Evaluating fear of falling among community-dwelling older people: A qualitative pattern model based on the experience of falls

This research was conducted in the context of the project IRIS 8A Health and Society (2002-2008) and financially supported by the University of Lausanne. It was aomed at developping a model based on the elder people's experience and allowed us to develop a "Portrait evaluation" of fear of falling using their examples and words. It is a very simple evaluation, which can be used by professionals, but by the elder people themselves. The "Portrait evaluation" and the user's guide are on free access, but we would very much approciate to know whether other people or scientists have used it and collect their comments. (contact: Chantal.Piot-Ziegler@unil.ch)The purpose of this study is to create a model grounded in the elderly people's experience allowing the development of an original instrument to evaluate FOF.In a previous study, 58 semi-structured interviews were conducted with community-dwelling elderly people. The qualitative thematic analysis showed that fear of falling was defined through the functional, social and psychological long-term consequences of falls (Piot-Ziegler et al., 2007).In order to reveal patterns in the expression of fear of falling, an original qualitative thematic pattern analysis (QUAlitative Pattern Analysis - QUAPA) is developed and applied on these interviews.The results of this analysis show an internal coherence across the three dimensions (functional, social and psychological). Four different patterns are found, corresponding to four degrees of fear of falling. They are formalized in a fear of falling intensity model.This model leads to a portrait-evaluation for fallers and non-fallers. The evaluation must be confronted to large samples of elderly people, living in different environments. It presents an original alternative to the concept of self-efficacy to evaluate fear of falling in older people.The model of FOF presented in this article is grounded on elderly people's experience. It gives an experiential description of the three dimensions constitutive of FOF and of their evolution as fear increases, and defines an evaluation tool using situations and wordings based on the elderly people's discourse.

Gender, age, and body surface area are the major determinants of ascending aorta dimensions in subjects with apparently normal echocardiograms.

BACKGROUND: Limited data have been published on the normal size of the ascending aorta (AA) measured using transthoracic echocardiography (TTE). METHODS: AA diameters were measured in 1799 patients with normal cardiac findings on TTE and compared with the diameters of the sinus of Valsalva (SoV). RESULTS: Mean diameters in men and women, respectively, were 3.4 and 3.1 cm for the SoV and 3.2 and 3.0 cm for the AA. The sizes of the SoV and the AA showed strong correlations with age, age squared, and body surface area. The 5th and 95th percentile curves for the SoV and AA showed faster growth of diameters in early adulthood compared with old age. The dimensions of the SoV were larger than those of the AA (mean differences, 0.19 cm in men and 0.08 cm in women), and the difference between the SoV and AA was negatively correlated with age. CONCLUSION: The findings of this study stress the importance of indexing dimensions of the SoV and the AA to age and body surface area separately for men and women.

Interpretaciones de la atenuación en artículos de revisión de Odontología

Este trabajo analiza cómo interpretan la atenuación 25 estudiantes universitarios venezolanos de Odontología, de nuevo ingreso, al responder a dos cuestionarios luego de leer un artículo de revisión. En el primero, con preguntas abiertas, debían interpretar algunas expresiones atenuadas preseleccionadas; en el segundo, debían elegir entre varias interpretaciones cerradas de los mismos fragmentos. Clasificamos sus respuestas en las siguientes categorías: reconocimiento, supresión y aumento de la atenuación, en el primer cuestionario; identificación de aproximadores, escudos, deícticos y construcciones impersonales, en el segundo. En los resultados predomina la identificación de atenuadores asociados a la dimensión semántica: el 30% reconoció la atenuación tal como fue usada en el original, el 30% aumentó su valor y el 40% no la logró identificar. Los estudiantes identificaron con mayor frecuencia los aproximadores, a diferencia de los escudos, las construcciones impersonales y los deícticos temporales. Estos resultados sugieren que es necesario formar a losestudiantes en el uso especializado de las dimensiones pragmática y sociocognitiva de la atenuación, en cursos de lectura y escritura académica. Solo este conocimiento específico permitirá que los estudiantes dominen el discurso científico prototípico de la Odontología.

Els nens i nenes amb “Dictamen d’escolarització” i amb suport del CDIAP: estudi de les dimensions de l’atenció a les necessitats especials de l’alumnat, entre tres i sis anys, escolaritzat en un centre públic de la comarca d’Osona

La meva recerca ha tingut com a punt de partida “Els nens i nenes amb “Dictamen d’escolarització” i amb suport del CDIAP: estudi de les dimensions de l’atenció a les necessitats especials de l’alumnat, entre tres i sis anys, escolaritzat en un centre públic de la comarca d’Osona”. A partir d’aquí, s’ha elaborat un marc teòric a partir de les lleis d’educació, decrets que regulen els diferents serveis i un seguit de conceptes bàsics. Un cop elaborat aquest marc teòric per tal de recollir les dades dels alumnes, de tres a sis anys, d’una escola en concret s’ha dissenyat un instrument de recollida de dades que li diem full resum de serveis (FRS). El FRS és un instrument que ens ha servit per recollir totes les dades d’alumnes amb necessitats específiques i, sobretot, per saber quin suport reben per part de l’escola i per part d’altres serveis. A més a més, per recollir informació sobre els diferents serveis que atenen aquesta diversitat s’ha elaborat un guió d’entrevistes (GE). Aquest GE serveix per recollir els aspectes més importants de les entrevistes realitzades a l’EAP (Equip d’Assessorament i Orientació Psicopedagògica), CDIAP (Centre de Desenvolupament Infantil i Atenció Precoç) i CSMIJ (Centre de Salut Mental Infantil i Juvenil). A partir de la informació extreta dels dos instruments, s’han elaborat unes conclusions respecte els objectius plantejats en aquest projecte i la pregunta plantejada a l’inici.

Multislice CT for assessing in-stent dimensions after left main coronary artery stenting: a comparison with three dimensional intravascular ultrasound

Objective: To evaluate the agreement between multislice CT (MSCT) and intravascular ultrasound (IVUS) to assess the in-stent lumen diameters and lumen areas of left main coronary artery (LMCA) stents. Design: Prospective, observational single centre study. Setting: A single tertiary referral centre. Patients: Consecutive patients with LMCA stenting excluding patients with atrial fibrillation and chronic renal failure. Interventions: MSCT and IVUS imaging at 912 months follow-up were performed for all patients. Main outcome measures: Agreement between MSCT and IVUS minimum luminal area (MLA) and minimum luminal diameter (MLD). A receiver operating characteristic (ROC) curve was plotted to find the MSCT cut-off point to diagnose binary restenosis equivalent to 6 mm2 by IVUS. Results: 52 patients were analysed. PassingBablok regression analysis obtained a β coefficient of 0.786 (0.586 to 1.071) for MLA and 1.250 (0.936 to 1.667) for MLD, ruling out proportional bias. The α coefficient was −3.588 (−8.686 to −0.178) for MLA and −1.713 (−3.583 to −0.257) for MLD, indicating an underestimation trend of MSCT. The ROC curve identified an MLA ≤4.7 mm2 as the best threshold to assess in-stent restenosis by MSCT. Conclusions: Agreement between MSCT and IVUS to assess in-stent MLA and MLD for LMCA stenting is good. An MLA of 4.7 mm2 by MSCT is the best threshold to assess binary restenosis. MSCT imaging can be considered in selected patients to assess LMCA in-stent restenosis

In the eye of the listener: pupil dilation elucidates discourse processing.

The current study investigated cognitive resource allocation in discourse processing by means of pupil dilation and behavioral measures. Short question-answer dialogs were presented to listeners. Either the context question queried a new information focus in the successive answer, or else the context query was corrected in the answer sentence (correction information). The information foci contained in the answer sentences were either adequately highlighted by prosodic means or not. Participants had to judge the adequacy of the focus prosody with respect to the preceding context question. Prosodic judgment accuracy was higher in the conditions bearing adequate focus prosody than in the conditions with inadequate focus prosody. Latency to peak pupil dilation was longer when new information foci were perceived compared to correction foci. Moreover, for the peak dilation, an interaction of focus type and prosody was found. Post hoc statistical tests revealed that prosodically adequate correction focus positions were processed with smaller peak dilation in comparison to all other dialog conditions. Thus, pupil dilation and results of a principal component analysis suggest an interaction of focus type and focus prosody in discourse processing.

Prevalence and dimensions of sexual orientation in Swiss adolescents: a cross-sectional survey of 16 to 20-year-old students.

AIM: Sexual orientation plays an important part in building identity during adolescence. The aim of this study was to describe patterns of sexual orientation, including sexual attraction, fantasies, affiliations and behaviour. METHODS: The study was based on the analysis of data from computerized self-administered questionnaires of a Swiss national survey on the sexual life of 16 to 20-year-old adolescents (n = 2,075 girls and 2,208 boys.). RESULTS: Overall, 95.0% of girls and 96.2% of boys described themselves as predominantly heterosexual; 1.4% of girls and 1.7% of boys as predominantly homosexual or bisexual; and 2.8% of teenagers (girls: 3.6%; boys: 2.1%) were "unsure" of their sexual orientation. The reported prevalence of homosexual attraction (girls: 2.0%; boys: 2.9%) exceeded homosexual fantasies (girls: 0.4%; boys: 0.5%) and affiliations (girls: 0.3%; boys: 0.5%). Among the 4205 respondents, 31 girls (1.5% of girls) and 56 boys (2.5% of boys) reported sexual behaviour (experience or penetrative intercourse) with a person of the same sex. Among 1.5% of girls and 2.5% of boys who reported sexual behaviour with a person of the same sex, 65% of boys and 80% of girls nevertheless considered themselves as heterosexual. CONCLUSION: For a comprehensive understanding of sexual orientation in adolescence a differentiated look at dimensions of sexual orientation is indispensable. This applies to clinical settings, public health and research.

The competitive position of the Nordic wood industry in Germany : intangible quality dimensions

Abstract

Are the World AIDS Conferences guilty of gender bias? Evidence from trends in the monitoring of WAC scientific discourse from 1989 to 2012

Background : The issue of gender is acknowledged as a key issue for the AIDS epidemic. World AIDS Conferences (WAC) have constituted a major discursive space for the epidemic. We sought to establish the balance regarding gender in the AIDS scientific discourse by following its development in the published proceedings of WAC. Fifteen successive WAC 1989-2012 served to establish a "barometer" of scientific interest in heterosexual and homo/bisexual men and women throughout the epidemic. It was hypothesised that, as in other domains of Sexual and Reproductive Health, heterosexual men would be "forgotten" partners. Method : Abstracts from each conference were entered in electronic form into an Access database. Queries were created to generate five categories of interest and to monitor their annual frequency. All abstract titles including the term "men" or "women" were identified. Collections of synonyms were systematically and iteratively developed in order to classify further abstracts according to whether they included terms referring to "homo/bisexual" or "heterosexual". Reference to "Mother to Child Transmission" (MTCT) was also flagged. Results : The category including "men", but without additional reference to "homo-bisexuel" (i.e. referring to men in general and/or to heterosexual men) consistently appears four times less often than the equivalent category for women. Excluding abstracts on women and MTCT has little impact on this difference. Abstracts including reference to both "men" and "homo-bisexual" emerge as the secondmost frequent category; presence of the equivalent category for women is minimal. Conclusion : The hypothesised absence of heterosexual men in the AIDS discourse was confirmed. Although the relative presence of homo-bisexual men and women as a focal subject may be explained by epidemiological data, this is not so in the case of heterosexual men and women. This imbalance has consequences for HIV prevention.

Analysing Professional Discourse in Interactive Learning: Integrating Historical and Situational Perspectives

Peer-reviewed