Validity and usability of a smart ball–driven serious game to monitor grip strength in independent elderlies

Telemonitoring is one of the most expedient answers to the strong need for preventive care imposed by the rapidly aging society. We propose an innovative solution to the detection of early signs of frailty by presenting a serious game controlled by a smart sensorized soft plastic ball, designed to achieve continuous home-based monitoring of muscle weakness in older adults. Design, development, and testing of the smart ball and of the game interface devised to guide the monitoring procedure are presented. Reliability and concurrent validity of the system in measuring maximal grip strength against the clinical standard Jamar\uae were evaluated. Serious game usability and acceptance were investigated on 26 elderlies. Smart ball and Jamar measurements were well correlated (0.76 and 0.80 for dominant and non-dominant hands) and test\u2013retest reliability of pressure measurements was excellent (intraclass correlation coefficient >0.94). The serious game was well accepted by the 96.1 percent of participants, who provided a strongly positive usability score (87.7/100). The smart ball\u2013driven serious game demonstrated excellent reliability and good validity in measuring grip strength. The proposed smart ball\u2013driven serious game can be used for home self-monitoring of grip strength in elderlies

Socio-demographic characteristics and cognitive performance in oldest old subjects asking for driving license renewal

Background: No papers have examined the relationship between socio-demographic characteristics and cognitive performance in oldest old subjects (i.e, > = 80 years old) asking for driving license renewal. We hypothesize that, even in this highly functioning population, age, sex, and education influence cognitive performance, expressed as total or single domain (raw) test scores. This research question allows to describe, identify, and preserve independence of subjects still able to drive safely. Methods: We examined cross-sectionally a cohort of > = 80 years old subjects (at enrollment) asking for driving license renewal in the Milan area, Italy, 2011\u20132017. The analysis was restricted to 3378 first and 863 second visits where individual\u2019s cognitive performance was evaluated. According to the study protocol, the Mini Mental State Examination (MMSE) test was administered at the first visit for driving license renewal and the Montreal Cognitive Assessment (MoCA) test at the second visit, following an additional renewal request. Ordinary least squares regression models were fitted at either time points. In each model, we included age, sex, and education as independent variables, whereas the dependent variable was total or single domain score for either test. In total, we fitted 15 regression models to assess our research hypothesis. Results: The median subject in our sample reached the maximum scores on domains targeting operational and tactical abilities implied in safe driving, but had sub-optimal scores in the long-term memory domain included among the strategic abilities. In multiple models, being > = 87 (versus 80- < 86 years old) significantly decreased the mean total and memory scores of MMSE, but not those of the MoCA. Females (versus males) had significantly higher mean total and long-term memory scores of either tests, but not other domains. Mean total and single domain scores increased for increasing education levels for either tests, with increments for high school graduates being ~ 2 of those with (at most) a junior high school diploma.Conclusions: Sex and education, as well as age to a lesser extent, predict cognitive functioning in our oldest old population, thus confirming that concepts like cognitive reserve and successful ageing are valuable constructs in the identification of older subjects still able to drive

How psychological intervention may impact in dealing physical frailty? : a study protocol of an European Project (664367 — FOCUS — HP-PJ-2014)

OBJECTIVES: PoliFIT-INFOcus is a follow-on study , part of the FOCUS project in which we developed guidelines concerning interventions to prevent or treat frailty. The study is a psycho-physio-educational group-based intervention to promote physical activity in older people to test the impact of FOCUS guidelines in practice. METHODS: 3-arm randomized controlled trial involving participants of the PoliFIT study. RESUTS: Participants will be randomly assigned to: 1) Receiving a booklet including advice on physical activity, nutrition and health psychology topics (control group) 2) Booklet+Pedometer+Group-based sessions with a knowledge-based psychological intervention (intervention 1) 3) Booklet + Pedometer + Group-based training sessions with a motivation-based psychological intervention (intervention 2) Session will be performed by a physiotherapist, a nutritionist and a health psychologist. Outcomes will be changes at 5 months in: average daily step-count , PASE, SPPB and Fried\u2019s criteria score, quality of life/psychological wellbeing, cognitive and functional performance, nutritional status and the occurrence of clinical events (i.e. access to the Emergency Room, hospitalization, falls). CONCLUSIONthe absence of a health psychology component (e.g. behaviour change strategies) is a barrier to the success of some interventions on frailty, including those aimed to impact the physical dimension of frailty. Inclusion of social components (e.g. group-based and or fun-promoting activities) is also a key of success. It is important to promote educational and psychoeducational interventions because they might be low resource demanding and more sustainable program on the long-term

Aging and oral care: An observational study of characteristics and prevalence of oral diseases in an Italian cohort

Background: Poor oral health is a common condition in patients suffering from dementia. Several aspects of this systemic pathology contribute to causing oral problems: cognitive impairment, behavior disorders, communication and, motor skills deterioration, low levels of cooperation and medical-nursing staff incompetency in the dental field. Objectives: The objectives of this study were to evaluate the prevalence and the characteristics of oral pathology in a demented elderly population, as well as to check the association between the different degree of dementia and the oral health condition of each patient. Materials and Methods: In this observational study (with cross-sectional design) two groups of elderly patients suffering from dementia, living in two different residential care institutions were recruited. The diagnosis of dementia of each included patient was performed using the Clinical Dementia Rating Scale. In order to evaluate the oral health condition of the included subjects, each patient underwent a physical examination of the oral cavity, during which different clinical parameters were analyzed (number of remaining teeth, oral mucosa, periodontal tissues, bone crests). To each parameter, a score was assigned. Spearman’s Rho test was used. Results: Regarding the prevalence of oral pathology in elderly suffering from dementia, it emerged that 20.58% of the included patients had mucosal lesions and/or new mucosal formations (in most cases undiagnosed and therefore untreated). The prevalence of periodontal disease was equal to 82.35% and a marked clinically detectable reabsorption of bone crests was found in almost all patients (88.23%). 24.13% of patients, who underwent the oral examination, had totally edentulous maxillae and/or with retained roots, without prosthetic rehabilitations. The correlation index r showed the presence of a linear correlation (inverse relationship) between the degree of dementia and the state of health of the oral cavity of each patient. Conclusions: Several factors contribute to poor oral health in the elderly suffering from dementia: cognitive functions deterioration, behavioral disorders and inadequate medical-staff nursing training on oral hygiene. This study also demonstrated that the lower the dementia degree is, the lower tends to be the oral health status. In order to guarantee a complete assistance to these patients, residential care institutions should include in their healthcare program specific dental protocols

Estudio cinético e isotérmico de la biosorción de Zinc (II) y Cadmio (II) para un sistema monometálico-bimetálico por Undaria pinnatífida sp

Se estudió la capacidad de adsorción que tiene el alga marina Undaria pinnatifida sp. en la adsorción de los iones metálicos de zinc y cadmio para un sistema individual (monometalico) y en mezclas (bimetálico) de una solución acuosa. Se estudió preliminarmente para este proceso, el tiempo de contacto, pH de la solución y tratamiento del biopolímero. El estudio de la cinética determinó que el comportamiento del sistema de adsorción fue de pseudo segundo orden usando la ecuación de Langergren (concentración inicial 50 mg/L, peso del biopolímero = 0,4g; pH = 3 - 5). El modelamiento no lineal de las isotermas de Langmuir y Freundlich, con el modelo de Langmuir se obtuvo un mejor coeficiente de correlación cercano a la unidad, determinándose que la máxima capacidad de sorción de los iones metales como zinc fue qmax = 44,91 mg/g y cadmio qmax = 102,38 mg/g a pH = 4 en un tiempo de contacto de 60 minutos, con el alga sin tratamiento en el sistema monometálico, siendo más eficiente la adsorción para el ion cadmio. Para el sistema bimetálico se empleó dos métodos: el método de las isoconcentraciones que dio a conocer el comportamiento en la adsorción de ambos metales en solución y el método de las concentraciones variables empleando el análisis de regresión del modelo de Langmuir modificado, que dio a conocer los valores de la capacidad máxima de adsorción, siendo para el ion metálico zinc qmax = 0,27 mmol/g; cadmio qmax= 1,27 mmol/g y para la adsorción de ambos metales sobre la biomasa qmax= 1,13 mmol/gFil: Mori C., M.. Universidad Peruana Cayetano Heredia; PerúFil: Maldonado G., H.. Universidad Nacional Mayor de San Marcos; PerúFil: Guzman L., E. Universidad Nacional Mayor de San Marcos; PerúFil: Eyras, María Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; ArgentinaFil: Bernardelli, Cecilia Elena. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Centro de Investigación y Desarrollo En Fermentaciones Industriales (i); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; ArgentinaFil: Viera, M.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Centro de Investigación y Desarrollo En Fermentaciones Industriales (i); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; ArgentinaFil: Donati, Edgardo Ruben. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico la Plata. Centro de Investigación y Desarrollo En Fermentaciones Industriales (i); Argentin

L'attività del Laboratorio di Tossicologia forense dell'Istituto di Medicina Legale di Parma ai sensi de T.U. 309/1990 (1° agosto 1990 - 31 luglio 1993)

Gli Autori espongono i risultati dell'attività svolta dal laboratorio di Tossicologia forense dell'Istituto di Medicina Legale di Parma, ai sensi del T.U. 309/1990, nel triennio 1° Agosto 1990-31 Luglio 1993. Sono stati elaborati i dati relativi alla quantità di stupefacente sequestrato nelle province di Parma, Piacenza e Mantova con particolare attenzione alla percentuale media di principio attivo delle sostanze considerate, alla loro provenienza e all'età dei soggetti segnalati

La percezione della disabilità con il questionario ICF-CY : il punto di vista del sanitario e del caregiver. Dati preliminari in una popolazione di bambini con ritardo mentale

Riassunto Introduzione e background: l\u2019ICF-CY (International Classification of Functioning, Disability and Health Children and Young), costituisce uno strumento importante per la valutazione olistica della salute. L\u2019ICF consente di indagare aspetti relativi alle Funzioni e alle Strutture Corporee, ad Attivit\ue0 e Partecipazione e ai Fattori Ambientali implicati nello stato di salute del soggetto. Studi precedentemente condotti hanno mirato ad indagare la coerenza tra questo nuovo strumento e quelli valutativi gi\ue0 in uso, al fine di evidenziarne eventuali punti di forza. Obiettivo: verificare l\u2019adeguatezza dell\u2019ICF come mezzo per creare un linguaggio comune tra differenti professionisti che interagiscono con il paziente, ricercando il livello di concordanza, mediante la somministrazione del questionario a sanitari, genitori ed insegnanti in una popolazione di minori con ritardo mentale. Materiali e Metodi: lo studio ha coinvolto 9 sanitari, Medici e professionisti dell\u2019area della riabilitazione, 40 genitori e 35 educatori che hanno compilato il questionario ICF-CY di 20 soggetti con ritardo mentale di et\ue0 compresa tra 3 e 11 anni seguiti presso un Servizio di NPIA per trattamenti o controlli periodici e iscritti in strutture formative del territorio. Per ciascun soggetto sono stati compilati 3 questionari ICF-CY e la compilazione \ue8 stata effettuata separatamente al fine di confrontare le risposte fornite. Analisi statistica: si \ue8 proceduto ad effettuare una comparazione dei punteggi assegnati a ciascuna voce dei questionari dello stesso bambino nelle quattro parti di cui l\u2019ICF si compone. Il confronto \ue8 stato effettuato tra tutti e tre i gruppi di valutatori (Kappa di Fleiss) nonch\ue9 a coppie: sanitari Vs genitori, genitori Vs insegnanti, sanitari Vs insegnanti (Kappa di Cohen). Risultati: si \ue8 riscontrata una diversit\ue0 nei risultati ottenuti dai due metodi di analisi utilizzati: il confronto tra i tre gruppi di esaminatori ha evidenziato una concordanza tra moderata e buona in tutte le parti del questionario; l\u2019analisi a coppie ha invece consentito di rilevare una concordanza moderata-buona nelle parti Funzioni corporee e Attivit\ue0 e partecipazione, un confronto impossibile nel 50% dei casi della parte Strutture Corporee, una discordanza nella parte Fattori ambientali per le coppie sanitari-insegnanti e genitori-insegnanti. Discussione: dai dati emersi, sembra che la discordanza rilevata nella parte Fattori Ambientali possa essere riferibile a carenza di linguaggio comune e deficit di comunicazione tra scuola e famiglia e tra professionisti e genitori; l\u2019incongruenza rilevata sulle Strutture Corporee \ue8 probabilmente legata alla tipologia del campione con disabilit\ue0 cognitiva e non funzionale, ma anche al dominio che per il suo contenuto si presta maggiormente ad essere compilato da sanitari. Conclusioni: l\u2019ICF si \ue8 dimostrato strumento adeguato per la rilevazione della differente percezione dello stato di salute e per il confronto tra differenti figure. Tuttavia, il ridotto campione a cui si fa riferimento non consente di trarre conclusioni definitive circa la significativit\ue0 dei livelli di concordanza rilevati e il reale accordo tra le differenti figure. Prospettive future di studio potrebbero dunque essere legate all\u2019incremento del campione oggetto di studio nonch\ue9 alla selezione di un campione con patologie differenti dal ritardo mentale. Abstract Introduction and background: ICF-CY is a comprehensive tool for holistic assessment of health that allows to investigate aspects of Functions and Body Structures, of Activities and Participation and of Environmental Factors involved in the health status of the subject. Previous studies about ICF had the purpose to investigate the consistency between this new instrument and assessment tools already in use, in order to highlight possible differences. Purpose: Verifying the effective usability of the ICF as tool for creating a common language between different figures that interact with the patient researching the level of correlation between the assessments made by sanitary staff, parents and teachers of children with mental retardation using ICF-CY check list. Materials and Methods: the study involved the use of the ICF-CY check list, 9 members of sanitary staff, including physicians and rehabilitators, 40 parents and 35 teachers filled in ICF-CY check list of 20 children with mental retardation, aged 3-11, followed by NPIA service for therapy or periodic controls, attending various educational institutions. For each subject of the sample were filled in three ICF-CY checklists and the compilation was carried out separately in order to compare the answers. Statistical Analysis: it was made by a comparison of the scores assigned to each item of the check lists of the same child. The comparison was made between all three groups of examiners (Kappa Fleiss) and in pairs: sanitary staff Vs parents, parents Vs teachers, sanitary staff Vs teachers (Cohen's Kappa). Results: there was a discrepancy in the results from the two methods of analysis used: the comparison between the three groups of examiners showed a correlation moderate-good in all parts of the check list; the analysis in pairs, allowed to observe the impossibility of calculate the correlation of scoring in Part 1.b (Body Structures) and a discordance in pairs sanitary staff-teacher and parent-teacher in Part 3 (Environmental Factors). Discussion: it seems that the discrepancy found in the Environmental Factors is attributable to a lack of communication between teachers and parents; the inconsistency detected on Body Structures is probably related to the reduced presence of malformations in the sample which did not allow to detect possible discrepancies. Conclusions: as documented in literature, the ICF is an appropriate tool for the detection of different perception of health status and the comparison of different opinions. However, the small sample of the study can't draw conclusions about the significance of the correlation levels detected and the real agreement between the different people. Prospects for the future study could be linked to the increase of the sample and the selection of a sample with different diseases

Outcome funzionali e soddisfazione in una popolazione di soggetti anziani sottoposti ad un programma di attività motoria funzionale adattata come promozione dell’invecchiamento sano e attivo

Background Il progressivo invecchiamento della popolazione comporta un incremento della prevalenza di malattie croniche che, sommate ad una ridotta attivit\ue0 fisica, possono determinare una limitazione funzionale nello svolgimento delle attivit\ue0 della vita quotidiana pi\uf9 o meno complesse (ADL e IADL) e una conseguente disabilit\ue0 che si pu\uf2 associare ad un aumento dei ricoveri, al ricorso all\u2019assistenza domiciliare, alla mortalit\ue0 con conseguente aumento della spesa sanitaria e costi sociali elevati. Tutto questo ha indotto la ricerca scientifica e la politica sanitaria a focalizzare l\u2019attenzione sulla promozione di un invecchiamento sano e attivo. Numerosi studi hanno dimostrato che programmi di esercizio fisico strutturato hanno effetti positivi sia sulla sarcopenia che sulla disabilit\ue0 e sono inversamente correlati al rapido declino delle funzioni psicofisiche che portano a gravi patologie come diabete, osteoporosi e problemi cardiovascolari. In questo contesto l\u2019attivit\ue0 fisica adattata pu\uf2 essere applicata come terapia a tutte le fasi della prevenzione con un considerevole impatto benefico sugli stili di vita sedentari e sulla promozione sociale di salute. Scopo dello Studio Analizzare i dati relativi agli outcome funzionali e alla soddisfazione in una popolazione di soggetti anziani sottoposti ad un programma di attivit\ue0 motoria funzionale adattata e strutturata come promozione dell\u2019invecchiamento sano e attivo - Progetto PoliFIT, presso la Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico - U.O.C. Geriatria - nel periodo compreso tra dicembre 2015 e luglio 2016. Metodo Il progetto si \ue8 proposto come uno studio pragmatico di applicazione di un intervento (attivit\ue0 fisica adattata per l\u2019anziano non disabile) gi\ue0 dimostrato efficace in letteratura nel prevenire la disabilit\ue0 in studi randomizzati controllati Disegno dello studio Studio randomizzato controllato che ha visto la partecipazione gratuita di 187 soggetti randomizzati in gruppo di lavoro e in gruppo di controllo secondo il disegno definito waiting list control group. Risultati Relativamente all\u2019outcome primario dello studio (tempo impiegato per percorrere 400 metri) dai dati emerge che il gruppo di lavoro ha ottenuto un miglioramento della performance rispetto al gruppo di controllo. Inoltre, se si osserva il dato stratificato per classi, emerge che la differenza tra le medie osservate della terza classe \ue8 significativa per p<0,01. Relativamente agli outcome secondari emerge che il gruppo di lavoro migliora anche per lo score della SPPB e da considerazioni statistiche emerge che la differenza tra le medie osservate per la prima, seconda e terza classe \ue8 significativa per p<0,01. Si sono dunque osservati miglioramenti nelle classi di soggetti meno abili, pi\uf9 sedentari e pi\uf9 anziani e dunque il programma di attivit\ue0 motoria adattata \ue8 risultato essere per loro maggiormente allenate

Evaluating online games/activities by a group of elderly in a robotic experience aimed at supporting their independent living = Valutazione di giochi/attivit&#224; online da parte di un gruppo di anziani, in un progetto di robotica a supporto del loro vivere indipendente

Le Tecnologie dell\u2019Informazione e della Comunicazione (TIC), in particolare robotica e domotica, si stanno progressivamente diffondendo nella societ\ue0 contemporanea e il loro utilizzo sta aumentando anche in ambito geriatrico. Anche se lo sviluppo di tecnologie dedicate agli anziani \ue8 principalmente finalizzato all\u2019assistenza e al monitoraggio della loro salute, le TIC possono anche favorire l\u2019apprendimento continuo e nuove forme di socializzazione. Il presente contributo espone i risultati di un\u2019indagine esplorativa basata su questionari, condotta con un campione persone di anziane, con familiarit\ue0 con le tecnologie, per raccogliere la percezione di usabilit\ue0 e il gradimento di alcuni giochi/attivit\ue0 online, analizzando il potenziale percepito di questi dispositivi per la socializzazione.Information and Communication Technologies (ICT), particularly robotics and domotics, are progressively spreading in the contemporary society and their use is increasing in the field of geriatrics too. Even if the implementation of new technologies dedicated to older people is mainly aimed at caring for them and monitor their health, ICT can also sustain continuing learning and develop new practices of socialization. This paper reports the results of an explorative questionnaire survey conducted with a sample of older people who had some familiarity with technologies. Our aim was to investigate their perception about usability and their enjoyment of some online digital games/activities, analyzing the perceived potentialities of those devices for elders\u2019 socialization