Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease

ABSTRACT The decline in frontal cognitive functions contributes to alterations of gait and increases the risk of falls in patients with dementia, a category which included Alzheimer's disease (AD). The objective of the present study was to compare the gait parameters and the risk of falls among patients at different stages of AD, and to relate these variables with cognitive functions. This is a cross-sectional study with 23 patients with mild and moderate AD. The Clinical Dementia Rating was used to classify the dementia severity. The kinematic parameters of gait (cadence, stride length, and stride speed) were analyzed under two conditions: (a) single task (free gait) and (b) dual task (walking and counting down). The risk of falls was evaluated using the Timed Up-and-Go test. The frontal cognitive functions were evaluated using the Frontal Assessment Battery (FAB), the Clock Drawing Test (CDT) and the Symbol Search Subtest. The patients who were at the moderate stage suffered reduced performance in their stride length and stride speed in the single task and had made more counting errors in the dual task and still had a higher fall risk. Both the mild and the moderate patients exhibited significant decreases in stride length, stride speed and cadence in the dual task. Was detected a significant correlation between CDT, FAB, and stride speed in the dual task condition. We also found a significant correlation between subtest Similarities, FAB and cadence in the dual task condition. The dual task produced changes in the kinematic parameters of gait for the mild and moderate AD patients and the gait alterations are related to frontal cognitive functions, particularly executive functions.     

Health-related quality of life in children and adolescents: subjective well being

The main objective of this study was to build a model, which includes personal and social factors, that helps to highlight factors that promote health-related quality of Life (HRQoL) in children and in adolescents. A sample of 3195 children and adolescents was acquired from 5th and 7th graders from all five Portuguese regions. In this study three independent latent variables were specified--Physical, Psychological and Social and two dependent latent variables were measured: Health behavior and Quality of Life. The integrative model was composed by different components: (1) health-related quality of life, integrated by 8 dimensions from KIDSCREEN-52; (2) health behavior, (3) variables related to physical health; (4) variables related to social health; (5) variables related to psychological health. As results were found strong correlation between psychological dimensions and self-esteem and other factors and a structural equation model was developed. The model presented a RMSEA index of .08. Similarly, adjustment levels for the CFI, NFI and IFI vary above or around .90, which suggests a good adjustment for the hypothesized model. The model presented significant qui-square. This study showed that in all the samples studied, the psychological variables were those that contributed at a superior level to HRQoL.     

Reducing the Floor Effect in the SF-6D: A Feasibility Study

The SF-6D suffers from a floor effect where for patient groups in severe health a significant number of patients report the lowest level of health possible for some dimensions, meaning the SF-6D cannot capture a deterioration in health for these patients. This paper presents a feasibility study aimed at reducing this floor effect. A modified SF-6D classification system was proposed that incorporated an additional level in each of the physical functioning and role limitations dimensions. The modified classification system was valued by a Portuguese general population sample (n = 140) using the Portuguese SF-6D protocol. A sample of 82 health states were valued and several regression models were estimated to produce preference weights to predict health state values for all states defined by the modified classification system. Estimations at the individual level were performed using 950 health state valuations. Models were analyzed in terms of logical consistency of coefficients, overall fit and predictive ability and were compared to Portuguese SF-6D models. The additional severity levels included in the modified classification system have significant decrements in health state values. These additional severity levels do not significantly impact on the modelled preference weights (the regression coefficients) of other levels across all dimensions. This feasibility study modified the SF-6D to reduce the floor effect. This study presents one option and further research in this area is encouraged.     

How Children Experience the Assets that Support their Learning

The study, on which this article is based, explored the ways in which primary school children in an urban (city centre) setting experience the assets and resources that support their learning. The researchers used a qualitative phenomenological research design incorporating an interpretive and constructivist perspective. The study was conducted in a primary school in Tshwane, Gauteng province, South Africa. The participants were eight African female participants in Grades 5–7 who had overcome extrinsic barriers to learning. They participated in a focus group discussion during which the relevant and natural units of significant statements were listed (horizontalisation) and structured into central clusters of meanings. Textural themes (what) and structural themes (how) were identified. The study found that human resource assets were central to the process of connecting a variety of assets that supported learning. The study also found a significant compound effect of assets, for example increased connected assets had a noteworthy additional positive effect on learning support. The identified assets interrelatedly mobilised other assets (textural findings) on one of five levels (structural findings: physical assets, social assets, safety assets, esteem assets and self-actualisation) in various systems and contexts that contribute to learning support. This article elaborates on these findings.     

Investigating Constituent Order Change With Elicited Pantomime: A Functional Account of SVO Emergence

One of the most basic functions of human language is to convey who did what to whom. In the world's languages, the order of these three constituents (subject [S], verb [V], and object [O]) is uneven, with SOV and SVO being most common. Recent experiments using experimentally elicited pantomime provide a possible explanation of the prevalence of SOV, but extant explanations for the prevalence of SVO could benefit from further empirical support. Here, we test whether SVO might emerge because (a) SOV is not well suited for describing reversible events (a woman pushing a boy) and (b) pressures to be efficient and mention subjects before objects conspire to rule out many other alternatives. We tested this by asking participants to describe reversible and non‐reversible events in pantomime, and we instructed some participants to be consistent in the form of their gestures and to teach them to the experimenter. These manipulations led to the emergence of SVO in speakers of both English (SVO) and Turkish (SOV).     

Extending the Common Sense Model to Explore the Impact of the Fear of COVID-19 on Quality of Life in an International Inflammatory Bowel Disease Cohort

The aim of this cross-sectional study was to use an extended common sense model (CSM) to evaluate the impact of fear of COVID-19 on quality of life (QoL) in an international inflammatory bowel disease cohort. An online study involving 319 adults (75% female, mean (SD) 14.06 (15.57) years of symptoms) completed the Gastrointestinal Symptom Rating Scale, Brief Illness Perceptions Questionnaire, Fear of Contracting COVID-19 Scale, Brief-COPE, Depression, Anxiety and Stress Scale, and the EUROHIS-QOL. The extended CSM had an excellent fit (χ² (9)?=?17.06, p?=?.05, χ²/N?=?1.90, RMSEA?=?0.05, SRMR?=?0.04, CFI?=?.99, TLI?=?.97, GFI?=?0.99), indicating the influence of gastrointestinal symptoms on QoL was mediated by illness perceptions, fear of COVID-19, adaptive and maladaptive coping, and psychological distress. Interventions targeting the fear of COVID-19 in the context of an individual’s perceptions will likely enhance QoL during the pandemic.