The purpose of the present investigation was to examine whether across-trials inconsistency in reaction time (RT), in addition to level of cognitive performance, is predictive of older adults’ performance on a measure of everyday problem solving through a series of three investigations. A sample of community dwelling non-demented older adults, ranging in age from 62 to 92, completed the Everyday Problems Test (EPT), a measure of everyday problem solving that indexes instrumental activities of daily living (IADLs). Performance on the EPT varied according to age, cognitive status, and education, and was significantly predicted by measures of global cognitive status, cognitive decline, and various basic cognitive abilities (i.e., speed of processing, fluid abilities, episodic memory, crystallized abilities). Both inconsistency and mean latencies on measures of RT were found to be significantly associated with concurrent EPT performance, such that slower and more inconsistent RTs were associated with poorer everyday problem solving abilities. Finally, inconsistency in RT made a unique contribution in predicting performance on the EPT two years later, over and above age, education, and various basic cognitive abilities. Structural equation modeling analyses indicated that the relationship between inconsistency in RT and future EPT performance was mediated by fluid and crystallized abilities. Neither inconsistency nor cognitive functioning were significantly associated with changes in EPT performance across two years. Examination of the relationships between IADL functioning, as assessed through self- and informant-report, and inconsistency and basic cognitive abilities demonstrated that everyday problem solving and measures of IADLs tap into related but distinct constructs. The overall pattern of results obtained lends support to the idea that inconsistency in RT represents a behavioural marker of neurological dysfunction. In addition, the present investigation is the first to suggest a relationship between inconsistency in RT and real-world outcomes, such as everyday problem solving and IADL functioning.

Contextualização: Devido ao aumento progressivo da fraqueza muscular na DMD, novos movimentos compensatórios e variação no tempo de execução de atividades funcionais são utilizados para prolongar a atividade funcional. Objetivos: Descrever a evolução dos movimentos compensatórios, observados nas atividades de sentar e de levantar da cadeira em crianças com DMD durante um ano. Comparar e correlacionar a evolução do tempo de execução dessas atividades com o número de movimentos compensatórios, e analisar a responsividade do tempo de execução dessa atividade em análise semestral, durante um ano. Método: Foram acompanhadas 23 crianças com DMD, deambulantes, com idade entre 5 e 12 anos, por um ano. Foram estudadas as atividades de sentar e de levantar da cadeira em 3 momentos (inicial, após seis e após doze meses) por meio da Escala de Avaliação Funcional para DMD (FES-DMD-D1). Utilizou-se ANOVAs para comparar a evolução do tempo de execução e do número movimentos compensatórios (escores das fases e subfases da FES-DMD-D1). O teste post hoc de Tukey foi utilizado quando identificado efeito principal significativo e o teste de Spearman, para correlacionar essas variáveis. A responsividade do tempo de execução foi analisada por meio do teste de tamanho do efeito (ES) e a média de resposta padronizada (MRP). Resultados: A evolução das atividades de sentar e de levantar da cadeira ao longo de 12 meses apresentou aumento significante do número dos movimentos compensatórios e do tempo de execução. Somente a atividade de levantar apresentou correlação de moderada a forte com o tempo de execução, e o tempo de execução desta atividade foi responsivo a partir de seis meses. Conclusão: Houve aumento progressivo do número dos movimentos compensatórios e do tempo de execução das atividades de sentar e levantar da cadeira, no período de um ano. Somente o levantar da cadeira apresentou correlação entre as variáveis estudadas. Para uma avaliação mais precisa da progressão da doença, sugerimos acompanhamento do tempo de execução da atividade de levantar da cadeira e, sempre que possível acompanhada da análise de presença de movimentos compensatórios / Background: With the progressive increase of muscle weakness in patients with DMD, new compensatory movements are employed to maintain the performance of functional activities. Objective: To describe the evolution of compensatory movements observed in sitting and rising from a chair in children with DMD. Compare and correlate the evolution of timed performance of these activities and the number of compensatory movements in one year. To analyze the responsiveness of timed performance in six-month and one year intervals. Method: Twenty-three ambulatory children with DMD, aged 5 to 12 years, were followed during one year. Sitting and rising from a chair were evaluated in three moments (initial assessment, after six and after twelve months) with the Functional Assessment Scale for DMD, domain 1 (FES-DMD-D1). Analyses of variance (ANOVA) compared the timed performances and numbers of compensatory movements (scores on the phases and subphases of FES-DMD-D1). Post hoc Tukey tests were used when a significant main effect was identified and the Spearman test was used to correlate these variables. Responsiveness of the timed performance was described by the effect size (ES) and the standardized response mean (SRM). Results: The progression of sitting and rising from a chair in one year resulted in a significant increase in FES-DMD-D1 scores and timed performance. Only rising from a chair showed moderate to strong correlation with timed performance. Timed performance was responsive in six months and one year reassessments. Conclusion: There was a progressive increase in the number of compensatory movements and timed performance of sitting and rising from a chair. Only rising from a chair showed correlation between compensatory movements and timed performance. For a more accurate assessment of DMD progression, we suggest monitoring the timed performance of rising from a chair and, whenever possible, scoring the compensatory movements

As experiências de maternidade nos presídios brasileiros têm crescido diante do aumento do número de mulheres presas. A complexidade dessa condição e as adversidades no meio das quais elas se desenrolam convocam pesquisadores a aprofundar o conhecimento destas experiências de modo a tirá-las da invisibilidade social. Esta pesquisa teve como objetivo conhecer e compreender a experiência da maternidade no cárcere, a partir do cotidiano e da trajetória de vida de mulheres egressas do sistema penitenciário. Foi realizado estudo exploratório, descritivo e reflexivo, de caráter qualitativo, balizando-se nos pressupostos da hermenêutica-dialética e na construção de duas histórias orais. Para a análise, elegeu-se como eixo central o conceito de cotidiano. Foi possível a identificação de dez categorias, apresentadas a partir de uma perspectiva temporal das trajetórias das colaboradoras. Como resultados, na experiência \"Gestação, parto e pós-parto\", observouse que as mulheres grávidas vivenciaram diferentes condições de vulnerabilidade e riscos para a sua integridade física, bem como do bebê em formação, com precário acesso aos cuidados em saúde e sob marcantes violações de direitos. Na experiência \"Maternidade no cárcere\", período em que mãe-bebê permaneceram juntos na instituição, constatou-se que, em contraponto ao desamparo vivenciado, práticas de solidariedade foram desenvolvidas pelas mulheres como modo de organização e resistência às dificuldades e privações materiais- afetivas por elas vividas. Constatou-se que a experiência de cuidados dos filhos era percebida como uma experiência prazerosa, mas também desgastante devido ao cuidado intensivo e exclusivo da criança e às tristezas e durezas vividas no contexto do encarceramento. Assim, frente às precariedades e às rígidas normas da prisão, as mulheres construíam estratégias para otimizar e garantir os cuidados dos bebês e de si, ora exibindo posturas de submissão ora de resistência e reinvenção do cotidiano. A anunciada separação mãe-bebê permeou o imaginário das mulheres durante todo o período da gravidez e cuidado do filho, antecipando o sofrimento da concretização da despedida. Após a entrega de seus filhos para suas famílias, as mulheres desenvolveram modos singulares de lidar com o sofrimento e com a preocupante sobrecarga física, emocional e financeira causada a seus familiares. No período \"Vida após o cárcere\", as experiências das colaboradoras mostraram a difícil retomada do contato com os filhos e as repercussões para sua relação futura com eles. Essas dificuldades foram agravadas pelas barreiras, preconceitos e precariedade de acesso às políticas sociais e às de suporte para a inclusão social após o encarceramento. Como resultado, as mulheres necessitaram agenciar, por si próprias, a construção de projetos de vida que viessem a garantir o futuro de seus filhos após a prisão. Concluiu-se que o cotidiano prisional se apresentou como violador e normatizador da experiência materna e de sua relação com as crianças. Ademais, constatou-se que a experiência de maternidade foi utilizada como mais um modo de punição das mulheres, com prejuízos a seus filhos, por vezes, irreparáveis e que extrapolaram o espaço-tempo do cárcere. Ainda assim, pôde-se perceber que, frente a violações e sofrimentos, as mulheres construíram espaços para reinvenção e resistência a esse aprisionante cotidiano / Maternity experiences in Brazilian prison has been growing considering the increase of incarcerated women. This complex and adverse condition call upon researchers to deepen these experiences\' knowledge in order to make them socially visible. This research aims to apprehend and understand the experience of maternity in prison through everyday life and life trajectories of women who got out of prison. This is an exploratory, descriptive and reflexive, qualitative study. We used dialectical hermeneutics framework and constructed two oral histories, using the everyday life concept as main axis to analyze them. We identified ten categories in a temporal perspective of the collaborators trajectories. The results of the \"Pregnancy, birth and after birth\" experience show that pregnant women had different vulnerability conditions and risks for their physical integrity and the baby\'s as well. There was precarious access to health care and rights violation. In the experience of \"Maternity in prison\" we verified that when mother and baby stayed together in the institution, opposing the helplessness they lived, women developed solidarity practices as a mean of organization and resistance of the difficulties and material-affective privation they experimented. The experience of children care was perceived as pleasurable and exhausting at the same time due to the intensive and exclusive children care and to the sadness and hardness experienced in prison. Therefore, considering the precariousness and the rigid prison rules, women built strategies to optimize and guarantee the babies\' care and their self-care by adopting a submissive and resistance stances rotatively, and the recreation of their daily lives. The announced separation of mother-baby has permeated the women\'s ideals during the whole pregnancy and childcare period, anticipating the suffering caused by the separation moment. After delivering the children for their families, women developed singular ways to deal with the suffering and with the physical, emotional and financial load caused to their families. In the \"Life after prison\" period, the collaborators had difficulties in reestablishing the contact with their children and were uncertain about the consequences of their relation with them. The barriers, prejudice and precariousness of the access to the social policies and the support for social inclusion exacerbated it. As a result, women needed to act by themselves in order to have a life plan that would guarantee their children\'s future after imprisonment. We concluded that everyday life in prison revels to be a violator and standardizer of the maternal experience and its relation to the children. Hence, we verified that maternity experience was used as punishment for women, causing damage to their children that might be irreparable and that goes beyond the prison space-time. Considering the violations and suffering women experienced, they constructed spaces for recreating and resisting to the constraining everyday life in prison

Orientador: José Eduardo Corrente / Resumo: O objetivo geral deste estudo foi avaliar o nível de atividade física, capacidade funcional e qualidade vida de idosos cadastrados nos Centros de Atenção Integral a Melhor Idade (CAIMI) da cidade de Manaus. Além disso, foi traçado um perfil socioeconômico e demográfico, avaliado os sintomas depressivos e presença de deficit cognitivo. Trata-se de um estudo transversal com 741 idosos cadastrados nos três CAIMI da cidade, no período de novembro de 2015 a março de 2017. As coletas eram realizadas por estudantes do curso de fisioterapia da Universidade Federal do Amazonas, previamente treinados. Para avaliação dos idosos, foram utilizados os questionários: Internacional Physical Activity Questionnaire (IPAQ), Escala de Qualidade de Vida de Flanagan (EQVF), Escala de Lawton e Brody, Índice de Katz, Escala de Depressão Geriátrica (EDG) e Mini Exame do Estado Mental (MEEM). Esta pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Universidade Federal do Amazonas, pelo parecer número 786. 685. Os idosos apresentaram média de idade de 69 anos, sendo que a maioria (521) era do sexo feminino, 44,94% casados e 60,05% não completaram o primeiro grau. Em relação à renda, 40,60% ganhavam até um salário mínimo e 53,51% diziam ser o principal provedor da casa. A maior frequência (72,74%) era de aposentados e 79,76% relataram ainda trabalhar. Referente ao nível de atividade física ,70,18% dos idosos foram classificados como ativos pelo IPAQ, 98,38% eram independentes, segundo índice de K... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The main objective of this study was to evaluate the level of physical activity, functional capacity and quality of life in elderly enrolled in specialized centers for elderly care in Manaus. In addition, a socioeconomic and demographic profile was drawn, in which depressive symptoms and cognitive deficit presence was accessed. A cross-sectional study was conducted with 741 elderly people enrolled in the three of thaose centers in the city, from November 2015 to March 2017. Interviews were carried out by previously trained physiotherapy students of Federal University of Amazonas. Questionnaires used were: International Physical Activity Questionnaire (IPAQ), Flanagan Life Quality Scale (QOLS), Lawton and Brody Scale, Katz Index, Geriatric Depression Scale (GDS), Mini-Mental State (MMSE). This research was approved by Research Ethics Committee at Federal University of Amazonas for under number 786,685. The elderly mean age was 69 years, and the majority (521) were female, 44.94% married and 60.05% did not complete the first degree. In relation to income, 40.60% earned up to a minimum wage and 53.51% said to be the main provider of the family. The highest frequency (72.74%) was retired subjects and 79.76% reported that they were still working. Regarding the level of physical activity, 70.18% of the elderly were classified as active by IPAQ, 98.38% were independent by Katz Index and, in the EQVF, they presented a mean of 80.07, indicating a positive satisfaction with their quali... (Complete abstract click electronic access below) / Doutor

INTRODUCTION: By the age of 65, every driver holding a valid driving license is required to undergo a compulsory medical examination according to Act 361/2000 Coll. The purpose of the examination should be to examine not only physical, but also psychosocial and cognitive factors that can affect the ability to drive safely. However, the extension of the validity of a driving license may have a considerable impact on the preservation of the existing self-sufficiency. GOALS: To determine the relationship of anamnestic data on the state of driving a motor vehicle with the state of cognitive functions. As a secondary goal, the work asks whether there is a correlation between the results of the Montreal cognitive test (MoCA-CZ1) with newly created memory screening tests (POBAV, ALBA and DOZNAT). METHODOLOGY: The research was based on a qualitative examination of the 39 drivers older than 65 years. Drivers were assessed by the state of cognitive function according to the Montreal Cognitive Test, and were then examined by "new short cognitive tests" targeting different types of memory. Finally, the participants filled out the questionnaire on subjective evaluation of driving skills. RESULTS: Dependence was found between the driving frequency and the groups of drivers with cognitive impairment and...

No description available.

Irrespective of the great individual variation, people diagnosed with RTT largely rely on support from others to be able to do and participate in activities throughout their lives. This thesis focuses on which activities are done and liked/disliked by girls and women with RTT in Sweden. The overall aim was to describe the everyday lives of female individuals with Rett syndrome. Two studies are included in this thesis. The first is a descriptive study, using secondary data from three earlier questionnaires, encompassing data from 175 participants (girls/women) described by 365 informants (parents/staff). Content analysis was used to analyse the openended questions. In the second study a Time-geographic diary method and the software VISUAL-TimePAcTs computer program, DAILY LIFE 2011 were used. Ten participants (teenagers/young female adults) with RTT and their 63 informants participated in the diary study. The main findings in the first study (I) were that the girls and women with RTT enjoyed activities that included aspects of ‘contact’, ‘sensory impression’ and ‘motion’. The activities most enjoyed over the years were bathing/swimming, listening to music or being outdoors/walking. The parents and staff also liked to do the same activities that the girls or women enjoyed doing, described as sharing their joy. Of the few activities that were reported as being unenjoyable, most were daily care activities. The diary study (II) showed that the most frequently reported activities were hygiene/toilet, moving around indoors, eating and getting dressed. Most time was spent in sleeping, daily care, medical and health care activities and also for travel/transportation. Little time remained for other kinds of activities especially for the young adults. Most time was spent with staff, thereafter with families, and the least time was spent with friends. The participant response that was reported most often during activities was ‘interested’, while ‘opposed’ was the least reported. Responses of ‘opposition’ were primarily seen during caring activities such as toileting, using the breathing mask, stretching, brushing teeth, being woken up, dressing and putting on orthoses. Responses of ‘engagement’ were noted in contexts of socialising, playing and communicating activities with friends or staff. Engagement responses were also reported during activities of ‘motion’ such as changing body position, moving in the water or gymnastics, eating food and snacks, and even when watching/listening to films, books or music. Thus, increased knowledge concerning the importance of activities for girls and women with RTT is essential for their well-being, participation and continued development. Increased knowledge could facilitate the choice of activities and a more varied use of activities. Regardless of age, severity of symptoms or developed skills, it is important that not only basic needs such as sleep, daily care and medical health care activities are fulfilled for individuals with Rett syndrome. It is also essential for them to spend time with friends, family and staff doing enjoyable activities both at home and in other places. / <p>Funding:</p><p>Linnéa and Josef Carlsson’s Foundation, Helsingborg, Sweden and the Folke Bernadotte Foundation, Stockholm, Sweden.</p>

Bakgrund: Ögonsjukdomar och nedsatt syn är ett folkhälsoproblem som förväntas att öka runt om i världen. Den främsta orsaken till synnedsättning och blindhet är ögonsjukdomar där några av de vanligaste är katarakt, åldersrelaterad makuladegeneration, glaukom och retinopati. Synnedsättning kan skapa fysiska och psykiska följder i det dagliga livet, exempelvis isolering, ökad risk för skador och minskad självständighet. Syfte: Syftet var att belysa personers upplevelser av att leva med synnedsättning och hur detta påverkar utförandet av aktiviteter i det dagliga livet. Metod: En litteraturstudie har genomförts med induktiv ansats. Sökningar gjordes i databaserna CINAHL och PubMed där 12 artiklar valdes ut som utgör grunden för uppsatsens resultat. Bearbetningen av den insamlade datan genomfördes med stöd av en innehållsanalys. Resultat: Det framkom att personer med nedsatt syn upplevde att synnedsättningen hade en betydande inverkan på de dagliga aktiviteterna. Detta visade sig genom att svårigheter uppstod vid vissa aktiviteter, såsom matlagning och mobilisering. Detta medförde att strategier skapades för att underlätta aktiviteterna. Situationen medförde även olika känslor, både positiva och negativa. Konklusion: Resultatet kan bidra med betydande kunskap kring hur personer med synnedsättning upplever aktiviteter i det dagliga livet, vilket är användbart för sjuksköterskan för att kunna tillämpa god omvårdnad och personcentrerad vård. / Background: Eye diseases and impaired vision are a public health problem that is expected to increase around the world. The main causes of visual impairment and blindness are eye diseases where some of the most common are cataract, age-related macular degeneration, glaucoma and retinopathy. Visual impairment can create physical and mental consequences in daily life, such as isolation, increased risk of injury and reduced independence. Purpose: The purpose was to highlight people's experience of living with visual impairment and how this affects the performance of activities in daily living. Method: A literature study has been conducted with an inductive approach. Searches were made in the databases CINAHL and PubMed where 12 articles were selected which formed the basis for this essays result. Results: It was found that people with impaired vision experienced that visual impairment had a significant impact on daily activities. This was evidenced by the fact that difficulties arose for example with cooking and mobilisation. This resulted in strategies that were created to facilitate activities. The situation also led to different emotions, both positive and negative. Conclusion: The results can contribute knowledge about how people with visual impairment experience activities in daily living, which is useful for better nursing and person-centered care.

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21306号 / 人健博第62号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 黒木 裕士, 教授 恒藤 暁, 教授 坂井 義治 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Le rôle de proche aidant est essentiel pour soutenir l’autonomie de la personne ayant la maladie d’Alzheimer (ou un autre trouble neurocognitif). Or, bien que la perception du proche aidant quant au statut fonctionnel de l’aîné à qui il offre du soutien ait déjà été étudiée, il n'existe pas de revue de littérature ayant abordé la correspondance entre l'évaluation d'un professionnel et la perception du statut fonctionnel par les proches aidants. L’objectif de cette étude est donc de comparer la perception du proche aidant et celle du professionnel de la santé quant au statut fonctionnel des aînés ayant la maladie d’Alzheimer (ou d’autres troubles neurocognitifs). Pour ce faire, un examen de la portée a été réalisé. Seize articles répondant aux critères d'inclusion ont été inclus dans l’étude. Toutes les études sélectionnées étaient non-expérimentales (transversale, longitudinale, cohorte avec groupe conrôle, cohorte, qualitative et mixte), et représentaient des échantillons hétérogènes concernant la dimension cognitive des sujets. La majorité des études (n=10) comptaient plus de femmes que d’hommes parmi ses participants. L’âge des aînés ayant un trouble neurocognitif variait entre 62,4 (±6,8) ans et 82,7 (±6,4) ans et celui des proches aidants variait de 48,2 (±15,2) ans à 79,6 (±8,5) ans. Les conjoints de personnes ayant la maladie d’Alzheimer ou un trouble neurocognitif sont les principaux dispensateurs d’aide parmi les proches aidants, suivi des enfants. Les milieux d'évaluation variaient entre le domicile, les milieux cliniques ou les laboratoires de centres de recherche. Les résultats de 75 % des études montrent que les évaluations faites par les professionnels donnent des résultats divergents avec la perception des proches aidants. Aussi, dans 31 % des études, la tendance était la sous-estimation des capacités par les proches aidants comparativement aux professionnels alors que dans 25 % des études, la tendance allait dans le sens de la surestimation des capacités. Enfin, dans 19 % des études, ou ne précisait pas la nature des divergences (sous-estimation ou surestimation). Des résultats portant sur la nature de la relation entre la personne ayant un trouble neurocognitif et son proche suggèrent que les conjoints ont tendance à surestimer les habiletés fonctionnelles des personnes ayant des troubles neurocognitifs à un stade léger, tandis que les proches ayant un autre type de lien (enfant, ami) montrent généralement une tendance à la sous-estimation. De plus, les divergences entre les proches aidants et les professionnels sont davantage susceptibles de porter sur des activités en lien avec les activités instrumentales de la vie quotidienne. Des études additionnelles auprès des proches aidants devront être réalisées en parallèle à des évaluations standardisées par des professionnels de la santé afin de recueillir des données plus complètes qui aideront à mieux comprendre quelles sont les activités qui sont perçues de façon divergente selon ces deux points de vue. / The role of the caregiver is essential in supporting the autonomy of those with Alzheimer's disease (or another neurocognitive disorder). However, although the caregiver's perception of the functional status of the person to whom he or she provides support has already been studied, no literature review that has addressed the correspondence between a professional assessment and the perception of functional status by caregivers. The objective of this study is therefore to compare the caregiver's perception and evaluation of the healthcare professional regarding the functional status of seniors with Alzheimer's disease (or other neurocognitive disorders). To do so, a scope review was conducted. Sixteen articles meeting the inclusion criteria were included in the study. All studies were non-experimental (cross-sectional, longitudinal, cohort with control group, cohort, qualitative and mixed), and represented heterogeneous samples with respect to the cognitive dimension of the subjects. The majority of studies (n=10) had more female than male participants. The age of seniors with a neurocognitive disorder ranged from 62.4 (±6.8) y.o. to 82.73 (±6.4) y.o., and that of caregivers ranged from 48.2 (±15.2) y.o. to 79.6 (±8.5) y.o. Spouses of people with Alzheimer's disease or a neurocognitive disorder were the primary caregivers among family caregivers, followed by children. Assessment settings varied from home, clinical settings or research center laboratories. The results of 75 % of the studies show that the assessments made by professionals gave results that diverge from the perception of caregivers. In 31 % of the studies, there was a tendency for caregivers to underestimate abilities compared to professionals, while in 25 % of the studies, there was a tendency for caregivers to overestimate abilities. Finally, in 19 % of the studies, the nature of the discrepancies (underestimation or overestimation) was not specified Results on the nature of the relationship between the person with a neurocognitive disorder and his/her caregiver suggest that spouses tend to overestimate the functional abilities of people with mild neurocognitive disorders, while relatives in other types of relationships (child, friend) generally show a tendency to underestimate them. Moreover, differences between caregivers and professionals are more likely to be related to activities related to instrumental activities of daily living. Additional studies with caregivers will have to be conducted in parallel with standardized assessments by healthcare professionals in order to collect more data to better understand which activities of functional status are perceived in a divergent way.