Measuring mobility in frail older people: reliability and validity of the Physical Mobility Scale

Objectives: The study was designed to show the validity and reliability of scoring the Physical Mobility Scale (PMS). PMS was developed by physiotherapists working in residential aged care to specifically show resident functional mobility and to provide information regarding each resident's need for supervision or assistance from one or two staff members and equipment during position changes, transfers, mobilising and personal care. Methods: Nineteen physiotherapists of varying backgrounds and experience scored the performances of nine residents of care facilities from video recordings. The performances were compared to scores on two 'gold standard' assessment tools. Four of the physiotherapists repeated the evaluations. Results: The PAIS showed excellent content validity and reliability. Conclusions: The PAIS provides graded performance of physical mobility, including level of dependency on staff and equipment. This is a major advantage over existing functional assessment tools. There is no need for specific training for physiotherapists to use the tool.

Validation and reliability of the Modified Elderly Mobility Scale

Objective: To establish concurrent validity, interrater and test-retest reliability of the Modified Elderly Mobility Scale (MEMS). Methods: Ninety elderly patients were scored on the MEMS. To establish concurrent validity, 75 patients MEMS scores were compared to Functional Independence Measure (FIM) scores using Spearman's correlation. Videotaped patient performances were used to establish interrater and test-retest reliability using percentage absolute agreement and intraclass correlation coefficients (ICCs). Results: The total MEMS score demonstrated a significant association with the motor (r = 0.725) and total FIM scores (r = 0.718). Absolute agreement for interrater reliability was greater than 93% for all test items, with 97 and 98% for the two new measures, respectively. Test-retest reliability demonstrated similar high levels of absolute agreement and had ICCs ranging from 0.870 to 1.0. Conclusions: The MEMS is a quick, valid and reliable test of motor function of elderly patients with a spread of functional levels.

Epidemiology of leisure, transportation, occupational, and household physical activity: prevalence and associated factors

Background: To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. Methods: This was a cross-sectional study aimed at investigating living and health conditions among the population of São Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. Results: The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Conclusion: Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries

Epidemiology of Leisure, Transportation, Occupational, and Household Physical Activity: Prevalence and Associated Factors

Background: To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. Methods: This was a cross-sectional study aimed at investigating living and health conditions among the population of So Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. Results: The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Conclusion: Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries.

Mobility and social network effects on extremist opinions

Understanding the emergence of extreme opinions and in what kind of environment they might become less extreme is a central theme in our modern globalized society. A model combining continuous opinions and observed discrete actions (CODA) capable of addressing the important issue of measuring how extreme opinions might be has been recently proposed. In this paper I show extreme opinions to arise in a ubiquitous manner in the CODA model for a multitude of social network structures. Depending on network details reducing extremism seems to be possible. However, a large number of agents with extreme opinions is always observed. A significant decrease in the number of extremists can be observed by allowing agents to change their positions in the network.

Ionic mobility of the solvated proton and acid-base titration in a four-compartment capillary electrophoresis system

Although H(+) and OH(-) are the most common ions in aqueous media, they are not usually observable in capillary electrophoresis (CE) experiments, because of the extensive use of buffer solutions as the background electrolyte. In the present work, we introduce CE equipment designed to allow the determination of such ions in a similar fashion as any other ion. Basically, it consists of a four-compartment piece of equipment for electrolysis-separated experiments (D. P. de Jesus et at, Anal. Chem., 2005, 77, 607). In such a system, the ends of the capillary are placed in two reservoirs, which are connected to two other reservoirs through electrolyte-filled tubes. The electrodes of the high-voltage power source are positioned in these reservoirs. Thus, the electrolysis products are kept away from the inputs of the capillary. The detection was provided by two capacitively coupled contactless conductivity detectors (CD), each one positioned about 11 cm from the end of the capillary. Two applications were demonstrated: titration-like procedures for nanolitre samples and mobility measurements. Strong and weak acids (pK(a) < 5), pure or mixtures, could be titrated. The analytical curve is linear from 50 mu M up to 10 mM of total dissociable hydrogen (r = 0.99899 for n =10) in 10-nL samples. By including D(2)O in the running electrolyte, we could demonstrate how to measure the mixed proton/deuteron mobility. When H(2)O/D(2)O (9 : 1 v/v) was used as the solvent, the mobility was 289.6 +/- 0.5 x 10(-5) cm(2) V(-1) s(-1). Due to the fast conversion of the species, this value is related to the overall behaviour of all isotopologues and isotopomers of the Zundel and Eigen structures, as well as the Stokesian mobility of proton and deuteron. The effect of neutral (o-phenanthroline) and negatively charged (chloroacetate) bases and aprotic solvent (DMSO) over the H(+) mobility was also demonstrated.

Evaluation of biologic occupational risk control practices: Quality indicators development and validation

Background: There is growing demand for the adoption of qualification systems for health care practices. This study is aimed at describing the development and validation of indicators for evaluation of biologic occupational risk control programs. Methods: The study involved 3 stages: (1) setting up a research team, (2) development of indicators, and (3) validation of the indicators by a team of specialists recruited to validate each attribute of the developed indicators. The content validation method was used for the validation, and a psychometric scale was developed for the specialists` assessment. A consensus technique was used, and every attribute that obtained a Content Validity Index of at least 0.75 was approved. Results: Eight indicators were developed for the evaluation of the biologic occupational risk prevention program, with emphasis on accidents caused by sharp instruments and occupational tuberculosis prevention. The indicators included evaluation of the structure, process, and results at the prevention and biologic risk control levels. The majority of indicators achieved a favorable consensus regarding all validated attributes. Conclusion: The developed indicators were considered validated, and the method used for construction and validation proved to be effective.

Multiple views of sustainable urban mobility: The case of Brazil

The aim of this work is to identify key factors of a sustainable urban mobility concept in a particular context. A multiple criteria decision analysis method was developed to identify the main variables associated to the concept. Looking at the results obtained in 11 cities of the five Brazilian regions, we conclude that the method is able to capture the different views and approaches discussed in the formulation of the mobility concept. Therefore, it can be used as a starting point for the formulation of public policies and also in the development of tools designed for monitoring the mobility conditions. (C) 2008 Elsevier Ltd. All rights reserved.

Identification and control of occupational risks in a Sao Paulo metropolitan region quarry

Crushed stone mining is the third largest mining economy in Brazil, where almost half is produced in the Sao Paulo metropolitan region. The segment registers the highest number of accidents among the extractive industries, which justifies the concern with workers` health and safety, and the importance of controlling occupational hazards. Since 2002, the NR-22 Standard (NR-22: Occupational Health and Safety in Mining) makes compulsory the elaboration of a Risk Management Program that identifies risks and establishes control measures. Considering the crushed stone mining industry importance to the state, this paper evaluates and discusses the risks identified in unit operations during the production process of crushed stone in an open pit mine in order to propose control measures for the development of the Risk Management Program. Although this study refers to a specific quarry, it can be applied to other mines from the same sector since some considerations are made regarding differences in manufacturing processes. The research was based on the identification of the main risks associated with drilling, blasting, load & haulage, crushing and screening through field measurements of some hazardous agents, together with company reports. The results contributed to the choice of the appropriate control measures for the improvement Of workers` health and safety conditions.

Absorption and Mobility of Boron in Young Citrus Plants

Boron (B) deficiency is widespread in Brazilian citrus orchards and has been considered an important soil constraint to citrus yield. The aim of this work was to study B uptake and its mobility in young citrus trees, under different B statuses, in two rootstocks. The experiment was carried out in a greenhouse, with `Valencia` sweet orange trees budded on Rangpur lime or Swingle citrumelo. The plants were grown in pots containing nutrient solutions under either adequate or deficient B supply. Plants with different B levels were transplanted into solution with adequate level of B, enriched in 10 B in different stages of development ( vegetative growth and fruiting). About 20 to 35% of B content in the new parts of orange tree came from plant reserves. Boron mobility within the plant was influenced by its nutritional status; that is, the longer the period was that the plants were grown under deficient supply, the smaller was the mobility. Boron concentration in the sweet orange trees on Swingle was higher than that on Rangpur, suggesting higher demand of swingle Citrumelo for B.

Air trapping: The major factor limiting diaphragm mobility in chronic obstructive pulmonary disease patients

Background and objective: Patients with COPD can have impaired diaphragm mechanics. A new method of assessing the mobility of the diaphragm, using ultrasound, has recently been validated. This study evaluated the relationship between pulmonary function and diaphragm mobility, as well as that between respiratory muscle strength and diaphragm mobility, in COPD patients. Methods: COPD patients with pulmonary hyperinflation (n = 54) and healthy subjects (n = 20) were studied. Patients were tested for pulmonary function, maximal respiratory pressures and diaphragm mobility using ultrasound to measure the craniocaudal displacement of the left branch of the portal vein. Results: COPD patients had less diaphragm mobility than did healthy individuals (36.5 +/- 10.9 mm vs 46.3 +/- 9.5 mm, P = 0.001). In COPD patients, diaphragm mobility correlated strongly with pulmonary function parameters that quantify air trapping (RV: r = -0.60, P < 0.001; RV/TLC: r = -0.76, P < 0.001), moderately with airway obstruction (FEV1: r = 0.55, P < 0.001; airway resistance: r = -0.32, P = 0.02) and weakly with pulmonary hyperinflation (TLC: r = -0.28, P = 0.04). No relationship was observed between diaphragm mobility and respiratory muscle strength (maximal inspiratory pressure: r = -0.11, P = 0.43; maximal expiratory pressure: r = 0.03, P = 0.80). Conclusion: The results of this study suggest that the reduction in diaphragm mobility in COPD patients is mainly due to air trapping and is not influenced by respiratory muscle strength or pulmonary hyperinflation.

An alternative approach for the determination of soil water mobility

A new laboratory method was proposed to establish an easily performed standard for the determination of mobile soil water close to real conditions during the infiltration and redistribution of water in a soil. It consisted of applying a water volume with a tracer ion on top of an undisturbed ring sample on a pressure plate under a known suction or pressure head. Afterwards, soil water mobility was determined by analyzing the tracer-ion concentration in the soil sample. Soil water mobility showed to be a function of the applied water volume. No relation between soil water mobility and applied pressure head could be established with data from the present experiment. A simple one- or two-parameter equation can be fitted to the experimental data to parameterize soil water mobility as a function of applied solute volume. Sandy soils showed higher mobility than loamy soils at low values of applied solute volumes, and both sandy and loamy soils showed an almost complete mobility at high applied solute volumes.

Genomics of pyrrolnitrin biosynthetic loci: evidence for conservation and whole-operon mobility within Gram-negative bacteria

Pyrrolnitrin (PRN) is a tryptophan-derived secondary metabolite produced by a narrow range of Gram-negative bacteria. The PRN biosynthesis by rhizobacteria presumably has a key role in their life strategies and in the biocontrol of plant diseases. The biosynthetic operon that encodes the pathway that converts tryptophan to PRN is composed of four genes, prnA through D, whose diversity, genomic context and spread over bacterial genomes are poorly understood. Therefore, we launched an endeavour aimed at retrieving, by in vitro and in silico means, diverse bacteria carrying the prnABCD biosynthetic loci in their genomes. Analysis of polymorphisms of the prnD gene sequences revealed a high level of conservation between Burkholderia, Pseudomonas and Serratia spp. derived sequences. Whole-operon- and prnD-based phylogeny resulted in tree topologies that are incongruent with the taxonomic status of the evaluated strains as predicted by 16S rRNA gene phylogeny. The genomic composition of c. 20 kb DNA fragments containg the PRN operon varied in different strains. Highly conserved and distinct transposase-encoding genes surrounding the PRN biosynthetic operons of Burkholderia pseudomallei strains were found. A prnABCD-deprived genomic region in B. pseudomallei strain K96243 contained the same gene composition as, and shared high homology with, the flanking regions of the PRN operon in B. pseudomallei strains 668, 1106a and 1710b. Our results strongly suggest that the PRN biosynthetic operon is mobile. The extent, frequency and promiscuity of this mobility remain to be understood.

Comparative analysis of the gas-phase reactions of cylindrospermopsin and the difference in the alkali metal cation mobility

Cylindrospermopsin (CYN) belongs to a group of toxins produced by several strains of freshwater cyanobacteria. It is a compact zwitterionic molecule composed of a uracil section and a tricyclic guanidinium portion with a primarily hepatotoxic effect. Using low multi-stage and high-resolution mass spectrometry, the gas-phase reactions of this toxin have been investigated. Our data show that collision-induced dissociation (CID) spectra of CYN are dominated by neutral losses, and three major initial fragmentation pathways are clearly distinguishable. Interestingly, comparative analysis of protonated and cationizated molecules showed a significant difference in the balance of the SO(3) and terminal ring elimination. These data indicate that the differential ion mobility of H(+), Li(+), Na(+) and K(+) leads to different fragmentation pathways, giving rise to mass spectra with different profiles. Copyright (C) 2008 John Wiley & Sons, Ltd.