The concept of physical limitations in knee osteoarthritis: as viewed by patients and health professionals

Objective: To comprehensively identify components of the physical limitation concept in knee osteoarthritis (OA) and to rate the clinical importance of these using perspectives of both patients and health professionals.Design: Concept mapping, a structured group process, was used to identify and organize data in focus groups (patients) and via a global web-based survey (professionals). Ideas were elicited through a nominal group technique and then organized using multidimensional scaling, cluster analysis, participant validation, rating of clinical importance, and thematic analyses to generate a conceptual model of physical limitations in knee OA. Results: Fifteen Danish patients and 200 international professionals contributed to generating the conceptual model. Five clusters emerged: ‘Limitations/physical deficits’; ‘Everyday hurdles’; ‘You’re not the person you used to be’; ‘Need to adjust way of living’; and ‘External limitations,’ each with sub-clusters. Patients generally found their limitations more important than the professionals did. Conclusion: Patients and professionals agreed largely on the physical limitation concept in knee OA. Some limitations of high importance to patients were lower rated by the professionals, highlighting the importance of including patients when conceptualizing patient outcomes. These data offer new knowledge to guide selection of clinically relevant outcomes and development of outcome measures in knee OA.

Physical Activity, Central Adiposity, and Functional Limitations in Community-Dwelling Older Adults.

BACKGROUND AND PURPOSE: Obesity and physical inactivity are independently associated with physical and functional limitations in older adults. The current study examines the impact of physical activity on odds of physical and functional limitations in older adults with central and general obesity. METHODS: Data from 6279 community-dwelling adults aged 60 years or more from the Health and Retirement Study 2006 and 2008 waves were used to calculate prevalence and odds of physical and functional limitation among obese older adults with high waist circumference (waist circumference ≥88 cm in females and ≥102 cm in males) who were physically active versus inactive (engaging in moderate/vigorous activity less than once per week). Logistic regression models were adjusted for age, sex, race/ethnicity, education, smoking status, body mass index, and number of comorbidities. RESULTS: Physical activity was associated with lower odds of physical and functional limitations among older adults with high waist circumference (odds ratio [OR], 0.59; confidence interval [CI], 0.52-0.68, for physical limitations; OR, 0.52; CI, 0.44-0.62, for activities of daily living; and OR, 0.44; CI, 0.39-0.50, for instrumental activities of daily living). CONCLUSIONS: Physical activity is associated with significantly lower odds of physical and functional limitations in obese older adults regardless of how obesity is classified. Additional research is needed to determine whether physical activity moderates long-term physical and functional limitations.

Food insecurity and physical activity among U.S. populations

Objectives: Examine the association between food insecurity (FI) and physical activity (PA) in the U.S. population. Methods: Accelerometry (PAM) and self-report PA (PAQ) data from NHANES 2003-2006 were used. Those aged less than six years or were older than 65 years, pregnant, with physical limitations, or with family income above 350% of the poverty line were excluded. FI was measured by the USDA Household Food Security Survey Module. Crude and adjusted odd ratios were calculated from logistic regression to identify the association between FI and adherence to the PA recommendation. Crude and adjusted coefficients were calculated from linear regression to identify the association between FI and both sedentary and activity minutes. Results: In children, FI was not associated with adherence to PA recommendation measured via PAM or PAQ (p>0.05) but was significantly associated with sedentary minutes (adjusted coefficient=10.74, one-sided p<0.05). Food-insecure children did less moderate-to-vigorous PA than did food-secure children (adjusted coefficient = -5.31, p = 0.032). In adults, FI was significantly associated with PA (adjusted OR=0.722 for PAM and OR=0.839 for PAQ, one-sided p<0.05) but not associated with sedentary minutes (p>0.05) Conclusions: FI children were more sedentary and FI adults were less likely to adhere to the PA recommendation than those without FI.

Household food insecurity is associated with less physical activity among children and adults in the U.S. population

Background Household food insecurity and physical activity are each important public-health concerns in the United States, but the relation between them was not investigated thoroughly. Objective We wanted to examine the association between food insecurity and physical activity in the U.S. population. Methods Physical activity measured by accelerometry (PAM) and physical activity measured by questionnaire (PAQ) data from the NHANES 2003–2006 were used. Individuals aged <6 y or >65 y, pregnant, with physical limitations, or with family income >350% of the poverty line were excluded. Food insecurity was measured by the USDA Household Food Security Survey Module. Adjusted ORs were calculated from logistic regression to identify the association between food insecurity and adherence to the physical-activity guidelines. Adjusted coefficients were obtained from linear regression to identify the association between food insecurity with sedentary/physical-activity minutes. Results In children, food insecurity was not associated with adherence to physical-activity guidelines measured via PAM or PAQ and with sedentary minutes (P > 0.05). Food-insecure children did less moderate to vigorous physical activity than food-secure children (adjusted coefficient = −5.24, P = 0.02). In adults, food insecurity was significantly associated with adherence to physical-activity guidelines (adjusted OR = 0.72, P = 0.03 for PAM; and OR = 0.84, P < 0.01 for PAQ) but was not associated with sedentary minutes (P > 0.05). Conclusion Food-insecure children did less moderate to vigorous physical activity, and food-insecure adults were less likely to adhere to the physical-activity guidelines than those without food insecurity.

Older people's perspectives on participation in physical activity: a systematic review and thematic synthesis of qualitative literature

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A hardware-based multi-disciplinary design optimization method for aeronautical applications

There are many applications in aeronautics where there exist strong couplings between disciplines. One practical example is within the context of Unmanned Aerial Vehicle(UAV) automation where there exists strong coupling between operation constraints, aerodynamics, vehicle dynamics, mission and path planning. UAV path planning can be done either online or offline. The current state of path planning optimisation online UAVs with high performance computation is not at the same level as its ground-based offline optimizer's counterpart, this is mainly due to the volume, power and weight limitations on the UAV; some small UAVs do not have the computational power needed for some optimisation and path planning task. In this paper, we describe an optimisation method which can be applied to Multi-disciplinary Design Optimisation problems and UAV path planning problems. Hardware-based design optimisation techniques are used. The power and physical limitations of UAV, which may not be a problem in PC-based solutions, can be approached by utilizing a Field Programmable Gate Array (FPGA) as an algorithm accelerator. The inevitable latency produced by the iterative process of an Evolutionary Algorithm (EA) is concealed by exploiting the parallelism component within the dataflow paradigm of the EA on an FPGA architecture. Results compare software PC-based solutions and the hardware-based solutions for benchmark mathematical problems as well as a simple real world engineering problem. Results also indicate the practicality of the method which can be used for more complex single and multi objective coupled problems in aeronautical applications.

Mobile applications of focused link discovery

Interaction with a mobile device remains difficult due to inherent physical limitations. This dif-ficulty is particularly evident for search, which re-quires typing. We extend the One-Search-Only search paradigm by adding a novel link-browsing scheme built on top of automatic link discovery. A prototype was built for iPhone and tested with 12 subjects. A post-use interview survey suggests that the extended paradigm improves the mobile information seeking experience.

Antiwindup design for induction motor control in the field weakening domain

Operation of induction machines in the high-speed and/or high-torque range requires field-weakening to comply with voltage and current physical limitations. This paper presents an anti-windup approach to this problem: rather than developing an ad-hoc field weakening strategy in the high-speed region, we equip an unconstrained vector-control design with an anti-windup module that automatically adjusts the current and flux set-points so that voltage and current constraints are satisfied at every operating point. The anti-windup module includes a feedforward modification of the set point aimed at maximizing the available torque in steady-state and a feedback modification of the controller based on an internal model-based antiwindup scheme. This paper includes a complete stability analysis of the proposed solution and presents encouraging experimental results on an industrial drive. © 2012 IEEE.

SymbolDesign: A User-centered Method to Design Pen-based Interfaces and Extend the Functionality of Pointer Input Devices

A method called "SymbolDesign" is proposed that can be used to design user-centered interfaces for pen-based input devices. It can also extend the functionality of pointer input devices such as the traditional computer mouse or the Camera Mouse, a camera-based computer interface. Users can create their own interfaces by choosing single-stroke movement patterns that are convenient to draw with the selected input device and by mapping them to a desired set of commands. A pattern could be the trace of a moving finger detected with the Camera Mouse or a symbol drawn with an optical pen. The core of the SymbolDesign system is a dynamically created classifier, in the current implementation an artificial neural network. The architecture of the neural network automatically adjusts according to the complexity of the classification task. In experiments, subjects used the SymbolDesign method to design and test the interfaces they created, for example, to browse the web. The experiments demonstrated good recognition accuracy and responsiveness of the user interfaces. The method provided an easily-designed and easily-used computer input mechanism for people without physical limitations, and, with some modifications, has the potential to become a computer access tool for people with severe paralysis.

Avaliação da participação em crianças e jovens com paralisia cerebral, na ilha de S. Miguel, Açores

Introdução: Nas crianças/jovens com Paralisia Cerebral (PC), as limitações motoras repercutem-se em limitações funcionais e, consequentemente, na diminuição da participação em ocupações. Sendo as manifestações da PC diferentes de indivíduo para indivíduo, estas vão refletir, dependendo da gravidade, quadro motor, ambiente físico e social, diferentes níveis de participação. Objetivo: O objetivo deste estudo foi avaliar a relação entre a idade, sexo e grau de comprometimento motor e a participação em crianças/jovens com diagnóstico de paralisia cerebral com idades compreendidas entre os 5 e os 18 anos na ilha de São Miguel. Amostra e Métodos: 25 crianças de ambos os sexos (5- 18 anos), sinalizadas em instituições especializadas de reabilitação e em Centros de Atividades Ocupações (CAO’s) na Ilha de São Miguel – Açores. Foram aplicados dois instrumentos de avaliação às crianças/jovens, Gross Motor Function Measure e Quality of Upper Extremity Skills Test, e foram entregues aos pais os outros dois instrumentos para autopreenchimento, Assessment of Life Habits e Child Health Questionnaire – Parent- Form 50. Na análise estatística, recorreu-se a testes como o Kolmogorov-Smirnov, Tstudent ou Mann-Whitney, teste de Fisher, teste de Spearman e ANOVA. Resultados: Não foram encontradas relações significativas entre a idade e o sexo e o nível de participação das crianças/jovens com PC. Contrariamente, ao avaliarmos a relação entre o grau de participação e o grau de afetação verificamos que esta é significativa (p=0,004). Conclusão: Na nossa amostra não se encontrou uma influência da idade e do sexo com a frequência da participação (relações não foram significativas). Contudo, pode-se concluir que as crianças/jovens que apresentam menos limitações motoras, como as que se enquadram no nível I/II da Gross Motor Function Classification System, apresentam níveis de participação maiores do que as que apresentam níveis de afetação motora maiores (Nível V)

La cause juste et suffisante de congédiement en droit québécois lors d’une absence du travail pour raison de santé

L’absentéisme au travail en raison de santé représente un enjeu important dans la société actuelle puisqu’il est en constante croissante. Il engendre plusieurs conséquences négatives pour les entreprises québécoises. Nous nous intéressons à l’absentéisme au travail en raison de santé, abordé sous un angle juridique. Le but de notre recherche consiste à identifier, à partir d’un échantillon de soixante-dix-sept décisions jurisprudentielles, les manquements fautifs et non fautifs qui constituent une cause juste et suffisante de congédiement dans les cas d’absence au travail en raison de santé. En ce qui concerne les manquements fautifs, nos résultats démontrent qu’occuper un second emploi durant une absence du travail, effectuer des activités incompatibles avec l’état de santé déclaré, faire des fausses déclarations, falsifier des documents médicaux, le défaut d’aviser lors d’une absence du travail sans autorisation, le défaut d’aviser lors d’une absence du travail en présence d’une convention collective, le refus de retourner au travail à la suite d’une directive de l’employeur et le refus de fournir les informations médicales nécessaires ne constituent pas indéniablement une cause juste et suffisante de congédiement. Pour les manquements non fautifs, notre analyse montre que les manquements reliés à l’assiduité au travail en présence et en l’absence d’une convention collective et les manquements reliés à la capacité de reprendre le travail en l’absence et en présence de limitations fonctionnelles psychologiques et physiques et en tenant compte du risque pour sa santé et sa sécurité ou risque pour celles des autres ne sont pas dans tous les cas une cause juste et suffisante de congédiement. Il appert, dans les décisions analysées en fonction des critères de Wohl c. Joly, que l’employeur doit démontrer les trois éléments pour qu’ils constituent une cause juste et suffisante de congédiement.

Spontane Strukturbildung in Mehrschichtsystemen unter Verwendung Molekularer Gläser

Den Schwerpunkt dieser Dissertation bildet zum einen die Entwicklung eines theoretischen Modells zur Beschreibung des Strukturbildungsprozesses in organisch/anorganischen Doppelschichtsystemen und zum anderen die Untersuchung der Übertragbarkeit dieser theoretisch gewonnenen Ergebnisse auf reale Systeme. Hierzu dienen systematische experimentelle Untersuchungen dieses Phänomens an einem Testsystem. Der Bereich der selbstorganisierenden Systeme ist von hohem wissenschaftlichen Interesse, erlaubt er doch die Realisierung von Strukturen, die nicht den Begrenzungen heutiger Techniken unterliegen, wie etwa der Beugung bei lithographischen Verfahren. Darüber hinaus liefert ein vertieftes Verständnis des Strukturbildungsprozesses auch eine Möglichkeit, im Falle entsprechender technischer Anwendungen Instabilitäten innerhalb der Schichtsysteme zu verhindern und somit einer Degradation der Bauteile entgegenzuwirken. Im theoretischen Teil der Arbeit konnte ein Modell im Rahmen der klassischen Elastizitätstheorie entwickelt werden, mit dessen Hilfe sich die Entstehung der Strukturen in Doppelschichtsystemen verstehen läßt. Der hier gefundene funktionale Zusammenhang zwischen der Periode der Strukturen und dem Verhältnis der Schichtdicken von organischer und anorganischer Schicht, wird durch die experimentellen Ergebnisse sehr gut bestätigt. Die Ergebnisse zeigen, daß es technologisch möglich ist, über die Vorgabe der Schichtdicke in einem Materialsystem die Periodizität der entstehenden Strukturen vorzugeben. Darüber hinaus liefert das vorgestellte Modell eine Stabilitätsbedingung für die Schichtsysteme, die es ermöglicht, zu jedem Zeitpunkt die dominierende Mode zu identifizieren. Ein Schwerpunkt der experimentellen Untersuchungen dieser Arbeit liegt auf der Strukturbildung innerhalb der Schichtsysteme. Das Testsystem wurde durch Aufbringen einer organischen Schicht - eines sog. Molekularen Glases - auf ein Glassubstrat realisiert, als Deckschicht diente eine Siliziumnitrid-Schicht. Es wurden Proben mit variierenden Schichtdicken kontrolliert erwärmt. Sobald die Temperatur des Schichtsystems in der Größenordnung der Glasübergangstemperatur des jeweiligen organischen Materials lag, fand spontan eine Strukturbildung auf Grund einer Spannungsrelaxation statt. Es ließen sich durch die Wahl einer entsprechenden Heizquelle unterschiedliche Strukturen realisieren. Bei Verwendung eines gepulsten Lasers, also einer kreisförmigen Wärmequelle, ordneten sich die Strukturen konzentrisch an, wohingegen sich ihre Ausrichtung bei Verwendung einer flächenhaften Heizplatte statistisch verteilte. Auffällig bei allen Strukturen war eine starke Modulation der Oberfläche. Ferner konnte in der Arbeit gezeigt werden, daß sich durch eine gezielte Veränderung der Spannungsverteilung innerhalb der Schichtsysteme die Ausrichtung der Strukturen (gezielt) manipulieren ließen. Unabhängig davon erlaubte die Variation der Schichtdicken die Realisierung von Strukturen mit einer Periodizität im Bereich von einigen µm bis hinunter zu etwa 200 nm. Die Kontrolle über die Ausrichtung und die Periodizität ist Grundvoraussetzung für eine zukünftige technologische Nutzung des Effektes zur kontrollierten Herstellung von Mikro- bzw. Nanostrukturen. Darüber hinaus konnte ein zunächst von der Strukturbildung unabhängiges Konzept eines aktiven Sensors für die optische Raster-Nahfeld-Mikroskopie vorgestellt werden, das das oben beschriebene System, bestehend aus einem fluoreszierenden Molekularen Glas und einer Siliziumnitrid-Deckschicht, verwendet. Erste theoretische und experimentelle Ergebnisse zeigen das technologische Potential dieses Sensortyps.

Prevalencia de signos y síntomas de desorden musculoesquelético y su asociación con factores ocupacionales en trabajadores de minas de carbón subterráneo en cinco municipios de la región de Ubaté, Cundinamarca 2013-2014

Estudio de corte transversal cuyo objetivo es identificar la prevalencia de signos y síntomas de desordenes musculoesqueléticos (DME) en trabajadores que realicen actividades laborales para las empresas mineras de carbón subterráneo en cinco municipios de la Región de Ubaté en el Departamento de Cundinamarca, 2013-2014. Los DME constituyen una de las causas de enfermedad de origen laboral más comunes en todo el mundo; en Colombia específicamente, representan el 82% de las enfermedades laborales. La minería en la Región de Ubaté es una de las principales fuentes producción y generación de empleo. Dado que el país se cuenta con escasa literatura al respecto en el sector minero, es importante dar a conocer la prevalencia de los signos y síntomas de DME y su asociación con los factores ocupacionales que se presentan en la minería subterránea. Se tuvo en cuenta una población de 1.901 trabajadores pertenecientes a 556 empresas de minería de carbón subterránea, donde la muestra fue estratificada por asignación proporcional, de conglomerados, con selección aleatoria y bietápica, correspondiente a 215 trabajadores mineros que trabajan en las 11 empresas seleccionadas, a quienes se aplicó el instrumento del cuestionario Nórdico y las pruebas clínicas estandarizadas para la evaluación de la presencia de signos y síntomas de DME. En los resultados se encontró que la mayor prevalencia de signos y síntomas de DME, se localizó en las regiones, lumbar y de hombros, los cuales están asociados principalmente a factores ocupacionales como el tipo de extracción manual y los cargos de descargue y frentero.

Haptically enabled interactive virtual reality prototype for general assembly

Desktop computers based virtual training systems are attracting paramount attention from manufacturing industries due to their potential advantages over the conventional training practices. Significant cost savings can be realized due to the shorter training-scenarios development times and reuse of existing engineering models. In addition, by using computer based virtual reality (VR) training systems, the time span from the product design to commercial production can be shortened due to non-reliance on hardware parts. Within the aforementioned conceptual framework, a haptically enabled interactive and immersive virtual reality (HIIVR) system is presented. Unlike existing VR systems, the presented idea tries to imitate real physical training scenarios by providing comprehensive user interaction, constrained within the physical limitations of the real world imposed by the haptics devices within the virtual environment. As a result, in contrast to the existing VR systems, capable of providing knowledge generally about assembly sequences only, the proposed system helps in procedural learning and procedural skill development as well, due to its high physically interactive nature.

Haptically enable interactive virtual assembly training system development and evaluation

Virtual training systems are attracting paramount attention from the manufacturing industries due to their potential advantages over the conventional training practices. Significant cost savings can be realized due to the shorter times for the development of different training-scenarios as well as reuse of existing designed engineering (math) models. In addition, use of computer based virtual reality (VR) training systems can shorten the time span from computer aided product design to commercial production due to non-reliance on the hardware parts for training. Within the aforementioned conceptual framework, a haptically enabled interactive and immersive virtual reality (HIVEx) system is presented. Unlike existing VR systems, the presented idea tries to imitate real physical training scenarios by providing comprehensive user interaction, constrained within the physical limitations of the real world. These physical constrains are imposed by the haptics devices in the virtual environment. As a result, in contrast to the existing VR systems that are capable of providing knowledge generally about assembly sequences only, the proposed system helps in cognitive learning and procedural skill development as well, due to its high physically interactive nature.