Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Michigan, 1970.

Thesis (M.S.)--University of Michigan, 1970.

Thesis (M.S.M.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / BACKGROUND/PURPOSE: Gait speed and walking endurance are measures of performance and overall health in older adults; however it is unclear whether measuring both provides additional clinically useful information over measuring just one. The purpose of this study is to systematically explore the co-variation of trajectories of speed and endurance over 8 years in healthy older adults, and to examine the association of knee extensor strength and cardiorespiratory impairment with distinct trajectories. Understanding such trajectories and their determinants will help clarify the utility of testing each outcome separately. METHODS: Data were obtained prospectively in a subset of the Health, Aging and Body Composition study (Health ABC), which included 2364 initially well-functioning men and women 70 to 79 years of age. Gait speed was determined from a 20-meter walk. Walking endurance was measured from a two-minute walk. The dual trajectories of gait speed and walking endurance were estimated using a group-based mixture model using SAS macro “PROC TRAJ”. The procedure calculates the probabilities of trajectory group membership for gait speed membership conditioning on walking endurance groups and vice versa. We also examined the association of knee extensor strength and cardiorespiratory impairment with distinctive trajectories adjusting for age, sex, and body mass index (BMI). RESULTS: We identified four gait speed trajectories and three walking endurance trajectories. Older adults with the greatest decline in gait speed and walking endurance slowed 0.032 m/s and 0.025 m/s per year, respectively. There was high correlation between gait speed and walking endurance trajectories, r= 0.84, p<0.0001. Less knee extensor strength and the presence of cardiorespiratory impairment were associated with membership in worse gait speed and walking endurance trajectories. After adjustment for walking endurance trajectories, only knee extensor strength was associated with worse gait speed trajectories. After adjustment for gait speed trajectories, both strength and cardiorespiratory impairments continued to be associated with walking endurance trajectories. CONCLUSIONS: There was high convergence of trajectories of gait speed and walking endurance. Therefore, changes in walking endurance can be inferred from measuring gait speed alone. However, cardiorespiratory impairment had a unique association with trajectories of walking endurance, but not gait speed. Therefore, measuring gait speed alone may not provide as much information as measuring walking endurance for those with cardiorespiratory impairment. / 2031-01-01

Malnutrition and dehydration are prevalent health risks among older adults in skilled nursing facilities, particularly among those with cognitive impairments. Existing behavioral interventions do not consider social aspects of mealtimes, and there is limited research on social aspects of mealtimes in older adults. The current study introduces nonconscious behavioral mimicry as a social approach to supplement existing interventions. A repeated measures design examining the imitation of a confederate’s drinking and cup touching behaviors was employed to investigate whether these behaviors can be altered due to nonconscious behavioral mimicry in healthy older adults (N = 14; M = 71 years old). Findings indicate that behavioral mimicry increased drinking behaviors, while no significant effect was observed with cup touching behaviors. One plausible reason for this is the goal-directed nature of drinking behaviors. This thesis supports further studies to increase the magnitude of nonconscious behavioral mimicry in older adult populations with cognitive impairments.

Late onset Alzheimer’s disease (LOAD) is the commonest form of dementia, affecting approximately 850,000 patients in the UK alone, predicted to exceed one million by 2025. The cause of LOAD is complex, but several large Genome Wide Association Studies have highlighted 21 genetic loci associated with this devastating disease and the ATP-Binding Cassette Protein, family A, member 7 (ABCA7) is one of these genetic loci. However, the exact reasons behind this association are still unknown, focusing work on identifying functional, pathogenic mutations within this locus. A total of 240 exonic variations within ABCA7 were therefore annotated in order to identify ones potentially altering the functionality of ABCA7. A total of five variants were predicted to be damaging by in silico annotation tools: rs3752233; rs59851484; rs3752237; rs114782266 and a novel mutation at genomic position 19:1056958. These were genotyped in the ARUK DNA Bank resource and three (rs59851484, rs3752239 and 19:1056958) showed tentative association with LOAD. However, lack of power in this study prevented any definitive associations from being formed. A further two variants were examined within functional cell assays. rs881768 had been predicted to affect the splicing of the ABCA7 protein and appeared to do so within minigene cellular assays. However, this did not appear to be the case when RNA from brain tissue harbouring this variation was examined. rs2020000 was examined through the dual luciferase assays, with the minor allele seeming to down regulate the reporter protein by approximately 30% (p < 0.02) in these in vitro assays. Functional variations within the ABCA7 locus do play a role in LOAD risk and improvements within functional databases and annotation programmes will assist in identifying these causative mutations, in order to put a halt to LOAD, as well as other destructive complex disorders.

Submitted by LARA ALVES MOREIRA null (laraamfisio@gmail.com) on 2017-05-09T23:54:51Z No. of bitstreams: 1 dissertacao lara completa com ficha.pdf: 614332 bytes, checksum: dbe06acf982b06f5b21a79f59b9dd657 (MD5) / Approved for entry into archive by Luiz Galeffi (luizgaleffi@gmail.com) on 2017-05-10T16:24:08Z (GMT) No. of bitstreams: 1 moreira_la_me_rcla.pdf: 614332 bytes, checksum: dbe06acf982b06f5b21a79f59b9dd657 (MD5) / Made available in DSpace on 2017-05-10T16:24:08Z (GMT). No. of bitstreams: 1 moreira_la_me_rcla.pdf: 614332 bytes, checksum: dbe06acf982b06f5b21a79f59b9dd657 (MD5) Previous issue date: 2017-03-13 / Introdução: O envelhecimento populacional mundial crescente tem gerado consequências aos sistemas de saúde, resultando em sobrecarga na saúde e qualidade de vida da pessoa idosa, estendendo-se desde idosos na comunidade às Instituições de Longa Permanência (ILP’s). A realidade virtual surge como uma proposta inovadora de interação capaz de atingir todas as idades e como uma potente ferramenta a ser utilizada por profissionais de saúde. Objetivos: Verificar a presença de melhora do equilíbrio e mobilidade em idosos institucionalizados submetidos ao treinamento com tecnologia do Nintendo Wii no controle de equilíbrio e mobilidade. Métodos: Os idosos participantes (n=10) da pesquisa serão avaliados antes e após o protocolo de treinamento com realidade virtual com duração de 8 semanas. A mobilidade funcional será avaliada pelo teste Time Up and Go, enquanto a força de reação ao solo será avaliada pela plataforma de força AMTI. Após verificação da normalidade, serão adotados testes estatísticos apropriados para análise dos dados. Em todos os testes estatísticos, serão adotados o nível de significância de p < 0,05. Resultados: Ao avaliar os resultados pré e pós intervenção com Wii, enquanto o equilíbrio estático avaliado pela Plataforma de Força não apresentou diferença significativa, enquanto que no Timed Up and Go para avaliar a mobilidade funcional foi encontrada diferença significativa (p= 0,03). Conclusão: os resultados demonstraram que a intervenção com Nintendo Wii foi capaz de melhorar a mobilidade funcional e sugeriu melhora clínica no equilíbrio estático de idosos institucionalizados. / Introduction: Growing global population aging has had consequences for health systems, resulting in an overload on the health and quality of life of the elderly, ranging from elderly in the community to Long-term Institutions (ILPs). Virtual reality emerges as an innovative proposal of interaction capable of reaching all ages and as a powerful tool to be used by health professionals. Objectives: To verify the presence of improved balance and mobility in institutionalized elderly subjects submitted to training with Nintendo Wii technology in balance and mobility control. Methods: Elderly participants (n = 10) of the research will be evaluated before and after the virtual reality training protocol lasting 8 weeks. Functional mobility will be evaluated by the Time Up and Go test, while the ground reaction force will be evaluated by the AMTI force platform. After checking for normality, appropriate statistical tests shall be adopted for data analysis. In all statistical tests, the significance level of p <0.05 will be adopted. Results: When evaluating the pre and post intervention results with Wii, while the Static Balance evaluated by the Strength Platform did not present a significant difference, whereas in the Timed Up and Go to evaluate the functional mobility, a significant difference was found (p = 0.03) . Conclusion: the results demonstrated that the intervention with Nintendo Wii was able to improve functional mobility and suggested clinical improvement in the static equilibrium of institutionalized elderly.

Orientador: Marcelo de Castro Meneghim / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-05T20:13:08Z (GMT). No. of bitstreams: 1 Sousa_EdnalvaMariade_M.pdf: 1082035 bytes, checksum: be1a328ac1799021e58a86fb4b483fd8 (MD5) Previous issue date: 2005 / Resumo: A precariedade da saúde bucal da população adulta e idosa, no Brasil, influencia diversos aspectos funcionais, sociais e psicológicos, diminuindo, assim, a qualidade de vida desses indivíduos. O cirurgião-dentista é de vital importância neste contexto, como profissional da área da saúde e agente modificador. Objetivos: avaliar o conhecimento do Cirurgião-Dentista do Serviço Municipal de Saúde de Campinas sobre práticas de promoção da saúde, verificar se as mesmas são realizadas na sua Unidade Básica de Saúde (UBS) e medir o impacto de informações sobre promoção da saúde fornecidas, por meio de uma apostila, sobre os mesmos. Dos 180 Cirurgiões-Dentistas do Serviço Municipal de Saúde da cidade de Campinas ¿ SP que aceitaram participar do estudo, a análise foi feita com 63 que responderam o questionário antes e depois. Estudo foi experimental, abordagem quantitativa, utilizando-se um questionário semi-estruturado e uma apostila específica como intervenção. O teste McNemar foi utilizado por se tratar de uma amostra com variável dicotômicas e dependentes entre si. Cada Cirurgião- Dentista foi o controle de si mesmo. Os testes foram realizados ao nível de significância de 5%. Principais resultados: A porcentagem de acertos em relação ao conhecimento sobre promoção da saúde, foi maior em todas as questões analisadas, por meio do teste estatístico MacNemar, após a leitura da apostila; 87,3% dos Cirurgiões-Dentistas relataram que a sua Unidade Básica de Saúde realiza ações de promoção da saúde; 79,2% dos profissionais afirmaram que já participaram de ações de promoção da saúde em escolas e 10% em asilos; forte tendência dos profissionais em direcionar mais recursos e estratégias de promoção da saúde para a população infantil. Concluí-se: a) A maioria dos participantes da pesquisa apresentou deficiência de conhecimento técnico em relação ao conceito e documentos sobre promoção da saúde; b) A maior parte dos Cirurgiões-Dentistas relatou, que a sua Unidade Básica de Saúde realiza ações de promoção da Saúde; c) Os profissionais do serviço municipal de saúde de Campinas adquiriram conhecimento sobre promoção da saúde, por meio da apostila fornecida; o percentual de acertos, após a leitura da apostila, foi maior em todas as questões analisadas antes e depois, sendo estatisticamente significantes / Abstract: The mouth health precariousness of adult and aged population, in Brazil, influences several functional, social, and psychological aspects, diminishing, thus, the life quality of these individuals. The dentist surgeon has got vital importance in this context as a health field professional and a modifier agent. Goals: to evaluate the knowledge of the Campinas Municipal Health Service dentist surgeon concerning the pratices of health promotion, to verify if these health promotion pratices are executed in his Health Basic Unit and to measure the impact of informations about health promotion by a given text on him. From 180 dentist surgeons of Campinas City Municipal Health Care that accepted to participate in the study, 63 were submitted to the analysis and answered the questionary before and after. Study was experimental, quantitative approach, utilizing a semi-structured questionary and a specific text as intervention. The MacNemar test was utilized because it is regarded as a sample with dichotomycs and dependents variables. The tests were accomplished at 5% of significant level. Main results: set right percentage concerning to knowledge of health promotion was larger in all analyzed questions, by the statistic MacNemar test, after the text reading; 87.3% of dentist surgeons told that their Health Basic Unit carry out actions of health promotion; 79.2% of professionals affirmed that they have participated in health promotion actions in schools and 10% in home for old people; strong tendency of professionals for conducting more resources and health promotion strategies for children education. It is concluded that: a) The majority of the research participants presented technical knowledge deficiency about the concept and documents related to health promotion b) The majority of the dentist surgeons reported that their Basic Health Unit carries out health promotion action; c) The professionals of Campinas Municipal Health Care acquired knowledge about health promotion by a furnished text; the set right percentage, after the text reading, was larger in all questions analysed before and after, being statiscally significant / Mestrado / Odontologia em Saude Coletiva / Mestre em Odontologia

Background: Numerous multidimensional assessment tools have been developed to measure frailty; however, the clinical feasibility of these tools is limited. We previously developed and validated an upper-extremity function (UEF) assessment method that incorporates wearable motion sensors. The purpose of the current study was to: 1) cross-sectionally validate the UEF method in a larger sample in comparison with the Fried index; 2) develop a UEF frailty index to predict frailty categories including non-frail, pre-frail, and frail based on UEF parameters and demographic information, using the Fried index as the gold standard; and 3) develop a UEF continuous score (points scores for each UEF parameter and a total frailty score) based on UEF parameters and demographic information, using the Fried index as the gold standard. Methods: We performed a cross-sectional validation and index development study within the Banner Medical Center, Tucson, and Banner Sun Health Research Institute, Sun City, Arizona. Community-dwelling and outpatient older adults (>= 60 years; n = 352; 132 non-frail, 175 pre-frail, and 45 frail based on Fried criteria) were recruited. For the UEF test, each participant performed a 20-s elbow flexion, within which they repetitively and rapidly flexed and extended their dominant elbow. Using elbow motion outcomes two UEF indexes were developed (categorical and score). The Fried index was measured as the gold standard. Results: For the categorical index, speed of elbow flexion, elbow range of motion, elbow moment, number of flexion, speed variability and reduction within 20 s, as well as body mass index (BMI) were included as the pre-frailty/frailty predictor parameters. Results from 10-fold cross-validation showed receiver operator characteristic area under the curve of 0.77 +/- 0.07 and 0.80 +/- 0.12 for predicting Fried pre-frailty and frailty, respectively. UEF score (0.1 to 1.0) was developed using similar UEF parameters. Conclusions: We present an objective, sensor-based frailty assessment tool based on physical frailty features including slowness, weakness, exhaustion (muscle fatigue), and flexibility of upper-extremity movements. Within the current study, the method was validated cross-sectionally using the Fried index as the gold standard and the UEF categorical index and UEF frailty score were developed for research purposes and potentially for future clinical use.