Promoção da saúde e funcionalidade em idosos com incapacidade cognitiva institucionalizados

A funcionalidade e a independência, factores preponderantes para o diagnóstico da saúde física e mental da pessoa idosa, são ameaçadas quando surge incapacidade física ou cognitiva que dificulte a realização das tarefas do dia-a-dia. Em situação de institucionalização, o auxílio ou a substituição na realização das AVDs geralmente potencia a imobilidade e a dependência do idoso. A actividade física, e concretamente o treino funcional, está associada a melhorias significativas no grau de dependência em idosos. Na promoção de programas de actividade física para indivíduos com distúrbios cognitivos, estratégias de comunicação verbal e não verbal, e de memorização provaram ser efectivas na facilitação da aprendizagem e na mudança de comportamentos. Assim, implementou-se um programa de actividade física em que participaram 13 utentes idosos com incapacidade cognitiva, institucionalizados numa valência de saúde mental, com o objectivo principal de maximizar a sua funcionalidade, através do treino funcional, e com recurso a estratégias comportamentais de comunicação e memorização. O estudo incluiu também um grupo de controlo constituído por 11 utentes. As sessões tiveram a duração de 30 minutos, e decorreram 2 vezes por semana, durante 12 semanas. Os resultados foram avaliados através dos seguintes indicadores: grau de dependência funcional (índice de Barthel), equilíbrio (teste Timed Up and Go), força de preensão (teste de força de preensão), velocidade da marcha (teste de marcha dos 10 metros). Foram efectuados três momentos de avaliação: antes do início da intervenção, ao final de 6 semanas e no final das 12 semanas de programa. Após a análise dos resultados, concluiu-se que este programa mostrou ser efectivo nos objectivos a que se propõe e exequível nesta população. No entanto, foram identificadas algumas limitações que deverão merecer atenção numa futura implementação.

Sublethal effects of suspended sediments on estuarine fish /

The objective of this study was to determine the effects, if any, of sublethal concentrations of suspended materials on the fish in estuarine systems. Experimental sediment suspensions reproduced the concentrations frequently found during flooding and at dredging sites and dredged-material disposal sites. The suspensions were of natural sediment, obtained from the Patuxent River estuary, Maryland, or commercially available Fuller's earth. Fish were collected in the Patuxent River estuary and transported to the laboratory. The selected fish species inhabited ecologically different sections of the estuary; therefore, the overall reactions of each species were unique. Seven species of estuarine fish were exposed to Fuller's earth and natural sediment suspensions for timed periods and hematological changes were noted. The effects of various concentrations of Fuller's earth suspensions on white perch gill tissue were determined. Oxygen consumption rates of striped bass, white perch, and toadfish were measured in filtered Patuxent River water and compared to consumption rates in filtered river water suspensions of Fuller's earth or Patuxent River sediment. Fish showed signs of stress in response to suspended sediments in most of the experiments. Results indicate that sublethal concentrations of suspended solids can affect estuarine fish.

Hydroaccoustic pinging as a diver tool for underwater navigation in surveying Puget Sound Eelgrass (Zostera marina) densities

Senior thesis written for Oceanography 445

In-home Assessment of Turning and Transitions using Inertial Sensors in Older Adults with Dementia and Older Caregivers

Thesis (Master's)--University of Washington, 2016-06

Tennis, incidence of URTI and salivary IgA

Tennis played at an elite level requires intensive training characterized by repeated bouts of brief intermittent high intensity exercise over relatively long periods of time (1 - 3 h or more). Competition can place additional stress on players. The purpose of this study was to investigate the temporal association between specific components of tennis training and competition, the incidence of upper respiratory tract infections (URT1), and salivary IgA, in a cohort of seventeen elite female tennis players. Timed, whole unstimulated saliva samples were collected before and after selected 1-h training sessions at 2 weekly intervals, over 12 weeks. Salivary IgA concentration was measured by ELISA and IgA secretion rate calculated (mug IgA x ml(-1) x ml saliva x min(-1)). Players reported URTI symptoms and recorded training and competition in daily logs. Data analysis showed that higher incidence of URTI was significantly associated with increased training duration and load, and competition level, on a weekly basis. Salivary IgA secretion rate (S-IgA) dropped significantly after 1 hour of tennis play. Over the 12-week period, pre-exercise salivary IgA concentration and secretion rate were directly associated with the amount of training undertaken during the previous day and week (p < 0.05). However, the decline in S-IgA after 1 h of intense tennis play was also positively related to the duration and load of training undertaken during the previous day and week (p < 0.05). Although exercise-induced suppression of salivary IgA may be a risk factor, it could not accurately predict the occurrence of URTI in this cohort of athletes.

Normal values of balance tests in women aged 20-80

OBJECTIVES: To determine normal values for four commonly used clinical functional balance tests from community-dwelling women aged 20 to 80 and to identify any significant decline due to aging. DESIGN: A cross-sectional study was undertaken to provide normative values for four clinical balance tests across 6 decade cohorts. SETTING: The Betty Byrne-Henderson Center for Women and Aging, Royal Womens' Hospital, Brisbane, Australia. PARTICIPANTS: Four hundred fifty-six community-dwelling, independently ambulant women with no obvious neurological or musculoskeletal-related disability, aged 20 to 80, were randomly recruited from a large metropolitan region. MEASUREMENTS: The clinical balance measures/tests were the Timed Up and Go test, step test, Functional Reach test, and lateral reach test. Multivariate analysis was used to test the effect for age, height, and activity level. RESULTS: Normal data were produced for each test across each decade cohort. Gradual decline in balance performance was confirmed, with significant effect for age demonstrated. CONCLUSION: New normative data across the adult age decades are available for these clinical tests. Use of clinical balance tests could complement other balance tests and be used to screen women aged 40 to 60 whose performance is outside the normal values for age and to decrease later falls risk.

Stability of benzylpenicillin during continuous home intravenous therapy

Objectives: The aim of this study was to investigate the temperature profile of home intravenous (iv) antibiotic reservoirs and the stability of 16 megaunits of benzylpenicillin sodium in 120 mL of sodium chloride 0.9% at constant and variable temperatures. Methods: A Tinytag computerized thermometer recorded temperatures every minute in the home iv antibiotic reservoir pouches of nine patients over a 24 h period. Similar bags containing benzylpenicillin sodium (16 megaunits) were maintained either at a constant 36degreesC, 26degreesC or 21-22degreesC or were worn in a pouch by five healthy volunteers for a 24 h period. Other bags were stored at 3-5degreesC for 10 days. The bags were sampled at timed intervals and benzylpenicillin concentrations assayed by HPLC. Results: Median temperatures recorded in the infusion bags worn by the nine patients were in the range 16.7-34.1degreesC. For infusion bags maintained at 36degreesC, 26degreesC and 21-22degreesC, the concentrations of benzylpenicillin dropped below 90% of the initial concentration at a mean time of 5 h 18 min, 12 h 54 min and 13 h 20 min, respectively, whereas for bags worn by the healthy volunteers the mean time for 10% loss of benzylpenicillin was 9 h 20 min. In contrast, at 3-5degreesC, concentrations of benzylpenicillin only dropped below 90% of the initial concentration at 8 days. Conclusions: Significant temperature-dependent degradation of benzylpenicillin occurs during continuous home iv antibiotic programme infusions, which could result in loss of efficacy.

Genetic time-series analysis identifies a major QTL for in vivo alcohol metabolism not predicted by in vitro studies of structural protein polymorphism at the ADH1B or ADH1C loci

After ingestion of a standardized dose of ethanol, alcohol concentrations were assessed, over 3.5 hours from blood (six readings) and breath (10 readings) in a sample of 412 MZ and DZ twins who took part in an Alcohol Challenge Twin Study (ACTS). Nearly all participants were subsequently genotyped on two polymorphic SNPs in the ADH1B and ADH1C loci known to affect in vitro ADH activity. In the DZ pairs, 14 microsatellite markers covering a 20.5 cM region on chromosome 4 that includes the ADH gene family were assessed, Variation in the timed series of autocorrelated blood and breath alcohol readings was studied using a bivariate simplex design. The contribution of a quantitative trait locus (QTL) or QTL's linked to the ADH region was estimated via a mixture of likelihoods weighted by identity-by-descent probabilities. The effects of allelic substitution at the ADH1B and ADH1C loci were estimated in the means part of the model simultaneously with the effects sex and age. There was a major contribution to variance in alcohol metabolism due to a QTL which accounted for about 64% of the additive genetic covariation common to both blood and breath alcohol readings at the first time point. No effects of the ADH1B*47His or ADH1C*349Ile alleles on in vivo metabolism were observed, although these have been shown to have major effects in vitro. This implies that there is a major determinant of variation for in vivo alcohol metabolism in the ADH region that is not accounted for by these polymorphisms. Earlier analyses of these data suggested that alcohol metabolism is related to drinking behavior and imply that this QTL may be protective against alcohol dependence.

Fluid shifts have no influence on ciprofloxacin pharmacokinetics in intensive care patients with intra-abdominal sepsis

This study aimed to investigate whether fluid shifts alter ciprofloxacin pharmacokinetics in critically ill patients over time. Patients >= 18 years, with normal renal function, requiring intensive care treatment and parenteral antibiotics were enrolled. Group A (22 patients) included patients with documented intra-abdominal infections. Group B (18 patients) included patients with severe sepsis from other causes. All patients received intravenous ciprofloxacin 400 mg every 8 h infused over 60 min. Eight timed blood specimens were taken on days 0, 2 and 7. Ciprofloxacin plasma concentrations were determined using high performance liquid chromatography. There were no significant differences between the pharmacokinetics of the two groups or over time. Ciprofloxacin pharmacokinetics in critically ill patients do not change over time, and intra-abdominal sepsis does not alter ciprofloxacin pharmacokinetic parameters to a greater degree than sepsis from other causes in critically ill patients. (c) 2005 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Costs of managing urinary and faecal incontinence in a sub-acute care facility: A "bottom-up" approach

Aims: To measure accurately the direct costs of managing urinary and faecal incontinence in the sub-acute care setting. Materials and Methods: Prospective observational study was undertaken in two sub-acute care units in a metropolitan hospital. A consecutive series of 29 consecutive patients with urinary and/or faecal incontinence, who were in-patients in a geriatric rehabilitation or subacute neurologic unit underwent routine timed voiding protocol, as per usual care. Face-to-face bedside recordings of all incontinence care, with detailed cost analysis, were undertaken. Results: A total of 3,621 occasions of continence care were costed. The median time per 24 hr spent caring for incontinence per patient was 109 min (interquartile range 88-140). Isolated urinary incontinence episodes occurred in 28 patients (96.5%), mixed urinary/faecal incontinence episodes observed in 79.3%, and episodes of pure faecal incontinence were seen in 62%. The median costs of incontinence care in the sub-acute setting was $49AU per 24 hr, the major share ($41) spent on staff wages. The incontinence tasks of toileting assistance, pad changes, bed changes and catheter care were spread evenly across the three 8 hr shifts of duty. Conclusions: As our population demographics include an increasingly greater portion of the elderly, for whom long term institutional care is becoming relatively more scarce, provision of care in the sub-acute unit that may allow rehabilitation and return to home warrants scrutiny. This is the first study that delineates the costs of managing urinary and faecal incontinence in the sub-acute care setting. Such costs are substantial and place a heavy burden upon night-time carets. (C) 2004 Wiley-Liss, Inc.

The effect of depression on balance decline in mature women

Depression has been identified as a risk factor for falls, and a change in balance ability over time has yet to be investigated. This study aimed to identify if, over a 3-year period, balance ability changed in 26 women who were on medication for depression, compared to 26 non-depressed women. The two groups were matched for age, number of co-morbidities, activity level, medications, and height. All participants were simultaneously enrolled in a larger, longitudinal study of ageing. Balance measures included the Functional Reach (FR) test, Lateral Reach (LR) test, Step Test (ST), Timed Up and Go, and the Modified Clinical Test of Sensory Integration and Balance, Unilateral Stance (ULS) and Limit of Stability (LOS) laboratory tests. Results showed a significant difference between the groups on ST, right ULS (eyes closed) and forward end point excursion of the LOS. There was no difference in the number of falls between groups. Analysis of the depressed group alone showed that right FR declined significantly and left and right LR tended towards decline, but not differently between groups. There was no between-group differences for these measures. There was no significant decline in non-depressed women for any measurement. Depressed women have less ability to maintain their balance than non-depressed women, and should be encouraged to participate in appropriate activities known to improve or maintain balance.

A theory for execution-time derivation in real-time programs

We provide an abstract command language for real-time programs and outline how a partial correctness semantics can be used to compute execution times. The notions of a timed command, refinement of a timed command, the command traversal condition, and the worst-case and best-case execution time of a command are formally introduced and investigated with the help of an underlying weakest liberal precondition semantics. The central result is a theory for the computation of worst-case and best-case execution times from the underlying semantics based on supremum and infimum calculations. The framework is applied to the analysis of a message transmitter program and its implementation. (c) 2005 Elsevier B.V. All rights reserved.

Production of triploid Kuruma shrimp, Marsupenaeus (Penaeus) japonicus (Bate) nauplii through inhibition of polar body I, or polar body I and II extrusion using 6-dimethylaminopurine

This study investigated the chromosome ploidy level of Marsupenaeus (Penaeus) japonicus (Bate) non-viable (unhatched) embryos and nauplii after exposure to 6-dimethylaminopurine (6-DMAP), timed to stop either polar body (PB) I, or PBI and II extrusion. Embryos from eight separate families or spawnings were exposed to 150 or 200 mu M 6-DMAP from 1- to 3-min post-spawning detection (psd) for a 4- to 5-min duration (timed to stop PBI extrusion). Separate aliquots of embryos from five of the same spawnings were also exposed to 200 mu M of 6-DMAP from 1- to 3-min psd for a 16-min duration (timed to stop both PBI and II extrusion). For one spawning, a third aliquot of embryos was exposed to 400 p M of 6-DMAP from 1- to 3-min psd for a 16-min duration (timed to stop both PBI and II extrusion). At 18-h psd, non-viable embryo and nauplii samples were taken separately for fluorescent activated cell sorting (FACS). FACS revealed that there were diploids and triploids among all treated non-viable embryos and nauplii. All control non-viable embryos and nauplii were diploid. Percentages of triploid induction for the 4- to 5-min and 16-min durations were not significantly different (P > 0.05). Additionally, no difference was found in the triploidy level of nonviable embryos compared to nauplii in these treatments. The percentage of triploid embryos and nauplii when exposed to 6-DMAP for a 4- to 5-min duration ranged from 29.57% to 99.23% (average 55.28 +/- 5.45%) and from 5.60% to 98.85% (average 46.70 +/- 7.20%), respectively. The percentage of triploid embryos and nauplii when exposed to 6-DMAP for a 16-min duration ranged from 11.71% to 98.96% (average 52.49 +/- 11.00%) and from 47.5% to 99.24% (average 79.38 +/- 5.24%), respectively. To our knowledge, this is the first documentation of successful PBI or PBI and II inhibition in shrimp. This study conclusively shows that treatment of M. japonicus embryos with 6-DMAP at 1- to 3-min pscl for either a 4- to 5-min duration (timed to stop PBl extrusion) or 16-min duration (timed to stop both PBI and II extrusion) results in viable triploid nauplii. (c) 2006 Elsevier B.V. All rights reserved.

Functional analysis of a real-time protocol for networked control systems

Traditional real-time control systems are tightly integrated into the industrial processes they govern. Now, however, there is increasing interest in networked control systems. These provide greater flexibility and cost savings by allowing real-time controllers to interact with industrial processes over existing communications networks. New data packet queuing protocols are currently being developed to enable precise real-time control over a network with variable propagation delays. We show how one such protocol was formally modelled using timed automata, and how model checking was used to reveal subtle aspects of the control system's dynamic behaviour.

Axiomatisation of an Interval Calculus for Theorem Proving

We provide an axiomatisation of the Timed Interval Calculus, a set-theoretic notation for expressing properties of time intervals. We implement the axiomatisation in the Ergo theorem prover in order to allow the machine-checked proof of laws for reasoning about predicates expressed using interval operators. These laws can be then used in the machine-assisted verification of real-time applications.