Background: Older adults experience health deconditioning during hospitalization. There are many facets of care impacting on older adults' health characteristics and their self confidence in managing their health. The aim of this follow-up study is to examine the long term effect of comprehensive discharge planning and nursing in-home follow-up for older adults (over 65 year old) incorporating physiotherapy exercise strategies on health characteristics. No published studies were located that had examined the impact of a comprehensive discharge program on the functional status and psychosocial among older frail adults at 12 months post-discharge. Design and methodology: Rehabilitation in Older People (RIO program) is a randomised controlled trial which evaluates the intervention of a comprehensive discharge program, exercise program incorporating nursing follow up. Participants of the RIO study were randomly allocated into usual care control group and an intervention group. The intervention group received a comprehensive training from an advanced practice gerontic nurse (APGN) and exercise strategies by physiotherapists. The APGN visited the participants in their home 48 hours post discharge, followed by telephone follow-up at 4, 8, 12 and 24 weeks. This study followed-up this cohort at 12 month via telephone interviews to evaluate their functional ability, quality of life, psychosocial characteristics and the levels of self-efficacy. The General Self-efficacy Scale (GSE) was used to measure their self-efficacy. Results: There is no difference between the demographic and health characteristics between the control and intervention group. There are significant difference in their functional ability, psychosocial health, measured by the tools mentioned above at 4 weeks (p < 0.05), 12 weeks (p < 0.05), and 24 weeks (p < 0.05), but not at 52 weeks. The possible reason could be due to lack of telephone follow up. Moreover, the levels of self-efficacy in this sample have been found to correlate with the functional ability and psychosocial at 12 months after discharge from an acute hospital.

Thesis (M.S.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Feb. 5, 2008). Includes bibliographical references (p. 71-79).

Diss. (sammanfattning) Göteborg : Univ. , 2008. / Härtill 4 uppsatser.

Lic.-avh. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 2 uppsatser.

Thesis (DR. P.H.)--University of Michigan.

Thesis (Ph. D.)--Oregon State University, 1998. / Typescript (photocopy). Includes bibliographical references (leaves 105-108). Also available on the World Wide Web.

Thesis (DR. P.H.)--University of Michigan.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.)--University of Michigan, 1990.

Orientador: Júlio Defaveri / Resumo: A paracoccidioidomicose (Pbmicose) é micose sistêmica causada pelo fungo dimórfico Paracoccidioides brasiliensis, que acomete principalmente trabalhadores rurais do sexo masculino. A doença tem como principais manifestações clínicas a forma aguda/subaguda e a forma crônica. Métodos sorológicos têm considerável valor na Pbmicose e diferentes testes têm sido utilizados no diagnóstico e monitoramento da resposta do paciente ao tratamento. O objetivo deste estudo foi avaliar a IFI, a ID e o ELISA antes e após introdução do tratamento de pacientes com a forma aguda/subaguda e a forma crônica da Pbmicose. Para cada teste, os seguintes parâmetros foram avaliados: sensibilidade (SE), especificidade (EP), valor preditivo positivo (VPP), valor preditivo negativo (VPN) e eficiência (EF). No período pré-tratamento a IFI teve SE=92,3%, VPP= 87,5%, VPN= 92% e EF=88,6%. A ID teve SE=94,93%, VPP=97,4%, VPN=95% e EF=96,2%. Para o ELISA, SE=100%, VPP=95%, VPN=100% e EF=97,4%. No grupo de doadores de sangue, a EP da IFI, da ID e do ELISA foram, respectivamente, de 93,3%, 100% e 100%. Em soros de pacientes com outras micoses sistêmicas (histoplasmose, criptococose, actinomicose, aspergilose e adiaspiromicose), as EP para os testes foram de 60%, 90% e 80%, respectivamente. Durante o tratamento, maior correlação foi obtida entre a ID e o ELISA (r= 0,61591, p<0,05), obtendo-se baixas correlações com a IFI. O tempo necessário para negativar o ELISA (Md= 20,0 meses) foi maior do que a ID (Md= 13,5 meses). O ELISA se negativou em geral nove meses após a ID, o que sugere que este teste passe a ser um referencial para suspensão do tratamento de manutenção. Devido à sua elevada sensibilidade, especificidade, VPP, VPN e eficiência, o ELISA deve ser incluído na rotina sorológica de pacientes com Pbmicose. / Abstract: Pararaccidioidomycosis (Pbmycosis) is a systemic mycosis caused by the dimorphic fungus Paracoccidioiodes brasiliensis, which often affects rural workers, usually male adults. The overt disease is manifested by two clinical forms, acute/subacute and chronic forms. Serological methods are of considerable value in Pbmycosis, and various tests has been utilized in the diagnostic and monitoring the patient's response to treatment. The aim of this study was to evaluated the reliability of the double immunodiffusion test (ID), indirect immunofluorescence (IIF) and immunoenzymatic assay (ELISA) in the pre-treatment and during the period of treatment of patients with acute/subacute and chronic forms of Pbmycosis. For each test the following parameters were evaluated: Sensitivity (SE), Specificity (SP), Positive and Negative Predictive Values (PPV and NPV) and Efficiency (EF). In the pre-treatment period these values for IFI were SE=92.3%, PPV=87.5%, NPV=92% and EF=88.6%. For ID: SE=94.9%, PPV=97.4%, NPV=95% EF=96.2%. For ELISA: SE=100%, PPV=95%, NPV=100% and EF=97.4%. In the group of blood donors, for IFI, ID and ELISA the ES were, respectively, 93.3%, 100% and 100%. In patients with other deep mycosis (histoplasmosis, cryptococcosis, actinomycosis, aspergillosis and adiaspiromycosis) the ES for these tests were respectively 60%, 90% and 80%. During the period of treatment, the highest correlation was observed between ID and ELISA (r= 0,61591, p<0,05), and the lowest correlations with IFI. The time elapsed to negative the ELISA was larger (Md=20 months) than for ID (Md= 13,5 meses). In overall, the ELISA negativated nine months after ID. This result suggests that the ELISA may be a referential test to monitoring the time for interruption of the treatment in Pbmycosis. Moreover, owing to its high values of SE, SP, PPV, NPV and EF, ELISA should be included in the serological routine for patients with Pbmycosis. / Mestre