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Herr, Janet. "Heart Failure Symptom Clusters and Functional Status." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2936.
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Abstract HEART FAILURE SYMPTOM CLUSTERS AND FUNCTIONAL STATUS Janet Kay Herr Ph.D A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University 2012 Major Director: Dr. Jeanne Salyer, Ph.D., R.N., F.N.A.P Associate Professor, Adult Health & Nursing Systems Clinical assessment of heart failure includes symptom identification and the evaluation of the relationship of symptoms to functional status. Symptom clusters are groups of at least 2 or 3 co-occurring symptoms that are related but are independent of other groups of symptoms. The objectives of this study are to: (1) examine relationships among symptoms commonly experienced by individuals with heart failure, (2) identify symptoms that form clusters, and (3) evaluate the impact of heart failure symptom clusters on attributes of functional status: limitations and mobility The Theory of Unpleasant Symptoms guided the conduct of this study. Heart failure symptoms and the outcome variables functional limitations and mobility were evaluated in a convenience sample of individuals (n = 117) with a confirmed diagnosis of heart failure recruited viii from an academic medical center. Principle components analysis was used to extract symptom clusters and regression analysis was used to evaluate the relationship between the symptom clusters, their interaction terms, the demographic variables, age and co-morbidity, and functional status. Three symptom clusters, sickness behavior, discomforts of illness, and GI distress were extracted. Predictors of functional limitations (F = 35.96, p = 0.0005, R2 = 0.578) included sickness behavior (β = -.681, p 0.0005), discomforts of illness (β = - .765, p = 0.0005) and the interaction term between these two symptom clusters (β = .649, p = 0.014). This model predicted 59% of the variance in functional limitations. Predictors of limited mobility (F 20.68, p = 0.0005, R2 = 0.275) included sickness behavior (β = -0.441, p 0.0005) and co-morbidity (β = -.200, p = 0.019). This model predicted 28% of the variance in mobility. Relationship between clusters of heart failure symptoms and functional limitations or mobility was observed. The interaction between discomforts of illness and sickness behaviors implies that not only do functional limitations increase as discomforts of illness increase, but increases at a faster rate when sickness behaviors are increased. Changes in sickness behaviors has the potential to improve mobility from being bed or chair bound everyday or most days to being bed or chair bound only some days.
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Scharpf, Tanya Pollack M. S. "Functional Status and Quality in Home Health Care." Case Western Reserve University School of Graduate Studies / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=case1112905040.
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Ekman, Urban. "Functional brain imaging of cognitive status in Parkinson's disease." Doctoral thesis, Umeå universitet, Fysiologi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96368.
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Parkinson’s disease (PD) is next to Alzheimer’s disease (AD) the second most common neurodegenerative disease. PD has traditionally been characterised as a motor disorder, but more recent research has revealed that cognitive impairments are frequent. Cognitive impairments in executive functions, attention, and working memory with reliance on dopaminergic transmission, are often described as dominating the cognitive profile in early-phase PD. However, although knowledge about the neuropathology that underlies the cognitive impairments in PD has increased, its features are complex and knowledge remains insufficient. Therefore, the aim of the current thesis was to improve the understanding of how task-evoked brain responses relate to cognitive status in patients with PD, with and without mild cognitive impairment (MCI), and to evaluate the predictive value of PD-MCI in respect of prodromal Parkinson’s disease dementia (PDD). This was conducted within the “new Parkinsonism in Umeå” (NYPUM) project, which is a prospective cohort study. Patients with idiopathic PD were included in this thesis, and the patients were examined with a comprehensive neuropsychological battery and with a functional MRI (fMRI) working memory protocol. During scanning, patients conducted a verbal two-back task in which they needed to maintain and actively update relevant information, and the primary outcome measure was blood-oxygen-level-dependent (BOLD) signal. This thesis shows that patients with PD-MCI had significantly lower BOLD signal responses than patients without MCI in frontal (anterior cingulate cortex) and striatal (right caudate) regions (Study I). The altered BOLD response in the right caudate was associated with altered presynaptic dopamine binding. The fronto-striatal alterations persisted across time but without any additional change. However, decreased posterior cortical (right fusiform gyrus) BOLD signal responses were observed in patients with PD-MCI relative to patients without MCI across time (Study II). Finally, PD-MCI at baseline examination is highly predictive for prodromal PDD with a six-fold increased risk. Cognitive tests with a posterior cortical basis, to a greater extent, are predictive for prodromal PDD than tests with a fronto-striatal basis. The observed working memory related alterations in patients with PD-MCI suggest that early cognitive impairments in PD are linked to fronto-striatal dopaminergic dysfunction. The longitudinal development of cognitive impairment in PD reflects additional posterior cortical dysfunction. This might reflect a dual syndrome, with dopamine-depleted fronto-striatal alterations that characterise PD-MCI in general, whereas additional posterior cortical cognitive alterations with a non-dopaminergic basis to a greater extent characterise prodromal PDD. If, and how, the two potential syndromes interact, is still unclear. Thus, this thesis provides information on cognitive neuropathological changes in PD that might contribute to more relevant choices of pharmacotherapy and diagnostic accuracy in respect of PDD. However, additional large-scale longitudinal imaging studies are needed to further clarify the neuropatholgogical features of PD-MCI in respect of prodromal PDD.
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Du, Plessis Marilize. "Fibromyalgia : association between specific psychological variables and functional status." Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/70212.
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Thesis (MA)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: This study investigated the association between functional status in fibromyalgia patients and helplessness, self-efficacy, social support and cognitive appraisal. Patients' assessments of their pain and global severity of illness (as rated on a visual analog scale) as well as a physician's rating of global severity, tended to correlate with helplessness and pain-related self-statements. Patients' perceived change in difficulty and satisfaction regarding activities of daily living (measured by means of the Modified Health Assessment Questionnaire) correlated negatively with self-efficacy beliefs and relationship strain, while patients' subjective assessment of their global improvement was related to self-efficacy. The objective rating by a physician of tender points correlated with catastrophizing self-statements and opportunity for confiding.
AFRIKAANSE OPSOMMING: In hierdie studie is die verband tussen die funksionele status van pasiënte met fibromialgie en die belewing van hulpeloosheid, selfdoeltreffendheid, sosiale ondersteuning en bepaalde kognisies ondersoek. Pasiënte se beoordeling van hulle ervaring van pyn en die globale ems van hulle siekte (soos beoordeel met behulp van 'n visuele analoogskaal), asook die geneesheer se beoordeling van die ems van hulle siekte, het met hulpeloosheid en pynverwante kognisies gekorreleer. Hulle waarneming van die verandering in die uitvoerbaarheid van, en hulle tevredenheid met hulle daaglikse aktiwiteite (gemeet met die Modified Health Assessment Questionnaire) het negatief verband gehou met selfdoeltreffendheid en verhoudingstremmings, terwyl hulle globale beoordeling van die verbetering in hulle siekte met selfdoeltreffendheid gekorreleer het. Die objektiewe assessering deur 'n geneesheer van sensitiewe liggaamsareas het verband getoon met disfunksionele kognisies (katastrofering) en vertroue in ander.
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Mayer, Gregory Lee. "Mental Status and Functional Behavior In Male Geriatric Patients." DigitalCommons@USU, 1989. https://digitalcommons.usu.edu/etd/5996.
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It was the goal of this study to examine the ecological validity of a number of measures of mental status for geriatric individuals. Subjects were 40 alert, ambulatory male VA patients. Mental status instruments included the Mini-Mental State Examination (MMSE), the Wechsler Memory Scale (WMS) and the Vocabulary subtest of the WAIS-R. Measures of functional behavior included the Woodcock-Johnson Scales of Independent Behavior (SIB) and the Parachek Geriatric Behavior Rating Scale (PGBRS). Significant relationships were found between the MMSE and the SIB, between the WMS and the SIB, and between the WMS and the PGBRS. It was found that estimation of functional behavior can be enhanced significantly through the use of battery of mental status instruments.
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Huls, Adele Ann. "Nutrition parameters predicting functional status decline in the older adult." Diss., The University of Arizona, 1999. http://hdl.handle.net/10150/284372.
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The present study was designed to test the hypotheses that there would be physical, affective, and cognitive function decline from baseline at 3 months and 6 months for the total group and within age groups and that decline would be predicted by nutritional status. Serum concentrations of albumin, cholesterol, hemoglobin, and percent lymphocytes and white blood cells (to calculate total lymphocyte count) were measured; fat reserves and somatic protein were estimated from anthropometry; and physical signs of malnutrition and a composite of nutritional status indicators were assessed. The participants in the 6-month longitudinal study were females and males aged 75-96 years (N = 132). Physical function was measured by the Physical Self Maintenance Tool (PSMT), the Instrumental Activities of Daily Living (IADL) scale, and the Tinetti Balance and Gait Evaluation to assess decline. Affective function was measured by the Geriatric Depression Scale (GDS). Cognitive function was measured by the California Verbal Learning Test (CVLT). Where decline was significant (p ≤ .05), nutritional parameters were used to predict (p ≤ .10) decline in this exploratory research. Logistic regression revealed physical decline in balance and gait which was predicted by high or low total lymphocyte counts and low fat reserves. Aspects of cognitive decline were predicted by low fat reserves; by combined low fat reserves, low albumin, low cholesterol, and low Mini Nutritional Assessment scores; and by combined high fat reserves and high cholesterol.
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Hassanein, Kamal Abdal-Aal Mohamed. "Functional status and quality of life in oral cancer patients." Thesis, University of Manchester, 2001. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.659359.
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Roseman, Emily C. Schultheis Maria T. "The role of unawareness on functional status in mild Alzheimer's dementia /." Philadelphia, Pa. : Drexel University, 2010. http://hdl.handle.net/1860/3275.
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Rebchuk, Alexander David. "Investigating impact exposure and functional neurological status in collegiate football players." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/58375.
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A single head impact in sport can cause an acute concussion, whereas repetitive head impacts are suspected to cause chronic neurological impairment. However, the diagnostic accuracy of concussion assessment tools are not well understood and sparse research evidence exists regarding the neurological implications of repetitive head impacts. The objective of this thesis was to investigate repetitive head impacts, including impact detection technology and neurocognitive function, over the duration of a collegiate football season. Thirty-five healthy participants were recruited from a collegiate football program for a three-part study. Participants adhered an impact detection sensor (xPatch, X2 Biosystems) to their right mastoid process prior to each game and practice. As well, they completed a weekly battery of neurological testing that included the graded symptom checklist, standardized assessment of concussion, balance error scoring system and King-Devick test. In experiment 1, we investigated the accuracy of the xPatch to classify each detected event as an impact or non-impact. We matched each event to game video and assigned a true positive, false positive, true negative or false negative classification. The sensitivity of the sensor was 77.6%, specificity was 70.4% and overall accuracy was 75.1%. Additionally, we determined that impact count is strongly correlated to cumulative head kinematic load, i.e. cumulative linear acceleration (r²=0.98), cumulative rotational acceleration (r²=0.98) and cumulative rotational velocity (r²=0.99). In experiment 2, we explored the relationship between alterations in neurological status and repetitive head impact exposure using linear mixed models. The number of head impacts sustained was significantly related to the number and severity of symptoms in participants, but not to any other indicator of neurological status. In experiment 3, we investigated the diagnostic accuracy of each neurological test using receiver operating characteristic curves and corresponding area under the curve values. The diagnostic accuracy for the graded symptom checklist was high (0.76-0.93), King-Devick Test was moderate (0.64-0.80), standardized assessment of concussion and balance error scoring system were poor (0.47-0.71). In summary, this thesis identified limitations in current impact detection technology, provided evidence of a link between repetitive head impacts and symptomatology, and determined that the graded symptom checklist can accurately diagnose concussion.Education, Faculty of
Kinesiology, School of
Graduate
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Chilma, Dorothy Madalo. "Nutritional status and functional ability of older people in rural Malawi." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312510.
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Bonham, Maxine. "The development of functional indicators of optimal nutritional status for copper." Thesis, University of Ulster, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274391.
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Munday, Karen. "Connective tissue related functional index of vitamin C status in man." Thesis, University of Cambridge, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.615636.
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Dickey, Mary Beth 1945. "Locus of control, morale and functional status in the institutionalized elderly." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/278782.
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A descriptive study was conducted to explore whether locus of control and morale had an effect on the physical ability of institutionalized elderly. A convenience sample of 20 men and women over the age of 65 living in a skilled nursing facility was used as the sample population. Quantitative research techniques were employed for data collection and analysis. No statistically significant relationship was found among the study variables of morale, locus of control or functional status. The length of time one had spent in the nursing facility did correlate with actual functional status. The male subjects indicated a higher perception in internal control of their lives while the female subjects showed a higher degree of positive adaptation in the nursing home setting, as measured by morale. Seventy-eight percent of the sample population viewed their health as either fair or poor. None of the subjects thought their health was excellent.
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Bakhshwin, Duaa M. "ASSOCIATION BETWEEN POLYPHARMACY AND FUNCTIONAL STATUS IN COMMUNITY-DWELLING OLDER ADULTS." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5356.
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Background: Polypharmacy has no consensus definition in the literature. Previously used definitions include those based on the number of medications and those based on unnecessary or inappropriate medication use. Polypharmacy has been associated with increased risk of disability and functional limitations that impair a person's ability to live independently. Older adults are a population of interest as they are at increased risk for both polypharmacy and functional impairments. Understanding the relationship between polypharmacy and functional impairment in older adults could help health care providers and policy makers to target an at-risk population for interventions.
Objectives:
To assess the relationship between the number of medications taken and functional status in community-dwelling older adults using a nationally representative dataset.
To assess the change in the relationship between the number of medications taken and functional status over time (2 years and 4 years).
To study confounders of the relationship between polypharmacy and functional status.
Methods: Data came from the Health and Retirement Study (HRS), collected in the following years: 2004, 2006 and 2008. The primary outcome was functional limitation as measured using the following validated tools: activities of daily living and instrumental activities of daily living (ADL and IADL). The exposure under study was polypharmacy status (no polypharmacy: < 5 prescribed medications, and polypharmacy: ≥5 prescribed medications). Both cross-sectional and longitudinal models were used to examine different aspects of the relationship between polypharmacy and functional status.
Results: A total sample size of 1,545 was included in our study. The prevalence of polypharmacy was 35.9% at the beginning of the study. Polypharmacy status was significantly associated with functional decline in both the cross-sectional and longitudinal analyses after controlling for confounders. Self-reported health (SRH) and light exercise were associated with functional decline in all cross-sectional analyses. Age, arthritis, and SRH were also associated with functional decline in all longitudinal analyses. Other confounders were also associated with functional decline.
Conclusion: Polypharmacy, defined as the use of more than five prescribed medications is a significant risk factor for functional decline in community-dwelling older adults.
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Black, Alexander Andrew. "Functional status, postural stability and falls among older adults with glaucoma." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/38882/1/Alexander_Black_Thesis.pdf.
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Visual impairment is an important contributing factor in falls among older adults, which is one of the leading causes of injury and injury-related death in this population. Visual impairment is also associated with greater disability among older adults, including poorer health-related quality of life, increased frailty and reduced postural stability. The majority of this evidence, however, is based on measures of central visual function, rather than peripheral visual function. As such, there is comparatively limited research on the associations between peripheral visual function, disability and falls, and even fewer studies involving older adults with specific diseases which affect peripheral visual function, the most common of which is glaucoma. Glaucoma is one of the leading causes of irreversible vision loss among older adults, affecting around 3 per cent of adults aged over 60 years. The condition is characterised by retinal nerve fibre loss, primarily affecting peripheral visual function. Importantly, the number of older adults with glaucomatous visual impairment is projected to increase as the ageing population grows. The first component of the thesis examined the cross-sectional association between glaucomatous visual impairment and health-related quality of life (Study 1a), functional status (Study 1b) and postural stability (Study 1c) among older adults. A cohort of 74 community-dwelling adults with glaucoma (mean age 74.2 ± 5.9 years) was recruited and completed a baseline assessment. A number of visual function measures was assessed, including central visual function (visual acuity and contrast sensitivity), motion sensitivity, retinal nerve fibre analysis and monocular and binocular visual field measures (monocular 24-2 and binocular integrated visual fields (IVF): IVF-60 and IVF-120). The analyses focused on the associations between the outcomes measures and severity and location of visual field loss, as this is the primary visual function affected by glaucoma. In Study 1a, we examined the association between visual field loss and health-related quality of life, measured by the Short Form 36-item Health Survey (SF-36). Greater binocular visual field loss, on both IVF measures, was associated with lower SF-36 physical component scores, adjusted for age and gender (Pearson's r =|0.32| to |0.36|, p<0.001). Furthermore, inferior visual field loss was more strongly associated with the SF-36 physical component than superior field loss. No association was found between visual field loss and SF-36 mental component scores. The association between visual field loss and functional status was examined in Study 1b. Functional status outcomes measures included a physical activity questionnaire (Physical Activity Scale for the Elderly, PASE), performance tests (six-minute walk test, timed up and go test and lower leg strength) and an overall functional status score. Significant, but weak, correlations were found between binocular visual field loss and PASE and overall functional status scores, adjusted for age and gender (Pearson's r =|0.24| to |0.33|, p<0.05). Greater inferior visual field loss, independent of superior visual field loss, was significantly associated with poorer physical performance results and lower overall functional status scores. In Study 1c, we examined the association between visual field loss and postural stability, using a swaymeter device which recorded body movement during four conditions: eyes open and closed, on a firm and foam surface. Greater binocular visual field loss was associated with increased postural sway, both on firm and foam surfaces, independent of age and gender (Pearson’s r =|0.44| to |0.46|, p <0.001). Furthermore, inferior visual field was a stronger contributor to postural stability, more so than the superior visual field, particularly on the foam condition with the eyes open. Greater visual field loss was associated with a reduction in the visual contribution to postural sway, which underlies the observed association with postural sway. The second component of the thesis examined the association between severity and location of visual field loss and falls during a 12-month longitudinal follow-up. The number of falls was assessed prospectively using monthly fall calendars. Of the 71 participants who successfully completed the follow up (mean age 73.9 ± 5.7 years), 44% reported one or more falls, and around 20% reported two or more falls. After adjusting for age and gender, every 10 points missed on the IVF-120 increased the rate of falls by 25% (rate ratio 1.25, 95% confidence interval 1.08 - 1.44) or every 5dB reduction in IVF-60 increased the rate of falls by 47% (rate ratio 1.47, 95% confidence interval 1.16 - 1.87). Inferior visual field loss was a significant predictor of falls, more so than superior field loss, highlighting the importance of the inferior visual field area in safe and efficient navigation. Further analyses indicated that postural stability, more so than functional status, may be a potential mediating factor in the relationship between visual field loss and falls. Future research is required to confirm this causal pathway. In addition, the use of topical beta-blocker medications was not associated with an increased rate of falls in this cohort, compared with the use of other topical anti-glaucoma medications. In summary, greater binocular visual field loss among older adults with glaucoma was associated with poorer health-related quality of life in the physical domain, reduced functional status, greater postural instability and higher rates of falling. When the location of visual field loss was examined, inferior visual field loss was consistently more strongly associated with these outcomes than superior visual field loss. Insights gained from this research improve our understanding of the association between glaucomatous visual field loss and disability, and its link with falls among older adults. The clinical implications of this research include the need to include visual field screening in falls risk assessments among older adults and to raise awareness of these findings to eye care practitioners and adults with glaucoma. The findings also assist in developing further research to examine strategies to reduce disability and prevent falls among older adults with glaucoma to promote healthy ageing and independence for these individuals.
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Lee, Dave. "Informatics tools for the analysis and assignment of phosphorylation status in proteomics." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/informatics-tools-for-the-analysis-and-assignment-of-phosphorylation-status-in-proteomics(48d2cc82-5bb2-4f07-9cdd-670467db4378).html.
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Presently, progress in the field of phosphoproteomics has been accelerated by mass spectrometry. This is not a surprise owing to not only the accuracy, precision and high-throughput capabilities of MS but also due to the support it receives from informaticians whom allow the automated analysis; making the task of going from a complex sample to a statistically satisfactory set of phosphopeptides and corresponding site positions with relative ease. However, the process of identifying and subsequently pinpointing the phosphorylation moiety is not straightforward and remains a challenging task. Furthermore, it has been suggested that not all phosphorylation sites are of equal functional importance, to the extent that some may even lack function altogether. Clearly, such sites will confound the efforts towards functional characterisation. The work in this thesis is aimed at these two issues; accurate site localisation and functional annotation. To address the first issue, I adopt a multi-tool approach for identification and site localisation; utilising the different underlying algorithms of each tool and thereby allowing an orthogonal perspective on the same tandem mass spectra. Doing so enhanced accuracy over any single tool by itself. The power of this multi-tool approach stemmed from its ability to not predict more true positives but rather by removal of false positives. For the second issue, I first investigated the hypothesis that those of functional consequence exhibit stronger phosphorylation-characteristic features such as the degree of conservation and disorder. Indeed, it was found that some features were enriched for the functional group. More surprisingly, there were also some that were enriched for the less-functional; suggesting their incorporation into a prediction algorithm would hinder functional prediction. With this in mind, I train and optimise several machine-learning algorithms, using different combinations of features in an attempt to (separately) improve general phosphorylation and functional prediction.
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Strauss, Eva von. "Being old in our society : health, functional status, and effects of research /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4189-0/.
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Timmerman, Angelique Antonius. "'How to describe the functional health status of children with otitis media'." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=9648.
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Forman, Jacqueline Marie. "Exploring changes in functional status while waiting for transcatheter aortic valve implantation." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/44803.
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As the body ages, there is a natural decline in physical and cognitive abilities. The presence of chronic disease can accelerate this process. Aortic stenosis (AS) is a structural heart disease primarily associated with aging. Untreated patients die within 2 to 5 years following the onset of symptoms. For individuals with multiple co-morbidities, surgical treatment is not an option because of high risk for surgical complications. An innovative and minimally invasive procedure called transcatheter aortic valve implantation (TAVI) has emerged as a safe and viable treatment option for higher risk patients. Because of the rapid disease progression of severe AS and the varying wait-times prior to procedure, it is important to understand changes in functional status while waiting for TAVI. The purpose of this study was to examine the changes in functional status between time of eligibility assessment and TAVI procedure date. Changes in functional status including 5-Metre Gait Speed, Canadian Study of Health and Aging Clinical Frailty Scale and Mini Mental State Examination were evaluated using an exploratory prospective cohort design.
Thirty two patients participated in the study with median age 81 (range 64 to 93). Functional status declined between time of assessment and time of TAVI: Gait speed increased by 0.53 seconds (p = 0.01) and Clinical Frailty Scale increased by 0.31 (from 4.3 to 4.6, p = 0.01). Patients who waited longer than six weeks for TAVI (n = 19) had a larger decline in gait speed than patients who waited less than six weeks (n = 10) (0.8 sec vs 0.0 sec, p = 0.04). Patients who were living alone (n =11) had a larger increase in frailty scores compared to patients living with another adult (n = 21) (0.6 vs 0.1, p = 0.05).
This study has shown that change in functional status may be an important assessment to monitor while patients are waiting for TAVI. Results may be used to facilitate individualized care and management strategies and inform health care policy to develop evidence based benchmarks for safe wait-times. Future research with larger samples could validate the exploratory findings of this study.
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Antoniv, A. A. "Kidneys functional status in patients with chronic kidney disease and nonalcoholic steatohepatitis." Thesis, БДМУ, 2020. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/18082.
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Simon, Jeannine. "Identification of Functional Immunological Indicators of Nutritional status during acute nutritional deprivation." Thesis, Virginia Tech, 1998. http://hdl.handle.net/10919/36605.
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Optimal functioning of the immune system is necessary for the host to be capable of mounting a sufficient immune response, especially in times of sickness and injury. Acute bouts of starvation may compromise immune function, and subsequently lead to increased susceptibility to infection. Immunocompetence has been suggested as a functional indicator of nutritional status as the function of the immune system relies upon nutrient dependent metabolic pathways and the provision of adequate nutrient substrates to synthesize its components. The sensitivity of monocyte phagocytic activity, major histocompatibility complex (MHC) class II expression, and fibronectin concentration were studied in 23 healthy cats during a 7 day period without food followed by a 7 day refeeding period. Blood samples were obtained for plasma fibronectin analysis and immune cell function tests on days 0, 4, 7, 11, and 14. A turbidimetric immunoassay was used for determination of plasma fibronectin concentration. Monocyte phagocytosis and MHC class II expression were measured using flow cytometric techniques. Weight, lymphocyte number, percent lymphocytes, white blood cell number, and serum albumin concentration were monitored throughout the study. Phagocytic activity, MHC class II expression, weight, lymphocyte number, percent lymphocytes, and white blood cell (WBC) number, decreased significantly (p<0.05) during the starvation period. Fibronectin concentration increased significantly (p<0.05) by day 4 of starvation. During refeeding there was a significant increase (p<0.05) in MHC class II expression, fibronectin concentration, weight, lymphocyte number, percent lymphocytes, and white blood cell number. Phagocytic activity decreased significantly (p<0.05) by day 11 of refeeding. Pearsons correlation analysis revealed a positive correlation (p<0.05, r=.2682) between weight change and phagocytosis. There was a positive correlation (p<0.05, r=.3588) between monocyte number and MHC class II expression, and between monocyte number and WBC number (p<0.05, r=.3506). Results indicate that maintenance of immune function is dependent upon the provision of continuous nutritional intake by the host. Plasma fibronectin, monocyte phagocytosis, MHC class II expression, and other immunological measures of health status were sensitive to acute alterations of nutritional intake and subsequent refeeding. Both phagocytic activity and MHC class II expression were found to be reliable indicators of nutritional status during acute nutritional deprivation. These data suggest that short periods of food deprivation may significantly decrease immune response.Master of Science
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Ershadi, Mahsa. "Establishing Predictors of Insight Problem Solving In Children: Age, Not Cognitive Control or Socioeconomic Status, Determines Immunity to Functional Fixedness." Thesis, Boston College, 2021. http://hdl.handle.net/2345/bc-ir:109037.
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Thesis advisor: Ellen WinnerCognitive control, the ability to limit attention to goal-relevant information, subserves higher-order cognitive functions such as reasoning, attention, planning and organization. Counterintuitively, deficits in these functions have proven advantageous in certain contexts: low cognitive control means less filtering of attention, and such unfiltered attention leads to novel solutions in insight problem solving contexts. Insight is the clear and often sudden discernment of a solution to a problem by means that are not obvious, and it plays an indispensable role in creative thinking. This study examined whether insight problem solving is a compensatory advantage for children of low socioeconomic status because of their known deficits in cognitive control. One hundred and forty-eight children ages 4 to 11 years old, each completed two insight problem solving tasks (the Box Problem and the Pencil Problem) and a cognitive control task (the Flanker/Reverse Flanker). In addition, their parents completed a sociodemographic questionnaire, which was used as a measure of their socioeconomic status and child rearing values of obedience versus independence. No association was found between children’s socioeconomic status and their ability to use insight to solve a problem. Results did show that older children exhibited less cognitive flexibility than did to younger children, and that diminished cognitive flexibility correlated with older children’s ability to solve the Box Problem; however, this effect did not hold when age, sex, race, socioeconomic status, and parental report of obedience versus independence, were accounted for. Ultimately, age was the only significant predictor of children’s insight problem solving ability, such that older children were significantly more likely to solve the Box Problem and to arrive at a solution more quickly for the Pencil Problem compared to younger children. Findings from this study are explained using evidence from research on children’s tool innovation showing that young children are poor at inventing tools, and that older children’s ability to use objects for atypical functions may be the result of their greater exposure to and experience with tools
Thesis (PhD) — Boston College, 2021
Submitted to: Boston College. Graduate School of Arts and Sciences
Discipline: Psychology
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Boucher, Susan Jane. "The reliability and validity of functional status indices used in a clinical trial /." Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=65940.
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Mak, Nin-fung Joseph, and 麥年豐. "Electromyographic characterization of functional status of back musculature: applications in low back painrehabilitation." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42182372.
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Kornuszko-Story, Margaret A. "Functional Status in Hospitalized Senior Patients| Measurement, Prediction Models, and Cost-Saving Opportunities." Thesis, Thomas Jefferson University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10928212.
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Functional Status in Hospitalized Senior Patients: Measurement, Prediction Models, and Cost-Saving Opportunities By Margaret A. Kornuszko-Story Abstract Seniors have declining functional ability which is made worse from immobility during hospitalization. Accountable providers have underestimated how addressing patient function can reduce costs and improve quality by reducing length of stay, readmissions, and discharges to skilled nursing facilities (SNF). This study conducted a budget impact analysis to determine potential cost savings associated with an early patient function assessment and mobility intervention. Binary logistic regression was employed to explore whether prediction models for discharge disposition and 30-day all-cause hospital readmissions can be improved with the addition of Ambulatory Measure Post-Acute Care (AM-PAC) predictors. Semi-structured interviews were conducted with process stakeholders to understand how function measurement and patient mobility can be supported in acute care facilities. Results indicated that acute care facilities in this Network would save a net of $6.4 million; and the Accountable Care Organization by reducing discharges to SNFs and readmissions would generate $4.6 million and $4.5 million respectively. AM-PAC Mobility and Self-Care scores are good predictors of discharge destination (C = 0.890), and while not significant predictors of readmission, improved the C-statistic from 0.792 to 0.811. All interviewees (n=13) stated that a culture of mobility is an important aspect for an early patient assessment and mobility intervention.
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Wiencek, Clareen. "Symptom Burden and Its Relationship to Functional Status in the Chronically Critically Ill." Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1207241196.
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Underhill, Andrea T. "Gender differences in traumatic brain injury outcomes survival, functional independence, and employment status /." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2008p/underhill.pdf.
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Ferdous, Tamanna. "Determinants and Functional Impact of Nutritional Status Among Older Persons in Rural Bangladesh." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-107369.
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Dong, Huan-Ji. "Health Maintenance in Very Old Age : Medical Conditions, Functional Outcome and Nutritional Status." Doctoral thesis, Linköpings universitet, Avdelningen för neurovetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-105087.
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The overall aim of this thesis was to provide better understanding of the underlying factors related to health maintenance in very old people, with a focus on medical conditions, functional outcome and nutritional status. Data were gathered from the ELSA 85 project (Elderly in Linköping Screening Assessment). The ELSA 85 project was started in 2007 with a population-based survey of 85-year-old individuals (n = 650) residing in Linköping municipality, Sweden. During the study period from 2007 to 2010, we conducted surveys by postal questionnaire, home visits, geriatric clinic visits, and reviews of electronic medical records as well as the database of health service consumption. A series of cross-sectional analyses were performed on multimorbidity, health service consumption, activities of daily living (ADLs), physical functioning and nutritional status. Of 650 eligible individuals, 496 (78% of those alive) completed the questionnaire (Paper I). Despite the prevalence of multimorbidity (68%) and frequent use of assistive technology for mobility (40%), the majority managed self-care (85%), usual activities (74%) and had high self-rated health (>60/100, visual analogue scale). Factors associated with in-patient care were an increased number of general practitioner visits, more use of assistive technology, community assistance, multimorbidity (≥2 chronic diseases) and/or heart failure and arrhythmia. Cluster analyses (n = 496, Paper II) revealed five clusters: vascular, cardiopulmonary, cardiac (only for men), somatic–mental (only for men), mental disease (only for women), and three other clusters related to ageing (one for men and two for women). Heart failure in men (odds ratio [OR], 2.4; 95% confidence interval [CI], 1–5.7) and women (OR, 3; 95% CI, 1.3–6.9) as a single morbidity explained more variance than morbidity clusters in models of emergency room visits. Men’s cardiac cluster (OR, 1.6; 95% CI, 1–2.7) and women’s cardiopulmonary cluster (OR, 1.7; 95% CI, 1.2–2.4) were significantly associated with hospitalization. The combination of the cardiopulmonary cluster with the men’s cardiac cluster (OR, 1.6; 95% CI, 1–2.4) and one of the women’s ageing clusters (OR, 0.5; 95% CI, 0.3–0.8) showed interaction effects on hospitalization. In Paper III, overweight (body mass index [BMI], 25–29.9 kg/m2) and obese (BMI, ≥30 kg/m2) individuals (n = 333) perceived more difficulty performing instrumental ADL (IADL) and had more comorbidities than their normal weight counterparts (BMI, 18.5–24.9 kg/m2). After controlling for socio-demographic factors, obese but not overweight individuals were more likely to perceive increased difficulty in performing outdoor activities (OR, 2.1; 95% CI, 1.1–4) and cleaning (OR, 2.2; 95% CI, 1.2–4.2) than their normal weight counterparts. Although obesity was also associated with multimorbidity (OR, 3; 95% CI, 1.2–8), the health service cost of each case of multimorbidity (n = 251) was highest in individuals of normal weight and nearly three times as much as in obese individuals (ratio, 2.9; 95% CI, 1.1–8.1). In Paper IV, 88-year-old obese women (n = 83) had greater absolute waist circumference, fat mass (FM) and fat-free mass (FFM), and lower handgrip strength (HS) corrected for FFM and HS-based ratios (HS/weight (Wt), HS/BMI, HS/FFM and HS/FM) than their normal weight and overweight counterparts. After adjusting for physical activity levels and the number of chronic diseases, the HS-based ratios explained more variance in physical functioning in Short Form-36 (R2, 0.52–0.54) than other single anthropometric or body composition parameters (R2, 0.45–0.51). Waist circumference, HS, and two HS-based ratios (HS/Wt and HS/FFM) were also associated with the number of IADL with no difficulty. In conclusion, the ELSA 85 population showed a fairly positive image of healthy perception, good functional ability as well as low use of health care among the majority of participants. Patterns of cardiac and pulmonary conditions were better associated than any single morbidity with hospitalization. Heart failure as a single morbidity was better associated than multimorbidity patterns with emergency room visits. For 85-year-olds, being obese, as opposed to overweight, was associated with self-reported activity limitations and comorbidities. Overweight elderly living in their own homes in this population had similar well-being to those of normal weight. In the cohort of 88-year-olds, obese women had high waist circumference, but their HS was relatively low in relation to their Wt and FFM. These parameters were better than BMI for predicting physical function and independent daily living.Att åldras innebär inte bara en utveckling över tid utan också en förändring av människans fysiologi och funktion. Vi har många olika bilder av åldrandet. Ofta överväger de negativa bilderna som betonar sjuklighet och höga samhällskostnader för vård och omsorg. ELSA 85, en förkortning av the Elderly in Linköping Screening Assessment, påbörjades 2007 med avsikt att kartlägga 85-åringars hälsotillstånd och funktion. Syftet med denna avhandling var att fördjupa kunskapen om faktorer med betydelse för bevarande av hälsa hos dessa 85-åringar. Populationsstudien genomfördes via enkätutskick (bl.a. livssituation, livskvalitet), hembesök (bl.a. aktiviteter i dagliga livet (ADL), kognitiva funktioner) och mottagningsbesök (bl.a. nutritionsstatus, rörelseförmåga, kroppslig undersökning, blodprover, läkemedel) under perioden mars 2007 till mars 2008. Vi kartlade även deltagarnas sjukvårdsbesök samt sjukvårdskostnader. Tre år senare, när individerna var 88 år, analyserades även kroppssammansättningen hos delar av populationen. Totalt 496 Linköpingsbor födda 1922, deltog i studien. Andelen som svarade på enkäten var 78 % av alla då levande 85-åringar. Resultaten visar att majoriteten av 85-åringarna klarade att sköta sin hygien (85%) samt huvudsakliga aktiviteter (74%). Sextio procent skattade sin hälsorelaterade livskvalitet som hög trots förekomst av flera kroniska sjukdomar och frekvent användning av hjälpmedel för att förbättra rörligheten. Oberoende riskfaktorer för slutenvård var multipla besök hos distriktsläkare, användande av flera hjälpmedel, förekomst av minst två sjukdomar eller förekomst av hjärtsvikt och arytmi. Multimorbiditet (förekomst av minst två kroniska sjukdomar) var vanligt hos 85-åringarna (68%). Olika kombinationer av sjukdomar hade varierande betydelse för behovet av sjukvård. I clusteranalys, där man försöker gruppera diagnoser med hög sannolikhet att förekomma hos en enskild individ, fann vi några cluster som var starkare relaterade till inläggning i slutenvård än andra. Clustren såg dessutom olika ut mellan män och kvinnor. För män var t.ex. kardiella och för kvinnor t.ex. hjärt-lung-cluster starkare relaterade till slutenvård än enskilda diagnoser. Personer med fetma (body mass index (BMI) ≥30 kg/m2) hade mer problem med rörlighet och instrumentell ADL (IADL) jämfört med de med normal- eller övervikt. Trots ett klart samband mellan fetma och multimorbiditet hade de normalviktiga individerna nästan tre gånger så höga hälso-sjukvårds kostnader som personer med fetma. Bland 88-åriga kvinnor, hade personer med fetma högre bukomfång, mer fettmassa (FM) och mer fettfri massa (FFM) men lägre handstyrka (HS) än de normal- eller överviktiga. Relativ HS, handstyrka i form av kvoter (HS/Vikt, HS/BMI, HS/FFM and HS/FM) hade starkare samband med fysisk funktion (Short Form-36, SF-36PF) än andra enskilda parametrar. Två enskilda parametrar (bukomfång och HS) samt HS/Vikt och HS/FFM var associerade med antal aktiviteter utan svårighet i IADL. Sammanfattningsvis är 85-åringarna inte så skröpliga som de ofta beskrivs. Studien ELSA 85 visar en övervägande positiv bild med bevarad hälsa och funktion för en övervägande del av populationen. De flesta 85-åringarna klarar sig ganska bra trots förekomst av flera sjukdomar. Vissa mönster av multimorbiditet med hjärt- och lungsjukdomar är mer relaterade till slutenvård medan hjärtsvikt hade hög risk för akutmottagningsbesök. Därför är det viktigt att beakta en komplexitet av sjukdomar, inte bara enskilda diagnoser eller antalet diagnoser, i planeringen av den framtida vården. Personer med normal- eller övervikt klarar sin funktion bättre och lever mer självständigt än de som lider av fetma. Den betydande andelen feta med begränsad rörlighet och funktion bland äldre kan komma att påverka behovet av tyngre omsorgsinsatser för den gruppen och är således en varningssignal inför framtiden.
【目的】 通过研究高龄老人的医疗情况，躯体功能和营养状态，提高对高龄老人健康维护相关因素的理解。 【方法】 ELSA 85 项目（林雪平老年人普查，Elderly in Linköping Screening Assessment）是一个以瑞典林雪平城市中85岁高龄老人（1922年出生， n = 650）为研究对象的人群研究。(1) 2007/03–2008/03：通过邮寄问卷，家庭访问及门诊检查的三个步骤， 我们搜集的数据包括：个人和家庭的背景信息（居住情况，既往的学历和工作程度，健康相关的生活质量EQ-5D等），身体机能（日常生活活动能力ADL评定，移动性测试等）和营养状态（人体测量等）。我们同时还阅览了所有注册的电子病历和每位老年人的年卫生费用。（2） 2010/06–2010/10: 在3年后的随访中，我们对所有88岁的女性老年人增加了人体组成测定和SF-36健康调查量表之生理功能子量表（SF-36PF）的评估。 ELSA 85 项目还包括了其他医学检查项目以及为期一年的随访（2008–2009）, 但这些数据统计并未列入本论文中。 【结果】 论文1：共496人（参与率78％）回寄并参与了问卷调查。总体而言，虽然慢性多病以及日常生活中频繁使用辅助身体移动的器具在85岁高龄老人中非常普遍，多数老年人仍然能够完成个人卫生自理和常规日常活动。他们在健康相关评价问卷中的评估自身健康状态多为良好 (EQ-5D评估）。与住院相关的风险因素包括：全科医生的年就诊次数，有共患疾病（存在两种或两种以上的慢性病征），或者是心力衰竭和心律失常两个单病种。 论文 2：运用聚类分析和性别分层对共患疾病归类，生成男女组各五个集群：血管性类疾病集群，心肺疾病集群，心源性疾病集群（只存于男性组内），躯体-精神心理疾病集群（只存于男性组内），精神心理性疾病集群（只存于女性组内），以及三个和老化过程有关的集群（男性组内1组，女性组内2组）。心力衰竭 （男性组内的比值比 OR = 2.4，95% 的可信区间CI = 1–5.7；女性组内 OR = 3，95% CI = 1.3–6.9) 作为单一病种在预测急诊就诊的模型中比任一共患疾病集群都能解释更多的变量值。男性组内的心源性疾病集群 （OR = 1.6，95% CI = 1–2.7） 和女性组内的心肺疾病集群（OR = 1.7，95% CI = 1.2–2.4）与预测是否住院显著有关。在住院模型中， 心肺疾病集群与男性的心源性疾病集群（OR = 1.6，95% CI = 1–2.4）， 或与女性组内的老化相关集群（OR = 0.5，95% CI = 0.3–0.8）具有显著的交互作用。 论文3：超重（体重指数 BMI：25–29.9 kg/m2）和肥胖（BMI ≥30 kg/m2）者在工具性日常生活活动评定（IADL）比正常体重者（BMI: 18.5–24.9 kg/m2）有更多的困难，再者也比正常体重者有更高伴发疾病的风险。但是在控制了混杂变量（社会人口因素）后，对照正常体重组，只有肥胖者而不是超重者的IADL（户外活动：OR= 2.1，95% CI=1.1–4；居室清洁：OR= 2.2，95% CI= 1.2–4.2）存在更大的困难。虽然肥胖与共患疾病相关（OR= 3，95% CI=1.2–8），有共患疾病的正常体重者的卫生服务消费却是共患疾病的肥胖者的近三倍（ratio= 2.9，95% CI= 1.1–8.1）。 论文 4：88岁女性肥胖组相比正常体重和超重组而言，其腰围值、脂肪群值和祛脂肪群值较大。肥胖者的绝对握力值在校正祛脂肪群后以及握力比值（握力/体重，握力/BMI，握力/祛脂肪群，等等）都较其他两组低。在控制个体的体力活动程度和慢性疾病数量后，握力比值对生理功能（SF-36PF）的解释度（R2：0.52–0.54）高于任何单一人体测量指标或人体组成成分的测定值（R2：0.45–0.51）。腰围值、绝对握力值及握力比值（握力/体重和握力/祛脂肪群）与IADL中无困难的活动项目数显著相关。 【结论】 ELSA 85 人群研究显示了一个相对健康的，个体功能良好的，且使用卫生服务较低的高龄老年群体。心源性和肺部疾病的共患与住院风险相关，而心力衰竭作为单一病种与急诊就诊有显著相关。对85岁高龄老人而言，肥胖（但不是超重）与个体的活动限制和伴发疾病有关。居住于自己住所内的超重高龄老人，其健康水平与正常体重者相近。在88岁女性高龄老人中，肥胖者有较大的腰围值和较低的握力比值（握力/体重和握力值/祛脂肪群）。这些指标比体重指数更好地反映了生理功能及高龄老人的日常独立生活能力。
Elderly in Linköping Screening Assessment, ELSA 85
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Mohs, Mary Ellen. "Zinc status and functional correlates in preschool and school-aged children in Egypt." Diss., The University of Arizona, 1989. http://hdl.handle.net/10150/184812.
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Zinc status of Egyptian children 18-30 months and 6-10 years of age was characterized in relation to morbidity, growth, and socioeconomic variables. In a pilot study of children whose general nutrition ranged from adequately nourished to moderately malnourished, mean hair zinc was 135 ug/g (63-230 ug/g), with suboptimal zinc status suggested for 44%. Predictors of hair and serum zinc levels were explored for 23 school-aged and 40 preschool children. Included in models were weaning age for preschool children, body size (length- or height- and weight-for-age Z scores), current growth over 6 months or longer, illness experience over 10 to 12 months, demographic variables affecting food availability and distribution, sex, and season. Data were collected by Egyptian workers as part of a larger field project. Hair and serum samples were analyzed for zinc content by atomic absorption spectrophotometry. Results showed no difference in hair zinc levels by color, presence or absence of louse egg fragments and mucilage, or presence or absence of henna dye. In multiple regression models, the best predictor of hair zinc in preschool children was season of year, with zinc lower in summer. Season, negative effect of percent of weeks ill with diarrhea, and positive effects of socioeconomic status (SES) based on father's education/literacy and economic subsistence base excluding agriculture (ESB-A) predicted 23% of total hair zinc variation in preschool children. In preschool children serum zinc was lower in summer. Season, positive effect of rate of weight increase, and negative effects of rate of height increase, SES based on father's occupation(s) (SES2), and ESB-A predicted 53% of total serum zinc variation in preschool children. Serum zinc was higher in summer in school-aged children. Season, negative effect of SES2 and ESB-A, and positive effects of percent weeks ill with diarrhea and height for age Z scores predicted 60% of total serum zinc variation in school-age children. Negative effects of percent weeks ill with diarrhea and parents' age and child:adult ratio predicted 29% of hair zinc in school-aged children.
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Sandhu, Navtej K. "Exploring the Influence of Functional Status on Older Adults' Social Relationships in Assisted Living Communities." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/gerontology_theses/31.
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Social relationships can have considerable influence on physical and mental well-being. AL research suggests that other residents are among the most available social contacts and that co-resident relationships can affect life satisfaction, quality of life, and well-being. Although functional status influences social relationships, research has yet to provide an in-depth understanding of how cognitive and physical function affects co-resident relationships in AL. In this thesis, I present an analysis of qualitative data collected over a one-year period in two diverse settings. The thesis addressed: 1) How does functional status influence co-resident relationships? ; and 2) What factors shape its influence? Analysis was guided by principles of Grounded Theory Method. Coming together and pulling apart signifies the key finding that functional status is multi-directional, fluid, and operates in different ways in various situations and across time. Facility and resident –level factors further affect the influence of functional status on co-resident relationships.
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Jones, Rebecca. "Perceptions of health, functional status, and nursing roles in noninstitutionalized elders with cardiac disease." Connect to resource, 2006. http://hdl.handle.net/1811/6547.
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Thesis (Honors)--Ohio State University, 2006.Title from first page of PDF file. Document formatted into pages: contains 37 p. Includes bibliographical references (p. 28-30). Available online via Ohio State University's Knowledge Bank.
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Chin, Michele Cecilia. "Functional status, social support, and self-perceived health among elderly women by living arrangement." FIU Digital Commons, 1999. http://digitalcommons.fiu.edu/etd/2335.
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The elderly population has been recognized as one of the fastest growing age groups in the United States and there has been a dramatic increase in the number of elderly women living alone in the community.
The purpose of this study was to examine the functional status, social support system, and self-perceived health of elderly women living alone and those living with others in Dade County, Florida. This study was derived from a larger Dade County Needs Assessment. The sample for this study included 1,278 elderly women who were white (n = 561), Hispanic (n = 550), black (n = 153), and "other" (n = 14).
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Hanusaik, Nancy Anna. "Association of measures of functional status with fat-free mass in frail elderly women." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ29708.pdf.
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Theander, Kersti. "Fatigue, functional status, health and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease." Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8268.
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Hanusaik, Nancy Anna. "Association of measures of functional status with fat-free mass in frail elderly women." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=27333.
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The association of functional status with fat-free mass (FFM) was examined cross-sectionally in a sample of 30 frail elderly women $(81.5 pm 7$ years) to evaluate potential outcome indicators for nutritional interventions. FFM, determined using multi-frequency bioelectrical impedance analysis, was lower in this frail group than in previous reports for "younger" elderly females. All measures of muscle strength (handgrip, biceps, quadriceps) were significantly correlated with FFM $ rm (r ge 0.45, p le 0.02),$ while the measures of global function (Timed "Up & Go" Test and walking speed) as well as self-perceived health were not. The measures of muscle strength and global function were found to have good reliability based on measurements taken on two occasions separated by one week $ rm (ICC ge 0.80).$
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Perl, Trish M. "Impact on outcome of premorbid and morbid functional status among patients with bloodstream infections." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68240.
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Functional status measurement is used to predict outcome of chronic medical conditions, such as cancer, but it has not been used for infections. Specifically, it is not known what happens to patients' functional status during an infection or whether functional status predicts patient outcome. In this report we examine the relationship between functional status and mortality. We also examine how functional status (measured by the Karnofsky, Barthel, and Eastern Cooperative Oncology Group scales) of patients with bloodstream infections changes from preinfection (baseline level) to infection, and from infection to postinfection. When prospectively studying 104 adult patients with bacteremia, demographic, host, clinical and treatment characteristics were compared between several subgroups: patients with nosocomial and community-acquired infections; with gram-negative, gram-positive, and polymicrobic infections; with different severities of underlying disease; and patients who did and did not survive. Patient demographic, host, clinical, and treatment characteristics of the subgroups examined were similar to those of bacteremic patients reported in the literature. Functional status decreased from its preinfection level, reached its lowest point at the time of infection, and within 3 weeks returned to baseline level. When patients acquired their bloodstream infection nosocomially, however, their scores did not return to baseline level. Overall, patients with nosocomial bloodstream infections had lower mean functional status scores, at each time point measured, than did the patients with community-acquired infections. Twenty-three patients died. Poorer preinfection and intrainfection functional status were associated with higher mortality. Functional status measures change significantly during the course of bloodstream infection and low scores are associated with fatal outcome.
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Freeman, Kaye Elizabeth. "Disease activity, functional ability and psychological status in individuals with newly diagnosed rheumatoid arthritis." Thesis, University of Derby, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313220.
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Hunt, Katherine J. "Physiological and functional status of older people discharged from hospital with ill-defined conditions." Thesis, University of Southampton, 2009. https://eprints.soton.ac.uk/71892/.
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This study was carried out in response to the policy attention directed at older people discharged from hospital with ill-defined conditions, or signs and symptoms related disease. In England there has been an increase in incidence of this type of hospital admission and policy suggests that patients with these codes have fewer medical/physiological and more ‘social’ conditions that could be better managed in community settings. Currently however, this population has not been characterised. Description of the functional and physiological status of these patients is essential for the planning of future health and social care services. Patients with ill-defined conditions were described via a cross-sectional study of 80 patients aged over 70 years admitted to hospital with collapse/falls. Number of chronic diseases and prescribed medications were obtained from the medical records. Routine blood tests were taken and serum cytokine concentrations (IL-1β, IL-6, TNF-α, IFN-γ) were measured. Deprivation score, functional status, depression and the prevalence of frailty were ascertained. 35 patients received ill-defined condition codes, 45 received other codes. Patients with ‘illdefined conditions’ had normal routine blood results but very high serum concentrations of pro-inflammatory cytokines which did not correlate with number of chronic diseases indicating considerable medical problems. As the policy had suggested, they also had prevalent functional impairment (65.7%), high rates of frailty (77.1%) and pre-frailty (14.3%), and depression (42.9%). Patients with ill-defined conditions had poor outcomes evident in the high readmission (60%) and mortality (20%) rates. Patients were hospitalised for a statistically significantly shorter period than patients with other codes (p<.05) and functional limitations and depression were associated with a longer length of stay. Increasing deprivation and TNF-α concentration were associated with an increase in the odds of an illdefined condition diagnosis at discharge. The association between functional limitations, frailty, chronic disease and depression add considerable complexity to the health of older people with ill-defined conditions. However, the prevalence of multiple morbidity, high serum concentrations of inflammatory markers and poor outcomes indicate that they also have considerable medical problems that may be largely unmet. These medical problems may result from chronic disease symptom crises and manifest as geriatric conditions for which there are no appropriate International Classification of Diseases (ICD-10) codes. The results of this study indicate a need for reevaluation of the ICD-10 system to incorporate the health problems faced by older people and further research into the effect of a more comprehensive community-based chronic disease management that aims to enable frail older people to maintain health and independence at home and prevent readmission in patients with ill-defined conditions.
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Shalimova, A. S., M. N. Kochueva, A. N. Belovol, V. A. Sukhonos, Валентина Григорівна Псарьова, N. N. Kirichenko, Валентина Григорьевна Псарева, and Valentyna Hryhorivna Psarova. "Structural and functional status of target organs in patients with essential hypertension and obesity." Thesis, Keystone Symposia on molecular and cellular biology, 2015. http://essuir.sumdu.edu.ua/handle/123456789/74775.
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Lee, Jiyeon. "Exploring chemotherapy-induced nausea and vomiting: The symptoms, interventions, and relationship to functional status." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3311334.
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Mak, Nin-fung Joseph. "Electromyographic characterization of functional status of back musculature applications in low back pain rehabilitation /." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42182372.
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Mak, Jenson Chun Sum. "Vitamin D replenishment and vitamin D status in functional outcomes following hip fracture surgery." Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/13825.
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Background: Older people presenting with hip fractures requiring surgery have a high prevalence of hypovitaminosis D, which is an important modifiable risk factor for falls and fractures. Inadequate sun exposure is the main reason for vitamin D deficiency in older people. Vitamin D supplements, with or without calcium have been shown to reduce falls and fracture risk in this population. Undertreated pain is a risk factor for delirium and a barrier to rehabilitation interventions following a hip fracture. A small number of randomised controlled trials (RCTs) have shown increased 25-OHD levels with a loading dose of vitamin D may improve falls and fractures. Low vitamin D levels have also been implicated in pain generally, as well as static and dynamic pain responses to mobility. It is not known whether oral vitamin D replenishment using a loading dose is effective, and if it is, what is the interplay this is with patient characteristics, in particular self-reported pain rating levels, lower limb mobility and 25-OHD levels. Aims: The aims of this research were (1) to characterise the predictive factors of 25-OHD levels; (2) to characterise the predictive factors of self-reported pain after hip fracture; (3) to determine the benefit of early loading-dose oral vitamin D replenishment and determine the 25-OHD response; (4) to evaluate safety profile of an initial high-dose (250,000IU) vitamin D followed by daily maintenance for 6 months; (5) to monitor its effects on functional mobility, falls, fractures, grip strength, health related quality of life and mortality. Methods: Participants of the REVITAHIP RCT cohort (mean age of 220 participants was 83.9 (SD 7.2) years and 77.1% were women): Active (111) and Placebo (107) participants were randomised to loading dose (250000IU vitamin D3) vs placebo followed by 6 months maintenance oral therapy (vitamin D3/calcium: 800IU/600mg) daily. Primary outcome measures are 2.4m gait-velocity, with secondary outcome measures of falls, fractures (Week-4), 25-OHD levels, quality-of-life measure (EQ-5D), mortality at weeks-2, 4 and 26 with additional measures of pain (via the numerical rating scale [NRS]) were correlated with patient characteristics in this cohort. Results: Hypovitaminosis D (25-OHD <50nmol/L) was present in 46.8% of participants and 15.4% had 25-OHD levels lower than 30nmol/L. Multivariate regression models demonstrated higher baseline vitamin D levels were significantly associated with higher premorbid Barthel Index scores and lower post-operative NRS pain levels. Further, the mean (SD) NRS pain score was 3.5 (2.3). More than half (61.9%, n=113) had NRS>3 and 18.1% (n=52) had NRS>5. Using the EQ-5D pain sub-score, 78.1% had moderate pain or discomfort and 7.9% had extreme pain or discomfort. Using a multivariate regression model, postoperative NRS was significantly higher in persons with a higher comorbidity count, those previously living independently alone, and surgical fixation with hemiarthroplasty. After loading dosing administration, 25-OHD levels were significantly higher for the Active group when compared to the Placebo group at 2 weeks (73 vs 66 nmol/L; p=.019) and at 4 weeks (83 vs 75nmol/L; p=.030). At week 4, the Active group had a significantly lower percentage of people with suboptimal 25-OHD levels (3.2% vs 15.4%, p=.019). At week 4, participants in the Active group had a gait velocity over 2.4m of 0.42m/s compared with 0.39m/s in the placebo group (p=.490). To week 4, seven (6.3%) participants in the Active group reported 1 or more falls compared to twenty-three (21.1%) in the Placebo group (χ2 = 4.327; p=.024) but there were no differences in fractures (2.7% vs 2.8%, p=.964) or grip strength. The number of deaths was non-significantly lower in the Active group compared with the Placebo group at 4 weeks (1 vs 3, p = .295). There was a trend for Active participants to have a higher total EQ-5D scores at Week 26 (88.1+/-13.2 vs 84.3+/-15.8, F=2.87, p=.092). Active participants were significantly more likely to present with ‘no pain or discomfort’ at Week 26 (96.4% vs 88.8%, p=.037). One case of hypercalcemia at 2 weeks was noted in the Active group which normalised after 4 and 26 weeks. Discussion and Conclusions: This study cohort shared similar demographic characteristics and comorbidities with other cohorts of people with hip fracture. Hypovitaminosis D was not as prevalent as previously documented. Patients taking vitamin D supplements and with higher premorbid Barthel Index, reflecting greater independence and activity, tended to have higher 25-OHD levels at baseline. Further, lower NRS pain ratings following surgery were associated with higher vitamin D levels. Overall, the levels of pain reported by this cohort are acceptable although approximately 10% to 15% had higher than reasonable levels of pain. Despite a higher than expected baseline 25-OHD level and moderate increases in 25-OHD levels, participants in the Active REVITAHIP group resulted in a greater percentage with target 25-OHD levels (>50nmol/L) compared with the placebo group with no significant differences in gait velocity at 4 weeks. Lower numbers of falls and improved pain control were noted in the Active group over the study period. In this cohort, there was a higher than expected baseline 25OH level which could have underestimated the effect of the intervention in a group with lower baseline 25-OHD levels.
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Fieo, Robert Anthony. "Determinants of functional decline in community-dwelling older adults." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/5501.
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The overarching theme of this thesis is the prevention of progressive-type disability. Unlike catastrophic disability, progressive disability is gradual and more common in older adults. Because progressive disability can take years to develop, it is often conceptualized as a continuum, from less to more disabled. Disability prevention, by definition, is designed to identify people who are as yet nondisabled but at high risk for future functional decline by identifying an early functional state associated with increased risk of subsequent disability (Fried & Guralnik, 1997). This thesis sought to address two challenges associated with identifying an early functional state of disability. The first challenge relates to instrument calibration. Traditional instruments (based on self-report) used for assessing disability, scales of activities of daily living (ADL) and instrumental activities of daily living (IADL), were originally developed to describe levels of functional status in institutionalized older adults. Thus, these instruments poorly discriminate, as well as underestimate disability in the early stages of development. Poor discrimination refers to tasks or activities (i.e., scale items) that prove unresponsive to changes in a particular person’s ability level. Performance measures on the other hand, such as walk time or grip strength, have proven to be quite responsive to early declines in functional status. Despite the popularity of performance measures used to assess health status in epidemiology or gerontological research, evidence suggests that they measure a somewhat different construct than self-reported activities of daily living. ADLs have a long history of use in the medical community, yet it has been proposed that the relative standing of ADLs, in relation to communitydwelling older adults, could be enhanced by improving construct validities that are at least equivalent to those of physical performance measures. Item response theory (IRT) methodology can be used to improve the structure of ADL scales so that they are more sensitive in detecting the early stages of functional decline within relatively high functioning older adults; a stage that has been shown to be more responsive to clinical interventions aimed at prevention of overt disability or frailty. IRT can improve ADL scales in multiple ways: by confirming an underlying uni-dimensional continuum of disability, establishing interval level measurement or item hierarchies, and increasing scale precision. As part of this thesis I conducted a systematic review of functional status scales, applied to community-dwelling older adults, which employed IRT procedures. The review was useful in that it draws attention to areas of functional assessment that can be improved upon, most notably, the topic of establishing interval level data and construct under-representation. Using data from the Cardiovascular Health Study, I was able to show that a common hierarchy of functional decline was observed for a diverse set of conditions and diseases that are prevalent among community-dwelling older adults. Such an indicator could be used to identify hierarchical declines relating to severity in diverse patient populations. Improvements in validity of functional status scales can also lead to the use of ADL-IADLs as potential determinates of disability, rather than simply acting as outcome measures of disability. Again using data from the Cardiovascular Health Study, I examined the predictive power of IADL (mobility-type) items on later disability. Self reported difficulty in 2 or 3 of the most difficult IADL items increased the odds of being disabled eight years later by a factor of 3.5. The odds of being disabled fell to 1.9 for those reporting difficulty with one item. The second challenge of this thesis relates to defining determinants of functional decline that manifest themselves at the earliest stages of the disablement process. As previously stated physical performance measures have been shown to be sensitive to early stages of functional decline. However, can other measures, potentially spanning multiple domains, be used to identify those at high risk for future disability? In particular I was interested in whether psychosocial and cognitive variables could be used to detect changes in functional status at the preclinical stages of the disablement process. With regard to the Cardiovascular Health Study, I was able to show that, for subjects within the normal range of cognitive functioning, performance in the lowest quartile of the Digit Symbol Substitution Test resulted in a 2.2 increase in the odds of being disabled. Performance on this measure, as well as selfreported mobility noted above, could detect decrements in functional status as much as 8 years prior. With the use of the Lothian Birth Cohort sample I explicitly investigated the psychosocial domain. I found that the level of depressive symptoms increased the odds of being disabled by 56%. Again, these symptoms were assessed as much as eight years prior to self-reported disability. The general findings of this thesis indicate that refinements in ADL-IADL measures can aid in the detection of disability at the pre-clinical level, and that cognitive function and intra-individual factors play a pivotal role in speeding up or slowing down the disablement process.
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Packham, Jonathan Charles. "Health status of adults with chronic arthritis since childhood : a clinical, functional and psychosocial assessment." Thesis, University of Southampton, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.403836.
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Feyissa, Ferew Lemma. "The relationship between adult anthropometry morbidity and functional status : a longitudinal study among rural Ethiopians." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.252081.
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Petersen, Elisabeth. "Physical activity, sence of coherence and functional health status in individuals with cronic musculoskeletal pain." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for sosialt arbeid og helsevitenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-13074.
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This thesis is a part of the project ― "Målrettede rehabiliteringstiltak", offering a multidisciplinary rehabilitation program, based on a salutogenic understanding of health, coping and illness. This thesis consists of two papers. The first paper provides an overview of physical activity, sense of coherence (SOC) and functional health status in individuals with chronic musculoskeletal pain. The paper builds upon health promotion through a biopsychosocial and salutogenic approach. Paper two is an empirical investigation who exploring the relationship among physical activity and sense of coherence in functional health status in individuals with chronic musculoskeletal pain. Hopefully, this thesis can provide new knowledge within factors that can help individuals with chronicDenne masteren er en del av prosjektet "Målrettede rehabiliteringstiltak", som tilbyr et tverrfaglig rehabiliteringsprogram, basert på den salutogene forståelse av helse, mestring og sykdom. Masteren består av to artikler. Den første artikkelen gir en oversikt over fysisk aktivitet, ―opplevelsen av sammenheng‖ (OAS) og den funksjonelle helsetilstand hos personer med kronisk smerter i muskel- og skjelett systemet. Den bygger på helsefremming gjennom en biopsykososial og salutogen tilnærming. Andre artikkel er en empirisk undersøkelse som utforsker sammenhenger blant fysisk aktivitet og OAS i funksjonell helsestatus hos personer med kroniske kronisk smerter i muskel- og skjelett systemet. Forhåpentligvis kan denne oppgaven gi ny kunnskap innen faktorer som kan hjelpe personer med kroniske smerter i muskel- og skjelett systemet for å få mer forståelse for egen situasjon.
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Byrd, Edwina Haith. "An analysis of functional status and utilization behavior in long-term care for the elderly /." The Ohio State University, 1985. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487259125218917.
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Guet, Sylvain. "Factors Associated with Functional Status in Community-Dwelling Hispanic Elders, in East Little Havana, FL." Diss., Temple University Libraries, 2010. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/97159.
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Physical TherapyPh.D.
Purpose: Data from a National Institute on Aging funded grant, developed by the University of Miami (UM), Center for Family Studies, were analyzed to determine if baseline levels of cognitive function, physical performance, psychological well-being, physical health, and social support (SS) predict functional status [basic (BADL) and instrumental (IADL) activities of daily living] among Hispanic elders (30 months later). Participants: The parent grant randomly selected a population based sample of Hispanic seniors living in East Little Havana, Florida: n=216, `M' age = 80.0 yrs, `SD' = 6.0; female = 63%. Methods: Data from two time points of the parent grant separated by 30 months were used in this analysis. Self report and physical measures of: cognitive function (MMSE), physical performance (gait speed, grip strength, number of blocks walked in past 7 days), psychological well-being (CES-D), physical health (BMI & self-rated health), SS (Received SS scale), and functional status (BADL and IADL), measured by a derivative of the OARS Functional Assessment Questionnaire, were examined. Two stepwise regression equations (one for BADL and one for IADL as dependent variables respectively) were calculated using SPSS v17.0. The study was approved by UM and Temple University's IRB. Results: Gait speed and physical activity were positively associated with IADL while physical activity was positively associated with BADL. In contrast, received social support and age were negatively associated with each of these outcomes. Conclusion: `Young-old,' Hispanic adults with lower levels of received SS and higher gait speeds and levels of physical activity exhibit greater BADL and IADL capacity. Social Relevance: Results of this study have implications for the development of strategies that delay long-term placement of Hispanic elders with disability.
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Krug, Jeffrey Bart Litofsky N. Scott Chandrasekhar Anand. "Functional outcome and self-perceived overall health status following surgery to remove primary brain tumor." Diss., Columbia, Mo. : University of Missouri--Columbia, 2008. http://hdl.handle.net/10355/5754.
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The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on September 25, 2009). Thesis advisors: Dr. N. Scott Litofsky & Dr. Anand Chandrasekhar. Includes bibliographical references.