Dissertations / Theses on the topic 'Disability and Functional Capacity'
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1
Kragnienė, Inga. "Skirtingos fizinės negalios neįgaliųjų plaukikų požiūris į klasifikacijos sistemą ir galimybės siekti rezultatų." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2008~D_20080618_125536-62354.
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Klasifikacijos pagrindinis tikslas - užtikrinti lygiavertį neįgaliųjų plaukikų su skirtingoms fizinėmis negalėmis dalyvavimą varžybose. Lygiavertiškumo įvertinimas yra labai sudėtingas procesas, dėl to vis dar tęsiasi mokslininkų diskusijos ieškant naujų tyrimo metodų, kaip išanalizuoti ir objektyviai įvertinti skirtingos negalios plaukikų galimybes dalyvauti neįgaliųjų plaukime. Tyrimo objektas – skirtingų fizinių negalių neįgalieji plaukikai. Dėl vis besitesinčios diskusijos apie klasifikacijos problemas ir išsamesnių tyrimų trūkumo, funkcinės plaukimo klasifikacinės sistemos tyrimai išlieka aktualūs ir reikšmingi. Dėl to, kad mažai tyrinėtas neįgaliųjų požiūris į klasifikacijos sistemą ir netyrinėtas treniruočių poveikis skirtingos negalios plaukikų rezultatams buvo suformuluotos tokios hipotezės:
• skirtingos fizinės negalios plaukikų požiūris į klasifikacijos sistemą turėtų būti teigiamas;
• skirtingos fizinės negalios tipo, bet tos pačios klasės plaukikų aerobinio pajėgumo rodikliai ir plaukimo rezultatai turėtų būti panašūs.
Šio darbo tyrimo tikslas – nustatyti ir įvertinti skirtingos fizinės negalios tipo plaukikų požiūrį ir galimybes dalyvauti neįgaliųjų plaukime, aerobinio pajėgumo rodiklių ir plaukimo rezultatų kitimo aspektais. Šiam tiksliu pasiekti buvo iškelta keletas uždavinių:
1. nustatyti ir įvertinti neįgaliųjų plaukikų požiūrį į klasifikacinę sistemą ir galimybes dalyvauti plaukime;
2. nustatyti ir įvertinti aštuonių savaičių trukmės treniruočių įtaką... [toliau žr. visą tekstą]Sport classification systems help to ensure that competition is equitable and individuals who, do so because of training and talent and not because their disability happens to be less severe then their opponents. For international competition the system changes. Since the late 1980”s international swimming for athletes with disabilities has used a functional classification system. It was a lot of proble in this disability system. Disability swimming is a complex social system with many individual actors interaction with each other to fulfill specific functions that are necessary to optimize disability swimming as a viable part of the disability sport movement. The purpose of this study was to determine of physical disable swimmer side and possibilities have a good result. Hypothesis of the research: • Sport classification system mast to help the person with different physical disable in the game; • the person with different physical disable in the same S4 class capacity mast to be the equable. The goals of this study: 1. ascertains and evaluate disabled swimmer side to classification systems; 2. ascertains and evaluate eight weeks aerobics training effect for S4 class disable swimmer; 3. ascertains and evaluate functional swimmers classification system capacity for S4 class different physical ddisable. Methods: • questioned; ��� testing; • exsperiment; • mathematical statistics. The research were carried out in Lithuanian academy of physical education in laboratory. In... [to full text]
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SUBRAMANIAN, ANAND. "DEVELOPING MTM MODIFIERS FOR TASKS PERFORMED BY INDIVIDUALS WITH PERMANENT PARTIAL DISABILITY OF THE FINGERS." University of Cincinnati / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1186662098.
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Steffensen, Birgit F. "Functional ability in non-ambulatory people with Duchenne muscular dystrophy or spinal muscular atrophy assessed with the EK scale /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-252-3.
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Lamarca, Casado Rosa. "Gender diferences in the association between disability and mortality in the elderly." Doctoral thesis, Universitat Pompeu Fabra, 2006. http://hdl.handle.net/10803/7097.
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Aquesta tesi avalua l'existència de diferencies per gènere en la relació entre discapacitat i mortalitat, i aspectes metodològics en l'anàlisi de supervivènciad'estudis de gent gran. Es van utilitzar les dades provinents d'una cohort de 1.315 subjectes amb edats superiors o iguals a 65 anys que van ser seguits durant un periode de 8 anys. La discapacitat es va mesurar mitjançant la capacitat que declarava l'individu per dur a terme activitats de la vida diària bàsiques. La discapacitat va evolucionar al llarg del temps empitjorant amb l'edat, però una proporció no menyspreable va ser capaç de recuperar-se. Es van observar diferències per gènere en l'evolució de la discapacitat: les dones tenien més dificultats en recuperar la seva capacitat funcional un cop esdevenien discapacitades. La força de l'associació entre la discapacitat i la mortalitat disminuia a edats avançades. Es van trobar diferencies per sexe: les dones depenents mostraven un risc de morir més alt que el homes depenents.
Polítiques de salut dirigides a dones discapacitades haurien de ser implementades degut a la proporció més elevada de dones discapacitades, la probabilitat menor que tenen de recuperar la capacitat funcional, i el risc de morir més elevat que presenten comparat amb homes dicapacitats.
This thesis evaluates the existence of gender differences in the relationship between disability and mortality, as well as methodological aspects of the survival analysis for elderly studies. Data from a cohort of 1,315 subjects aged 65 years and older followed-up 8 years was used. Disability was assessed by self-reported difficulty to perform basic activities of daily living.
Disability evolved over time worsening with age, but a non-negligible proportion was able to recover. There were gender differences in the evolution of disability: women were less able to regain functional capacity once they become disabled. The strength of the association between disability and mortality decreased in the older ages. But differences by gender were found: dependent elderly women showed a higher risk of dying compared to dependent men.
Health policies focusing on disabled women should be implemented, due to the higher proportion of disabled women, the lower probability of regaining functional capacity, and their higher risk of dying compared to disabled men.
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Pepera, Garyfallia K. "Assessments of functional capacity in cardiac rehabilitation." Thesis, University of Essex, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.536959.
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Hamilton, Arthur. "India and Intellectual Disability: An Intersectional Comparison of Disability Rights Law and Real Needs." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/40282.
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Given its vast population, India has one of the highest absolute numbers of people with intellectual disability (PwIDs) in the world. Studies have placed the prevalence as high as 3.1% of children aged between 2 to 5 years and 5.2% of children aged between 6 to 9 years. India recently passed the Rights of Persons with Disabilities Act, 2016 (RPwD Act), to align itself with the United Nations Convention on the Rights of Persons with Disabilities. This thesis applied the complementary methods of the review of academic and grey literature, document analysis of the RPwD Act, and in-depth informant interviews to become the first full study on the extent to which the RPwD Act meets the needs of PwIDs. Drawing on the biopsychosocial model of disability and intersectional theory, the findings show that the RPwD Act only partially meets the needs of PwIDs. The RPwD Act does incorporate progressive elements such as affirmative action provisions in the labour market, measures to prevent unethical research on PwIDs, and steps toward inclusive education. However, the Act stipulates a disability certification process that remains mired in the medical model of disability and is mostly inaccessible in rural areas. It also continues the system of legal guardianship dating to the colonial era which deprives many PwIDs of legal capacity and leaves some of them confined to long-term institutions with highly inadequate levels of care. Other problems in the Act include inadequate provisions to provide privacy, reproductive rights and education, and protection from discrimination.
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Klineburger, Philip C. "The Dynamic Functional Capacity Theory: Music Evoked Emotions." Diss., Virginia Tech, 2014. http://hdl.handle.net/10919/50991.
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The music-evoked emotion literature implicates many brain regions involved in
emotional processing but is currently lacking a model that specifically explains how they
temporally and dynamically interact to produce intensely pleasurable emotions. A
conceptual model, The Dynamic Functional Capacity Theory (DFCT), is proposed that
provides a foundation for the further understanding of how brain regions interact to
produce intense intensely pleasurable emotions. The DFCT claims that brain regions
mediating emotion and arousal regulation have a limited functional capacity that can be
exceeded by intense stimuli. The prefrontal cortex is hypothesized to abruptly deactivate
when this happens, resulting in the inhibitory release of sensory cortices, the limbic
system, the reward-circuit, and the brainstem reticular activating system, causing
'unbridled' activation of these areas. This process produces extremely intense emotions.
This theory may provide music-evoked emotion researchers and Music Therapy
researchers a theoretical foundation for continued research and application and also to
compliment current theories of emotion.Ph. D.
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Charil, Arnaud. "Morphological and functional correlates of disability in multiple sclerosis." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=111891.
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This doctoral dissertation presents a series of studies that were conducted to investigate the relationship between morphological, as well as functional, changes and clinical disability in multiple sclerosis (MS) using magnetic resonance imaging (MRI) and functional MRI (fMRI).The extent of macroscopic brain tissue damage, as seen on T2-weighted MRI scans, is poorly correlated with measures of functional impairment in MS. We hypothesized that this might be due to the failure to take lesion location into account. By combining sophisticated lesion segmentation tools with the statistical and stereotaxic techniques of functional neuroimaging, we have shown a relationship between lesion location and the extent and type of physical and cognitive disability.
Brain atrophy is another manifestation of MS. We conducted the first large-scale study of focal cortical atrophy in MS that uses cortical thickness measurements across the entire cortex. We present evidence that cortical atrophy occurs relatively early in the course of the disease, despite the lack of severe disability in MS patients, as assessed by the Expanded Disability Status Scale (EDSS), and follows a pattern of focal thinning that is more pronounced in areas that are heavily inter-connected with other brain regions, such as anterior cingulate cortex and association areas, suggesting that interruption of white matter tracts by MS plaques might play a causative role in cortical atrophy.
Finally, we conducted an fMRI study of working memory in controls, cognitively unimpaired and impaired MS patients that revealed significant differences in the regions that were activated between the groups. Most interestingly, while both cognitively unimpaired MS patients and control subjects significantly activated the left dorsolateral prefrontal cortex and the left thalamus, cognitively impaired MS patients failed to significantly activate these areas. Levels of deactivation within the medial prefrontal/anterior cingulate cortices and posterior cingulate cortex were inferior in MS patients than in controls. This study suggests that with an increased white matter lesion volume there is an increased damage to a number of afferents and efferents to and from the thalamus (cortico-basal ganglia-thalamo-cortical loops and other thalamo-cortical projections) that ultimately causes the observed cognitive deficits. These cognitive deficits seem also to be dependent on a reduced capacity of MS patients to show task-related deactivations.
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Boahen, Godfred Fordjour. "Ethnicity, learning disability, and the Mental Capacity Act 2005 : a social constructionist ethnography of an integrated learning disability service." Thesis, Open University, 2013. http://oro.open.ac.uk/54718/.
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This thesis explores how the Mental Capacity Act 2005 (MCA) is operationalised within an integrated statutory learning disability service and examines how the legislation is manifested in everyday lived experience of an ethnic minority. In England and Wales, the MCA established a framework for assessing cognitive decision-making ability with mental capacity conceptualised as 'objective', 'rational' and person-specific. Taking as points of departure rationality and individualism which are associated with Western liberal democracy, the MCA evokes interest in how the notion of mental capacity is understood within different cultures. In the statutory context, with on-going heated debates about the epistemology of mental capacity, there is the need to examine how professionals concretise an arguably nebulous concept in their roles. These aforementioned issues are addressed in this thesis through examination of data collected during two phases of ethnographic fieldwork in a London local authority. Proposing a new relational model as a theoretical approach, it is argued that ethnicity, learning disability, and mental capacity emanate from human interactions; therefore, greater attention should be paid to context and localised meanings to better understand how they interact in everyday living.
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Blomqvist, Sven. "Postural balance, physical activity and capacity among young people with intellectual disability." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-71227.
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The overall aim of this thesis was to investigate postural balance, physical activity, physical capacity and their associations in young people (16-20 years) with intellectual disability (ID), mild to moderate. The aim was also to study the reliability and concurrent validity of postural balance tests. To evaluate postural balance, one assessor used five common postural balance tests and one new test. The tests were performed twice for 89 young people with ID (one to twelve days apart). Intraclass correlation coefficients greater than 0.80 were achieved for four of the common balance tests: Extended Timed Up and Go Test (ETUGT), Modified Forward Reach Test (MFRT), One-Leg Stance Test (OLS), and a Force Platform Test (FPT). The smallest real difference ranged from 12% to 40%; less than 20% is considered to be low. For the six balance tests, the concurrent validity varied between none to low. Falls are more common for young people with ID compared to young people without ID. One reason could be impaired postural balance. The postural balance for young people with ID has not been thoroughly investigated. Therefore, five balance tests and three muscle strength tests were used to compare young people with ID with an age-matched control group without ID (n=255). The young people with ID had significantly lower scores on most of the postural balance tests and muscle strength tests of the trunk and lower limbs. Muscle strength, height, and body mass index had no strong association with postural balance. The results also illustrated that young people with ID did not rely more on vision for their balance ability compared to peers without ID. It seems that postural balance is impaired for young people with ID when evaluated with common tests. An everyday situation is to react to unexpected balance disturbances to avoid falls by using different postural responses. Since young people with ID seem to fall more often than peers without ID, it is valuable to investigate if those postural responses are different between the groups. Therefore, young people with and without ID (n=99) were exposed to six backward surface translations and several postural muscle responses were evaluated: muscle synergies and strategies, muscle onset latency, time-to-peak amplitude, and adaptation. The responses of the investigated muscles – the gastrocnemius, the biceps femoris, and the erector spinae L4 level – were measured using electromyography. The results showed that there were no differences between the two groups with respect to synergies or strategies, muscle onset latency, and time-to-peak amplitude. An overall pattern was seen, that young people with ID adapted their muscle response slower in all three muscles than peers without ID, but this pattern was not statistically significant. Studies have shown that people with ID have impaired postural balance, a lower level of physical activity, and lower aerobic capacity compared to people without ID. The association is however not investigated. Therefore, postural balance (postural sway indirectly measured with the subjects standing on a force platform), physical activity (measured with a pedometer), and aerobic capacity (measured with a sub-maximal ergometer cycle test) were used to assess young people with and without ID (n=106). To investigate the subjects’ view of their own health, the subjects completed an adapted questionnaire that addressed their perceived health. The analysis showed no significant associations between postural balance, level of physical activity, and aerobic capacity. The subjects in the ID group, both men and women, had significantly lower aerobic capacity compared to subjects without ID. The answers from the health questionnaire did not correspond to the measured outcomes from the physical tests for young people with ID. In conclusion, ETUGT and MFRT can be used to evaluate change in postural balance over time in young people with mild to moderate ID. The low concurrent validity suggests that the postural balance tests probably challenge various subsystems. Young people with ID have impaired postural balance and perform lower on muscle strength tests than age-matched controls. Postural muscle responses after external perturbations seem to be similar for young people with and without ID, but the ability to adapt muscle responses after repeated perturbations appears to be slower for young people with ID. The studies in the thesis also indicate that young people with ID have reduced level of physical activity and lower aerobic capacity. The lack of association between the different physical functions indicates that they should be evaluated and exercised separately. Young persons with ID might have more difficulty realising the health advantage of being physically active, as they do not seem to make this connection. Because of this, it is important that parents/guardians, school staff, physiotherapists, and others encourage them to participate in physical activity.
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Strickler, Amy Ann. "Functional Capacity Outcomes following Coronary Artery Bypass Graft Surgery." Thesis, Virginia Tech, 1998. http://hdl.handle.net/10919/36680.
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The objective of this study was to determine if this is possible to predict 3 mo post-CABG treadmill VO2pk outcomes from a combination of pre-surgical physical fitness and health and clinical status variables. To determine the VO2pk, subjects performed a maximal treadmill test using a ramp protocol and gas analysis. When all pre-surgical variables where included in a multiple linear regression, the analysis yielded a model that included the prior to surgery VSAQ, orthopedic limitations, and angiotensin converting enzymes (ACE) inhibitor drugs as significant predictors (R2 = 0.50, N = 63). When an RER of 1.1 was achieved during the treadmill test, myocardial infarction (MI) and if so, the length of time lapse from the MI, chronic heart failure, lipid lowering drugs, BMI, ACE inhibitor drugs, and orthopedic limitations (R2 = 0.56, N =29) were significant predictors. The data suggest that there is some relationship between post-surgical outcomes and pre-surgical physical fitness.Master of Science
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Read, Natalie. "Exploring constructs of capacity in learning disability contexts : power, protection and institutional practices." Thesis, University of East London, 2016. http://roar.uel.ac.uk/5398/.
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The Mental Capacity Act (2005) is a legislative framework designed to promote autonomy and support those who may struggle to make decisions for themselves. Previous research suggests that the implementation of the Mental Capacity Act raises a number of challenges for professionals (McVey, 2013; Walji, Fletcher & Weatherhead, 2014) and that applying the Act in learning disability settings may be particularly complex (Brown & Marchant, 2013). The concepts of ‘capacity’ and ‘learning disability’ draw on knowledge across legal, philosophical and psychiatric discourses, which may imply different practices for professionals. Semi-structured interviews were completed with eight professionals working in adult community learning disability services. A Foucauldian approach to discourse analysis was used to examine how capacity was constructed in professionals’ accounts of their experiences implementing the Mental Capacity Act. The discourses and subject positions available to professionals and people with learning disabilities were considered. Analysis of professionals’ accounts suggested that ‘legal’ and ‘rights’ discourses of capacity were oriented to. Knowledge of capacity was constructed as being limited to professionals, with families and service users often in need of further information on the Mental Capacity Act. ‘Legal’ and ‘rights’ discourses enabled multiple subject positions for professionals and people with learning disabilities. These positions allowed for both restrictive and empowering practices. Promoting subject positions of ‘personhood’ appeared to allow for alternative understandings of capacity, in which decision-making is an interdependent rather than independent process. This study suggests that capacity assessments are sites of tension between multiple discourses. Co-constructing meanings of capacity within services and across disciplines may allow for the development of best practice, and facilitate supported decision-making practices with people with learning disabilities.
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Goldsmith, Lesley. "Informed consent for pharmacogenomic testing in people with a learning disability." Thesis, University of Plymouth, 2011. http://hdl.handle.net/10026.1/316.
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Informed consent for pharmacogenomic testing in people with a learning disability Background Advances in genomic healthcare will enable medication to be tailored to each individual’s needs, based on subtle genetic variations. This will result in individuals being asked to consent to genetic testing for this purpose. The recent political agenda for social change has emphasised the right of people with learning disabilities to have more autonomy and make their own decisions. There have also been significant changes in the way healthcare practitioners relate to their patients, with a shift away from paternalism towards shared decision-making. Research Aim The aims of the study were (1) to explore the information needs of people with mild to moderate learning disabilities with respect to pharmacogenomic tests and (2) to identify ways of facilitating informed consent. Methods An integrative literature review was conducted to identify research on informed consent to healthcare interventions in people with learning disabilities (Phase 1). Subsequent phases (Phases 2-4) of the study were conducted using an ethnographic approach. Phase 2 involved observation of six participants with learning disabilities undergoing a routine blood test consultation in general practice. This was followed by Phase 3, in which semi-structured interviews with 14 participants with learning disabilities were conducted. In Phase 4, three different methods were used: focus groups with carers (four paid carers, five family carers), an on-line bulletin board for healthcare professionals (five participants) and interviews with six key informants from the field of learning disability. Findings The data showed consent procedures were often inadequate and there was inconsistent knowledge of mental capacity law amongst health professionals. Provision of information to patients prior to a blood test was variable, but interviews with people with learning disabilities revealed the fact that this information may not be wanted by them. People with learning disabilities viewed pharmacogenomic tests as similar to other blood tests and would want access to them. The attitudes of paid carers and family carers differed in terms of decision-making opportunities for people with learning disabilities. Conclusions Healthcare practitioners, carers and people with learning disability need to be familiar with the principles of the Mental Capacity Act to facilitate valid consent in the healthcare context. Healthcare practitioners also need to be made aware of developments in pharmacogenomics if it is to become part of routine health care. Finally, this study demonstrated the value of qualitative research in exploring the knowledge and attitudes of people with learning disability.
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Hudson, Annette. "Low intensity exercise, functional capacity and lipoprotein metabolism in women." Thesis, Loughborough University, 1991. https://dspace.lboro.ac.uk/2134/27954.
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Moriello, Carolina. "Relation of muscle strength to functional walking capacity post stroke." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97973.
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The main objective of this observational, cross sectional study is to estimate the extent to which muscle strength is independently associated with functional walking capacity among stroke patients. Sixty three stroke patients, from 3 to 12 months post onset, were evaluated on functional walking capacity (6 Minute Walk Test), muscle strength (hand held dynamometry), balance (Berg Balance Scale), and tone (Modified Ashworth Scale and Composite Spasticity Index). The results showed that a global index of muscle strength, balance, tone and comorbids explain 70% of the variability of the 6MWT. Moreover, the muscle strength of the affected side in gravity related positions, as an index, explain most of the variability (37%), in comparison to the other positions. In addition, the hip flexor in an alternate against gravity position, as an individual muscle, explains the most variability of walking capacity.
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Laikind, Lawrence A. "The Application of Article 12 of the Convention on the Rights of Persons with Disabilities(CRPD) to decisions of Australian tribunals and court administering guardianship legislation." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101500/1/Lawrence_Laikind_Thesis.pdf.
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This thesis examines compliance of decisions by Australian tribunals and courts administering guardianship legislation with the requirement of Article 12 of the Convention on the Rights of Persons with Disabilities that all adults have the right to universal legal capacity. Over 300 publically available guardianship tribunal and court decisions involving residential accommodation were examined from NSW, Queensland and Victoria. The cases reviewed were from the period between Australia’s ratification of the Convention in 2008 and July 2015. There was variable compliance with the Convention across the States. The principles in the guardianship legislation were more important than the Convention, and ‘best interests’ principles took priority over autonomy-based principles consistent with the Convention.
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Badduke, Chansonette. "Functional genomic analysis of novel microdeletions and microduplications associated with intellectual disability." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/56242.
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Intellectual disability (ID) is a diagnosis given to persons who have life-long cognitive and adaptive impairments that begin early in life. ID affects about 1-3% of the population. Extremely small chromosome losses and gains, called microdeletions and microduplications respectively (or collectively Copy Number Variants, CNVs), are the cause of ID in ~15% of cases and their identification has helped to pinpoint genomic regions that contain ID-genes. The objective of my PhD research was to search for ID candidate genes in subjects with ID, focusing on the functional genomic analysis of genes from CNVs and in the rest of the genome. I studied individuals with unique de novo pathogenic CNVs at chromosomal position 2p15-16.1 or with familial CNVs at chromosomal position 1q21.1. I used a multi-faceted approach that included the study of candidate genes’ 1) expression, 2) sequence variants, 3) knock down consequence in C. elegans and 4) imprinting potential. My results showed that the best candidate genes from the 2p15-16.1 CNV are XPO1, USP34 and REL because their expression is reduced in individuals with deletions. In case of the 1q21.1 CNV, I identified two candidate genes (CHD1L and PRKAB2) from the CNV that had altered expression and cellular function. I also identified a pathogenic sequence change in ATF6 in individuals with a familial 1q21.1 duplication. ATF6 is located outside the 1q21.1 CNV and is part of the Endoplasmic Reticulum (ER) stress response pathway which may contribute to the phenotypic variability in this family. Finally, I identified 3 CNVs in children with ID that overlap putative imprinted regions. The results of my study therefore led to the identification of genes which could contribute to ID as their function is altered in patients with the CNV or their characteristics suggest that they can be sensitive to copy number changes. This work contributes to an improved understanding of how CNVs and additional genetic changes in the rest of the genome can lead to ID.Medicine, Faculty of
Pathology and Laboratory Medicine, Department of
Graduate
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Chaim, Isaac Alexander. "Functional DNA repair capacity assays : a focus on base excision repair." Thesis, Massachusetts Institute of Technology, 2016. http://hdl.handle.net/1721.1/104221.
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Thesis: Ph. D., Massachusetts Institute of Technology, Department of Biological Engineering, 2016.Cataloged from PDF version of thesis.
Includes bibliographical references.
The integrity of our DNA is challenged by roughly 100,000 lesions per cell on a daily basis. Failure to cope with DNA damage can lead to cancer, immunodeficiency and degenerative disease. Quantitating and understanding an individual's DNA repair capacity may enable us to predict and prevent disease in a personalized manner. Base Excision Repair (BER) is known for the recognition and repair of endogenous and exogenous mutagenic non-helix-distorting lesions produced by DNA base alkylation, deamination and oxidation. BER is initiated by the action of one of eleven DNA glycosylases known-to-date. Many studies have shown that levels of these glycosylases can vary between individuals, suggesting a basis for inter-individual differences in DNA repair capacity. Moreover, the methods for measuring DNA repair capacity used so far are cumbersome, time consuming, low throughput and only allow for the analysis of one glycosylase at a time. We have taken a fluorescence-based multiplex flow-cytometric host cell reactivation assay wherein the activity of several DNA glycosylases and their immediate downstream endonuclease (APE1) can be tested simultaneously, at single-cell resolution, under physiological conditions. Taking advantage of the transcriptional properties of several DNA lesions we have designed and engineered specific fluorescent reporter plasmids for OGG1, AAG, MUTYH, UNG and APE1. Inter-individual differences in DNA repair capacity of a panel of cell lines derived from healthy individuals have been measured. Regression models that incorporate these measurements have been developed in order to predict cellular sensitivity to the chemotherapeutic and DNA damaging agents 5-FU, H₂O₂ and MMS, with the interest of understanding the contributions that these differences can have on personalized disease prevention and treatment. Finally, we have conducted a pilot population study with 56 healthy subjects where we implemented all the methods developed in order to determine the feasibility of measuring DNA repair capacity variations in a healthy human population. Additionally, we report the discovery of a novel in vivo role of the TC-NER pathway in the repair of the lipid-peroxidation product, 3,N⁴-etheno-cytosine.
by Isaac Alexander Chaim.
Ph. D.
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Menezes, Karla Vanessa Rodrigues Soares. "Impact of hospitalization in functional and mobility capacity of older adults." PROGRAMA DE P?S-GRADUA??O EM CI?NCIAS DA SA?DE, 2017. https://repositorio.ufrn.br/jspui/handle/123456789/24122.
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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES)
Introduction: As people get older, it remains a challenge maintaining functional capacity. Functioning consists of the ability to perform self-care activities (i.e. activities of daily living - ADLs) classified inside the level of ?activity and participation? of the International Classification of Functioning, Disability and Health (ICF). Previous studies have identified different risk factors for worsening functional capacity during hospitalization, including older age, sociodemographic characteristics, pre-existing impairment, cognitive loss, delirium, and comorbidity. In-hospital mobility has received particular attention due to its important association to loss of functional capacity. Few studies about hospitalization effects on older adults have been done in Brazil. Identifying older adults at risk for loss in functional capacity during hospitalization will help researchers and clinicians in order to make informed decisions. Objectives: This study contemplates three objectives: first, to provide an updated review to identify and appraise relevant instruments for measuring older adults? mobility based on the ICF conceptual framework in the context of an acute care or intensive geriatric rehabilitation unit, and to appraise and compare their measurement properties; second, to evaluate if in-hospital mobility assessed at admission is predictive of loss in functional capacity during hospitalization of older adults and to verify if other variables combined with in-hospital mobility can better predict loss in functional capacity; third, to assess functional changes of hospitalized older adults from pre-admission (baseline) until discharge and identify predictors of loss in functional capacity. Methods: This cohort prospective study was conducted at the Onofre Lopes University Hospital (HUOL), Natal/RN, Brazil, between January 1, 2014 and April 30, 2015. The study enrolled all consecutive patients aged 60 years and older who were acutely admitted and met the following inclusion criteria: 1) ability to provide informed consent; 2) admitted directly from the community; 3) screening for study eligibility performed in the first 24 hours of admission. Independent variables included personal characteristics, domestic living activities (i.e. instrumental activities of daily living ? IADL) evaluated by Lawton and Brody?s scale, cognition evaluated by Legan?s cognitive test, depression assessed by Geriatric Depression Scale (GDS-15), and in-hospital mobility evaluated by the Short Physical Performance Battery (SPPB). The dependent variable of functional capacity was assessed by the Katz scale. These instruments were applied at two different times: at admission (first 24 hours) and at discharge (12-24 hours before). Analysis included descriptive statistics, bivariate and multivariate analysis by means of frequencies, means ? standard error, receiver-operating characteristic (ROC), logistic binary regression and Generalized Estimating Equation (GEE). Data were entered into the Statistical Package for Social Sciences (SPSS) version 18.0 for Windows. Results: From the 1256 included at discharge, 65 (5.1%) died during hospitalization, thus the final sample consisted of 1191 older adults. The mean age was 70.02 (?7.34) and mean length of hospital stay was 7.65 days (?9.94). Our sample had a high prevalence of surgery (70.1%). Regarding the best instruments to assess mobility, the De Morton Mobility Index (DEMMI) and SPPB presented the best balance between mobility coverage, measurement properties and applicability to acute care and intensive geriatric rehabilitation units. A SPPB cutoff point of 6.5 (62% sensitivity, 54% specificity) identified 593 (49.8%) patients at risk for loss in functional capacity. In logistic regression, SPPB alone presented a statistically significant prediction loss of functional capacity between admission and discharge. Finally, regarding changes in functional capacity, 52.5% of the older adults were discharged with worse functional capacity than baseline. Being dependent for domestic life activities, presence of depression symptons, low levels of cognition and in-hospital mobility were risk factors for greater loss in functional capacity after a hospitalization event. Conclusion: We conclude that DEMMI and SPPB were the best instruments to assess mobility in hospitalized older adults. Regarding functional capacity, half the sample presented loss in functioning between baseline and discharge, while in-hospital mobility evaluated by SPPB can predict loss of function in hospitalized older adults. In addition to in-hospital mobility, dependence for domestic living activities, low levels of cognition and depression improve the detection of cases for being at risk of loss in functional capacity.
Introdu??o A medida que as pessoas envelhecem manter sua funcionalidade permanece um desafio. A funcionalidade consiste da habilidade do indiv?duo de realizar atividades de auto-cuidado (e.g. atividades de vida di?ria ? AVD?s) classificados dentro do n?vel de atividade e participa??o da Classifica??o Internacional de Funcionalidade, Incapacidade e Sa?de (CIF). Estudos anteriores identificaram fatores de risco para a diminui??o da capacidade funcional durante a hospitaliza??o que inclu?am idade avan?ada, caracter?sticas socioecon?micas, incapacidade preexistente, perda cognitiva, del?rio, co-morbidade. Mobilidade dentro do hospital tem recebido aten??o especial devido a sua importante rela??o com a perda da capacidade funcional. Poucos estudos foram realizados tendo como foco a avalia??o dos efeitos da hospitaliza??o em idosos brasileiros. Identificar idosos em risco para a perda funcional durante a hospitaliza??o poder? auxiliar pesquisadores e cl?nicos a tomar decis?es baseadas em evid?ncia. Objetivos Esse estudo contempla tr?s objetivos. Primeiro: promover uma atualiza??o a cerca dos instrumentos relevantes utilizados para avaliar a mobilidade de idosos baseado no conceito da CIF no contexto de hospitaliza??o ou unidades de reabilita??o geri?trica intensiva. Segundo: avaliar se a mobilidade avaliada dentro do hospital na admiss?o ? preditiva de perda funcional durante a hospitaliza??o em idosos e identificar fatores preditores de perda funcional. Terceiro: avaliar mudan?as funcionais desde antes da interna??o (medida de base) at? a alta hospitalar e identificar preditores de perda funcional. M?todos Esse estudo do tipo coorte prospectivo foi realizado no Hospital Universit?rio Onofre Lopes (HUOL), localizado em Natal/RN, Brasil entre primeiro de Janeiro de 2014 a 30 de Abril de 2015. Participaram do estudo pacientes com 60 anos ou mais de idade admitidos no hospital e que preencheram os crit?rios de inclus?o: 1) fornecer o termo de consentimento assinado; 2) advindo da comunidade; 3) ser abordado para participar do estudo dentro das primeiras 24 horas de interna??o. As vari?veis independentes incluem caracter?sticas pessoais, atividades de vida dom?stica (e.g. atividades instrumentais de vida di?ria ? AIVDs) avaliada pela escala de Lawton e Brody?s, a cogni??o foi avaliada pelo teste cognitivo de Legan?s, a depress?o foi investigada atrav?s da escala de depress?o geri?trica (GDS-15), a mobilidade dentro do hospital foi avaliada pela Short Physical Performance Battery (SPPB). A vari?vel dependente capacidade funcional foi avaliada pela escala de Katz. Esses instrumentos foram avaliados em dois momentos distintos: na admiss?o (primeiras 24 horas) e na alta hospitalar (12-24 horas antes). A an?lise estat?stica inclui an?lise descritiva, bivariada e multivariada, atrav?s de frequ?ncias, m?dias ? erro padr?o, receiver-operating characteristic (ROC), regress?o log?stica bin?ria e Equa??o de Estimativa Generalizada (EEG). Os dados foram inseridos atrav?s do SPSS vers?o 18.0 para Windows. Resultados Na alta hospitalar dos 1256 idosos inclu?dos na pesquisa 65 (5,1%) foram a ?bito durante a hospitaliza??o o que culminou em uma amostra final de 1191 idosos. A idade m?dia foi de 70,02 (?7,34), 684 (57,4%) dos participantes s?o homens e 790 eram casados (66,3%). A m?dia de dias de interna??o foi de 7,65 dias (?9,94). Nossa amostra apresentou uma frequ?ncia alta para abordagem cir?rgica (>70%). Em rela??o aos melhores instrumentos para avaliar mobilidade o De Morton Mobility Index (DEMMI) e o SPPB apresentaram o melhor equil?brio entre a cobertura do conceito de mobilidade, propriedades psicom?tricas e aplicabilidade em ambiente hospitalar e unidades de reabilita??o geri?trica. O ponto de corte do SPPB de 6.5 (62% sensibilidade, 54% especificidade) identificou 593 (49.8%) pacientes em risco para perda da capacidade funcional. Na regress?o log?stica o SPPB sozinho apresentou predi??o estatisticamente significante para perda funcional entre admiss?o e alta hospitalar. Finalmente em rela??o ?s mudan?as funcionais 52,5% dos idosos receberam alta hospitalar com uma capacidade funcional pior do que antes da interna??o. Ser dependente para as atividades instrumentais de vida di?ria, presen?a de sintomas depressivos, baixos n?veis de cogni??o e mobilidade dentro do hospital foram fatores de risco para perda funcional ap?s um evento de hospitaliza??o. Conclus?o Conclu?mos que DEMMI e SPPB foram os melhores instrumentos para avaliar mobilidade em idosos hospitalizados. Com rela??o a capacidade funcional metade da amostra apresentou perda da funcionalidade entre linha de base e alta hospitalar e a mobilidade dentro do hospital avaliada pelo SPPB pode predizer perda da capacidade funcional em idosos hospitalizados. Somando ? mobilidade dentro do hospital, depend?ncia para atividades dom?sticas, baixos n?veis de cogni??o e depress?o melhora a detec??o de casos de idosos em risco para perda da capacidade funcional
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Zullo, Melissa D. "Cardiovascular Disease Management and Functional Capacity in Patients With Metabolic Syndrome." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1232721609.
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Piersol, Catherine Verrier. "Examining Caregiver Appraisal of Functional Capacity in Family Members with Dementia." VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/3131.
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The vast majority of persons with Alzheimer’s disease and related dementias live at home and are cared for by families or close friends/neighbors. An essential element to daily care decisions is the caregiver’s appraisal of function in the family member with dementia. This dissertation comprises three separate papers exploring caregiver appraisal of functional capacity, using secondary data from a study conducted at Thomas Jefferson University of 88 patient-caregiver dyads, funded by the Alzheimer’s Association (L. Gitlin, PhD, principal investigator; Grant # IIRG-07-28686). The caregivers were primarily female (88.6%), white (77.3%), and spouses (55.7%), with a mean age of 65.8. All caregivers had a high school education or higher and had provided care from 6 months to 22 years. The majority of the participants with dementia were female (52.3%) and white (76.1) with a mean age of 81.7. Their scores on the MMSE ranged from 10 to 28 (M = 17.7, SD = 4.6, N = 87). The first paper examined construct and interrater reliability of the Functional Capacity Card Sort (FCCS), a tool designed to measure subjective caregiver appraisal. Using spearman’s rank correlations the FCCS was found to be statistically associated with the Caregiver Assessment of Function and Upset scale (r = .43, p < 0.0001, N = 86) and not statistically associated with the Neuropsychiatric Inventory scale (r = -.14, p = .16, N = 86), supporting convergent and discriminant validity respectfully. Kendall’s coefficient of concordance revealed a strong agreement among caregivers in the ranking of the six cards of the FCCS, Kendall W (5, 72) = 0.83, p = .0001, supporting interrater reliability of the FCCS. The second and third paper demonstrated the utility of the FCCS in distinguishing three groups of caregivers based on their estimation of functional capacity in the person with dementia compared to a gold standard occupational therapy assessment. Fifty-two (61%) of the caregivers overestimated function, 19 (22%) caregivers underestimated function, and 15 (17%) were concordant with the standardized assessment. Further analysis explored personal and home environment factors in relation to caregiver appraisal. The Kruskal-Wallis test showed cognitive status in the person with dementia (H (2, N = 85) = 3.67, p = .16) and caregiver depressive symptoms (H (2, N = 86) = 1.35, p = .51) were not associated with the caregiver’s appraisal of functional capacity in the person with dementia. Linear regression and proportional odds logistic regression, adjusted for cognitive status in the person with dementia, did not reveal a relationship between caregiver appraisal and the number of observed home hazards [F (1, N = 86) = .01, p = .94] or the unmet needs reported by the caregiver [Wald χ2 (1, N = 86) = .95, p = .33], respectively. Linear regression showed a trend towards the hypothesis that caregiver concordant/underestimation of functional capacity have greater home adaptations compared to caregiver overestimation [F (1, N = 86) = 3.06, p = .08]. The papers in totality demonstrate the utility of the FCCS to assess caregiver appraisal and interpret level of estimation, which can guide the therapeutic approach and treatment plan by an occupational therapist or other health professional. Further understanding of caregiver appraisal and associated factors is critical to providing best practice in dementia care. Limitations and future directions for research are discussed.
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Nisar, Shiraz A., Raghunandan Muppidi, Sumit Duggal, Adrian V. Hernández, Vidyasagar Kalahasti, Wael Jaber, and Omar A. Minai. "Impaired Functional Capacity Predicts Mortality in Patients with Obstructive Sleep Apnea." The American Thoracic Society, 2014. http://hdl.handle.net/10757/337271.
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oam1998@outlook.comBackground: Obstructive sleep apnea (OSA) is associated with increased mortality, for which impaired functional capacity (IFC) has been established as a surrogate. We sought to assess whether IFC is associated with increased mortality in patients with OSA and whether IFC is predictive of increased mortality after accounting for coronary artery disease. Methods: Patients with OSA who underwent both polysomnography testing and exercise stress echocardiogram were selected. Records were reviewed retrospectively for demographics, comorbidities, stress echocardiographic parameters, and polysomnography data. Univariable and multivariable logistic regression analysis was used to evaluate the association between IFC and overall mortality. We then evaluated the variables associated with IFC in the overall population and in the subgroup with normal Duke treadmill score (DTS). Results: In our cohort, 404 (26%) patients had IFC. The best predictors of IFC were female sex, history of smoking, ejection fraction less than 55, increased body mass index, presence of comorbidities, abnormal exercise echocardiogram, abnormal heart rate recovery, and abnormal DTS. Compared with those without IFC, patients with IFC were 5.1 times more likely to die (odds ratio [OR], 5.1; 95% confidence interval [CI], 2.5–10.5; P , 0.0001) by univariate analysis and 2.7 times more likely to die (OR, 2.7; 95% CI, 1.2–6.1; P = 0.02) by multivariate analysis, when accounting for heart rate recovery, DTS, and sleep apnea severity. Among those without coronary artery disease, patients with IFC were at significantly increased risk of mortality (OR, 4.3; 95% CI, 1.35–13.79; P = 0.0088) compared with those with preserved functional capacity. Conclusions: In our OSA population, IFC was a strong predictor of increased mortality. Among those with normal DTS, IFC identified a cohort at increased risk of mortality.
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Borea, Rieckhof Costanza. "Disability and human rights." THĒMIS-Revista de Derecho, 2015. http://repositorio.pucp.edu.pe/index/handle/123456789/108818.
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All persons are subjects of law, but not everyone has the “capacity” to fully exercise them. On this basis, people with disabilities have seen their opportunities for development as human beings limited.Why it that people with disabilities have been historically marginalized by the Law? In this article, the author presents a detailed analysis on the subject, including the legal paradigm change that was the adoption of the Convention on the Rights of Persons with Disabilities.Todas las personas somos sujetos de Derecho, perono todos tenemos la “capacidad” para poder ejercerlos plenamente. Bajo este argumento, las personas con discapacidad han visto limitadas sus posibilidades de desarrollarse como seres humanos.¿Por qué las personas con discapacidad han sido históricamente marginadas por el Derecho? En el presente artículo, la autora nos presenta un detallado análisis sobre la materia, incluyendo el cambio de paradigma jurídico que supuso la adopción de la Convención sobre los Derechos de la Personacon Discapacidad.
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Rytsälä, Heikki. "Functional and work disability and treatment received by patients with major depressive disorder." Helsinki : University of Helsinki, 2006. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/rytsala/.
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Clough, Beverley. "Exploring the potential of relational approaches to mental capacity law." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/exploring-the-potential-of-relational-approaches-to-mental-capacity-law(5054a274-bf7c-46e7-92ff-6c3fa665559a).html.
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The Mental Capacity Act 2005, and the domestic law surrounding it, is currently in a state of instability, having undergone rigorous scrutiny by the House of Lords Select Committee. At an international level, the United Nations Convention on the Rights of Persons with Disabilities 2006 has cast substantial doubt over the very basis of this legal framework. The recommendations made by the Select Committee, and any resulting action by the government to address these, will be hoped to have an impact on the implementation of the legislation on those falling within its remit. On a deeper level, however, this thesis seeks to critically engage with the theoretical underpinnings which inform and guide this legislative framework. This entails a questioning of the ways in which those with disabilities and their carers are responded to under the statute. Exploring the theoretical debates in this context leads to a conclusion that the Act promulgates an individualistic approach to the concept of mental capacity, and does not adequately reflect the reality and lived experiences of those deemed to lack capacity or their informal carers. The papers in this thesis interrogate these issues through a focus on three distinct areas- carers interests under the best interests test; the Deprivation of Liberty Safeguards though a social model lens; and capacity to consent to sex. In doing so, this thesis suggests that more relationally and contextually focused approaches can inform a legal framework which is attentive and responsive to the interwoven interests of those with cognitive impairments and their carers, and which facilitates the enjoyment of rights through a focus on the societal, structural and institutional barriers which have historically worked to exclude these individuals.
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Jarrell, Loretta Anne. "Functional capacity in men and women during early recovery following myocardial infarction." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq20657.pdf.
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Warman, Chardon Jodi. "The reliability and the validity of the Motility and Functional Capacity Evaluation." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0015/MQ52963.pdf.
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Boer, Pieter. "The functional fitness capacity of adults with Down Syndrome in South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5263.
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Thesis (M Sport Sc (Sport Science)--University of Stellenbosch, 2010.ENGLISH ABSTRACT: Functional fitness refers to the physical capacity to perform normal everyday activities safely and independently without undue fatigue. More specifically, functional fitness refers to having adequate strength, flexibility, mobility and endurance to execute essential tasks efficiently and effortlessly. Being functionally fit is important for all populations, but even more so for populations at risk for loosing functional capacity such as the elderly, disabled, and those with chronic medical conditions. Down syndrome individuals form part of the intellectually disabled population and show even more marked reductions in physical and functional capacities when compared to this already functionally limited population. Most DS individuals live sedentary lives, are obese, and age prematurely. For these reasons it is important to develop their functional capacities optimally. Although standardised tests are available for youngsters with intellectual disability, this is not the case for DS individuals. This study therefore endeavoured to describe the physical and functional fitness capacity of DS adults and to determine how much individual physical attributes contribute to functional capacity. 17 items, of which the validity and reliability have been determined, were included in the test battery. This included 2 balance tests, 2 flexibility tests, 2 coordination tests, 5 muscular strength and endurance tests, 2 functional tasks and an aerobic test. A total of 371 individuals from DS centres and institutions across seven provinces in South Africa volunteered to participate in the study. The study sample was categorised according to gender and four different age groups (18-25, 26-35, 36-45, >45 years) for further analysis. DS men were taller, heavier and had a greater arm span and sitting height than DS women. The majority of the participants were either overweight or obese. DS men performed significantly better on all but three tests compared to the women. The women performed better on the sit- and- reach flexibility test and the chair stand test, however, differences were not statistically significant. Physical test items correlated significantly and strongly to functional performance in 9 items for DS men and 5 items for DS women. Importantly, balance items correlated stronger with functional performance in DS women than in DS men. This is not a new finding and suggests that separate training programs should be developed for DS men and DS women. This is the first study of its kind in South Africa and confirms the findings of previous studies that DS adults have both low physical and functional capacities. They are particularly weak in terms of basic endurance and strength, which have been shown are trainable variables in DS individuals. The study also provides valuable criterion referenced values for an adult DS population. This information will assist health professionals in tailoring appropriate training programs to address functional limitations, as well as the negative health consequences associated with ageing. This special population thus need the assistance of sport scientists, as well as the community, to integrate them into special training and activity programs to improve their quality of life.
AFRIKAANSE OPSOMMING : Funksionele fiksheid verwys na die fisieke kapasiteit om alledaagse aktiwiteite op ‘n veilige en onafhanklike wyse uit te voer sonder om oormatige vermoeienis te ervaar. Meer spesifiek beteken funksionele fiksheid dat ‘n person voldoende krag, lenigheid, beweeglikheid en uithouvermoë besit om essensiële take doeltreffend en moeiteloos te voltooi. Alle populasies behoort funksioneel fiks te wees, maar dit is self meer belangrik vir populasies wat die risiko het om hul funksionele kapasiteit te verloor, soos bejaardes, persone met gestremdhede en diegene met kroniese mediese toestande. Down sindroom individue is deel van die populasie met intellektueel gestremdhede en hulle het selfs meer fisieke en funksionele beperkinge as die intellektueel gestremdes. Die meeste persone met DS het ‘n onaktiewe leefstyl, is vetsugtig en ervaar premature veroudering. Vir hierdie redes is dit uiters belangrik om hulle funksionele kapasiteit optimaal te ontwikkel. Hoewel gestandaardiseerde toetse beskikbaar is vir jong persone met intellektueel gestremdhede, is dit nie die geval met DS individue nie. Hierdie studie was ‘n poging om die fisieke en funksionele fiksheidkapasiteit van DS volwassenes te beskryf en te bepaal tot watter mate fisieke eienskappe funksionele kapasiteit bepaal. 17 items, waarvan die geldigheid en herhaalbaarheid bepaal is, is ingelsuit in die toetsbattery. Dit het die volgende ingesluit: 2 balanstoetse, 2 lenigheidstoetse, 2 koordinasietoetse. 5 spierkrag en uithouvermoë toetse, 2 funksionale take en een aërobiese toets. ‘n Totaal van 371 individue van DS sentrums en instellings in sewe provinsies in Suid Afrika het vrywillig ingestem om aan die studie deel te neem. Die steekproef is volgens geslag en ouderdom in vier kategorieë verdeel (18-25, 26-35, 36-45, >45 jaar) vir verdere analise. DS mans was langer, swaarder en het ‘n langer armlengte en sithoogte gehad as DS vroue. Die meerderheid van die deelnemers was of oorgewig of vetsugtig. DS mans het beduidend beter as die vroue gevaar in al die toetse, behalwe drie. Die vroue het beter gevaar in die sit en strek lenigheidstoets en die stoel opstaan toets, maar die verskille was nie statisties betekenisvol nie. Nege fisieke toetsitems vir mans het sterk en betekenisvol gekorreleer met funksionele kapasiteit, terwyl 5 items vir vroue betekenisvolle korrelasies gewys het. Balans items het sterker met funksionele kapasiteit in vroue as in mans gekorreleer. Hierdie is nie ‘n nuwe bevinding nie en bevestig dat verskillende oefenprogramme vir DS mans en vroue ontwikkel moet word. Hierdie is die eerste studie van sy soort in Suid Afrika en bevestig die resultate van vorige studies dat DS volwassenes beide lae fisieke en funksionele kapasiteite het. Hulle is veral swak ten opsigte van basiese uithouvermoë en spierkrag, maar beide hierdie veranderlikes kan by DS persone ingeoefen word. Hierdie studie voorsien ook waardevolle kriterium verwysingswaardes vir ‘n volasse DS populasie. Hierdie inligting kan persone in die gesondheidsberoepe help om gepaste oefenprogramme saam te stel om die funksionele beperkings en negatiewe gesondheidsgevolge wat met veroudering geassosieer word, aan te spreek. Hierdie spesiale populasie benodig dus die hulp van sportwetenskaplikes, sowel as die gemeenskap, om hulle te integreer in spesiale oefen- en aktiwiteitsprogramme om sodoende hulle kwaliteit van lewe te verbeter.
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Ned-Matiwane, Lieketseng. "A study to explore the capacity of family and service providers to facilitate participation of disabled youth in accessing opportunities in skills development and employment in Cofimvaba, Eastern Cape." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/11007.
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Includes abstract.Includes bibliographical references.
The study aimed to explore the capacity of family and service providers to facilitate the participation of disabled youth in accessing skills development and employment opportunities in rural areas. The objectives were to describe the family and service providers' understanding of disability; identify visions and strategies for promoting inclusion of disabled youth in skills development and employment opportunities; analyse the provision of services related to the economic development of disabled youth; identify the gaps in skills in facilitating disabled youth's transition in the economic development; and identify the available material resources for economic development of disabled youth.
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Cavuoto, Lora Anne. "Evaluating obesity-related differences in upper extremity and trunk muscular capacity." Diss., Virginia Tech, 2012. http://hdl.handle.net/10919/28345.
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Work-related musculoskeletal disorders (WMSDs), particularly overexertion injuries, represent a significant economic burden and involve substantial adverse personal outcomes. Two important contemporary changes in workforce demographics may be associated with an increase in the future incidence and cost of WMSDs. First, more than two-thirds of the US adult population is now either overweight or obese, a doubling of the prevalence of obesity over the past 30 years. Second, there has been a shift toward an older worker population, whose injuries often require more time away from work. Obesity and aging can modify job demands and affect worker capacity in terms of muscular and psychomotor function. However, there is a lack of empirical studies quantifying the work-relevant (or ergonomic) impacts related to task demands, capacities, and their potential imbalance. This research assessed obesity- and age-related differences in physical capacity by measuring localized muscle fatigue, endurance, and the effects of fatigue on psychomotor function. Three experiments were completed, progressing from controlled static to more complex intermittent and functional tasks. The work also examined whether obesity and age effects are modified by workplace/workstation configuration, specifically the extent to which body segment masses need to be supported. With obesity, strength was higher, but endurance time was lower, particularly for the more complex tasks. Interaction effects between obesity and age were seen in only a few measures across the studies and did not indicate a consistent effect. Outcomes of this research can facilitate the development of more effective (i.e., inclusive) guidelines to control WMSD risk and contribute to both proactive and reactive interventions to reduce excessive exposures to physical risk factors. Overall, the research goal is to help ensure that ergonomic guidelines and practice are appropriate (or are adapted) to accommodate the diverse and changing workforce.Ph. D.
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Dürrheim, Erna Theresia. "Some physiological effects of deep underground mining and the relationship with physical work capacity and functional work capacity assessment outcomes." Thesis, North-West University, 2012. http://hdl.handle.net/10394/9019.
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Motivation: The South-African deep level gold mining industry has adapted in many ways, as the pursuit for gold has led deep into the earth core, where rock face temperatures measure around 60°C. Ventilation adapted through engineering developments like refrigeration systems, creating cooler work environments to an extent. Despite these developments the risks of high ambient temperatures coupled with strenuous work and dehydration remains, leading to alternative methods of control that have to indicate whether employees have the necessary functional capacity to perform daily work tasks.
Objectives: The objectives of this study were: to measure and compare the physiological effects of the tasks performed by workers in an underground mining environment; To measure the soundness of heart rate as a gauge of work stress in real-life work conditions, taking into account the stressors that influence it; to determine the efficacy of functional and physical work capacity assessments as a method of determining work readiness.
Methods: A study group (n = 16) was chosen to represent the “most exposed” work population, all of whom have previously passed the functional work capacity and physical work capacity assessments. The assessments were repeated and the maximal oxygen uptake assessment was done. The participants were divided into two groups (n = 8) according to their work areas. Measurements were taken over a period of eight consecutive shifts. Each group was later divided into three groups as per the work they performed. Dehydration was determined through urine analysis and body weight changes. Heart rate was observed continuously through a heart rate monitor and oral temperature was measured on an hourly basis.
Results: The shift durations seen during this study were much longer than the customary 8-hour work day. The mean HR results of group I, which was suspected of having the most strenuous work, were very similar to the results for group II and III. This group did, however, have the highest % heart rate ≥ 120 beats per minute and mean cumulative heart beats, group III having the lowest. All of the groups were found to be mildly dehydrated at the end of their shifts, the urine specific gravity indicating that the participants were generally already considerably dehydrated at the onset of the shifts. Group I was the only group whose mean heart rate had a statistically significant correlation (r ≥ 0.5) with % weight loss. There was a statistically significant (p ≤ 0.05) correlation between heart rate and mean oral temperature for all of the groups. The participants that passed the functional work capacity and physical work capacity assessments were found to have performed comparatively better during the real-time shifts than those that failed.
Conclusions: Although there were several employees that had a high mean maximum heart rate, none of the mean heart rates were higher than the self-pacing rate of 110 beats per minute. This ability of self- pacing was seen in the way the participants were able to manage energy expenditure by alternating between heavy and lighter tasks. A great concern is the fact that all of the participants had a % weight loss (0.9 – 2.8% weight loss) indicative of mild dehydration after the shifts, on top of morning urine specific gravity samples (1.020 – 1.025) showing signs of considerable dehydration. Several correlations were found between the functional work capacity and physical work capacity assessments and maximum temperature, maximum heart rate and maximal oxygen uptake, suggesting a significant relationship between the real life situation and the homogenous laboratory setting. comparing the employees that passed the functional work capacity and physical work capacity assessment to those that failed, a marked difference was seen in their respective performances. The groups that passed had a lower mean heart rate and maximum heart rate and higher maximal oxygen uptake. It may, therefore, be concluded that the functional work capacity and physical work capacity assessments provide a valid evaluation of an individual’s work capacity and potential to cope with the varying demands of underground work.Thesis (MSc (Occupational Hygiene))--North-West University, Potchefstroom Campus, 2013.
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Lindström, Camilla. "Föräldraskap och neuropsykiatriskt funktionshinder : upplevelse och påverkan av diagnos." Thesis, Stockholm University, Department of Social Work, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-6692.
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The aim in the study is to search for a deeper understanding of how parents experience a neurological diagnose of the child and how this affects the parenthood. Parenthood was seen in a systemtheoretical perspective as a social construction. The narrative method was used in two lifestory parentinterviews. The analysis was made from parenthood. The result formed stories about parenthood with children having neuropsyciatric functional disability who even came to be a woman’s struggle. Two stories became central, one about righteousness and commonship and one against diagnosis and network. The struggle for support and understanding from the surrounding network was central. There was also a fight between the network and the parent of the authority to decide the child’s normality. The parent and child early experience a segregation in society based on diagnose. Parents experienced insecurity and difficulties regarding dose and sideeffects in medication the child. The networks reception was central for the acceptance of diagnosis and for keeping the parentcompetence. The public debate of inherent or environment created doubt and insecurity. In the stories there was a tendency that the struggle went beside the child and parenthood and instead became a struggle for righteousness against society.
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Puthoff, Michael Leonard. "The relationship between impairments in muscle performance, functional limitations, and disability in older adults." Diss., University of Iowa, 2006. http://ir.uiowa.edu/etd/73.
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Mazzoni, Claudia F. "Impairment, disability, and functional assessment in individuals symptomatic of upper extremity cumulative trauma disorder." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0004/NQ42959.pdf.
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Yu, Miao, Nanhai Huang, and Qianxin Xu. "Multi-functional adjustable table for people staying longer time in bed due to disability." Thesis, Blekinge Tekniska Högskola, Institutionen för maskinteknik, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-813.
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This product presents the design of a useful multi-functional adjustable table. It will bring great convenience to people with disability who spend most of time in bed, so as to meet their daily needs. Since there are already many similar products on the market, we focused on updating the functions on table, which can help people reading books or using tablet PC on beds in a comfortable way. It can also support people to stand up and walk around. There is a C-clamp fixing the product consolidated to bed. Besides, the hydraulic and micro-computer systems are used to adjust the table into a proper height automatically. The whole structure was designed in Autodesk Inventor 2015, and the simulation, test, analysis experiments were made in Abaqus 6.1.2 to ensure its safety and stability. In addition, this design can be an incentive for the improvement of the auxiliary equipment, highlighting the importance of the development of mechanisms for the healthcare.
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Gee, Christine Elizabeth. "The capacity for functional recovery in the flight system of Locusta migratoria migratorioides." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/nq22458.pdf.
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Cox, Alison. "Variations in behaviour function in individuals with intellectual disability and psychotropic medication." Wiley, 2015. http://hdl.handle.net/1993/30735.
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Psychopharmacological and behavioural interventions are used to treat challenging behaviours (e.g., self-injury, aggression, stereotypy, bizarre vocalizations) in individuals with intellectual disability (ID), often in combination. However, little is known about the behavioural mechanisms underlying psychopharmacological treatment. Establishing a better understanding of these mechanisms could contribute to improving treatment efficacy. For this study, I conducted repeated functional analyses using single-subject experimental designs to assess the impact of naturally varying dosages of psychotropic medications on behaviour function. Four individuals with ID who engaged in challenging behaviour and were undergoing psychotropic medication changes participated. Medication impact across two topographies for one participant, and three topographies for another participant were assessed, for a total of seven cases. For Analysis 1, I calculated standardized mean differences between baseline and final drug administration phases to estimate the overall effect of medication. I used this information to examine whether response rate following drug administration was related to response rate during baseline, referred to as rate-dependency. Rate-dependency was not observed. Analysis 2 explored the relation between psychotropic medications and behaviour function identified through functional analyses. Challenging behaviour was the dependent variable, while functional analysis conditions and psychotropic medication level served as independent variables. The latter was a quasi-experimental variable given participants’ psychiatric team prescribed changes independent of the researchers. Behaviour function correspondence, defined as no function change after a medication manipulation, was observed across 14 of the 21 medication manipulations (67%).October 2015
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Pritchard-Jones, Laura Gwynne. "Making health and welfare decisions in old age : challenging the adequacy of mental disability law and theory." Thesis, University of Manchester, 2016. https://www.research.manchester.ac.uk/portal/en/theses/making-health-and-welfare-decisions-in-old-age-challenging-the-adequacy-of-mental-disability-law-and-theory(f3f29f67-6454-4013-8d6e-e5a783ca97fd).html.
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Old age – and particularly the increasing numbers of older people globally and within the United Kingdom - is becoming a social and political phenomenon. Yet despite this, very little has been written on how the law – and especially mental disability law – intersects with old age. This is notwithstanding the fact that many older people may encounter conditions that impact their mental or cognitive abilities, and proportionally, may therefore be greatly affected by this area of law. By drawing on a number of theories – sometimes termed ‘relational’ theories – which are derived predominantly from feminist theory, this thesis seeks to explore the adequacy of mental disability law for safeguarding health and welfare-related decision-making of older adults in three areas; where an older person has been subjected to ageism, where they have been the victim of interpersonal abuse, and where they have dementia and may lack mental capacity. Within this broader goal, this thesis has two specific aims. First, to explicitly critique and challenge the adequacy of the law as it is applied in these circumstances. It is suggested in particular that a deeper analysis of the law in both its previous and current forms betrays the liberal and unduly individualistic roots of the legislative framework. These are roots that are predicated on non-interference, and an idealistic paradigm of the rational, autonomous, and healthy bodied individual. This – it is contended throughout – is an unsuitable philosophy to underpin the law, particularly where the law engages with older adults. Second, this thesis aims to navigate a more suitable pathway within the law as it currently exists. While operating as a tool to critique the legislative framework and its underpinning philosophy, it is argued that the theories drawn upon throughout the thesis also have the potential to highlight how the law could be implemented in such a way so as to emphasise the importance of the realities of the lived experiences of old age, and particularly the experience of ageism, abuse, and dementia. Crucially, it is also suggested that such theories can help the law pay greater attention to the complex web of relationships – both positive and negative; personal and societal – that an older person may find themselves embedded within, and that frequently take on an added significance in old age.
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Nickel, Jennie T. "Functional disability and the use of health services by elderly women with coronary heart disease /." The Ohio State University, 1986. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487323583620189.
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Dechman, Gail Sterns. "The effect of lung volume below normal functional residual capacity on respiratory system mechanics." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=41568.
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This thesis examines changes in the mechanical behaviour of the canine and human respiratory systems to changes in lung volume below normal functional residual capacity (FRC). In open chested dogs lung elastance (E$ sb{ rm L}$) increased and lung resistance (R$ sb{ rm L}$) changed little with decreases in positive end-expiratory pressure (PEEP) of the ventilatory circuit. The dominance of plastoelastic lung tissue properties at low lung volumes was used to interpret the lack of change in R$ sb{ rm L}$. Computed tomography demonstrated that pleural effusion (PE) created atelectasis in dependent caudal lung regions which contributed to the overall lung volume loss. PE produced a decrease in only lung vertical height while chest wall dimensions changed both vertically and horizontally. E$ sb{ rm L}$ and R$ sb{ rm L}$ increased while elastance and resistance of the chest wall were little affected by these shape and density changes. In close-chested, anesthetised, paralysed, ventilated humans a decrease in PEEP below normal FRC caused an increase in R$ sb{ rm L}$, E$ sb{ rm L}$ and both chest wall elastance and resistance. Median sternotomy caused E$ sb{ rm L}$ to increase with increasing PEEP while the negative volume dependence of R$ sb{ rm L}$ remained. Most of the difference between open-chested and closed-chested E$ sb{ rm L}$ was presumably due to lung collapse in the open-chested state.
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Lee, Fu-Hua Lawrence. "The use of functional capacity to predict postoperative outcomes in subjects undergoing colorectal resection." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114185.
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Introduction: There is increasing evidence to suggest that functional capacity assessment can identify patients at high risk for major surgery, however previous studies have used heterogeneous patient populations. We sought to investigate the effect of poor functional capacity on the incidence of postoperative complications in a population of subjects undergoing elective colorectal surgery. Methods: A retrospective cohort study of adult subjects undergoing elective colorectal resection at a single university-affiliated institution from 2005 to 2011 who were participants in three clinical trials was performed. The main exposure variable was poor functional capacity as measured by cardiopulmonary exercise testing (CPET) or by the distance walked in six-minutes (6MWT). The main outcome variable was complications that occurred within 30 days of the index operation and length of stay. Receiver-operating characteristics curves identified threshold for increased perioperative risk. Multiple regression models estimated the effect of exposure on the outcome by adjusting for confounders. Results: A total of 296 were included in the overall subject cohort. The 6MWT was available in all subjects, and CPET was available in 114 subjects. The overall incidence of postoperative complications was 42% (126/296). The threshold for increased perioperative risk was found to be a peak oxygen consumption (VO2) < 72% of predicted,and a 6MWT < 392 meters. After adjusting for confounders, the odds of suffering a major complication was 7.66 times (95% confidence interval 1.57–37.44) higher in subjects with peak VO2 < 72% of predicted compared to those with peak VO2 ≥ 72% of predicted. The odds of suffering a cardiopulmonary complication (OR 4.75, 95% CI1.46–15.44) or minor complications (OR 1.87, 95% CI 1.02 – 3.46) was significantly higher in subjects with 6MWT < 392 meters. However, major complications were not associated with 6MWT < 392 meters (OR 1.10, 95% CI 0.42–2.99), after adjusting for confounders. Conclusions: Poor functional capacity is associated with increased perioperative risk in subjects undergoing elective colorectal surgery. Functional capacity assessment can be performed using CPET or the 6MWT.Introduction: Il existe un nombre croissant de preuves qui suggèrent que l'évaluation de la capacité fonctionnelle permet d'identifier les patients à hauts risques pour une chirurgie majeure. Toutefois, les études antérieures ont été basées sur des populations de patients hétérogènes. Nous avons cherché à étudier l'impact d'une faible capacité fonctionnelle sur l'incidence de complications postopératoires au sein d'une population de patients devant subir une chirurgie colorectale. Méthodes: Nous avons réalisé une étude de cohorte de patients adultes, ayant subi une résection colorectale entre 2005 et 2011 dans une même institution affiliée à une université, qui avaient participé à trois essais cliniques. La variable d'exposition principale était une faible capacité fonctionnelle telle que mesurée par l'épreuve fonctionnelle d'exercice (EFX) ou par le test de marche de six minutes (TDM6). Les objectifs principaux étaient les complications développées durant les 30 jours suivant l'opération indexée ainsi que la durée du séjour hospitalier. Les valeurs seuils corrélées avec les complications ont été identifiées à l'aide de courbes ROC. Les modèles de régression multiples ont permis d'estimer l'effet de l'exposition sur les objectifs principaux en ajustant pour les facteurs confondants Résultats: Un total de 296 patients ont été inclus dans la cohorte. Les résultats du TDM6 étaient disponibles pour tous les patients et ceux de l'EFX l'étaient pour 114 patients. L'incidence globale des complications postopératoires était de 42% (126/296). La valeur seuil corrélée avec les complications était un pic de consommation d'oxygène (VO2pic)inférieur au 72% de prédiction et un TDM6 inférieur à 392 mètres. Après l'ajustementpour les facteurs confondants, les chances de développer une complication majeure étaient 7.66 fois (intervalle de confiance à 95%: 1.57-37.44) plus élevées chez les patientsavec un VO2pic < 72% de prédiction. Un TDM6 < 392 mètres était indépendamment associé à une chance plus importante de développer une complication cardio-pulmonaire(OR ajusté 4.75, IC à 95% 1.46-15.44) ou une morbidité mineure (ORa 1.87, IC à 95%1.02-3.46), mais pas une complication majeure (ORa 1.10, IC à 95% 0.42-2.99). Conclusion: Une faible capacité fonctionnelle est associée à des risques péri-opératoires plus élevés chez les patients subissant une chirurgie colorectale. Une évaluation de la capacité fonctionnelle peut être réalisée à l'aide de l'EFX ou du TDM6.
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Hayes, Sandra C. "Exercise, functional capacity and quality of life in peripheral blood stem cell transplant patients." Thesis, Queensland University of Technology, 2001. https://eprints.qut.edu.au/36758/7/36758_Digitised%20Thesis.pdf.
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Woodbury, Ryan Kenneth. "Investigating sit-to-stand velocity and power to assess functional capacity in older people." Thesis, Woodbury, Ryan Kenneth (2022) Investigating sit-to-stand velocity and power to assess functional capacity in older people. Masters by Research thesis, Murdoch University, 2022. https://researchrepository.murdoch.edu.au/id/eprint/66125/.
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Portable inertial measurement units allow movement velocity and power to be measured during functional assessments for older people, providing comprehensive assessment of their functional capacity. This study investigated the reliability of PUSH Band 2.0 velocity and power during a single, five-repetition and thirty-second duration sit-to-stand (STS) in older adults, and the relationship of these data with other tests of functional capacity. Twenty-four older adults (14 female; age: 72±5) attended one familiarisation and two experimental testing sessions. Mean STS velocity and power were measured during both testing sessions. Additionally, dynamometry assessments of maximal voluntary contraction (MVC), rate of torque development (RTD) and muscular endurance were measured in one session, while a functional testing battery was performed in the other session. The level of significance was set at p ≤ 0.05. Velocity and power demonstrated excellent relative reliability for all STS tasks (intraclass correlation coefficient = 0.91-0.98). Single-repetition STS velocity observed moderate absolute reliability (coefficient of variation = 6.5%), while velocity and power during all other STS tasks observed good absolute reliability (CV = 3.2-4.8%). Velocity during one (r = -0.64-0.57), five (r = -0.53-0.46) and thirty-second STS (r = -0.51-0.42) correlated with all functional battery scores. Thirty-second STS velocity correlated with MVC (r = 0.41), but not endurance (r = 0.27-0.36) or RTD (r = 0.24-0.37). Power during one (r = 0.50), five (r = 0.62) and thirty-second STS (r = 0.67) significantly correlated with MVC. No other significant correlations were observed. Mean STS velocity and power should not replace functional capacity assessments. However, these data may assist practitioners to monitor improvements in movement velocity and power following exercise interventions or to quantify reductions in capacity following a period of inactivity.
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Murphy, Rebecca Cowell. "Advocating for advance directives guidelines for health care professionals /." Thesis, Montana State University, 2009. http://etd.lib.montana.edu/etd/2009/murphy/MurphyR0509.pdf.
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An advance directive, such as a Living Will or Durable Power of Attorney for Health Care, allows a person to give their instructions about future medical care if he or she is unable to participate in decisions due to serious illness or incapacity. Despite the fact the Patient Self Determination Act requires health care facilities to provide patients with information about advance directives on admission, and the public and health care professionals support the use of advance directives, few people actually complete these documents. This project was developed in support of a local community hospital's commitment to promote the creation and use of advance directives. Part one of the project involved working with the hospital's Advance Directive Committee to update and revise the Advance Directive Policy and Procedure to meet Joint Commission Standards. Part two of the project was the creation of an Advance Directive Education Module for health care professionals designed to be used as part of the employees' annual education review. The new policy created a solid framework for health care professionals to follow when working with patients and their health care goals. The computer-based Advance Directive Education Module reviewed general information about advance directives, informed health care professionals of the new Advance Directive Policy and Procedure, and gave facility-specific actions to take when working with patients and their advance directives.
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Ripat, Jacqueline Dawn. "The relationship between functional upper limb kinematics, pain and perceived disability in individuals with rheumatoid arthritis." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0008/MQ32234.pdf.
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Ávila-Funes, José Alberto. "Relations entre le risque nutritionnel, les symptômes dépressifs et la capacité fonctionnelle chez la personne âgée de la communauté une analyse secondaire des données de l'étude NuAge." Mémoire, Université de Sherbrooke, 2007. http://savoirs.usherbrooke.ca/handle/11143/3912.
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La dépression et la malnutrition ne sont pas des conditions inévitables du vieillissement et elles représentent des problèmes de santé très importants étant donné leur prévalence élevée et leurs effets néfastes sur les capacités fonctionnelles. Précédemment, aucun travail de recherche ne s'est intéressé à étudier l'effet explicatif de la nutrition dans la relation entre la dépression et la capacité fonctionnelle. Objectifs. 1) Déterminer l'effet du risque nutritionnel (RN) dans la relation entre les symptômes dépressifs (SD) et la capacité fonctionnelle (CF) des personnes âgées. Méthodologie. Les données de base (TI) des 1,793 hommes (48 %) et femmes (52 %) (74,4[plus ou moins]4,1 ans) de la cohorte NuAge ont été utilisées pour les analyses. La CF a été mesurée par le score global de 4 tests de performance physique selon la méthode proposée par Guralnik et coil. (Timed"up & go", vitesse de marche (4 m), levée de chaise (5X), équilibre unipodal). Un résultat [supérieur ou égal à] 11 ou [inférieur ou égal à] 20 à l'Échelle de dépression gériatrique indique la présence de SD et un score [supérieur ou égal à] 3 au Dépistage nutritionnel des aînés (DNA[copyright]), un RN. Des analyses de variance ont été utilisées pour comparer les groupes suivants sur leur CF : saris RN et sans SD, avec RN et sans SD, sans RN et avec SD, avec RN et avec SD. La régression linéaire multivariée a permis de tester l'effet modificateur du RN VII dans la relation SD/CF ainsi que les associations entre le score global de CF et plusieurs variables sociodémographiques et sanitaires. Résultats. Le RN est présent chez 51% des sujets et sa prévalence est plus élevée dans les groupes plus âgés dans les 2 sexes ([rhô][inférieur à]0,001). La prévalence des SD est plus élevée chez les femmes (12,7%) que chez les hommes (7,7%) ([rhô]=0,001) de même que le score de CF (H: 10,59[plus ou moins]3,41; F: 9,25[plus ou moins]3,40; [rhô][inférieur à]0,001). Chez les deux sexes, la meilleure performance a été observée chez les plus jeunes et chez ceux qui rapportaient plus d'activités physiques. Par contre, le score de CF est plus faible dans le groupe avec RN et avec SD (8,86[plus ou moins]3,42) en comparaison avec le groupe sans RN et sans SD (10,55[plus ou moins]3,28) ([rhô]=0,001). L'inclusion du RN dans un modèle comprenant l'âge, le sexe et les SD a montré que le RN a un effet additionnel indépendant sur la CF ([rhô][inférieur à]0,001), lequel persiste après l'ajustement selon la scolarité, le revenu, l'indice de masse corporelle, le fardeau de la maladie et l'activité physisque. Par contre, l'interaction (RN*SD) n'est pas significative indiquant que le RN ne modifie pas la relation entre les SD et le score de CF. Ce dernier modèle explique 34% de la variabilité observée dans le score de la CF. Conclusion. Le risque nutritionnel est associé, de façon indépendante, à une capacité fonctionnelle réduite, mais ne modifie pas la relation entre cette dernière et les symptômes dépressifs. Étant donné l'importance des capacités fonctionnelles pour le maintien de l'autonomie, le développement de programmes comprenant la prévention du risque nutritionnel est une voie plausible et raisonnable d'intervention. De plus, ces programmes devraient inclure des composantes psychosociales qui auraient le potentiel de soulager les symptômes dépressifs. Malgré leurs limites liées aux analyses transversales, nos résultats proposent des hypothèses pour identifier les personnes âgées les plus à risque de présenter des limites fonctionnelles.
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Leskinen, R. (Riitta). "Late-life functional capacity and health among Finnish war veterans:Veteran Project 1992 and 2004 surveys." Doctoral thesis, Oulun yliopisto, 2015. http://urn.fi/urn:isbn:9789526208671.
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Abstract Becoming involved in war is an experience that has the potential to shape later-life health. The aim of the present study was to explore Finnish Second World War veterans’ health status and the determinants of self-rated health (SRH) and functional capacity, especially the ability to walk, and to identify risk factors and their combinations that predict late-life mortality among veterans. The study population comprised Finnish Second World War veterans who participated in the Veteran 1992 and Veteran 2004 Project surveys. In 1992, a postal questionnaire was sent to all 242,720 war veterans living in Finland. The follow-up survey, the Veteran 2004 Project, was conducted with a randomized sample of veterans who participated in the Veteran 1992 Project. The total number of participants in the baseline survey was 177,989 men and 48,745 women, and in the follow-up survey, 4,348 men and 651 women. The response rate was high in both surveys: 93% in 1992 and 87% in 2004. All analyses were conducted separately for men without disability, men with disability and women. In a cross-sectional study, SRH and functional capacity was found to be better among 80–84-year-old Finnish war veterans in 2004 compared with 1992, although the prevalence of many diseases increased during the follow-up. Among the 4,999 veterans who participated in both surveys, the majority rated their health as improved or unchanged during the follow-up. Walking difficulties and cardiovascular (CVD), musculoskeletal and neurological diseases were found to be predictors of declined SRH. When exploring functional capacity among veterans, neurological and musculoskeletal diseases, but especially walking difficulties, predicted veterans’ future functional impairment as many as 12 years in advance, and worsening of these conditions was associated with impaired activities of daily living. During an average 9.9-year follow-up, walking difficulties alone or together with multimorbidity and/or with a third risk factor was the most important risk factor for total and for CVD mortality among all veteran groups. In conclusion, the majority of veterans rated their SRH as improved or unchanged during the follow-up. The importance of walking difficulties as a determinant of SRH and functional capacity and as a predictor of mortality was confirmedTiivistelmä Tutkimuksen tarkoituksena oli arvioida suomalaisten toisen maailmansodan veteraanien terveydentilaa ja tutkia, mitkä tekijät vaikuttavat veteraanien itsearvioituun terveyteen ja toimintakykyyn (erityisesti kävelykykyyn) sekä tunnistaa ne riskitekijät ja tekijäyhdistelmät, jotka ennustavat kuolleisuutta. Tutkimuspopulaationa käytettiin Veteraaniprojekti 1992 ja Veteraaniprojekti 2004 -tutkimuksiin osallistuneita veteraaneja. Vuonna 1992 kysely lähetettiin postitse jokaiselle Suomessa tuolloin asuneelle 242 720 veteraanille. Seurantatutkimukseen valittiin 5 750 veteraanin satunnaisotos vuoden 1992 tutkimukseen osallistuneista. Veteraaniprojekti 1992 -tutkimukseen osallistui 177 989 miestä ja 48 745 naista ja seurantatutkimukseen 4 348 miestä ja 651 naista. Osallistumisprosentti oli 93 % (1992) ja 87 % (2004). Analyysit tehtiin erikseen veteraanimiehille joilla ei ollut invaliditeettia, invalidimiehille ja naisille. Poikkileikkaustutkimuksessa tarkasteltiin 80–84-vuotiaiden veteraanien terveyttä ja toimintakykyä vuosina 1992 ja 2004. Vuonna 2004 veteraanit arvioivat terveytensä ja toimintakykynsä paremmiksi kuin samanikäiset veteraanit vuonna 1992, vaikka monet sairaudet yleistyivät seuranta-aikana. Suurin osa molempiin kyselyihin vastanneista 4 999 veteraanista arvioi terveytensä joko parantuneen tai pysyneen ennallaan seuranta-aikana. Veteraanien kokemat kävelyvaikeudet, sydän- ja verisuonisairaudet, tuki-ja liikuntaelinsairaudet sekä neurologiset sairaudet ennustivat itsearvioidun terveyden heikkenemistä. Sydän- ja verisuonisairauksia lukuun ottamatta edellä mainitut tekijät ennustivat myös toimintakyvyn laskua jopa 12 vuotta etukäteen. Myös kävelykyvyn heikkeneminen ja sairauksien paheneminen seuranta-aikana ennustivat toimintakyvyn laskua. Kävelyvaikeudet joko yksin tai yhdessä multimorbiditeetin ja/tai jonkin kolmannen riskitekijän kanssa oli tärkein sekä kokonaiskuolleisuutta että sydän- ja verisuonitautikuolleisuutta ennustava tekijä kaikissa veteraaniryhmissä keskimäärin 9,9 vuoden seuranta-aikana. Yhteenvetona voidaan todeta, että enemmistö tutkimukseen osallistuneista veteraaneista arvioi terveytensä joko parantuneen tai pysyneen ennallaan seuranta-aikana. Koetut kävelyvaikeudet ovat erittäin tärkeä itsearvioitua terveyttä, toimintakykyä ja kuolleisuutta ennustava tekijä
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Kowalik, Raph. "A review of surface Electromyography used to determine sincerity of effort in Functional Capacity Evaluations." Thesis, Högskolan i Halmstad, Biomekanik och biomedicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-23253.
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Simpson, Shmona. "Genetic, structural, and functional exploration of the restrictive capacity of TRIM proteins against immunodeficiency viruses." Thesis, University of Oxford, 2017. https://ora.ox.ac.uk/objects/uuid:1af588ba-603a-4f39-9443-bb1a95d983f5.
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HIV-2 differs from HIV-1 in that many infected people experience normal survival, whilst only 20% progress rapidly to AIDS. Understanding mechanisms of delayed HIV-2 disease progression could provide new insights into HIV control. The Caio Community Cohort was established in Guinea-Bissau in the setting of high HIV-2 prevalence. This thesis investigates the role of polymorphic host restriction factors of the TRIM family in HIV-2 outcome. TRIM proteins are a family of E3 ubiquitin-ligases, where closely-related TRIM5α and TRIM22 are thought to inhibit HIV-1 transcription, uncoating and budding. There was an association between TRIM5α amino acid substitution R136Q and reduced HIV-2 viral load/prolonged survival. Conversely, P479L was enriched among HIV-2 infected participants and progressors with CD4+ T cell decline. TRIM22 was highly polymorphic in this cohort, revealing three novel coding variants. Although most substitutions were located in the putative virus-interacting PRYSPRY domain, two in the coiled-coil, D155N and R242T, showed significant and divergent associations with survival. R242T was enriched in HIV-2 infected participants, who progressed to death at twice the rate of wild-type controls. In silico studies predicted D282, D360, and R321 of TRIM22 to be highly conserved, exposed residues, for which polymorphisms would be deleterious. When aligned with sequences from the potent HIV-1 restriction factor, rhesus macaque TRIM5α, TRIM22 substitutions R321K, T415I, and D360Y were spatially relevant to residues involved in HIV-1 restriction. The role of TRIM22 in HIV restriction was supported by in vitro pilot studies showing that TRIM22 was upregulated by HIV-1 infection in a lymphoid cell line and co-localised with the HIV-1 capsid protein p24. Overexpression of TRIM22 resulted in the restriction of VSV-G pseudotyped HIV-1 and SIVmac. The R242T substitution diminished TRIM22's restriction of HIV-1 and SIVmac: protein analysis suggested that this may be due to the inability of the R242T mutant to fully dimerise.
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Barker, Roger Alistair. "Factors important in the survival and functional capacity of intracerebral adrenal and embryonic nigral grafts." Thesis, University of Cambridge, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.336537.
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