This thesis examines the effect of an individually targeted exercise programme when compared to a general exercise programme in patients with Chronic Obstructive Pulmonary Disease (COPD). The effect ...of these programmes upon domestic function and daily activity is also examined. Initially, the test-retest reliability of the primary measure of domestic function, the Canadian Occupational Performance Measure (COPM) was examined. The COPM was completed in 15 patients with stable COPD. The intra class correlation coefficients were high indicating that the COPM is a reliable measure in patients with COPD. A large randomised prospective trial was then completed. 185 patients with stable COPD referred for seven-week hospital based, outpatient pulmonary rehabilitation programme, were recruited. A third of these patients (n=61) were initially assigned to a pre treatment group in order to establish the variability of all outcome measures. Patients were randomly assigned to either a general exercise programme (GEP) (n=90) or an individually targeted exercise programme (ITEP) (n=90). Functional targets for patients in the ITEP were identified using the COPM. Activity monitors measured daily activity. Exercise performance was measured using the Incremental Shuttle Walking Test and the Endurance Shuttle Walk Test and measures of health status were also employed. Both treatment groups made statistically significant improvements in domestic function, exercise performance and health status. However there were no statistically significant differences between the GEP and the ITEP. This study demonstrated that general exercise training is as effective as more complex individually targeted training. ITEP is no more effective at prolonging the benefits of pulmonary rehabilitation when compared the GEP.
This study investigated changes in positive perceptions of illness following rehabilitation. Patients completed the 38 positive-item Silver Lining Questionnaire (SLQ) on two occasions: 20 chronic ...obstructive pulmonary disease (COPD) patients on entry to a waiting list and at the start of rehabilitation; 35 COPD and 29 cardiac patients at the start and end of a rehabilitation programme. At first assessment, on average, between seven and 13 items were endorsed depending on group. Positivity increased after rehabilitation for COPD patients ( p <0.01), and cardiac patients ( p <0.001): on average three and four additional items were endorsed respectively. There was no change in positivity for patients on the waiting list. The data suggest that rehabilitation leads to an increase in perceived positive consequences of illness.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
34.
In remembrance of William Christopherson, MD Schrodt, G Randolph; Sewell, Catherine Louise
Archives of pathology & laboratory medicine (1976),
12/2008, Letnik:
132, Številka:
12
Journal Article
Recenzirano
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Functional assessment-based interventions are a tertiary support that have been incorporated in many three-tiered models of prevention to support students who do not respond to more global prevention ...efforts. Although endorsed by host of reputable organizations (e.g., National Association of School Psychologists) and mandated in Individuals with Disabilities Education Act (IDEA, 1997, 2004), concerns have been raised that this mandate may not be warranted if functional assessment-based interventions do not meet minimum criteria to establish this as an evidence-based practice. One issue contributing to this concern is variability in the functional assessment process. John Umbreit and colleagues (2007) have attempted to address this concern by introducing a systematic approach that includes (a) a Function Matrix to analyze functional assessment data and identify the hypothesized function(s) of the target behavior and (b) a Function-Based Intervention Decision Model to guide intervention planning. In this chapter, we applied the core quality indicators for single-case research developed by Horner, Carr, Halle, McGee, Odom, and Wolery (2005) to studies conducted using this practice to determine the extent to which this systematic approach to functional assessment-based interventions met the standards for evidence-based practices for use in educational settings across the K-12 continuum for students with or at-risk for high incidence disabilities. If this practice is deemed to meet criteria, then this systematic approach may be particularly useful in meeting the mandate established in IDEA. Results suggest that it may be appropriate to establish this systematic method as a promising practice.
Pulmonary rehabilitation can help patients with chronic obstructive pulmonary disease improve their exercise tolerance and quality of life. Care packages can be devised and managed by respiratory ...nurses.
INTRODUCTION
This study investigated whether self‐reported sleep quality is associated with brain amyloid beta (Aβ) accumulation.
METHODS
Linear mixed effect model analyses were conducted for 189 ...cognitively unimpaired (CU) older adults (mean ± standard deviation 74.0 ± 6.2; 53.2% female), with baseline self‐reported sleep data, and positron emission tomography‐determined brain Aβ measured over a minimum of three time points (range 33.3–72.7 months). Analyses included random slopes and intercepts, interaction for apolipoprotein E (APOE) ε4 allele status, and time, adjusting for sex and baseline age.
RESULTS
Sleep duration <6 hours, in APOE ε4 carriers, and sleep efficiency <65%, in the whole sample and APOE ε4 non‐carriers, is associated with faster accumulation of brain Aβ.
DISCUSSION
These findings suggest a role for self‐reported suboptimal sleep efficiency and duration in the accumulation of Alzheimer's disease (AD) neuropathology in CU individuals. Additionally, poor sleep efficiency represents a potential route via which individuals at lower genetic risk may progress to preclinical AD.
Highlights
In cognitively unimpaired older adults self‐report sleep is associated with brain amyloid beta (Aβ) accumulation.
Across sleep characteristics, this relationship differs by apolipoprotein E (APOE) genotype.
Sleep duration <6 hours is associated with faster brain Aβ accumulation in APOE ε4 carriers.
Sleep efficiency < 65% is associated with faster brain Aβ accumulation in APOE ε4 non‐carriers.
Personalized sleep interventions should be studied for potential to slow Aβ accumulation.
