Thesis (M. Phil.)--University of Hong Kong, 1995. / Includes bibliographical references (leave 83-94).

Orientador: Monica Rodrigues Perracini / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T16:56:35Z (GMT). No. of bitstreams: 1 Ramos_JulianedeLemosArmada_M.pdf: 90007552 bytes, checksum: 7cf7dca133f49a8f8d5a13aa1989e1c9 (MD5) Previous issue date: 2012 / Resumo: Objetivo: Explorar a associação entre o alto custo de uma tarefa cognitiva adicionada à tarefa motora e variáveis sociodemográficas, clínicas, cognitivas e físico funcionais e propor um modelo explicativo para o alto custo da dupla tarefa em idosos da comunidade. Métodos: Estudo transversal, de base populacional com uma amostra de 308 idosos homens e mulheres, com 65 anos ou mais, residentes na comunidade derivada do Estudo Rede FIBRA (Perfis de Fragilidade em Idosos Brasileiros). Foram coletados dados relativos a variáveis sociodemográficas, clínicas, cognitivas e físico funcionais. A variável desfecho foi o custo (DTC) gerado ao se adicionar a tarefa cognitiva de evocar os dias da semana de trás para frente ao realizar o Timed Up and Go Test (TUG). O DTC para cada participante foi calculado e dividido em quartis. Os idosos do primeiro quartil (baixo custo) foram comparados aos idosos do quarto quartil (alto custo) (n=154) por meio da análise de regressão univariada em relação às variáveis de interesse. As razões de chance (odds ratio) de apresentar um alto DTC foram investigadas por meio da análise de regressão logística multivariada. Resultados: A amostra foi constituída de 64% de mulheres, sendo 69,4% da amostra independentes na realização das Atividades Instrumentais de Vida Diária (AIVD), com idade média de 71,0 (±5,5) anos. O custo médio da dupla tarefa (DTC) foi de 55,9%. O modelo final derivado das análises de regressão multivariada apontou que os idosos com comprometimento na praxia construtiva (OR=3,79; IC=1.7-8.2; p<0.001), com idades entre 70-74 anos (OR=4.25; IC=1.7- 10.4; p=0,002) e 75-79 anos (OR=4,59; IC=1.5-13.9; p=0,007) e com diagnóstico de artrite ou reumatismo (OR=3,5; IC=1.3-9.2; p=0,01) apresentaram maior chance de pertencer ao grupo de alto custo. Aqueles idosos com melhor desempenho no teste de Fluência Verbal (OR=0.8; IC=0.8-0.9; p=0,009) tiveram menor chance de apresentar um alto DTC. A área sob a curva ROC mostrou que o modelo foi capaz de estimar 78% dos casos de idosos com alto DTC. Conclusão: Sugere-se que um alto custo na realização de dupla tarefa pode ser um bom modelo para identificar idosos comunitários com baixa reserva funcional cognitivo-motora e que esta está particularmente associada ao baixo desempenho em testes de função executiva, idade e artrite. Estes resultados apontam que a escolha de exercícios que exijam a execução de tarefas motoras mais complexas, envolvendo percepção espacial, memória, planejamento de movimentos a partir da modificação das condições da própria tarefa e ou do ambiente pode ser útil no desenvolvimento de programas de exercícios preventivos em idosos comunitários / Abstract: Objective: To explore the association between the high cost of a cognitive task added to the motor task and sociodemographic, clinical, cognitive, physical function variables and to propose an explanatory model for the high cost of dual task in the elderly. Methods: Cross-sectional, population-based sample of 308 elderly men and women, aged 65 and older living in the community derived from FIBRA (Profiles of Frailty in Elderly Brazilians). We collected data on sociodemographic, clinical, cognitive and physical functional variables. The outcome variable was the cost (DTC) generated by adding the cognitive task of evoking the days of the week backwards to perform the Timed Up and Go Test (TUG). The DTC for each participant was calculated and divided into quartiles. The elderly of the first quartile (low cost) were compared to the fourth quartile seniors (high cost) (n = 154) by univariate regression analysis regarding the variables of interest. The odds ratios of having a high DTC were investigated by multivariate logistic regression analysis. Results: The sample consisted of 64% women, 69.4% of the sample being independent in the performance of Instrumental Activities of Daily Living (IADL), with a mean age of 71.0 (± 5.5) years. The average cost of dual task (DTC) was 55.9%. The final model derived from multivariate regression analyzes showed that older people with compromised constructive praxis (OR = 3.79, CI = 1.7-8.2, p <0.001), aged 70-74 years (OR = 4.25, CI = 1.7-10.4, p = 0.002) and 75-79 years (OR = 4.59, CI = 1.5-13.9, p = 0.007) and diagnosed with arthritis or rheumatism (OR = 3.5, CI = 1.3-9.2; p = 0.01) were more likely to belong to the group of high cost. Those seniors with better performance on Verbal Fluency test (OR = 0.8, CI = 0.8-0.9, p = 0.009) were less likely to have a high DTC. The area under the ROC curve showed that the model was able to estimate 78% of cases of elderly patients with high DTC. Conclusion: It is suggested that a high cost in performing dual tasks can be a good model to identify elderly community with low functional cognitive-motor reserve and it is particularly associated with poor performance on tests of executive function, age and arthritis. These results indicate that the choice of exercises that require the execution of more complex motor tasks, involving spatial perception, memory, planning movements from the changing conditions of the task or the environment itself may be useful in developing preventive exercise programs in elderly community / Mestrado / Gerontologia / Mestra em Gerontologia

Submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background: Motor learning theories indicate that training improves motor performance by reducing variability and increasing task control. Elastic tubing and tyre resistance training methods may allow for the development of control over the dynamics of spinal manipulation. This study thus aimed to determine whether training with elastic tubing and tyre resistance, in conjunction with the standard manipulative training at the Durban University of Technology, resulted in the development of control of the dynamics of manipulation compared to training with the standard training alone. Methods: A quantitative, prospective, experimental cohort design was used. Fifty-three participants were randomly allocated into tyre or elastic tubing resistance training intervention groups, or the control group. All groups continued with the standard manipulative training at the Durban University of Technology. The dynamics of manipulation were measured with the Dynadjust pre-, mid- and post-training. The SPSS was utilised to compute the parametric and non-parametric analyses. Results: The results showed no statistically significant differences over time for any of the measured dynamics of manipulation. None of the groups (excluding the control group for S-I manipulation) developed control of the relationships between the dynamics. Overall, there was no difference between the groups with regards to development of control of the dynamics. Conclusion: The results suggest that the additional training methods, should be carefully considered when employed over a short term. Study limitations include the sample size and the effect of outliers, therefore any firm conclusions drawn from this study are required to be interpreted with caution.

BACKGROUND: Descending kerbs during locomotion involves the regulation of appropriate foot placement before the kerb-edge and foot clearance over it. It also involves the modulation of gait output to ensure the body-mass is safely and smoothly lowered to the new level. Previous research has shown that vision is used in such adaptive gait tasks for feedforward planning, with vision from the lower visual field (lvf) used for online updating. The present study determined when lvf information is used to control/update locomotion when stepping from a kerb. METHODOLOGY/PRINCIPAL FINDINGS: 12 young adults stepped down a kerb during ongoing gait. Force sensitive resistors (attached to participants' feet) interfaced with an high-speed PDLC 'smart glass' sheet, allowed the lvf to be unpredictably occluded at either heel-contact of the penultimate or final step before the kerb-edge up to contact with the lower level. Analysis focussed on determining changes in foot placement distance before the kerb-edge, clearance over it, and in kinematic measures of the step down. Lvf occlusion from the instant of final step contact had no significant effect on any dependant variable (p>0.09). Occlusion of the lvf from the instant of penultimate step contact had a significant effect on foot clearance and on several kinematic measures, with findings consistent with participants becoming uncertain regarding relative horizontal location of the kerb-edge. CONCLUSION/SIGNIFICANCE: These findings suggest concurrent feedback of the lower limb, kerb-edge, and/or floor area immediately in front/below the kerb is not used when stepping from a kerb during ongoing gait. Instead heel-clearance and pre-landing-kinematic parameters are determined/planned using lvf information acquired in the penultimate step during the approach to the kerb-edge, with information related to foot placement before the kerb-edge being the most salient.

The purpose of this study was to compare muscle strength and psychomotor performance measures in healthy (n = 18) and frail (n = 21) groups of elderly women utilizing movements requiring various amounts of strength and ballistic action. Subjects were community-dwelling females ranging in age from 66-92 years. Evaluations of functional assessment of motor skills and grip strength occurred. Psychomotor performance was measured through production of aiming movements on a Digitizing Tablet. RT, MT, and movement kinematics (e.g., peak velocity, deceleration, movement adjustments) were evaluated. Differences between groups were apparent in quantity and quality of movement. Healthy subjects were stronger and faster than frail subjects, producing smoother movements with fewer adjustments. Strength appears to differentially affect healthy and frail samples and merits further exploration.

Surgical processes are a complex function of a number of inter-related factors that include individual skills, team working and operating theatre environment. Individual skills can be divided to technical and non-technical skills. This distinction between technical and non-technical skills is rather recent in the healthcare literature. There are studies made about assessing non-technical skills performed in the operating theatre but studies made to assess theatre nurses‘ technical skills have been lacking until recently. The aim of this study is to evaluate clinical applicability of a newly developed observation tool in different contexts and through observing describe similarities or differences between theatre nursing. The observations in the present study are structured with a newly developed observational tool that is developed to assess technical skills of a theatre nurse. The two authors of this study performed the data collection simultaneously at different operation departments. The present study makes evident that the technical skills required of a theatre nurse are considerably different in two different countries. Therefore, it is difficult to use an observational tool without modifying it according to local routines. / Kirurgiska processer består av ett antal komplext inbördes relaterade faktorer som inkluderar individuella färdigheter, teamarbete och miljön i operationssalen. Individuella färdigheter kan delas till tekniska och icke-tekniska färdigheter. Denna åtskillnad mellan tekniska och icke-tekniska färdigheter är ganska ny i omvårdnadslitteraturen. Det har genomförts studier där man har bedömt icke-tekniska färdigheter som utförs i operationssalen men studier för att bedöma operationssjuksköterskans tekniska färdigheter har saknats fram till nyligen. Syftet med denna studie är att utvärdera den kliniska tillämpligheten av ett nyutvecklat observationsverktyg i olika kontext och genom att observera kunna beskriva likheter eller skillnader mellan tekniska färdigheter. Observationerna i den aktuella studien är strukturerade med ett nyutvecklat observationsverktyg som är utvecklad för att bedöma en operationssjuksköterskas tekniska färdigheter. De två författarna till denna studie genomförde datainsamlingen samtidigt på olika operationsavdelningar. Den aktuella studiens resultat visar att de tekniska färdigheterna som krävs av en operationssjuksköterska är betydligt olika i två olika länder. Därför är det svårt att använda ett observationsverktyg utan att anpassa det enligt de lokala rutinerna.

While most people with schizophrenia face the functional consequences of a lifelong disorder, very few studies have investigated the specific domain of daily living activities performance. The purpose of this thesis was to examine the relationships between daily activity performance, cognitive deficits, and community functioning in people with schizophrenia. More specifically, the objectives were: 1) to describe functional limitations during daily task performance, 2) to explore the existence of subgroups of participants with similar functional limitations profiles, 3) to explore the relationships between daily task performance and cognitive functions as well as 4) with community functioning. This thesis tested the hypothesis that limitations in task performance negatively influence community functioning. / A sample of 82 individuals with schizophrenia and 28 healthy controls participated in this study and were assessed during a meal preparation task with the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis and on cognitive tests of visuospatial memory, spatial working memory, visuomotor coordination, planning and selective attention. Community functioning was assessed with the Independent living Skills Survey and the Multnomah Community Ability Scale. Limitations in the Perceive, Recall and Plan quadrants of the PRPP System, were found in participants with schizophrenia when compared to a control group (n = 28), as well as in the complete sample (n = 82). Participants in the high-efficiency subgroup ( n =36) were more independent in daily living and performed better on the visuospatial associative learning task than the low-efficiency subgroup (n = 46). At the specific level of individual profiles, participants were distributed along a continuum of low- to high-functioning on the PRPP System factors and on functional, cognitive, and clinical characteristics. / The associative learning task was most associated with task performance, along with working memory and planning. Finally, less efficient planning skills were associated with a lower level of community functioning, confirming the hypothesis. These results emphasize the relationship of associative visual memory to daily task performance, as well as that of efficiency in daily activities for residential status. Integrating these findings into the rehabilitation process will contribute to better meeting the needs of people with schizophrenia.

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

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 6 uppsatser.

Thesis (Ph. D.)--University of Missouri-Columbia, 2008. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. "May 2008" Includes bibliographical references.