The Impact of Visual Impairments on Mobility Performance in Community-Dwelling Older Adults

Background and Purpose: Falls are a major concern for elderly adults and can have a significant impact on overall health and well-being. Declines in vision with aging may be related to the development of fear of falling (FOF) and impaired mobility. It is possible that impaired vision due to common eye diseases can increase the FOF avoidance behavior and affect mobility function in this population. The purpose of this study was to investigate the relation among visual impairment, mobility performance, and FOF avoidance behavior in older adults. Methods: Inclusion criteria for eligible participants were: 50 years of age and older, able to walk 50 m without assistance, and able to understand simple instructions related to the assessments. A total of 455 participants from local community adult activity centers (males=152, females=303; age=73.1±7.7 years, range=51-97 years) participated. Physical mobility was assessed using an instrumented Timed Up-and-Go test. Visual acuity (VA) was tested using a standard Snellen chart. Avoidance behavior was assessed using the Fear of Falling Avoidance Behavior Questionnaire (FFABQ). Participants’ general health and presence of eye diseases (age-related macular degeneration, cataracts, and glaucoma) was assessed using a survey of medical history. A two-way ANOVA was used to investigate effect of VA and avoidance behavior on TUG performance. An additional two-way ANOVA test was used to investigate the effect of self-reported eye disease and avoidance behavior on TUG performance. Results and Discussion: There was a statistically significant difference between avoiders and non avoiders’ TUG score (avoiders=12.45±5.85 sec, non-avoiders 8.29±3.48, p\u3c0.001). The VA has no significant effect on TUG time (no impairment= 8.69 ± 3.49 sec, mild impairment= 9.42 ± 5.05 sec, moderate impairment= 8.11 ± 2.08 sec, severe impairment= 9.45 ± 2.68 sec, p=0.791). There is no significant VA group by avoider group interaction (p=0.66). There was also a statistically significant difference in TUG scores between participants with and without eye disease (eye disease=9.37±5.08, no eye disease=8.29±2.80, p=0.004). There is no significant eye disease by avoider group interaction (p=0.144). iv Conclusion: The results of this study indicated that the presence of one or more self-reported eye diseases and higher FOF avoidance behavior were both associated with decreased mobility. Contrary to the initial hypothesis of the present study, there was no relation between VA and mobility, nor VA and FOF avoidance behavior. It is important for clinicians to inquire about the presence of eye diseases and administer the FFABQ to older adults in order to identify risk factors related to decline in physical mobility. Presently, the continued use of the Snellen chart to assess for VA as a part of fall risk assessment may be inadequate. Future studies should focus on developing a more comprehensive clinical assessment of vision that expands beyond visual acuity for the geriatric population

Early and late complications of bariatric operation.

Weight loss surgery is one of the fastest growing segments of the surgical discipline. As with all medical procedures, postoperative complications will occur. Acute care surgeons need to be familiar with the common problems and their management. Although general surgical principles generally apply, diagnoses specific to the various bariatric operations must be considered. There are anatomic considerations which alter management priorities and options for these patients in many instances. These problems present both early or late in the postoperative course. Bariatric operations, in many instances, result in permanent alteration of a patient\u27s anatomy, which can lead to complications at any time during the course of a patient\u27s life. Acute care surgeons diagnosing surgical emergencies in postbariatric operation patients must be familiar with the type of surgery performed, as well as the common postbariatric surgical emergencies. In addition, surgeons must not overlook the common causes of an acute surgical abdomen-acute appendicitis, acute diverticulitis, acute pancreatitis, and gallstone disease-for these are still among the most common etiologies of abdominal pathology in these patients

Early Genealogy of the Davis Family

Copied directly from the Genealogy written by John Clement Davis in the latter years of his life. While the original Genealogy was written in 1896, the date of this handwritten copy is dated December 17, 1950. The primary downloadable document, also embedded as a pdf below, contains the original document followed by the transcription. Transcription by Davis Baird.https://commons.clarku.edu/early_genealogy/1000/thumbnail.jp

Teaching Them to Fish: Using a Districtwide System of Supports To Improve College and Career Readiness in a Rural School District

This dissertation served as a case study that examined the impact of a districtwide system of support drawn from existing literature and organizational structure and management. The identified framework, the Limelight County College and Career Readiness Intervention (LCRI) Framework, utilized the Plan, Do, Study, Act (PDSA) cycle of improvement science. Three reoccurring themes or focus areas were identified as significant: curriculum instructional framework redesign, comprehensive guidance, and professional development. While the study\u27s findings are constrained by the density of the data gathered within a limited time frame, the findings provide many opportunities for longitudinal studies and confirm the integrity of the intervention framework. The findings also indicate that the framework must be implemented with fidelity to sustain these gains. Since the research on structured supports from a district perspective is limited, it would be beneficial for educational institutions and practitioners to continue to seek understanding on providing pathways that will ensure student success and cultivate communities of change. Doing so will ensure that students continue growing and communities continue to thrive. Thriving children will continue to fish for the rest of their lives

VCP-dependent muscle degeneration is linked to defects in a dynamic tubular lysosomal network in vivo.

Lysosomes are classically viewed as vesicular structures to which cargos are delivered for degradation. Here, we identify a network of dynamic, tubular lysosomes that extends throughout Drosophila muscle, in vivo. Live imaging reveals that autophagosomes merge with tubular lysosomes and that lysosomal membranes undergo extension, retraction, fusion and fission. The dynamics and integrity of this tubular lysosomal network requires VCP, an AAA-ATPase that, when mutated, causes degenerative diseases of muscle, bone and neurons. We show that human VCP rescues the defects caused by loss of Drosophila VCP and overexpression of disease relevant VCP transgenes dismantles tubular lysosomes, linking tubular lysosome dysfunction to human VCP-related diseases. Finally, disruption of tubular lysosomes correlates with impaired autophagosome-lysosome fusion, increased cytoplasmic poly-ubiquitin aggregates, lipofuscin material, damaged mitochondria and impaired muscle function. We propose that VCP sustains sarcoplasmic proteostasis, in part, by controlling the integrity of a dynamic tubular lysosomal network

Sweetheart: fox trot song

https://digitalcommons.ithaca.edu/sheetmusic/1113/thumbnail.jp

The Phases and Faces of the Duke Lacrosse Controversy: A Conversation James E. Coleman, Jr.

This panel took place at the 2008 Annual Meeting of the Southeastern Association of Law Schools ( SEALS ) in July 2008 in West Palm Beach, Florid

Postcard: L. H. Davis, Coffee Man

This black and white photographic postcard features a shop in Lindsborg, Kansas. Goods are on display on the left side of the room. A counter for weighing and pouring coffee is in the foreground on the right. The cash register sits on the right side of the foreground. Printed text is at the bottom of the card. Handwriting is on the back of the card.https://scholars.fhsu.edu/tj_postcards/1560/thumbnail.jp

Evidence from scanning tunneling microscopy in support of a structural model for the InSb(001)-c(8×2) surface

In this letter we present evidence from scanning tunneling microscopy studies in support of a recently proposed structural model for the indium-terminated c(8×2) surface of InSb(001). This structural model, by Norris and co-workers, is based on a surface x-ray diffraction study [Surf. Sci. 409, 27 (1998)], and represents a significant departure from previously suggested models for the c(8×2) reconstruction on any (001) surface of the common III–V semiconductor materials. Although filled state images of the InSb(001)-c(8×2) surface have previously been published, empty states image of sufficient quality to extract any meaningful information have not previously been reported. The observations are in excellent agreement with the recently proposed model for this surface reconstruction

Flavor-symmetry Breaking with Charged Probes

We discuss the recombination of brane/anti-brane pairs carrying $D3$ brane charge in $AdS_5 \times S^5$. These configurations are dual to co-dimension one defects in the ${\cal N}=4$ super-Yang-Mills description. Due to their $D3$ charge, these defects are actually domain walls in the dual gauge theory, interpolating between vacua of different gauge symmetry. A pair of unjoined defects each carry localized $(2+1)$ dimensional fermions and possess a global $U(N)\times U(N)$ flavor symmetry while the recombined brane/anti-brane pairs exhibit only a diagonal U(N). We study the thermodynamics of this flavor-symmetry breaking under the influence of external magnetic field.Comment: 21 pages, 10 figure