Lower Level Of Independence Research Articles

Socio-demografske karakteristike kao determinante kvaliteta života i depresivnosti starih u Srbiji

Studying the process of aging and old age is an important question in social sciences. The quality of life at this age, among other things, is being enriched with new life opportunities and challenges, as well as developmental tasks every single individual has to face with. Therefore the focus of this research is the correlation of the quality of life and depressiveness with different demographic characteristics of older people in Serbia. The demographic variables included: gender, age, education, marital status and monthly income of the respondents. The quality of life is measured using the Older People's Quality of Life Questionnaire - OPQOL (Bowling, 2009), as well as several questions on life domain satisfaction and chronical disease, while depressiveness was measured using Geriatric Depression Scale - GDS (Greenberg, 2007). The sample was a convenience one, consisted of 497 respondents, 50,35% of men and 49,7% of women, 65-92 years old. The final results show that the quality of life of older people in Serbia is within the average range, and depressiveness belongs to the -category with the level of mild occurence. Men are more satisfied with a job they have or used to have, while women better estimate their independence and control over their life. The age of respondents positively correlates with marital satisfaction, satisfaction with job, with parental role, health, social relations, independence and monthly incomes. The amount of monthly income positively correlates with job satisfaction and well-being, while it is negatively correlated with health, social relations, independence, home and neighbourhood, financial status and the depressiveness of the respondents. The level of education is significantly correlated with marital satisfaction, job, whole life, health, social relations and activities, satisfaction with home and neighbourhood, emotional and psychic well-being, financial status and the level of depressiveness of the respondents. The persons who are still married are more satisfied with marriage and their own parenthood, with well-being, have a higher level of satisfaction with their religious and cultural life, while there is a lower level of depressiveness in regard to the persons who are not married. The respondents who have some kind of a chronic disease are less satisfied with life, generally speaking, because of poor health; they have a lower level of independence and satisfaction with their own home and neighbourhood, a lower level of well-being and less satisfaction with their monthly income. However, they showed a lower level of depressiveness in regard to the ones who have no chronic diseases. Socio-demographic characteristics of the respondents, as well as somatic chronic disease and depressiveness are significant indicators of the quality of life of older people. Being aware of the already known quality of life of older people can point out some practical implications important for creating and implementing the programmes intended for older people, while being focused on the improvement of the quality of life and standards.

The Corporate Governance of Australian Listed Construction Companies

This paper compares the compliance level of Australian StockExchange (ASX) listed construction and non-constructioncompanies with the ASX Corporate Governance Council (CGC)recommendations on sound corporate governance. It alsoexamines the difference in board characteristics between thetwo groups, paying particular attention to differences in boardindependence. It concludes that compared with the top 20 ASXlisted non-construction companies, listed construction companiesare less compliant overall particularly with regards to boardstructure, and have lower levels of independence both in terms ofCEO/Chairperson duality, the ratio of executive to non-executiveindependent directors and independent membership of nomination,remuneration and audit committees. These conclusions areimportant because sound corporate governance has beenassociated with higher levels of organisational resilience derivedfrom the reputational and fi nancial benefi ts of greater transparency,market value, investor attractiveness and organisationalperformance.

Factors predicting quality of life in a group of Polish subjects with multiple sclerosis: Accounting for functional state, socio-demographic and clinical factors

ObjectivesQuality of life (QoL) has presently a firmly established position as an important endpoint in medical care. Multiple sclerosis (MS) is a chronic neurological disease with considerable effect on patients’ QoL. QoL of MS patients from many European countries has already been assessed but little is known on health-related QoL of Polish subjects with MS. Few studies have taken into consideration multiple predictors of QoL. The aim of this study was to elicit the most relevant factors that determine QoL of Polish group of MS patients. Socio-demographic and clinical factors as well as the influence of disability level were analyzed in this study. Patients and methods173 MS patients and 86 healthy controls underwent assessment using the Mini Mental Status Examination, WHOQOL-100, Beck Depression Inventory and Fatigue Severity Scale. Data were analyzed by a stepwise linear regression analysis. ResultsMS patients had significantly worse global QoL and worse QoL in physical and psychological health domains, lower level of independence, worse social relations and were less satisfied with the surrounding environment they lived in compared with healthy controls (p<0.05). MS subjects had also higher level of depression and fatigue compared to healthy controls (p<0.05). ConclusionsThe study determined that the strongest predictors of global QoL of Polish MS patients were depression, disability level and fatigue.

Adult psychosocial outcomes of children with specific language impairment, pragmatic language impairment and autism

Background: The few studies that have tracked children with developmental language disorder to adulthood have found that these individuals experience considerable difficulties with psychosocial adjustment (for example, academic, vocational and social aptitude). Evidence that some children also develop autistic symptomatology over time has raised suggestions that developmental language disorder may be a high-functioning form of an autism spectrum disorder (ASD). It is not yet clear whether these outcomes vary between individuals with different subtypes of language impairment.Aims: To compare the adult psychosocial outcomes of children with specific language impairment (SLI), pragmatic language impairment (PLI) and ASD.Methods & Procedures: All participants took part in research as children. In total, there were 19 young adults with a childhood history of Specific Language Impairment (M age = 24;8), seven with PLI (M age = 22;3), 11 with high functioning ASD (M age = 21;9) and 12 adults with no history of developmental disorder (Typical; n = 12; M age = 21;6). At follow-up, participants and their parents were interviewed to elicit information about psychosocial outcomes.Outcomes & Results: Participants in the SLI group were most likely to pursue vocational training and work in jobs not requiring a high level of language/literacy ability. The PLI group tended to obtain higher levels of education and work in ‘skilled’ professions. The ASD participants had lower levels of independence and more difficulty obtaining employment than the PLI and SLI participants. All groups had problems establishing social relationships, but these difficulties were most prominent in the PLI and ASD groups. A small number of participants in each group were found to experience affective disturbances. The PLI and SLI groups showed lower levels of autistic symptomatology than the ASD group.Conclusions & Implications: The between-group differences in autistic symptomatology provide further evidence that SLI, PLI, and ASD are related disorders that vary along qualitative dimensions of language structure, language use and circumscribed interests. Childhood diagnosis showed some relation to adult psychosocial outcome. However, within-group variation highlights the importance of evaluating children on a case-by-case basis.

Characteristics and Rehabilitation Outcomes Among Patients With Blast and Other Injuries Sustained During the Global War on Terror

Sayer NA, Chiros CE, Sigford B, Scott S, Clothier B, Pickett T, Lew HL. Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror. ObjectiveTo describe characteristics and rehabilitation outcomes among patients who received inpatient rehabilitation for blast and other injuries sustained in Iraq and Afghanistan during the Global War on Terror. DesignObservational study based on chart review and Department of Veterans Affairs (VA) administrative data. SettingThe 4 VA polytrauma rehabilitation centers (PRCs). ParticipantsService members (N=188) admitted to a PRC during the first 4 years of the Global War on Terror for injuries sustained during Operation Iraqi Freedom or Operation Enduring Freedom. InterventionMultidisciplinary comprehensive rehabilitation program. Main Outcomes MeasuresCognitive and motor FIM instrument gain scores and length of stay (LOS). ResultsMost war-injured patients had traumatic brain injury, injuries to several other body systems and organs, and associated pain. Fifty-six percent had blast-related injuries, and the pattern of injuries was unique among those with injuries secondary to blasts. Soft tissue, eye, oral and maxillofacial, otologic, penetrating brain injuries, symptoms of post-traumatic stress disorder, and auditory impairments were more common in blast-injured patients than in those with war injuries of other etiologies. The mechanism of the injury did not predict functional outcomes. LOS was variable, particularly for those with blast injuries. Patients with low levels of independence at admissions made the most progress but remained more dependent at discharge compared with other PRC patients. The rate of gain was slower in this low-functioning group. ConclusionsBlasts produce a unique constellation of injuries but do not make a unique contribution to functional gain scores. Findings underscore the need for assessment and treatment of pain and mental health problems among patients with polytrauma and blast-related injuries. Patients with polytrauma have lifelong needs, and future research should examine needs over time after community re-entry.

Modelling deterioration of foot health in older people following discharge from NHS podiatry services

Background Podiatry services across the country have different access criteria for treatment and increasing pressure on resources has led to increasing moves to ‘treat and discharge’ rather than retaining patients for regular monitoring. Aim This study seeks to model the probability of the development of a medium or high risk foot pathology following discharge from NHS podiatry services. Method Clinical foot health data were collected from 343 patients aged 65 years and over who had been discharged from NHS podiatry services and who had a ‘low risk’ podiatric condition. These patients were followed up at approximately 8 monthly intervals and a maximum of 3 assessments per patient were obtained (on 247 patients). A logistic regression analysis was performed to predict the probability of developing a medium or high risk podiatric complaint within the time limit of the study (mean time from discharge to completion of third assessment = 26 months, S.D. = 8.7 m). Results Eleven percent of the sample developed high-risk conditions and 4% developed medium risk conditions within the time of the study. Three risk factors were found for the development of medium to high-risk pathology. These were low levels of independence (OR = 0.65, 95% CI = 0.45–0.94), age at discharge (OR = 1.069, 95% CI = 1.003–1.139) and a diabetes/age interaction. Conclusions Logistic regression analysis allows risk factors for deterioration of foot health after discharge from NHS podiatry services to be identified. The main risk factors are related to lack of independence, age and having diabetes. The study found a relatively high proportion of older people deteriorated rapidly without professional surveillance. The results of this study indicate that regular foot health monitoring would prevent undetected deterioration and should be targeted at older age groups, at those who have decreased levels of independence and those with diabetes.

FEVER DURING POST-ACUTE REHABILITATION IN PATIENTS WITH BRAIN INJURY

To investigate the incidence of fever during the post-acute rehabilitation phase in patients with brain injury. Prospective study. Seventy-four patients with brain injury. Patients were evaluated for the presence of fever during the rehabilitation phase. Demographics, time since injury, acute hospital and rehabilitation stay, brain injury and clinical characteristics were recorded for all subjects. Of the study group, 36 patients (36/74; 48.6%) had at least 1 event qualified as fever. The most common cause of fever was urinary tract infection. There were only 2 patients considered as having central fever. Fever was significantly more frequent in patients with a greater number of neurological impairments, more severe neurological impairments and a lower level of independence. The rehabilitation stay was prolonged in patients with fever. The average length of rehabilitation stay was 62.5 days and 49.8 days in patients with or without fever, respectively. Infection is the most common cause of fever after brain injury and the incidence of central fever is low.

A method for measuring quality of life through subjective weighting of functional status

Stineman MG, Wechsler B, Ross R, Maislin G. A method for measuring quality of life through subjective weighting of functional status. Arch Phys Med Rehabil 2003;84 Suppl 2:S15-22. Objective: To apply a new tool to understand the quality of life (QOL) implications of patients[apos ] functional status. Design: Results from the Features-Resource Trade-Off Game were used to form utility weights by ranking functional activities by the relative value of achieving independence in each activity compared with all other component activities. The utility weights were combined with patients[apos ] actual levels of performance across the same activities to produce QOL-weighted functional status scores and to form [ldquo ]value rulers[rdquo ] to order activities by perceived importance. Setting: Persons with severe disabilities living in the community and clinicians practicing in various rehabilitation disciplines. Participants: Two panels of 5 consumers with disabilities and 2 panels of 5 rehabilitation clinicians. Interventions: The 4 panels played the Features Resource Trade-Off Game by using the FIMTTM instrument definitions. Main Outcome Measures: Utility weights for each of the 18 FIM items, QOL-weighted FIM scores, and value rulers. Results: All 4 panels valued the achievement of independence in cognitive and communication activities more than independence in physical activities. Consequently, the unweighted FIM scores of patients who have severe physical disabilities but relatively intact cognitive skills will underestimate QOL, while inflating QOL in those with low levels of independence in cognition and communication but higher physical function. Conclusion: Independence in some activities is more valued than in others; thus, 2 people with the same numeric functional status score could experience very different QOL. QOL-weighted functional status scores translate objectively measured functional status into its subjective meaning. This new technology for measuring subjective function-related QOL has a variety of applications to clinical, educational, and research practices.

An Experimental Investigation of Retention and Rotation Requirements

We provide results from an experiment designed to assess whether mandatory rotation and/or retention of auditors increases auditors' independence by reducing their willingness to issue reports biased in favor of management. Auditors' reporting is compared across the following four regimes: one that does not require either rotation or retention, a second that requires retention only, a third that requires rotation only, and a fourth that requires both rotation and retention. We find that the rotation requirements in the third and fourth regimes decreased auditor‐subjects' willingness to issue biased reports, relative to the two regimes in which rotation was not imposed. In these other two regimes, however, many manager‐subjects voluntarily retained the same auditor‐subjects over multi‐periods. While the long running interactions between manager‐ and auditor‐subjects resulted in more favorable reports by auditor‐subjects (a lower level of independence), the established relationships also induced manager‐subjects to make higher investments.

Assistive devices used by home-based elderly persons with arthritis.

This article examines assistive device use by home-based elderly persons with arthritis. Sixty-six persons were interviewed for the State University of New York at Buffalo (University at Buffalo) Rehabilitation Engineering Research Center Consumer Assessment Study, which sought information on need for and current use of assistive devices. Subjects were assigned to a moderate or a severe arthritis group according to the impact of arthritis on their activities. Subjects in the severe arthritis group had more chronic diseases, a higher level of pain, and a lower level of independence in self-care activities than subjects in the moderate arthritis group. Similarities between the groups included relatively poor health, high rate of medication use, depression, use of a high number of assistive devices (about 10 per person), and an expressed need for additional devices, such as reachers, magnifiers, grab bars, jar openers, and hearing aids. Generally, there was a high rate of satisfaction with the assistive devices used. Most subjects missed being able to participate in at least one activity; most of these activities were active and many related to leisure time. Findings also revealed that subjects had inadequate information on assistive devices, which suggests the importance of more occupational therapy involvement with elderly persons in selecting devices.

Are hospital assessments of daily living activities valid?

The level of functional achievement gained during a rehabilitation programme provides the basis for supplying aids and requesting community services on discharge. In a study of follow up regimes for patients with rheumatoid arthritis a comparison was made between functional assessments in hospital before discharge and at home shortly after discharge. A small number of the activities assessed showed a significant change at home and these changes were all towards a lower level of independence.