Rationale: Diagnosis of sarcopenia in older adults is essential for early treatment in clinical practice. Bio-electrical impedance analysis (BIA) may be a valid means to assess appendicular lean mass (ALM) in older adults, but limited evidence is available. Therefore, we aim to evaluate the validity of BIA to assess ALM in older adults.Methods: In 215 community dwelling older adults (age ≥ 55 years), ALM was measured by BIA (Tanita MC-780; 8-points) and compared with dual-energy X-ray absorptiometry (DXA, Hologic Discovery A) as reference. Validity for assessing absolute values of ALM was evaluated by: 1) bias (mean difference), 2) percentage of accurate predictions (within 5% of DXA values), 3) individual error (root mean squared error (RMSE), mean absolute deviation), 4) limits of agreement (Bland-Altman analysis). For diagnosis of low ALM, the lowest quintile of ALM by DXA was used (below 21.4 kg for males and 15.4 for females). Sensitivity and specificity of detecting low ALM by BIA were assessed.Results: Mean age of the subjects was 71.9 ± 6.4, with a BMI of 25.8 ± 4.2 kg/m2, and 70% were females. BIA slightly underestimated ALM compared to DXA with a mean bias of -0.6 ± 0.2 kg. The percentage accurate predictions was 54% with RMSE 1.6 kg and limits of agreements −3.0 to +1.8 kg. Sensitivity was 79%, indicating that 79% of subjects with low ALM according to DXA also had low ALM with the BIA. Specificity was 90%, indicating that 90% of subjects with ‘no low’ ALM according to DXA also had ‘no low’ ALM with the BIA.Conclusions: This comparison showed a poor validity of BIA to assess absolute values of ALM, but a reasonable sensitivity and specificity to diagnose a low level of ALM in community-dwelling older adults in clinical practice.Disclosure of interest: None declared.
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Purpose – The purpose of this paper is to examine the prevalence of psychopathology including substance use disorders in a sample of detained female systematic offenders.Design/methodology/approach – All case files of female systematic offenders who had been subjected to a special court order for systematic offenders in the period 2004-2014 were studied. A total of 81 fairly complete case files were selected for the study. These were all systematic offenders as they had been sentenced for at least 25 offences with an average of 102 offences over a period of 17.5 years. Findings – All except one woman were addicted to substances in the past year, with an average duration of addiction of 21 years. In addition, 53 per cent were diagnosed with another DSM Axis I disorder and 73 per cent were diagnosed with a personality disorder. Furthermore, 32-59 per cent were found to haveintellectual dysfunctions. In total, 12 per cent had one type of the above disorders, 43 per cent two types, 31 per cent three types and 14 per cent all four types. The prevalence rates of these disorders were higher than those reported in other prison studies.Research limitations/implications – It is concluded that female systematic offenders can be characterised as problematic in many respects. Even in such a problematic group treatment can be provided.Originality/value – The present study is the only study that provides prevalence data of mental disorders among female systematic offenders.
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In this article a generic fault detection and diagnosis (FDD) method for demand controlled ventilation (DCV) systems is presented. By automated fault detection both indoor air quality (IAQ) and energy performance are strongly increased. This method is derived from a reference architecture based on a network with 3 generic types of faults (component, control and model faults) and 4 generic types of symptoms (balance, energy performance, operational state and additional symptoms). This 4S3F architecture, originally set up for energy performance diagnosis of thermal energy plants is applied on the control of IAQ by variable air volume (VAV) systems. The proposed method, using diagnosis Bayesian networks (DBNs), overcomes problems encountered in current FDD methods for VAV systems, problems which inhibits in practice their wide application. Unambiguous fault diagnosis stays difficult, most methods are very system specific, and finally, methods are implemented at a very late stage, while an implementation during the design of the HVAC system and its control is needed. The IAQ 4S3F method, which solves these problems, is demonstrated for a common VAV system with demand controlled ventilation in an office with the use of a whole year hourly historic Building Management System (BMS) data and showed it applicability successfully. Next to this, the influence of prior and conditional probabilities on the diagnosis is studied. Link to the formal publication via its DOI https://doi.org/10.1016/j.buildenv.2019.106632
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The purpose of this article is the presentation of a multidimensional guideline for the diagnosis of anxiety and anxiety-related behavior problems in people with intellectual disability (ID), with a substantial role for the nurse in this diagnostic process. DESIGN AND METHODS: The guideline is illustrated by a case report of a woman with ID with severe problems. FINDINGS: It appears that a multidimensional diagnostic approach involving multidisciplinary team efforts can result in a more accurate diagnosis and improved subsequent treatment. PRACTICE IMPLICATIONS: Nurses should be engaged in the diagnostic process because of their ability to make direct observations and to actively participate in carrying out all parts of the guideline.
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Background/Aims: Analogy learning, a motor learning strategy that uses biomechanical metaphors to chunk together explicit rules of a to-be-learned motor skill. This proof-of-concept study aims to establish the feasibility and potential benefits of analogy learning in enhancing stride length regulation in people with Parkinson’s. Methods: Walking performance of thirteen individuals with Parkinson’s was analysed using a Codamotion analysis system. An analogy instruction; “following footprints in the sand” was practiced over 8 walking trials. Single- and dual- (motor and cognitive) task conditions were measured before training, immediately after training and 4-weeks post training. Finally, an evaluation form was completed to examine the interventions feasibility. Findings: Data from 12 individuals (6 females and 6 males, mean age 70, Hoehn and Yahr I-III) were analysed, one person withdrew due to back problems. In the single task condition, statistically and clinically relevant improvements were obtained. A positive trend towards reducing dual task costs after the intervention was demonstrated, supporting the relatively implicit nature of the analogy. Participants reported that the analogy was simple to use and became easier over time. Conclusions: Analogy learning is a feasible and potentially implicit (i.e. reduced working memory demands) intervention to facilitate walking performance in people with Parkinson’s.
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Background: The diagnosis of sarcopenia is essential for early treatment of sarcopenia in older adults, for which assessment of appendicular lean mass (ALM) is needed. Multi-frequency bio-electrical impedance analysis (MF-BIA) may be a valid assessment tool to assess ALM in older adults, but the evidences are limited. Therefore, we validated the BIA to diagnose low ALM in older adults.Methods: ALM was assessed by a standing-posture 8 electrode MF-BIA (Tanita MC-780) in 202 community-dwelling older adults (age ≥ 55 years), and compared with dual-energy X-ray absorptiometry (DXA) (Hologic Inc., Marlborough, MA, United States; DXA). The validity for assessing the absolute values of ALM was evaluated by: (1) bias (mean difference), (2) percentage of accurate predictions (within 5% of DXA values), (3) the mean absolute error (MAE), and (4) limits of agreement (Bland-Altman analysis). The lowest quintile of ALM by DXA was used as proxy for low ALM (< 22.8 kg for men, < 16.1 kg for women). Sensitivity and specificity of diagnosing low ALM by BIA were assessed.Results: The mean age of the subjects was 72.1 ± 6.4 years, with a BMI of 25.4 ± 3.6 kg/m2, and 71% were women. BIA slightly underestimated ALM compared to DXA with a mean bias of -0.6 ± 1.2 kg. The percentage of accurate predictions was 54% with a MAE of 1.1 kg, and limits of agreement were -3.0 to + 1.8 kg. The sensitivity for ALM was 80%, indicating that 80% of subjects who were diagnosed as low ALM according to DXA were also diagnosed low ALM by BIA. The specificity was 90%, indicating that 90% of subjects who were diagnosed as normal ALM by DXA were also diagnosed as normal ALM by the BIA.Conclusion: This comparison showed a poor validity of MF-BIA to assess the absolute values of ALM, but a reasonable sensitivity and specificity to recognize the community-dwelling older adults with the lowest muscle mass.
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This study aims to explore the experiences and needs of individuals after a first episode of psychosis with regard to the way in which information about diagnosis, treatment options and prognosis is communicated with them. psychosis, communicating, stigma, needs, individual’s perception
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Background Anxiety and challenging behaviour (CB) often occur simultaneously in people with intellectual disabilities (ID). Understanding the associations between anxiety and CB may contribute to more accurate diagnoses and management of both anxiety and CB in this population. Aims To examine the relationship between anxiety and CB. Methods A literature review covering the period from January 2000 to January 2012. Results Seven studies about the relationship between psychiatric disorders, including anxiety, and CB were identified. These studies confirm the relationship between anxiety and CB in people with ID, although the precise nature of this relationship remains unclear. Conclusions The study points toward the existence of a moderate association between anxiety and CB. Further research is needed to clarify the complex nature of the association between anxiety and CB.
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Clinical decision support systems (CDSSs) have gained prominence in health care, aiding professionals in decision-making and improving patient outcomes. While physicians often use CDSSs for diagnosis and treatment optimization, nurses rely on these systems for tasks such as patient monitoring, prioritization, and care planning. In nursing practice, CDSSs can assist with timely detection of clinical deterioration, support infection control, and streamline care documentation. Despite their potential, the adoption and use of CDSSs by nurses face diverse challenges. Barriers such as alarm fatigue, limited usability, lack of integration with workflows, and insufficient training continue to undermine effective implementation. In contrast to the relatively extensive body of research on CDSS use by physicians, studies focusing on nurses remain limited, leaving a gap in understanding the unique facilitators and barriers they encounter. This study aimed to explore the facilitators and barriers influencing the adoption and use of CDSSs by nurses in hospitals, using an extended Fit Between Individuals, Tasks, and Technology (FITT) framework.
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De module “Diagnostiek van Angst en Gedragsproblemen” bestaat uit 3 onderdelen: 1) Achtergronden, 2) Het werkboek, 3) Invullijsten Ze is bedoeld voor multidisciplinaire teams (begeleiders, teamleiders, gedragswetenschappers, vaktherapeuten, artsen (AVG)). Beleidsmakers en andere geïnteresseerden kunnen eveneens kennis nemen dit document. Tevens is een implementatiehandleiding toegevoegd. De module is ontwikkeld tussen 2005 tot 2008 en getoetst met een wetenschappelijk onderzoek tussen 2009 tot 2014. Tijdens dit onderzoek is de module toegepast en zijn de resultaten verwerkt. Tijdens de ontwikkeling van de module is samengewerkt met organisaties uit de praktijk. Dit achtergronddocument beschrijft de opbouw van de module, de theorie en tot slot de aanbevelingen. De instructies voor dit team zijn opgenomen in het werkboek. Het werkboek bevat daarnaast ook specifieke instructies voor de (persoonlijk) begeleider. Voor de observaties die begeleiders uitvoeren zijn invullijsten beschikbaar.
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