Validation of a mobility item bank for older patients in primary care

Background: To develop and validate an item bank to measure mobility in older people in primary care and to analyse differential item functioning (DIF) and differential bundle functioning (DBF) by sex. Methods: A pool of 48 mobility items was administered by interview to 593 older people attending primary health care practices. The pool contained four domains based on the International Classification of Functioning: changing and maintaining body position, carrying, lifting and pushing, walking and going up and down stairs. Results: The Late Life Mobility item bank consisted of 35 items, and measured with a reliability of 0.90 or more across the full spectrum of mobility, except at the higher end of better functioning. No evidence was found of non-uniform DIF but uniform DIF was observed, mainly for items in the changing and maintaining body position and carrying, lifting and pushing domains. The walking domain did not display DBF, but the other three domains did, principally the carrying, lifting and pushing items. Conclusions: During the design and validation of an item bank to measure mobility in older people, we found that strength (carrying, lifting and pushing) items formed a secondary dimension that produced DBF. More research is needed to determine how best to include strength items in a mobility measure, or whether it would be more appropriate to design separate measures for each construct.

What do older people understand by mobility-related difficulties?

Despite the centrality of the difficulty concept in the study of disability, there has been little research on its significance from the point of view of people with functional limitations. The main objective of this study was to describe what older people understand when asked about difficulty in undertaking mobility activities. As a secondary objective, we considered whether there are any differences depending on the type of activities, according to the International Classification of Functioning (ICF) mobility domains. Methods: Seventeen community-dwelling men and women aged 70 years old or over were interviewed by means of a questionnaire containing 55 items covering the ICF mobility domains. The participants responded to the items while thinking aloud, saying what led them to give a specific answer about their level of difficulty. Inductive content analysis was conducted and categories, subthemes and themes were identified. Results: Causes of difficulty (pathologies, impairments, symptoms) and accommodations (task modifications and use of aids) were the two themes identified; and their importance (and that of the subthemes included) varied across the types of activity. All the participants said that they had no difficulty in at least one task, despite mentioning changes in the way they performed them. Conclusions: Older people's opinions were consistent with theoretical models of disability and with the standard practice of measuring functional limitations by asking about the degree of difficulty; however, the design of these measures needs to be improved in order to detect perceptions of no difficulty in the presence of task modification.

Los mármoles comerciales “Marrón Imperial” y “Marrón Emperador” (S.E. España). Caracterización petrológica y criterios de exploración

Los mármoles comerciales "Marrón Imperial" y "Marrón Emperador" son dolomías brechoides que de acuerdo con la clasificación del MIA pertenece al Grupo C de mármoles comerciales. Se determinan sus parámetros petrofísicos según la norma UNE. Sus rasgos petrológicos se estudian mediante microscopio petrográfico de luz transmitida y microscopio electrónico de barrido (MEB) (en modo de electrones secundarios y electrones retrodispersados). Estas rocas son básicamente dolomías mesocristalinas con abundantes vénulas calcíticas politexturales relacionadas con procesos de brechificación y de dolomitización. Rasgos kársticos aumentan la complejidad petrológica de estas rocas ornamentales cuyo litosoma son las dolomías masivas del Cretácico Superior (¿Turoniense?) del dominio Prebético Externo. El material explotado pertenece a una alineación morfoestructural que va desde Jumilla hasta el NE de Caudete y está relacionado con la falla Jumilla-Yecla-Caudete-Font de la Figuera. La relación entre esta falla y las dolomías turonienses son el principal criterio de exploración de estas rocas ornamentales.