Intra and Inter-Tester Reliability for Lumbar Flexion and Extension Using the Dualer Digital Inclinometer

Purpose: The purpose of this study was to determine the intra- and inter-tester reliability of the DualerTM Digital Inclinometer when measuring lumbar flexion and extension. Past studies examining reliability of inclinometers have reported variable results. Few studies in the literature have sought to determine the reliability of the Dualer™ Digital Inclinometer for measuring lumbar flexion and extension. Methods: The subjects who participated in this study were university students between 20 and 41 years of age without a significant history of back pain (n=22). Two testers measured each subject\u27s lumbar flexion and extension, hip flexion and extension, and straight leg raise during each of two measuring sessions. Results: Intraclass correlation coefficients (ICC) as an indication of intra-tester reliability for lumbar flexion, extension and total motion for tester one were .59, .73, and .76 respectively. ICC values for lumbar flexion, extension and total motion for tester two were .67, .74, and .70, respectively. Inter-tester reliability was not established because of insufficient intra-tester reliability. Discussion: Many factors may have contributed to the lack of high intra-tester reliability. The subject, tester, and sensitivity of the instrument or procedure may have caused errors. In order to use the Dualer™ with the currently recommended procedure clinically, the clinician must be aware of the limitations and seek to minimize the sources of error

Oregon Psychologists on Prescriptive Authority: Divided Views and Little Knowledge

With over half of all states having considered legislating prescriptive authority, an immense amount of time and money has been invested. The literature is limited in terms of understanding if opinions toward prescriptive authority are grounded in knowledge and what implications that has for altering these opinions. Following a veto of a prescriptive authority bill in Oregon, 399 licensed Oregon clinical psychologists were surveyed regarding their attitudes and knowledge. In terms of knowledge, only 6.5% knew which three states/territories currently have prescriptive authority and 70.4% were unfamiliar with any of the prerequisites for postdoctoral training in psychopharmacology. Reflecting division, 43.4% were in favor, 25.4% were undecided, and 31.2% were in opposition to broadening privileges for psychologists. Further, only 15.2% expressed interest in pursuing training or 6.7% in becoming prescribers. Data on access, training, and legislative costs were presented to participants in the education condition. These participants showed significant gains in their knowledge across all domains and their opinions shifted only in these specific areas leaving their general stance on the issue unchanged. In contrast to ardent supporters who argue that their “data should provide reassurance to psychologists spearheading legislative initiatives” because of high approval ratings (Sammons et al., 2000, p. 608), our data suggest disagreement amongst a group of professionals who are not particularly well-informed, nor interested in becoming prescribers. Future work should investigate whether expanding the data relevant to other facets of the argument contributes to further targeted change or an overall change in opinion toward prescriptive authority

Metabolic Syndrome and Cognitive Decline in Early Alzheimer’s Disease and Healthy Older Adults

This is the author's accepted manuscript. The original is available at http://content.iospress.com/articles/journal-of-alzheimers-disease/jad121168Metabolic syndrome (MetS) is a cluster of risk factors (i.e., abdominal obesity, hypertension, dyslipidemia, glucose and insulin dysregulation) that is associated with cardiovascular disease, diabetes, and dementia. Recent studies addressing the association of MetS with cognitive performance and risk for dementia report mixed results. An important step in clarifying these conflicting results is determining whether cognition is influenced by the effects of individual MetS components versus the additive effects of multiple components. We assessed the effect of MetS on cognitive performance and decline over two years in 75 cases of early Alzheimer’s disease (AD) and 73 healthy older adult controls in the Brain Aging Project. Using factor analytic techniques, we compared the effect of a combined MetS factor to the effect of individual MetS components on change in attention, verbal memory, and mental status. In healthy controls, a combined MetS factor did not significantly predict cognitive performance, though higher insulin predicted poorer cognitive performance outcomes. In the AD group, higher scores on a combined MetS factor predicted better cognitive outcomes. Our findings suggest that MetS does not have the same association with cognitive decline in healthy older adults and those with early AD. We suggest that individual MetS components should not be evaluated in isolation and that careful methodological approaches are needed to understand the timing and non-linear relationships among these components over time

Reduced Lean Mass in Early Alzheimer Disease and Its Association With Brain Atrophy

This is the published version. Copyright American Medical AssociationObjective: To examine body composition in individuals with early AD and without dementia and its relation to cognition and brain volume. Design: Cross-sectional case-control study. Participants: Individuals without dementia (Clinical Dementia Rating, 0; n=70) and with early-stage AD (Clinical Dementia Rating, 0.5 or 1; n=70) in the Alzheimer and Memory Program at the University of Kansas School of Medicine. Main Outcome Measures: Participants were evaluated with brain magnetic resonance imaging (MRI), neuropsychological testing, and dual-energy x-ray absorptiometry to determine whole-body fat and lean masses. Body mass index was calculated as weight in kilograms divided by height in meters squared. Results: Lean mass was reduced in persons with early AD compared with controls without dementia (F=7.73; P=.006) after controlling for sex. Whole-brain volume (=.20; P.001), white matter volume (=.19; P.001), and global cognitive performance (=.12; P=.007) were associated with lean mass (dependent variable) when controlling for age and sex. The total body fat and percentage of body fat values were not different across groups or related to cognition and brain volume. Conclusion: Loss of lean mass is accelerated in AD and is associated with brain atrophy and cognitive performance, perhaps as a direct or indirect consequence of AD pathophysiology or through shared mechanisms common to both AD and sarcopenia

Neuropsychiatric Profiles in Dementia

This is the author's accepted manuscript. The original is available at http://pt.wkhealth.com/pt/re/lwwgateway/landingpage.htm;jsessionid=Wy1M9PqrBY1LGf0bN3QqF0h42YJqr4mTnW1ZdGT87Wllb4qvTbQb!-396536289!181195628!8091!-1?sid=WKPTLP:landingpage&an=00002093-201110000-00006We compared patterns of neuropsychiatric symptom across four dementia types (AD, VAD, DLB, PDD), and two mixed groups (AD/VAD, AD/DLB) in sample of 2,963 individuals from the National Alzheimer’s Coordinating Center Uniform Data Set between September 2005 and June 2008. We used confirmatory factor analysis to compare neuropsychiatric symptom severity ratings made by collateral sources on the Neuropsychiatric Inventory (NPI-Q) for people with Clinical Dementia Rating scores of 1 or higher. A three factor model of psychiatric symptoms (mood, psychotic, and frontal) was shared across all dementia types. Between-group comparisons revealed unique neuropsychiatric profiles by dementia type. The AD group had moderate levels of mood, psychotic, and frontal symptoms while VAD exhibited the highest levels and PDD had the lowest levels. DLB and the mixed dementias had more complex symptom profiles. Depressed mood was the dominant symptom in people with mild diagnoses. Differing psychiatric symptom profiles provide useful information regarding the non-cognitive symptoms of dementia

Measuring Physical Activity in Older Adults with and without Early Stage Alzheimer’s Disease

This is the author's accepted manuscript. The original is available at http://www.tandfonline.com/doi/abs/10.1080/07317115.2013.788116#.VvMAj_krK70We compared subjective reports of physical activity with objective measures of physical fitness including cardiorespiratory capacity, body composition, and physical performance in 146 older adults with and without early stage Alzheimer’s disease (ESAD). Respondents reported primarily unstructured and low-intensity activities, including walking and housework. Individuals with ESAD participated in fewer and lower intensity physical activities than those without ESAD. In those without ESAD, housework was related to lower body mass index, leisure walking was related to faster speed on a timed walking test, and participation in sports was related to higher peak oxygen intake. In individuals with ESAD, reported physical activities did not predict any of the physical fitness, body composition, or physical performance measures. We conclude that measures of physical activity require expansion of unstructured and low intensity activities to improve sensitivity in sedentary populations, especially in older adults with ESAD

Bringing Black Feminist's Thoughts, Self-Definitions, and Creative Agency to Digital Media and Technology Design

Users from marginalized groups are often faced with the challenges that result from a lack of diverse thought in the design and implementation of media and technologies that we engage in our daily lives. It is these artifacts that result in the harm, erasure, and hyper-surveillance of Black and Brown people. We seek to disrupt problematic narratives present in tech and design fields by (re)inserting Black Feminism and leveraging our personal experiences to build on design methods. Though research centered on the importance of women’s experiences and standpoints in tech practice is crucial, feminist scholarship has not always reflected the values and the liberation of women who are not white. This paper uses personal narrative to argue for the value of Black feminist thought and methods in the sub-disciplines of computing, such as digital media, human computer interaction (HCI) and human-centered computing (HCC)