Syftet med denna litteraturstudie var att undersöka hur osteoporos-relaterade frakturer påverkar vuxna människors aktiviteter i dagliga livet och upplevda livskvalitet. Uppsatsen är skriven med ändamål att hjälpa sjuksköterskor bättre förstå hur de drabbade patienterna lever för att underlätta omvårdnaden av dem. Metoden som använts är en litteraturstudie där sex kvantitativa och en kvalitativ studie kritiskt granskats efter modifierade versioner av Willman & Stoltz (2006) protokoll för kvalitetsbedömning. Databaserna PubMed och Cinahl användes för artikelsökningarna. Resultatet visar att osteoporos-relaterade frakturer försämrar förmågan till både personliga- och instrumentella aktiviteter i dagliga livet, särskilt gällande aktiviteterna som kräver rörlighet. Livskvalitet var överlag sänkt för samtliga frakturtyper i studierna, och kunde delas upp i tre kategorier; fysisk påverkan, mental påverkan och smärta. Samtliga kategorier visade signifikant sämre resultat för människor med osteoporos-relaterade frakturer. Positionen av frakturerna kan ha stor påverkan på hur alla tre kategorier påverkas, och likaså kan förekomst av smärta påverka de båda andra kategorierna. / The aim of this literature review was to investigate into how osteoporosis-related fractures affect the activities of daily living and quality of life for adult humans. The purpose of this study was to help nurses better understand how the affected patients live their lives, in order to facilitate nursing of them. The method used is a literature review based on one qualitative and six quantitative studies that were critically examined using modified versions of Willman & Stoltz (2006) protocol for estimation of quality. PubMed and Cinahl were the databases being used for the article search. The result indicates that osteoporosis-related fractures impair the ability for personal as well as instrumental activities of daily living, especially regarding the activities that requires mobility. The quality of life for all of the fracture types presented in the studies was overall reduced, and could be arranged into three categories; physical effect, mental effect and pain. All three categories showed significant worse results for humans with osteoporosis-related fractures. The position of the fractures could influence all three categories, likewise as occurrence of pain could affect the remaining categories.

Individuals with intellectual disabilities often lack access to appropriate sexual education, leading to negative impacts on their well-being and safety. Occupational therapists can play a vital role in addressing sexual education, health, behaviors, and community safety for these individuals. The Talk aims to empower school-based occupational therapists to become advocates and educators in the field of sexual health and behaviors, improving overall well-being and safety. This 6-hour presentation celebrates neurodiversity and provides up-to-date information and case studies to enhance understanding and promote strategies for working with young adults with intellectual disabilities. The program seeks to reduce the risk of sexual victimization and promote education and strategies for increased bodily autonomy and a better future. Plans for program implementation, funding, and evaluation of The Talk are included as well as dissemination of program findings to advance the occupational therapy evidence base.

Introduktion/bakgrund: Multipel skleros [MS] är en kronisk inflammatorisk neurologisk sjukdom som medför till en mängd olika symptom, både fysiska som trötthet och nedsatt rörlighet samt emotionella som depression. Detta kan reducera den fysiska- och  kognitiva funktionen vilken kan begränsa dagliga aktiviteter som exempelvis sysselsättning och egenvård. Syfte: Syftet med litteraturstudien var att belysa erfarenheter hos personer med MS om vilken betydelse psykisk ohälsa har för deras dagliga aktiviteter eller ADL. Metod: Litteraturstudiens metod utgick från de nio stegen av Polit & Beck (2021) där relevanta vetenskapliga artiklar inom ett specifikt område sammanställs. Urvalsprocessen bestod av tre steg. Tio artiklar inkluderades varav sju artiklar var med kvantitativ design och tre artiklar med kvalitativ design. Artiklarna hämtades från databaserna CINAHL och PSYCINFO. Innehållet i artiklarna bearbetades och tre teman framkom som presenterades i resultatet.  Resultat: Resultatet redovisades i tre olika teman som beskriver vilken betydelse psykisk ohälsa har bland dagliga aktiviteter och ADL hos personer med MS. Dessa teman var svårigheter i arbetssituation, funktionsnedsättningens betydelse i vardagen och svårigheter i sociala sammanhang. Slutsats: Depression var det tillståndet som framhävde resultatet mest och visade sig vara den mest påverkande faktorn till begränsningar i dagliga aktiviteter och ADL bland personer med MS

Purpose: Data from a National Institute on Aging funded grant, developed by the University of Miami (UM), Center for Family Studies, were analyzed to determine if baseline levels of cognitive function, physical performance, psychological well-being, physical health, and social support (SS) predict functional status [basic (BADL) and instrumental (IADL) activities of daily living] among Hispanic elders (30 months later). Participants: The parent grant randomly selected a population based sample of Hispanic seniors living in East Little Havana, Florida: n=216, `M' age = 80.0 yrs, `SD' = 6.0; female = 63%. Methods: Data from two time points of the parent grant separated by 30 months were used in this analysis. Self report and physical measures of: cognitive function (MMSE), physical performance (gait speed, grip strength, number of blocks walked in past 7 days), psychological well-being (CES-D), physical health (BMI & self-rated health), SS (Received SS scale), and functional status (BADL and IADL), measured by a derivative of the OARS Functional Assessment Questionnaire, were examined. Two stepwise regression equations (one for BADL and one for IADL as dependent variables respectively) were calculated using SPSS v17.0. The study was approved by UM and Temple University's IRB. Results: Gait speed and physical activity were positively associated with IADL while physical activity was positively associated with BADL. In contrast, received social support and age were negatively associated with each of these outcomes. Conclusion: `Young-old,' Hispanic adults with lower levels of received SS and higher gait speeds and levels of physical activity exhibit greater BADL and IADL capacity. Social Relevance: Results of this study have implications for the development of strategies that delay long-term placement of Hispanic elders with disability. / Physical Therapy

Background People with rheumatic or neurologic conditions are commonly referred for occupational therapy because of decreased ability to perform ADL tasks. Upon referral, occupational therapists use a client-centred, occupationfocused approach when evaluating a person's perceived and observed quality of ADL task performance to clarify the nature and extent of the person’s problems, plan interventions and determine effectiveness of interventions. Evaluation of the extent of problems and change following intervention require the use of linear measures of ADL. The aim of this doctoral thesis was to develop and validate linear measures of perceived and observed quality of ADL task performance for occupational therapy clinical praxis and research. Methods To develop linear measures of observed quality of ADL task performance based on Rasch measurement methods, clients with ABI (n=70) were evaluated using a 3-category rating scale and the ADL Taxonomy. Similarly, to develop linear measures of perceived quality of ADL task performance women with rheumatic diseases (n=118) reported their ability on a questionnaire and in an interview based on the ADL Taxonomy and a 4- category rating scale. To further validate the ADL ability measures of the Assessment of Motor and Process Skills (AMPS) data were collected in two samples. In a sample of women with chronic widespread pain (CWP) or fibromyalgia (FM) (n=50) the ADL ability measures were validated with regard to discrimination, stability and sensitivity to changes. Discrimination was examined by comparing AMPS data from women with CWP/FM to those of healthy women. Stability and sensitivity to change were examined based on repeated AMPS observations pre and post intervention. In addition, sensitivity to change was examined in a sample of clients with ABI (n=36) using a pre- and post-test design. Finally, the validity of the AMPS ADL ability measures in relation to perceived ADL ability was examined in women with rheumatic diseases (n=118) and women with CWP/FM (n=50). Results Based on the results of the four studies in this thesis, we were able to conclude that it was possible to obtain linear measures of observed quality of ADL task performance based on a revised version of the ADL Taxonomy (ADL-O). It was also possible to obtain linear measures of perceived quality of ADL task performance based on revised versions of the ADL Taxonomy using the formats of questionnaires (ADL-Q) and interviews (ADL-I). Moreover, it was possible to establish further evidence of validity of the ADL ability measures of the AMPS. Thus, the AMPS ADL ability measures could discriminate between women with CWP/FM and healthy women. The ADL ability measures of remained stable when no intervention was provided and the ADL motor ability measures were sensitive to change among women with CWP/FM. Moreover, the ADL ability measures were sensitive to change among clients with low ADL ability following ABI. Finally, only low to moderate correlations were found between measures of perceived and observed ADL ability. Conclusions Rasch analyses of revised versions of the ADL Taxonomy suggest that the majority of the ADL tasks and rating scales focused on quality of ADL task performance can be used to obtain linear measures of quality of ADL task performance based on methods of questionnaire, interview or observation. Furthermore, the studies provided evidence of validity of the ADL ability measures of the AMPS in relation to discrimination, stability and sensitivity to change and relation to perceived ADL ability. The results may, therefore, enhance the use of ADL instruments that provide linear measures of perceived and observed quality of ADL task performance in occupational therapy clinical praxis and research.

Diss. (sammanfattning) Umeå : Umeå universitet, 2010.

Made available in DSpace on 2014-12-17T15:47:00Z (GMT). No. of bitstreams: 1 AnaLFM_TESE.pdf: 3970701 bytes, checksum: 513ce9d2a22c9323df778dcf23fb1033 (MD5) Previous issue date: 2012-07-30 / Model-oriented strategies have been used to facilitate products customization in the software products lines (SPL) context and to generate the source code of these derived products through variability management. Most of these strategies use an UML (Unified Modeling Language)-based model specification. Despite its wide application, the UML-based model specification has some limitations such as the fact that it is essentially graphic, presents deficiencies regarding the precise description of the system architecture semantic representation, and generates a large model, thus hampering the visualization and comprehension of the system elements. In contrast, architecture description languages (ADLs) provide graphic and textual support for the structural representation of architectural elements, their constraints and interactions. This thesis introduces ArchSPL-MDD, a model-driven strategy in which models are specified and configured by using the LightPL-ACME ADL. Such strategy is associated to a generic process with systematic activities that enable to automatically generate customized source code from the product model. ArchSPLMDD strategy integrates aspect-oriented software development (AOSD), modeldriven development (MDD) and SPL, thus enabling the explicit modeling as well as the modularization of variabilities and crosscutting concerns. The process is instantiated by the ArchSPL-MDD tool, which supports the specification of domain models (the focus of the development) in LightPL-ACME. The ArchSPL-MDD uses the Ginga Digital TV middleware as case study. In order to evaluate the efficiency, applicability, expressiveness, and complexity of the ArchSPL-MDD strategy, a controlled experiment was carried out in order to evaluate and compare the ArchSPL-MDD tool with the GingaForAll tool, which instantiates the process that is part of the GingaForAll UML-based strategy. Both tools were used for configuring the products of Ginga SPL and generating the product source code / Estrat?gias dirigidas a modelos t?m sido usadas para facilitar a customiza??o de produtos no contexto de Linhas de Produtos de Software (LPS) e gera??o de c?digo fonte desses produtos derivados atrav?s do gerenciamento de variabilidades. A maioria dessas estrat?gias faz uso da especifica??o de modelos baseados em UML (Unified Modeling Language), que apesar de ser amplamente aplicada, possui algumas limita??es por ser essencialmente gr?fica, apresentar defici?ncia em descrever precisamente a sem?ntica da representa??o da arquitetura do sistema e gerar um modelo extenso, o que dificulta a visualiza??o e compreens?o dos elementos do sistema. J? as linguagens de descri??o arquiteturais (ADLs) oferecem suporte textual e gr?fico para representa??o estrutural dos elementos arquiteturais, suas restri??es e intera??es. Essa tese apresenta ArchSPL-MDD, uma estrat?gia dirigida a modelos especificados e configurados usando a ADL LightPL-ACME. Tal estrat?gia est? associada a um processo gen?rico com atividades sistem?ticas que permitem a gera??o autom?tica do c?digo fonte customizados a partir do modelo do produto. A estrat?gia ArchSPL-MDD integra o desenvolvimento orientado a aspectos (DSOA), desenvolvimento dirigido a modelos (DDM), e LPS, o que permite a modelagem expl?cita e modulariza??o de variabilidades e caracter?sticas transversais. O processo ? instanciado pela ferramenta ArchSPL-MDD, que oferece suporte para a especifica??o, em LightPL-ACME dos modelos de dom?nio que s?o o foco do desenvolvimento. O ArchSPL-MDD usa como estudo de caso o middleware de TV Digital Ginga. De forma a avaliar a efici?ncia, aplicabilidade, expressividade e complexidade da estrat?gia ArchSPL-MDD, foi realizado um experimento controlado que avalia e compara a ferramenta ArchSPL-MDD, com a ferramenta GingaForAll, que instancia o processo que faz parte da estrat?gia GingaForAll, baseada em UML. Ambas as ferramentas foram usadas para configura??o do produto da LPS do do middlelare Ginga e gera??o de c?digo fonte do produto

Made available in DSpace on 2014-12-17T15:47:53Z (GMT). No. of bitstreams: 1 FelipeAPP_DISSERT.pdf: 2094888 bytes, checksum: 2f662bc70058d8584f0a23ab28517f43 (MD5) Previous issue date: 2011-01-19 / Distributed multimedia systems have highly variable characteristics, resulting in new requirements while new technologies become available or in the need for adequacy in accordance with the amount of available resources. So, these systems should provide support for dynamic adaptations in order to adjust their structures and behaviors at runtime. This paper presents an approach to adaptation model-based and proposes a reflective and component-based framework for construction and support of self-adaptive distributed multimedia systems, providing many facilities for the development and evolution of such systems, such as dynamic adaptation. The propose is to keep one or more models to represent the system at runtime, so some external entity can perform an analysis of these models by identifying problems and trying to solve them. These models integrate the reflective meta-level, acting as a system self-representation. The framework defines a meta-model for description of self-adaptive distributed multimedia applications, which can represent components and their relationships, policies for QoS specification and adaptation actions. Additionally, this paper proposes an ADL and architecture for model-based adaptation. As a case study, this paper presents some scenarios to demonstrate the application of the framework in practice, with and without the use of ADL, as well as check some characteristics related to dynamic adaptation / Sistemas multim?dia distribu?dos possuem caracter?sticas bastante vari?veis, podendo implicar em novos requisitos ? medida que novas tecnologias s?o disponibilizadas ou na necessidade de adequa??o de acordo com a quantidade de recursos dispon?veis. Dessa forma, tais aplica??es devem ser capazes de realizar ajustes e adapta??es din?micas, permitindo alterar sua estrutura e comportamento. Com o objetivo de prover capacidades de autoadapta??o nesses sistemas, este trabalho apresenta uma abordagem de adapta??o baseada em modelos. ? proposto um framework reflexivo e baseado em componentes para a constru??o e suporte de sistemas multim?dia distribu?dos autoadaptativos, fornecendo v?rias facilidades para o desenvolvimento e evolu??o de tais sistemas, como adapta??o din?mica. A proposta do framework ? manter um ou mais modelos de representa??o do sistema em tempo de execu??o, de modo que alguma entidade externa possa realizar uma an?lise desses modelos identificando problemas e tentando resolv?-los. Esses modelos integram o metan?vel reflexivo das aplica??es atuando como uma autorrepresenta??o do sistema. Para isso, o framework define um metamodelo para a descri??o de aplica??es multim?dia distribu?das autoadaptativas, o qual ? capaz de representar componentes e seus relacionamentos, pol?ticas para especifica??o de QoS e a??es de adapta??o. Adicionalmente, ? proposta uma ADL e uma arquitetura para adapta??o baseada em modelos. Como estudo de caso o trabalho apresenta alguns cen?rios buscando exemplificar o uso do framework na pr?tica, com e sem o uso da ADL, bem como verificar algumas caracter?sticas relacionadas ? adapta??o din?mica

The purpose of this study was to identify factors that predict quality of life (QOL) for aging adults and to examine and compare Baby Boomers', Older Adults' and Younger Adults' responses to the 2010 National Health Interview Survey/QOL Functioning and Disability. Significant findings included several significant values based on the multivariate regression to estimate a model to predict QOL. In particular, being male, four ethnicities other than white, being older than Boomer, age in 10 years, the Functional Difficulty Index, the Functional Limitation Index scores, chronic heart disease, asthma, and arthritis all had significant p values. Adults with chronic heart disease, asthma, or arthritis scored lower on the QOL index, but cancer, stroke, or diabetes were not associated with the QOL index. Two hypotheses had strong support. Lower scores on both the Functional Difficulty Index and the Functional Limitation Index yielded lower QOL scores. Further research recommendations include establishing reliability and validity of the QOL index; running additional regressions for demographics (ethnicity, marital status, etc.) to predict possible combinations of variables predicting QOL or barriers to QOL; and investigating the viability of incorporating the QOL index into an electronic medical record (EMR) dashboard parameter to serve as a screening mechanism for those aging adults most at risk for chronicities or co-morbidities that place them at risk for losing their ability to age in place in the home of their choosing.

Approved for public release; distribution in unlimited. / The thesis research examines the emergence of Sharable Content Object Reference Model (SCORM) architecture currently under development by the Advanced Distributed Learning (ADL) initiative established by the Department of Defense (DoD). SCORM is a collection of specifications adapted from multiple sources to provide a comprehensive suite of E-Learning capabilities that enable interoperability, accessibility, and reusability of Web-based learning content. To understand better the implementation issues of SCORM architecture, the authors analyze all versions of SCORM to understand the evolution of this emerging architecture. It contrasts the evolving requirements for shareable content objects with concerns of copyright issues. The authors address development and implementation issues surrounding the maturation of SCORM architecture and the ADL initiative. The authors recommend that DoD, international, and civilian business partners join in improving E-Learning by embracing technology, such as SCORM, that allows for shareable content objects to be used and reused within civilian and military education and training Learning Management Systems (LMS) across the World Wide Web. / Lieutenant Commander, United States Navy / Lieutenant, United States Naval Reserve