Wu, Allan D; Kraus, Peter H; Blasucci, Lucia M; Shamim, Ejaz A; Sethi, Kapil D; Spielman, Jennifer; Kubota, Ken; Grove, Andrew S; Dishman, Eric; Taylor, C Barr

    2009-03-15

    We tested the feasibility of a computer based at-home testing device (AHTD) in early-stage, unmedicated Parkinson's disease (PD) patients over 6 months. We measured compliance, technical reliability, and patient satisfaction to weekly assessments of tremor, small and large muscle bradykinesia, speech, reaction/movement times, and complex motor control. relative to the UPDRS motor score. The AHTD is a 6.5'' x 10'' computerized assessment battery. Data are stored on a USB memory stick and sent by internet to a central data repository as encrypted data packets. Although not designed or powered to measure change, the study collected data to observe patterns relative to UPDRS motor scores. Fifty-two PD patients enrolled, and 50 completed the 6 month trial, 48 remaining without medication. Patients complied with 90.6% of weekly 30-minute assessments, and 98.5% of data packets were successfully transmitted and decrypted. On a 100-point scale, patient satisfaction with the program at study end was 87.2 (range: 80-100). UPDRS motor scores significantly worsened over 6 months, and trends for worsening over time occurred for alternating finger taps (P = 0.08), tremor (P = 0.06) and speech (P = 0.11). Change in tremor was a significant predictor of change in UPDRS (P = 0.047) and was detected in the first month of the study. This new computer-based technology offers a feasible format for assessing PD-related impairment from home. The high patient compliance and satisfaction suggest the feasibility of its incorporation into larger clinical trials, especially when travel is difficult and early changes or frequent data collection are considered important to document.

  8. A Home-Based Educational Intervention Improves Patient Activation Measures and Diabetes Health Indicators among Zuni Indians.

    Directory of Open Access Journals (Sweden)

    Vallabh O Shah

    Full Text Available One in three people will be diagnosed with diabetes by 2050, and the proportion will likely be higher among Native Americans. Diabetes control is currently suboptimal in underserved populations despite a plethora of new therapies. Patient empowerment is a key determinant of diabetes control, but such empowerment can be difficult to achieve due to resource limitation and cultural, language and health literacy barriers. We describe a home-based educational intervention using Community Health Representatives (CHRs, leading to improvement in Patient Activation Measures scores and clinical indicators of diabetes control.Sixty participants with type 2 diabetes (T2D completed a baseline evaluation including physical exam, Point of Care (POC testing, and the Patient Activation Measure (PAM survey. Participants then underwent a one hour group didactic session led by Community Health Representatives (CHRs who subsequently carried out monthly home-based educational interventions to encourage healthy lifestyles, including diet, exercise, and alcohol and cigarette avoidance until follow up at 6 months, when clinical phenotyping and the PAM survey were repeated.PAM scores were increased by at least one level in 35 (58% participants, while 24 participants who started at higher baseline score did not change. Six months after intervention, mean levels of A1C decreased by 0.7 ± 1.2%; fasting blood glucose decreased by 24.0 ± 38.0 mg/dl; BMI decreased by 1.5 ± 2.1 kg/m2; total cholesterol decreased by 12.0 ± 28.0 mg/dl; and triglycerides decreased by 52.0 ± 71.0 mg/dl. All of these changes were statistically significant (p < 0.05.This six month, CHR led and community-oriented educational intervention helps inform standards of practice for the management of diabetes, engages diabetic populations in their own care, and reduces health disparities for the underserved population of Zuni Indians.ClinicalTrials.gov NCT02339311.

  9. Examination of Direct Discharge Measurement Data and Historic Daily Data for Selected Gages on the Middle Mississippi River, 1861-2008

    Science.gov (United States)

    Huizinga, Richard J.

    2009-01-01

    An examination of data from two continuous stage and discharge streamgages and one continuous stage-only gage on the Middle Mississippi River was made to determine stage-discharge relation changes through time and to investigate cause-and-effect mechanisms through evaluation of hydraulic geometry, channel elevation and water-surface elevation data. Data from discrete, direct measurements at the streamgages at St. Louis, Missouri, and Chester, Illinois, during the period of operation by the U.S. Geological Survey from 1933 to 2008 were examined for changes with time. Daily stage values from the streamgages at St. Louis (1861-2008) and Chester (1891-2008) and the stage-only gage at Cape Girardeau, Missouri (1896-2008), throughout the historic period of record also were examined for changes with time. Stage and discharge from measurements and stage-discharge relations at the streamgages at St. Louis and Chester indicate that stage for a given discharge has changed with time at both locations. An apparent increase in stage for a given discharge at increased flows (greater than flood stage) likely is caused by the raising of levees on the flood plains, and a decrease in stage for a given discharge at low flows (less than one-half flood stage) likely is caused by a combination of dikes in the channel that deepen the channel thalweg at the end of the dikes, and reduced sediment flux into the Middle Mississippi River. Since the 1960s at St. Louis, Missouri, the stage-discharge relations indicated no change or a decrease in stage for a given discharge for all discharges, whereas at Chester, Illinois, the stage-discharge relations indicate increasing stage for a given discharge above bankfull because of sediment infilling of the overflow channel. Top width and average velocity from measurements at a given discharge for the streamgage at St. Louis, Missouri, were relatively constant through time, with the only substantial change in top width resulting from the change in

  10. Performance of STICS model to predict rainfed corn evapotranspiration and biomass evaluated for 6 years between 1995 and 2006 using daily aggregated eddy covariance fluxes and ancillary measurements.

    Science.gov (United States)

    Pattey, Elizabeth; Jégo, Guillaume; Bourgeois, Gaétan

    2010-05-01

    Verifying the performance of process-based crop growth models to predict evapotranspiration and crop biomass is a key component of the adaptation of agricultural crop production to climate variations. STICS, developed by INRA, was part of the models selected by Agriculture and Agri-Food Canada to be implemented for environmental assessment studies on climate variations, because of its built-in ability to assimilate biophysical descriptors such as LAI derived from satellite imagery and its open architecture. The model prediction of shoot biomass was calibrated using destructive biomass measurements over one season, by adjusting six cultivar parameters and three generic plant parameters to define two grain corn cultivars adapted to the 1000-km long Mixedwood Plains ecozone. Its performance was then evaluated using a database of 40 years-sites of corn destructive biomass and yield. In this study we evaluate the temporal response of STICS evapotranspiration and biomass accumulation predictions against estimates using daily aggregated eddy covariance fluxes. The flux tower was located in an experimental farm south of Ottawa and measurements carried out over corn fields in 1995, 1996, 1998, 2000, 2002 and 2006. Daytime and nighttime fluxes were QC/QA and gap-filled separately. Soil respiration was partitioned to calculate the corn net daily CO2 uptake, which was converted into dry biomass. Out of the six growing seasons, three (1995, 1998, 2002) had water stress periods during corn grain filling. Year 2000 was cool and wet, while 1996 had heat and rainfall distributed evenly over the season and 2006 had a wet spring. STICS can predict evapotranspiration using either crop coefficients, when wind speed and air moisture are not available, or resistance. The first approach provided higher prediction for all the years than the resistance approach and the flux measurements. The dynamic of evapotranspiration prediction of STICS was very good for the growing seasons without

  11. The Youth Daily Life Before Fulfilling Socio-educational Measures of Deprivation of Liberty in Brazil: Ordinary Experiences That Are Tangent to the Inclusion in Drug Trafficking.

    Science.gov (United States)

    Costa, Luciana Assis; Rocha, Daniete Fernandes; Vieira, Gabriela; Reis, Adriene

    2016-09-01

    The aim of this paper is to demonstrate some understanding of the daily lives of young people facing socio-educational measures of incarceration, especially regarding the predisposing factors that may explain their involvement in criminal occupations and activities (Although the socio-educational measures applicable to adolescents configures as a response to committing of an offence, it has a mostly educational and not punitive character.). This is an exploratory study with a qualitative approach. The data collection instrument used was semi-structured interviews with 22 young men aged between 12 and 17 years, on condition of deprivation of freedom in four youth centres in Belo Horizonte, Minas Gerais, Brazil. The results showed that these adolescents had a way of life associated with a scarcity of resources owned by households (including little control over them, despite the efforts of their mothers); low adherence to school; limited institutional access to activities in their free time; exposure to predisposing factors to crime, such as early contact with crime through neighbourhood and family relationships; and profiting from crime. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Measure Guideline. Heat Pump Water Heaters in New and Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Shapiro, Carl [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Puttagunta, Srikanth [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Owens, Douglas [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2012-02-01

    This Building America Measure Guideline is intended for builders, contractors, homeowners, and policy-makers. This document is intended to explore the issues surrounding heat pump water heaters (HPWHs) to ensure that homeowners and contractors have the tools needed to appropriately and efficiently install HPWHs

  13. Measurement Properties of the Motivation for Youth Treatment Scale with a Residential Group Home Population

    Science.gov (United States)

    Lambert, Matthew C.; Hurley, Kristin Duppong; Tomlinson, M. Michele Athay; Stevens, Amy L.

    2013-01-01

    Background: A client's motivation to receive services is significantly related to seeking services, remaining in services, and improved outcomes. The Motivation for Youth Treatment Scale (MYTS) is one of the few brief measures used to assess motivation for mental health treatment. Objective: To investigate if the psychometric properties of the…

  14. Measuring Dust Emission from the Mojave Desert (USA) by Daily Remote-Camera Observations and Wind-Erosion Measurements: Bearing on "Unseen" Sources and Global Dust Abundance

    Science.gov (United States)

    Reynolds, R. L.; Urban, F.; Goldstein, H. L.; Fulton, R.

    2017-12-01

    A large gap in understanding the effects of atmospheric dust at all spatial scales is uncertainty about how much and whence dust is emitted annually. Digital recording of dust emission at high spatial and temporal resolution would, together with periodic flux measurements, support improved estimates of local-scale dust flux where infrastructure could support remote internet enabled cameras. Such recording would also elucidate wind-erosion dynamics when combined with meteorological data. Remote camera recording of dust-emitting settings on and around Soda Lake (Mojave Desert) was conducted every 15 minutes during daylight between 10 Nov. 2010 and 31 Dec. 2016 and images uploaded to a web server. Examination of 135,000 images revealed frequent dust events, termed "dust days" when plumes obscured mountains beyond source areas. Such days averaged 68 (sd=10) per year (2011 through 2016). We examined satellite retrievals (MODIS, GOES) for dust events during six cloudless days of highest and longest duration dust emission but none were observed. From Apr. 2000 through May 2013, aeolian sediments collected at three sites were sampled and weighed. Estimates of the emitted mass of silt- and clay-size fractions were made on the basis of measured horizontal mass flux, particle sizes of sediment in collectors, and roughly determined areas of dust generation. Over this period, nearly 4 Tg yr-1 of dust (as particulate matter flood in the basin in late Dec. 2010 that deposited flood sediment across the lake basin. Increased emission was likely related to the availability of fresh, unanchored flood sediment. Within the Mojave and Great Basin deserts of North America, many settings akin to those at Soda Lake similarly emit dust that is rarely detected in satellite retrievals. These findings strongly imply that local and regional dust emissions from western North America are far underestimated and that, by extension to relatively small dust-source areas across all drylands, global

  15. Levels of naturally occurring gamma radiation measured in British homes and their prediction in particular residences

    Energy Technology Data Exchange (ETDEWEB)

    Kendall, G.M. [University of Oxford, Cancer Epidemiology Unit, Oxford (United Kingdom); Wakeford, R. [University of Manchester, Centre for Occupational and Environmental Health, Institute of Population Health, Manchester (United Kingdom); Athanson, M. [University of Oxford, Bodleian Library, Oxford (United Kingdom); Vincent, T.J. [University of Oxford, Childhood Cancer Research Group, Oxford (United Kingdom); Carter, E.J. [University of Worcester, Earth Heritage Trust, Geological Records Centre, Henwick Grove, Worcester (United Kingdom); McColl, N.P. [Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, Didcot, Oxon (United Kingdom); Little, M.P. [National Cancer Institute, DHHS, NIH, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States)

    2016-03-15

    Gamma radiation from natural sources (including directly ionising cosmic rays) is an important component of background radiation. In the present paper, indoor measurements of naturally occurring gamma rays that were undertaken as part of the UK Childhood Cancer Study are summarised, and it is shown that these are broadly compatible with an earlier UK National Survey. The distribution of indoor gamma-ray dose rates in Great Britain is approximately normal with mean 96 nGy/h and standard deviation 23 nGy/h. Directly ionising cosmic rays contribute about one-third of the total. The expanded dataset allows a more detailed description than previously of indoor gamma-ray exposures and in particular their geographical variation. Various strategies for predicting indoor natural background gamma-ray dose rates were explored. In the first of these, a geostatistical model was fitted, which assumes an underlying geologically determined spatial variation, superimposed on which is a Gaussian stochastic process with Matern correlation structure that models the observed tendency of dose rates in neighbouring houses to correlate. In the second approach, a number of dose-rate interpolation measures were first derived, based on averages over geologically or administratively defined areas or using distance-weighted averages of measurements at nearest-neighbour points. Linear regression was then used to derive an optimal linear combination of these interpolation measures. The predictive performances of the two models were compared via cross-validation, using a randomly selected 70 % of the data to fit the models and the remaining 30 % to test them. The mean square error (MSE) of the linear-regression model was lower than that of the Gaussian-Matern model (MSE 378 and 411, respectively). The predictive performance of the two candidate models was also evaluated via simulation; the OLS model performs significantly better than the Gaussian-Matern model. (orig.)

  16. Levels of naturally occurring gamma radiation measured in British homes and their prediction in particular residences

    International Nuclear Information System (INIS)

    Kendall, G.M.; Wakeford, R.; Athanson, M.; Vincent, T.J.; Carter, E.J.; McColl, N.P.; Little, M.P.

    2016-01-01

    Gamma radiation from natural sources (including directly ionising cosmic rays) is an important component of background radiation. In the present paper, indoor measurements of naturally occurring gamma rays that were undertaken as part of the UK Childhood Cancer Study are summarised, and it is shown that these are broadly compatible with an earlier UK National Survey. The distribution of indoor gamma-ray dose rates in Great Britain is approximately normal with mean 96 nGy/h and standard deviation 23 nGy/h. Directly ionising cosmic rays contribute about one-third of the total. The expanded dataset allows a more detailed description than previously of indoor gamma-ray exposures and in particular their geographical variation. Various strategies for predicting indoor natural background gamma-ray dose rates were explored. In the first of these, a geostatistical model was fitted, which assumes an underlying geologically determined spatial variation, superimposed on which is a Gaussian stochastic process with Matern correlation structure that models the observed tendency of dose rates in neighbouring houses to correlate. In the second approach, a number of dose-rate interpolation measures were first derived, based on averages over geologically or administratively defined areas or using distance-weighted averages of measurements at nearest-neighbour points. Linear regression was then used to derive an optimal linear combination of these interpolation measures. The predictive performances of the two models were compared via cross-validation, using a randomly selected 70 % of the data to fit the models and the remaining 30 % to test them. The mean square error (MSE) of the linear-regression model was lower than that of the Gaussian-Matern model (MSE 378 and 411, respectively). The predictive performance of the two candidate models was also evaluated via simulation; the OLS model performs significantly better than the Gaussian-Matern model. (orig.)

  17. Using spontaneous commentary of nursing home residents to develop resident-centered measurement tools: A case study.

    Science.gov (United States)

    Bangerter, Lauren R; Abbott, Katherine; Heid, Allison; Eshraghi, Karen; Van Haitsma, Kimberly

    Nursing home (NH) residents routinely complete surveys that assess their health, well-being, preferences, and care needs. Such surveys reveal important information, however, are largely based on the concerns of providers as opposed to the concerns of residents. Thus, researchers must enhance efforts to ensure that these surveys are guided by the priorities, needs, and concerns of residents. We present a case study to demonstrate how spontaneous commentary of NH residents holds particular efficacy for ensuring that measurement tools are guided by the needs, concerns, and priorities of residents. Spontaneous comments from NH residents (N = 370) collected as part of a study developing the Preferences for Everyday Living Inventory for NH residents (PELI-NH) were used to refine the PELI-NH across key phases of measurement development. This work demonstrates how the spontaneous commentary of NH residents may contribute to the refinement of NH measurement tools, and allow researchers to base these tools on the needs and priorities of NH residents. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. How can whole house fiscal measures encourage consumers to improve the energy efficiency of their homes?

    International Nuclear Information System (INIS)

    Waterson, Elaine

    2005-01-01

    Over recent years energy efficiency markets in the UK have shown significant growth in the sale of energy efficient white goods and, more recently, efficient boilers. However, despite significant incentives available through energy supplier EEC programmes (a market mechanism), insulation markets have shown limited growth. In particular, cavity wall insulation - the largest single household energy efficiency opportunity in the UK - is difficult to sell. It is a discretionary purchase and not a priority for most consumers. To date UK fiscal measures for energy efficiency have been designed specifically to tackle barriers to the purchase of defined products, including insulation, rather than to tackle the energy efficiency of the house as a whole. For example contractor installed insulation already benefits from 5% VAT, but this is of little or no benefit where insulation is installed for free or is highly subsidised. This paper considers how a more holistic fiscal approach could stimulate consumer action on measures that have, to date, been difficult to sell. Specifically a fiscal approach that focuses on the energy efficiency of the house as a whole. In the context of introduction of the energy report in 2006, under the Energy Performance of Buildings Directive, this paper i) identifies a number of promising new fiscal measures, ii) discusses the prospects for their future success and iii) sets out the contribution that their introduction could make to the UK government's climate change targets and its sustainable energy agenda

  19. Relevance to Home Blood Pressure Monitoring Protocol of Blood Pressure Measurements Taken Before First- Morning Micturition and in the Afternoon

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Monteiro de Almeida

    2014-10-01

    Full Text Available Background: The importance of measuring blood pressure before morning micturition and in the afternoon, while working, is yet to be established in relation to the accuracy of home blood pressure monitoring (HBPM. Objective: To compare two HBPM protocols, considering 24-hour ambulatory blood pressure monitoring (wakefulness ABPM as gold-standard and measurements taken before morning micturition (BM and in the afternoon (AM, for the best diagnosis of systemic arterial hypertension (SAH, and their association with prognostic markers. Methods: After undergoing 24-hour wakefulness ABPM, 158 participants (84 women were randomized for 3- or 5-day HBPM. Two variations of the 3-day protocol were considered: with measurements taken before morning micturition and in the afternoon (BM+AM; and with post-morning-micturition and evening measurements (PM+EM. All patients underwent echocardiography (for left ventricular hypertrophy - LVH and urinary albumin measurement (for microalbuminuria - MAU. Result: Kappa statistic for the diagnosis of SAH between wakefulness-ABPM and standard 3-day HBPM, 3-day HBPM (BM+AM and (PM+EM, and 5-day HBPM were 0.660, 0.638, 0.348 and 0.387, respectively. The values of sensitivity of (BM+AM versus (PM+EM were 82.6% × 71%, respectively, and of specificity, 84.8% × 74%, respectively. The positive and negative predictive values were 69.1% × 40% and 92.2% × 91.2%, respectively. The comparisons of intraclass correlations for the diagnosis of LVH and MAU between (BM+AM and (PM+EM were 0.782 × 0.474 and 0.511 × 0.276, respectively. Conclusions: The 3 day-HBPM protocol including measurements taken before morning micturition and during work in the afternoon showed the best agreement with SAH diagnosis and the best association with prognostic markers.

  20. Search for buildings with high radon levels in Sweden: measurements carried out by local authorities in both older and newly built homes

    International Nuclear Information System (INIS)

    Swedjemark, G.A.

    1988-01-01

    Local authorities in Sweden have made about 58,000 radon daughter measurements with the following aims: (1) to search for houses with high radon daughter levels, (2) to determine the level above which the house would be regarded as an insanitary dwelling, and (3) to check that the radon daughter concentrations in newly built houses are below the established limit. The sampling of dwellings is therefore not representative for Swedish homes. 5300 homes were found to have levels above the limit 400 Bq.m -3 EER. The highest level found was 28,000 Bq.m -3 . In about one third of the homes found to have levels exceeding the limit, measures had been carried out to decrease the radon daughter concentration. About half of the homes in which the levels were decreased had levels below the limit for rebuilding, e.g. 200 Bq.m -3 . Measurements in order to ascertain levels in newly built houses were made in about 1100 homes out of 200,000 built since 1981 which was the year in which requirements for newly built houses came into force. Of those built with radon-protective foundations, 94% had concentrations below the 70 Bq.m -3 EER limit, compared to 80% for traditional building techniques. (author)

  1. Factors influencing quit attempts among male daily smokers in China.

    Science.gov (United States)

    Zhao, Luhua; Song, Yang; Xiao, Lin; Palipudi, Krishna; Asma, Samira

    2015-12-01

    China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation analyses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking-related variables affected making a quit attempt. An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15-24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Factors influencing quit attempts among male daily smokers in China✩

    Science.gov (United States)

    Zhao, Luhua; Song, Yang; Xiao, Lin; Palipudi, Krishna; Asma, Samira

    2015-01-01

    Background China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. Methods The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation anal yses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking related variables affected making a quit attempt. Results An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15–24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. Conclusion Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. PMID:26441296

  3. Using existing population-based data sets to measure the American Academy of Pediatrics definition of medical home for all children and children with special health care needs.

    Science.gov (United States)

    Bethell, Christina D; Read, Debra; Brockwood, Krista

    2004-05-01

    National health goals include ensuring that all children have a medical home. Historically, medical home has been determined by the presence of a usual or primary source of care, such as a pediatrician or a family physician. More recent definitions expand on this simplistic notion of medical home. A definition of medical home set forth by the American Academy of Pediatrics (AAP) includes 7 dimensions and 37 discrete concepts for determining the presence of a medical home for a child. Standardized methods to operationalize these definitions for purposes of national, state, health plan, or medical practice level reporting on the presence of medical homes for children are essential to assessing and improving health care system performance in this area. The objective of this study was to identify methods to measure the presence of medical homes for all children and for children with special health care needs (CSHCN) using existing population-based data sets. Methods were developed for using existing population-based data sets to assess the presence of medical homes, as defined by the AAP, for children with and without special health care needs. Data sets evaluated included the National Survey of Children With Special Health Care Needs, the National Medical Expenditures Panel Survey, the Consumer Assessment of Health Plans Study Child Survey (CAHPS), and the Consumer Assessment of Health Plans Study Child Survey--Children With Chronic Conditions (CAHPS-CCC2.0H). Alternative methods for constructing measures using existing data were compared and results used to inform the design of a new method for use in the upcoming National Survey of Children's Health. Data from CAHPS-CCC2.0H are used to illustrate measurement options and variations in the overall presence of medical homes for children across managed health care plans as well as to evaluate in which areas of the AAP definition of medical home improvements may be most needed for all CSHCN. Existing surveys vary in

  4. The Parental Bonding Instrument: A psychometric measure to assess parenting practices in the homes in Bangladesh.

    Science.gov (United States)

    Karim, A K M Rezaul; Begum, Taslima

    2017-02-01

    There is growing importance of the Parental Bonding Instrument (PBI) in clinical practice and research on parenting and parental bonding. Since the development of this diagnostic tool (Parker et al., Brit. J. Med. Psycho.1979; 52:1-10), a number of validation studies have been done in various cultures. The aim of the present study was to translate the measure into Bangla and validate in Bangladeshi culture. A total of 200 adolescents participated in the study. Exploratory factor analysis (EFA) of the data from 191 participants (who provided complete responses) identified a two-factor (Care and Overprotection) structure of the PBI with 17 items. The two factors together explained 44.18% of the total variance. The factors showed moderate to very high internal consistency (Cronbach's α=0.863 for Care; 0.622 for Overprotection), and very strong convergent and discriminant validity as evident by their correlations with the measures of cognitive distortions and antisocial behaviors. In line with the original tool we defined four types of parenting style, such as Affectionate constraint, Affectionless control, Optimal parenting, and Neglectful parenting. This study opens the door of future research on parenting practices and parent-child relationships in Bangladesh. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. The Harmonising Outcome Measures for Eczema (HOME) statement to assess clinical signs of atopic eczema in trials.

    Science.gov (United States)

    Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S; Simpson, Eric; Furue, Masutaka; Deckert, Stefanie; Dohil, Magdalene; Apfelbacher, Christian; Singh, Jasvinder A; Chalmers, Joanne; Williams, Hywel C

    2014-10-01

    The lack of core outcome sets for atopic eczema (AE) is a major obstacle for advancing evidence-based treatment. The global Harmonising Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE trials. This article deals with the standardization of measurement instruments to assess clinical signs of AE. To resolve the current lack of standardization of the assessment of clinical signs of AE, we followed a structured process of systematic reviews and international consensus sessions to identify 1 core outcome measurement instrument for assessment of clinical signs in all future AE trials. Systematic reviews indicated that from 16 different instruments identified to assess clinical signs of AE, only the Eczema Area and Severity Index (EASI) and the objective Scoring Atopic Dermatitis (SCORAD) index were identified as extensively validated. The EASI has adequate validity, responsiveness, internal consistency, and intraobserver reliability. The objective SCORAD index has adequate validity, responsiveness, and interobserver reliability but unclear intraobserver reliability to measure clinical signs of AE. In an international consensus study, patients, physicians, nurses, methodologists, and pharmaceutical industry representatives agreed that the EASI is the preferred core instrument to measure clinical signs in all future AE trials. All stakeholders involved in designing, reporting, and using clinical trials on AE are asked to comply with this consensus to enable better evidence-based decision making, clearer scientific communication, and improved patient care. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. CDC WONDER: Daily Fine Particulate Matter

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Daily Fine Particulate Matter data available on CDC WONDER are geographically aggregated daily measures of fine particulate matter in the outdoor air, spanning...

  7. Daily Patterns of Preschoolers' Objectively Measured Step Counts in Six European Countries: Cross-Sectional Results from the ToyBox-Study.

    Science.gov (United States)

    Van Stappen, Vicky; Van Dyck, Delfien; Latomme, Julie; De Bourdeaudhuij, Ilse; Moreno, Luis; Socha, Piotr; Iotova, Violeta; Koletzko, Berthold; Manios, Yannis; Androutsos, Odysseas; Cardon, Greet; De Craemer, Marieke

    2018-02-07

    This study is part of the ToyBox-study, which is conducted in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain), aiming to develop a cost-effective kindergarten-based, family-involved intervention to prevent overweight and obesity in four- to six-year-old preschool children. In the current study, we aimed to examine and compare preschoolers' step count patterns, across the six European countries. A sample of 3578 preschoolers (mean age: 4.8 ± 0.4) was included. Multilevel analyses were performed to take clustering of measurements into account. Based on the average hourly steps, step count patterns for the six European countries were created for weekdays and weekend days. The step count patterns during weekdays were related to the daily kindergarten schedules. Step count patterns during weekdays showed several significant peaks and troughs ( p steps were observed during afternoon naptimes and high numbers of steps during recess. In Germany, step count patterns did not show clear peaks and troughs, which can be explained by a less structured kindergarten schedule. On weekend days, differences in step count patterns were observed in the absolute number of steps in the afternoon trough and the period in which the evening peak occurred. Differences in step count patterns across the countries can be explained by differences in (school) policy, lifestyle habits, and culture. Therefore, it might be important to respond to these step count patterns and more specifically to tackle the inactive periods during interventions to promote physical activity in preschoolers.

  8. SIMADL: Simulated Activities of Daily Living Dataset

    Directory of Open Access Journals (Sweden)

    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.

  9. Home Network Security

    NARCIS (Netherlands)

    Scholten, Hans; van Dijk, Hylke

    2008-01-01

    Service discovery and secure and safe service usage are essential elements in the deployment of home and personal networks. Because no system administrator is present, setup and daily operation of such a network has to be automated as much as possible with a high degree of user friendliness. To

  10. Pilot Implementation of a Field Study Design to Evaluate the Impact of Source Control Measures on Indoor Air Quality in High Performance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Widder, Sarah H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chamness, Michele A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Petersen, Joseph M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Maddalena, Randy L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Destaillats, Hugo [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Russell, M. L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-10-01

    To improve the indoor air quality in new, high performance homes, a variety of standards and rating programs have been introduced to identify building materials that are designed to have lower emission rates of key contaminants of concern and a number of building materials are being introduced that are certified to these standards. For example, the U.S. Department of Energy (DOE) Zero Energy Ready Home program requires certification under the U.S. Environmental Protection Agency (EPA) Indoor airPLUS (IaP) label, which requires the use of PS1 or PS2 certified plywood and OSB; low-formaldehyde emitting wood products; low- or no-VOC paints and coatings as certified by Green Seal Standard GS-11, GreenGuard, SCS Indoor Advantage Gold Standard, MPI Green Performance Standard, or another third party rating program; and Green Label-certified carpet and carpet cushions. However, little is known regarding the efficacy of the IAP requirements in measurably reducing contaminant exposures in homes. The goal of this project is to develop a robust experimental approach and collect preliminary data to support the evaluation of indoor air quality (IAQ) measures linked to IAP-approved low-emitting materials and finishes in new residential homes. To this end, the research team of Pacific Northwest National Laboratory (PNNL) and Lawrence Berkeley National Laboratory (LBNL) developed a detailed experimental plan to measure IAQ constituents and other parameters, over time, in new homes constructed with materials compliant with IAP’s low-emitting material and ventilation requirements (i.e., section 6.1, 6.2, 6.3, and 7.2) and similar homes constructed to the state building code with conventional materials. The IAQ in IAP and conventional homes of similar age, location, and construction style is quantified as the differences in the speciated VOC and aldehyde concentrations, normalized to dilution rates. The experimental plan consists of methods to evaluate the difference between low

  11. Home Care

    Science.gov (United States)

    ... are part of home healthcare agencies. You may benefit from home care if you are dealing with ... it will trigger an emergency response or checkup phone call. Newer technologies ... or mobile testing technology (home diagnostics), including x-rays and ...

  12. Children's perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: a qualitative and quantitative study.

    Science.gov (United States)

    Hume, C; Salmon, J; Ball, K

    2005-02-01

    Environmental factors may have an important influence on children's physical activity, yet children's perspectives of their home and neighborhood environments have not been widely assessed. The aim of this study was to investigate children's perceptions of their environments, and to examine associations between these perceptions and objectively measured physical activity. The sample consisted of 147, 10-year-old Australian children, who drew maps of their home and neighborhood environments. A subsample of children photographed places and things in these environments that were important to them. The maps were analyzed for themes, and for the frequency with which particular objects and locations appeared. Physical activity was objectively measured using accelerometers. Six themes emerged from the qualitative analysis of the maps and photographs: the family home; opportunities for physical activity and sedentary pursuits; food items and locations; green space and outside areas; the school and opportunities for social interaction. Of the 11 variables established from these themes, one home and two neighborhood factors were associated with children's physical activity. These findings contribute to a broader understanding of children's perceptions of their environment, and highlight the potential importance of the home and neighborhood environments for promoting physical activity behavior.

  13. 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

    2016-01-01

    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 nursing home model, has shown positive psychological outcomes. However, little is known about whether the Green House nursing home model has positive effects on physical function compared to traditional nursing homes. To examine the longitudinal effects of the Green House nursing home model by comparing change patterns of activities of daily living function over time between Green House home residents and traditional nursing home residents. A retrospective longitudinal study. Four Green House organizations (nine Green House units and four traditional units). A total of 242 residents (93 Green House residents and 149 traditional home residents) who had stayed in the nursing home at least 6 months from admission. The outcome was activities of daily living function, and the main independent variable was the facility type in which the resident stayed: a Green House 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. The mean activities of daily living function showed deterioration over time, and the rates of deterioration between Green House and traditional home residents were not different over time. Four different activities of daily living 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. Although Green House nursing homes are

  14. Improvement of a questionnaire measuring activity limitations in rising and sitting down in patients with lower-extremity disorders living at home

    NARCIS (Netherlands)

    Roorda, LD; Molenaar, IW; Lankhorst, GJ; Bouter, LM

    2005-01-01

    Objective: To improve a self-administered questionnaire that includes 42 dichotomous items and measures activity limitations in rising and sitting down (R&S) in patients with lower-extremity disorders who live at home. Design: Cross-sectional study. Setting: Outpatient clinics of secondary and

  15. Measuring activity limitations in walking : Development of a hierarchical scale for patients with lower-extremity disorders who live at home

    NARCIS (Netherlands)

    Roorda, LD; Roebroeck, ME; van Tilburg, T; Molenaar, IW; Lankhorst, GJ; Bouter, LM

    2005-01-01

    Objective: To develop a hierarchical scale that measures activity limitations in walking in patients with lower-extremity disorders who live at home. Design: Cross-sectional study. Setting: Orthopedic workshops and outpatient clinics of secondary and tertiary care centers. Participants: Patients

  16. Nursing home Facebook reviews: who has them, and how do they relate to other measures of quality and experience?

    Science.gov (United States)

    Gaudet Hefele, Jennifer; Li, Yue; Campbell, Lauren; Barooah, Adrita; Wang, Joyce

    2018-02-01

    The growing use of social media creates opportunities for patients and families to provide feedback and rate individual healthcare providers. Whereas previous studies have examined this emerging trend in hospital and physician settings, little is known about user ratings of nursing homes (NHs) and how these ratings relate to other measures of quality. To examine the relationship between Facebook user-generated NH ratings and other measures of NH satisfaction/experience and quality. This study compared Facebook user ratings of NHs in Maryland (n=225) and Minnesota (n=335) to resident/family satisfaction/experience survey ratings and the Centers for Medicare and Medicaid (CMS) 5-star NH report card ratings. Overall, 55 NHs in Maryland had an official Facebook page, of which 35 provided the opportunity for users to rate care in the facility. In Minnesota, 126 NHs had a Facebook page, of which 78 allowed for user ratings. NHs with higher aid staffing levels, not affiliated with a chain and located in higher income counties were more likely to have a Facebook page. Facebook ratings were not significantly correlated with the CMS 5-star rating or survey-based resident/family satisfaction ratings. Given the disconnect between Facebook ratings and other, more scientifically grounded measures of quality, concerns about the validity and use of social media ratings are warranted. However, it is likely consumers will increasingly turn to social media ratings of NHs, given the lack of consumer perspective on most state and federal report card sites. Thus, social media ratings may present a unique opportunity for healthcare report cards to capture real-time consumer voice. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care.

    Science.gov (United States)

    Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew

    2018-06-01

    The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.

  18. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    DEFF Research Database (Denmark)

    Chalmers, J. R.; Simpson, Elizabeth M; Apfelbacher, C. J.

    2016-01-01

    and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group and small group discussions. Small groups were allocated a priori to ensure representation of different...... in addition to their frequency. Much of the discussion on quality of life concerned the Dermatology Life Quality Index and Quality of Life Index for Atopic Dermatitis; however, consensus on a preferred instrument for measuring this domain could not be reached. In summary, POEM is recommended as the HOME core...

  19. Measurements of daily urinary uranium excretion in German peacekeeping personnel and residents of the Kosovo region to assess potential intakes of depleted uranium (DU)

    International Nuclear Information System (INIS)

    Oeh, U.; Priest, N.D.; Roth, P.; Ragnarsdottir, K.V.; Li, W.B.; Hoellriegl, V.; Thirlwall, M.F.; Michalke, B.; Giussani, A.; Schramel, P.; Paretzke, H.G.

    2007-01-01

    Following the end of the Kosovo conflict, in June 1999, a study was instigated to evaluate whether there was a cause for concern of health risk from depleted uranium (DU) to German peacekeeping personnel serving in the Balkans. In addition, the investigations were extended to residents of Kosovo and southern Serbia, who lived in areas where DU ammunitions were deployed. In order to assess a possible DU intake, both the urinary uranium excretion of volunteer residents and water samples were collected and analysed using inductively coupled plasma-mass spectrometry (ICP-MS). More than 1300 urine samples from peacekeeping personnel and unexposed controls of different genders and age were analysed to determine uranium excretion parameters. The urine measurements for 113 unexposed subjects revealed a daily uranium excretion rate with a geometric mean of 13.9 ng/d (geometric standard deviation (GSD) = 2.17). The analysis of 1228 urine samples from the peacekeeping personnel resulted in a geometric mean of 12.8 ng/d (GSD = 2.60). It follows that both unexposed controls and peacekeeping personnel excreted similar amounts of uranium. Inter-subject variation in uranium excretion was high and no significant age-specific differences were found. The second part of the study monitored 24 h urine samples provided by selected residents of Kosovo and adjacent regions of Serbia compared to controls from Munich, Germany. Total uranium and isotope ratios were measured in order to determine DU content. 235 U/ 238 U ratios were within ± 0.3% of the natural value, and 236 U/ 238 U was less than 2 x 10 -7 , indicating no significant DU in any of the urine samples provided, despite total uranium excretion being relatively high in some cases. Measurements of ground and tap water samples from regions where DU munitions were deployed did not show any contamination with DU, except in one sample. It is concluded that both peacekeeping personnel and residents serving or living in the Balkans

  20. The role of geriatric assessment tests and anthropometric measurements in identifying the risk of falls in elderly nursing home residents

    Science.gov (United States)

    Yardimci, Bulent; Aran, Sinan N.; Ozkaya, Ismail; Aksoy, Sevki M.; Demir, Tarik; Tezcan, Gulsen; Kaptanoglu, Aysegul Y.

    2016-01-01

    Objectives: To determine the relation among the risk of falls, geriatric assessment, and anthropometric measurements, including the mini mental state examination, geriatric depression scale, handgrip test, and key pinch test. Methods: This prospective study included 89 residents hospitalized between May 2014 and September 2015 in the geriatric care unit of the Istanbul Balikli Rum Hospital, Istanbul, Turkey. Patients were followed-up for one year, and their falls were recorded. Medical records of the included patients were retrieved and analyzed. Results: A total of 89 patients, comprising 37 men and 52 women with an average age of 75.8 ± 8.2 years were included in the study. The residents’ annual falling averages were 1.0 ± 1.5. The most significant factors were identified to be predicted muscle mass, skeletal muscle index, whole body bioimpedance, dominant arm muscle strength, dominant arm bioimpedance, and free fat mass. Conclusions: The mini mental test, geriatric depression scale and lawton-brody scale combined with the handgrip, 6-meters walking, and bioimpedance tests are favorable for detecting the risk of falls and recurrent falls in vulnerable elderly nursing home residents. PMID:27652361

  1. Associations between seasonal meteorological conditions and the daily step count of adults in Yokohama, Japan: Results of year-round pedometer measurements in a large population

    Directory of Open Access Journals (Sweden)

    Kimihiro Hino

    2017-12-01

    Full Text Available People's year-round interpersonal step count variations according to meteorological conditions are not fully understood, because complete year-round data from a sufficient sample of the general population are difficult to acquire. This study examined the associations between meteorological conditions and objectively measured step counts using year-round data collected from a large cohort (N=24,625 in Yokohama, Japan from April 2015 to March 2016.Two-piece linear regression analysis was used to examine the associations between the monthly median daily step count and three meteorological indices (mean values of temperature, temperature-humidity index (THI, and net effective temperature (NET.The number of steps per day peaked at temperatures between 19.4 and 20.7°C. At lower temperatures, the increase in steps per day was between 46.4 and 52.5 steps per 1°C increase. At temperatures higher than those at which step counts peaked, the decrease in steps per day was between 98.0 and 187.9 per 1°C increase. Furthermore, these effects were more obvious in elderly than non-elderly persons in both sexes. A similar tendency was seen when using THI and NET instead of temperature. Among the three meteorological indices, the highest R2 value with step counts was observed with THI in all four groups.Both high and low meteorological indices discourage people from walking and higher values of the indices adversely affect step count more than lower values, particularly among the elderly. Among the three indices assessed, THI best explains the seasonal fluctuations in step counts. Keywords: Elderly, Developed countries, Health policy, Humidity, Linear regression, Physical activity, Temperature

  2. Can we measure daily tobacco consumption in remote indigenous communities? Comparing self-reported tobacco consumption with community-level estimates in an Arnhem Land study.

    Science.gov (United States)

    Clough, Alan R; MacLaren, David J; Robertson, Jan A; Ivers, Rowena G; Conigrave, Katherine M

    2011-03-01

    In remote Indigenous Australian communities measuring individual tobacco use can be confounded by cultural expectations, including sharing. We compared self-reported tobacco consumption with community-level estimates in Arnhem Land (Northern Territory). In a cross-sectional survey in three communities (population 2319 Indigenous residents, aged ≥16 years), 400 Indigenous residents were interviewed (206 men, 194 women). Eight community stores provided information about tobacco sold during the survey. To gauge the impact of 255 non-Indigenous residents on tobacco turnover, 10 were interviewed (five men, five women). Breath carbon monoxide levels confirmed self-reported smoking. Self-reported number of cigarettes smoked per day was compared with daily tobacco consumption per user estimated using amounts of tobacco sold during 12 months before the survey (2007-2008). 'Lighter smokers' (Indigenous study participants, 305 (76%) used tobacco; four chewed tobacco. Of 301 Indigenous smokers, 177 (58%) provided self-reported consumption information; a median of 11-11.5 cigarettes per day in men and 5.5-10 cigarettes per day in women. Men were three times (odds ratio=2.9) more likely to be 'heavier smokers'. Store turnover data indicated that Indigenous tobacco users consumed the equivalent of 9.2-13.1 cigarettes per day; very similar to self-reported levels. Sixty per cent (=6/10) of non-Indigenous residents interviewed were smokers, but with little impact on tobacco turnover overall (2-6%). Smoking levels reported by Indigenous Australians in this study, when sharing tobacco was considered, closely reflected quantities of tobacco sold in community stores. © 2010 Australasian Professional Society on Alcohol and other Drugs.

  3. Measuring sustainable homes

    DEFF Research Database (Denmark)

    Olesen, Gitte Gylling Hammershøj; Knudstrup, Mary-Ann; Heiselberg, Per

    2011-01-01

    Paperet studerer Active House Visionen og Active House Specifikation ”work-in-progress” for at identificere parametre til måling af fremtidens bæredygtig hjem. Fremgangsmåde er baseret på Mixed Methods Research strategi hvor målingerne er relateret til både kvantitative og kvalitative aspekter i...

  4. Homing oneself

    DEFF Research Database (Denmark)

    Winther, Ida Wentzel

    2009-01-01

    What is home? A building, a physical and mental phenomenon, or a concept?  There are many homes and ways `to home oneself´. Many of us quite often dwell in other places than at home (as professional commuters between two places, as travellers staying in hotels, as children of divorced parents...

  5. Evaluation and adjustment of description of denitrification in the DailyDayCent and COUP models based on N2 and N2O laboratory incubation system measurements

    Science.gov (United States)

    Grosz, Balázs; Well, Reinhard; Dannenmann, Michael; Dechow, René; Kitzler, Barbara; Michel, Kerstin; Reent Köster, Jan

    2017-04-01

    data-sets are needed in view of the extreme spatio-temporal heterogeneity of denitrification. DASIM will provide such data based on laboratory incubations including measurement of N2O and N2 fluxes and determination of the relevant drivers. Here, we present how we will use these data to evaluate common biogeochemical process models (DailyDayCent, Coup) with respect to modeled NO, N2O and N2 fluxes from denitrification. The models are used with different settings. The first approximation is the basic "factory" setting of the models. The next step would show the precision in the results of the modeling after adjusting the appropriate parameters from the result of the measurement values and the "factory" results. The better adjustment and the well-controlled input and output measured parameters could provide a better understanding of the probable scantiness of the tested models which will be a basis for future model improvement.

  6. Managing Daily Life

    Science.gov (United States)

    ... Duchenne / Managing Daily Life Print Email Managing Daily Life Environmental accessibility As the person with Duchenne starts ... such as wider doorways and ramps, can make life easier once the person with Duchenne cannot climb ...

  7. Daily Weather Records

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These daily weather records were compiled from a subset of stations in the Global Historical Climatological Network (GHCN)-Daily dataset. A weather record is...

  8. Prediction of Advisability of Returning Home Using the Home Care Score

    Directory of Open Access Journals (Sweden)

    Akiyoshi Matsugi

    2015-01-01

    Full Text Available Purpose. The aim of this study was to assess whether the home care score (HCS, which was developed by the Ministry of Health and Welfare in Japan in 1992, is useful for the prediction of advisability of home care. Methods. Subjects living at home and in assisted-living facilities were analyzed. Binominal logistic regression analyses, using age, sex, the functional independence measure score, and the HCS, along with receiver operating characteristic curve analyses, were conducted. Findings/Conclusions. Only HCS was selected for the regression equation. Receiver operating characteristic curve analysis revealed that the area under the curve (0.9, sensitivity (0.82, specificity (0.83, and positive predictive value (0.84 for HCS were higher than those for the functional independence measure, indicating that the HCS is a powerful predictor for advisability of home care. Clinical Relevance. Comprehensive measurements of the condition of provided care and the activities of daily living of the subjects, which are included in the HCS, are required for the prediction of advisability of home care.

  9. Prediction of Advisability of Returning Home Using the Home Care Score

    Science.gov (United States)

    Matsugi, Akiyoshi; Tani, Keisuke; Tamaru, Yoshiki; Yoshioka, Nami; Yamashita, Akira; Mori, Nobuhiko; Oku, Kosuke; Ikeda, Masashi; Nagano, Kiyoshi

    2015-01-01

    Purpose. The aim of this study was to assess whether the home care score (HCS), which was developed by the Ministry of Health and Welfare in Japan in 1992, is useful for the prediction of advisability of home care. Methods. Subjects living at home and in assisted-living facilities were analyzed. Binominal logistic regression analyses, using age, sex, the functional independence measure score, and the HCS, along with receiver operating characteristic curve analyses, were conducted. Findings/Conclusions. Only HCS was selected for the regression equation. Receiver operating characteristic curve analysis revealed that the area under the curve (0.9), sensitivity (0.82), specificity (0.83), and positive predictive value (0.84) for HCS were higher than those for the functional independence measure, indicating that the HCS is a powerful predictor for advisability of home care. Clinical Relevance. Comprehensive measurements of the condition of provided care and the activities of daily living of the subjects, which are included in the HCS, are required for the prediction of advisability of home care. PMID:26491568

  10. Examining Racial and Ethnic Differences in Nursing Home Quality.

    Science.gov (United States)

    Hefele, Jennifer Gaudet; Ritter, Grant A; Bishop, Christine E; Acevedo, Andrea; Ramos, Candi; Nsiah-Jefferson, Laurie A; Katz, Gabrielle

    2017-11-01

    Identifying racial/ethnic differences in quality is central to identifying, monitoring, and reducing disparities. Although disparities across all individual nursing home residents and disparities associated with between-nursing home differences have been established, little is known about the degree to which quality of care varies by race//ethnicity within nursing homes. A study was conducted to measure within-facility differences for a range of publicly reported nursing home quality measures. Resident assessment data on approximately 15,000 nursing homes and approximately 3 million residents (2009) were used to assess eight commonly used and publicly reported long-stay quality measures: the proportion of residents with weight loss, with high-risk and low-risk pressure ulcers, with incontinence, with depressive symptoms, in restraints daily, and who experienced a urinary tract infection or functional decline. Each measure was stratified by resident race/ethnicity (non-Hispanic white, non-Hispanic black, and Hispanic), and within-facility differences were examined. Small but significant differences in care on average were found, often in an unexpected direction; in many cases, white residents were experiencing poorer outcomes than black and Hispanic residents in the same facility. However, a broad range of differences in care by race/ethnicity within nursing homes was also found. The results suggest that care is delivered equally across all racial/ethnic groups in the same nursing home, on average. The results support the call for publicly reporting stratified nursing home quality measures and suggest that nursing home providers should attempt to identify racial/ethnic within-facility differences in care. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  11. Daily lifestyles in the fog and haze weather.

    Science.gov (United States)

    Cai, Dong-Ping; He, Yong-Ming

    2016-01-01

    China is being plagued by a large-scaled lasting fog and haze, under which people have to work and live. Therefore, it matters to do what we can to minimize the adverse impact of the fog and haze on individual health on a daily basis. Relative literatures on the fog and haze have been searched and reviewed. Particular attention has been paid to the literatures on the adverse impact of the fog and haze on the people's health and on the ways minimizing this impact. Coming across the weather of fog and haze, appropriate measures taken can minimize its adverse impact on individuals on a daily basis. The measures included vitamin intake, water drinking, air cleaning indoors, stay-at-home, and mask wearing outdoors. These measures are simple and proven effective. Simple and effective measures seem to be sufficient to minimizing the adverse impact of the fog and haze on the individual's health on a daily basis. Lifestyle changes, awareness of environment protection, energy conservation, and new and clean energy use are ultimate ways to curb the air pollution and reduce the occurrence of the fog and haze.

  12. Home, Smart Home

    DEFF Research Database (Denmark)

    Hansen, Ellen Kathrine; Olesen, Gitte Gylling Hammershøj; Mullins, Michael

    2013-01-01

    The article places focus on how smart technologies integrated in a one family- home and particular the window offer unique challenges and opportunities for designing buildings with the best possible environments for people and nature. Toward an interdisciplinary approach, we address the interaction...... between daylight defined in technical terms and daylight defined in aesthetic, architectural terms. Through field-tests of a Danish carbon-neutral home and an analysis of five key design parameters, we explore the contradictions and potentials in smart buildings, using the smart window as example of how...... to the energy design is central. The study illuminates an approach of the design of smart houses as living organisms by connecting technology with the needs of the occupants with the power and beauty of daylight....

  13. Factors associated with home hazards: Findings from the Malaysian Elders Longitudinal Research study.

    Science.gov (United States)

    Romli, Muhammad H; Tan, Maw P; Mackenzie, Lynette; Lovarini, Meryl; Kamaruzzaman, Shahrul B; Clemson, Lindy

    2018-03-01

    Previous studies have investigated home hazards as a risk factor for falls without considering factors associated with the presence of home hazards. The present study aimed to determine patterns of home hazards among urban community-dwelling older Malaysians, and to identify factors contributing to home hazards. Cross-sectional data from the initial wave of the Malaysian Elders Longitudinal Research study were used. Basic demographics were obtained from the Global Questionnaire. Basic and instrumental activities of daily living were measured using the Katz and Lawton-Brody scales, and home hazards were identified using the Home Falls and Accidents Screening Tool. Participants were also asked if they had fallen in the previous 12 months. Data were analyzed from 1489 participants. Hazards were frequently identified (>30%) in the toilet and bathroom areas (no grab rail, no non-slip mat, distant toilet), slippery floors, no bedside light access and inappropriate footwear. Lower educational attainment, traditional housing, Chinese ethnicity, greater number of home occupants, lower monthly expenditure, poor vision and younger age were the factors independently associated with home hazards. This study provides evidence that home hazards are a product of the interaction of the individual's function within their home environment. Hazards are also influenced by local sociocultural and environmental factors. The relationship between home hazards and falls appears complex and deserves further evaluation. Geriatr Gerontol Int 2018; 18: 387-395. © 2017 Japan Geriatrics Society.

  14. Home-based Healthcare Technology

    DEFF Research Database (Denmark)

    Verdezoto, Nervo

    of these systems target a specific treatment or condition and might not be sufficient to support the care management work at home. Based on a case study approach, my research investigates home-based healthcare practices and how they can inform future design of home-based healthcare technology that better account......Sustaining daily, unsupervised healthcare activities in non-clinical settings such as the private home can challenge, among others, older adults. To support such unsupervised care activities, an increasingly number of reminders and monitoring systems are being designed. However, most...

  15. Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk.

    Science.gov (United States)

    Tisher, Kristen; Mann, Kimberly; VanDyke, Sarah; Johansson, Charity; Vallabhajosula, Srikant

    2018-03-05

    Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention.

  16. Introduction of assistive devices: home nurses' practices and beliefs.

    Science.gov (United States)

    Roelands, Marc; Van Oost, Paulette; Depoorter, Anne Marie; Buysse, Ann; Stevens, Veerle

    2006-04-01

    This paper reports a study describing home nurses' intention and current practices regarding introducing assistive devices, and investigating whether their practice is related to social cognitive factors (attitudes, subjective norms and self-efficacy). Home nurses not only care for patients in particular medical domains, but also educate and guide them towards more independence. Patients with age-related disabilities in mobility and self-care might benefit from the use of assistive devices. A home nurse might be the first and only person to discuss the disability and use of an assistive device. Therefore, home nurses' beliefs about the introduction of assistive devices could affect their daily practices. A cross-sectional study was conducted with a convenience sample of 64 home nurses chosen from a random sample of home nursing departments. The home nurses completed a self-administered questionnaire. The Theory of Planned Behaviour framework was used to develop the social cognitive measures regarding each of the six steps distinguished in the introduction of assistive devices. Home nurses had positive attitudes and high levels of intention, subjective norm and self-efficacy towards most steps of the decision process to introduce assistive devices. In a multiple linear regression analysis, attitude and self-efficacy predicted intention to introduce assistive devices to older clients with disabilities. Intention was correlated to home nurses' current practices. The findings suggest that conditions are present to involve home nurses more explicitly in the introduction of assistive devices to their patients. Social cognitive factors should be taken into account when developing interventions that aim to support home nurses to do this.

  17. Home-Use Tests - Cholesterol

    Science.gov (United States)

    ... Medical Procedures In Vitro Diagnostics Home Use Tests Cholesterol Share Tweet Linkedin Pin it More sharing options ... a home-use test kit to measure total cholesterol. What cholesterol is: Cholesterol is a fat (lipid) ...

  18. Home range and travels

    Science.gov (United States)

    Stickel, L.F.; King, John A.

    1968-01-01

    . Peromyscus generally used and maintained several or many different home sites and refuges in various parts of their home ranges, and frequently shifted about so that their principal activities centered on different sets of holes at different times. Once established, many Peromyscus remained in the same general area for a long time, perhaps for the duration of their lives. Extent of their travels in different directions and intensity of use of different portions of their home ranges varied within a general area in response to habitat changes, loss of neighbors, or other factors. Various authors have obtained both direct and indirect evidence of territoriality, in some degree, among certain species of Peromyscus. Young mice dispersed from their birth sites to establish home ranges of their own. Adults also sometimes left their home areas; some re-established elsewhere; others returned after exploratory travels. Most populations contained a certain proportion of transients; these may have been wanderers or individuals exploring out from established home ranges or seeking new ones. When areas were depopulated by removal trapping, other Peromyscus invaded. Invasion rates generally followed seasonal trends of reproduction and population density. Peromyscus removed from their home areas and released elsewhere returned home from various distances, but fewer returned from greater distances than from nearby; speed of return increased with successive trials. The consensus from present evidence is that ho-ming is made possible by a combination of random wandering and familiarity with a larger area than the day-to-day range. Records of juvenile wanderings during the dispersal phase and of adult explorations very nearly encompassed the distances over which any substantial amount of successful homing occurred. Methods of measuring sizes of home ranges and the limitations of these measurements were discussed in brief synopsis. It was co

  19. Development and preliminary validation of a questionnaire to measure satisfaction with home care in Greece: an exploratory factor analysis of polychoric correlations

    Directory of Open Access Journals (Sweden)

    Niakas Dimitris

    2010-07-01

    Full Text Available Abstract Background The primary aim of this study was to develop and psychometrically test a Greek-language instrument for measuring satisfaction with home care. The first empirical evidence about the level of satisfaction with these services in Greece is also provided. Methods The questionnaire resulted from literature search, on-site observation and cognitive interviews. It was applied in 2006 to a sample of 201 enrollees of five home care programs in the city of Thessaloniki and contains 31 items that measure satisfaction with individual service attributes and are expressed on a 5-point Likert scale. The latter has been usually considered in practice as an interval scale, although it is in principle ordinal. We thus treated the variable as an ordinal one, but also employed the traditional approach in order to compare the findings. Our analysis was therefore based on ordinal measures such as the polychoric correlation, Kendall's Tau b coefficient and ordinal Cronbach's alpha. Exploratory factor analysis was followed by an assessment of internal consistency reliability, test-retest reliability, construct validity and sensitivity. Results Analyses with ordinal and interval scale measures produced in essence very similar results and identified four multi-item scales. Three of these were found to be reliable and valid: socioeconomic change, staff skills and attitudes and service appropriateness. A fourth dimension -service planning- had lower internal consistency reliability and yet very satisfactory test-retest reliability, construct validity and floor and ceiling effects. The global satisfaction scale created was also quite reliable. Overall, participants were satisfied -yet not very satisfied- with home care services. More room for improvement seems to exist for the socio-economic and planning aspects of care and less for staff skills and attitudes and appropriateness of provided services. Conclusions The methods developed seem to be a

  20. Breakthrough scenarios to Finnish elderly and home care diabetes treatment system with a new mHealth glucose measurement solution Mendor Balance & Mendor Smart

    OpenAIRE

    Ahola, Antti

    2016-01-01

    This paper is a qualitative market segment research of an existing product combination for monitoring blood glucose values of diabetic people with a cellular network connected device with cloud application on reporting and analysis. Research attempts to answer to four main questions. What are the current and future technological requirements from glucose measurement devices, services and diabetes home care solutions? Which specific groups of customers or other stakeholders in assisted living ...

  1. Associations among daily stressors and salivary cortisol: findings from the National Study of Daily Experiences.

    Science.gov (United States)

    Stawski, Robert S; Cichy, Kelly E; Piazza, Jennifer R; Almeida, David M

    2013-11-01

    While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1694 adults (age=57, range=33-84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30min post-waking, before lunch and before bed, on four consecutive interview days resulting in 5995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Associations among Daily Stressors and Salivary Cortisol: Findings from the National Study of Daily Experiences

    Science.gov (United States)

    Stawski, Robert S.; Cichy, Kelly E.; Piazza, Jennifer R.; Almeida, David M.

    2013-01-01

    While much research has focused on linking stressful experiences to emotional and biological reactions in laboratory settings, there is an emerging interest in extending these examinations to field studies of daily life. The current study examined day-to-day associations among naturally-occurring daily stressors and salivary cortisol in a national sample of adults from the second wave of the National Study of Daily Experiences (NSDE). A sample of 1,694 adults (Age=57, Range=33–84; 44% male) completed telephone interviews detailing their stressors and emotions on eight consecutive evenings. Participants also provided saliva samples upon waking, 30 minutes post-waking, before lunch and before bed, on four consecutive interview days resulting in 5,995 days of interview/cortisol data. Analyses revealed three main findings. First, cortisol AUC was significantly higher on stressor days compared to stressor-free days, particularly for arguments and overloads at home, suggesting that daily stressors are associated with increased cortisol output, but that not all daily stressors have such an influence. Second, individuals reporting a greater frequency of stressor days also exhibited a steeper diurnal cortisol slope. Finally, daily stressor-cortisol associations were unaltered after adjustment for daily negative affect and physical symptoms. Our discussion focuses on the influence of naturally-occurring daily stressors on daily cortisol and the role of daily diary approaches for studying healthy cortisol responses to psychosocial stressors outside of traditional laboratory settings. PMID:23856186

  3. Measuring the quality of infection control in Dutch nursing homes using a standardized method; the Infection prevention RIsk Scan (IRIS)

    NARCIS (Netherlands)

    Willemsen, I.; Nelson-Melching, J.; Hendriks, Y.; Mulders, A.; Verhoeff, S.; Kluytmans-Vandenbergh, M.; Kluytmans, J.

    2014-01-01

    BACKGROUND: We developed a standardised method to assess the quality of infection control in Dutch Nursing Home (NH), based on a cross-sectional survey that visualises the results. The method was called the Infection control RIsk Infection Scan (IRIS). We tested the applicability of this new tool in

  4. Home hemodialysis

    DEFF Research Database (Denmark)

    Agar, John W; Perkins, Anthony; Heaf, James G

    2015-01-01

    We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use.......We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use....

  5. [Aromatherapy in nursing homes].

    Science.gov (United States)

    Barré, Lucile

    2015-01-01

    Pierre Delaroche de Clisson hospital uses essential oils as part of its daily organisation for the treatment of pain and the development of palliative care. The setting up of this project, in nursing homes and long-term care units, is the fruit of a complex mission carried out by a multidisciplinary team, which had to take into account the risks involved and overcome a certain amount of reluctance. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Measured winter and spring-time indoor temperatures in UK homes over the period 1969–2010: A review and synthesis

    International Nuclear Information System (INIS)

    Vadodaria, K.; Loveday, D.L.; Haines, V.

    2014-01-01

    This paper presents a review and synthesis of average winter and spring-time indoor temperatures in UK homes measured over the period 1969–2010. Analysis of measured temperatures in a sample of solid wall dwellings in the UK, conducted as part of the CALEBRE research project, is included. The review suggests that, for periods when occupation was likely, there has been little or no increase in winter and spring-time average living room temperatures over the last 40 years, with average recorded living room temperatures having been historically lower than the WHO-recommended value of 21 °C. Correspondingly, for periods of likely occupation, average bedroom temperatures appear to have increased. Compared with non-domestic buildings, there have been fewer investigations of domestic thermal comfort, either in the UK or elsewhere, and hence the paper also calls for further detailed investigations of domestic indoor temperatures during occupied hours together with thermal comfort evaluations in order to better understand domestic thermal environments. Based on suggestions from the limited range of studies available to date, living room temperatures may need to be maintained within the range 20–22 °C for thermal satisfaction, though this requires confirmation through further research. The study also emphasises that improving the energy efficiency of homes should be the primary means to effect any increases in indoor temperatures that are deemed essential. Considerations for future policy are discussed. - Highlights: • We review indoor temperatures measured in UK homes during 1960-2010. • We present analysis of temperature recorded by our study in 20 UK homes. • Little or no increase observed in living room temperatures for the last 40 years. • Occupied bedroom temperatures appear to have increased. • Living room temperatures have been historically lower than the WHO guidelines

  7. Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

    Directory of Open Access Journals (Sweden)

    Beck Barbara-Beate

    2009-12-01

    Full Text Available Abstract Background Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care. Methods 1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings. Results Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance. Conclusions Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices

  8. Depression of home cage wheel running is an objective measure of spontaneous morphine withdrawal in rats with and without persistent pain

    Science.gov (United States)

    Kandasamy, Ram; Lee, Andrea T.; Morgan, Michael M.

    2017-01-01

    Opioid withdrawal in humans is often subtle and almost always spontaneous. In contrast, most preclinical studies precipitate withdrawal by administration of an opioid receptor antagonist such as naloxone. These animal studies rely on measurement of physiological symptoms (e.g., wet dog shakes) in the period immediately following naloxone administration. To more closely model the human condition, we tested the hypothesis that depression of home cage wheel running will provide an objective method to measure the magnitude and duration of spontaneous morphine withdrawal. Rats were allowed access to a running wheel in their home cage for 8 days prior to implantation of two 75 mg morphine or placebo pellets. The pellets were removed 3 or 5 days later to induce spontaneous withdrawal. In normal pain-free rats, removal of the morphine pellets depressed wheel running for 48 hours compared to rats that had placebo pellets removed. Morphine withdrawal-induced depression of wheel running was greatly enhanced in rats with persistent inflammatory pain induced by injection of Complete Freund’s Adjuvant (CFA) into the hindpaw. Removal of the morphine pellets following 3 days of treatment depressed wheel running in these rats for over 6 days. These data demonstrate that home cage wheel running provides an objective and more clinically relevant method to assess spontaneous morphine withdrawal compared to precipitated withdrawal in laboratory rats. Moreover, the enhanced withdrawal in rats with persistent inflammatory pain suggests that pain patients may be especially susceptible to opioid withdrawal. PMID:28366799

  9. Home Health Care Agencies

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.

  10. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking ...

  11. The HOME Inventory and Family Demographics.

    Science.gov (United States)

    Bradley, Robert H.; Caldwell, Bettye M.

    1984-01-01

    Examines the relation between the Home Observation for Measurement of Environment (HOME) Inventory and sex, race, socioeconomic status, the amount of crowding in the home, and birth order. Performs multivariate analysis of covariance on an intact family sample using HOME subscales as criterion measures and status and structural variables as…

  12. 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...

  13. The Impact of a Home-Based Computerized Cognitive Training Intervention on Fall Risk Measure Performance in Community Dwelling Older Adults, a Pilot Study.

    Science.gov (United States)

    Blackwood, J; Shubert, T; Fogarty, K; Chase, C

    2016-02-01

    Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance. This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group. Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19). Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program. Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7. Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14 m/s in the intervention group. A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.

  14. Physical Behavior in Older Persons during Daily Life: Insights from Instrumented Shoes

    Directory of Open Access Journals (Sweden)

    Christopher Moufawad el Achkar

    2016-08-01

    Full Text Available Activity level and gait parameters during daily life are important indicators for clinicians because they can provide critical insights into modifications of mobility and function over time. Wearable activity monitoring has been gaining momentum in daily life health assessment. Consequently, this study seeks to validate an algorithm for the classification of daily life activities and to provide a detailed gait analysis in older adults. A system consisting of an inertial sensor combined with a pressure sensing insole has been developed. Using an algorithm that we previously validated during a semi structured protocol, activities in 10 healthy elderly participants were recorded and compared to a wearable reference system over a 4 h recording period at home. Detailed gait parameters were calculated from inertial sensors. Dynamics of physical behavior were characterized using barcodes that express the measure of behavioral complexity. Activity classification based on the algorithm led to a 93% accuracy in classifying basic activities of daily life, i.e., sitting, standing, and walking. Gait analysis emphasizes the importance of metrics such as foot clearance in daily life assessment. Results also underline that measures of physical behavior and gait performance are complementary, especially since gait parameters were not correlated to complexity. Participants gave positive feedback regarding the use of the instrumented shoes. These results extend previous observations in showing the concurrent validity of the instrumented shoes compared to a body-worn reference system for daily-life physical behavior monitoring in older adults.

  15. Away-from-home meals: Prevalence and characteristics in a metropolis

    Directory of Open Access Journals (Sweden)

    Bartira Mendes Gorgulho

    2014-12-01

    Full Text Available Objective: This study aimed to characterize away-from-home meals. Methods: This population-based, cross-sectional study measured dietary intake by administering 24-hour recalls by telephone. Away-from-home breakfast, lunch, and dinner were described and characterized according to the foods that contribute most to the intake of energy, fat, sodium, and added sugar per meal. Results: f the 834 respondents, 24% had had at least one meal away from home. The average energy intake per away-from-home meal was 628 kcal (±101 kcal, about 35% of the average daily intake for this population. Meals contained both healthy foods, such as rice, beans, and fish, and unhealthy foods, such as soft drinks, snacks, sandwiches, and pizza. Conclusion: Individuals who ate away from home had worse diets. However, the presence of healthy foods indicates a possibility of improvement if purposeful programmatic actions are taken.

  16. FDG and FLT-PET for Early measurement of response to 37.5 mg daily sunitinib therapy in metastatic renal cell carcinoma.

    Science.gov (United States)

    Horn, Kevin P; Yap, Jeffrey T; Agarwal, Neeraj; Morton, Kathryn A; Kadrmas, Dan J; Beardmore, Britney; Butterfield, Regan I; Boucher, Kenneth; Hoffman, John M

    2015-09-03

    Metastatic renal cell carcinoma has a poor prognosis and an intrinsic resistance to standard treatment. Sunitinib is an oral receptor tyrosine kinase inhibitor that has been used as a first-line targeted therapy in metastatic renal cell carcinoma. While computed tomography (CT) is currently the gold standard for response assessment in oncological trials, numerous studies have shown that positron emission tomography (PET) imaging can provide information predictive of tumor response to treatment earlier than the typical interval for standard of care follow-up CT imaging. In this exploratory study we sought to characterize early tumor response in patients with metastatic renal cell carcinoma treated with continuous daily 37.5 mg sunitinib therapy. Twenty patients underwent dynamic acquisition positron emission tomography (PET) imaging using (18) F-fluorodeoxyglucose (FDG) and (18) F-fluorothymidine (FLT) at baseline and early in treatment (after 1, 2, 3 or 4 weeks) with 37.5 mg continuous daily dosing of sunitinib. Semi-quantitative analyses were performed to characterize the tumor metabolic (FDG) and proliferative (FLT) responses to treatment. Proliferative responses were observed in 9/19 patients and occurred in 2 patients at one week (the earliest interval evaluated) after the initiation of therapy. A metabolic response was observed in 5/19 patients, however this was not observed until after two weeks of therapy were completed. Metabolic progression was observed in 2/19 patients and proliferative progression was observed in 1/19 patients. Baseline FDG-PET tumor maximum standardized uptake values correlated inversely with overall survival (p = 0.0036). Conversely, baseline (18) F-fluorothymidine PET imaging did not have prognostic value (p = 0.56) but showed a greater early response rate at 1-2 weeks after initiating therapy. While preliminary in nature, these results show an immediate and sustained proliferative response followed by a delayed

  17. Prolonged efficacy of the 300IR 5-grass pollen tablet up to 2 years after treatment cessation, as measured by a recommended daily combined score

    DEFF Research Database (Denmark)

    Didier, Alain; Malling, Hans-Jørgen; Worm, Margitta

    2015-01-01

    BACKGROUND: The 300IR (index of reactivity) 5-grass pollen tablet has favorable short-term and sustained clinical efficacy in patients with grass pollen-induced allergic rhinoconjunctivitis (ARC). Here, we report maintenance of efficacy and safety over 2 years following treatment discontinuation....... METHODS: Randomized, double-blind, placebo-controlled, parallel-group, multicenter Phase 3 trial in patients aged 18-50 years with ARC. During study years 1-3, patients received a daily sublingual tablet containing either 300IR 5-grass pollen extract or placebo, according to a discontinuous pre...... medication score (DRMS). RESULTS: 633 patients with ARC were randomized to placebo (n = 219) or 300IR 5-grass pollen tablet, beginning 4 months (4 M, n = 207) or 2 months (2 M, n = 207) prior to the estimated start of the grass pollen season and continuing until season's end. During the first post...

  18. Accelerometer measured daily physical activity and sedentary pursuits--comparison between two models of the Actigraph and the importance of data reduction.

    Science.gov (United States)

    Tanha, Tina; Tornberg, Åsa; Dencker, Magnus; Wollmer, Per

    2013-10-31

    Very few validation studies have been performed between different generations of the commonly used Actigraph accelerometers. We compared daily physical activity data generated from the old generation Actigraph model 7164 with the new generation Actigraph GT1M accelerometer in 15 young females for eight consecutive days. We also investigated if different wear time thresholds had any impact on the findings. Minutes per day of moderate and vigorous physical activity (MVPA), vigorous physical activity (VPA) and very vigorous physical activity (VVPA) were calculated. Moreover, minutes of sedentary pursuits per day were calculated. There were significant (P physical activity. Median minutes of sedentary pursuits per day are highly dependent on which wear time threshold that is used, and not by accelerometer model.

  19. Medium-Term Stability of the Photon Beam Energy of An Elekta CompactTM Linear Accelerator Based on Daily Measurements of Beam Quality Factor

    Directory of Open Access Journals (Sweden)

    Mohammad Amin Mosleh-Shirazi

    2016-04-01

    Full Text Available Introduction In this study, we aimed to assess the medium-term energy stability of a 6MV Elekta CompactTM linear accelerator. To the best of our knowledge, this is the first published article to evaluate this linear accelerator in terms of energy stability. As well as investigating the stability of the linear accelerator energy over a period of several weeks, the results will be useful for estimation of the required tolerance values for the beam quality factor (BQF of the PTW QUICKCHECK weblineTM (QCW daily checking device. Materials and Methods Over a 13 week period of routine clinical service, 52 daily readings of BQF were taken and then analyzed for a 10×10 cm2 field. Results No decreasing or increasing trend in BQF was observed over the study period. The mean BQF value was estimated at 5.4483 with a standard deviation (SD of 0.0459 (0.8%. The mean value was only 0.1% different from the baseline value. Conclusion The results of this medium-term stability study of the Elekta Compact linear accelerator energy showed that 96.2% of the observed BQF values were within ±1.3% of the baseline value. This can be considered to be within the recommended tolerance for linear accelerator photon beam energy. If an approach of applying ±3 SD is taken, the tolerance level for BQF may be suggested to be set at ±2.5%. However, further research is required to establish a relationship between BQF value and the actual changes in beam energy and penetrative quality.

  20. Lightship Daily Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Observations taken on board lightships along the United States coasts from 1936 - 1983. Generally 4-6 observations daily. Also includes deck logs, which give...

  1. DailyMed

    Data.gov (United States)

    U.S. Department of Health & Human Services — DailyMed provides high quality information about marketed drugs. This information includes FDA labels (package inserts). This Web site provides health information...

  2. Daily Weather Maps

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Several different government offices have published the Daily weather maps over its history. The publication has also gone by different names over time. The U.S....

  3. Radon in homes of the Portland, Oregon Area: Radon data from local radon testing companies collected by CRM (Continuous Radon Measurement) machines

    Science.gov (United States)

    Whitney, H.; Lindsey, K.; Linde, T.; Burns, S. F.

    2013-12-01

    Students from the Department of Geology at Portland State University paired up with the Oregon Health Authority to better understand radon gas values in homes of the Portland metropolitan area. This study focuses on radon values collected by continuous radon measurement (CRM) machines, taken by local radon testing companies. The local companies participating in this study include Alpha Environmental Services, Inc., Cascade Radon, Environmental Works, The House Detectives, LLC, and Soil Solutions Environmental Services, Inc. In total, 2491 radon readings spanning across 77 zip codes were collected from local companies in the Portland metropolitan area. The maximum value, average value, percentage of homes greater than 4 pCi/L and total rank sum was calculated and used to determine the overall radon potential for each zip code (Burns et al., 1998). A list and four maps were produced showing the results from each category. Out of the total records, 24 zip codes resulted in high radon potential and the average reading for the entire Portland Metropolitan area was 3.7 pCi/L. High potential zip codes are thought to be a result of sand and gravel (Missoula Flood deposits) and faults present in the subsurface. The CRM data was compared with both long-term and short-term data provided by the Oregon Health Authority to validate radon potentials in each zip code. If a home is located in a zip code with high or moderate radon potential across two types of data sets, it is recommended that those homes be tested for radon gas.

  4. Unimaginable homes

    DEFF Research Database (Denmark)

    Møller, Kristian; Klausen, Maja

    2018-01-01

    The chapter draw from critical mediatization theory, critical intimacy theory, and cultural gerontology and asks: How do elderly people practice their mediatized homes? Which roles do media play in constituting and disturbing the flows of bodies into the home? Moreover: how do dominant...... in the making of the mediatized home space. We conclude by returning to the research questions and making explicit how researching flows of bodies that in many ways inhabit homes of the in-between contributes to both gerontological and geomediatization research agendas....

  5. Measurement of special access to home visit nursing services among Japanese disabled elderly people: using GIS and claim data.

    Science.gov (United States)

    Naruse, Takashi; Matsumoto, Hiroshige; Fujisaki-Sakai, Mahiro; Nagata, Satoko

    2017-05-30

    Home care service demands are increasing in Japan; this necessitates improved service allocation. This study examined the relationship between home visit nursing (HVN) service use and the proportion of elderly people living within 10 min' travel of HVN agencies. The population of elderly people living within reach of HVN agencies for each of 17 municipalities in one low-density prefecture was calculated using public data and geographic information systems. Multilevel logistic analysis for 2641 elderly people was conducted using medical and long-term care insurance claims data from October 2010 to examine the association between the proportion of elderly people reachable by HVNs and service usage in 13 municipalities. Municipality variables included HVN agency allocation appropriateness. Individual variables included HVN usage and demographic variables. The reachable proportion of the elderly population ranged from 0.0 to 90.2% in the examined municipalities. The reachable proportion of the elderly population was significantly positively correlated with HVN use (odds ratio: 1.938; confidence interval: 1.265-2.967). Residents living in municipalities with a lower reachable proportion of the elderly population are less likely to use HVN services. Public health interventions should increase the reachable proportion of the elderly population in order to improve HVN service use.

  6. Effect of riboflavin supply on student body's provision in north-western Poland with riboflavin measured by activity of glutathione reductase considering daily intake of other nutrients.

    Science.gov (United States)

    Szczuko, Małgorzata; Seidler, Teresa; Mierzwa, Mariusz; Stachowska, Ewa; Chlubek, Dariusz

    2011-06-01

    The riboflavin nutritional status of 120 people, age 22-25, studying in Szczecin, Poland, together with contents of their daily food servings were studied. Body's provision with riboflavin was determined using the erythrocyte glutathione reductase activity coefficient (EGRAC) and was compared with a sample in which the enzyme activity was stimulated with flavin adenine dinucleotide. The information concerning diets was collected with the method of a 7-day food record prior to blood collection. Biochemical deficiency in riboflavin was observed in 33.7% of women and 25% of men. The resulting average EGRAC value was 1.02 for women and 0.88 for men. Assessment of significant differences in riboflavin provision between the sexes revealed better provision in the male group. The comparison of EGRAC values with riboflavin content in 7-day diets of the respondents showed that the average intake of this vitamin in the female group, in which biochemical deficiency was observed, amounted to 1.05 mg, whereas in the male group it was, on average, 1.39 mg. In the group of people in which the potential risk of riboflavin deficiency in the body was not observed, the level of this vitamin consumption was, on average, 1.43 mg and 1.8 mg in the female and male groups, respectively. Women with biochemical riboflavin deficiency consumed significantly less of all the analyzed nutrients in comparison with the people without riboflavin deficiency.

  7. Microcontroller Based Home Security and Load Controlling Using Gsm Technology

    OpenAIRE

    Mustafijur Rahman; A.H.M Zadidul Karim; Sultanur Nyeem; Faisal Khan; Golam Matin

    2015-01-01

    "Home automation" referred to as 'Intelligent home' or 'automated home', indicates the automation of daily tasks with electrical devices used in homes. This could be the control of lights or more complex chores such as remote viewing of the house interiors for surveillance purposes. The emerging concept of smart homes offers a comfortable, convenient and safe and secure environment for occupants. These include automatic load controlling, fire detection, temperature sensing, and motion detecti...

  8. Validation of the Beurer BM 44 upper arm blood pressure monitor for home measurement, according to the European Society of Hypertension International Protocol 2002.

    Science.gov (United States)

    Lüders, Stephan; Krüger, Ralf; Zemmrich, Claudia; Forstner, Klaus; Sturm, Claus-Dieter; Bramlage, Peter

    2012-12-01

    The present study aimed to validate the automated upper arm blood pressure (BP) measuring device BM 44 for home BP monitoring according to the 2002 Protocol of the European Society of Hypertension. The most important new feature of the new device was an integrated 'WHO indicator', which categorizes the patient's individual result within the WHO recommendations for target BP by a coloured scale. Systolic and diastolic BPs were measured sequentially in 35 adult participants (16 men, 19 women) using a standard mercury y-tubed reference sphygmomanometer (two observers) and the BM 44 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 15 participants in phase 1 and a further 18 participants in phase 2 of the validation study. The BM 44 device passed phase 1 of the validation study successfully with a number of absolute differences between device and observers of 5, 10 and 15 mmHg for at least 28 out of 25, 35 out of 35 and 40 out of 40 measurements, respectively. The device also achieved the targets for phases 2.1 and 2.2, with 23 and 26 participants having had at least two of three device-observers differences within 5 mmHg for systolic and diastolic BP, respectively. The Beurer BM 44 upper arm BP monitor has passed the International Protocol requirements, and hence can be recommended for home use in adults. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.

  9. Work demands and health consequences of organizational and technological measures introduced to enhance the quality of home care services--A subgroup analysis.

    Science.gov (United States)

    Andersen, Gunn Robstad; Bendal, Synne; Westgaard, Rolf H

    2015-11-01

    This study of home care workers in a Norwegian municipality aimed to examine the effect of two measures involving organizational (job checklists) and technological (personal digital assistants) job aids on perceived work demands and musculoskeletal health. Questionnaire data was collected in 2009 (n = 138, response rate 76.2%) and 2011 (n = 80, response rate 54%). Forty-six home care workers responded at both waves. Respondents were assigned into 'high', 'moderate' and 'low' strain groups based on their responses to open and closed survey questions regarding impact of the two measures. One-way ANOVA with post-hoc t-tests and regression analyses investigated group differences and examined development in variables. Perceived work demands and health effects over the two-year study period were unchanged overall, yet significant differences between subgroups were highlighted. Work demands and shoulder-neck pain remained high for high-strain workers, but were reduced for low and moderate strain workers. Management should be aware of diversity in worker responses to rationalizations and give priority to supplementary, targeted measures to counteract adverse effects. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  10. Chronic daily headaches

    Directory of Open Access Journals (Sweden)

    Fayyaz Ahmed

    2012-01-01

    Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.

  11. 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...

  12. Australia's Bond Home Bias

    OpenAIRE

    Anil V. Mishra; Umaru B. Conteh

    2014-01-01

    This paper constructs the float adjusted measure of home bias and explores the determinants of bond home bias by employing the International Monetary Fund's high quality dataset (2001 to 2009) on cross-border bond investment. The paper finds that Australian investors' prefer investing in countries with higher economic development and more developed bond markets. Exchange rate volatility appears to be an impediment for cross-border bond investment. Investors prefer investing in countries with ...

  13. Global Historical Climatology Network - Daily (GHCN-Daily), Version 3

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Global Historical Climatology Network - Daily (GHCN-Daily) dataset integrates daily climate observations from approximately 30 different data sources. Version 3...

  14. "Even 'Daily' is Not Enough": How Well Do We Measure Domestic Violence and Abuse?-A Think-Aloud Study of a Commonly Used Self-Report Scale.

    Science.gov (United States)

    Evans, Maggie; Gregory, Alison; Feder, Gene; Howarth, Emma; Hegarty, Kelsey

    2016-01-01

    This article explores the challenges of providing a quantitative measure of domestic violence and abuse (DVA), illustrated by the Composite Abuse Scale, a validated multidimensional measure of frequency and severity of abuse, used worldwide for prevalence studies and intervention trials. Cognitive "think-aloud" and qualitative interviewing with a sample of women who had experienced DVA revealed a tendency toward underreporting their experience of abuse, particularly of coercive control, threatening behavior, restrictions to freedom, and sexual abuse. Underreporting was linked to inconsistency and uncertainty in item interpretation and response, fear of answering truthfully, and unwillingness to identify with certain forms of abuse. Suggestions are made for rewording or reconceptualizing items and the inclusion of a distress scale to measure the individual impact of abuse. The importance of including qualitative methods in questionnaire design and in the interpretation of quantitative findings is highlighted.

  15. Longitudinal proxy measurements in multiple sclerosis: patient-proxy agreement on the impact of MS on daily life over a period of two years

    NARCIS (Netherlands)

    van der Linden, F.A.H.; Kragt, J.J.; van Bon, M.; Klein, M.; Thompson, A.J.; van der Ploeg, H.M.; Polman, C.H.; Uitdehaag, B.M.J.

    2008-01-01

    Background: The use of self-report measurements in clinical settings is increasing. However, in patients with limitations that interfere with reliable self-assessment such as cognitive impairment or mood disturbances, as may be the case in multiple sclerosis (MS), data collection might be

  16. 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...

  17. For Debate: Personalized Health Care: As Exemplified by Home Sodium Measurements in a Child with Central Diabetes Insipidus and Impaired Thirst Perception.

    Science.gov (United States)

    van der Linde, A A A; van Herwaarden, A E; Oosting, J D; Claahsen-van der Grinten, H L; de Grouw, E P L M

    2018-04-01

    We describe a 6-year old boy with central diabetes insipidus (CDI) caused by destruction of the pituitary gland due to treatment of an optical pathway glioma. He has been treated with chemotherapy and has had several debulking operations over the past years and consequently developed central hypocortisolism, hypothyroidism and CDI. The treatment of CDI was gravely complicated by an impaired thirst perception and compulsive drinking behavior. He was frequently seen at the ER or admitted due to dysregulation of fluid balance. In order to provide better self-reliance, home point of care testing (POCT) sodium measurement was introduced. Realizing POCT sodium measurement resulted in a significant decrease of ER visits and clinical admissions due to dysregulation of fluid balance. This case is an example of personalized health care and has led to better self-reliance and quality of life. Copyright© of YS Medical Media ltd.

  18. Exploring the Factor Structure of the Job Demands-Resources Measure With Patient Violence on Direct Care Workers in the Home Setting.

    Science.gov (United States)

    Byon, Ha Do; Harrington, Donna; Storr, Carla L; Lipscomb, Jane

    2017-08-01

    Workplace violence research in health care settings using the Job Demands-Resources (JD-R) framework is hindered by the lack of comprehensive examination of the factor structure of the JD-R measure when it includes patient violence. Is patient violence a component of job demands or its own factor as an occupational outcome? Exploratory factor analysis and confirmatory factor analysis were conducted using a sample of direct care workers in the home setting (n = 961). The overall 2-construct JD-R structure persisted. Patient violence was not identified as a separate factor from job demands; rather, two demand factors emerged: violence/emotional and workload/physical demands. Although the three-factor model fits the data, the two-factor model with patient violence being a component of job demands is a parsimonious and effective measurement framework.

  19. County level socioeconomic position, work organization and depression disorder: a repeated measures cross-classified multilevel analysis of low-income nursing home workers.

    Science.gov (United States)

    Muntaner, Carles; Li, Yong; Xue, Xiaonan; Thompson, Theresa; O'Campo, Patricia; Chung, Haejoo; Eaton, William W

    2006-12-01

    This study simultaneously tests the effect of county, organizational, workplace, and individual level variables on depressive disorders among low-income nursing assistants employed in US nursing homes. A total of 482 observations are used from two waves of survey data collection, with an average two-year interval between initial and follow-up surveys. The overall response rate was 62 percent. The hierarchically structured data was analyzed using multilevel modeling to account for cross-classifications across levels of data. Nursing assistants working in nursing homes covered by a single union in three states were asked about aspects of their working conditions, job stress, physical and mental health status, individual and family health-care needs, household economics and household strain. The 241 nursing assistants who participated in this study were employed in 34 nursing homes and lived in 49 counties of West Virginia, Ohio and Kentucky. The study finds that emotional strain, related to providing direct care to elderly and disabled clients, is associated with depressive disorder, as is nursing home ownership type (for-profit versus not-for-profit). However, when controlling for county level socioeconomic variables (Gini index and proportion of African Americans living in the county), neither workplace nor organizational level variables were found to be statistically significant associated with depressive disorder. This study supports previous findings that emotional demand in health-care environments is an important correlate of mental health. It also adds empirical evidence to support a link between financial strain and depression in US women. While this study does not find that lack of a seniority wage benefits--a factor that can conceivably exacerbate financial strain over time--is associated with depressive disorder among low-income health-care workers, it does find county level measures of poverty to be statistically significant predictors of depressive

  20. 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.

  1. Availability of Care Concordant With Patient-centered Medical Home Principles Among Those With Chronic Conditions: Measuring Care Outcomes.

    Science.gov (United States)

    Pourat, Nadereh; Charles, Shana A; Snyder, Sophie

    2016-03-01

    Care delivery redesign in the form of patient-centered medical home (PCMH) is considered as a potential solution to improve patient outcomes and reduce costs, particularly for patients with chronic conditions. But studies of prevalence or impact at the population level are rare. We aimed to assess whether desired outcomes indicating better care delivery and patient-centeredness were associated with receipt of care according to 3 important PCMH principles. We analyzed data from a representative population survey in California in 2009, focusing on a population with chronic condition who had a usual source of care. We used bivariate, logistic, and negative-binomial regressions. The indicators of PCMH concordant care included continuity of care (personal doctor), care coordination, and care management (individual treatment plan). Outcomes included flu shots, count of outpatient visits, any emergency department visit, timely provider communication, and confidence in self-care. We found that patients whose care was concordant with all 3 PCMH principles were more likely to receive flu shots, more outpatient care, and timely response from providers. Concordance with 2 principles led to some desired outcomes. Concordance with only 1 principle was not associated with desired outcomes. Patients who received care that met 3 key aspects of PCMH: coordination, continuity, and management, had better quality of care and more efficient use of the health care system.

  2. Does item overlap render measured relationships between pain and challenging behaviour trivial? Results from a multicentre cross-sectional study in 13 German nursing homes.

    Science.gov (United States)

    Kutschar, Patrick; Bauer, Zsuzsa; Gnass, Irmela; Osterbrink, Jürgen

    2017-07-01

    Several studies suggest that pain is a trigger for challenging behaviour in older adults with cognitive impairment. However, such measured relationships might be confounded due to item overlap as instruments share similar or identical items. The purpose of this study was to examine whether the frequently observed association between pain and challenging behaviour might be traced back to item overlap. This multicentre cross-sectional study was conducted in 13 nursing homes and examined pain (measure: Pain Assessment in Advanced Dementia Scale) and challenging behaviour (measure: Cohen-Mansfield Agitation Inventory) in 150 residents with severe cognitive impairment. The extent of item overlap was determined by juxtaposition of both measures' original items. As expected, comparison between these instruments revealed an extensive item overlap. The statistical relationship between the two phenomena can be traced back mainly to the contribution of the overlapping items, which renders the frequently stated relationship between pain and challenging behaviour trivial. The status quo of measuring such associations must be contested: constructs' discrimination and instruments' discrimination have to be discussed critically as item overlap may lead to biased conclusions and assumptions in research as well as to inadequate care measures in nursing practice. © 2017 John Wiley & Sons Ltd.

  3. The influence of work- and home-related stress on the levels and diurnal variation of ambulatory blood pressure and neurohumoral factors in employed women.

    Science.gov (United States)

    Kario, Kazuomi; James, Gary D; Marion, RoseMerie; Ahmed, Mustafa; Pickering, Thomas G

    2002-07-01

    The purpose of this study was to examine the effects of self-reported perceived stress at work and home on the levels, variation and co-variation of ambulatory blood pressure (BP), pulse rate (PR) and urinary catecholamine, cortisol, and aldosterone excretion measured at work, home and during sleep in women employed outside the home. The subjects of the study were 134 women (mean age 34.4 +/- 9.6 years, range 18 to 64 years) who were employed in managerial, technical or clerical positions at the same work place. Perceived stress at work and home was self-reported on a scale from 0 (low) to 10 (high). BP, PR and the urinary rates of excretion of epinephrine, norepinephrine, cortisol and aldosterone were averaged in the daily work environment from 11 AM to 3 PM, in the daily home environment from approximately 6 PM to 10 PM, and during sleep from approximately 10 PM to 6 AM the following morning. The results showed that systolic and diastolic BP (SBP and DBP) and the rates of urinary catecholamine, cortisol, and aldosterone excretion measured in the work environment were significantly higher than corresponding measurements taken in the home environment. SBP measured at work was also positively correlated with the difference in perceived stress between work and home (p home environment were positively correlated with stress at home. When the subjects were divided into groups based on whether the work or home environment was perceived to be most stressful, women reporting greater stress at work (n=85) had higher work SBP (p work DBP (p home environment to be more stressful (n=34). There were no differences in the urinary hormonal excretion rates between these perceived-stress groups. Among women with greater perceived stress at home, the home-stress score was positively correlated with sleep SBP level (r = 0.310, p home pulse rate ( r= 0.414, p work stress may increase ambulatory BP levels throughout the day, while home stress may induce additional sympathetic

  4. Intake and excretion of 99Tc in a common sea alga, (hijiki Hizikia Fusiforme), as ingested in the daily diet - A measurement in an adult male

    International Nuclear Information System (INIS)

    Kawamura, H.; Hirano, S.; Nishimuta, M.

    2003-01-01

    Ingestion and excretion of environmental 99 Tc was measured in an adult male who ingested 'hijiki' food in his diet that contained a sub-bequerel activity per kg, and which was prepared from a marine alga, Hizikia fusiforme,or hijiki in Japanese, traditionally eaten in the Japanese diet. Harvested hijiki was boiled, dried and cooked. This was eaten at each meal five times over 2 d. All faeces and 24-h urine samples were collected during the 3 d before and subsequent 11 d starting from the day when the intake began. The ingestion intake was measured by analysing the dried hijiki material. 99 Tc was determined by using liquid-liquid extraction and low-background beta ray spectrometry. The excreta were also analysed for minerals by atomic absorption spectrometry. The apparent absorption rate in the gastrointestinal tract for 99 Tc under these conditions was calculated to be approximately 0.5. The present result from a single subject indicates the need for further studies. (author)

  5. Measuring buildings for sustainability: Comparing the initial and retrofit ecological footprint of a century home – The REEP House

    International Nuclear Information System (INIS)

    Bin, Guoshu; Parker, Paul

    2012-01-01

    Highlights: ► Life cycle energy, carbon and ecological footprints of a century home are studied. ► The operational impact accounts for most of the total lifecycle impact. ► Sourcing energy-intensive materials locally only reduces embodied impacts a little. ► Deep energy retrofits (80% savings) achieved substantial environmental benefits. ► The environmental payback period of major energy retrofits is less than 2 years. - Abstract: The residential sector is recognized as a major energy consumer and thus a significant contributor to climate change. Rather than focus only on current energy consumption and the associated emissions, there is a need to broaden sustainability research to include full life cycle contributions and impacts. This paper looks at houses from the perspective of the ecological footprint (EF), a well-known sustainability indicator. Exemplifying single-detached houses of the early 20th century, the century-old REEP House (downtown Kitchener, Canada), together with its high performance energy retrofits, is examined in detail. This research combines material, energy and carbon emission studies. Its scope covers the life cycle of the house, including the direct and indirect consumption of material and energy, and concomitant carbon emissions during its stages of material extraction, transportation, construction, operation, and demolition. It is revealed that the REEP House had a typical impact on the environment when it was built, and, even though the renovations to improve energy efficiency by 80% introduce additional embodied environmental impacts, they are environmentally sound activities because the environmental payback period is less than 2 years.

  6. A Comparison between Two Instruments for Assessing Dependency in Daily Activities: Agreement of the Northwick Park Dependency Score with the Functional Independence Measure

    Directory of Open Access Journals (Sweden)

    Siv Svensson

    2012-01-01

    Full Text Available Background. There is a need for tools to assess dependency among persons with severe impairments. Objectives. The aim was to compare the Functional Independence Measure (FIM and the Northwick Park Dependency Score (NPDS, in a sample from in-patient rehabilitation. Material and Methods. Data from 115 persons (20 to 65 years of age with neurological impairments was gathered. Analyses were made of sensitivity, specificity, positive predictive value, and negative predictive value. Agreement of the scales was assessed with kappa and concordance with Goodman-Kruskal’s gamma. Scale structures were explored using the Rank-Transformable Pattern of Agreement (RTPA. Content validation was performed. Results. The sensitivity of the NPDS as compared to FIM varied between 0.53 (feeding and 1.0 (mobility and specificity between 0.64 (mobility and 1.0 (bladder. The positive predictive value varied from 0.62 (mobility to 1.0 (bladder, and the negative predictive value varied from 0.48 (bowel to 1.0 (mobility. Agreement between the scales was moderate to good (four items and excellent (three items. Concordance was good, with a gamma of −.856, an asymptotic error (ase of .025, and P<.000. The parallel reliability between the FIM and the NPDS showed a tendency for NPDS to be more sensitive (having more categories when dependency is high. Conclusion. FIM and NPDS complement each other. NPDS can be used as a measure for severely injured patients who are sensitive when there is a high need of nursing time.

  7. Stressors and Well-Being among Caregivers to Older Adults with Dementia: The In-Home versus Nursing Home Experience.

    Science.gov (United States)

    Stephens, Mary Ann Parris; And Others

    1991-01-01

    Examined differences in stressors and well-being for caregivers who care for relative with dementia at home and those with relative in nursing home (n=120). Found no differences in depression or somatic complaints, but nursing home caregivers reported fewer social disruptions and more stressors resulting from activities of daily living assistance,…

  8. Bidirectional, Temporal Associations of Sleep with Positive Events, Affect, and Stressors in Daily Life Across a Week.

    Science.gov (United States)

    Sin, Nancy L; Almeida, David M; Crain, Tori L; Kossek, Ellen Ernst; Berkman, Lisa F; Buxton, Orfeu M

    2017-06-01

    Sleep is intricately tied to emotional well-being, yet little is known about the reciprocal links between sleep and psychosocial experiences in the context of daily life. The aim of this study is to evaluate daily psychosocial experiences (positive and negative affect, positive events, and stressors) as predictors of same-night sleep quality and duration, in addition to the reversed associations of nightly sleep predicting next-day experiences. Daily experiences and self-reported sleep were assessed via telephone interviews for eight consecutive evenings in two replicate samples of US employees (131 higher-income professionals and 181 lower-income hourly workers). Multilevel models evaluated within-person associations of daily experiences with sleep quality and duration. Analyses controlled for demographics, insomnia symptoms, the previous day's experiences and sleep measures, and additional day-level covariates. Daily positive experiences were associated with improved as well as disrupted subsequent sleep. Specifically, positive events at home predicted better sleep quality in both samples, whereas greater positive affect was associated with shorter sleep duration among the higher-income professionals. Negative affect and stressors were unrelated to subsequent sleep. Results for the reversed direction revealed that better sleep quality (and, to a lesser degree, longer sleep duration) predicted emotional well-being and lower odds of encountering stressors on the following day. Given the reciprocal relationships between sleep and daily experiences, efforts to improve well-being in daily life should reflect the importance of sleep.

  9. CDC WONDER: Daily Air Temperatures and Heat Index

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Daily Air Temperature and Heat Index data available on CDC WONDER are county-level daily average air temperatures and heat index measures spanning the years...

  10. Body composition is associated with physical activity in daily life as measured using a triaxial accelerometer in both men and women.

    Science.gov (United States)

    den Hoed, M; Westerterp, K R

    2008-08-01

    Activity-related energy expenditure is the most variable component of total energy expenditure and thus an important determinant of energy balance. To determine whether body composition is related to physical activity in both men and women. A total of 134 healthy participants were recruited (80 women, 54 men; aged 21+/-2 years; body mass index, 22.0+/-2.4). Physical activity was measured for a period of 2 weeks using a triaxial accelerometer for movement registration (Tracmor). Percentage body fat (%BF) was determined by underwater weighing and deuterium dilution according to Siri's three-compartment model. The participant characteristics-body mass, height and gender together explained a substantial part of the variation in %BF (R(2)=0.75, SEE=4.0%). Adding physical activity to the model increased the explained variation in %BF with 4% (R(2)=0.79, SEE=3.7%, Pwomen, %BF and physical activity were significantly associated (Pmen, %BF was only associated with physical activity when seasonality was taken into account as well (Pmen participating more in season bound sports, because an association was found without adjusting for seasonality when only men with a consistent year-round participation in sports were considered. Evidence was found for an association between body composition and physical activity in both genders. A consistent year-round degree of physical activity appears to be a prerequisite to reveal the association. Moreover, Tracmor-assessed physical activity improves the estimate of %BF when a participant's characteristics are taken into account.

  11. The Effect of Spectral Quality on Daily Patterns of Gas Exchange, Biomass Gain, and Water-Use-Efficiency in Tomatoes and Lisianthus: An Assessment of Whole Plant Measurements.

    Science.gov (United States)

    Lanoue, Jason; Leonardos, Evangelos D; Ma, Xiao; Grodzinski, Bernard

    2017-01-01

    Advancements in light-emitting diode (LED) technology have made them a viable alternative to current lighting systems for both sole and supplemental lighting requirements. Understanding how wavelength specific LED lighting can affect plants is thus an area of great interest. Much research is available on the wavelength specific responses of leaves from multiple crops when exposed to long-term wavelength specific lighting. However, leaf measurements do not always extrapolate linearly to the complexities which are found within a whole plant canopy, namely mutual shading and leaves of different ages. Taken together, both tomato ( Solanum lycopersicum ) leaves under short-term illumination and lisianthus ( Eustoma grandiflorum ) and tomato whole plant diurnal patterns of plants acclimated to specific lighting indicate wavelength specific responses of both H 2 O and CO 2 gas exchanges involved in the major growth parameters of a plant. Tomato leaves grown under a white light source indicated an increase in transpiration rate and internal CO 2 concentration and a subsequent decrease in water-use-efficiency (WUE) when exposed to a blue LED light source compared to a green LED light source. Interestingly, the maximum photosynthetic rate was observed to be similar. Using plants grown under wavelength specific supplemental lighting in a greenhouse, a decrease in whole plant WUE was seen in both crops under both red-blue (RB) and red-white (RW) LEDs when compared to a high pressure sodium (HPS) light. Whole plant WUE was decreased by 31% under the RB LED treatment for both crops compared to the HPS treatment. Tomato whole plant WUE was decreased by 25% and lisianthus whole plant WUE was decreased by 15% when compared to the HPS treatment when grown under RW LED. The understanding of the effects of wavelength specific lighting on both leaf and whole plant gas exchange has significant implications on basic academic research as well as commercial greenhouse production.

  12. The Effect of Spectral Quality on Daily Patterns of Gas Exchange, Biomass Gain, and Water-Use-Efficiency in Tomatoes and Lisianthus: An Assessment of Whole Plant Measurements

    Directory of Open Access Journals (Sweden)

    Jason Lanoue

    2017-06-01

    Full Text Available Advancements in light-emitting diode (LED technology have made them a viable alternative to current lighting systems for both sole and supplemental lighting requirements. Understanding how wavelength specific LED lighting can affect plants is thus an area of great interest. Much research is available on the wavelength specific responses of leaves from multiple crops when exposed to long-term wavelength specific lighting. However, leaf measurements do not always extrapolate linearly to the complexities which are found within a whole plant canopy, namely mutual shading and leaves of different ages. Taken together, both tomato (Solanum lycopersicum leaves under short-term illumination and lisianthus (Eustoma grandiflorum and tomato whole plant diurnal patterns of plants acclimated to specific lighting indicate wavelength specific responses of both H2O and CO2 gas exchanges involved in the major growth parameters of a plant. Tomato leaves grown under a white light source indicated an increase in transpiration rate and internal CO2 concentration and a subsequent decrease in water-use-efficiency (WUE when exposed to a blue LED light source compared to a green LED light source. Interestingly, the maximum photosynthetic rate was observed to be similar. Using plants grown under wavelength specific supplemental lighting in a greenhouse, a decrease in whole plant WUE was seen in both crops under both red-blue (RB and red-white (RW LEDs when compared to a high pressure sodium (HPS light. Whole plant WUE was decreased by 31% under the RB LED treatment for both crops compared to the HPS treatment. Tomato whole plant WUE was decreased by 25% and lisianthus whole plant WUE was decreased by 15% when compared to the HPS treatment when grown under RW LED. The understanding of the effects of wavelength specific lighting on both leaf and whole plant gas exchange has significant implications on basic academic research as well as commercial greenhouse production.

  13. Longitudinal proxy measurements in multiple sclerosis: patient-proxy agreement on the impact of MS on daily life over a period of two years

    Directory of Open Access Journals (Sweden)

    Thompson Alan J

    2008-02-01

    Full Text Available Abstract Background The use of self-report measurements in clinical settings is increasing. However, in patients with limitations that interfere with reliable self-assessment such as cognitive impairment or mood disturbances, as may be the case in multiple sclerosis (MS, data collection might be problematic. In these situations, information obtained from proxy respondents (e.g. partners may replace self-ratings. The aim of this study was to examine the value of proxy ratings at separate points in time and to assess patient-proxy agreement on possible changes in disease impact of MS. Methods Fifty-six MS patients and their partners completed the Multiple Sclerosis Impact Scale (MSIS-29 at baseline and follow-up, two years later. Patient-proxy agreement was assessed at both time points by calculating intraclass correlation coefficients (ICCs, exact and global agreement and the mean directional differences between groups. Agreement of change over time was assessed by calculating ICCs between change scores. In parallel, global ratings of both patients and proxy respondents of the extent to which the patient had improved or deteriorated over the past two years were collected to validate possible changes on the MSIS-29. Results At both time points, agreement on the physical scale was higher than agreement on the psychological scale (ICCs at baseline were 0.81 for the physical scale and 0.72 for the psychological scale; at follow-up, the ICC values were 0.86 and 0.65 respectively. At follow-up, statistically significant mean differences between patients and proxies were noted for the physical scale (-4.8 ± 12.7, p = 0.006 and the psychological scale (-8.9 ± 18.8, p = 0.001. Agreement between change scores on the MSIS-29 was fair (ICC Conclusion Proxy respondents could act as a reliable source of information in cross-sectional studies. Moreover, results suggested that agreement on change over time might be better for proxy respondents compared to

  14. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  15. Effect of exposure to evening light on sleep initiation in the elderly: a longitudinal analysis for repeated measurements in home settings.

    Science.gov (United States)

    Obayashi, Kenji; Saeki, Keigo; Iwamoto, Junko; Okamoto, Nozomi; Tomioka, Kimiko; Nezu, Satoko; Ikada, Yoshito; Kurumatani, Norio

    2014-05-01

    Epidemiologic data have demonstrated associations of sleep-onset insomnia with a variety of diseases, including depression, dementia, diabetes and cardiovascular diseases. Sleep initiation is controlled by the suprachiasmatic nucleus of the hypothalamus and endogenous melatonin, both of which are influenced by environmental light. Exposure to evening light is hypothesized to cause circadian phase delay and melatonin suppression before bedtime, resulting in circadian misalignment and sleep-onset insomnia; however, whether exposure to evening light disturbs sleep initiation in home settings remains unclear. In this longitudinal analysis of 192 elderly individuals (mean age: 69.9 years), we measured evening light exposure and sleep-onset latency for 4 days using a wrist actigraph incorporating a light meter and an accelerometer. Mixed-effect linear regression analysis for repeated measurements was used to evaluate the effect of evening light exposure on subsequent sleep-onset latency. The median intensity of evening light exposure and the median sleep-onset latency were 27.3 lux (interquartile range, 17.9-43.4) and 17 min (interquartile range, 7-33), respectively. Univariate models showed significant associations between sleep-onset latency and age, gender, daytime physical activity, in-bed time, day length and average intensity of evening and nighttime light exposures. In a multivariate model, log-transformed average intensity of evening light exposure was significantly associated with log-transformed sleep-onset latency independent of the former potential confounding factors (regression coefficient, 0.133; 95% CI, 0.020-0.247; p = 0.021). Day length and nighttime light exposure were also significantly associated with log-transformed sleep-onset latency (p = 0.001 and p < 0.001, respectively). In conclusion, exposure to evening light in home setting prolongs subsequent sleep-onset latency in the elderly.

  16. Autonomy among physically frail older people in nursing home settings

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

    BACKGROUND: Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings...... participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub......-dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual...

  17. Diurnal and seasonal variation in air exchange rates and interzonal airflows measured by active and passive tracer gas in homes

    DEFF Research Database (Denmark)

    Bekö, Gabriel; Gustavsen, Sine; Frederiksen, Marie

    2016-01-01

    Outdoor air delivery to buildings is an important parameter in the assessment of pollutant exposure indoors. Detailed and well controlled measurements of air exchange rates (AER) and interzonal airflows in residential environment are scarce. We measured the outdoor AERs in up to six rooms in five...... rooms. Window opening behavior had a strong influence on AERs, which were highest during occupied daytime periods, lowest in the night; highest in the summer, lowest in the winter. Significant differences were found between AERs measured by the different techniques. The median nighttime AER in all...... studied the pollutant distribution from one room (source room) and interzonal airflows across the dwellings. The air within a given floor was well mixed, with the average tracer gas concentration in the non-source rooms reaching approximately 70% of the source room concentration. There was less air...

  18. The Daily Selection

    DEFF Research Database (Denmark)

    Skjold, Else

    2015-01-01

    In this PhD thesis, The Daily Selection, I will be addressing the overall question of how research on wardrobes can contribute to a more effective connection between the production and the consumption of dress objects. The thesis builds on exemplary studies of people in their wardrobes....... As such, the parts, when taken as a whole, represent an evolving process through which my overall research questions are being filtered and reflected. My scholarly approach builds on the fusing of fashion and dress research and design research, in this way closing a gap between dress practice as...

  19. Radiation in daily life

    International Nuclear Information System (INIS)

    Mora Rodriguez, P.

    1999-01-01

    The medical community benefits on a daily basis from the ionizing radiations used in the diagnosis and treatment of disease. The doses received in the medical field are only a small fraction of the total radiation received in a year. This bibliographic review has several objectives. The first one is to present the different components of natural radiation (background radiation). Secondly, it will introduce many consumer products that contain radioactive sources and expose our bodies. Third, arguments to diminish the radiation phobia will be presented and finally an easy to understand dosimetric magnitude will be introduced for the physician, the technologist and the patient. (author) [es

  20. Diurnal and seasonal variation in air exchange rates and interzonal flows measured by active tracer gas in five Danish homes

    DEFF Research Database (Denmark)

    Clausen, Geo; Bekö, Gabriel; Toftum, Jørn

    2016-01-01

    We measured the air exchange rates (AER) in up to six rooms in five naturally ventilated dwellings across four seasons using active tracer gas. Night time AER was also estimated in all bedrooms based on occupant-generated CO2. Additionally, we studied the pollutant distribution across the dwellin...

  1. Thirty years of research on diagnostic and therapeutic thresholds for the self-measured blood pressure at home.

    NARCIS (Netherlands)

    Staessen, J.A.; Thijs, L.; Ohkubo, T.; Kikuya, M.; Richart, T.; Boggia, J.; Adiyaman, A.; Dechering, D.G.; Kuznetsova, T.; Thien, Th.; Leeuw, P. de; Imai, Y.; O'brien, E.; Parati, G.

    2008-01-01

    OBJECTIVE: The goal of this review study is to summarize 30 years of research on cut-off limits for the self-measured blood pressure. METHODS: We reviewed two meta-analyses, several prospective outcome studies in populations and hypertensive patients, studies in pregnant women, three clinical trials

  2. Returning home

    DEFF Research Database (Denmark)

    Agergaard, Jytte; Brøgger, Ditte

    2016-01-01

    flows. By focusing on these educational migrants, this paper explores how they connect to their rural homes. Guided by a critical reading of the migration-development scholarship, the paper examines how migrants and their relatives make sense of educational migrants’ remitting and returning practices......, and by comparing three groups of educational migrants, the migrants’ reasons for staying connected and sending remittances are scrutinized. The paper finds that although educational migrants do not generate extensive economic remittances for local development in Nepal, they stay connected to their rural homes...

  3. Vascular access for home haemodialysis.

    Science.gov (United States)

    Al Shakarchi, Julien; Day, C; Inston, N

    2018-03-01

    Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. Our cohort consisted of 74 patients. On initiation of home haemodialysis, 62 individuals were using an arteriovenous fistula as vascular access, while the remaining were on a tunnelled dialysis catheter. Of the 12 patients who started on a tunnelled dialysis catheter, 5 were subsequently converted to either an arteriovenous fistula ( n = 4) or an arteriovenous graft ( n = 1). During the period of home haemodialysis use, four arteriovenous fistula failed or thrombosed with patients continuing on home haemodialysis using an arteriovenous graft ( n = 3) or a tunnelled dialysis catheter ( n = 1). To maintain uninterrupted home haemodialysis, interventional rates were 0.32 per arteriovenous fistula/arteriovenous graft access-year and 0.4 per tunnelled dialysis catheter access-year. Hospital admission rates for patients on home haemodialysis were 0.33 per patient-year. Our study has shown that home haemodialysis can be safely and independently performed at home within a closely managed home haemodialysis programme. The authors also advocate the use of arteriovenous fistulas for this cohort of patients due to both low complication and intervention rates.

  4. Validation of Transtek LS808-B for self/home measurement according to the European Society of Hypertension International Protocol revision 2010.

    Science.gov (United States)

    Liu, Zhong Hua; Liu, Xian Yue; Wu, Wen Jun

    2016-12-01

    This study aimed to evaluate the accuracy of Transtek LS808-B according to the European Society of Hypertension International Protocol revision 2010 (ESH-IP2010). A total of 33 adult individuals (19 men and 14 women, mean age 46.8±15.8 years) were recruited; their systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using the mercury sphygmomanometer and Transtek LS808-B. A total of 99 pairs of measurements were obtained from these 33 participants for comparison in two parts with three grading phases. All the validation requirements were fulfilled. The number of absolute difference between the tested device and the observers within 5, 10, and 15 mmHg was 73, 94, and 98 for SBP and 78, 94, and 99 for DBP, respectively. The mean±SD of the device-observer difference was 0.5±4.4 mmHg for SBP and 0.2±4.1 mmHg for DBP. The number of participants with two or three device-observer differences within 5 mmHg was 24 for SBP and 27 for DBP. In addition, two of the participants had no device-observer difference within 5 mmHg for SBP and one of the participants had the same for DBP. Transtek LS808-B has passed all phases of ESH-IP 2010, and hence can be recommended for self/home measurement in adult populations.

  5. Home Photovoltaic System Design in Pangkalpinang City

    Science.gov (United States)

    Sunanda, Wahri

    2018-02-01

    This research aims to obtain the design of home photovoltaic systems in Pangkalpinang and the opportunity of economic savings. The system consists of photovoltaic with batteries. Based on electricity consumption of several houses with installed power of 1300 VA and 2200 VA in Pangkalpinang for one year, the daily load of photovoltaic system is varied to 40%, 30% and 20% of the average value of the daily home electricity consumption. The investment costs, the cost of replacement parts and the cost of electricity consumption accrued to PLN during lifetime of systems (25 years) are also calculated. The result provided that there are no economic saving opportunities for photovoltaic systems with batteries at home with installed power of 1300 VA and 2200 VA in Pangkalpinang. The most economical is the photovoltaic system with the daily load of 20% of the average value of the daily home electricity consumption. The configuration of photovoltaic system for 1300 VA home consists of 10 modules of 200 wattpeak and 4 batteries 150 AH, 12 Volt while photovoltaic system for 2200 VA home consists of 15 modules of 200 wattpeak and 6 batteries 150 AH,12Volt.

  6. Daily remote monitoring of implantable cardioverter-defibrillators

    DEFF Research Database (Denmark)

    Hindricks, Gerhard; Varma, Niraj; Kacet, Salem

    2017-01-01

    Aims: Remote monitoring of implantable cardioverter-defibrillators may improve clinical outcome. A recent meta-analysis of three randomized controlled trials (TRUST, ECOST, IN-TIME) using a specific remote monitoring system with daily transmissions [Biotronik Home Monitoring (HM)] demonstrated...

  7. Capturing daily urban rhythms: the use of location aware technologies

    CSIR Research Space (South Africa)

    Krygsman, S

    2007-07-01

    Full Text Available Daily activities and travel often follow a natural rhythm or flow that is structured by the fixed spatial and temporal constraints. The work and home location act as pegs that define individual’s activity space and it is within these spaces...

  8. Mobilizing Older Adults: Harnessing the Potential of Smart Home Technologies. Contribution of the IMIA Working Group on Smart Homes and Ambient Assisted Living.

    Science.gov (United States)

    Demiris, G; Thompson, H J

    2012-01-01

    This paper highlights the potential of smart home applications to not only assess mobility determinants for older adults in the home environment but also provide the opportunity for tailored interventions. We present a theoretical framework for assessing mobility parameters and utilizing this information to enable behavior change based on the Health Belief Model. We discuss examples that showcase the potential of smart home systems to not only measure but also improve mobility for community dwelling older adults. Mobility is a complex construct that cannot be addressed with a single monitoring approach or a single intervention. Instead, tailored interventions that address specific needs and behaviors of individuals and take into consideration preferences of older adults and potentially their social network are needed to effectively enforce positive behavior change. Smart home systems have the ability to capture details of one's daily living that could otherwise not be easily obtained; however, such data repositories alone are not sufficient to improve clinical outcomes if appropriate mechanisms for data mining and analysis, as well as tailored response systems are not in place. Unleashing the potential of smart home applications to measure and improve mobility has the potential of transforming elder care and providing potentially cost-effective tools to support independence for older adults. A technologically driven smart home application can maximize its clinical relevance by pursuing interactive features that can lead to behavior change.

  9. Home-based intermediate care program vs hospitalization

    Science.gov (United States)

    Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

    2008-01-01

    OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

  10. Sensor technology for smart homes.

    Science.gov (United States)

    Ding, Dan; Cooper, Rory A; Pasquina, Paul F; Fici-Pasquina, Lavinia

    2011-06-01

    A smart home is a residence equipped with technology that observes the residents and provides proactive services. Most recently, it has been introduced as a potential solution to support independent living of people with disabilities and older adults, as well as to relieve the workload from family caregivers and health providers. One of the key supporting features of a smart home is its ability to monitor the activities of daily living and safety of residents, and in detecting changes in their daily routines. With the availability of inexpensive low-power sensors, radios, and embedded processors, current smart homes are typically equipped with a large amount of networked sensors which collaboratively process and make deductions from the acquired data on the state of the home as well as the activities and behaviors of its residents. This article reviews sensor technology used in smart homes with a focus on direct environment sensing and infrastructure mediated sensing. The article also points out the strengths and limitations of different sensor technologies, as well as discusses challenges and opportunities from clinical, technical, and ethical perspectives. It is recommended that sensor technologies for smart homes address actual needs of all stake holders including end users, their family members and caregivers, and their doctors and therapists. More evidence on the appropriateness, usefulness, and cost benefits analysis of sensor technologies for smart homes is necessary before these sensors should be widely deployed into real-world residential settings and successfully integrated into everyday life and health care services. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. Human daily rhythms measured for one year.

    Science.gov (United States)

    Binkley, S; Tome, M B; Crawford, D; Mosher, K

    1990-08-01

    Four human subjects recorded their wake-up and to-sleep times for one year each. The data were plotted to display individual circadian rhythms and the data were analyzed statistically. First, individuals had characteristic patterns in which visible changes in the patterns were observed mainly when time zones were changed because of travel. Second, the months with the latest wake-up and latest to-sleep times concentrated around the winter solstice; the months with the earliest wake-up and earliest to-sleep times concentrated around the fall equinox. Third, new moon versus full moon days were not different. Fourth, one-hour changes between standard and daylight savings time in the USA were reflected by near one-hour changes in two subjects, but not in a third. Fifth, weekend delays in wake-up time (0.8-1.6 hours), weekend delays in to-sleep time (0.1-0.5 hours), and shorter weekend awake time (0.8-1.3 hours) were observed. Sixth, throughout the year, wake-up times were close to the time of sunrise, but to-sleep times were several hours past sunset.

  12. Impact of daily cooling treatment on skin inflammation in patients with chronic venous disease.

    Science.gov (United States)

    Kelechi, Teresa J; Mueller, Martina; King, Dana E; Madisetti, Mohan; Prentice, Margie

    2015-05-01

    People with chronic venous disease are at high risk for developing venous leg ulcers. Inflammation is posited as a pathological factor for this chronic condition as evidenced by persistently elevated skin temperature. As part of a larger trial to test the effects of a cooling regimen on leg ulcer prevention, the objective of this preliminary study was to evaluate the first 30 days of intense daily cooling. Compared to a placebo control cuff, a gel cuff applied to the most severely affected lower leg skin for 30 min daily showed no statistically significant differences between temperatures taken in the home at baseline compared to those measured at the 1 month follow up visit. There were also no differences in temperatures noted between the two groups, although the temperatures in the treatment group were lower 30 min after treatment, an indication of adherence. There was no discernable decrease or increase in temperature at a given time point during the 30 day treatment period compared to the control group. It may be better to have patients monitor skin temperature on a daily basis and then apply the cuff as necessary, rather than requiring daily cooling based on baseline measurement. This "prn" approach may provide a sufficient cooling milieu to prevent escalation of inflammation and thwart ulcer occurrence or recurrence. Clinical trials registration #NCT01509599. Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  13. Fermilab | Home

    Science.gov (United States)

    Industry Students and teachers Media ... Five (more) fascinating facts about DUNE Engineering the Mathematics in Music June 2 10 a.m. Get to Know the Lederman Science Center June 3 1 p.m. Ask a Scientist Security, Privacy, Legal Use of Cookies Quick Links Home Contact Phone Book Fermilab at Work For Industry

  14. Home Automation

    OpenAIRE

    Ahmed, Zeeshan

    2010-01-01

    In this paper I briefly discuss the importance of home automation system. Going in to the details I briefly present a real time designed and implemented software and hardware oriented house automation research project, capable of automating house's electricity and providing a security system to detect the presence of unexpected behavior.

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample pouch) Ostomy self-care checklist Evaluation (Complete the Ostomy Patient Survey . We ...

  16. Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?

    Science.gov (United States)

    Craiovan, B; Weber, M; Worlicek, M; Schneider, M; Springorum, H R; Zeman, F; Grifka, J; Renkawitz, T

    2016-06-01

    The aim of this prospective study is to validate a vector arithmetic method for measuring acetabular cup orientation after total hip arthroplasty (THA) and to verify the clinical practice. We measured cup anteversion and inclination of 123 patients after cementless primary THA twice by two examiners on AP pelvic radiographs with a vector arithmetic method and compared with a 3D-CT based reconstruction model within the same radiographic coronal plane. The mean difference between the radiographic and the 3D-CT measurements was - 1.4° ± 3.9° for inclination and 0.8°± 7.9° for anteversion with excellent correlation for inclination (r = 0.81, p cup position after THA on pelvic radiographs by this vector arithmetic method, there is a need for a correct postoperative ap view, with special regards to the pelvic tilt for the future. • Measuring acetabular cup orientation on anteroposterior radiographs of the hip after THA is a helpful procedure in everyday clinical practice as a first-line imaging modality• CT remains the golden standard to accurately determine acetabular cup position.• Future measuring on radiographs for cup orientation after THA should account for integration of the pelvic tilt in order to maximize the measurement accuracy. Citation Format: • Craiovan B, Weber M, Worlicek M et al. Measuring Acetabular Cup Orientation on Antero-Posterior Radiographs of the Hip after Total Hip Arthroplasty with a Vector Arithmetic Radiological Method. Is It Valid and Verified for Daily Clinical Practice?. Fortschr Röntgenstr 2016; 188: 574 - 581. © Georg Thieme Verlag KG Stuttgart · New York.

  17. New daily persistent headache

    Directory of Open Access Journals (Sweden)

    Alok Tyagi

    2012-01-01

    Full Text Available New daily persistent headache (NDPH is a chronic headache developing in a person who does not have a past history of headaches. The headache begins acutely and reaches its peak within 3 days. It is important to exclude secondary causes, particularly headaches due to alterations in cerebrospinal fluid (CSF pressure and volume. A significant proportion of NDPH sufferers may have intractable headaches that are refractory to treatment. The condition is best viewed as a syndrome rather than a diagnosis. The headache can mimic chronic migraine and chronic tension-type headache, and it is also important to exclude secondary causes, particularly headaches due to alterations in CSF pressure and volume. A large proportion of NDPH sufferers have migrainous features to their headache and should be managed with treatments used for treating migraine. A small group of NDPH sufferers may have intractable headaches that are refractory to treatment.

  18. Making Daily Mobility

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Wind, Simon

    elucidate aspects of urban everyday mobility that can be utilized in policy and planning perspectives. This knowledge can aid construction of generalized qualitative scenarios that together with quantitative transport models can serve as wider knowledge foundation in decision making process.......In 2012 the average daily transportation distance for every Dane were 40 km (TU Data). Realising how much of life is spend thinking about, planning and performing mobility practices it becomes evident that it is much more than an instrumental physical phenomenon – it has great repercussions on life......, social networks, understanding of places and ultimately ourselves and others. To successfully accomplish everyday life, households have to cope with large number of different activities and mobility in relation to their children, work, social life, obligations, expectations, needs and wishes. Drawing...

  19. Physics in daily life

    CERN Document Server

    Hermans, Jo

    2012-01-01

    This book provides answers to everyday questions that any curious mind would ask, like : Why is water blue ? What makes ice so slippery ? How do we localize sound ? How do we keep our body temperature so nice and constant ? How do we survive the sauna at 90 C ? Why do large raindrops fall faster than small ones, and what exactly is their speed ? The answers are given in an accessible and playful way, and are illustrated with funny cartoons. In this book forty "Physics in Daily Life" columns, which appeared earlier in Europhysics News, are brought together in one inspiring volume. As well as being a source of enjoyment and satisfying insights for anyone with some physics background, it also serves as a very good teaching tool for science students. This booklet is a feast of erudition and humour.

  20. Automated high-performance cIMT measurement techniques using patented AtheroEdge™: a screening and home monitoring system.

    Science.gov (United States)

    Molinari, Filippo; Meiburger, Kristen M; Suri, Jasjit

    2011-01-01

    The evaluation of the carotid artery wall is fundamental for the assessment of cardiovascular risk. This paper presents the general architecture of an automatic strategy, which segments the lumen-intima and media-adventitia borders, classified under a class of Patented AtheroEdge™ systems (Global Biomedical Technologies, Inc, CA, USA). Guidelines to produce accurate and repeatable measurements of the intima-media thickness are provided and the problem of the different distance metrics one can adopt is confronted. We compared the results of a completely automatic algorithm that we developed with those of a semi-automatic algorithm, and showed final segmentation results for both techniques. The overall rationale is to provide user-independent high-performance techniques suitable for screening and remote monitoring.

  1. Closing the Energy Efficiency Gap: A study linking demographics with barriers to adopting energy efficiency measures in the home

    International Nuclear Information System (INIS)

    Pelenur, Marcos J.; Cruickshank, Heather J.

    2012-01-01

    This paper presents a study which linked demographic variables with barriers affecting the adoption of domestic energy efficiency measures in large UK cities. The aim was to better understand the ‘Energy Efficiency Gap’ and improve the effectiveness of future energy efficiency initiatives. The data for this study was collected from 198 general population interviews (1.5–10 min) carried out across multiple locations in Manchester and Cardiff. The demographic variables were statistically linked to the identified barriers using a modified chi-square test of association (first order Rao–Scott corrected to compensate for multiple response data), and the effect size was estimated with an odds-ratio test. The results revealed that strong associations exist between demographics and barriers, specifically for the following variables: sex; marital status; education level; type of dwelling; number of occupants in household; residence (rent/own); and location (Manchester/Cardiff). The results and recommendations were aimed at city policy makers, local councils, and members of the construction/retrofit industry who are all working to improve the energy efficiency of the domestic built environment. -- Highlights: ► 7 demographic variables linked to 8 barriers to adopting energy efficiency measures. ► A modified chi-square test for association was used (first order Rao–Scott corrected). ► Results revealed strong associations between most of the demographics and barriers. ► Data was collected from 198 interviews in the UK cities of Manchester and Cardiff. ► Specific recommendations are presented for regional policy makers and industry.

  2. A Daily Diary Approach to the Examination of Chronic Stress, Daily Hassles and Safety Perceptions in Hospital Nursing.

    Science.gov (United States)

    Louch, Gemma; O'Hara, Jane; Gardner, Peter; O'Connor, Daryl B

    2017-12-01

    Stress is a significant concern for individuals and organisations. Few studies have explored stress, burnout and patient safety in hospital nursing on a daily basis at the individual level. This study aimed to examine the effects of chronic stress and daily hassles on safety perceptions, the effect of chronic stress on daily hassles experienced and chronic stress as a potential moderator. Utilising a daily diary design, 83 UK hospital nurses completed three end-of-shift diaries, yielding 324 person days. Hassles, safety perceptions and workplace cognitive failure were measured daily, and a baseline questionnaire included a measure of chronic stress. Hierarchical multivariate linear modelling was used to analyse the data. Higher chronic stress was associated with more daily hassles, poorer perceptions of safety and being less able to practise safely, but not more workplace cognitive failure. Reporting more daily hassles was associated with poorer perceptions of safety, being less able to practise safely and more workplace cognitive failure. Chronic stress did not moderate daily associations. The hassles reported illustrate the wide-ranging hassles nurses experienced. The findings demonstrate, in addition to chronic stress, the importance of daily hassles for nurses' perceptions of safety and the hassles experienced by hospital nurses on a daily basis. Nurses perceive chronic stress and daily hassles to contribute to their perceptions of safety. Measuring the number of daily hassles experienced could proactively highlight when patient safety threats may arise, and as a result, interventions could usefully focus on the management of daily hassles.

  3. Evaluation of the Use of Home Blood Pressure Measurement Using Mobile Phone-Assisted Technology: The iVitality Proof-of-Principle Study

    NARCIS (Netherlands)

    Wijsman, L.W.; Richard, E.; Cachucho, R.; Craen, A.J. de; Jongstra, S.; Mooijaart, S.P.

    2016-01-01

    BACKGROUND: Mobile phone-assisted technologies provide the opportunity to optimize the feasibility of long-term blood pressure (BP) monitoring at home, with the potential of large-scale data collection. OBJECTIVE: In this proof-of-principle study, we evaluated the feasibility of home BP monitoring

  4. Evaluation of the Use of Home Blood Pressure Measurement Using Mobile Phone-Assisted Technology: The iVitality Proof-of-Principle Study

    NARCIS (Netherlands)

    Wijsman, Liselotte W.; Richard, Edo; Cachucho, Ricardo; de Craen, Anton J. M.; Jongstra, Susan; Mooijaart, Simon P.

    2016-01-01

    Mobile phone-assisted technologies provide the opportunity to optimize the feasibility of long-term blood pressure (BP) monitoring at home, with the potential of large-scale data collection. In this proof-of-principle study, we evaluated the feasibility of home BP monitoring using mobile

  5. Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative).

    Science.gov (United States)

    Chalmers, J R; Thomas, K S; Apfelbacher, C; Williams, H C; Prinsen, C A; Spuls, P I; Simpson, E; Gerbens, L A A; Boers, M; Barbarot, S; Stalder, J F; Abuabara, K; Aoki, V; Ardeleanu, M; Armstrong, J; Bang, B; Berents, T L; Burton, T; Butler, L; Chubachi, T; Cresswell-Melville, A; DeLozier, A; Eckert, L; Eichenfield, L; Flohr, C; Futamura, M; Gadkari, A; Gjerde, E S; van Halewijn, K F; Hawkes, C; Howells, L; Howie, L; Humphreys, R; Ishii, H A; Kataoka, Y; Katayama, I; Kouwenhoven, W; Langan, S M; Leshem, Y A; Merhand, S; Mina-Osorio, P; Murota, H; Nakahara, T; Nunes, F P; Nygaard, U; Nygårdas, M; Ohya, Y; Ono, E; Rehbinder, E; Rogers, N K; Romeijn, G L E; Schuttelaar, M L A; Sears, A V; Simpson, M A; Singh, J A; Srour, J; Stuart, B; Svensson, Å; Talmo, G; Talmo, H; Teixeira, H D; Thyssen, J P; Todd, G; Torchet, F; Volke, A; von Kobyletzki, L; Weisshaar, E; Wollenberg, A; Zaniboni, M

    2018-05-01

    This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to predefined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon. © 2018 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

  6. Estimativa do total de horas abaixo de determinada temperatura-base através das medidas diárias da temperatura do ar Number of hours below any base temperature estimated by daily measurements of air temperature

    Directory of Open Access Journals (Sweden)

    Luiz B. Angelocci

    1979-01-01

    Full Text Available São propostas equações matemáticas para estimar o total diário de horas abaixo de determinada temperatura-base, em certo período, utilizando-se somente dos valores diários das temperaturas máxima, mínima e das 21 horas (hora local. A comparação entre os totais diários e mensais de "horas de frio" estimados pelas equações propostas e os observados através de termogramas, para várias localidades do Estado de São Paulo, mostrou boa concordância entre os métodos de cálculo. O modelo proposto dispensa o uso de registros contínuos de temperatura. As vantagens de tal estimativa residem na maior disponibilidade de registros de temperaturas máximas, mínimas e das 21 horas, permitindo maior densidade de pontos em trabalhos de zoneamento agroclimático e de cartografia, além da eliminação do processo de cotação de termogramas.Mathematical equations are proposed to estimate the daily number of hours in which the air temperature remains below a determined treshold value. The equations require only daily values of maximum, minimum and 9 p.m. local time temperature, measured inside the meteorological shelter. This technique is suitable for machine computation thus avoiding the tremendous task of quantifying a large number of thermograms. This fact permits the utilization of a greater number of stations in studies of crop zonation and cartography. Good correlations were obtained between estimated and observed data of the daily and monthly total number of hours below 7°C, 13°C and 17°C, for five stations in the State of São Paulo, Brazil, showing relative accuracy of the proposed equations.

  7. Bringing Your Baby Home

    Science.gov (United States)

    ... for Educators Search English Español Bringing Your Baby Home KidsHealth / For Parents / Bringing Your Baby Home What's ... recall your baby's seemingly endless crying episodes. The Home Front Introducing your baby to others at home ...

  8. The Medical Home

    Science.gov (United States)

    ... Videos for Educators Search English Español The Medical Home KidsHealth / For Parents / The Medical Home What's in ... for your child. What Does the Term "Medical Home" Mean? A medical home isn't a place ...

  9. Daily Stressors and Adult Day Service Use by Family Caregivers: Effects on Depressive Symptoms, Positive Mood and DHEA-S

    Science.gov (United States)

    Zarit, Steven H.; Whetzel, Courtney A.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Rovine, Michael J.; Klein, Laura Cousino

    2014-01-01

    Objectives This study examines effects of daily use of adult day services (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Design We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and non-intervention days to evaluate within- and between-person effects of the intervention. Setting Caregivers were interviewed daily by telephone at home. Participants 151 family caregivers of IWD who were using ADS. Measurements Saliva samples were collected from caregivers 5 times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days following ADS use. Daily DHEA-S levels covaried significantly with daily positive mood, but not depressive symptoms. Conclusions These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors. PMID:24566240

  10. Smart homes and home health monitoring technologies for older adults: A systematic review.

    Science.gov (United States)

    Liu, Lili; Stroulia, Eleni; Nikolaidis, Ioanis; Miguel-Cruz, Antonio; Rios Rincon, Adriana

    2016-07-01

    Around the world, populations are aging and there is a growing concern about ways that older adults can maintain their health and well-being while living in their homes. The aim of this paper was to conduct a systematic literature review to determine: (1) the levels of technology readiness among older adults and, (2) evidence for smart homes and home-based health-monitoring technologies that support aging in place for older adults who have complex needs. We identified and analyzed 48 of 1863 relevant papers. Our analyses found that: (1) technology-readiness level for smart homes and home health monitoring technologies is low; (2) the highest level of evidence is 1b (i.e., one randomized controlled trial with a PEDro score ≥6); smart homes and home health monitoring technologies are used to monitor activities of daily living, cognitive decline and mental health, and heart conditions in older adults with complex needs; (3) there is no evidence that smart homes and home health monitoring technologies help address disability prediction and health-related quality of life, or fall prevention; and (4) there is conflicting evidence that smart homes and home health monitoring technologies help address chronic obstructive pulmonary disease. The level of technology readiness for smart homes and home health monitoring technologies is still low. The highest level of evidence found was in a study that supported home health technologies for use in monitoring activities of daily living, cognitive decline, mental health, and heart conditions in older adults with complex needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Diagnostic performance of an automatic blood pressure measurement device, Microlife WatchBP Home A, for atrial fibrillation screening in a real-world primary care setting.

    Science.gov (United States)

    Chan, Pak-Hei; Wong, Chun-Ka; Pun, Louise; Wong, Yu-Fai; Wong, Michelle Man-Ying; Chu, Daniel Wai-Sing; Siu, Chung-Wah

    2017-06-15

    To evaluate the diagnostic performance of a UK National Institute for Health and Care Excellence-recommended automatic oscillometric blood pressure (BP) measurement device incorporated with an atrial fibrillation (AF) detection algorithm (Microlife WatchBP Home A) for real-world AF screening in a primary healthcare setting. Primary healthcare setting in Hong Kong. This was a prospective AF screening study carried out between 1 September 2014 and 14 January 2015. The Microlife device was evaluated for AF detection and compared with a reference standard of lead-I ECG. Diagnostic performance of Microlife for AF detection. 5969 patients (mean age: 67.2±11.0 years; 53.9% female) were recruited. The mean CHA 2 DS 2 -VASc ( C : congestive heart failure [1 point]; H : hypertension [1 point]; A 2 : age 65-74 years [1 point] and age ≥75 years [2 points]; D : diabetes mellitus [1 point]; S : prior stroke or transient ischemic attack [2 points]; VA : vascular disease [1 point]; and Sc : sex category [female] [1 point])score was 2.8±1.3. AF was diagnosed in 72 patients (1.21%) and confirmed by a 12-lead ECG. The Microlife device correctly identified AF in 58 patients and produced 79 false-positives. The corresponding sensitivity and specificity for AF detection were 80.6% (95% CI 69.5 to 88.9) and 98.7% (95% CI 98.3 to 98.9), respectively. Among patients with a false-positive by the Microlife device, 30.4% had sinus rhythm, 35.4% had sinus arrhythmia and 29.1% exhibited premature atrial complexes. With the low prevalence of AF in this population, the positive and negative predictive values of Microlife device for AF detection were 42.4% (95% CI 34.0 to 51.2) and 99.8% (95% CI 99.6 to 99.9), respectively. The overall diagnostic performance of Microlife device to detect AF as determined by area under the curves was 0.90 (95% CI 0.89 to 0.90). In the primary care setting, Microlife WatchBP Home was an effective means to screen for AF, with a reasonable sensitivity of 80.6% and

  12. Occupational Therapy Predischarge Home Visits in Acute Hospital Care: A Randomized Trial.

    Science.gov (United States)

    Clemson, Lindy; Lannin, Natasha A; Wales, Kylie; Salkeld, Glenn; Rubenstein, Laurence; Gitlin, Laura; Barris, Sarah; Mackenzie, Lynette; Cameron, Ian D

    2016-10-01

    To determine whether an enhanced occupational therapy discharge planning intervention that involved pre- and postdischarge home visits, goal setting, and follow-up (the HOME program) would be superior to a usual care intervention in which an occupational therapy in-hospital consultation for planning and supporting discharge to home is provided to individuals receiving acute care. Randomized controlled trial. Acute and medical wards. Individuals aged 70 and older (N = 400). Primary outcomes: activities daily living (ADLs; Nottingham Extended Activities of Daily Living) and participation in life roles and activities (Late Life Disability Index (LLDI)). Occupational therapist recommendations differed significantly between groups (P occupational therapy recommendations as the in-hospital only consultation, which had a greater emphasis on equipment provision, but HOME did not demonstrate greater benefit in global measures of ADLs or participation in life tasks than in-hospital consultation alone. It is not recommended that home visits be conducted routinely as part of discharge planning for acutely hospitalized medical patients. Further work should develop guidelines for quality in-hospital consultation. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  13. Edificio Daily Mirror

    Directory of Open Access Journals (Sweden)

    Williams, Owen

    1963-07-01

    Full Text Available The building has 18 levels. The Press occupies the 4 basement floors. The ground floor is taken up with the entrance hall, and an indoor carriage way. A snack bar and the telephone operators are situated on the second floor. The production department and the medical services are located on the third storey, whilst the fourth is occupied by the offices and library. The fifth floor is the beginning of the higher section of the building. This floor and up to including the 11th floor are devoted to office space, except for the 10th storey, which contains the office apartments of the directors and the Council Chamber. Equipment related to various services of the building is housed on the 12th storey. Finally, this tall building constitutes a fine landmark in the London skyline. The Daily Mirror building is outstanding for the appropriate nature, the completeness and the quality of its installations, which thus provide the most widely read paper in the world with outstandingly efficient offices.Este edificio consta de 18 plantas. El cuerpo de Prensa se aloja en los cuatro sótanos; los vestíbulos de entrada y una calzada interior para vehículos se hallan en la planta baja; la primera alberga un snack-bar y centralita telefónica; la segunda, el departamento de producción y centro de asistencia médica, y la tercera, las oficinas y biblioteca principales. La cuarta planta señala el comienzo del bloque alto; esta planta, junto con las quinta, sexta, séptima, octava y décima, están dedicadas a oficinas. La novena contiene las oficinas-apartamentos de los directores y salas de Consejo, y la undécima, la maquinaria para las diversas instalaciones del edificio. La elevada torre constituye un grandioso hito de referencia en esta zona de Londres. El «Daily Mirror» se distingue por el acierto, número y perfección de sus instalaciones, que proporcionan, al periódico de mayor actualidad mundial, las más adecuadas y amplias oficinas modernas.

  14. Neighbourhood walkability, daily steps and utilitarian walking in Canadian adults.

    Science.gov (United States)

    Hajna, Samantha; Ross, Nancy A; Joseph, Lawrence; Harper, Sam; Dasgupta, Kaberi

    2015-11-24

    To estimate the associations of neighbourhood walkability (based on Geographic Information System (GIS)-derived measures of street connectivity, land use mix, and population density and the Walk Score) with self-reported utilitarian walking and accelerometer-assessed daily steps in Canadian adults. A cross-sectional analysis of data collected as part of the Canadian Health Measures Survey (2007-2009). Home neighbourhoods (500 m polygonal street network buffers around the centroid of the participant's postal code) located in Atlantic Canada, Québec, Ontario, the Prairies and British Columbia. 5605 individuals participated in the survey. 3727 adults (≥18 years) completed a computer-assisted interview and attended a mobile clinic assessment. Analyses were based on those who had complete exposure, outcome and covariate data (n=2949). GIS-derived walkability (based on land use mix, street connectivity and population density); Walk Score. Self-reported utilitarian walking; accelerometer-assessed daily steps. No important relationship was observed between neighbourhood walkability and daily steps. Participants who reported more utilitarian walking, however, accumulated more steps (walkability and odds of walking ≥1 h/week for utilitarian purposes (eg, Q4 vs Q1 of GIS-derived walkability: OR=1.66, 95% CI 1.31 to 2.11; Q3 vs Q1: OR=1.41, 95% CI 1.14 to 1.76; Q2 vs Q1: OR=1.13, 95% CI 0.91 to 1.39) independent of age, sex, body mass index, married/common law status, annual household income, having children in the household, immigrant status, mood disorder, perceived health, ever smoker and season. Contrary to expectations, living in more walkable Canadian neighbourhoods was not associated with more total walking. Utilitarian walking and daily steps were, however, correlated and walkability demonstrated a positive graded relationship with utilitarian walking. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  15. Nursing students' attitudes about home health nursing.

    Science.gov (United States)

    Prestia, Mindy; Murphy, Susan; Yoder, Marian

    2008-09-01

    In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

  16. Analyzing the Effects of Urban Combat on Daily Casualty Rates

    National Research Council Canada - National Science Library

    Yazilitas, Hakan

    2004-01-01

    .... The available data set contains measurements about the battles like initial strengths, daily casualties, terrain, front width, linear density, attacker's and defender's country, and armor losses...

  17. Android based security and home automation system

    OpenAIRE

    Khan, Sadeque Reza; Dristy, Farzana Sultana

    2015-01-01

    The smart mobile terminal operator platform Android is getting popular all over the world with its wide variety of applications and enormous use in numerous spheres of our daily life. Considering the fact of increasing demand of home security and automation, an Android based control system is presented in this paper where the proposed system can maintain the security of home main entrance and also the car door lock. Another important feature of the designed system is that it can control the o...

  18. Measuring care of the elderly: psychometric testing and modification of the Time in Care instrument for measurement of care needs in nursing homes

    Directory of Open Access Journals (Sweden)

    Nyberg Per

    2008-09-01

    Full Text Available Abstract Background Aging entails not only a decrease in the ability to be active, but also a trend toward increased dependence to sustain basic life functions. An important aspect for appropriately elucidating the individual's care needs is the ability to measure them both simply and reliably. Since 2006 a new version of the Time in Care needs (TIC-n instrument (19-item version has been explored and used in one additional municipality with the same structure as the one described in an earlier study. Methods The TIC-n assessment was conducted on a total of 1282 care recipients. Factor analysis (principal component was applied to explore the construct validity of the TIC-n. Cronbach's alpha was ca