Physical Independence Research Articles

“Doctor, What Would You do if You Were Me?” - A Survey of Physician Perspectives Toward Glioblastoma Resection

How maximal safe resection (MSR) of glioblastoma is implemented in the clinical setting remains understudied. Here, we utilized a survey-based approach to understand physician perspectives on this matter. Scenarios involving glioblastomas were presented to physicians who were asked to select from planned sub-total resection (STR), gross total resection (GTR), medical therapy only, or palliative care. Demographic, experience, and Likert scales of value assessment were collected. In the scenario involving a corpus callosum glioblastoma, 2.33% opted for GTR. For a right frontal glioblastoma, 91.7% opted for GTR. In contrast, only 30.8% chose GTR of a right motor strip glioblastoma (p< 0.001). When presented with a left motor strip glioblastoma, fewer respondents (12.7%,p < 0.001) opted for GTR. Physicians who placed a high value on preserving physical independence were more likely to forgo GTR for right motor glioblastomas (HR=0.068,95% CI:0.47-0.97,p=0.035), and physicians who placed a high value on their faith were more likely to opt for surgical treatments that differ from the general consensus, for instance opting for GTR of the corpus callosum glioblastoma (HR=4.18,95%CI:1.63-10.74,p=0.003). No other associations were found between the choice for GTR and other variables collected. Our results suggest that while maximal safe resection remains a guiding principle for glioblastoma resection, physician preference in terms of the extent of resection varies significantly as a function of tumor location and personal values.

Physical fitness in the elderly

This semi-experimental study aimed to investigate the impact of personalized and supervised exercise on the physical fitness of elderly people. Ninety people aged 60 or over took part in the study, in which significant improvements were observed in various dimensions of physical fitness. The data analyzed showed significant improvements in several dimensions of physical fitness. In particular, localized muscular strength and endurance showed substantial gains, highlighting the effectiveness of our exercise programs in improving functional capacity. When comparing the diagnostic and formative assessments, differences were observed, including improvements in body composition, localized muscular endurance, muscular strength and a positive evolution in the general fitness index (∆% = 7.89%, p&gt;0.0001). This study emphasizes the possible benefits of individualized and supervised exercise programs to promote physical fitness and independence in the elderly population.

Physical independence and related factors among older adults: a systematic review and meta-analysis

Background: Adopting a physically active lifestyle is advocated as a strategy to prevent loss of physical independence and support healthy aging. This study aimed to evaluate the physical independence and related factors among older adults. Materials and methods: This systematic review and meta-analysis was conducted through electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database from the earliest to 1 April 2022. Two researchers independently extracted information from the studies and evaluated the quality of the studies. The analysis was conducted using CMA program version 3, and each study’s importance was determined based on its inverse variance. Results: Five thousand seven hundred thirty-three older adults participated in this review in six studies. All evaluated studies had high quality. The mean score of physical independence in older adults was 20.07 (SE=0.76) out of 24 (95% CI: 18.58–21.56; I2 =98.573%; P&lt;0.001). Physical activity is very important for physical independence and reduces the risk of physical dependence in older adults. Other factors, such as sex, BMI, age, abnormal performance, timed performance, sufficiently active, muscle function, handgrip strength, lower extremity function, lower body strength, maximal isometric knee extension power, lung function, aerobic endurance, sedentary time, agility, and the prevalence of arthritis, had a significant relationship with physical independence in older adults. Conclusion: Older adults demonstrate favourable levels of physical independence. Notably, physical activity emerges as a significant determinant positively associated with such independence. Thus, policymakers and administrators are encouraged to strategize the creation of conducive environments for walking and exercise among older adults.

Tackling Non-Small Cell Lung Cancer in Young Adults: From Risk Factors and Genetic Susceptibility to Lung Cancer Profile and Outcomes.

Lung cancer has traditionally been associated with advanced age; however, its increasing incidence among young adults raises concerning questions regarding its etiology and unique considerations for this population. In contrast to the older population, the onset of lung cancer at younger age may be attributed to a complex interplay of incompletely understood individual susceptibility and prevalent environmental risk factors beyond tobacco smoke exposure, such as radon gas and air pollution, which are widespread globally. Consequently, this leads to distinct clinical and molecular profiles, requiring a tailored approach. Furthermore, a diagnosis of cancer represents a threatening event during the prime years of a young person's life, prompting concern about career development, social aspects, fertility aspirations, and physical independence. This poses significant additional challenges for health care professionals in a field that remains underexplored. This comprehensive review recognizes lung cancer in young adults as a distinct entity, exploring its clinical and molecular characteristics, diverse predisposing factors, and priorities in terms of quality of life, with the aim of providing practical support to oncologists and enhancing our understanding of this under-researched population.

Teaching Students With Disabilities in Chinese Regular Education Classrooms: Outcomes and Influential Factors

Purpose Learning in a regular classroom (LRC) has become the main educational placement for students with disabilities in China. This study investigates the outcomes of LRC and their influential factors from the teachers’ experiences and perspectives. Design/Approach/Methods Seven inclusive education teachers participated in semi-structured interviews. Thematic analysis was conducted to analyze the qualitative data. Findings The results show that social participation and contribution, physical presence, academic performance, self-concept, and independence are the key outcomes of LRC from inclusive education teachers’ experiences and perspectives. Moreover, the factors influencing the key desired outcomes include the severity of disabilities and problem behaviors, professional support, teaching practice, inclusive climate, and collaboration between schools and families. Originality/Value This study provides valuable insights into the outcomes and influential factors of inclusive education in the context of LRC in China. These findings inform efforts to improve inclusive education practices and enhance the educational experiences of students with special needs.

Evaluating the effects of hormone therapy termination on skeletal muscle and physical independence in postmenopausal women.

In women, the age-related decline in skeletal muscle structure and function is accelerated after menopause, which implicates the role of decreased circulating estrogen levels. Indeed, boosting estrogen, by means of postmenopausal hormone therapy (HT), generally proves beneficial to skeletal muscle. The evidence regarding whether these benefits persist even after cessation of HT is limited, nor is it clear how physical behavior (PB) impacts on benefits. Hence, this exploratory study focused on the interplay between HT administration/cessation, PB and in vivo skeletal muscle structure and function. Fifty healthy women (≥60 y) were included; 19 had an HT administration history (≥9 mo, with now ~8-y hiatus in treatment) and 31 no such history. On seven continuous days, PB data were collected using triaxial accelerometry and analyzed using compositional data analysis. Gastrocnemius medialis muscle volume, architecture, and function were determined using ultrasonography, electromyography, dual x-ray absorptiometry, and dynamometry. Current serum estradiol levels were measured using ELISA. Only fascicle length and duration of HT administration were positively associated. With respect to PB levels, we found a pattern suggesting greater vitality (higher physical activity and lower sedentarism) in previous HT users, compared with nonusers, despite the two groups currently no longer exhibiting significantly different levels of circulating estradiol. After an 8-year hiatus in treatment, HT provides limited advantages in gastrocnemius medialis muscle properties. Interestingly, it perhaps enhances vitality despite prolonged cessation, which in the longer term would facilitate greater physical independence, especially considering the association of sedentary behavior with greater frailty.

Creatine supplementation and resistance training to preserve muscle mass and attenuate cancer progression (CREATINE-52): a protocol for a double-blind randomized controlled trial

BackgroundMuscle mass is important for metastatic prostate cancer survival and quality of life (QoL). The backbone of treatment for men with metastatic castration sensitive prostate cancer (mCSPC) is androgen deprivation therapy (ADT) with an androgen signaling inhibitor. ADT is an effective cancer treatment, but it facilitates significant declines in muscle mass and adverse health outcomes important to mCSPC survivors, such as fatigue, and reductions in physical function, independence, insulin sensitivity, and QoL. In non-metastatic CSPC survivors, resistance training (RT) preserves muscle mass and improves these related health outcomes, but the biggest barrier to RT in CSPC survivors of all stages is fatigue. Creatine monohydrate supplementation coupled with RT (Cr + RT) may address this barrier since creatine plays a critical role in energy metabolism. Cr + RT in cancer-free older adults and other clinical populations improves muscle mass and related health outcomes. Evidence also suggests that creatine supplementation can complement cancer treatment. Thus, Cr + RT is a strategy that addresses gaps in survivorship needs of people with mCSPC. The purpose of this parallel, double-blind randomized controlled trial is to test the effects of 52-weeks of Cr + RT compared with placebo (PLA) and RT (PLA + RT) on muscle mass, other related health outcomes, and markers of cancer progression.MethodsWe will carry out this trial with our team’s established, effective, home-based, telehealth RT program in 200 mCSPC survivors receiving ADT, and evaluate outcomes at baseline, 24-, and 52-weeks. RT will occur twice weekly with elastic resistance bands, and an established creatine supplementation protocol will be used for supplementation delivery. Our approach addresses a major facilitator to RT in mCSPC survivors, a home-based RT program, while utilizing a supervised model for safety.DiscussionFindings will improve delivery of comprehensive survivorship care by providing a multicomponent, patient-centered lifestyle strategy to preserve muscle mass, improve health outcomes, and complement cancer treatment (NCT06112990).

Benefits of Pilates exercises on functional fitness and quality of life in older men: A quasi-experimental study

Introduction: As age increases, declines in basic motor skills are observed in older men. Limited physical activity-based interventions, such as Pilates exercises, focus on enhancing these basic motor skills. This study aimed to identify the benefits of Pilates exercises on functional fitness and the quality of life in older men. Material and Methods: Older men were randomly assigned to either a Pilates exercises group or a control group. Balance, strength, flexibility, and agility were tested using the Senior Fitness Test (SFT). The Quality-of-Life Questionnaire (SF-36) assessed the quality of life before and after 6 weeks of Pilates exercises. Differences over time between the experimental and control groups were assessed by 2×2 (group by time) repeated-measures analysis of variance. Results: The mean scores of dynamic balance and lower body strength significantly improved post-intervention in both groups, but the level of significance was higher in the Pilates group. Flexibility, agility, and quality of life significantly improved in the Pilates group. Conclusions: Pilates exercises may improve the physical and social independence of older men. Designing appropriate protocols for Pilates exercises and doing these exercises correctly and regularly by older men may reduce their common mobility problems and limit the risk of falls that cause severe injuries in older people. However, further research is needed.

Human sensorimotor resting state beta events and aperiodic activity show good test–retest reliability

ObjectiveDiseases affecting sensorimotor function impair physical independence. Reliable functional clinical biomarkers allowing early diagnosis or targeting treatment and rehabilitation could reduce this burden. Magnetoencephalography (MEG) non-invasively measures brain rhythms such as the somatomotor ‘rolandic’ rhythm which shows intermittent high-amplitude beta (14–30 Hz) ‘events’ that predict behavior across tasks and species and are altered by sensorimotor neurological diseases. MethodsWe assessed test–retest stability, a prerequisite for biomarkers, of spontaneous sensorimotor aperiodic (1/f) signal and beta events in 50 healthy human controls across two MEG sessions using the intraclass correlation coefficient (ICC). Beta events were determined using an amplitude-thresholding approach on a narrow-band filtered amplitude envelope obtained using Morlet wavelet decomposition. ResultsResting sensorimotor characteristics showed good to excellent test–retest stability. Aperiodic component (ICC 0.77–0.88) and beta event amplitude (ICC 0.74–0.82) were very stable, whereas beta event duration was more variable (ICC 0.55–0.7). 2–3 minute recordings were sufficient to obtain stable results. Analysis automatization was successful in 86%. ConclusionsSensorimotor beta phenotype is a stable feature of an individual’s resting brain activity even for short recordings easily measured in patients. SignificanceSpontaneous sensorimotor beta phenotype has potential as a clinical biomarker of sensorimotor system integrity.

Identification and assessment of Electronic Aids for Daily Living considered essential by persons with high level tetraplegia: a case series

Although assistive technology (AT) is recognized as a basic human right, access to AT, and particularly electronic aids to daily living (EADL), is limited. We aimed to understand how persons with high level spinal cord injury (SCI) prioritize EADL needs and assess satisfaction and efficacy of self-identified EADL. Thus, in this case series, we recruited three participants with C4, C5 or C6 SCI receiving in-patient SCI rehabilitation. Each received dedicated occupational therapy-based assistance in identifying EADL items within an unrestricted envelope of support ($5000 CDN) for use in maximizing physical independence and supporting their return to community-based living. Items identified were categorized by need (emergency/security; home environment control; or virtual access to the outside world). Each participant selected distinct EADL. Evaluation of selected EADL items indicated very high satisfaction. The selected EADL contributed to participants’ returns to employment, community life, or reduced requirements for attendant services. These findings suggest that identification of essential technology should reflect the unique needs of each person and the context in which it will be used. These findings also support use of mainstream technology to meet EADL needs of individuals with limited physical abilities.

The Impact of Basic First Aid Training on Knowledge Levels of School-Aged Children

Aim: Children's increased physical activity and independence, coupled with their inability to take precautions, increases the risk of injury. Learning first aid is crucial in preventing deaths resulting from accidents or injuries, as well as preventing the worsening of the patient's condition and facilitating recovery. This study was conducted to determine the impact of basic first aid training on knowledge levels of school-aged children.&#x0D; Material and Method: This quasi-experimental study was conducted with 265 students in the 5th grade of four secondary schools in İstanbul. Data were collected using the “Information Form” and “Knowledge Assessment Form for First Aid Training”. Students received 90 minutes of instruction as part of their basic first aid training. Data were collected face-to-face before and one-month after the training.&#x0D; Results: The average age of the students was 10.17±0.45 years and 57.4% (n=152) were female. The students' mean first aid knowledge scores before and after the training were 63.94±5.35 and 92.67±9.70, respectively, and there was a statistically significant difference between them (p

Fit Islands: Designing a Multifunctional Virtual Urban Community to Promote Healthy Aging for Chinese Older Adults

Within the context of an aging global population, the demographic structure of emerging economies is undergoing a dramatic transformation. Emerging economies have a large population base and rapid economic development, but they are ill-prepared to deal with population aging. Limited resources force many older adults to face health issues such as chronic diseases and loss of physical independence, exacerbating the burden of traditional family and societal elderly care. Uncontrollable events such as the COVID-19 pandemic and regional conflicts have exacerbated the plight of older adults. Improving the quality of life and health of older adults has become a development priority in emerging economies in the face of a rapidly aging population. The development of smart cities has brought with it many available digital technologies, and the consequent development of smart aging offers endless possibilities for improving the quality of life and health of older people, making cities more inclusive of older people. Researchers from developed economies have attempted to address the health issues of older adults through a technology that combines physical exercise and digital technology called Exergame. However, existing projects are not suitable for older adults in emerging economies due to differences in national conditions. The aim of this project is therefore to propose a universal approach to designing a health-promoting Exergame system in the format of a virtual urban community to help emerging economies cope with aging populations, making cities more inclusive. To verify the feasibility of this approach, the authors designed an expandable Exergame called “Fit Islands”, using China as a case study. Based on the initial demonstration, the authors conducted functional tests. The result is that Fit Islands can meet the development objective of motivating Chinese older people to increase their physical activity, providing initial evidence of the feasibility of an Exergame system to promote healthy aging in emerging economies. The application of Fit Islands demonstrates the feasibility of the universal Exergame development method, which can, in principle, provide comprehensive and practical guidance for other countries.

Physical and Social Correlates of Rhythmic and Team Sports

This study aimed to compare the self-concepts and scholastic performances of the athlete and non-athlete high school students from Nueva Ecija using descriptive-correlational research method. Specifically, this study described the profile of the respondents in terms of age, gender, and academic performance and their self-concept as to their physical attributes, scholastic competence, athletic competence, artistic expression, autonomy and independence; global self-worth, goal setting, family relationship, morality and religiosity, social competence, romantic relationship, close friendship, and affiliation. Through t-test and Pearson product moment correlation, significant results were found out.

HIP fracture Supplemental Therapy to Enhance Recovery (HIPSTER): a protocol for a randomised controlled trial

IntroductionHip fractures result in substantial health impacts for patients and costs to health systems. Many patients require prolonged hospital stays and up to 60% do not regain their prefracture level...

Factors Influencing Social and Community Participation of People with Spinal Cord Injury in Karnataka, India.

Social and community participation are major indicators to assess the adequacy of treatment and rehabilitation in patients with spinal cord injury (SCI). This study examined the relationship between functional independence, level of disability, and social and community participation among people with SCI in India. In this cross sectional study, 110 persons with SCI, aged 18 years and above participated in a community setting, in Karnataka, India. Spinal Cord Independence Measure Version III-self-reporting (SCIM III-SR), Craig Handicap Assessment and Reporting Technique (CHART), and WHO Disability Assessment Schedule 2.0 (WHODAS) were the clinical outcome measures. Spearman's correlation and stepwise multiple linear regression were done to determine association and identify the factors determining the community participation of people with SCI. CHART physical independence had a positive correlation with SCIM self-care (R = 0.446) and SCIM mobility (r = 0.434). CHART cognitive independence (R = -0.38) and CHART mobility (R = -0.396) had a weak correlation with WHODAS. SCIM self-care and SCIM mobility (R2 = 0.34) were determinants of CHART cognitive independence. SCIM respiratory and sphincter management and SCIM self-care (R2 = 0.327) were determinants of CHART mobility. Self-care and mobility of people with SCI determine their ability to successfully reintegrate into the community, warranting a comprehensive community rehabilitation program.

Empowerment Model to Enhance Food Self-Sufficiency at Mushroom Industry Center

This research formulates a good and proper empowerment model for mushroom farmer groups in order to increase the self-sufficiency of mushroom food independence. The model developed through empowering mushroom farmers by making baglogs, F0 and F1, to the sale of fresh and processed mushroom products, both online and offline based among. Data collection is used through observation, interviews, questionnaires, documentation and surveys. The analysis method with project-based learning works directly on empowerment activities (mentoring, counseling, direct action services) in order to increase food self-sufficiency from upstream to downstream (making F0 seeds, F1 baglogs to production). Model development with path analysis is to build a among-based empowerment model formulation. The among-based empowerment strategy is developed and implemented through independent learning that places participants as objects and subjects. Participants in the empowerment of mushroom farmers, prioritize family values, physical and mental independence. The data analysis method uses the concept of a hypothetical model and analyzes the behavioral trends of mentoring participants and the results of the formulation of among-based empowerment are able to improve the mushroom food independence

Sonification for Personalised Gait Intervention.

Mobility challenges threaten physical independence and good quality of life. Often, mobility can be improved through gait rehabilitation and specifically the use of cueing through prescribed auditory, visual, and/or tactile cues. Each has shown use to rectify abnormal gait patterns, improving mobility. Yet, a limitation remains, i.e., long-term engagement with cueing modalities. A paradigm shift towards personalised cueing approaches, considering an individual's unique physiological condition, may bring a contemporary approach to ensure longitudinal and continuous engagement. Sonification could be a useful auditory cueing technique when integrated within personalised approaches to gait rehabilitation systems. Previously, sonification demonstrated encouraging results, notably in reducing freezing-of-gait, mitigating spatial variability, and bolstering gait consistency in people with Parkinson's disease (PD). Specifically, sonification through the manipulation of acoustic features paired with the application of advanced audio processing techniques (e.g., time-stretching) enable auditory cueing interventions to be tailored and enhanced. These methods used in conjunction optimize gait characteristics and subsequently improve mobility, enhancing the effectiveness of the intervention. The aim of this narrative review is to further understand and unlock the potential of sonification as a pivotal tool in auditory cueing for gait rehabilitation, while highlighting that continued clinical research is needed to ensure comfort and desirability of use.

Multiplex technique of data transmission in residual class systems

The research object: data transmission in optical communication lines. The subject of research is algorithms for the construction of digital data and methods of their transmission over buses in optical computer systems and in backbone fiber-optic systems. The problem to be solved is the need to devise new methods that ensure increased reliability and cryptographic stability of optical transmission systems. To solve the task, the issue of expanding the theory of timer signal structures and the system of residual classes for the organization of multifactorial multiplex data transmission through the channels of modern information transmission systems was investigated. The factor space is defined (as an example) for fiber optic transmission systems where different multiplexing options are used or may be used. The possibility of adapting algorithms for the construction of digital signal structures for their further transmission in the system of residual classes by various methods of multiplexing has been substantiated. The main principles of transmission were considered: the principle of independence of multiplexing the transmission of residues on each module and the principle of logical dependence and physical independence of the system of channels for transmission of residue values for a specific module of a specific system of residue classes. The basic principle is that at each specific point in time in the multivariate binary space, only one of the possible values of each factor can be equal to unity. A comparison with existing transmission systems shows that the proposed technique could provide data transmission at a speed of up to 16 Tbit/s in a transmission bandwidth of 200 THz. At the same time, the capacity of the alphabet of transmitted characters will be 39468 different characters. It also provides a significant increase in the reliability of the entire transmission system

What Matters Most: The Documented Goals, Values and Motivators of Advanced Cancer Patients.

Goals of care conversations are essential to delivery of goal concordant care. Infrequent and inconsistent goals of care documentation potentially limit delivery of goal concordant care. At Kaiser Permanente San Francisco Cancer Center, a standardized documentation template was designed and implemented to increase goals of care documentation by oncologists. The centralized, prompt-based template included value clarification of the goals and values of advanced cancer patients beyond treatment preferences. Documented conversations using the template during the initial pilot period were reviewed to characterization the clinical context in which conversations were recorded. Common goals and motivators were also identified. A total of 178 advanced cancer patients had at least 1 documented conversation by a medical oncologist using the goals of care template. Oncologists consistently documented within the template goals of therapy and motivating factors in decision making. The most frequently documented goals of care were "Avoiding Pain and Suffering," "Physical Independence," and "Living as Long as Possible." The least recorded goal was "Comfort Focused Treatment Only." Review of oncologist documented goals of care conversations using a prompt-based template allowed for characterization of the clinical context, therapy goals and motivators of advanced cancer patients. Communication of goals of care conversations by oncologists using a standardized prompt-based template within a centralized location has the potential to improve delivery of goal concordant care.

Examination of Perception of Nursing Care and Quality of Recovery in Surgical Patients According to Some Variables

Objective: The study aims to determine the relationship between the quality of care perception and healing quality levels of surgical patients and to determine the differences according to their characteristics. Materials and Methods: The descriptive cross-sectional study was carried out on 237 patients treated in the surgical clinics of a university hospital from December 2021 to May 2022. Data were collected using a descriptive information form, the Patient's Perception of Nursing Care Scale, and the Quality of Recovery-40 Scale. Results: The mean total score of the Patient's Perception of Nursing Care Scale was 71.45±9.81, and the mean total score of the Quality of Recovery-40 Scale was 106±15.95. The mean score of the physical independence sub-dimension of the Quality of Recovery-40 Scale was the highest (21.14±5.73), and the mean score of the pain sub-dimension was the lowest (9.32±3.57). There was statistically significant relationship between gender, having a companion, and Patient's Perception of Nursing Care Scale and between having a chronic disease and the Quality of Recovery-40 Scale. Conclusion: It was found that the level of patient's perception of nursing care was high, the level of recovery quality was below average, and there was no relationship between the level of perception of nursing care.