Dementia-specific adaptations to physical performance tests of balance, mobility, and lower limb strength and function: a reliability study in people with dementia

Background Valid and reliable physical performance tests are crucial for accurately assessing the physical performance of people with dementia (PwD) and for evaluating the effects of interventions. However, existing physical performance tests for PwD often show insufficient reliability. This study aims to investigate the reliability of physical performance tests of balance, mobility and lower limb strength and function that were specifically adapted for PwD. Methods We conducted a reliability study with test-retest design and a one-week gap between tests among PwD living in nursing homes. Adaptations were made to either the instruction and administration, or the scoring of the three physical performance tests as follows: The Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) for balance (adaptations to administration and scoring), the Timed-Up and Go Test (TUG) and its five phases (standing up, walking, turning around, walking, sitting down) for mobility (adaptations to instruction, administration and scoring in terms of analysing the five phases separately, and the Sit-to-Stand test (STS) for lower limb strength and function (adaptations to instruction and administration). The tests were standardized in terms of cues used to administer and guide them. We assessed absolute reliability (Standard Error of Measurement; Coefficient of Variance, Minimal Detectable Change) and relative reliability (Intraclass correlation coefficient; weighted Cohen’s Kappa). The absolute and relative test-retest reliability of the PP tests was assessed. Results We examined relative and absolute reliability values of PP tests in a sample of 26 PwD (mean age, 88 years; mean Mini Mental State Examination (MMSE) score, 14). No statistically significant differences were found between baseline and retest. Relative reliability values ranged from 0.258 to 0.505 for balance (FICSIT), 0.011 to 0.860 for mobility (TUG), and 0.506 to 0.678 for lower limb strength and function (STS). Absolute reliability values as indicated by the coefficient of variation (CV) ranged from 23.5 to 92.8. Conclusions Adaptations regarding test administration and/ or scoring did not improve reliability values as compared to the original test versions. TUG test phases showed the highest reliability values for the gait phases. Future adaptations should focus on reducing the cognitive component of demand during physical performance tests. Assistive technologies such as augmented reality could improve test reliability by providing more consistent and controlled test environment

Francisella tularensis Transmission by Solid Organ Transplantation, 20171.

In July 2017, fever and sepsis developed in 3 recipients of solid organs (1 heart and 2 kidneys) from a common donor in the United States; 1 of the kidney recipients died. Tularemia was suspected only after blood cultures from the surviving kidney recipient grew Francisella species. The organ donor, a middle-aged man from the southwestern United States, had been hospitalized for acute alcohol withdrawal syndrome, pneumonia, and multiorgan failure. F. tularensis subsp. tularensis (clade A2) was cultured from archived spleen tissue from the donor and blood from both kidney recipients. Whole-genome multilocus sequence typing indicated that the isolated strains were indistinguishable. The heart recipient remained seronegative with negative blood cultures but had been receiving antimicrobial drugs for a medical device infection before transplant. Two lagomorph carcasses collected near the donor's residence were positive by PCR for F. tularensis subsp. tularensis (clade A2). This investigation documents F. tularensis transmission by solid organ transplantation

Are nursing home employees ready for the technical evolution? German-wide survey on the status quo of affinity for technology and technology interaction

Background Technological devices can support nursing home employees; however, their perspective is not sufficiently studied. Our aims were thus to (a) examine affinity for technology and technology interaction and related sociodemographic confounders, as well as (b) detect possible requirements and boundary conditions relevant for the development and implementation of assistive technologies among nursing home employees. Methods We conducted an online survey between May and July of 2022 among 200 nursing home employees in Germany. The survey included two questionnaires, that is, Affinity for Technology Interaction (ATI) and Affinity for Technology—Electronic Devices (TA-EG; subscales TA-EG-Enthusiasm, TA-EG-Competence, TA-EG-Positive Consequences, and TA-EG-Negative Consequences), as well as sociodemographic variables, that is, age, gender, professional groups, education/graduation level. We carried out factorial variance and multiple regression analyses. Results There were differences between age groups in ATI (lower score with increasing age) and between gender, age, and professional group in TA-EG (lower score for females, participants with higher ages, and nursing home managers). Predictors of ATI were age and professional group, predictors of TA-EG, TA-EG-Enthusiasm, and TA-EG-Competence were gender, age, and professional group. Predictors of TA-EG-Positive Consequences were education and professional group. Conclusions We observed rather high affinity for technology and technology interaction values overall, and particularly for nursing home employees compared to managers. Significant predictors for technology affinity and interaction may have important implications, for example the perspectives of nursing home employees and managers should be considered separately in the technological design, development, and implementation process. Furthermore, an open dialogue between all stakeholders should be encouraged to increase the probability of actual technology use